Healdsburg City Council
January 20, 2026

I. INTRODUCTION
A. PURPOSE OF IFB
The City of Healdsburg (City) is seeking informal bids for the Powell Avenue Catch Basin Replacement Project The successful Bidder will be responsible for providing the removal of the existing drainage inlet located adjacent to 900 Powell Avenue and installation of new precast drainage inlet and on-grade gutter depression and other such items of work as are required to complete the Project in accordance with the Draft Contract (Attachment 3), the Special Provisions(Attachment 3; Exhibit E), and Technical Specifications (Attachment 3; Exhibit D). It is the responsibility of the successful Bidder to ensure that the services are delivered to the City as per specifications and provisions listed and agreed to herein. It is the City’s intent that this IFB shall result in a firm, fixed price contract. The resulting awarded contract will be executed on the draft contract provided with this solicitation. (Attachment 3) For a period which shall commence as of the Effective date of the resulting contract, and which period shall terminate within 25 working days of the effective date, unless otherwise extended for additional time in accordance with provisions of the Draft Contract herein, the Contractor shall perform the work generally consisting of: removal of the existing drainage inlet located adjacent to 900 Powell Avenue and installation of new precast drainage inlet and on-grade gutter depression in accordance with the terms and provisions of the Draft Contract herein, the Special Provisions and Technical Specifications(Attachment 3).

B. BIDDER REGISTRATION
All Bidders who intend to respond to this solicitation must register as a prospective proposer by completing the Plan Holders List Registration Form on the City website project page at Healdsburg.gov/Bids. Prospective Biddersthat obtained this solicitation from the City website will have already completed this form prior to obtaining access to the solicitation and related documents.

C. AWARD DETERMINATION
Award will be made to the responsible Bidder who submits the lowest responsive Bid after the verification of minimum requirements and application of any preferences. The City reserves the right to reject any and all Bids, to waive formalities or to accept any Bid which appears to serve the best interest of the City of Healdsburg.

D. PRICING

1. If an inconsistency exists between the amount listed for a unit price in a bid and the total listed for that bid item (e.g., if the total listed for a bid item does not equal the unit price listed in the bid multiplied by the quantity listed), subject to applicable law, the unit price will be deemed to accurately reflect the Bidder’s intent concerning the bid item and the intended total for the bid item will be deemed to be the unit price as listed in the bid multiplied by the quantity listed.

2. If the bid price is a lump sum total made up of smaller individual bid item prices and an inconsistency exists between the lump sum total bid price and any individual bid item price, subject to applicable law, the individual bid item prices as listed in the bid will be deemed to accurately reflect the bidder’s intended bid and the intended lump sum total bid will be deemed to be the sum of the individual bid item prices as listed in the Item 6.j
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bid, even if that sum is different from the amount actually listed as the lump sum total bid.

3. Any federal, state, or local tax payable on articles to be furnished will be included in the lump sum total bid price and paid by the Contractor under the contract. The City is exempt from federal excise tax and will provide a certificate of exemption to the successful bidder upon request.

E. IFB SCHEDULE
Action Date
IFB Posting 11/13/2025
Mandatory Pre-Bid Meeting 12/3/2025 at 11:00am
Questions (if any) Due 12/5/2025
Bids Due no later than: 12/11/2025 at 2:00pm
Council Award 1/5/2026
Anticipated Issuance of Executed Purchase Contract 1/19/2026 F. MANDATORY PRE-BID MEETING
A mandatory pre-bid meeting will be held on the date and time identified in the IFB Schedule.

The pre-bid meeting will be held at 900 Powell Avenue, Healdsburg, CA 95448.

G. EXAMINATION/INTERPRETATION OF THE BID DOCUMENTS
Requests for interpretations or clarifications of the solicitation requirements should be made in writing and submitted via email to [email protected]. The last day to submit questions is identified in the IFB Schedule section of this solicitation. Bidders shall be solely responsible for examining this solicitation, including interpreting any factors that could affect their Bid. Bidders shall be solely responsible for their failure to examine the documents. If a Bidder discovers any ambiguity, conflict, discrepancy, omission, or other error in the solicitation, the Bidder should immediately notify the City of the error in writing and request modification or clarification of the solicitation. The City will provide modifications or clarifications by addendum to all registered plan holders. The City will not be responsible for failure to correct errors.

H. SOLICITATION MODIFICATIONS
The City reserves the right to change the IFB schedule or issue addenda to amend the solicitation at any time. The City also reserves the right to cancel or reissue the solicitation. All such addenda shall be documented in writing and will become part of the solicitation. Any addenda for this solicitation will be posted on the City website project page and emailed to any registered plan holders.

I. WITHDRAWAL OF BID
Bids may be withdrawn at any time prior to the submission time specified in the IFB Schedule earlier in this solicitation, provided notification is received in writing signed by the bidder or its properly authorized representative. Bids cannot be changed or withdrawn after the time designated for receipt.

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J. BID PROTESTS
Any protest of the proposed Project award must be submitted in writing to the City no later than 5:00 PM on the third business day following the date of the bid opening. All bids will be available for inspection by the next business day after the bid opening. All bidders have equal access to the bids. The company protesting the bid will be asked to contact the City Clerk, of the City Manager’s Office, and review the bids onsite at City Hall, 401 Grove Street, Healdsburg CA 95448. The bid protest must contain a complete statement of the basis for the protest. The protest must state the facts and refer to the specific portion of the document or the specific statute that forms the basis for the protest. The protest must include the name, address, and telephone number of the person representing the protesting party. The party filing the protest must concurrently transmit a copy of the protest to the proposed awardee. The party filing the protest must have actually submitted a bid for the Project. A subcontractor of a party filing a bid for the Project may not submit a bid protest. A party may not rely on the bid protest submitted by another bidder but must timely pursue its own protest. The procedure and time limits set forth in these Information for Bidders are mandatory and are the bidders’ sole and exclusive remedy in the event of a bid protest. Any bidder’s failure to fully comply with these procedures will constitute a waiver of any right to further pursue a bid protest, including filing of a challenge of the award pursuant to the California Public Contract Code, filing of a claim pursuant to the California Government Code, or filing of any other legal proceedings. The City will review all timely protests prior to award of the Project. The City will not be required to hold an administrative hearing to consider any protests, but may do so at its option. At the time of the City Council’s consideration of the Project award, the City Council will also consider the merits of any timely protests. The City Council may either reject the protest and award to the lowest responsible bidder or accept the protest and award the bid to the next lowest responsible bidder. Nothing in this section will be construed as a waiver of the City’s right to reject all bids.

II. BIDDER ELIGIBILITY REQUIREMENTS
The City will appoint an individual to verify that the lowest Bidder meets the eligibility requirements of this section. If the apparent awardee fails to meet the qualifications, the City appointee will move to the second ranked Bidder and so on until an award may be made.

A. BIDDERS’ CERTIFICATIONS
Bidders must complete, sign, and submit with their Bid the Bidder Information and Certifications Form (Attachment 2), agreeing to comply with the requirements of this solicitation for their Bid to be deemed responsive.

B. PREVAILING WAGE REQUIREMENTS
This agreement is subject to prevailing wage requirements as specified in Exhibit F of the attached Draft Contract (Attachment 3).

C. TECHNICAL SPECIFICATIONS / SPECIAL PROVISIONS
Please review Attachment 3; Exhibit D: Technical Specifications included and attached hereto. All Bids must meet these minimum requirements in order to be deemed responsive. All Bids shall comply with the Special Provisions included with this IFB and attached hereto as Attachment 3; Exhibit E: Special Provisions.

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D. LEGAL REQUIREMENTS AND PERMITS:

The Bidder agrees to fully comply with all local, city, state and federal laws, regulations and ordinances governing performance of contractual services required hereunder, and it will be the responsibility of the Bidder to obtain any and all necessary permits, licenses and/or clearances prior to initiating an agreement. The Bidder shall, if requested by the City, supply certification and evidence of such compliance. Prices quoted shall not include Federal Excise Tax. California Sales Tax will be paid on material discretely priced in accordance with the agreement payment schedule. Bids shall be for the total net price including all applicable taxes and charges, delivered F.O.B., City of Healdsburg.

E. REQUIRED LICENSES
No bid will be accepted from, or agreement awarded to, a Bidder who is not licensed in accordance with the law, who does not hold a license qualifying them to perform work under this agreement. The Contractor must possess a Class A license in accordance with the requirements of the bid package and applicable law. Additionally, Bidder must have any and all licensesrequired by law in performing the services of this solicitation even if not specified in this solicitation.

F. REQUIRED EXPERIENCE
All work will be accomplished by qualified personnel. Uncorrected workmanship that continues for the same cause after three (3) written notices to the Contractor from the City Manager, or his designee, shall constitute grounds for termination of the agreement in accordance with the Termination for Cause provision of Exhibit B Terms and Conditions.

G. SEVERABILITY AND LEGALITY:

If any provisions of this agreement shall be held to be invalid, illegal or unenforceable, the validity, legality and enforceability of the remaining provisions shall not in any way be affected or impaired thereby.

H. BONDS
Bond requirements (if applicable) for the awarded Contractor shall be specified in the Prevailing Wage and Public Works Provisions included with this IFB and attached hereto as Attachment 3; Exhibit F: Prevailing Wage and Public Works Provisions.

In accordance with California Public Contract Code Section 20170, all bids must be presented under sealed cover and include one of the following forms of bidder’s security in the amount of ten-percent (10%) of the total bid: cash, cashier’s check made payable to the City, certified check made payable to the City, or a bidder’s bond. If using a bidder’s bond, Bidders must use the form attached hereto as Attachment 2: Appendix 1.

I. DEPARTMENT OF INDUSTRIAL RELATIONS
SB854 (Stat. 2014, Chapter 28) establishes that no contractor or subcontractor may be listed on a bid proposal for a public works project unless registered with the Department of Industrial Relations (DIR) pursuant to Labor Code Section 1725.5 [with limited exceptions from this requirement for bid purposes only under Labor Code Section 1771.1(a)]. No contractor or subcontractor may be awarded a contract for public work on a public works project unless registered with the DIR pursuant to Labor Code Section 1725.5. This project is subject to compliance monitoring and enforcement by the DIR. All contractors and subcontractors must Item 6.j
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furnish electronic certified payroll records directly to the Labor Commissioner (aka Division of Labor Standards Enforcement). The prime contractor must also post job site notices prescribed by regulation.

III. BID FORMAT AND SUBMITTAL INSTRUCTIONS
A. BID FORMAT
All bids must be in ink or typewritten. No pencil figures or erasures are permitted. Mistakes may be crossed out and corrections inserted adjacent thereto and must be initialed, together with the date of correction, in ink by the person signing the Bid. All bids submitted shall be executed by the bidder or its authorized representative.

Bids shall be emailed to [email protected] with the subject line: IFB-18-025; Attention:

Central Services.

B. REQUIRED BID DOCUMENTS
Bidder must submit all required documents listed below to be eligible for award.

1. Cost Bid Form (Attachment 1) (Requires Signature)
The Bidder must complete the attached Cost Bid Form (Attachment 1). All bids submitted shall be executed by the Bidder or its authorized representative. At no time will rates or costs be considered confidential. Bidders that deviate from this format may be deemed non-responsive.

2. Bidder Information and Certifications Form (Attachment 2) (Requires Signature) The Bidder must complete the attached Bidder Information and Certifications Form (Attachment 2). The form must be signed by the Bidder or authorized representative to bind the bidding firm contractually. Bidders that deviate from this format may be deemed non-responsive.

3. Bid Bond (Attachment 2: Appendix 1) (Requires Signature) C. METHOD AND LOCATION OF BID DELIVERY
Bids shall be emailed to [email protected] with the subject line: IFB-18-025; Attention:

Central Services. Bids need to be submitted by the date and time indicated in the IFB Schedule earlier in this solicitation.

IV. BID AWARD PROCESS
Bids will be evaluated based on responses to the information requested in this solicitation. It is the intent of the City to award a fixed price contract with the lowest responsible, responsive Bidder. All Bidders acknowledge that they have made themselves familiar with the requirements of this IFB.

A. BID EVALUATION

1. Stage One: Bid Opening
The City will open each Bid received prior to the submission deadline to determine the apparent low bidder.

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2. Stage Two: Bid Screening
The City will screen Bids for compliance with the Screening Criteria in Section E of this Part to determine the responsible Bidder who submits the lowest responsive Bid. Bids that fail any of the screening criteria are considered non-responsive and will be rejected.

The City may conduct optional telephone Clarification Interviews with Bidders during the screening process to clarify and/or verify information submitted in the Bid. However, these interviews may not be used to change or add to the content of the original Bid.

Bidders will not be reimbursed for time spent answering clarifying questions.

B. PREFERENCES AND NOTICE OF AWARD

1. Tie Breakers
In the event of a tie after the application of preferences, the award will go first to a Proposer with their primary business located in the City of Healdsburg. If a tie breaker is still required, the City will flip a coin to determine the winner.

2. Notice of Proposed Award
The City will post the Bid Summary on its website and will email it to all entities that submitted a Bid.

C. AGREEMENTS

1. Agreements
The lowest responsive Bid will be developed into a proposed agreement using the attached Draft Contract (Attachment 3). Contractor may provide services only after full execution of the agreement.

2. Agreement Development:

The City will send the Contractor an agreement for approval and signature. The agreement will include the applicable terms and conditions and will incorporate this solicitation and the Bid by reference. The City reserves the right to modify the award documents (including the terms and conditions) prior to executing any agreement.

3. Failure to Execute an Agreement:

If the City is unable to successfully execute an agreement with a Bidder in a timely manner, it reserves the right to cancel the pending award and use the funds elsewhere, such as to fund the next lowest, eligible bid.

D. REJECTION OF BIDS/IMMATERIAL DEFECT:

1. The City reserves the right to reject any or all bids and to waive any minor informalities or irregularities contained in any bid. The City reserves the right to accept any portion of any bid, unless the bid package expressly provides that the award will be made as a whole.

2. The City may waive any immaterial defect or deviation contained in a Bid. The City’s waiver will not modify the Bid or excuse the successful Bidder from full compliance with solicitation requirements.

3. Bids that do not pass the screening stage shall be rejected.

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E. STAGE TWO: BID SCREENING

SCREENING CRITERIA
The Application must pass ALL criteria to progress to Stage Two.

Pass/Fail

1. The Bid is received by the by the due date and time specified in the “IFB Schedule” earlier in this solicitation and is received in the required manner.

Pass Fail

2. The Bidder Information and Certifications (Attachment 2) is signed where indicated.

Pass Fail

3. The Bid Cost Bid Form (Attachment 1) is complete. Pass Fail

4. The Bid does not indicate that any contents are proprietary or confidential in nature.

Pass Fail

5. The Bid is not timed to expire. Pass Fail

6. The Bid does not contain false or intentionally misleading statements or references that do not support an attribute or condition contended by the Bidder.

Pass Fail

7. The Bid does not contain caveats that conflict with the solicitation, and the variation or deviation is material.

Pass Fail

8. The Bidder has not included a statement or otherwise indicated that it will not accept the terms and conditions, or that acceptance is based on modifications to the terms and
conditions.

Pass Fail
V. ADDITIONAL ATTACHMENTS AND INFORMATION
A. ATTACHMENT 1 COST BID FORM
B. ATTACHMENT 2 BIDDER INFORMATION AND CERTIFICATIONS FORM C. ATTACHMENT 3 DRAFT CONTRACT

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CITY OF HEALDSBURG

CITY COUNCIL AGENDA STAFF REPORT
MEETING DATE: January 20, 2026
SUBJECT: Amendment to Abel De Luna Community Center Multicultural Center Improvements Agreement with Goring & Straja Architects for Design and Bidding Support Services
PREPARED BY: Tom Campbell, Project Manager
STRATEGIC INITIATIVE(S):

Maintain and Improve Infrastructure and Facilities
Provide Resident-Driven Community Services
RECOMMENDED ACTION(S):

Adopt a Resolution approving an amendment to the Professional Services Agreement with Goring & Straja Architects for cost estimating, design, and bidding support services for the Abel De Luna Community Center Multicultural Center Improvements project in an amount not-to-exceed $79,336 and authorizing the City Manager to execute the amendment and change orders up to 10% of the amended agreement amount.

COMMUNITY ENGAGEMENT/OUTREACH:

The City of Healdsburg’s 2023 Diversity, Equity and Inclusion plan (DEI Plan) by Acosta Latino Learning Partnership includes recommendations and goals for the review, improvement, and establishment of community equity programming both within the City government and throughout the greater Healdsburg Community. Nine community events and in-depth listening sessions with 150 community members informed the DEI Plan, which recommends the development of a multicultural center to provide a space dedicated to celebrating cultural heritage and fostering a sense of belonging.

The Healthcare Foundation of Northern Sonoma County (the Foundation) led an initiative in 2024 to advance the multicultural center goal and brought together several community partners, including Corazón Healdsburg and Alliance Medical Center. The Foundation engaged Goring & Straja Architects and Carducci Associates, two Bay area design firms, who led a participatory process that engaged 129 residents through surveys, eight listening sessions, and two design workshops. The resulting Multicultural Center Report (the Report) identified the existing Abel De Luna Community Center as the preferred location for a multicultural center and outlined design and programming concepts that would build upon existing resources and strengthen community Item 6.k
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connections to realize the multicultural center goal by integrating it within the existing facility.

BACKGROUND:

In 2021, the City Council awarded a contract to Acosta Latino Learning Partnership (ALLP) for the development of a Diversity, Equity, and Inclusion (DEI) Plan for the City. On August 7, 2023, the City Council received a presentation from staff and ALLP on the draft DEI Plan and directed staff to hold an implementation workshop, which occurred on October 23, 2023, where the City Council accepted the City’s DEI Plan.

The City’s DEI Plan includes a goal of creating a multicultural center in Healdsburg and encourages community organizations to engage in implementing the plan. In February 2024, the Healthcare Foundation announced a grant of $285,000 from Providence to support a community convening and visioning process for residents of Healdsburg to explore the potential for a multicultural Community Wellness Center. The Foundation held eight listening sessions and two design workshops throughout 2024 and released its Multicultural Center Report in January 2025.

On April 21, 2025, City Council received a presentation about the Abel De Luna Community Center multicultural center concepts and grant funding from Sonoma County. City Council directed staff to begin integrating the concepts into the design and operation of the community center and to return with a grant agreement that would authorize receipt of the County funding.

The City Council was supportive of a grant-funded project focused on the painting and planting concepts in Tiers 1 and 2 of the Report’s framework. Also in April 2025, City Council held a goal setting session and included implementing the multicultural center concepts as a proposed Fiscal Year 2025-26 goal.

On June 16, 2025, the City Council approved a grant agreement with the County of Sonoma Department of Emergency Management in the amount of $500,000 for improvements to the Abel De Luna Community Center, including implementation of the Multicultural Center concepts identified in the Report and enhancements related to the Community Center’s role as a resiliency hub during disasters, emergency response, and recovery.

DISCUSSION/ANALYSIS:

Since execution of the grant agreement, staff have worked collaboratively with Coraz ó n Healdsburg and the Healthcare Foundation to develop an implementation plan to conduct a first phase of the improvements. On December 15, 2025, the City Manager executed a professional services agreement with Goring & Straja Architects for the development of cost estimates for the first three tiers of the framework and a rough order of magnitude estimate for the Report's framework in its entirety. The total initial contract not-to-exceed amount is $46,025.

Staff propose increasing the not-to-exceed amount for Goring & Straja’s contract by $35,168 for a total contract not-to exceed-amount of $81,193 so that Goring & Straja can begin design work on the painting and planting concepts in Tiers 1 and 2 of the Report’s framework and the resiliency hub enhancements required by the grant agreement with Sonoma County. Staff also propose council authorize City Manager to approve contract amendments up to 10% of the contract amount, $8,119.

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The Healthcare Foundation and Coraz ó n Healdsburg continue to fundraise for additional private contributions towards the grand-funded project. In June 2025, Corazon Healdsburg was awarded a grant from PG&E which included $70,000 for enhancements related to the Community Center’s role as a resiliency hub. And in October 2025, the Healthcare Foundation secured a $200,000 pledge from an anonymous donor for the project.

Staff are working with Coraz ó n Healdsburg and the Healthcare Foundation to draft a Memorandum of Understanding (MOU) that defines and formalizes roles and responsibilities for the Multicultural Center project. It is anticipated that the City will be responsible for implementation of the project, and Coraz ó n Healdsburg and the Healthcare Foundation will lead community outreach and fundraising efforts. Staff anticipates bringing the MOU to City Council for review and approval in the near future.

ENVIRONMENTAL STEWARDSHIP:

The Multicultural Center Report and the concepts therein contemplate an overall approach towards low impact design. Implementation of this approach would be addressed during the design development stage of the project.

ALTERNATIVES:

The City Council could choose not to adopt a resolution amending the professional services agreement with Goring & Straja Architects and provide further direction to staff.

FISCAL IMPACT:

The adopted budget for the Adel De Luna Community Center Multicultural Center Resilience Hub Improvements Project CS006 is $500,000, funded entirely by a grant from the County of Sonoma Department of Emergency Management. The current design contract totals $46,025. Staff are proposing to amend the contract, increasing the total to $81,193, and authorizing a 10% contract contingency for a total authorized amount of $89,312. The deployment of any additional grants or funds derived from fundraising will be outlined in the forthcoming MOU and any necessary budget adjustments will be proposed at that time.

ENVIRONMENTAL ANALYSIS:

Improvements to the Abel De Luna Community Center are exempt from the provisions of the California Environmental Quality Act (CEQA) pursuant to CEQA CCR Title 14, Section 15301 (exemption for existing facilities) because the improvements consist of the maintenance and minor alteration of an existing public facility, involving negligible or no expansion of existing or former use.

ATTACHMENT(S):

Resolution
Healdsburg Multicultural Center Report
Goring & Straja Proposal
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CITY OF HEALDSBURG
RESOLUTION NO. -2026

ADOPT A RESOLUTION APPROVING AN AMENDMENT TO

THE PROFESSIONAL SERVICES AGREEMENT WITH

GORING & STRAJA ARCHITECTS FOR COST ESTIMATING,

DESIGN AND BIDDING SUPPORT SERVICES FOR THE ABEL

DE LUNA COMMUNITY CENTER MULTICULTURAL

CENTER PROJECT, AUTHORIZING THE CITY MANAGER

TO EXECUTE THE AMENDMENT, INCREASING THE NOT
TO EXCEED AMOUNT TO $81,193, AND CONTRACT
CHANGE ORDERS UP TO 10% OF THE AMENDED

CONTRACT AMOUNT
WHEREAS, the City Council accepted the City’s Diversity, Equity, and Inclusion Plan at an implementation workshop on October 23, 2023 and said plan includes a goal of creating a multicultural center in Healdsburg and encourages community organizations to engage in implementing the plan; and
WHEREAS, in 2024, the Healthcare Foundation and Corazon Healdsburg led a grantfunded community convening and visioning process for residents of Healdsburg to explore the potential for a multicultural Community Wellness Center, and released its Multicultural Center Report (the “Report”) in January 2025; and
WHEREAS, in April 2025, the City Council received a presentation about the Abel De Luna Community Center multicultural center concepts and potential grant funding from Sonoma County, directed staff to begin integrating the concepts into the design and operation of the community center and to return with a grant agreement that would authorize receipt of the County funding; and expressed support for a grant-funded project focused on the painting and planting concepts in Tiers 1 and 2 of the Report’s framework.

WHEREAS, also in April 2025, City Council held a goal setting session and included implementing the multicultural center concepts as a proposed Fiscal Year 2025-26 goal; and WHEREAS, in June 2025, the City Council approved a grant agreement with the County of Sonoma Department of Emergency Management in the amount of $500,000 for improvements to the Abel De Luna Community Center, including implementation of the Multicultural Center concepts identified in the Report and enhancements related to the Community Center’s role as a resiliency hub during times disasters, emergency response, and recovery; and WHEREAS, On December 15, 2025, the City Manager executed a professional services agreement with Goring & Straja Architects for the development of cost estimates for the first three tiers of the framework and a rough order of magnitude estimate for the Report's framework in its entirety; and
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Resolution No. -2026

WHEREAS, staff recommends that the City Council approve an amendment increasing the not-to-exceed amount by $35,168 to $81,193 for design and bidding services focused on the painting and planting concepts in Tiers 1 and 2 of the Multicultural Center concepts identified in the Report and enhancements related to the Community Center’s role as a resiliency hub; and WHEREAS, staff are also recommending Council authorize the City Manager to execute the amendment on behalf of the City and change orders up to 10% of the amended agreement amount; and
WHEREAS, City Council’s approval of an amendment to a Professional Services Agreement is not subject to the provisions of the California Environmental Quality Act (CEQA) because approving an amendment to a Professional Services Agreement is not a project, since it will not have a direct or reasonably foreseeable indirect impact on the environment.

NOW, THEREFORE, BE IT RESOLVED that the City Council of the City of Healdsburg hereby:

1. Approves an amendment to the professional services contract with EBA Engineering, increasing the not-to-exceed amount by $35,168 to $81,193.

2. Authorizes the City Manager to execute the amendment on behalf of the City and change orders up to 10% of the amended contract amount totaling $8,119.

3. Determines that improvements to the Abel de Luna Community Center are exempt from the provisions of the California Environmental Quality Act (CEQA) pursuant to CEQA CCR Title 14, Section 15301 (exemption for existing facilities) because the improvements consist of the maintenance and minor alteration of an existing public facility, involving negligible or no expansion of existing or former use.

PASSED, APPROVED, AND ADOPTED by the City Council of the City of Healdsburg this 20th day of January, 2026, by the following vote:

SO ORDERED: ATTEST:
_________________________________ __________________________________ J. Chris Herrod, Mayor Raina Allan, City Clerk
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GORING & STRAJA ARCHITECTS, PC
Tom Campbell, Project Manager
City of Healdsburg | Community Services Department
1557 Healdsburg Avenue
Healdsburg, CA 95448
25 September 2025
29 October 2025 REVISED
SUBJECT: Fee Proposal - Healdsburg Multicultural Center - First Tier VIA: email: [email protected]
Dear Tom:

Per your request, we are delighted to assist you and the City of Healdsburg with implementing the First Tier from the Master Plan Study for the Healdsburg Multicultural Center. Tom Campbell, hereinafter called Owner, requires at this stage of the project, Goring & Straja Architects PC, hereinafter called Architect, proposes the following Scope of Services and Fees:

I. THE PROJECT:

As described in the First Tier, the project includes painting all exterior surfaces (including all exterior walls and columns). In addition, the Architect will assist with coordinating (2) exterior wall murals and environmental signage consultant.

II. PROPOSED SCOPE OF SERVICES:

A. The Architect will provide Architectural Services as follows:

FIRST TIER:
• Meet with Owner as required.
• Visit the Site as required.
• Research paint manufacturer options.
• Prepare color studies and coordinate “brush-out” options on selected exterior walls • Prepare Key Plan and Exterior Elevations identifying color selections and mural locations. • Meetings:
- Community Workshops - (2) total
- Presentation to Community Services (Parks + Recreation) - Presentation to City Council
• Assist City of Healdsburg with bidding process (it is assumed the City of Healdsburg will prepare bid documents).
• Review completed work and prepare a Punch List (if required) 729 Heinz Avenue, Suite 1, Berkeley, CA 94710
Telephone 510 848 0895
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GORING & STRAJA ARCHITECTS, PC
A. The Architect's Services do not include submittal for or monitoring of Building Permit Review - it is assumed a Building Permit will not be required.. Should submittal of a Building Permit Application be required, the Architect would be compensated at the Architect’s Standard Hourly Rates.

III. COMPENSATION:

A. The Architect will be compensated for Services described above as follows:
• FIRST TIER: Architect’s Standard Hourly Rates not to exceed Eight Thousand Dollars ($8,000) - Meetings: 4 total @ 4 hours per meeting = 16 hours
- Paint Research: 4 hours
- Key Plan + Exterior Elevations: 16 hours
- Color Studies: 4 hours
- Coordinate Brush-outs: 4 hours
- Bid Assist: 2 hours
- Punch List: 2 hours
• WAYFINDING & SIGNAGE: Services provided by Jeppson EGD (see attached proposal dated

10.22.25)
- Visioning/Programming (12 Hours): $2,580.00
- Design Development (40 Hours): $8,600.00
- Construction Documentation (26 Hours): $5590.00
- Construction Administration (14 Hours): $3,-010.00
- Estimated Project Reimbursables: $500.00
- GaS mark-up @ 10%: $1,978.00
• ADD ALTERNATE: Services provided by Jeppson EGD (see attached proposal dated 10.22.25) - Upgrade existing driveway sign to a permanent monument sign and update existing Building Entrance sign: $4480.00
- GaS mark-up @ 10%: $448.00
B. Standard Hourly Rates are as follows:

PRINCIPAL: $250/hour
PROJECT ARCHITECT: $150/hour
PROJECT MANAGER: $120/hour
JOB CAPTAIN: $100/hour
DESIGNER: $95/hour
DRAFTER/RESOURCE: $65/hour
C. In addition to the Fees quoted above, normal and customary reimbursable expenses would be billed to the Owner at the Architect's cost-plus ten percent (10%). Reimbursable expenses include all reproduction, plotting, messenger, and Engineering/Consultant costs. Other reimbursable items must be approved by the Owner prior to being incurred. In-house plots and reproductions are invoiced at market rate plus the 10% mark-up.
729 Heinz Avenue, Suite 1, Berkeley, CA 94710
Telephone 510 848 0895
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GORING & STRAJA ARCHITECTS, PC
D. Fees will be invoiced monthly reflecting work completed to date and would be payable on receipt. Invoices would also include Reimbursable Expenses incurred to date.

E. A service charge of 1.5% monthly (18% per annum) will be applied to accounts 30 days past issuance.

IV. ADDITIONAL SERVICES:

A. If required, compensation for such services shall be computed at the Architect's Standard Hourly Rates.

B. Additional Services will not be performed without prior authorization by the Owner.

VI. OTHER CONDITIONS:

A. Terms and conditions of this Agreement would be as described in AIA Document B104, Standard Form of Agreement Between Owner and Architect for a Project of Limited Scope, 2017 version, unless otherwise noted herein.

B. The Architect will not be responsible for the detection of, nor disposal of, any hazardous substances at the project site.

C. Changes which are initiated by the Owner during construction may result in Additional Services and Compensation.

D. It is assumed that this project will require no special review processes. Should additional Planning Department or other Review Agency approvals be required, the Architect’s time will be compensated at the Standard Hourly Rates.

E. No Services by any Engineering and/or other consultants are included under the terms of this Agreement.

F. To the fullest extent permitted by law, the Architect's total liability to the Owner, for any and all injuries, claims, losses, expenses, damages or claim expenses arising out of this Agreement, from any cause or causes, shall be limited to a single aggregate sum not to exceed our fee. The Owner further agrees to indemnify and hold the Architect harmless for any such liability resulting from claims made by others, to the extent that such liability would exceed the total amount of the Architect's fee.

This agreement may be changed by written agreement signed for the Architect by a Principal of Goring + Straja Architects PC and for the Owner by Tom Campbell. If this is agreeable to you, please sign below and return one copy for our records together with the Initial Payment.

ARCHITECT DATE
729 Heinz Avenue, Suite 1, Berkeley, CA 94710
Telephone 510 848 0895
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GORING & STRAJA ARCHITECTS, PC
29 0c6 2025
Douglas Thornley, Principal
License No: 20018

OWNER DATE
City of Healdsburg | Community Services Department
Tom Campbell, Project Manager
251029_First Tier proposal-revised
729 Heinz Avenue, Suite 1, Berkeley, CA 94710
Telephone 510 848 0895
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CITY OF HEALDSBURG

CITY COUNCIL AGENDA STAFF REPORT
MEETING DATE: January 20, 2026
SUBJECT: BloodRoot Ramble Agreement Amendment
PREPARED BY: Matthew L. Milde, Recreation Supervisor
STRATEGIC INITIATIVE(S):
- Maintain and improve infrastructure and facilities
- Maintain and enhance public health and safety
RECOMMENDED ACTION(S):

Adopt a Resolution approving the Second Amendment to the three-year agreement with Reeve Wines for the BloodRoot Ramble event at the Abel De Luna Community Center campus and authorizing the City Manager to execute the amendment.

COMMUNITY ENGAGEMENT/OUTREACH:

All properties within 1,500 feet of the Abel De Luna Community Center will be notified in writing and will be provided with preliminary event details and contact information in advance of each event. Reeve Wines (the “Organizer”) will coordinate all special event outreach to the residential and business community as required in their conditions of approval.

BACKGROUND:

In 2024, the City received a special event application for an external, private, ticketed event called the BloodRoot Ramble sponsored by Reeve Wines. The proposed event was an all-day concert with music, food, wine, and beer hosted at the Healdsburg Community Center with an attendance of 2,500. The City Council reviewed and conditionally approved the Organizer’s request on March 18, 2024, and the event was held on Saturday, June 1, 2024.

On November 18, 2024, City Council directed the City Manager to enter into a three-year agreement with Reeve Wines for the BloodRoot Ramble event. The agreement granted conditional approval for the event to occur at the Healdsburg Community Center campus, since renamed Abel De Luna Community Center, annually on the first Saturday in June, and included use of the site beginning Friday at 8:00 a.m. through the following Sunday at 12:00 p.m. for 2025, 2026, and 2027.

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On May 19, 2025, City Council authorized the City Manager to amend the agreement to allow for an extra day set-up starting on the Thursday prior to the event to allow for a more efficient loadin of infrastructure, support event logistics, and reduce impact on the turf grass.

No major issues or concerns have arisen from the 2024 or 2025 concert events.

DISCUSSION/ANALYSIS:

The Organizer has submitted a request to amend the existing agreement to change the ticketed event hours from 12:00-8:00 p.m. to 2:00-10:00 p.m. on Saturday, June 6, 2026, and Saturday, June 5, 2027. Additionally, to extend the duration of event clean-up on Sunday, June 7, 2026, and Sunday, June 6, 2027, until 3:00 p.m. No other changes are proposed to event or permitted activities.

Special Event Policy (Resolution 150-2023) 3.2.2, restricts special events from excluding the public from the general use of any City park or public property. If waived, the sports field and blacktop area would not be available for use by the general public from approximately 8:00 a.m. the Thursday before each event through 3:00 p.m. the following Sunday. The dates requested are June 4-7, 2026, and June 3-6, 2027.

Restricting access during the requested Sundays would impact some recreational users. However, other fields are available in town for recreational use such as the High School and Jr. High sites.

There are no City programs or City-sponsored programs scheduled to use these areas during these timeframes.

In addition to the terms and conditions in the special event agreement and the conditions of the special event permit, the Organizer would be required to adhere to all directives, regulations, ordinances, and guidelines issued by the California Department of Public Health (CDPH), the Sonoma County Health Officer, and the City of Healdsburg that are in effect at the time of the event. Lastly, the organizer has agreed that all required special event insurance documentation must be approved by the City at least fifteen days before the start date of the agreement.

Staff have reviewed the request and determined that the proposed adjustments are low impact, do not conflict with City or City-sponsored programming, and do not expand the previously approved event footprint, attendance, or scope of permitted activities. The requested extension of clean-up hours into Sunday afternoon supports thorough site restoration and reduces the need for expedited or incomplete post-event breakdown activities. The Organizer will remain subject to all applicable City policies, permit conditions, insurance requirements, and health and safety regulations, ensuring continued City oversight and risk management. Accordingly, staff support the requested amendment.

ENVIRONMENTAL STEWARDSHIP:

California law (AB 2176) requires special events and public venue facilities with more than 2,000 participants per day to develop and implement a waste management plan. As a condition of approval, the Organizer must submit a detailed waste management plan and will be expected to follow their plan during their permitted activities.

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ALTERNATIVES:

Deny all or any combination of the request.

Modify any portion of the request.

Continue the item and reconsider at a future meeting.

FISCAL IMPACT:

One fee would be assessed totaling $124.31 if the amendment is approved:
$124.31 – City Council Review Fee (for staff time associated with preparing the amendment for Council consideration)
The fee will be billed to the Organizer in accordance with the City’s Master Fee Schedule. Any additional City staff time required on will also be billed to the Organizer per the existing Cost Recovery Deposit Agreement.

The Organizer also bears responsibility for any costs associated with damages to City venues during the event, surpassing what is considered normal wear and tear. This includes expenses for repairs, litter removal, trash collection, and other cleanup requirements arising from the event. A portion or the entirety of the damage deposit may be allocated to address such damages or other clean-up activities.

ENVIRONMENTAL ANALYSIS:

Entering into an agreement is not subject to the provisions of the California Environmental Quality Act (CEQA) because authorizing conditional approval of a special event is not a project, since it will not have a direct or reasonably foreseeable indirect impact on the environment. Even if adopting an agreement were to be considered a project, it would be exempt from CEQA pursuant to CEQA Guidelines Section 15304(e) because the special event permits constitute a temporary use of land having negligible or no permanent effects on the environment. Further, issuing special event permits are considered normal operations of existing facilities for public gatherings (CEQA Guidelines Section 15323). Temporary special events occurring on the Healdsburg Community Center campus have occurred with regularity for several years and future events would not represent a change in the operation. Therefore, entering into an agreement is exempt from CEQA.

In addition, there will be no impact on environmental resources of hazardous or critical concern.

The proposed actions will not result in cumulative impacts, impacts to scenic highways, or historic resources, nor will the actions involve a hazardous waste site or unusual circumstances. Therefore, none of the exceptions pursuant to CEQA Guidelines Section 15300.2 apply.

ATTACHMENT(S):

Resolution
Reeve Wines - Second Amendment
Reeve Wines - Request Letter
Reeve Wines - Original Agreement
Reeve Wines - Agreement First Amendment
HMC Chapter 12.24 Special Events
Policy for Special Events and City Partnerships
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CITY OF HEALDSBURG
RESOLUTION NO. ____-2026

A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF

HEALDSBURG APPROVING A SECOND AMENDMENT TO A

THREE-YEAR AGREEMENT WITH REEVE WINES FOR THE

BLOODROOT RAMBLE ON THE ABEL DE LUNA

COMMUNITY CENTER CAMPUS AND AUTHORIZING THE

CITY MANAGER TO EXECUTE THE AMENDMENT
WHEREAS, Reeve Wines (“Organizer”) held two privately ticketed concert events “Banshee Fest” in 2016 and “The BloodRoot Ramble” in 2023 in West Plaza Park located in the City of Healdsburg (“City”) with attendance between 500-600 people; and WHEREAS, in 2024 and 2025, the Organizer hosted two privately ticketed concert events “The BloodRoot Ramble” at the Healdsburg Community Center campus, drawing an attendance of approximately 2,000-2,500 individuals per event and generating more than $250,000 in fundraising to combat gun violence.

WHEREAS, to facilitate the Event and related activities, certain waivers from the Healdsburg Municipal Code and Policy for Special Events and City Partnerships are necessary; and
WHEREAS, in addition to the terms and conditions of the Special Event Agreement (“Agreement”) and any conditions of approval on the Permit, Organizer will adhere to all directives, regulations, ordinances, and guidelines issued by the California Department of Public Health, the Sonoma County Health Officer, and the City of Healdsburg, including those related to environmental stewardship; and
WHEREAS, the current agreement grants conditional approval for the event to occur at the Healdsburg Community Center campus, since renamed Abel De Luna Community Center, annually on the first Saturday in June, and included use of the site beginning Thursday at 8:00 a.m. through the following Sunday at 12:00 p.m. for 2025, 2026, and 2027.

WHEREAS, the Organizer must successfully be issued a Special Event Permit from the City and provide a deposit pursuant to their Cost Recovery Agreement for the Event to occur and for the Special Event Agreement to be operative; and
WHEREAS, the City now desires to amend the first amendment to the three-year Agreement with the Organizer to conditionally approve a request to amend the ticketed event hours to 2:00 p.m. to 10:00 p.m. on Saturday, June 6, 2026, and Saturday, June 5, 2027. Additionally, to conditionally approve a requested waiver of the Special Event Policy (Resolution 150-2023) 3.2.2, which restricts special events from excluding the public from the general use of any City park or public property, to restrict access the Abel De Luna Community Center field on Sunday, June 7, 2026 and Sunday, June 6, 2027.

NOW, THEREFORE, BE IT RESOLVED, that the City Council of the City of Healdsburg:

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Resolution No. -2026

1. This action is not subject to the provisions of the California Environmental Quality Act (CEQA) because permitting an event at the Community Center is exempt from CEQA pursuant to CEQA Guidelines Section 15304(e) because the special event constitutes a temporary use of land having negligible or no permanent effects on the environment.

Further, issuing special event permits are considered normal operations of existing facilities for public gatherings (CEQA Guidelines Section 15323). Temporary special events occurring on the Healdsburg Community Center campus have occurred with regularity for several years and future events would not represent a change in the operation.

Therefore, entering into an agreement is exempt from CEQA. In addition, there will be no impact on environmental resources of hazardous or critical concern. The proposed actions will not result in cumulative impacts, impacts to scenic highways, or historic resources, nor will the actions involve a hazardous waste site or unusual circumstances. Therefore, none of the exceptions pursuant to CEQA Guidelines Section 15300.2 apply.

2. Amends the Special Event Agreement with Organizer, attached hereto as Exhibit A, and authorizes the City Manager to execute the Amendment.

3. Authorizes the Organized to modify ticketed event hours to 2:00 p.m. to 10:00 p.m. on Saturday, June 6, 2026, and Saturday, June 5, 2027.

4. Authorizes additional hours the Organizer can restrict access to the Abel De Luna Community Center field for clean-up occurring on Sunday, June 7, 2026, and Sunday, June 6, 2027.

PASSED, APPROVED AND ADOPTED, by the City Council of the City of Healdsburg this 20th day of January, 2026 by the following:

SO ORDERED: ATTEST:
___________________________________ ___________________________________ J. Chris Harrod, Mayor Raina Allan, City Clerk
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SECOND AMENDMENT TO FEE AGREEMENT AND SPECIAL EVENT
CONDITIONAL APPROVAL FOR THE BLOODROOT RAMBLE 2025-2027 This Second Amendment to the Fee Agreement and Special Event Conditional Approval for the Bloodroot Ramble (“Amendment”) is made and entered into this ____ day of ___________ 2026 (“Effective Date”), between the City of Healdsburg, a California municipal corporation ("City"), and Reeve Wines ("Organizer"). City and Organizer may be each referred to as “Party” or collectively as the "Parties." WHEREAS, on or around November 18, 2024, the Parties entered into a Fee Agreement and Special Event Conditional Approval for the Bloodroot Ramble (“Agreement”); and
WHEREAS, on or around May 19, 2025, the Parties entered into a First Amendment to Fee Agreement and Special Event Conditional Approval for the Bloodroot Ramble (“Agreement”); and
WHEREAS, as stated in the first amendment to the Agreement, the Bloodroot Ramble (“Event”) spans four days, including set-up and tear-down; and WHEREAS, Organizer has requested an amendment to the ticketed event hours and requests additional hours for clean-up, and the City wishes to grant the requests.

WHEREAS, the City is requesting of the Organizer that all required special event insurance documentation be approved by the City at least fifteen days before the start date of the agreement.

NOW THEREFORE, the Parties agree as follows:
1) Section 4 (Event Period) of the Agreement is modified to read as follows:

Event Period. The Event shall be held once per year for a period of four (4) calendar days during the first weekend in June commencing on Thursday at 8:00 a.m. and extending through Sunday at 3:00 p.m. (“Event Period”), with the ticketed Events occurring on Saturday from 2:00 p.m. – 10:00 p.m. every year beginning in 2026 through 2027. Including set-up and tear-down, the dates are as follows:
• Thursday, June 4, 2026 to Sunday, June 7, 2026
• Thursday, June 3, 2027 to Sunday, June 6, 2027
2) All other provisions of the Agreement remain in full force and effect.

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IN WITNESS WHEREOF, the parties have executed this Agreement as of the date first above written.

CITY OF HEALDSBURG:

By: _____________________________ Date: _________________ Jeff Kay
City Manager
ATTEST:

By: _____________________________ Date: _________________ Raina Allan
City Clerk
APPROVED AS TO FORM:

By: _____________________________ Date: _________________ Samantha W. Zutler
City Attorney
REEVE WINES:

By: _____________________________
________________________________
Its: _____________________________
Date: _________________
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January 4, 2026
Dear Members of Healdsburg City Council,
Once again we would like to thank you for allowing us the opportunity to have the BloodRoot Ramble at the Abel De Luna Community Center Fields on Saturday, June 6, 2026. This year to we would like to amend our event time from 12PM-8PM to 2PM-10PM.

We would also like to adjust this time frame for the remainder of our three-year agreement:

Friday, June 5, 2027
Benefits of adjusting time:
+ Less time in heat of the day, more time during cooler hours. + Headliner will be able to utilize lights for a better experience. + The overall amount of time for set up, tear down, and showtime remains the same.

Other considerations:
+ Facing our stage southwest last year proved to help with neighborhood noise. + We only had one sound complaint in 2025, which was personally addressed. + Shuttle times will be adjusted accordingly.
+ Tear down timing will remain the same. We will be off the field by 3PM on Sunday, June 7, 2026.

Feel free to reach out with any questions or concerns.

Many thanks for your consideration,
Kelly & Noah Dorrance
BloodRoot Wines
415-624-7413
[email protected]
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Year 1_________ Year 2_________ Year 3_________ Year 4_________ Year 5_________ Contractor Name: __________________________________________________________ Description of Services: _______________________________________________________________ Department: ________________________ Project Manager _________________Phone:____________ Initial not-to-exceed amount: ____________
Begin Date __________________ End date_________________ CPI increase per year: Yes ___ No ___ If Agreement has multiple years, then encumbrance should be applied in the following manner:
_____Amendment #1- Amount $ ____________ End Date____________ _____Amendment #2- Amount $ ____________ End Date____________ _____Amendment #3- Amount $ ____________ End Date____________ _____Amendment #4- Amount $ ____________ End Date____________ _____Amendment #5- Amount $ ____________ End Date____________ Total not-to-exceed Amount: _______________________
Funding Source: _________________________________________ Budgeted: Yes _______ No _______ (Include Acct# and Project #)
DIR Number ____________________
Resolution No. ___________
City Council approval date____________________________

AGREEMENT CHECK LIST
Katie Edgar, Finance Director:_________________________ Check all that apply: Certificate(s) of Insurance attached: GL____ Auto ___ Excess ____ W/C* ____ Prof (E&O) ____ *Workers’ Comp Declaration _____ Other _________________ Tyler Kettmann, Risk Manager:_____________________________ Business License No.: __________________ Expiration Date: _______________ ____W-9 (if new vendor) Department Head Approval:_____________________________
Grant Funded?: Yes _______ No _______
127-2024
Community Services
The BloodRoot Ramble Event - Fee Agreement and Special Event November 11, 2024
431-3128
X
X
Matt Milde
11/18/2024
$5,000
$5,000
Reeves Wines
6/30/2027
Docusign Envelope ID: 5A4899FE-A1B9-45DA-A0D8-256AB8B575F7 N/A Revenue
N/A
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FEE AGREEMENT AND SPECIAL EVENT CONDITIONAL APPROVAL
FOR THE BLOODROOT RAMBLE 2025-2027
This Agreement and Special Event Conditional Approval ("Agreement") is made and entered into this __ day of ________ 2024 (“Effective Date”), between the City of Healdsburg, a California municipal corporation ("City"), and Reeve Wines ("Organizer"). City and Organizer may be each referred to as “Party” or collectively as the "Parties."

RECITALS
A. City is the owner of certain parcels of real property known as the "Healdsburg Community Center" located at 1557 Healdsburg Ave., in the City of Healdsburg, County of Sonoma, State of California, and “City Hall Parking Lot” located at 401 Grove St., in the City of Healdsburg, County of Sonoma, State of California, collectively known as "Properties".

B. Organizer has previously applied for a special event permit to utilize the Properties to conduct The BloodRoot Ramble (“Event”). The details of the Event are memorialized in Organizer’s 2024 Special Event Permit (“2024 Permit”) issued to Organizer, attached as Exhibit B and incorporated by reference herein.

C. The Event is a significant and commercially-oriented gathering of substantial proportions, attracting an estimated 2,500 ticketed attendees. The successful execution of the Event requires the allocation and utilization of significant City resources including public spaces, infrastructure, and a comprehensive security and safety assessment, all dedicated to ensuring the health and safety of the general public, including event participants.

D. The City acknowledges the Event's positive impact on the local community, tourism, and the economy, while also recognizing the imperative of responsibly and sustainably managing City resources.

E. Organizer desires to obtain and City desires to grant conditional approval for the Event on the dates requested for calendar years 2025, 2026 and 2027, including granting the requested waiver of the provisions of the Healdsburg Municipal Code and Policy for Special Events and City Partnerships.

F. Organizer anticipates and represents that the Event will be held in substantially similar form as described in the 2024 Permit throughout the three year term of this Agreement.

NOW THEREFORE, in consideration of the mutual covenants and conditions contained herein, the Parties agree as follows:

1. Conditional Event Approval. The City hereby grants conditional approval for the Event, subject to the conditions and terms contained herein, and subject to any Conditions of Approval on any special event permit issued by the Community Services Director or their designee to the Organizer for the Event, to be held in substantially similar form as described in the 2024 Permit. If the Community Services Director determines that the application for the Event materially differs such that it requires additional City resources or would impose a materially different burden Docusign Envelope ID: 5A4899FE-A1B9-45DA-A0D8-256AB8B575F7 18th November
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on the City as compared to the 2024 Permit, the City may deny the application pursuant to the provisions of Healdsburg Municipal Code Chapter 12.24. The City Council hereby waives the following provisions, as requested by the Organizer, and as described below:
i. HMC 12.28.2020(A), restricting consumption of alcohol in any public park, thereby authorizing consumption of alcohol on the Healdsburg Community Center Field during the dates and times indicated in the special event permit issued by the Community Services Director or their designee.
ii. Special Event Policy (Resolution 150-2023) 3.2.2, which prohibits special events from excluding the public from the general use of any City park or public property on the Healdsburg Community Center Field, annually on the Friday before the Event at 8:00 a.m. through the following Sunday at 12:00 p.m. to facilitate a privately ticketed event, protect event equipment overnight, and ensure public safety during logistical event set-up and clean-up operations. iii. Special Event Policy (Resolution 150-2023) 4.2, which prohibits a special event with more than 2,500 attendees from being scheduled in a City venue outside the Downtown Core on the same day that a major event (Saturday Farmers’ Market) is scheduled at a Downtown Core venue.

2. Fees. Organizer agrees to pay City all applicable special event permitting fees based on the Master Fee Schedule in effect at time of payment along with fees memorialized in the Cost Recovery Deposit Agreement, attached hereto as Exhibit A and incorporated by reference. A schedule of permit fee deadlines shall be included in the Conditions of Approval attached to the special event permit issued by the Community Services Director or their designee.

In addition, the Organizer agrees to pay the City a $2,500 non-refundable Healdsburg Community Center campus improvement fee, which shall be due on or before January 1 of each calendar year preceding the Event.

For services requested of City staff for which no fee is listed in this Master Fee Schedule, the Director of the department whose services are requested shall determine the appropriate fee, based on approved hourly rates for staff time involved in the service or activity.

3. Cost Recovery Deposit Agreement. Prior to and as a condition to the issuance of the Special Event Permit, Organizer agrees to execute a Cost Recovery Deposit Agreement provided by the City. Organizer is responsible for all costs related to the Event, including Event security, damage, and City staff and consultant costs, including overtime costs. Prior to or at the time of execution of the Cost Recovery Deposit Agreement and thereafter in accordance with the terms of the Cost Recovery Deposit Agreement, Organizer will pay to the City a deposit of $10,000, to be applied to costs subject to the Cost Recovery Deposit Agreement.

4. Event Period. The Event shall be held once per year for a period of three (3) calendar days during the first weekend in June commencing from Friday at 8:00 a.m. and extending through Sunday at 12:00 p.m. (“Event Period”), with ticketed Event occurring on Saturday from 12:00 p.m. – 8:00 p.m every year beginning in 2025 through 2027. Including setup and tear-down, the proposed dates are as follows:

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• Friday, June 6, 2025 to Sunday, June 8, 2025
• Friday, June 5, 2026 to Sunday, June 7, 2026
• Friday, June 4, 2027 to Sunday, June 6, 2027

5. Special Event Permit Required. Organizer shall submit a special event permit application annually to the City no later than 90 days before the Event, and shall comply with the terms and conditions set forth in the approved special event permit. Additionally, as a condition for issuance of a special event permit, Permittee shall obtain and/or provide the following documents annually to the satisfaction of the City Manager:
i. Special Event Permit Application
ii. Event Layout (Preliminary & Final)
iii. Insurance with Endorsement
iv. Workers Compensation Declaration
v. Risk Management Plan
vi. Parking Plan
vii. Private Security Contract
viii. Waste Management / Zero Waste Plan
ix. Perimeter Control Plan
x. Tent Permit
xi. ABC License
xii. Supplemental Documents as required
xiii. Post-Event Report (due 60 days after event)

6. Meetings and Updates. Organizer is required to attend all meetings as required by City staff to coordinate the Event. Organizermay also request meetings with City staff and City will undertake to reasonably accommodate Organizer’s request(s). Organizer agrees to respond to requests from the City to provide a status update within 48 hours of receipt.

7. Effective Date, Term. This Agreement shall be effective as of the date indicated above and shall have a term of three (3) years.

8. Severability. If any provision of this Agreement shall be held or made invalid by a court decision, statute or rule, or shall be otherwise rendered invalid, the remainder of this Agreement shall not be affected thereby.

9. Choice of Law. This Agreement shall be governed and construed in accordance with the laws of the State of California and any lawsuit or action relating in any way to this Agreement must be filed in Sonoma County, California.

IN WITNESS WHEREOF, the parties have executed this Agreement as of the date first above written.

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CITY OF HEALDSBURG:

By: _____________________________ Date: _________________ Jeff Kay
City Manager
ATTEST:

By: _____________________________ Date: _________________ Raina Allan
City Clerk
APPROVED AS TO FORM:

By: _____________________________ Date: _________________ Samantha W. Zutler
City Attorney
REEVE WINES:

By: _____________________________
________________________________
Its: _____________________________
Date: _________________
Docusign Envelope ID: 5A4899FE-A1B9-45DA-A0D8-256AB8B575F7 5/13/2025
Kelly Dorrance Proprietor
5/13/2025
5/15/2025
5/15/2025
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EXHIBIT “A”
Cost Recovery Deposit Agreement
Reeve Wines – 2025-27 BloodRoot Rambles

1. Scope of Agreement: This Agreement is between the City of Healdsburg (“City”) and Reeve Wines (“Organizer”) regarding Organizer’s payment of City costs for services provided by City to Organizer related to the Event (as defined in Section 2). City and Organizer are sometimes referred to herein as a “Party” or “Parties”.

2. Event Description: The BloodRoot Ramble was held on June 8, 2024, and is proposed to continue annual basis (“Event”) for three years, through 2027. The Event takes place in the City at the Healdsburg Community Center campus with off-site shuttle service throughout the City from designated parking lots. The Organizer intends the Event to include live performances by several musical bands or artists of national notoriety, alcohol booths, food booths/trucks, event staging, VIP viewing area, merchandise booth, and shuttle servicing to and from the Event. The Event venue within the Healdsburg Community Center campus will be enclosed by fencing and accessible exclusively to ticketed attendees, with a maximum of 2,500 tickets sold. The Event will be held on one day in the month of June.

3. Effective Date and Term of this Agreement:

This Agreement shall take effect upon approval by the City Council ("Effective Date") and shall have a term of one (1) year from the Effective Date (“Term”). This agreement shall automatically renew for two successive one (1) year periods unless the Event no longer takes place or if either Party delivers a notice of non-renewal in writing to the other Party no later than thirty (30) days prior to the end of the current one (1) year Term. Notices shall be provided as set forth in Section 6. This Agreement expires upon payment to City of all costs pursuant to this Agreement arising from Organizer’s 2027 Event.

4. Special Event Permit: Organizer shall be required to obtain a Special Event Permit (the “Permit”) annually in accordance with the City's Policy for Special Events and City Partnership. Organizer shall comply with the terms and conditions set forth in the approved Permit. The Organizer shall not be entitled to hold the Event or utilize City property for the Event unless Organizer obtains a Permit.

5. Organizer Payment of City Costs: In addition to any costs the Organizer is required to pay under the Permit, Organizer agrees to pay City for the cost of City staff and City consultants in connection with Event planning and implementation leading up to Event (“City Costs”) for each year the Event takes place during the Term of this Agreement. Upon the Effective Date, and each year during the term of the Agreement by January 1, the Organizer will provide the City with an initial deposit of $10,000 (the “Deposit”). City Costs will be tracked and charged against the Deposit each year. If the initial Deposit falls below $2,500, during each year of the Term, Organizer must deposit additional funds in order to replenish the deposit to $10,000 within seven (7) days of notification by the City. City staff time will be tracked and charged back to the Organizer, based on total costs incurred. City Costs include, but are not limited to the following:

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(a) City staff time associated with Event planning, including, but not limited to: Event plan review, logistic and support inquiries, pre-Event meetings with City staff, pre and post-Event site walk through, and any additional time that requires City staff involvement in the planning process not outlined in the Permit. (b) Unexpected staff time during event set-up, implementation, and breakdown. City staff will be assigned to work the Event and Organizer is responsible for such costs under the Special Event Policy and the Permit. If additional staff are needed to respond to the Event or staff time exceeds the amount covered by the Permit, those costs will be charged against the Deposit. (c) All or part of the deposit may be used to address any damage, outside of regular wear and tear to any City property used for the Event. City staff and Organizer will conduct a post-Event walkthrough to ensure the City property is returned to its pre-Event. If damage to City property exceeds the Deposit, Organizer will be required to reimburse City for any expenses above and beyond remaining Deposit within 30-days after notice from the City.
(d) The City will return any remaining Deposit balance after Event completion each year, including the postEvent walkthrough and once final payment has been processed each year.

6. Notice: Organizer shall provide written notice to the City in the event that there is a change in the Organizer’s interest in the property, the Event, or the billing address or contact person for the Event. Said notice shall be mailed first class, postage paid, certified mail to:

City of Healdsburg, Attn: Matt Milde
1557 Healdsburg Avenue
Healdsburg, CA 95448
Notices to the Organizer shall be sent to:

Reeve Wines, Attn: Kelly Dorrance
P.O. Box 380
Healdsburg, CA 95448

7. Indemnification: Organizer agrees to defend, indemnify, release and hold harmless the City of Healdsburg, its agents, officers, employees and elected and appointed officials from any claim, action or proceedings brought against any of the foregoing individuals or entities, related to the Event, and this Agreement. The indemnification shall include, but not be limited to, damages, costs, expenses, attorneys’ fees or expert witness fees that may be asserted by any person or entity arising out of or in connection with the Event and related permits or applications, this Agreement or related applications, passive or active negligence on the part of the City, its agents, officers, attorneys, employees, and elected officials.

8. Entire Agreement: Modifications in Writing. This Agreement contains the Parties’ entire agreement with respect to the subject matter hereof. Any modifications or additions to this Agreement must be made in writing by the Parties.

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9. Authorization: This Agreement shall only be executed by authorized representatives of the Parties. The persons executing this Agreement represent that they have the express authority to enter into agreements on behalf of their respective Party.

The Parties have executed this Agreement as of the Effective Date.

ORGANIZER CITY OF HEALDSBURG
By:___________________________ By:_____________________________ Kelly Dorrance Jeffrey Kay
Co-Owner City Manager
Reeve Wines City of Healdsburg
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The City Clerk’s Office will not process agreements until it receives at least one agreement signed by the consultant/contractor and all supporting documents (e.g., check, etc.).

Organizer Name: Kelly Dorrance / Reeve Wines
Project Name: The BloodRoot Ramble
Project Manager: Matt Milde, Facilities and Events Supervisor Initial Deposit Amount: $10,000
Deposit GL Account: ______________________ Project Number: __________________ _________________________________________
Department Head Signature
_________________________________________
Katie Edgar, Finance Director
______________________________________
Tyler Kettmann, Risk Manager

COST RECOVERY AGREEMENT CHECK LIST
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EXHIBIT “B”
2024 The BloodRoot Ramble
Special Event Permit
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EXHIBIT “A”
2024 The BloodRoot Ramble
Special Event Permit Application with Conditions of Approval Docusign Envelope ID: 781F2AC0-E4BE-41BE-9B67-24F89528AD3D Docusign Envelope ID: 5A4899FE-A1B9-45DA-A0D8-256AB8B575F7 Item 6.l
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APPENDIX A
Special Event Permit Application // 2024 BloodRoot Ramble June 8, 2024

SECTION A
A:2 – “The event is accessible to the general public, meaning, no portion of the event is exclusive to specific guest lists or ticket holders” Our event will be ticketed. Tickets will be $85 for the day. We plan to sell 2500.

Tickets will be purchased online through Eventbrite with e-ticket delivery to attendees.

We will set up a will call station at BloodRoot three days prior where guests can get wristbands to wear for the event.

We will secure temporary WiFi with Spectrum Technologies.

A:3 – “The even remains largely unchanged compared to its previous occurrence.” The format and experience of the event will not be that different from our 2023 Ramble with the exception of size and location. We have a more well-known band Docusign Envelope ID: 781F2AC0-E4BE-41BE-9B67-24F89528AD3D Docusign Envelope ID: 5A4899FE-A1B9-45DA-A0D8-256AB8B575F7 Item 6.l
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and can sell more tickets (i.e., raise more money) in a bigger space. We also appreciate the flat, square, useable space of the Community Center Fields. The biggest difference will be:
2023: West Park Plaza / 550 attendees / 2 food vendors / 10 portapotties 2024: Community Center Fields / 2500 attendees / 4 food vendors / 16 portapotties shuttles and paid parking
A:5 – “All special event activity will occur in the Downtown Core, meaning, all public property within 1,500’ of the Healdsburg Plaza.”
Last year our event was downtown. This year we need more space and would like to move to the community center. We see value in being able to sell more tickets, have more space for designated blanket & chair areas, have a few more food options, and space for an exhibit on fighting gun violence and moments of societal change.

Please see B:1 (sound) and the parking plan to read about how we’ll address being in a residential zone.

A:8 – “One or more areas of the event will be fenced or have restricted/controlled areas.”
The entire event will have 8’ privacy fencing with along the outside perimeter of the field. The bike path and parking lots will remain accessible. Within the perimeter fencing, there will be:
+ Two entrances/exits
+ One secured gate for load-in – load-out
+ One secured gate at the parking lot for fire access
+ Access gates will be monitored
There will be fencing within the perimeter to secure the back stage area. See the site plan for approximate locations.

SECTION B
B:1 – “Sound amplification or any other noise generating equipment will be used” This is a music concert, so there will be sound amplification. All sound will happen during daylight hours and within the hours of 10AM – 8PM. There will be a sound Docusign Envelope ID: 781F2AC0-E4BE-41BE-9B67-24F89528AD3D Docusign Envelope ID: 5A4899FE-A1B9-45DA-A0D8-256AB8B575F7 Item 6.l
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check in the morning (10:30-11:30) and then the concert with four bands will run from 12:30-7:30.

We live in the affected neighborhood so are familiar with event noise from the community center. We plan to put notices on all doors 30 days before the event.

We will aim to provide notices within 1600 feet from the source (we will also include the neighborhood at Chiquita and Grove). See map below:

Verbiage for the notices will have the following information:

The BloodRoot Ramble
Healdsburg’s Homegrown Music and Wine Festival
Saturday, June 8, 2024 from 12PM – 8PM
Healdsburg Community Center Fields
Hello neighbors! We live on Lorraine Court and own a winery in Healdsburg. We will be hosting a music festival and fundraiser to help combat gun violence in our Docusign Envelope ID: 781F2AC0-E4BE-41BE-9B67-24F89528AD3D Docusign Envelope ID: 5A4899FE-A1B9-45DA-A0D8-256AB8B575F7 Item 6.l
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schools after our losing our 9-year-old niece in the Covenant School shooting. You’ll likely hear the festival from your home, and we would like to extend an invitation to join us. Tickets are available here (QR Code). We appreciate your support and understanding as we pull off an ambitious community event for a good cause. {{ QR CODE }}
Cheers, Noah and Kelly Dorrance, BloodRoot & Reeve Wines [email protected]
B:5 – “Signage will be installed on display in advance of the event.” During permitted hours we will have some branded banners & directional signage on the fence and in the sandwich boards parking lot.

B:6 – “Event will include entertainment features or interactive games.” Live music will be the main entertainment feature.

B:7 – “The event organizers will arrange and install all required barricades and road signs”
We will install the signage mentioned in B:5 in addition to “SHUTTLE PICK UP” signage at City Hall and “SHUTTLE DROP OFF” signage at the drive through area by the field.

We will also have “NO EVENT PARKING” signs on the sidewalk corners of Paul Wittke, Sunnyvale, and Terrace + Healdsburg Avenue, with HBG PD permission.

SECTION C
C:2 – A tent with a size exceeding 400 square feet, or a combination of multiple tents, regardless of individual sizes, with a combined area surpassing 400 square feet.

There will be a combination of 16 tents. Please see site plan for size and placement.

C:3 – “On-site cooking, deep frying, or devices producing open flames” Docusign Envelope ID: 781F2AC0-E4BE-41BE-9B67-24F89528AD3D Docusign Envelope ID: 5A4899FE-A1B9-45DA-A0D8-256AB8B575F7 Item 6.l
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We will have four licensed food vendors from local restaurants and caterers. They will each carry their own insurance and food-handlers certification. We will likely have three food trucks and two vendors with tents and food prep areas.

We plan to place the food on the edge of the parking lot between the grass and the security fencing to have a secure surface for cooking and for less wear and tear on the lawn.

C:4 – “Compressed gas cylinders (i.e., propane….) will be used.

Our food vendors will use propane for their grills. Each vendor will have their own fire hydrant.

SECTION F

Insurance
We are in process of a policy with the same policy holder as 2023 Ramble with updated specifications.

SECTION G
Permits Required:

Propane Permit
Tent Permit
Facility Use Permit
ABC License
All Permits are in process.

SECTION H
Supplemental Documents:

Private Security – Working on contract
Written Notices to Businesses / Property Owners – See B:1 OTHER

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FIRST AID – We are hiring a contract First Aid company to provide a tent, first aid supplies, and two first aid professionals to administer as necessary. SEE RISK MANAGEMENT PLAN.

FUNDRAISING – Through sponsorships, in-kind donations and tickets sales, we are hoping to raise more than $100K to help fight gun violence. We will take no profit from the event.

GREEN ROOM – We would like to use three rooms in the Community Center for green rooms. Each room will have snacks + water.

SITE PLAN – Attached, and to scale.

PARKING / TRAFFIC PLAN – Please see attached Parking Plan.

POST EVENT SURVEY FROM 2023 - We sent a survey to all the emails associated with ticket sales. 71 people responded.

COMMENTS
Absolutely loved it! hope you make it an annual tradition. We'll come back and bring friends :)
Loved it! Would come again please do it!
Fantastic community, event and music. Exactly what Healdsburg needs more of.

It was such a sweet, fun event! The wine, music, afterparty, vibes, and weather (though not in your control) were fantastic!
I was calling it the 375ml of BottleRock since it was a smaller version. Great to have it in town.

Event was great. Music was spectacular. Loved the different venues and the feel of each one. We had a blast and would attend again.

I live in St. Helena, loved event, please do it next year, SUSTO are my favorite band, Lone Bellow was incredible set, bravo.

I really loved the event. I'm already ready to buy tickets for next year! HOW SATISFIED WERE YOU WITH THE EVENT(S), ON A SCALE OF 1-5? FIVE | 71% (51)
FOUR | 22.5% (16)
THREE | 5.6% (4)
TWO & ONE | Zero
FEEDBACK -- TOP 3 REQUESTS
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Water stations, Shade, More food options
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MAIN
STAGE
36x24
BACKSTAGE
SUB
FLOOR
36x24
100'
100'

VIP TENT
43x34
MERCH
10x20
PORTAPOTTIES
GATE 2
GATE 1 MAIN GATE
10x10
G
AT
E
3 SHADE
20x20
SHADE
20x20
SHADE
20x20
BEV TENT 1
(2) 10x10
FOOD 1 FOOD 2 FOOD 3 FOOD 4 FOOD 5
SOUND
20x20
35'
35' 0"

PARKING AREA

SHUTTLE DROP

MAIN PARKING LOT

GRASS LINE

WHITE CONCRETE LINE

GRASS LINE

WHITE CONCRETE LINE
264'

BAND TENT
30x40
BAR
15x15
FIRST
AID
10x10

VOLUNTEER
10x10
WATER

STATION
10x10

RESTROOM

RESTROOM

MOONLIGHT

TRAILER
BEV TENT 2
(2) 10x10

MOONLIGHT

TRAILER
23'
19'
22'

GRASS LINE
22'
NA
54'
40'
68'
8'
40'
88'
21'
334'
21'
19'
40'
20'
31'
121'
34'
KEY:

Line: Existing Fence
Line: Rented Fence
Line: Grass Line
100'
26'
16'
16' 0"
16'
16' 0"
90'
89' 4"
40'
38' 8"
30'
30' 0"
28'
28' 0"
80'
80' 7 7/16"
48'
48' 0"
20'
20' 0"
20'
20' 0" 20'
20' 0" 20'20' 0" 48'48' 0"
46'
46' 8"
HAND
WASH
STATIONS

MIX GARDEN MATERIALS COMPANY
H
E
A
L
D
S
B
U
R
G
AV
E
.

FOSS CREEK

PATHWAY

FOSS CREEK

PATHWAY

FOSS CREEK

PATHWAY
225'
330'
329' 4"
178'
177' 7 1/8"

HEALDSBURG COMMUNITY CENTER

MAIN FIELD
GATE
GATE
GATE
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BloodRoot Ramble, Parking Plan
Healdsburg Community Center & City Hall
June 8, 2024

CAR CALCULATION
2500 Attendees
500 Healdsburg Residents who can walk, bike, shuttle, be dropped off. 400 people staying in hotels who can walk, bike, shuttle. 100 people who will Uber or take Sonoma County Transit. 1500 attendees who will drive in.

Average 3 people per car: 500 cars estimate // City requesting 800 stalls

PARKING ATTENDANT / MONITOR SHUTTLE STOP / DIRECTION

EVENT VENUE
SOUTH LOT + BLACK TOP
#1 SOUTH LOT — DROP OFF AND UBER/LYFT ONLY
#2 BLACKTOP — USED FOR SHUTTLE DROP, LOAD IN EQUIPMENT, FOOD TRUCK, 10 ACCESSIBLE SPOTS AND STAFF
HAMMER LOT + DIRT LOT
#3 HAMMER & #4 DIRT LOT — PREPAID PARKING FOR 125 (140 CAPACITY) AT $60 1 2
4 3
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SHUTTLES & DESIGNATED PARKING
We will have rented three 56 passenger shuttles that will run continuously. One will run from City Hall to Venue continuously throughout the duration of the event. The other will run from Healdsburg High School to Venue continuously throughout the duration of the event. The third shuttle will run from Fitch Mountain Middle School to Venue continuously throughout the duration of the event. All of these lots are withing 3-5 minutes of the Venue.

CITY HALL PARKING LOT (BLUE) – 100 spots – Two Attendants HEALDSBURG HIGH SCHOOL (RED) PARKING LOT – 250 spots – Three Attendants FITCH MOUNTAIN SCHOOL PARKING LOT (GREEN) – 70 spots – Two Attendants DIRT AND HAMMER LOT AT VENUE (PREMIUM PAID) – 125 spots – Five Attendants TOTAL SECURED = 545
*We have other lots under negotiation to add. See below.

Attendees will pre-buy a $10 Shuttle Ticket as an add on to their ticket. One week prior to the event, Shuttle Ticket holders will be divided into color groups, and will be emailed arrival instructions. We will also put the lot information on our website for attendees to reference.

Walk-ons are welcome to the City Hall shuttle if they are coming from a downtown hotel.

The yellow dots indicate parking attendant staff. We are hiring CPA Valet to provide professional services. These folks will monitor shuttle stops, ins and outs, and directing cars to open spots. We have 15 people in total. They will have vest and batons and walkie talkies.

BLUE LOT // CITY HALL (Old screen shot, additional parking to right) 100 Designated Spots + Shuttle Stop
Also Foot Traffic from Downtown Residents and Hotels
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RED LOT // HEALDSBURG HIGH SCHOOL
250 Designated Spots + Shuttle Stop

GREEN LOT // FITCH MOUNTAIN SCHOOL
70 Designated Spots + Shuttle Stop

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OTHER LOTS UNDER CONSIDERATION:

HEALDSBURG COMMUNITY CHURCH, 1100 University Ave, 90 Spots THE HEALDSBURG SCHOOL / MAXX PROPERTIES LOT, 33 Healdsburg Ave, 110 spots

BIKE PROGRAM
We have partnered with the Sonoma County Bicycle Coalition to donate 20 bike racks to park 200 bikes. Coalition volunteers would hand these out.

COMMUNICATIONS
In all of our emails, confirmations, receipts and on our website we will lay out a clear communication plan to encourage walking, biking, carpooling, Sonoma County Transit. We will make mention of distance from downtown and hotels, and encourage use of the Foss Creek Bike Path.

If anyone comes to park at the Venue without a paid ticket, we will direct them back downtown to take the shuttle.

Here are drafts of our communications:
1) ON WEBSITE:
“A very limited amount of parking passes at the venue are available to purchase (including 10 accessible spots). Absolutely no neighborhood parking allowed.

Offsite parking and shuttle passes are also offered. This is a convenient way to have a guaranteed parking spot, with a short three-minute ride to the front gate. Shuttles will run continuously throughout the duration of the event. Location details will be released the week prior to the event.

Event is an easy walk or ride on the Foss Creek Bike Path. Bike racks will be available. ½ mile from Hotel Trio & Dry Creek Inn OR 1 ½ mile from the Healdsburg Plaza.

Stay tuned for more details on transportation options.” 2) EMAIL 30 DAYS OUT TO ALL ATTENDEES WITHOUT A PARKING OR SHUTTLE PASS:

Subject: Parking Options at The Ramble
“Hello! We are one month out from The Ramble! To ensure things run smoothly and the experience is great for both our attendees and our neighbors, please review your options if you are arriving by car.

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OPTION ONE (IF STILL AVAILABLE) – ONSITE EVENT PARKING (hyperlink to site) - A very limited amount of parking passes at the venue are available to purchase (including 10 accessible spots).

OPTION TWO – OFFSITE PARKING & QUICK SHUTTLE (hyperlink to site) - Offsite parking and shuttle passes are also offered. This is a convenient way to have a guaranteed parking spot, with a short three-minute ride to the front gate. Shuttles will run continuously throughout the duration of the event. Location details will be released the week prior to the event.

OPTION THREE – USE YOUR LEGS – The event is an easy walk or ride on the Foss Creek Bike Path. Bike racks will be available. The Healdsburg Community Center is ½ mile from Hotel Trio & Dry Creek Inn OR 1 ½ mile from the Healdsburg Plaza.
*Reminder - No neighborhood parking allowed!*
Please reach out with any questions by replying to this email.” 3) WEBSITE UPDATE 30 DAYS OUT
Maps and color coding of lots will be posted online with arrival instructions:
“Please see below for parking assignment locations:

All lots will be attended and monitored. Please be ready to show your pass to the attendant.

Check your inbox for your assignment and arrival instruction, and email [email protected] if you have any questions.

PREMIER ONSITE PARKING
BLUE LOT PARKING – 5 Minute Shuttle
RED LOT PARKING – 3 Minute Shuttle
GREEN LOT PARKING – 3 Minute Shuttle
Reminder – ABSOLUTELY NO NEIGHBORHOOD PARKING ALLOWED”
4) EMAIL PARKING ASSIGNMENT COMMUNICATIONS
“We are excited to Ramble with you! Please see below for parking instruction PREMIER ONSITE PARKING – Please arrive at the entrance of the lot from the Grove Street entrance (we will show a graphic example). Be ready to show your pass at the entrance and you will be guided to your spot.

SHUTTLES – You have been assigned the (insert color) lot at (insert address). Please arrive at the entrance (we will show a graphic example) and be ready to show your pass at the entrance. Shuttles will be running continuously during the duration of the event.

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Email [email protected] if you have any questions.” 5) ONE WEEK OUT – Same email as 30 day out, but as a second reminder.

LED SIGNS
We will also have rented TWO LED ROAD SIGNS that will be in place from Tuesday, June 4 – Sunday, June 9.

SIGN ONE will face SOUTHBOUND traffic on Healdsburg Avenue at the northwest corner of Grove and Healdsburg Avenue.

SIGN TWO will face NORTHBOUND traffic on Healdsburg Avenue at the northeast corner of Sunnyvale and Healdsburg Avenue. See dots exactly where signs will go. Signs will not block sidewalk, parking, or bike path. Signage text below:
“BE AWARE OF EVENT TRAFFIC FROM SAT 6/8 12P-8P
DRIVE SLOWLY”
“NO NEIGHBORHOOD PARKING” SIGNS
We will also have “NO EVENT PARKING” signs on the sidewalk corners of Paul Wittke, Sunnyvale, and Terrace + Healdsburg Avenue, with HBG PD permission.

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BloodRoot Wines
Kelly & Noah Dorrance
Healdsburg, CA 95448
March 7, 2024
Dear Neighbors,
We are writing to inform you about an upcoming special event that is anticipated to take place in our vicinity. In fact, our family lives nearby on Lorraine Court. We are excited to host the 2 nd annual BloodRoot Ramble at the
Healdsburg Community Center Field and we want to ensure that you are aware of the details.

Event Name: BloodRoot Ramble
Date: Saturday, June 8, 2024
Time: 12PM-8PM
Event Details: This is a ticketed concert with live music and food and drink vendors with all proceeds in support of gun violence prevention. We lost our niece in the Nashville Covenant School shooting in March 2023, and with the help of the artists performing, we’re hoping to raise more than $100K for the cause.

To Note: There will be amplified music during sound-checks starting around 9:30AM, and will continue off and on throughout the event. There is a maximum attendance of 2,500 for this ticket event, so there will also be increased foot, car, bike and shuttle traffic. Most attendees will arrive via shuttles from designated offsite parking lots. We will also have LED and posted signage discouraging special event parking in the neighborhood. Music will have a hard stop at 8PM.

This event is not sponsored by the City of Healdsburg. As part of our commitment to maintaining open communication with the Healdsburg community, we are notifying all businesses, residents, and property owners in the area of this event. We understand the importance of being considerate of our neighbors, and we aim to minimize any inconveniences that may arise. Please know that the sidewalk and entrance to your property remain open and unobstructed throughout the duration of the event. If you have any issues during the event, please call 707-387-7058.

If you have any questions, concerns, or require additional information about the event, please feel free to contact us via email or phone below. City Council will be considering our special event permit application at their next meeting, 6PM, Monday, March 18 at Healdsburg City Hall, 401 Grove Street should you want to attend, learn more, and offer any public comment. You can download the meeting information from the Coty’s website at https://healdsburg.gov/543/Agendas-Minutes typically beginning Wednesday evening the week prior the he meeting.

We value your input and appreciate your understanding as we work together to create a successful and enjoyable event for the community. Thank you for your cooperation, and we look forward to your continued support.

Sincerely,
Kelly & Noah
707-387-7058
[email protected]
www.bloodrootramble.com
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City of Healdsburg
401 Grove Street
Healdsburg, California 95448
(707) 431-3128
[email protected]
Date Issued: Monday, March 18, 2024
Special Event Permit Conditions
Event: The BloodRoot Ramble 2024 Date Range: Friday, June 7, 2024, at 8:00 a.m. through Sunday, June 9, 2024, at Noon
Location: Healdsburg Community Center Set-up: Friday, June 7, 2024, at 8:00 a.m. to Saturday, June 8, 2024, at Noon
Applicant: Reeve Wines Event: Saturday, June 8, 2024, from Noon to 8:00 p.m.

Contact: Kelly Dorrance Clean-up: Saturday, June 8, 2024, from 8:00 p.m. to Sunday, June 9, 2024, at Noon
A – PERMITTED SPACES
Location Start Time End Time Notes
Healdsburg Community
Center Field
Friday, June 7th at
8:00 a.m.

Sunday, June 9th at
Noon
• Fencing to restrict public access
of the field may only occur
Friday, June 7, 2024, at 8:00 a.m.
through Sunday, June 9, 2024, at
12:00 p.m.
• Foss Creek Pathway must remain
open and unobstructed for public
use at all times.

Healdsburg Community
Center: Blacktop, South Lot,
Hammer Lot, and Dirt Lot
Saturday, June 8th at
8:00 a.m.

Saturday, June 8th
at 8:00 p.m.
• Sidewalks and pedestrian
walkways need to remain
unobstructed.
• No parking or staging equipment
in emergency zones.

City Hall Parking Lot Saturday, June 8th at
11:30 a.m.

Saturday, June 8th
at 9:00 p.m.
• Sidewalks and pedestrian
walkways need to remain
unobstructed.
• No parking or staging equipment
in emergency zones.

Private property owner written approval is required for all parking / shuttling locations that occur on private property by May 25, 2024.

B - HEALDSBURG CITY COUNCIL – APPROVALS

1. Consumption of alcohol in a public park for The BloodRoot Ramble:
• Healdsburg Community Center Field
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• Saturday, June 8, 2024, Noon to 8:00 p.m.

2. Restrict access to a public park for The BloodRoot Ramble:
• Healdsburg Community Center Field
• Friday, June 7, 2024, at Noon through Sunday, June 9, 2024 at Noon

3. Host a major special event with more than 2,500 attendees in a City venue outside the Downtown Core on the same day that a major event is scheduled at a Downtown Core venue. • The BloodRoot Ramble
• Saturday, June 8, 2024, Noon to 8:00 p.m.

C – SPECIAL EVENT CONDITIONS OF APPROVAL

1. Deposit
• Reeve Wines shall make an initial deposit of $5,000 per the 2024 Cost Recovery Deposit Agreement. • The City will account for costs the City incurs for all planning, setup, event delivery, and takedown/cleanup including but not limited to City staff time, use of City equipment, and other internal and external costs. All City costs shall be the responsibility of Reeve Wines and will be reimbursed by means of a deposit account.
• When the deposit balance reaches $1,250.00, Reeve Wines shall be required to replenish the deposit amount to the original $5,000.00.
• All or part of the deposit may be used to cover City expenses associated with the event including, but not limited to:
o City staff time associated with planning, setup, event deliver, takedown, and event follow-up. o Non-compliance to the permit parameters.
o Violation of any special event condition, policy, or ordinance. o Damage to City property not considered normal wear and tear. o Event cleanup.

2. Fees
• This event is considered a Major Special Event under the City of Healdsburg Policy for Special Events and City Partnerships. The special event permit application processing fee is due on May 15, 2024. • Reeve Wines is responsible for all associated event costs as approved by City Council in the most current version of the of City of Healdsburg Master Fee Schedule. • For services requested of City staff for which no fee is listed in this Master Fee Schedule, the Director of the department whose services are requested shall determine the appropriate fee, based on approved hourly rates for staff time involved in the service or activity.

3. Insurance, Indemnification, and Waivers
The applicant is required to provide the following:

A. A Certificate of Liability Insurance with Endorsement meeting the City’s minimum requirements by May 15, 2024 (Chapter 12.24 Special Events, Healdsburg Municipal Code). As a condition of use of City of Healdsburg facilities or City programs, your organization must provide, at your sole expense, each of the following items as indicated:
o Proof of insurance comprised of certificate of Insurance and original Policy Endorsement of comprehensive general liability insurance written by one or more responsible insurance companies licensed to do business in California. This coverage must:

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 This insurance is primary with respect to the additional insured named above. Any other insurance available to The City of Healdsburg, its officers, officials, caretakers, employees and volunteers shall be excess and noncontributing.”  Name the City of Healdsburg, its officers, officials, caretakers, employees and volunteers as additional insured by endorsement against liability for injury to persons, damages to property and for the death of a person or persons arising or resulting from any act or omission on the part of your organization, its agents or employees.  Include liability coverage for claims made by participants in your event/program. You are advised that any and all exclusions pertaining to athletic or recreational event/programs must be disclosed in the endorsement and failure to do so will not necessarily insulate your organization form individual liability for claims made as a result of the use of the facilities and your even/program.  Be PRIMARY insurance with respect to the additional insured named above. Any other insurance available to The City of Healdsburg, its officers, officials, caretakers, employees and volunteers be excess and noncontributing.  The comprehensive general liability insurance policy limits of such insurance shall not be less than $2,000,000 per occurrence for bodily injury, personal injury and property damage. a. Any deductible or self-insured retention must be identified and approved by the City. In the event the deductible is deemed to be too great, the City may require you to have your insurer eliminate the deductible or reduce it.  Include proof of Workers’ Comp Insurance as required by the State of California and Employer’s Liability Insurance.
 Include a Liquor Liability endorsement.
o You must satisfy these requirements by furnishing the City with certificates of insurance and endorsements affecting the required coverage. The certificate and endorsements are to be on ISO-approved forms. The City will not accept a Certificate of Insurance alone as proof of insurance coverage. The City will not accept the wording listed in the box below in the Description of Operations box on the Certificate.

4. Event Layout and Installation
• Reeve Wines shall provide a preliminary event layout on April 15, 2024 for City review. The City shall provide comments and required changes for the preliminary event layout to Reeve Wines. • Reeve Wines shall provide a final event layout to the City on May 15, 2024 for final City approval. No changes to the event layout shall be made without written consent of the City. • All equipment such as tents and stages must be installed so as not to damage parking surfaces, walkways, lighting, trees or landscaping, or other City infrastructure. No drilling into pavement or ground is permitted, and nothing can be attached to City property such as light poles or signs. • A 6’ clearance must be provided at all times to any public utility box, panel, or fixture. • Special event shall not exclude the public from the general use of the Foss Creek Pathways, public sidewalks, and Healdsburg Community Center campus.

5. Trash, Recycling, and Composting
• Reeve Wines shall use as much reusable and compostable materials as possible to move towards a zero-waste event.
• City facilities, and any person renting a City facility, shall not provide prepared food in disposable food service ware that contains polystyrene foam or PFAS (HMC 8.10.030).

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• Reeve Wines shall be required to meet or exceed all current waste and conservation requirements that are in place by the State, County and/or City at the time of the event, and must conform to all applicable municipal and county codes and regulations, including serving products and food waste. • Reeve Wines shall submit a waste management plan for City review no later than May 15, 2024. • All trash, recycling, and compost units shall be removed on or before 11:00 a.m. on June 10, 2024.

6. No Parking Signage (City Hall and Healdsburg Community Center Campus Parking Lots) • Reeve Wines shall:
o No-Parking Signage – Post “No-Parking / Tow Away” a-frame signage:
 City Hall Parking Lot subject to the closure a minimum of 24 hours prior to event.  Reeve Wines shall coordinate signs from Community Services by May 25, 2024.  If desired, Reeve Wines may rent barricades from Community Services by confirming quantities needed by May 25, 2024.
o Public Noticing – Notify all business and residences within a 1,500’ radius of the Healdsburg Community Center by May 25, 2024 and include the following information:
 Event details (name, date, time, etc.)
 Hours of amplified noise
 Contact number that can be called to voice any concerns/issues during the event.

7. Safety & Risk Management
• Reeve Wines shall submit and follow a Risk Management Plan that includes mitigation measures for combating potential risks and hazards. A Preliminary Risk Management Plan is due on April 15, 2024 with a Final Risk Management Plan due on May 25, 2024. The plan must include (but is not limited to):

A. Identifying and prioritizing risks associated with the event and assigning mitigation measures.

B. A medical response plan including but not limited to the staging of medical personnel throughout the duration of the event and medical incident response protocols.

C. Location of designated emergency vehicle parking.
• Reeve Wines is required to follow all orders, regulations, ordinances, and guidelines of the California Department of Public Health (CDPH), the Sonoma County Health Officer, and the City of Healdsburg in effect at the time of the event.
• Pedestrian emergency exits must be provided at separate and clearly signed egress points at the event site and capable of opening a minimum of 14’ wide unobstructed. These emergency exit points should be clearly labeled on the event layout/map and included in the Permitter Control Plan due on April 15, 2024.

8. Parking & Traffic
• Reeve Wines shall prepare and submit a Finalized Parking Control Plan for City review on May 1, 2024. The plan must include (but is not limited to):
o Confirmed location of 800 parking stalls for event participants; not including on-site parking for event staff, vendors, and trailers.
o Specific shuttle pick-up locations with corresponding parking capacity. o Specific shuttle drop-off location (must avoid crossing of streets by pedestrians). o Methods used to encourage and promote accessibility of shuttle service locations outside of the downtown core and encourage alternative modes of transportation other than personal vehicles. o On-site ADA accessible Parking.

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o Exact placement of LED signage that shall be placed on Healdsburg Ave. (northbound and southbound facing) between June 2–8, 2024; and include specific text. o Professional staff should be employed to monitor parking lots and for traffic control in and out of the venue parking.
o Parking operations shall not create back-up onto public streets. o “No Event Parking” signs may be placed on the surrounding streets as indicated in the permit application, but would not be enforceable.
o Event attendees parking in the Healdsburg Community Center Dirt Lot must be directed to enter from Grove St. heading NE toward Healdsburg Ave.; and exit NE toward Healdsburg Ave.

9. Event Planning Updates
• Reeve Wines shall meet with the City’s Facilities and Events Supervisor (and other City staff as needed) as specified below. Reeve Wines shall work with the Facilities and Events Supervisor to schedule these meetings.
o April 2023
o May 13-16, 2024 (On-site: Pre-Event Walkthrough)
o June 10, 2024 (On-Site: Post-Event Walkthrough)
• Reeve Wines must respond to requests from the Special Event Permit Committee to provide a status update at any time.

10. Restrictions & Violations
• Live and/or recorded amplified sound or excessive noise is prohibited during daytime hours: before 7:00 a.m. and after 8:00 p.m.
• Any violation of any special event permit requirements shall be noted, and the event may be subject to sanctions by the City in subsequent applications, up to and including denial of future use. • City reserves the to terminate all or part of this permit immediately without notice if the Reeve Wines does not adhere to all city requirements or if the facility is damaged or destroyed. • Filming activities for the purpose of motion picture, commercial, or videotaping on or of City property for commercial purposes is prohibited without a City of Healdsburg Film Permit. A film permit can be obtained by contacting Facilities and Events Supervisor, Matt Milde at (707) 431-3128 or [email protected].
• Discharge of weapons, explosives, firearms, or pyrotechnics is prohibited.

11. Other Conditions
• Reeve Wines shall assure that all participants selling goods and services adhere to local requirements. • Reeve Wines shall be responsible for the cost of all damage to City venues resulting from the event and shall be responsible for any repairs, litter removal, trash collection or other clean up caused by the event. All or part of the damage deposit may be applied to costs. • No food trucks, carts, or trailers, portable BBQ’s, etc. shall be driven or parked on City-owned sidewalks or lawns.
• All portable toilets and handwash stations are limited to hard surface / non-turfed areas. • No digging or cutting of any shrubs, vegetation, and/or trees. • Glass beverage containers are prohibited in City parks (Ord. 967 § 1,2000. Code 1964 § 14A-38.) • No spray paint or /chalk/spray-on chalk used on roads, parkinareas, grass, sidewalks, etc. • The onsite event organizer shall retain a copy of the special event permit and keep on location. (Ord. 819/1, 1987. Code 1964/16-A-10)
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• The City must approve, in writing, any modifications to the event after the event permit has been issued.
• Special event set-up & break-down activities are permitted during day-use hours only, from 7:00 a.m. to 10:00 p.m.
• A Facility Use Permit for the Healdsburg Community Center must be obtained by May 15, 2024. o Please note that no alcohol is allowed in the Healdsburg Community Center without City Council approval.
• Post-Event Report submitted to permit review team 60-days after the event that includes the following:
o Data on Parking Lot capacities during the event
o Log of neighborhood calls received with issues/concerns addressed o Final attendance number
o Summary of notable incidents
D – HEALDSBURG POLICE DEPARTMENT CONDITIONS OF APPROVAL

1. All state laws, city ordinances and parking regulations are subject to enforcement.

2. Amplified Sound
• Must be kept at a reasonable level and not violate Healdsburg Municipal Code at any time during the event, including setup and takedown.

3. Private Security
• Reeve Wines must provide for private security as outlined on page 9 of the special event application.

The required number of security guards is subject to any changes to the layout or scope of event. (a copy of the security contract must be provided by May 1, 2024).

4. Alcohol
• Alcohol sales must be in conjunction with a valid ABC license and a city council waiver must be obtained.
• Persons purchasing or being served alcohol must be 21 or older. Valid identification must be shown.

Must have hand stamped or be issued a wristband. No alcohol to be sold or served to intoxicated persons.
• All alcohol sales and service to stop at 7:45 p.m.
• Submit copy of ABC License by May 25, 2024.

5. Perimeter Control
• Perimeter of event area must be fenced and posted with signs indicating no alcohol outside of event area. Fencing shall be of a type that prevents people from entering or exiting, except at designed spaces. Event organizer must provide the police department with fencing specifications no later than April 15, 2024.
• Event staff shall be stationed at gates to prevent persons from leaving event area with open alcohol.

Persons with alcohol outside of event area will be subject to citation. (HMC 9.12.170).

6. Police Staffing
• This event has the potential to bring a significant increase in people to the City of Healdsburg. Given the increase in people and traffic, the police department reserves the right to require two (2) officers tentative to work the event and two (2) more to upstaff patrol depending on staffing availability. This Docusign Envelope ID: 781F2AC0-E4BE-41BE-9B67-24F89528AD3D Docusign Envelope ID: 5A4899FE-A1B9-45DA-A0D8-256AB8B575F7 Item 6.l
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is a large-scale event and will likely impact the areas surrounding activities both at the venue and downtown drop off areas.
• Event organizers shall provide current and anticipated attendance numbers on April 15, 2024, May 15, 2024; and June 5, 2024. A determination will be made at that time as to the number of officers and the duration they will be required. The cost will be billed to the event at the rate indicated on the approved master fee schedule at that time.

E – HEALDSBURG FIRE DEPARTMENT CONDITIONS OF APPROVAL

1. Cooking Booth and Food Truck Requirements
• Food vendors must comply with the cooking both requirements as listed in the attached inspection form and drawing. Vendors will be inspected prior to the event. • Barbeques and cooking apparatus must be located 10 ft. away from any combustible materials including tents and canopies.
• Fire extinguishers are required at all cooking booths. • Grills and deep fat fryers that give off grease laden vapors are required to be at least 18 inches to the exterior of the booth.
• Propane is to be stored outside of the membrane.
• Food trucks shall have the Ansul system tagged as inspected and certified within 6 months of the date of the event.
• Limited Use Propane Permit is required by May 15, 2024.

2. Tents
• Tents over 400 sq. ft. will require a tent permit and will require inspection from Healdsburg Fire Department. The permit will provide the tent owner/operator of the above listed requirements. The tent permit application can be found online at www.healdsburg.gov under Fire Department. • No open flame will be allowed under the tent structure. Tents shall be subject to the Parking, Cooking, No Smoking, and other requirements as identified in T-19 CCR, CFC 3203. • If 50-gallon poly drums are used to secure tents, the drums must be clean of chemicals or debris prior to filling.
• Tent permit applications shall be submitted May 1, 2024.

3. Inspection
• Contact the Healdsburg Fire Department Fire Marshal prior to the event for inspections of the tents and vendor booths at (707) 431-3125. A 48-hour inspection notice must be given.

4. Review and Approval
• Final Special Event Layout and permit materials must be approved by the Healdsburg Fire Department.

F – CONDITION DEADLINES
March 2024 City Council Review and Approval
Review and Signing of Special Event Permit and Special Event Agreements Initial Event deposit due
April 2024 Status Update Check-in Meeting
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April 15, 2024 Provide preliminary Special Event Layout Provide preliminary Risk Management Plan
Provide preliminary attendance numbers
May 1, 2024 Finalized Parking Control Plan due
Provide copy of security contract
Submit Tent Permit Application
May 13-16, 2024 On-site: Pre-Event Walkthrough
May 15, 2024 Special event permit application processing fee is due Provide Certificate of Liability Insurance with Endorsements Finalized Special Event Layout Due
Submit a Waste Management Plan
Permitter Control Plan due
Provide current attendance numbers
Limited Use Propane Permit
Facility Use Permit for Healdsburg Community Center
May 25, 2024 Confirm “No Parking” signs and barricade quantities and schedule a signage/barricade pick-up date with Community Services
Public notification deadline: 1,500’ radius of Healdsburg Community Center Final Risk Management Plan due
Provide copy of ABC license for alcohol sales
Private property owner written approvals due
June 2-8, 2024 LED signage placed on Healdsburg Ave. (northbound and southbound facing) June 5, 2024 Provide final attendance numbers
June 7, 2024 “No Parking” signage in place in Parking Lots (24-hours in advance) June 10, 2024 On-Site: Post-Event Walkthrough
All trash, recycling, and compost units removed by 11:00 a.m.

July 8, 2024 Submit Post-event report
All required materials outlined in the above conditions are due by the assigned date to Recreation Supervisor, Matt Milde (707-431-3128 / [email protected]).

We hope that your special event is a success.

If you have any questions related to the attached conditions, please contact Recreation Supervisor, Matt Milde at (707) 431-3128.

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CITY OF HEALDSBURG
RESOLUTION NO. 127-2024

A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF

HEALDSBURG APPROVING A THREE-YEAR SPECIAL

EVENT AGREEMENT AND A THREE-YEAR COST

RECOVERY DEPOSIT AGREEMENT WITH REEVE WINES

FOR THE BLOODROOT RAMBLE ON THE HEALDSBURG

COMMUNITY CENTER CAMPUS AND AUTHORIZING THE

CITY MANAGER TO EXECUTE THE AGREEMENTS
WHEREAS, Reeve Wines (“Organizer”) held two privately ticketed concert events “Banshee Fest” in 2016 and “The BloodRoot Ramble” in 2023 in West Plaza Park located in the City of Healdsburg (“City”) with attendance between 500-600 people; and WHEREAS, the Organizer held one privately ticketed concert event “The BloodRoot Ramble” in 2024 at the Healdsburg Community Center campus with a sold-out attendance of 2,500 people and raised more than $200,000.00 to fight gun violence; and WHEREAS, to facilitate the Event and related activities, certain waivers from the Healdsburg Municipal Code and Policy for Special Events and City Partnerships are necessary; and
WHEREAS, Organizer has also agreed to financially contribute to Healdsburg Community Center improvements, which aims to address financial considerations, support future improvements, and streamline the Event's financial management; and WHEREAS, Healdsburg Municipal Code Section 12.24, Special Events, requires the Organizer of any event with an anticipated attendance over 1,000 to, in addition to submitting an application for a Special Event Permit (“Permit”) to the Community Services Department, to enter into a Cost Recovery Deposit Agreement and a Special Event Agreement with the City. Both agreements are subject to City Council review and approval; and WHEREAS, in addition to the terms and conditions of the Special Event Agreement and any conditions of approval on the Permit, Organizer will adhere to all directives, regulations, ordinances, and guidelines issued by the California Department of Public Health, the Sonoma County Health Officer, and the City of Healdsburg, including those related to environmental stewardship; and
WHEREAS, the Organizer must successfully be issued a Special Event Permit from the City, execute a Cost Recovery Deposit Agreement, and provide a deposit pursuant to that Cost Recovery Agreement for the Event to occur and for the Special Event Agreement to be operative; and
WHEREAS, the City now desires to enter into a three-year year Special Event Agreement (“Agreement”) and a three-year Cost Recovery Deposit Agreement with Organizer to conditionally approve the Event as well as the requested waivers and establish cost recovery parameters.

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FEE AGREEMENT AND SPECIAL EVENT CONDITIONAL APPROVAL
FOR THE BLOODROOT RAMBLE 2025-2027
This Agreement and Special Event Conditional Approval ("Agreement") is made and entered into this __ day of ________ 2024 (“Effective Date”), between the City of Healdsburg, a California municipal corporation ("City"), and Reeve Wines ("Organizer"). City and Organizer may be each referred to as “Party” or collectively as the "Parties."

RECITALS
A. City is the owner of certain parcels of real property known as the "Healdsburg Community Center" located at 1557 Healdsburg Ave., in the City of Healdsburg, County of Sonoma, State of California, and “City Hall Parking Lot” located at 401 Grove St., in the City of Healdsburg, County of Sonoma, State of California, collectively known as "Properties".

B. Organizer has previously applied for a special event permit to utilize the Properties to conduct The BloodRoot Ramble (“Event”). The details of the Event are memorialized in Organizer’s 2024 Special Event Permit (“2024 Permit”) issued to Organizer, attached as Exhibit B and incorporated by reference herein.

C. The Event is a significant and commercially-oriented gathering of substantial proportions, attracting an estimated 2,500 ticketed attendees. The successful execution of the Event requires the allocation and utilization of significant City resources including public spaces, infrastructure, and a comprehensive security and safety assessment, all dedicated to ensuring the health and safety of the general public, including event participants.

D. The City acknowledges the Event's positive impact on the local community, tourism, and the economy, while also recognizing the imperative of responsibly and sustainably managing City resources.

E. Organizer desires to obtain and City desires to grant conditional approval for the Event on the dates requested for calendar years 2025, 2026 and 2027, including granting the requested waiver of the provisions of the Healdsburg Municipal Code and Policy for Special Events and City Partnerships.

F. Organizer anticipates and represents that the Event will be held in substantially similar form as described in the 2024 Permit throughout the three year term of this Agreement.

NOW THEREFORE, in consideration of the mutual covenants and conditions contained herein, the Parties agree as follows:

1. Conditional Event Approval. The City hereby grants conditional approval for the Event, subject to the conditions and terms contained herein, and subject to any Conditions of Approval on any special event permit issued by the Community Services Director or their designee to the Organizer for the Event, to be held in substantially similar form as described in the 2024 Permit. If the Community Services Director determines that the application for the Event materially differs such that it requires additional City resources or would impose a materially different burden Resolution No. 127-2024
Exhibit A
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on the City as compared to the 2024 Permit, the City may deny the application pursuant to the provisions of Healdsburg Municipal Code Chapter 12.24. The City Council hereby waives the following provisions, as requested by the Organizer, and as described below:
i. HMC 12.28.2020(A), restricting consumption of alcohol in any public park, thereby authorizing consumption of alcohol on the Healdsburg Community Center Field during the dates and times indicated in the special event permit issued by the Community Services Director or their designee.
ii. Special Event Policy (Resolution 150-2023) 3.2.2, which prohibits special events from excluding the public from the general use of any City park or public property on the Healdsburg Community Center Field, annually on the Friday before the Event at 8:00 a.m. through the following Sunday at 12:00 p.m. to facilitate a privately ticketed event, protect event equipment overnight, and ensure public safety during logistical event set-up and clean-up operations. iii. Special Event Policy (Resolution 150-2023) 4.2, which prohibits a special event with more than 2,500 attendees from being scheduled in a City venue outside the Downtown Core on the same day that a major event (Saturday Farmers’ Market) is scheduled at a Downtown Core venue.

2. Fees. Organizer agrees to pay City all applicable special event permitting fees based on the Master Fee Schedule in effect at time of payment along with fees memorialized in the Cost Recovery Deposit Agreement, attached hereto as Exhibit A and incorporated by reference. A schedule of permit fee deadlines shall be included in the Conditions of Approval attached to the special event permit issued by the Community Services Director or their designee.

In addition, the Organizer agrees to pay the City a $2,500 non-refundable Healdsburg Community Center campus improvement fee, which shall be due on or before January 1 of each calendar year preceding the Event.

For services requested of City staff for which no fee is listed in this Master Fee Schedule, the Director of the department whose services are requested shall determine the appropriate fee, based on approved hourly rates for staff time involved in the service or activity.

3. Cost Recovery Deposit Agreement. Prior to and as a condition to the issuance of the Special Event Permit, Organizer agrees to execute a Cost Recovery Deposit Agreement provided by the City. Organizer is responsible for all costs related to the Event, including Event security, damage, and City staff and consultant costs, including overtime costs. Prior to or at the time of execution of the Cost Recovery Deposit Agreement and thereafter in accordance with the terms of the Cost Recovery Deposit Agreement, Organizer will pay to the City a deposit of $10,000, to be applied to costs subject to the Cost Recovery Deposit Agreement.

4. Event Period. The Event shall be held once per year for a period of three (3) calendar days during the first weekend in June commencing from Friday at 8:00 a.m. and extending through Sunday at 12:00 p.m. (“Event Period”), with ticketed Event occurring on Saturday from 12:00 p.m. – 8:00 p.m every year beginning in 2025 through 2027. Including setup and tear-down, the proposed dates are as follows:

Resolution No. 127-2024
Exhibit A
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• Friday, June 6, 2025 to Sunday, June 8, 2025
• Friday, June 5, 2026 to Sunday, June 7, 2026
• Friday, June 4, 2027 to Sunday, June 6, 2027

5. Special Event Permit Required. Organizer shall submit a special event permit application annually to the City no later than 90 days before the Event, and shall comply with the terms and conditions set forth in the approved special event permit. Additionally, as a condition for issuance of a special event permit, Permittee shall obtain and/or provide the following documents annually to the satisfaction of the City Manager:
i. Special Event Permit Application
ii. Event Layout (Preliminary & Final)
iii. Insurance with Endorsement
iv. Workers Compensation Declaration
v. Risk Management Plan
vi. Parking Plan
vii. Private Security Contract
viii. Waste Management / Zero Waste Plan
ix. Perimeter Control Plan
x. Tent Permit
xi. ABC License
xii. Supplemental Documents as required
xiii. Post-Event Report (due 60 days after event)

6. Meetings and Updates. Organizer is required to attend all meetings as required by City staff to coordinate the Event. Organizermay also request meetings with City staff and City will undertake to reasonably accommodate Organizer’s request(s). Organizer agrees to respond to requests from the City to provide a status update within 48 hours of receipt.

7. Effective Date, Term. This Agreement shall be effective as of the date indicated above and shall have a term of three (3) years.

8. Severability. If any provision of this Agreement shall be held or made invalid by a court decision, statute or rule, or shall be otherwise rendered invalid, the remainder of this Agreement shall not be affected thereby.

9. Choice of Law. This Agreement shall be governed and construed in accordance with the laws of the State of California and any lawsuit or action relating in any way to this Agreement must be filed in Sonoma County, California.

IN WITNESS WHEREOF, the parties have executed this Agreement as of the date first above written.

CITY OF HEALDSBURG:

By: _____________________________ Date: _________________ Resolution No. 127-2024
Exhibit A
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Jeff Kay
City Manager
ATTEST:

By: _____________________________ Date: _________________ Raina Allan
City Clerk
APPROVED AS TO FORM:

By: _____________________________ Date: _________________ Samantha W. Zutler
City Attorney
REEVE WINES:

By: _____________________________
________________________________
Its: _____________________________
Date: _________________
Resolution No. 127-2024
Exhibit A
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EXHIBIT “A”
Cost Recovery Deposit Agreement
Reeve Wines – 2025-27 BloodRoot Rambles

1. Scope of Agreement: This Agreement is between the City of Healdsburg (“City”) and Reeve Wines (“Organizer”) regarding Organizer’s payment of City costs for services provided by City to Organizer related to the Event (as defined in Section 2). City and Organizer are sometimes referred to herein as a “Party” or “Parties”.

2. Event Description: The BloodRoot Ramble was held on June 8, 2024, and is proposed to continue annual basis (“Event”) for three years, through 2027. The Event takes place in the City at the Healdsburg Community Center campus with off-site shuttle service throughout the City from designated parking lots. The Organizer intends the Event to include live performances by several musical bands or artists of national notoriety, alcohol booths, food booths/trucks, event staging, VIP viewing area, merchandise booth, and shuttle servicing to and from the Event. The Event venue within the Healdsburg Community Center campus will be enclosed by fencing and accessible exclusively to ticketed attendees, with a maximum of 2,500 tickets sold. The Event will be held on one day in the month of June.

3. Effective Date and Term of this Agreement:

This Agreement shall take effect upon approval by the City Council ("Effective Date") and shall have a term of one (1) year from the Effective Date (“Term”). This agreement shall automatically renew for two successive one (1) year periods unless the Event no longer takes place or if either Party delivers a notice of non-renewal in writing to the other Party no later than thirty (30) days prior to the end of the current one (1) year Term. Notices shall be provided as set forth in Section 6. This Agreement expires upon payment to City of all costs pursuant to this Agreement arising from Organizer’s 2027 Event.

4. Special Event Permit: Organizer shall be required to obtain a Special Event Permit (the “Permit”) annually in accordance with the City's Policy for Special Events and City Partnership. Organizer shall comply with the terms and conditions set forth in the approved Permit. The Organizer shall not be entitled to hold the Event or utilize City property for the Event unless Organizer obtains a Permit.

5. Organizer Payment of City Costs: In addition to any costs the Organizer is required to pay under the Permit, Organizer agrees to pay City for the cost of City staff and City consultants in connection with Event planning and implementation leading up to Event (“City Costs”) for each year the Event takes place during the Term of this Agreement. Upon the Effective Date, and each year during the term of the Agreement by January 1, the Organizer will provide the City with an initial deposit of $10,000 (the “Deposit”). City Costs will be tracked and charged against the Deposit each year. If the initial Deposit falls below $2,500, during each year of the Term, Organizer must deposit additional funds in order to replenish the deposit to $10,000 within seven (7) days of notification by the City. City staff time will be tracked and charged back to the Organizer, based on total costs incurred. City Costs include, but are not limited to the following:

Resolution No. 127-2024
Exhibit B
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(a) City staff time associated with Event planning, including, but not limited to: Event plan review, logistic and support inquiries, pre-Event meetings with City staff, pre and post-Event site walk through, and any additional time that requires City staff involvement in the planning process not outlined in the Permit. (b) Unexpected staff time during event set-up, implementation, and breakdown. City staff will be assigned to work the Event and Organizer is responsible for such costs under the Special Event Policy and the Permit. If additional staff are needed to respond to the Event or staff time exceeds the amount covered by the Permit, those costs will be charged against the Deposit. (c) All or part of the deposit may be used to address any damage, outside of regular wear and tear to any City property used for the Event. City staff and Organizer will conduct a post-Event walkthrough to ensure the City property is returned to its pre-Event. If damage to City property exceeds the Deposit, Organizer will be required to reimburse City for any expenses above and beyond remaining Deposit within 30-days after notice from the City.
(d) The City will return any remaining Deposit balance after Event completion each year, including the postEvent walkthrough and once final payment has been processed each year.

6. Notice: Organizer shall provide written notice to the City in the event that there is a change in the Organizer’s interest in the property, the Event, or the billing address or contact person for the Event. Said notice shall be mailed first class, postage paid, certified mail to:

City of Healdsburg, Attn: Matt Milde
1557 Healdsburg Avenue
Healdsburg, CA 95448
Notices to the Organizer shall be sent to:

Reeve Wines, Attn: Kelly Dorrance
P.O. Box 380
Healdsburg, CA 95448

7. Indemnification: Organizer agrees to defend, indemnify, release and hold harmless the City of Healdsburg, its agents, officers, employees and elected and appointed officials from any claim, action or proceedings brought against any of the foregoing individuals or entities, related to the Event, and this Agreement. The indemnification shall include, but not be limited to, damages, costs, expenses, attorneys’ fees or expert witness fees that may be asserted by any person or entity arising out of or in connection with the Event and related permits or applications, this Agreement or related applications, passive or active negligence on the part of the City, its agents, officers, attorneys, employees, and elected officials.

8. Entire Agreement: Modifications in Writing. This Agreement contains the Parties’ entire agreement with respect to the subject matter hereof. Any modifications or additions to this Agreement must be made in writing by the Parties.

Resolution No. 127-2024
Exhibit B
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9. Authorization: This Agreement shall only be executed by authorized representatives of the Parties. The persons executing this Agreement represent that they have the express authority to enter into agreements on behalf of their respective Party.

The Parties have executed this Agreement as of the Effective Date.

ORGANIZER CITY OF HEALDSBURG
By:___________________________ By:_____________________________ Kelly Dorrance Jeffrey Kay
Co-Owner City Manager
Reeve Wines City of Healdsburg
Resolution No. 127-2024
Exhibit B
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The City Clerk’s Office will not process agreements until it receives at least one agreement signed by the consultant/contractor and all supporting documents (e.g., check, etc.).

Organizer Name: Kelly Dorrance / Reeve Wines
Project Name: The BloodRoot Ramble
Project Manager: Matt Milde, Facilities and Events Supervisor Initial Deposit Amount: $10,000
Deposit GL Account: _____________________; _________
(Include Acct# and Project #, if applicable)
______________________________________
Katie Edgar, Finance Director
_________________________________________
Department Head Signature
To be completed by City Clerk’s Office
CDC TO ASD Date Routed: _____________
CITY CLERK to CITY MANAGER Date Routed: _________ Date Returned________ CITY CLERK’S OFFICE SCANNED IN LIBRARY AND EMAILED TO PM/CDC CITY CLERK’S OFFICE TO PROVIDE CHECK TO UB FOR DEPOSIT
Date Processed: _________

COST RECOVERY AGREEMENT CHECK LIST
Resolution No. 127-2024
Exhibit B
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EXHIBIT “B”
2024 The BloodRoot Ramble
Special Event Permit
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GAC26932-CA 1

UNITED STATES FIRE INSURANCE COMPANY
Administrative Offices: 5 Christopher Way • 3rd Floor • Eatontown, NJ 07724

BLANKET BENEFITS - ACCIDENTS ONLY CERTIFICATE
This Certificate contains the terms under which the United States Fire Insurance Company agrees to insure certain persons and pay benefits.

This Certificate is a part of, and is governed by, a Group Policy that has been issued in the state of CALIFORNIA and shall be governed by its laws.

Coverage under this Certificate is provided in consideration of payment of the initial premium, continued payment of premiums when due, and completion of an Application. This Certificate is a part of, and is governed by, a Group Policy. The Group Policy has been issued to, and is the contract between, the Group Policyholder and The United States Fire Insurance Company. The Group Policy is held by the Group Policyholder and may be inspected upon request at any reasonable time. The name of the Group Policyholder is shown in the Schedule.

This Certificate has been issued to you, the Certificateholder, as a Participant under the Group Policy, in accordance with the terms, conditions, and limitations of the Group Policy.
10 DAY RIGHT TO RETURN THIS CERTIFICATE: If for any reason, you are not satisfied with this Certificate, you may return it to us within 10-days after receiving it. Upon its return, we will refund any premium paid and this Certificate will be deemed void, just as though it had never been issued.

NOTICE

THIS NOTICE IS TO ADVISE YOU THAT SHOULD YOU HAVE ANY QUESTIONS OR COMPLAINTS REGARDING THIS CERTIFICATE, YOU MAY CONTACT UNITED STATES FIRE INSURANCE COMPANY AT 5 CHRISTOPHER WAY EATONTOWN, NEW JERSEY 07724 or CALL (732) 676-9800

ALSO AVAILABLE IS THE CONSUMER SERVICES DIVISION OF THE CALIFORNIA DEPARTMENT OF INSURANCE, WHICH MAY BE CONTACTED AS FOLLOWS: CALIFORNIA DEPARTMENT OF INSURANCE CONSUMER SERVICES DIVISION; 300 SPRING STREET, SOUTH TOWER LOS ANGELES, CALIFORNIA 90013 or call 1-800-927- HELP or 1-800-927-4357

THE DEPARTMENT OF INSURANCE SHOULD BE CONTACTED ONLY AFTER DISCUSSIONS WITH THE INSURANCE COMPANY OR ITS REPRESENTATIVES HAVE FAILED TO PRODUCE A SATISFACTORY RESOLUTION TO THE PROBLEM.

Required Disclosure under California Insurance Code § 10270.3: Please note that all benefits payable under this Certificate may be subject to reduction, to the extent provided in this Certificate, to the extent that you are entitled to benefits, whether on an indemnity basis or on a provision-of-service basis, for hospital, medical, dental, or surgical expenses under any other valid and collectible individual, group, or blanket insurance policy or contract, hospital or medical service program, or group-practice prepayment plan, except for automobile medical payments insurance.

THIS IS ACCIDENT ONLY COVERAGE. READ IT CAREFULLY.

BENEFITS ARE NOT PAYABLE FOR LOSS DUE TO SICKNESS.

THIS CERTIFICATE PAYS BENEFITS FOR SPECIFIC LOSSES FROM ACCIDENTS ONLY.

THIS CERTIFICATE IS NOT RENEWABLE.

Signed for The United States Fire Insurance Company By:

Signature Signature

0DUF-$GHH-DPHV.UDXV Chairman and CEO Secretary
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GAC26932-CA 2

TABLE OF CONTENTS
The following provisions appear within this Certificate in the following order:

Schedule of Benefits
Definitions
Scope of Coverage
Description of Hazards
Description of Benefits
Exclusions
Additional Exclusions
Limitations
Premium Provisions
General Provisions
Claim Provisions
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GAC26932-CA 3

SCHEDULE OF BENEFITS
COVERAGE IS PROVIDED UNDER GROUP POLICY NUMBER: AH-GA26932-002 ISSUED TO GROUP POLICYHOLDER: The Group and Blanket Accident & Health Insurance Trust CERTIFICATEHOLDER:

CERTIFICATE NUMBER:

CERTIFICATE EFFECTIVE DATE:

CERTIFICATE EXPIRATION DATE:

CLASSES OF ELIGIBLE PERSONS:

A person may be covered only under one Class of Eligible Persons even though He or She may be eligible under more than one class.

See Application
HAZARDS INSURED AGAINST:

Class Hazard # Description of Hazard
See Application Policyholder Functions
BENEFIT PERIOD: Provided treatment begins within 30 days from the date of Injury, Benefits are payable for 52 weeks from the date of an Injury. The Injury must occur after the Effective Date and prior to the Expiration Date and care must be Medically Necessary.

DEDUCTIBLE AMOUNT: See Below
COINSURANCE PERCENTAGE: 100% URC (Usual, Reasonable & Customary) Up to the Policy Maximum
MAXIMUM BENEFIT AMOUNT: 6HH%HORZ

MEDICAL EXPENSE BENEFIT
Hospital Room & Board Daily Maximum Benefit Amount: URC Intensive Care Room & Board Daily Maximum Benefit: URC
Hospital Miscellaneous Maximum Benefit Amount: URC
Outpatient Pre-Admission Testing Benefit Amount: URC
Outpatient Hospital Emergency Room Treatment Maximum Benefit Amount: URC Surgical Benefits:

Primary Surgeons Maximum Benefit Amount: URC
Assistant Surgeon, Second Surgical Opinion, Consultation Maximum Benefit: URC Anesthesia Maximum Benefit: URC
Surgical Facility Maximum Benefit per Operating Session: URC Reeve Wines LLC DBA BloodRoot Wines
US2174930
May 06, 2025
Jun 10, 2025
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Doctor’s Visits
In-Hospital Maximum Benefit: URC
Office Visits Maximum Benefit: URC
Maximum for All In-Hospital and Office Doctor’s Visits: URC X-ray and Laboratory Maximum Benefit Amount: URC
Nursing Maximum Benefit Amount: URC
Physiotherapy Benefit
Maximum Benefit Amount (Hospital Inpatient): URC
Maximum Benefit Amount (Outpatient): URC
Maximum for All Physiotherapy Combined (Inpatient & Outpatient): URC Ambulance Maximum Benefit Amount: URC
Medical Equipment Rental Charges Maximum Benefit Amount: URC Medical Services and Supplies Maximum Benefit Amount
(Blood, Blood Transfusions, Oxygen): URC
Dental Treatment For Injury Only
Maximum Benefit Amount: See Below
Out-Patient Prescription Drug Benefit
Maximum Benefit Amount: URC
Accidental Death, Dismemberment, Loss of Sight, Speech, Hearing, Or Paralysis Principal Sum: See Below
Aggregate Limit per Accident for AD&D only See Below
Class I:

Option 1 Limits:

All active spectators and/or ticketholders who are attending an Insured Group's sponsored, scheduled and supervised short-term event, for whom premium has been paid.
$5,000 Accidental Death & Accidental Dismemberment Benefit $5,000 Accident Medical Expense Benefit (Excess Basis)
$100 Corridor Deductible (per incident per person)
$250 Dental Maximum (per Tooth per Accident)
$50,000 Aggregate Limit per Accident for AD&D only
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DEFINITIONS
The terms shown below shall have the meaning given in this section whenever they appear in this Certificate.

Additional terms may be defined within the provision to which they apply. "Accident" means a sudden, unforeseeable external event which causes Injury to one or more Covered Persons. "Benefit Period" means the period of time from the date of Injury, as shown in the Schedule of Benefits. "Covered Person" means an Insured Person eligible for coverage as identified in the Enrollment/Application][who is a U.S citizen residing in the United States, or if not a U.S. citizen, resides permanently in the United States],for whom proper premium payment has been made when due, and who is therefore insured under the Policy and this Certificate. "Deductible" means the amount of Eligible Expenses which must be paid by the Covered Person before benefits are payable under this Certificate. It applies separately to each Covered Person. "Eligible Expenses" means the Usual, Reasonable and Customary charges for services or supplies which are incurred by the Covered Person for the Medically Necessary treatment of an Injury. Eligible Expenses must be incurred while this Certificate is in force.
"He", "his" and "him" includes "she", "her" and "hers." "Health Care Plan" means any contract, policy or other arrangement for benefits or services for medical or dental care or treatment under:
(1) Group or blanket insurance, whether on an insured or self-funded basis; (2) Hospital or medical service organizations on a group basis; (3) Health Maintenance Organizations on a group basis.
(4) Group labor management plans;
(5) Employee benefit organization plan;
(6) Professional association plans on a group basis; or (7) Any other group employee welfare benefit plan as defined in the Employee Retirement Income Security Act of 1974 as amended.
"Hospital" means an institution which:
(1) Is operated pursuant to law;
(2) Is primarily and continuously engaged in providing medical care and treatment to sick and injured persons on an inpatient basis;
(3) Is under the supervision of a staff of Physicians;
(4) Provides 24-hour nursing service by or under the supervision of a graduate registered nurse, (R.N.); (5) Has medical, diagnostic and treatment facilities, with major surgical facilities; (a) On its premises; or
(b) Available to it on a prearranged basis; and
(6) Charges for its services.
“Hospital” does not include:
(1) A clinic or facility for:
(a) Convalescent, custodial, educational or nursing care; (b) The aged, drug addicts or alcoholics; or
(c) Rehabilitation; or
(2) A military or veterans hospital or a hospital contracted for or operated by a national government or its agency unless:
(a) The services are rendered on an emergency basis; and (b) A legal liability exists for the charges made to the individual for the services given in the absence of insurance.
"Hospital Stay" means a Medically Necessary overnight confinement in a Hospital when room and board and general nursing care are provided for which a per diem charge is made by the Hospital.

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"Injury" means bodily harm of which an Accident is the proximate cause. All injuries to the same Covered Person sustained in one accident, including all related conditions and recurring symptoms of the Injuries will be considered one Injury.
"Medically Necessary" or "Medical Necessity" means a treatment, service or supply that is:
(1) required to treat an Injury;
(2) prescribed or ordered by a Physician or furnished by a Hospital; (3) performed in a setting required by the condition;
(4) consistent with the medical and surgical practices prevailing in the area for treatment of the condition at the time rendered.

The purchasing or renting air conditioners; air purifiers, motorized transportation equipment, escalators or elevators in private homes, swimming pools or supplies for them; and general exercise equipment are not considered Medically Necessary.

The fact that a Physician may prescribe, authorize, or direct a service does not of itself make it Medically Necessary or covered by the Group Policy.
"Nurse" means either a professional, licensed, graduate registered nurse (R.N.) or a professional, licensed practical nurse (L.P.N.).
“Physician” means a person who is a doctor of medicine, osteopathy, psychology or other legally qualified practitioner of a healing art that is required by law to be licensed and is acting within the scope of his/her license under the laws in the state in which he/she practices and providing only those medical services which are within the scope of his/her license or certificate. It does not include an Insured, an Insured’s Spouse, Domestic Partner, son, daughter, father, mother, brother or sister or other relative; "Supervised or Sponsored Activity" means a Certificateholder or School authorized function:
(1) In which the Covered Person participates;
(2) Which is organized by or under its auspices;
which is within the scope of customary activities for such entity and is shown on the Schedule of Benefits. "Usual, Reasonable and Customary means the amount that is the normal payment range for a specific medical procedure performed within a given geographic area. If the charges submitted are higher than what is considered normal for the covered services, then We may not allow the full amount charged.

SCOPE OF COVERAGE
We will provide the benefits described in this Certificate to all Covered Persons who suffer a covered loss which:
(1) Is within the scope of the DESCRIPTION OF BENEFITS PROVISIONS and is the proximate result of disease or bodily infirmity, from an Injury which is suffered in an Accident; (2) Occurs while the person is a Covered Person under this Certificate; and (3) Is within the scope of the risks set forth in the DESCRIPTION OF HAZARDS provisions.

Full Excess Medical Expense:

If an Injury to the Covered Person results in his incurring Eligible Expenses for any of the services in the SCHEDULE OF BENEFITS, we will pay the Eligible Expenses incurred, subject to the Deductible Amount and Coinsurance Percentage (if any), that are in excess of Expenses payable by any other Health Care Plan, regardless of any Coordination of Benefits provision contained in such Health Care Plan.

The Covered Person must be under the care of a Physician when the Eligible Expenses are incurred. The Expense must be incurred solely for the treatment of a covered Injury:
(1) While the person is insured under this Certificate; or (2) During the Benefit Period stated on the SCHEDULE OF BENEFITS.

The first Expense must be incurred within the time frame shown on the SCHEDULE OF BENEFITS.

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The total of all medical benefits payable under this Certificate is shown on the SCHEDULE OF BENEFITS: and (1) Subject to the specific maximums shown on the SCHEDULE OF BENEFITS; and (2) Subject to compliance with the requirement, set forth in the Limitations section of this Certificate.

PROVISIONS CONCERNING COVERED PERSONS
Eligibility:

Persons eligible to be insured under this Certificate are those persons described as an ELIGIBLE CLASS on the Application. This includes anyone who may become eligible while this Certificate is in force.

Effective Dates:

A Covered Person will become an insured under this Certificate, provided proper premium payment is made, on the latest of:
(1) The Effective Date of this Certificate; or
(2) The day he becomes eligible according to the referenced date shown in the Application.

Termination:

Insurance for a Covered Person will end on the earliest of:
(1) The date he is no longer in an Eligible Class.
(2) The date he reports for active duty in any Armed Forces, according to the referenced date shown in the Application. We will refund, upon receipt of proof of service, any premium paid, calculated from the date active duty begins until the earlier of:
(a) The date the premium is fully earned; or
(b) The Expiration Date of this Certificate.

This does not include Reserve or National Guard duty for training; (3) The end of the period for which the last premium contribution is made; or (4) The date the Group Policy is terminated.

DESCRIPTION OF HAZARDS
HAZARD: POLICYHOLDER FUNCTIONS
Subject to all other provisions of this Certificate, coverage is provided for a Covered Person while he is:
(1) Attending or participating in a Supervised or Sponsored Activity; or (2) Attending a Policyholder function.

The activity has to be an event or activity sponsored by and part of the operations of the policyholder.

The Covered Person must be:
(1) On the premises of the Policyholder:
(a) During its normal hours;
(b) During scheduled functions; or
(c) During other periods if he is attending or participating in a Supervised or Sponsored Activity; (2) Not on Policyholder: premises and attending or participating in a Supervised or Sponsored Activity; (3) Traveling directly, without interruption:
(a) Between his home and the Policyholder premises for participation in a Supervised or Sponsored Activity; (b) Between the site of the Supervised or Sponsored Activity and his home or the Policyholder: premises. (c) In a vehicle which is:
(i) Designated or furnished by the Policyholder:;
(ii) Operated by a properly licensed adult driver; and
(iii) Under the direct supervision of the Policyholder; or (d) In a vehicle other than that described in (3)(c) when:
(i) Operated by a properly licensed driver; and
(ii) Travel time does not exceed an hour each way.

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Travel time includes the time:
(i) To or from home, the Certificateholder's address and the Supervised or Sponsored Activity; (ii) Before the appointed time; and
(iii) After the Supervised or Sponsored Activity is completed.

Unless otherwise stated, we will pay benefits for a covered loss, only once, even if coverage was provided under more than one Description of Hazards.

DESCRIPTION OF BENEFITS
BENEFIT A: BENEFITS FOR ACCIDENTAL DEATH, DISMEMBERMENT, LOSS OF SIGHT, SPEECH AND HEARING; OR PARALYSIS
If, within 1-year from the date of an Accident covered by this Certificate, Injury from such Accident, results in Loss listed below, we will pay the percentage of the Principal Sum set opposite the loss in the table below. If the Covered Person sustains more than one such Loss as the result of one Accident, we will pay only one amount, the largest to which he is entitled. This amount will not exceed the Principal Sum which applies for the Covered Person.

Loss Percentage of Principal Sum
Loss of Life 100%
Loss of Both Hands 100%
Loss of Both Feet 100%
Loss of Entire Sight of Both Eyes 100%
Loss of One Hand and One Foot 100%
Loss of One Hand and Entire Sight of One Eye 100%
Loss of One Foot and Entire Sight of One Eye 100%
Loss of Speech and Hearing (both ears) 100%
Quadriplegia (total Paralysis of both upper and lower limbs) 100% Paraplegia (total Paralysis of both lower limbs 50%
Loss of One Hand 50%
Loss of One Foot 50%
Loss of Entire Sight of One Eye 50%
Loss of Speech 50%
Loss of Hearing (both ears) 50%
Hemiplegia (total Paralysis of upper and lower limbs on one side of body) 50% Loss of Thumb and Index Finger of the Same Hand 25%
Loss of a hand or foot means complete Severance through or above the wrist or ankle joint.

Loss of sight means the total, permanent loss of sight of the eye. The loss of sight must be irrecoverable by natural, surgical or artificial means.

Loss of speech means total, permanent and irrecoverable loss of audible communication.

Loss of hearing means total and permanent loss of hearing in both ears which cannot be corrected by any means.

Loss of a thumb and index finger means complete Severance through or above the metacarpophalangeal joints (the joints between the fingers and the hand).

In California, loss of a thumb and index finger means loss by complete Severance of at least one whole phalanx of each.
"Severance" means the complete separation and dismemberment of the part from the body. "Paralysis" means loss of use, without Severance, of a limb. This loss must be determined by a Physician to be complete and not reversible.

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BENEFIT - MEDICAL EXPENSE
We will pay, Eligible Expenses for a Covered Person’s Injury, subject to the Deductible Amount and Coinsurance Percentage, if any, shown in the Schedule of Benefits. Eligible Expenses are those incurred for:
(1) Hospital Room and Board – charges for a semi-private daily room rate for each day of the Hospital Stay, up to the Maximum Daily Benefit Amount shown in the Schedule of Benefits for Hospital Room and Board. (2) Intensive Care Room and Board - charges for each day of Intensive Care Unit confinement, up to the Daily Maximum Benefit Amount shown in the Schedule of Benefits for the Intensive Care Room and Board benefit.

This payment is in lieu of payment for the Hospital Room and Board charges for those days. (3) Hospital Miscellaneous - charges during a Hospital Stay, up to the Maximum Daily Benefit Amount shown in the Schedule of Benefits for the Hospital Miscellaneous benefit. Miscellaneous charges do not include charges for telephone, radio or television, extra beds or cots, meals for guests, take home items, or other convenience items.
(4) Outpatient Hospital Expenses - charges by a Hospital for:
(a) Pre-admission testing (confinement must occur within 7 days of the testing); or (b) Emergency room treatment, up to the Maximum Benefit Amount per emergency shown in the Schedule of Benefits for the Outpatient Emergency Room Treatment benefit. (5) Surgical Benefits - charges for:
(a) A Physician, for primary performance of a surgical procedure, up to the Maximum Benefit Amount shown in the Schedule of Benefits per procedure. Two or more surgical procedures through the same incision will be considered as one procedure. However, we will pay up to 1.57 times the surgical procedure charge when more than one surgical procedure through different operating fields are performed during the same surgical session.
(b) A Physician, for: (i) assistant surgeon duties; (ii) a second surgical opinion; or (iii) consultation, up to the Maximum Benefit shown in the Schedule of Benefits for an Assistant Surgeon, Second Surgical Opinion, and Consultation.
(c) Anesthesia and its administration, up to the Maximum Benefit Amount shown in the Schedule of Benefits for the Anesthesia benefit.
(d) Use of surgical facilities, up to the Maximum Benefit Amount per operating session, as shown in the Schedule of Benefits for the Surgical Facility benefit. (6) Physician’s Visits - charges by a Physician for other than pre- or post-operative care:
(a) For in-Hospital visits, up to the Maximum Benefit Amount shown in the Schedule of Benefits for Physician’s Visit – In-Hospital.
(b) For office visits, up to the Maximum Benefit Amount shown in the Schedule of Benefits for Physician’s Office Visits.

Total visits per Injury will not exceed the combined Maximum shown in the Schedule of Benefits for All InHospital and Office Physician’s Visits. (7) X-Ray and Laboratory - charges for X-ray and laboratory tests, up to the Maximum Benefit Amount shown in the Schedule of Benefits for the X-ray & Laboratory benefit. (8) Nursing Services - Charges for nursing services (other than routine Hospital care) by or under the supervision of a licensed graduate registered nurse, up to the Maximum Benefit Amount shown on the Schedule of Benefits for the Nursing benefit.
(9) Physiotherapy - Charges for physiotherapy:
(a) While Hospital confined, up to the Maximum Benefit Amount shown in the Schedule of Benefits for the Hospital Inpatient Physiotherapy benefit;
(b) As an outpatient, up to the Maximum Benefit Amount shown on the Schedule of Benefits for the Outpatient Physiotherapy benefit.

Physiotherapy includes:

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(a) Heat treatment;
(b) Diathermy;
(c) Microtherm;
(d) Ultrasonic;
(e) Adjustment;
(f) Manipulation;
(g) Massage therapy and
(h) Acupuncture.

Total treatment per Injury will not exceed the Maximum Benefit Amounts for Physiotherapy shown in the Schedule of Benefits.
(10) Ambulance - from the place where the Injury occurred to the Hospital, up to the Maximum Benefit Amount shown in the Schedule of Benefits for the Ambulance benefit. (11) Medical Equipment Rental - charges for medical equipment for:
(a) A wheelchair;
(b) An iron lung; or
(c) Other medical equipment for which prior approval by us has been given; up to the Maximum Benefit Amount shown in the Schedule of Benefits for the Medical Equipment Rental benefit.
(12) Medical Services and Supplies - Charges for medical services and supplies for:
(a) Oxygen and its administration;
(b) Blood and blood transfusions;
up to the Maximum Benefit Amount shown in the Schedule of Benefits for the Medical Service & Supply benefit.
(13) Dental Treatment - Charges for dental treatment for Injury to a tooth which was sound and natural at the time of Injury, up to the Maximum Benefit Amount shown in the Schedule of Benefits for the Dental Treatment benefit.

The amounts payable under this Medical Expense benefit could be greatly reduced if the Covered Person does not comply with the requirements in the Limitations section of this Certificate.

BENEFIT - OUT-PATIENT PRESCRIPTION DRUG BENEFIT
We will pay the Eligible Expenses, subject to the Deductible Amount and Coinsurance Percentage shown in the Schedule of Benefits, if any; for a Prescription Drug or medication when prescribed by a Physician on an outpatient basis.

Prescription Drug means a drug which:
(1) Under Federal law may only be dispensed by written prescription; and (2) Is utilized for the specific purpose approved for general use by the Food and Drug Administration.

The Prescription Drug must be dispensed for the out-patient use by the Covered Person:
(1) On or after the Covered Person's Effective Date; and (2) By a licensed pharmacy provider.

Benefits are payable up to the Maximum Benefit Amount shown on the Schedule of Benefits.

The amount payable under this benefit could be greatly reduced if the Covered Person does not comply with the requirements in the Limitations section of this Certificate.

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EXCLUSIONS
Benefits will not be paid for a Covered Person's loss which:
(1) Is proximately caused by the Covered Person’s own:
(a) Intentionally self-inflicted Injury, suicide or any attempt thereat. (In Missouri this applies only while sane.); (b) Voluntary self-administration of any drug or chemical substance not prescribed by, and taken according to the directions of, a doctor (Accidental ingestion of a poisonous substance is not excluded.); (c) Commission or attempt to commit a felony;
(d) Participation in a riot or insurrection;
(e) [Injury caused by, contributed to or resulting from the Covered Person’s use of alcohol, illegal drugs or medicines that are not taken in the dosage or for the purpose as prescribed by the Covered Person’s Physician.
(2) Is proximately caused by:
(a) Declared or undeclared war or act of war;
(b) Aviation, except as specifically provided in this Certificate; (c) Sickness, disease, bodily or mental infirmity or medical or surgical treatment thereof, bacterial or viral infection, regardless of how contracted. This does not include bacterial infection that is the natural and foreseeable result of an accidental external bodily injury or accidental food poisoning.

ADDITIONAL EXCLUSIONS
Benefits will not be paid for:

1. Normal health checkups;

2. Dental care or treatment other than care of sound, natural teeth and gums required on account of Injury resulting from an Accident while the Covered Person is covered under this Certificate, and rendered within 6 months of the Accident;

3. Services or treatment rendered by a doctor, nurse or any other person who is:
(a) Employed or retained by the Certificateholder; or
(b) Who is the Covered Person or a member of his immediate family;

4. Charges which:
(a) The Covered Person would not have to pay if he did not have insurance; or (b) Are in excess of Usual, Reasonable and Customary charges.

5. An Injury that is caused by flight in:
(a) An aircraft, except as a fare-paying passenger;
(b) A space craft or any craft designed for navigation above or beyond the earth's atmosphere; or (c) An ultra light, hang-gliding, parachuting or bungi-cord jumping;

6. Travel in or upon:
(a) A snowmobile;
(b) Any two or three wheeled motor vehicle;
(c) Any off-road motorized vehicle not requiring licensing as a motor vehicle;

7. Any Accident where the Covered Person is the operator of a motor vehicle and does not possess a current and valid motor vehicle operator's license;

8. That part of medical expense arising out of a motor vehicle accident to the extent such benefits are payable by any automobile insurance Certificate without regard to fault. (Does not apply in any state where prohibited);

9. Injury that is:
(a) The result of the Covered Person being Intoxicated. (“Intoxicated” will have the meaning determined by the laws in the jurisdiction of the geographical area where the loss occurs); or (b) Caused by any narcotic, drug, poison, gas or fumes voluntarily taken, administered, absorbed or inhaled, unless prescribed by a doctor;

10. Any Sickness, except infection which occurs directly from an Accidental cut or wound or diagnostic tests or treatment, or ingestion of contaminated food;

11. Blood or Blood plasma, except for charges by a Hospital for the processing or administration of blood;

12. Elective treatment or surgery, health treatment, or examination where no Injury is involved;

13. Injury sustained while in the service of the armed forces of any country. When the Covered Person enters the armed forces of any country, we will refund the unearned pro rata premium upon request;

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15. Treatment in any Veterans Administration or Federal Hospital, except if there is a legal obligation to pay;

16. Treatment of temporomandibular joint (TMJ) disorders involving the installation of crowns, pontics, bridges or abutments, or the installation, maintenance or removal of orthodontic or occlusal appliances or equilibration therapy;

17. Cosmetic surgery, except for reconstructive surgery on a diseased or injured part of the body;

18. Benefits will not be provided for services or injuries or diseases related to your job to the extent you are covered or are required to be covered by the Workers’ Compensation law. If you enter into a settlement giving up your right to recover future medical benefits under a Workers’ Compensation law, this policy will not pay those medical benefits that would have been payable in absence of that settlement;

19. The repair or replacement of existing artificial limbs, orthopedic braces, or orthotic devices;

20. Rest cures or custodial care;

21. The repair or replacement of existing dentures, partial dentures, braces or fixed or removable bridges;

22. Expenses incurred for an Accident after the Benefit Period shown in the Schedule of Benefits;

23. Orthopedic appliances which are used mainly to protect an Injury so that a covered student can take part in interscholastic or intercollegiate sports;

24. Hernia of any kind; or any bacterial infection that was not caused by an Accidental cut or wound;

25. Prescription medicines unless specifically provided for under this Certificate.

26. Injuries, which result over a period of time (such as blisters, tennis elbow, etc.) are not covered.

LIMITATIONS
Any benefits payable under this Certificate will be limited to the following:
(1) The medical benefits otherwise payable under this Certificate will be reduced by 50% if:
(a) Excess insurance is provided under this Certificate; and (b) The Covered Person has coverage under another plan providing medical expense benefits; and (c) The other plan is an HMO, PPO or similar arrangement ("PPO-Preferred Provider Organization" means an Organization offering health care services through designated health care providers who agree to perform these services at rates lower than nonpreferred providers.); and (d) The Covered Person does not use the facilities or services of the HMO, PPO or similar arrangement for the provision of benefits.

The Covered Person’s limitation does not apply to emergency treatment required within 24 hours after an Accident which occurred outside the geographic area serviced by the HMO, PPO or similar arrangement. (2) Costs that exceed the Usual, Reasonable and Customary charges in the area where the services are furnished or supplies provided. Services, supplies and equipment must be:
a) Medically necessary for the care or treatment of a covered Injury; b) Received while coverage is in force under this Certificate; and c) Rendered and/or prescribed by a licensed Physician other than the Covered Person (or a member of his household or immediate family) in accordance with current medical standards and practices. (3) The application of the Coordination of Benefits or Non-Duplication of Benefits provision. (4) If the Covered Person is admitted into the Hospital on a Friday or a Saturday on a non-emergency basis and the procedure for which he is admitted is not performed on the day of or the day after admission, we will not pay the Hospital charges for room and board or miscellaneous Hospital charges for the initial Friday or Saturday preceding the procedure.

MEDICAL REVIEW REQUIREMENTS
A Covered Person may request an independent medical review (“IMR”) of disputed health care services from the California Department of Insurance if he or she believes that we have improperly denied, modified, or delayed health care services. A disputed health care service is any health care service eligible for coverage and payment under the Covered Person’s coverage that has been denied, modified, or delayed by us, in whole or in part because the service is not Medically Necessary.

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The IMR process is in addition to any other procedures or remedies that may be available. There is no application or processing fee of any kind for an IMR. The Covered Person has the right to provide information in support of the request for an IMR. We must provide the Covered Person with an IMR application form together with any grievance disposition letter that denies, modifies, or delays health care services. A decision not to participate in the IMR process may cause a Covered Person to forfeit any California statutory right to pursue legal action against us regarding the disputed health care service. It should be noted that we do not believe any such California statutory right exists which is applicable to it. For more information regarding the IMR process, or to request an application form, please contact us.

Eligibility. The California Department of Insurance will review the Covered Person’s application for an IMR to confirm that:

1. a. The provider has recommended a health care service as Medically Necessary. b. The Covered Person has received urgent care or emergency services that a provider determined was Medically Necessary; or
c. The Covered Person has been seen by a provider for the diagnosis or treatment of the medical condition for which he or she seeks independent review.

2. The disputed health care service has been denied, modified, or delayed by us based in whole or in part on a decision that the health care service is not Medically Necessary; and

3. The Covered Person filed a grievance with us and the disputed decision is upheld or the grievance remains unresolved after 30 days. If the grievance requires expedited review, the Covered Person may bring it immediately to the attention of the California Department of Insurance. It may waive the requirement that the Covered Person follow the plan’s grievance process in extraordinary and compelling cases.

If a case is eligible for an IMR, the dispute will be submitted to a medical specialist who will make an independent determination as to whether or not the care is Medically Necessary. The Covered Person will receive a copy of the assessment made. If the IMR determines the service is Medically Necessary, we will provide benefits for the health care service.

For non-urgent cases, the IMR organization designated by the California Department of Insurance must provide its determination within 30 days of receipt of the Covered Person’s application and supporting documents. For urgent cases involving an imminent and serious threat to a Covered Person’s health, including, but not limited to, serious pain, the potential loss of life, limb, or major bodily function, or the immediate and serious deterioration of the Covered Person’s health, the IMR organization must provide its determination within three business days.

PREMIUM PROVISIONS
GRACE PERIOD:

Unless not less than five days prior to the premium due date we have delivered to the Insured or have mailed to the Insured’s last address as shown by our records written notice of our intention not to renew this Policy beyond the period for which the premium has been accepted, a grace period of 31 days will be granted for the payment of each premium falling due after the first premium, during which grace period the policy shall continue in force (subject to the right of the insurer to cancel in accordance with the cancellation provision hereof).

PREMIUMS:

Premium due dates are the first of every month. Premium payment made in advance or for more than a one month period will not affect any provisions of this Certificate with regard to change. Failure by the Certificateholder to pay premiums within the grace period shall be deemed notice to us to terminate coverage at the end of the period for which premium was paid.

CHANGES IN RATES:

We have the right to change the premium rates on any premium due date:
(1) After the first 12 months insurance is in effect;
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(3) Coinciding with a change in the risks we have assumed.

We will give 31 days written notice of any change under (1) above. Notice will be sent to the Certificateholder's most recent address in our records.

GENERAL PROVISIONS
ENTIRE CONTRACT; CHANGES:

This Certificate, including the endorsements and the attached papers, if any, constitutes the entire contract of insurance. No change in this policy shall be valid until approved by one of our executive officers and unless such approval be endorsed hereon or attached hereto. No agent has authority to change this Certificate or to waive any of its provisions.

All statements made by the Policyholder or by a Covered Person in the absence of fraud, be deemed a representation and not a warranty. No such statement shall (avoid the insurance or reduce the benefits under the Policy or) be used in defense to a claim hereunder unless it is contained in a written application, nor shall any such statement of the Policyholder or Covered Person, except a fraudulent misstatement, be used at all to void the Policy or this Certificate after it has been in force for three years from the date of its issue, nor shall any such statement of any person eligible for coverage under the Policy, except a fraudulent misstatement, be used at all in defense to a claim for loss incurred or disability (as defined in the policy) commencing after the insurance coverage with respect to which claim is made has been in effect for three years from the date it became effective.

WORKERS' COMPENSATION INSURANCE:

This Certificate is not in lieu of and does not affect any requirement for coverage under any Workers' Compensation Insurance.

CONFORMITY WITH STATE STATUTES:

Any provision of this Certificate in conflict, on the Effective Date of this Certificate, with the laws of the state where it is delivered, is amended to conform to the minimum requirements of such laws.

CLAIM PROVISIONS
NOTICE OF CLAIM:

Written notice of claim must be given to us within 20 days after the occurrence or commencement of any loss covered by this Certificate policy, or as soon thereafter as is reasonably possible. Notice given by or on behalf of the Insured or Covered Person to us at our administrative office listed on the cover-page of this Certificate, or to our authorized agent, with information sufficient to identify the Insured or Covered Person, shall be deemed notice to us.

CLAIM FORMS:

Upon our receipt of a notice of claim, we will furnish to the claimant such forms as are usually furnished by us for filing proofs of loss. If such forms are not furnished within 15 days after the giving of such notice the claimant shall be deemed to have complied with the requirements of this Certificate as to proof of loss upon submitting, within the time fixed in this Certificate for filing proofs of loss, written proof covering the occurrence, the character and the extent of the loss for which claim is made.

PROOF OF LOSS:

Written proof of loss must be furnished to us in the case of a claim for loss for which this Certificate provides periodic payment contingent upon continuing loss within 90 days after the end of the period for which we are liable. Written proof that the loss continues must be furnished to us at intervals required by us.

In case of claim for any other loss, proof must be furnished within 90 days after the date of such loss.

If that is not reasonably possible, we will not deny or reduce any claim if proof is furnished as soon as reasonably possible. Proof must, in any case, be furnished not more than a year later, except for lack of legal capacity.

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TIME OF PAYMENT OF CLAIMS:

Benefits payable under this Certificate for any loss other than loss for which this Certificate provides any periodic payment will be paid immediately upon receipt of due written proof of such loss. Subject to due written proof of loss, all accrued indemnities for loss for which this policy provides periodic payment will be paid Monthly and any balance remaining unpaid upon the termination of liability will be paid immediately upon receipt of due written proof.

PAYMENT OF CLAIMS:

Benefits for a Covered Person’s loss of life will be payable in accordance with the beneficiary designation and the provisions respecting such payment which may be prescribed herein and effective at the time of payment. If no such designation or provision is then effective, such benefit shall be payable to the estate of the Covered Person.

Any other accrued benefits unpaid at the Covered Person’s death may, at our option, be paid either to such beneficiary or to such estate. All other Benefits will be payable to the Covered Person.

If any benefits under this policy shall be payable to the estate of a Covered Person, or to a Cover Person or beneficiary who is a minor or otherwise not competent to give a valid release, we may pay such Benefit, up to an amount not exceeding $1,000, to any relative by blood or connection by marriage of the Covered Person or beneficiary who is deemed by us to be equitably entitled thereto. Any payment made by us in good faith pursuant to this provision shall fully discharge us to the extent of such payment.

Subject to any written direction of a Covered Person in the application or otherwise all or a portion of any benefits provided by this certificate on account of hospital, nursing, medical, or surgical services may, at our option and unless the Covered Person requests otherwise in writing not later than the time of filing proofs of that loss, be paid directly to the person or persons having paid for the hospitalization or medical or surgical aid, or to the hospital or person rendering those services; but it is not required that the service be rendered by a particular hospital or person.

PAYMENT OF CLAIMS: OTHER BENEFITS:

All other benefits will be paid to the Covered Person, if he is living, if not, we will pay his beneficiary or his estate.

PHYSICAL EXAMINATION:

We, at our own expense, shall have the right and opportunity to examine the person of the Covered Person when and as often as it may reasonably require during the pendency of a claim hereunder and to make an autopsy in case of death where it is not forbidden by law.

TIME LIMIT ON CERTAIN DEFENSES:

After the Policy has been in force for a period of three years, no statements of the Policyholder contained in the application, and no statement relating to insurability made by any Covered Persons eligible for coverage under the Policy shall be used to deny a claim or in contesting the validity of the insurance with respect to which such statement was made after the insurance has been in force prior to the contest for a period of three years during the lifetime of the person with respect to whom any such statement was made.

No claim for loss incurred after three years from the effective date of the insurance coverage with respect to which the claim is made shall be reduced or denied on the ground that a disease or physical condition, not excluded from coverage by name or specific description effective on the date of loss, had existed prior to the effective date of the coverage with respect to which the claim is made:

LEGAL ACTIONS:

No action at law or in equity shall be brought to recover benefits under this Certificate less than 60 days after written proof of loss has been furnished as required by this Certificate. No such action shall be brought more than 3 years after the time written proof of loss is required to be furnished.

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Guaranty Notice (California) 07/2011
California Guaranty Notice

NOTICE OF PROTECTION PROVIDED BY THE CALIFORNIA LIFE AND HEALTH INSURANCE

GUARANTEE ASSOCIATION
This notice provides a brief summary regarding the protection provided to policyholders by the California Life and Health Insurance Guarantee Association (“the Association). The purpose of this Association is to assure that policyholders will be protected, within limits, in the unlikely event that a member insurer becomes financially unable to meet its obligations. Insurance Companies licensed in California to sell life insurance, health insurance, annuities and structured settlement annuities are members of the Association. The valuable extra protection provided through the Association is not unlimited and is not a substitute for consumers’ care in selecting insurers.

This protection was created under California law, which determines who and what is covered and he amounts of coverage.

Below is a brief summary of the coverages, exclusions, and limit provided by the Association. This summary does not cover all provisions of the law; nor does it in any way change anyone’s rights or obligations under the Act or the rights or obligations of the Association.

COVERAGE
• Persons Covered
Generally, an individual is covered by the California Life and Health Insurance Guarantee Association if the insurer was a member of the Association and the individual lives in California at the time the insurer is determined by a court to be insolvent. Coverage is also provided to policy beneficiaries, payees or assignees, whether or not they live in California.
• Amounts of Coverage
The basic coverage protections provided by the Association are as follows:

Life Insurance, Annuities and Structured Settlement Annuity Benefits For life insurance policies, annuities and structured settlement annuities, the Association will provide the following:
• Life Insurance
80% of death benefits but not to exceed $300,000
80% of cash surrender or withdrawal values but not to exceed $100,000 • Annuities and Structured Settlement Annuities
80% of the present value of annuity benefits, including net cash withdrawal and net cash surrender values but not to exceed $250,000.

The maximum amount of protection provided by the Association to an individual, for all life insurance, annuities and structured settlement annuities is $300,000, regardless of the number of polices or contracts covering the individual.

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• Health Insurance
The maximum amount of protection provided by the Association to an individual, as of April 1, 2011, is $470,125. This amount will increase or decrease based upon changes in the health care cost component of the consumer price index to the date on which an insurer becomes an insolvent insurer.

COVERAGE LIMITATIONS AND EXCLUSIONS FROM COVERAGE
The California Life and Health Insurance Guarantee Association may not provide coverage for this policy. Coverage by the Association generally requires residency in California. You should not rely on coverage by the Association in selecting an insurance company or in selecting an insurance policy.

The following policies and persons are among those that are excluded from Association coverage:
• A policy or contract issued by an insurer that was not authorized to do business in California when it issued the policy or contract;
• A policy issued by a health care service plan (HMO), a hospital or medical service organization, a charitable organization, a fraternal benefit society, a mandatory state pooling plan, a mutual assessment company, an insurance exchange, or a grants and annuities society;
• If the person is provided coverage by the guaranty association of another state; • Unallocated annuity contracts; that is, contracts which are not issued to and owned by an individual and which do not guaranty annuity benefits to an individual;
• Employer and association plans, to the extent they are self-funded or uninsured; • A policy or contract providing any health care benefits under Medicare Part C or Part D; • An annuity issued by an organization that is only licensed to issue charitable gift annuities; • Any policy or portion of a policy which is not guaranteed by the insurer or for which the individual has assumed the risk, such as certain investment elements of a variable life insurance policy or a variable annuity contract; • Any policy of reinsurance unless an assumption certificate was issued; • Interest rate yields (including implied yields) that exceed limits that are specified in Insurance Code Section 1607.02(b) (C)

NOTICES
Insurance companies or their agents are required by law to give or send you this notice. Policyholders with additional questions should first contact their insurer or agent. To learn more about coverages provided by the Association please visit the Association’s website at www.califega.org, or contact either of the following:

California Life and Health Insurance or Consumer Service Division Guarantee Association California Department of Insurance P.O. Box 16860 300 South Spring Street
Beverly Hills, CA 90209-3319 Los Angeles, CA 90013
(323) 782-0182 (800) 927-4357 or (213) 897-8921
Insurance companies and their agents are not allowed by California law to use the existence of the Guarantee Association or its coverage to solicit, induce or encourage you to purchase any form of insurance policy. When selecting an insurance company, you should not rely on Association coverage. If there is an inconsistency between this notice and California law, then California law will control.

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When used throughout this document “Company”, “Our”, “We”, or “Us” means:

United States Fire Insurance Company
The North River Insurance Company

GRIEVANCE PROCEDURES
When you submit a claim and that claim is denied, we will provide a written statement containing the reasons for the Adverse Determination. You have the right to request a review of any Company decision or action pertaining to our contractual relationship and to appeal any adverse claim determination we’ve made by filing a Grievance.

These procedures have been developed to ensure a full investigation of a Grievance through a formal process.

DEFINITIONS
A “Grievance” is a written complaint requesting a change to a previous claim decision, claims payment, the handling or reimbursement of health care services, or other matters pertaining to your coverage and our contractual relationship.

An “Adverse Determination” is a determination by the Company or its designated utilization review organization that (i) a service, treatment, drug, or device, is experimental, investigational, specifically limited or excluded by your coverage; or (ii) a facility admission, the availability of care, continued stay or other health care services proposed or furnished have been reviewed and, based upon the information provided, does not meet the contractual requirements for medical necessity, appropriateness, health care setting, level of care or effectiveness and therefore, the benefit coverage is denied, reduced or terminated in whole or in part.

INFORMAL GRIEVANCE PROCEDURE
You, your authorized representative, or a provider acting on your behalf may submit an oral complaint to us within 60-days after an event that causes a dispute. Telephoning allows you to discuss your complaint or concerns and gives us the opportunity to immediately resolve the problem.

If we don’t have all the information necessary to review your complaint, we will request any additional information within 5 business days of receiving your complaint. After we receive all the necessary information, we will provide you, your authorized representative, or a provider acting on your behalf with our written decision within 30-days after receiving the complaint and all necessary information.

If the problem cannot be resolved in this manner, you still have the right to submit a written request for the complaint to be reviewed through the Formal Grievance Procedure, as outlined below.

FORMAL GRIEVANCE PROCEDURE
A formal Grievance may be submitted by you, your authorized representative, or in the event of an Adverse Determination, by a provider acting on your behalf.

If you file a formal Grievance, you will have the opportunity to submit written comments, documents, records and other information you feel are relevant to the Grievance, regardless of whether those materials were considered in the initial Adverse Determination.

First Level Review
Within 3 working business days after receiving the Grievance, we must acknowledge the Grievance and provide you, your authorized representative or a provider with the name, address, and telephone number of the coordinator handling the Grievance and information on how to submit written material. The person(s) who reviews the Grievance will not be the same person(s) who made the initial Adverse Determination. During the review, all information, documents, and other materials submitted relating to the claim will be considered, regardless of whether they were considered in making the previous claim decision. The Insured will not be allowed to attend, or have a representative attend, a First Level Review. The Insured may, however, submit written material for consideration by the reviewer(s).

Grievance
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When the Grievance is based in whole or in part on a medical judgment, the review will be conducted by, or in consultation with, a medical doctor with appropriate training and expertise to evaluate the matter.

Following our review of your Grievance, we must issue a written decision to you and, if applicable, to your representative or provider, within 20-days after receiving the Grievance. The written decision must include:
(1) The name(s), title(s) and professional qualifications of any person(s) participating in the First Level Review process.
(2) A statement of the reviewer’s understanding of the Grievance. (3) The specific reason(s) for the reviewer’s decision in clear terms and the contractual basis or medical rationale used as the basis for the decision in sufficient detail for the Insured to respond further to our position.
(4) A reference to the evidence or documentation used as the basis for the decision. (5) If the claim denial is based on medical necessity, experimental treatment or similar exclusion, instructions for requesting an explanation of the scientific or clinical rationale used to make the determination.
(6) A statement advising you of your right to request a Second Level Review, if applicable, and a description of the procedure and timeframes for requesting a Second Level Review.

Second Level Review
The Second Level Review process is available if you are not satisfied with the outcome of the First level Review for an Adverse Determination. Within ten business days after receiving a request for a Second Level Review, we will advise you of the following:
(1) the name, address, and telephone number of a person designated to coordinate the Grievance review for the Company;
(2) a statement of your rights, including the right to:
• attend the Second Level Review
• present his/her case to the review panel;
• submit supporting materials before and at the review meeting; • ask questions of any member of the review panel;
• be assisted or represented by a person of his/her choice, including a provider, family member, employer representative, or attorney.
• request and receive from us free of charge, copies of all relevant documents, records and other information that is not confidential or privileged that were considered in making the Adverse Determination.

We must convene a review panel and hold a review meeting within 45-days after receiving a request for a Second Level Review. We will notify you in writing of the meeting date at least 15-days prior to the date. The review meeting will be held during regular business hours at a location reasonable accessible to you. In cases where a face-to-face meeting is not practical for geographic reasons, we will offer you the opportunity to communicate with the review panel at our expense by conference call or other appropriate technology. Your right to a full review may not be conditioned on whether or not you appear at the meeting.

If you choose to be represented by an attorney, we may also be represented by an attorney. If we choose to have an attorney present to represent our interests, we will notify you at least 15 working days in advance of the review that an attorney will be present and that you may wish to obtain legal representation of your own.

The panel must be comprised of persons who:
(1) were not previously involved in any matter giving rise to the Second Level Review; (2) are not employees of the Company or Utilization Review Organization; and (3) do not have a financial interest in the outcome of the review.

A person previously involved in the Grievance may appear before the panel to present information or answer questions.

All persons reviewing a Second Level Grievance involving a Utilization Review non-certification or a clinical issue will be providers who have appropriate expertise, including at least one clinical peer. If we use a clinical peer on an appeal of a Utilization Review non-certification or on a First Level Review, we may use one of our employees on the Second Level Review panel if the panel is comprised of 3 or more persons.

Grievance
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We must issue a written decision to you and, if applicable, to your representative or provider, within 10 business days after completing the review meeting. The decision must include:
(1) the name(s), title(s) and qualifying credentials of the members of the review panel; (2) a statement of the review panel’s understanding of the nature of the Grievance and all pertinent facts; (3) the review panel’s recommendation to the Company and the rationale behind the recommendation; (4) a description of, or reference to, the evidence or documentation considered by the review panel in making the recommendation;
(5) in the review of a Utilization Review non-certification or other clinical matter, a written statement of the clinical rationale, including the clinical review criteria, that was used by the review panel to make the determination;
(6) the rationale for the Company’s decision if it differs from the review panel’s recommendation; (7) a statement that the decision is the Company’s final determination in the matter; (8) notice of the availability of the Commissioner’s office for assistance, including the telephone number and address of the Commissioner’s office.

EXPEDITED REVIEW
You are eligible for an expedited review when the timeframes for an Informal, formal First Level review or Second Level review would reasonably appear to seriously jeopardize your life or health, or your ability to regain maximum function. An expedited review is also available for all Grievances concerning an admission, availability of care, continued stay or health care service for a person who has received emergency services, but who has not been discharged from a facility.

A request for an expedited review may be submitted orally or in writing. An expedited review must be evaluated by an appropriate clinical peer in the same or similar specialty as would typically manage the case being reviewed. If we don’t have the information necessary to decide an appeal, we will send you notification of precisely what is required within 24-hours of our receipt of your Grievance. All necessary information, including our decision, will be transmitted by telephone, facsimile, or the most expeditious method available. Provided we have enough information to make a decision, you, your authorized representative, or a provider acting on your behalf will be notified of the determination as expeditiously as the medical condition requires, but in no event more than 72-hours after the review has commenced. Written confirmation of our decision will be provided within 2 working business days of the decision and will contain the same items described in the written decision requirements for First Level reviews.

If the expedited review does not resolve the situation, you, your representative or a provider acting on your behalf may submit a written Grievance.

We will not provide an expedited review for retrospective reviews of Adverse Determinations.

Grievance
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UNITED STATES FIRE INSURANCE COMPANY
Administrative Offices: 5 Christopher Way • Eatontown, NJ 07724

PARTICIPATING ORGANIZATION ENDORSEMENT
This Endorsement is attached to and made part of the Certificate as of the Certificate Effective Date. It applies only to Accidents and losses of life that occur on or after that date. It is subject to all of the provisions, limitations and exclusions of the Certificate except as they are specifically modified by this Endorsement.

1. The following definition is added to the Definitions section of the Certificate:

Participating Organization – means an organization:
1) Which elects to offer coverage under the Group Policy by completing a Participation Organization Application that has been accepted by the Company; 2) Which completes a participation agreement with the Company; 3) Which remits the required premium when due; if applicable, and 4) While coverage through the Participating Organization is available under the Certificate.

2. The following section is added to the Certificate:

PARTICIPATING ORGANIZATION EFFECTIVE AND TERMINATION DATES Effective Date. A Participating Organization’s coverage under the Certificate begins on the later of: 1) Participating Organization Effective Date shown in the Participating Organization Application at 12:01AM Standard Time at the address of the Participating Organization shown in the Participating Organization Application; or 2) the Certificate Effective Date.

Termination Date. We may terminate coverage on or after the anniversary of any premium due date. Written notice must be given at least 31 days prior to such premium due date.

The Participating Organization may terminate the coverage on any premium due date. Failure by the Participating Organization to pay premium when due or within any applicable grace period shall be deemed notice to us to terminate coverage at the end of the period for which premium was paid.

3. The references in the Certificate to “Certificateholder,” where applicable, mean “Participating Organization,” respectively.

4. The following language applies to each Rider attached to the Certificate:

Any Riders attached to the Certificate apply only with respect to Accidents and losses of life that occur on or after the later of:
1) The effective date of each Rider; or
2) The effective date of the Participating Organization’s coverage under each Rider.

Each Rider applies with respect to a Participating Organization’s coverage under the Certificate only if the Participating Organization has elected the coverage described in each Rider, as indicated in the Participating Organization Application.

Signed for United States Fire Insurance Company By:

Signature Signature

0DUF-$GHH-DPHV.UDXV Chairman and CEO Secretary
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When used throughout this document “The Company”, “Our”, “We”, or “Us” means:

United States Fire Insurance Company
The North River Insurance Company
Crum & Forster Indemnity Company

PRIVACY POLICY AND PRACTICES
The Company values your business and your trust. In order to administer insurance policies and provide you with effective customer service, we must collect certain information about our customers. We want you to know that we are committed to protecting your private information and we will comply with all federal and state privacy laws. Below is a Privacy Notice describing our policy regarding the collection and disclosure of personal information. Please review this Notice and keep a copy of it with your records.

Your Privacy is Our Concern
When you apply to The Company for insurance or make a claim against a policy written by The Company, you disclose information about yourself to us. There are legal requirements governing the collection, use, and disclosure of such information. The Company maintains physical, electronic, and procedural safeguards that comply with state and federal regulations to guard your personal information. We also limit employee access to personally identifiable information to those with a business reason for knowing such information. The Company instructs our employees as to the importance of the confidentiality of personal information, and takes measures to enforce employee privacy responsibilities.

What kind of information do we collect about you and from whom? We obtain most of our information from you. The application or claim form you complete, as well as any additional information you provide, generally gives us most of the information we need to know. Sometimes we may contact you by phone or mail to obtain additional information. We may use information about you from other transactions with us, our affiliates, or others. Depending on the nature of your insurance transaction, we may need additional information about you or other individuals proposed for coverage. We may obtain the additional information we need from third parties, such as other insurance companies or agents, government agencies, medical personnel, the state motor vehicle department, information clearinghouses, credit reporting agencies, courts, or public records. A report from a consumer reporting agency may contain information as to creditworthiness, credit standing, credit capacity, character, general reputation, hobbies, occupation, personal characteristics, or mode of living.

What do we do with the information collected about you? If coverage is declined or the charge for coverage is increased because of information contained in a consumer report we obtained, we will inform you, as required by state law or the federal Fair Credit Reporting Act. We will also give you the name and address of the consumer reporting agency making the report. We may retain information about our former customers and may disclose that information to affiliates and non-affiliates only as described in this notice.

To whom do we disclose information about you?
We may disclose all the information that we collect about you, as described above. We may disclose such information about you to our affiliated companies, such as:
• Insurance companies;
• Insurance agencies;
• Third party administrators;
• Medical bill review companies; and
• Reinsurance companies.

We may also disclose nonpublic personal information about you to affiliated and nonaffiliated third parties as permitted by law. You have a right to access and correct the personal information we collect, maintain, and disclose about you.

How to contact Us
You may obtain a more detailed description of the information practices prescribed by law by contacting us at the address below. Remember to include your name, address, policy number, and daytime phone number.

Privacy Policy Coordinator
Fairmont Speciality
5 Christopher Way, 3rd Floor
Eatontown, New Jersey 07724
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GA27037

APPLICATION
is made to

UNITED STATES FIRE INSURANCE COMPANY
Administrative Office: 5 Christopher Way, Eatontown, NJ 07724 Policy Number:

Policyholder:

Address:

The Policyholder hereby applies to United States Fire Insurance Company for the group special risk coverage provided by the Policy as described in the Attachment No. 1. The Policyholder approves and accepts the Policy by the signature shown below. The Policy takes effect on the date specified on the face page of the Policy.

DATED AT:
on:

SIGNED FOR THE POLICYHOLDER:

By: __On File_______________________________________________________________ (Signature and Title)
Agent's Name: ______________________________________________________________ (Must be a Resident Licensed Agent where required by law) Reeve Wines LLC DBA BloodRoot Wines
US2174930
Reeve Wines LLC DBA BloodRoot Wines
4551 Dry Creek Road
Healdsburg, CA 95448
Healdsburg, CA
May 06, 2025
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GA27037 Attachment
ATTACHMENT # 1

Requested Effective Date:

Event Name and Location:

Event Date:

Class and Option:

Rate:

Premium:

Event Name and Location:

Event Date:

Class and Option:

Rate:

Premium:

Event Name and Location:

Event Date:

Class and Option:

Rate:

Premium:

Event Name and Location:

Event Date:

Class and Option:

Rate:

Premium:

Reeve Wines LLC DBA BloodRoot Wines
May 06, 2025
1) The BloodRoot Ramble Set Up
Abel de Luna CommunityCenter Fields
1557 Healdsburg Ave, Healdsburg
Healdsburg, CA 95448
Jun 05, 2025 - Jun 08, 2025
Class 1, Option 1

8.00% of primary GL premium (no minimum premium)
$30.40
2) The BloodRoot Ramble VIP Reception
Reeve Wines
4551 Dry Creek Road
Healdsburg, CA 95448
Jun 06, 2025
Class 1, Option 1

8.00% of primary GL premium (no minimum premium)
$30.40
3) The BloodRoot Little Saint VIP Reception
Little Saint
25 North Street
Healdsburg, CA 95448
Jun 06, 2025
Class 1, Option 1

8.00% of primary GL premium (no minimum premium)
$30.40
4) The BloodRoot Ramble Main Event
Abel de Luna CommunityCenter Fields
1557 Healdsburg Ave, Healdsburg
Healdsburg, CA 95448
Jun 07, 2025
Class 1, Option 1

8.00% of primary GL premium (no minimum premium)
$30.40
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GA27037 Attachment
ATTACHMENT # 1

Requested Effective Date:

Event Name and Location:

Event Date:

Class and Option:

Rate:

Premium:

Reeve Wines LLC DBA BloodRoot Wines
May 06, 2025
5) The BloodRoot Ramble
Reeve Wines LLC BloodRoot Wines
118 North Street
Healdsburg, CA 95448
Jun 07, 2025
Class 1, Option 1

8.00% of primary GL premium (no minimum premium)
$30.40
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Telephone: (713) 462-1000
Facsimile: (713) 462-4210
provided for:

As per attached Terms and Conditions

POLICY NUMBER:

This insurance effected on behalf of:
by:

Michael J. Schell $OH[DQGHU LXGORZ
President and CEO Secretary
In Witness Whereof, the Company has executed and attested these presents but this policy shall not be valid unless signed by a duly authorized representative of the Company

ALL CLAIMS TO BE REPORTED IMMEDIATELY TO
H25SE10374
Houston Casualty Company
Houston Casualty Company
Reeve Wines LLC DBA BloodRoot Wines
4551 Dry Creek Road
Healdsburg , CA 95448
13403 NORTHWEST FREEWAY
HOUSTON, TX 77040
Special Event Liability Insurance
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IMPORTANT NOTICE:

1. The insurance policy that you have purchased is being issued by an insurer that is not licensed by the State of California. These companies are called “nonadmitted” or “surplus line” insurers.

2. The insurer is not subject to the financial solvency regulation and enforcement that apply to California licensed insurers.

3. The insurer does not participate in any of the insurance guarantee funds created by California law. Therefore, these funds will not pay your claims or protect your assets if the insurer becomes insolvent and is unable to make payments as promised.

4. The insurer should be licensed either as a foreign insurer in another state in the United States or as a non-United States (alien) insurer. You should ask questions of your insurance agent, broker, or “surplus line” broker or contact the California Department of Insurance at the toll-free number 1-800-927-4357 or internet website www.insurance.ca.gov. Ask whether or not the insurer is licensed as a foreign or non-United States (alien) insurer and for additional information about the insurer. You may also visit the NAIC’s internet website at www.naic.org. The NAIC—the National Association of Insurance Commissioners—is the regulatory support organization created and governed by the chief insurance regulators in the United States.

5. Foreign insurers should be licensed by a state in the United States and you may contact that state’s department of insurance to obtain more information about that insurer. You can find a link to each state from this NAIC internet website:
https://naic.org/state_web_map.htm.

6. For non-United States (alien) insurers, the insurer should be licensed by a country outside of the United States and should be on Docusign Envelope ID: 5A4899FE-A1B9-45DA-A0D8-256AB8B575F7 Item 6.l
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the NAIC’s International Insurers Department (IID) listing of approved nonadmitted non-United States insurers. Ask your agent, broker, or “surplus line” broker to obtain more information about that insurer.

7. California maintains a “List of Approved Surplus Line Insurers (LASLI).” Ask your agent or broker if the insurer is on that list, or view that list at the internet website of the California Department of Insurance: www.insurance.ca.gov/01-consumers/120-company/07- lasli/lasli.cfm.

8. If you, as the applicant, required that the insurance policy you have purchased be effective immediately, either because existing coverage was going to lapse within two business days or because you were required to have coverage within two business days, and you did not receive this disclosure form and a request for your signature until after coverage became effective, you have the right to cancel this policy within five days of receiving this disclosure. If you cancel coverage, the premium will be prorated and any broker’s fee charged for this insurance will be returned to you.

D-2 (Effective January 1, 2020)
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COMMERCIAL LINES POLICY

COMMON POLICY DECLARATIONS
Policy No. Producer No.: 84213
Renewal of: Producer: HCC Specialty
Named Insured and Mailing Address:

Policy Period*: From
Standard Time at your mailing address shown above.

Business Description:

IN RETURN FOR THE PAYMENT OF THE PREMIUM, AND SUBJECT TO ALL THE TERMS OF THIS POLICY, WE AGREE WITH YOU TO PROVIDE THE INSURANCE AS STATED IN THIS POLICY.

THIS POLICY CONSISTS OF THE FOLLOWING COVERAGE PARTS FOR WHICH A PREMIUM IS INDICATED. THIS PREMIUM MAY BE SUBJECT TO ADJUSTMENT.

PREMIUM
Commercial Property Coverage Part $
Commercial General Liability Coverage Part $
Commercial Crime Coverage Part $
Commercial Inland Marine Coverage Part $
Boiler and Machinery Coverage Part $
Commercial Auto Coverage Part $
Commercial Liquor Liability Coverage Part $
Hired Auto and Non-Owned Auto Liability $
TRIA $
Damage to Premises Rented to You $
TOTAL $
Premium shown is payable: at inception; $ 1st Anniversary; $ 2nd Anniversary Forms and Endorsement(s) made a part of this policy at time of issue *: See forms schedule *Omits applicable Forms and Endorsements if shown in specific Coverage Part/Coverage Form Declarations.

Countersigned:

By
Authorized Representative

THESE DECLARATIONS TOGETHER WITH THE COMMON POLICY CONDITIONS, COVERAGE PART DECLARATIONS, COVERAGE PART COVERAGE FORM(S) AND FORMS AND ENDORSEMENTS, IF ANY, ISSUED TO FORM A PART THEREOF, COMPLETE THE ABOVE NUMBERED POLICY.

JDL 190(0)-X (ED. 11-85) Includes copyrighted material of Insurance Services Office, Inc., with its permission. Copyright, Insurance Services 46116 (11/92) Office, Inc., 1983, 1984
H CP Dec Issue Date:

HOUSTON CASUALTY COMPANY
13403NORTHWESTFREEWAY
HOUSTON,TX77040
H25SE10374
N/A
ReeveWinesLLCDBABloodRootWines
4551DryCreekRoad
Healdsburg,CA95448
May06,2025ToJun10,202512:01A.M.

AsperLimitedEventCoverageEndorsementattachedherein 3,100.00
2,589.00

58.00 100.00
5,847.00
$5,847.00
May06,2025
**Plus$10.00UnderwritingFee$175.71CASurplusLinesTax$10.54CAStampingFee Docusign Envelope ID: 5A4899FE-A1B9-45DA-A0D8-256AB8B575F7 Item 6.l
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FORMS and ENDORSEMENTS SCHEDULE

FORMS PART OF POLICY NO.:

ISSUED TO:

BY:

Houston Casualty Company
H25SE10374
Reeve Wines LLC DBA BloodRoot Wines
Description File Name
HCCDecPage
CommercialLinesPolicyDeclaration
FormsandEndorsementsSchedule
CommercialGeneralLiabilityDeclarations
ISO2013"Occurrence"CommercialGeneralLiabilityCoverageForm CommonPolicyConditions
MedicalPayments-CoverageC-ExclusionEndorsement
Abuse&MolestationExclusionEndorsement
Assaultand/orBatteryExclusionEndorsement
CollapseofTemporaryStructuresExclusionEndorsement
GeneralLiabilityExtensionEndorsement
Fireworks/PyrotechnicsExclusionEndorsement
NuclearEnergyLiabilityExclusionEndorsement
ProfessionalLiabilityExclusionEndorsement
SecuritiesandFinancialInterestExclusionEndorsement Sports/Leisure/EntertainmentActivitiesandDevicesExclusionEndorsement WarLiabilityExclusion
ServiceofSuitClauseEndorsement
StuntExclusionEndorsement
ViolationofStatutesExclusionEndorsement
SilicosisExclusionEndorsement
AttendanceLimitationExclusionEndorsement
DISCLOSUREPURSUANTTOTERRORISMRISK
CaponLossesFromCertifiedActsofTerrorism
LimitedEventCoverageEndorsement
LimitedEventCoverageEndorsementAddendum
AI-DesignatedPersons
AI-Subdivision
LiquorLiabilityDeclarations
LiquorLiabilityCoverageForm
RequirementsforWrittenContractwithVendororExhibitor HCC1022082022Exclusion-FirearmsorWeapons
HCC1017012022MarijuanaExclusion
WaiverofSubrogation
TimeStampEndorsement
Personal&AdvertisingInjuryExclusion
ExclusionofTerrorism
AdditionalInsured-ManagersorLessors
IndianaChanges-Cancellation&Nonrenewal
ExclusionUnmannedAircraft
CommunicableDiseaseExclusion
SL_CaliforniaD-2
n/a
HCPDec
HFormSched
CDDS011001
CG00011207
IL00171198
CG21351001
CG21460798
HABEX
HCTSEX
HGLEXT
HFW/PTEX
IL00210504
HPLEX
HSFIEX
HSLEEX
CG00631202
HSOS
HSTEX
HVSEX
HSILEX
HATTLTEX
IL09851220
CG21700115
HLMTEVT
n/a
CG20260704
CG20120798
CGDS030798
HLLCVGFORM
HRQVE
HCC1022082022
HCC1017012022
CG24041093
102215
SE10920219
CG21900106
HC-GL-40-0200117
IL02721121
CG21090615
CG21320509
July-2023
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CG DS 01 10 01 © ISO Properties, Inc., 2000 Page 1 of 2 POLICY NUMBER: COMMERCIAL GENERAL LIABILITY
CG DS 01 10 01

COMMERCIAL GENERAL LIABILITY DECLARATIONS
NAMED INSURED:

MAILING ADDRESS:

POLICY PERIOD: FROM TO AT 12:01 A.M. TIME AT

YOUR MAILING ADDRESS SHOWN ABOVE

IN RETURN FOR THE PAYMENT OF THE PREMIUM, AND SUBJECT TO ALL THE TERMS OF THIS POLICY, WE AGREE WITH YOU TO PROVIDE THE INSURANCE AS STATED IN THIS POLICY.

LIMITS OF INSURANCE
EACH OCCURRENCE LIMIT $

DAMAGE TO PREMISES
RENTED TO YOU LIMIT $ Any one premises
MEDICAL EXPENSE LIMIT $ Any one person
PERSONAL & ADVERTISING INJURY LIMIT $ Any one person or organization GENERAL AGGREGATE LIMIT $
PRODUCTS/COMPLETED OPERATIONS AGGREGATE LIMIT $
RETROACTIVE DATE (CG 00 02 ONLY)
THIS INSURANCE DOES NOT APPLY TO "BODILY INJURY", "PROPERTY DAMAGE" OR "PERSONAL AND ADVERTISING INJURY" WHICH OCCURS BEFORE THE RETROACTIVE DATE, IF ANY, SHOWN BELOW.

RETROACTIVE DATE: Not Applicable
(ENTER DATE OR "NONE" IF NO RETROACTIVE DATE APPLIES)
FORM OF BUSINESS:

DESCRIPTION OF BUSINESS

INDIVIDUAL PARTNERSHIP JOINT VENTURE TRUST

LIMITED LIABILITY COMPANY ORGANIZATION, INCLUDING A CORPORATION (BUT NOT INCLUDING

A PARTNERSHIP, JOINT VENTURE OR LIMITED LIABILITY COMPANY) BUSINESS DESCRIPTION:

HOUSTON CASUALTY COMPANY HCC SPECIALTY
H25SE10374
Reeve Wines LLC DBA BloodRoot Wines
4551 Dry Creek Road
Healdsburg , CA 95448
May 06, 2025 Jun 10, 2025
2,000,000
0 2,000,000
2,000,000
2,000,000
1,000,000
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ALL PREMISES YOU OWN, RENT OR OCCUPY

LOCATION NUMBER ADDRESS OF ALL PREMISES YOU OWN, RENT OR OCCUPY

CLASSIFICATION AND PREMIUM

LOCATION
NUMBER

CLASSIFICATION CODE
NO.

PREMIUM
BASE

RATE ADVANCE PREMIUM
Prem/
Ops
Prod/Comp
Ops
Prem/
Ops
Prod/Comp
Ops
STATE TAX OR OTHER (if applicable) $ N/A
TOTAL PREMIUM (SUBJECT TO AU- $
DIT)
PREMIUM SHOWN IS PAYABLE: AT INCEPTION $
AT EACH ANNIVERSARY $ N/A
(IF POLICY PERIOD IS MORE THAN ONE YEAR AND PREMIUM IS PAID IN ANNUAL INSTALLMENTS) AUDIT PERIOD (IF APPLICABLE) ANNUALLY SEMIANNUALLY QUARTERLY MONTHLY

ENDORSEMENTS
ENDORSEMENTS ATTACHED TO THIS POLICY:

See Attached Endorsements Schedule

THESE DECLARATIONS, TOGETHER WITH THE COMMON POLICY CONDITIONS AND COVERAGE FORM(S) AND ANY ENDORSEMENT(S), COMPLETE THE ABOVE NUMBERED POLICY.

Countersigned: By:
(Date) (Authorized Representative)
NOTE

OFFICERS' FACSIMILE SIGNATURES MAY BE INSERTED HERE, ON THE POLICY COVER OR ELSEWHERE AT THE COMPANY'S OPTION.

See Attached Limited Event Coverage Endorsement
See Attached
Limited Event
Coverage
Endorsement
43424 N/A $1,900 N/A
Additional Insured(s) $100 $100
TRIA $32 $32
Excess GL Premium $1,000 $1,000
Waiver of Subrogation $100 $100
Damage to Premises $100 $100
$3,232
$3,232
May 06, 2025
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COMMERCIAL GENERAL LIABILITY
CG 00 01 04 13
CG 00 01 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 16

COMMERCIAL GENERAL LIABILITY COVERAGE FORM
Various provisions in this policy restrict coverage.

Read the entire policy carefully to determine rights,
duties and what is and is not covered.

Throughout this policy the words "you" and "your"
refer to the Named Insured shown in the Declarations,
and any other person or organization qualifying as a
Named Insured under this policy. The words "we",
"us" and "our" refer to the company providing this
insurance.

The word "insured" means any person or organization
qualifying as such under Section II – Who Is An
Insured.

Other words and phrases that appear in quotation
marks have special meaning. Refer to Section V –
Definitions.

SECTION I – COVERAGES
COVERAGE A – BODILY INJURY AND PROPERTY

DAMAGE LIABILITY

1. Insuring Agreement
a. We will pay those sums that the insured
becomes legally obligated to pay as damages
because of "bodily injury" or "property damage"
to which this insurance applies. We will have
the right and duty to defend the insured against
any "suit" seeking those damages. However,
we will have no duty to defend the insured
against any "suit" seeking damages for "bodily
injury" or "property damage" to which this
insurance does not apply. We may, at our
discretion, investigate any "occurrence" and
settle any claim or "suit" that may result. But:
(1) The amount we will pay for damages is
limited as described in Section III – Limits
Of Insurance; and
(2) Our right and duty to defend ends when we
have used up the applicable limit of
insurance in the payment of judgments or
settlements under Coverages A or B or
medical expenses under Coverage C.

No other obligation or liability to pay sums or
perform acts or services is covered unless
explicitly provided for under Supplementary
Payments – Coverages A and B.
b. This insurance applies to "bodily injury" and
"property damage" only if:
(1) The "bodily injury" or "property damage" is
caused by an "occurrence" that takes place
in the "coverage territory";
(2) The "bodily injury" or "property damage"
occurs during the policy period; and
(3) Prior to the policy period, no insured listed
under Paragraph 1. of Section II – Who Is
An Insured and no "employee" authorized
by you to give or receive notice of an
"occurrence" or claim, knew that the "bodily
injury" or "property damage" had occurred,
in whole or in part. If such a listed insured
or authorized "employee" knew, prior to the
policy period, that the "bodily injury" or
"property damage" occurred, then any
continuation, change or resumption of such
"bodily injury" or "property damage" during
or after the policy period will be deemed to
have been known prior to the policy period.
c. "Bodily injury" or "property damage" which
occurs during the policy period and was not,
prior to the policy period, known to have
occurred by any insured listed under
Paragraph 1. of Section II – Who Is An Insured
or any "employee" authorized by you to give or
receive notice of an "occurrence" or claim,
includes any continuation, change or
resumption of that "bodily injury" or "property
damage" after the end of the policy period.
d. "Bodily injury" or "property damage" will be
deemed to have been known to have occurred
at the earliest time when any insured listed
under Paragraph 1. of Section II – Who Is An
Insured or any "employee" authorized by you to
give or receive notice of an "occurrence" or
claim:
(1) Reports all, or any part, of the "bodily injury"
or "property damage" to us or any other
insurer;
(2) Receives a written or verbal demand or
claim for damages because of the "bodily
injury" or "property damage"; or
(3) Becomes aware by any other means that
"bodily injury" or "property damage" has
occurred or has begun to occur.
e. Damages because of "bodily injury" include
damages claimed by any person or
organization for care, loss of services or death
resulting at any time from the "bodily injury".

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2. Exclusions
This insurance does not apply to:
a. Expected Or Intended Injury
"Bodily injury" or "property damage" expected
or intended from the standpoint of the insured.

This exclusion does not apply to "bodily injury"
resulting from the use of reasonable force to
protect persons or property.
b. Contractual Liability
"Bodily injury" or "property damage" for which
the insured is obligated to pay damages by
reason of the assumption of liability in a
contract or agreement. This exclusion does not
apply to liability for damages:
(1) That the insured would have in the absence
of the contract or agreement; or
(2) Assumed in a contract or agreement that is
an "insured contract", provided the "bodily
injury" or "property damage" occurs
subsequent to the execution of the contract
or agreement. Solely for the purposes of
liability assumed in an "insured contract",
reasonable attorneys' fees and necessary
litigation expenses incurred by or for a party
other than an insured are deemed to be
damages because of "bodily injury" or
"property damage", provided:
(a) Liability to such party for, or for the cost
of, that party's defense has also been
assumed in the same "insured contract";
and
(b) Such attorneys' fees and litigation
expenses are for defense of that party
against a civil or alternative dispute
resolution proceeding in which damages
to which this insurance applies are
alleged.
c. Liquor Liability
"Bodily injury" or "property damage" for which
any insured may be held liable by reason of:
(1) Causing or contributing to the intoxication of
any person;
(2) The furnishing of alcoholic beverages to a
person under the legal drinking age or
under the influence of alcohol; or
(3) Any statute, ordinance or regulation relating
to the sale, gift, distribution or use of
alcoholic beverages.

This exclusion applies even if the claims
against any insured allege negligence or other
wrongdoing in:
(a) The supervision, hiring, employment,
training or monitoring of others by that
insured; or
(b) Providing or failing to provide
transportation with respect to any
person that may be under the influence
of alcohol;
if the "occurrence" which caused the "bodily
injury" or "property damage", involved that
which is described in Paragraph (1), (2) or (3)
above.

However, this exclusion applies only if you are
in the business of manufacturing, distributing,
selling, serving or furnishing alcoholic
beverages. For the purposes of this exclusion,
permitting a person to bring alcoholic
beverages on your premises, for consumption
on your premises, whether or not a fee is
charged or a license is required for such
activity, is not by itself considered the business
of selling, serving or furnishing alcoholic
beverages.
d. Workers' Compensation And Similar Laws
Any obligation of the insured under a workers'
compensation, disability benefits or
unemployment compensation law or any
similar law.
e. Employer's Liability
"Bodily injury" to:
(1) An "employee" of the insured arising out of
and in the course of:
(a) Employment by the insured; or
(b) Performing duties related to the conduct
of the insured's business; or
(2) The spouse, child, parent, brother or sister
of that "employee" as a consequence of
Paragraph (1) above.

This exclusion applies whether the insured
may be liable as an employer or in any other
capacity and to any obligation to share
damages with or repay someone else who
must pay damages because of the injury.

This exclusion does not apply to liability
assumed by the insured under an "insured
contract".

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CG 00 01 04 13 © Insurance Services Office, Inc., 2012 Page 3 of 16 f. Pollution
(1) "Bodily injury" or "property damage" arising
out of the actual, alleged or threatened
discharge, dispersal, seepage, migration,
release or escape of "pollutants":
(a) At or from any premises, site or location
which is or was at any time owned or
occupied by, or rented or loaned to, any
insured. However, this subparagraph
does not apply to:
(i) "Bodily injury" if sustained within a
building and caused by smoke,
fumes, vapor or soot produced by or
originating from equipment that is
used to heat, cool or dehumidify the
building, or equipment that is used to
heat water for personal use, by the
building's occupants or their guests;
(ii) "Bodily injury" or "property damage"
for which you may be held liable, if
you are a contractor and the owner
or lessee of such premises, site or
location has been added to your
policy as an additional insured with
respect to your ongoing operations
performed for that additional insured
at that premises, site or location and
such premises, site or location is not
and never was owned or occupied
by, or rented or loaned to, any
insured, other than that additional
insured; or
(iii) "Bodily injury" or "property damage"
arising out of heat, smoke or fumes
from a "hostile fire";
(b) At or from any premises, site or location
which is or was at any time used by or
for any insured or others for the
handling, storage, disposal, processing
or treatment of waste;
(c) Which are or were at any time
transported, handled, stored, treated,
disposed of, or processed as waste by
or for:
(i) Any insured; or
(ii) Any person or organization for whom
you may be legally responsible; or
(d) At or from any premises, site or location
on which any insured or any contractors
or subcontractors working directly or
indirectly on any insured's behalf are
performing operations if the "pollutants"
are brought on or to the premises, site
or location in connection with such
operations by such insured, contractor
or subcontractor. However, this
subparagraph does not apply to:
(i) "Bodily injury" or "property damage"
arising out of the escape of fuels,
lubricants or other operating fluids
which are needed to perform the
normal electrical, hydraulic or
mechanical functions necessary for
the operation of "mobile equipment"
or its parts, if such fuels, lubricants
or other operating fluids escape from
a vehicle part designed to hold, store
or receive them. This exception does
not apply if the "bodily injury" or
"property damage" arises out of the
intentional discharge, dispersal or
release of the fuels, lubricants or
other operating fluids, or if such
fuels, lubricants or other operating
fluids are brought on or to the
premises, site or location with the
intent that they be discharged,
dispersed or released as part of the
operations being performed by such
insured, contractor or subcontractor;
(ii) "Bodily injury" or "property damage"
sustained within a building and
caused by the release of gases,
fumes or vapors from materials
brought into that building in
connection with operations being
performed by you or on your behalf
by a contractor or subcontractor; or
(iii) "Bodily injury" or "property damage"
arising out of heat, smoke or fumes
from a "hostile fire".
(e) At or from any premises, site or location
on which any insured or any contractors
or subcontractors working directly or
indirectly on any insured's behalf are
performing operations if the operations
are to test for, monitor, clean up,
remove, contain, treat, detoxify or
neutralize, or in any way respond to, or
assess the effects of, "pollutants".

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(2) Any loss, cost or expense arising out of
any:
(a) Request, demand, order or statutory or
regulatory requirement that any insured
or others test for, monitor, clean up,
remove, contain, treat, detoxify or
neutralize, or in any way respond to, or
assess the effects of, "pollutants"; or
(b) Claim or suit by or on behalf of a
governmental authority for damages
because of testing for, monitoring,
cleaning up, removing, containing,
treating, detoxifying or neutralizing, or in
any way responding to, or assessing the
effects of, "pollutants".

However, this paragraph does not apply to
liability for damages because of "property
damage" that the insured would have in the
absence of such request, demand, order or
statutory or regulatory requirement, or such
claim or "suit" by or on behalf of a
governmental authority.
g. Aircraft, Auto Or Watercraft
"Bodily injury" or "property damage" arising out
of the ownership, maintenance, use or
entrustment to others of any aircraft, "auto" or
watercraft owned or operated by or rented or
loaned to any insured. Use includes operation
and "loading or unloading".

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"
involved the ownership, maintenance, use or
entrustment to others of any aircraft, "auto" or
watercraft that is owned or operated by or
rented or loaned to any insured.

This exclusion does not apply to:
(1) A watercraft while ashore on premises you
own or rent;
(2) A watercraft you do not own that is:
(a) Less than 26 feet long; and
(b) Not being used to carry persons or
property for a charge;
(3) Parking an "auto" on, or on the ways next
to, premises you own or rent, provided the
"auto" is not owned by or rented or loaned
to you or the insured;
(4) Liability assumed under any "insured
contract" for the ownership, maintenance or
use of aircraft or watercraft; or
(5) "Bodily injury" or "property damage" arising
out of:
(a) The operation of machinery or
equipment that is attached to, or part of,
a land vehicle that would qualify under
the definition of "mobile equipment" if it
were not subject to a compulsory or
financial responsibility law or other
motor vehicle insurance law where it is
licensed or principally garaged; or
(b) The operation of any of the machinery
or equipment listed in Paragraph f.(2) or
f.(3) of the definition of "mobile
equipment".
h. Mobile Equipment
"Bodily injury" or "property damage" arising out
of:
(1) The transportation of "mobile equipment" by
an "auto" owned or operated by or rented or
loaned to any insured; or
(2) The use of "mobile equipment" in, or while
in practice for, or while being prepared for,
any prearranged racing, speed, demolition,
or stunting activity.
i. War
"Bodily injury" or "property damage", however
caused, arising, directly or indirectly, out of:
(1) War, including undeclared or civil war;
(2) Warlike action by a military force, including
action in hindering or defending against an
actual or expected attack, by any
government, sovereign or other authority
using military personnel or other agents; or
(3) Insurrection, rebellion, revolution, usurped
power, or action taken by governmental
authority in hindering or defending against
any of these.
j. Damage To Property
"Property damage" to:
(1) Property you own, rent, or occupy, including
any costs or expenses incurred by you, or
any other person, organization or entity, for
repair, replacement, enhancement,
restoration or maintenance of such property
for any reason, including prevention of
injury to a person or damage to another's
property;
(2) Premises you sell, give away or abandon, if
the "property damage" arises out of any
part of those premises;
(3) Property loaned to you;
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CG 00 01 04 13 © Insurance Services Office, Inc., 2012 Page 5 of 16 (4) Personal property in the care, custody or
control of the insured;
(5) That particular part of real property on
which you or any contractors or
subcontractors working directly or indirectly
on your behalf are performing operations, if
the "property damage" arises out of those
operations; or
(6) That particular part of any property that
must be restored, repaired or replaced
because "your work" was incorrectly
performed on it.

Paragraphs (1), (3) and (4) of this exclusion do
not apply to "property damage" (other than
damage by fire) to premises, including the
contents of such premises, rented to you for a
period of seven or fewer consecutive days. A
separate limit of insurance applies to Damage
To Premises Rented To You as described in
Section III – Limits Of Insurance.

Paragraph (2) of this exclusion does not apply
if the premises are "your work" and were never
occupied, rented or held for rental by you.

Paragraphs (3), (4), (5) and (6) of this
exclusion do not apply to liability assumed
under a sidetrack agreement.

Paragraph (6) of this exclusion does not apply
to "property damage" included in the "productscompleted operations hazard". k. Damage To Your Product
"Property damage" to "your product" arising out
of it or any part of it.
l. Damage To Your Work
"Property damage" to "your work" arising out of
it or any part of it and included in the "productscompleted operations hazard".

This exclusion does not apply if the damaged
work or the work out of which the damage
arises was performed on your behalf by a
subcontractor.
m. Damage To Impaired Property Or Property
Not Physically Injured
"Property damage" to "impaired property" or
property that has not been physically injured,
arising out of:
(1) A defect, deficiency, inadequacy or
dangerous condition in "your product" or
"your work"; or
(2) A delay or failure by you or anyone acting
on your behalf to perform a contract or
agreement in accordance with its terms.

This exclusion does not apply to the loss of use
of other property arising out of sudden and
accidental physical injury to "your product" or
"your work" after it has been put to its intended
use.
n. Recall Of Products, Work Or Impaired
Property
Damages claimed for any loss, cost or
expense incurred by you or others for the loss
of use, withdrawal, recall, inspection, repair,
replacement, adjustment, removal or disposal
of:
(1) "Your product";
(2) "Your work"; or
(3) "Impaired property";
if such product, work, or property is withdrawn
or recalled from the market or from use by any
person or organization because of a known or
suspected defect, deficiency, inadequacy or
dangerous condition in it.
o. Personal And Advertising Injury
"Bodily injury" arising out of "personal and
advertising injury".
p. Electronic Data
Damages arising out of the loss of, loss of use
of, damage to, corruption of, inability to access,
or inability to manipulate electronic data.

However, this exclusion does not apply to
liability for damages because of "bodily injury".

As used in this exclusion, electronic data
means information, facts or programs stored as
or on, created or used on, or transmitted to or
from computer software, including systems and
applications software, hard or floppy disks, CDROMs, tapes, drives, cells, data processing devices or any other media which are used
with electronically controlled equipment.
q. Recording And Distribution Of Material Or
Information In Violation Of Law
"Bodily injury" or "property damage" arising
directly or indirectly out of any action or
omission that violates or is alleged to violate:
(1) The Telephone Consumer Protection Act
(TCPA), including any amendment of or
addition to such law;
(2) The CAN-SPAM Act of 2003, including any
amendment of or addition to such law;
(3) The Fair Credit Reporting Act (FCRA), and
any amendment of or addition to such law,
including the Fair and Accurate Credit
Transactions Act (FACTA); or
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(4) Any federal, state or local statute,
ordinance or regulation, other than the
TCPA, CAN-SPAM Act of 2003 or FCRA
and their amendments and additions, that
addresses, prohibits, or limits the printing,
dissemination, disposal, collecting,
recording, sending, transmitting,
communicating or distribution of material or
information.

Exclusions c. through n. do not apply to damage
by fire to premises while rented to you or
temporarily occupied by you with permission of the
owner. A separate limit of insurance applies to this
coverage as described in Section III – Limits Of
Insurance.

COVERAGE B – PERSONAL AND ADVERTISING

INJURY LIABILITY

1. Insuring Agreement
a. We will pay those sums that the insured
becomes legally obligated to pay as damages
because of "personal and advertising injury" to
which this insurance applies. We will have the
right and duty to defend the insured against
any "suit" seeking those damages. However,
we will have no duty to defend the insured
against any "suit" seeking damages for
"personal and advertising injury" to which this
insurance does not apply. We may, at our
discretion, investigate any offense and settle
any claim or "suit" that may result. But:
(1) The amount we will pay for damages is
limited as described in Section III – Limits
Of Insurance; and
(2) Our right and duty to defend end when we
have used up the applicable limit of
insurance in the payment of judgments or
settlements under Coverages A or B or
medical expenses under Coverage C.

No other obligation or liability to pay sums or
perform acts or services is covered unless
explicitly provided for under Supplementary
Payments – Coverages A and B.
b. This insurance applies to "personal and
advertising injury" caused by an offense arising
out of your business but only if the offense was
committed in the "coverage territory" during the
policy period.

2. Exclusions
This insurance does not apply to:
a. Knowing Violation Of Rights Of Another
"Personal and advertising injury" caused by or
at the direction of the insured with the
knowledge that the act would violate the rights
of another and would inflict "personal and
advertising injury".
b. Material Published With Knowledge Of
Falsity
"Personal and advertising injury" arising out of
oral or written publication, in any manner, of
material, if done by or at the direction of the
insured with knowledge of its falsity.
c. Material Published Prior To Policy Period
"Personal and advertising injury" arising out of
oral or written publication, in any manner, of
material whose first publication took place
before the beginning of the policy period.
d. Criminal Acts
"Personal and advertising injury" arising out of
a criminal act committed by or at the direction
of the insured.
e. Contractual Liability
"Personal and advertising injury" for which the
insured has assumed liability in a contract or
agreement. This exclusion does not apply to
liability for damages that the insured would
have in the absence of the contract or
agreement.
f. Breach Of Contract
"Personal and advertising injury" arising out of
a breach of contract, except an implied
contract to use another's advertising idea in
your "advertisement".
g. Quality Or Performance Of Goods – Failure
To Conform To Statements
"Personal and advertising injury" arising out of
the failure of goods, products or services to
conform with any statement of quality or
performance made in your "advertisement".
h. Wrong Description Of Prices
"Personal and advertising injury" arising out of
the wrong description of the price of goods,
products or services stated in your
"advertisement".

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CG 00 01 04 13 © Insurance Services Office, Inc., 2012 Page 7 of 16 i. Infringement Of Copyright, Patent,
Trademark Or Trade Secret
"Personal and advertising injury" arising out of
the infringement of copyright, patent,
trademark, trade secret or other intellectual
property rights. Under this exclusion, such
other intellectual property rights do not include
the use of another's advertising idea in your
"advertisement".

However, this exclusion does not apply to
infringement, in your "advertisement", of
copyright, trade dress or slogan.
j. Insureds In Media And Internet Type
Businesses
"Personal and advertising injury" committed by
an insured whose business is:
(1) Advertising, broadcasting, publishing or
telecasting;
(2) Designing or determining content of web
sites for others; or
(3) An Internet search, access, content or
service provider.

However, this exclusion does not apply to
Paragraphs 14.a., b. and c. of "personal and
advertising injury" under the Definitions
section.

For the purposes of this exclusion, the placing
of frames, borders or links, or advertising, for
you or others anywhere on the Internet, is not
by itself, considered the business of
advertising, broadcasting, publishing or
telecasting.
k. Electronic Chatrooms Or Bulletin Boards
"Personal and advertising injury" arising out of
an electronic chatroom or bulletin board the
insured hosts, owns, or over which the insured
exercises control.
l. Unauthorized Use Of Another's Name Or
Product
"Personal and advertising injury" arising out of
the unauthorized use of another's name or
product in your e-mail address, domain name
or metatag, or any other similar tactics to
mislead another's potential customers.
m. Pollution
"Personal and advertising injury" arising out of
the actual, alleged or threatened discharge,
dispersal, seepage, migration, release or
escape of "pollutants" at any time.
n. Pollution-related
Any loss, cost or expense arising out of any:
(1) Request, demand, order or statutory or
regulatory requirement that any insured or
others test for, monitor, clean up, remove,
contain, treat, detoxify or neutralize, or in
any way respond to, or assess the effects
of, "pollutants"; or
(2) Claim or suit by or on behalf of a
governmental authority for damages
because of testing for, monitoring, cleaning
up, removing, containing, treating,
detoxifying or neutralizing, or in any way
responding to, or assessing the effects of,
"pollutants".
o. War
"Personal and advertising injury", however
caused, arising, directly or indirectly, out of:
(1) War, including undeclared or civil war;
(2) Warlike action by a military force, including
action in hindering or defending against an
actual or expected attack, by any
government, sovereign or other authority
using military personnel or other agents; or
(3) Insurrection, rebellion, revolution, usurped
power, or action taken by governmental
authority in hindering or defending against
any of these.
p. Recording And Distribution Of Material Or
Information In Violation Of Law
"Personal and advertising injury" arising
directly or indirectly out of any action or
omission that violates or is alleged to violate:
(1) The Telephone Consumer Protection Act
(TCPA), including any amendment of or
addition to such law;
(2) The CAN-SPAM Act of 2003, including any
amendment of or addition to such law;
(3) The Fair Credit Reporting Act (FCRA), and
any amendment of or addition to such law,
including the Fair and Accurate Credit
Transactions Act (FACTA); or
(4) Any federal, state or local statute,
ordinance or regulation, other than the
TCPA, CAN-SPAM Act of 2003 or FCRA
and their amendments and additions, that
addresses, prohibits, or limits the printing,
dissemination, disposal, collecting,
recording, sending, transmitting,
communicating or distribution of material or
information.

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COVERAGE C – MEDICAL PAYMENTS

1. Insuring Agreement
a. We will pay medical expenses as described
below for "bodily injury" caused by an accident:
(1) On premises you own or rent;
(2) On ways next to premises you own or rent;
or
(3) Because of your operations;
provided that:
(a) The accident takes place in the
"coverage territory" and during the policy
period;
(b) The expenses are incurred and reported
to us within one year of the date of the
accident; and
(c) The injured person submits to
examination, at our expense, by
physicians of our choice as often as we
reasonably require.
b. We will make these payments regardless of
fault. These payments will not exceed the
applicable limit of insurance. We will pay
reasonable expenses for:
(1) First aid administered at the time of an
accident;
(2) Necessary medical, surgical, X-ray and
dental services, including prosthetic
devices; and
(3) Necessary ambulance, hospital,
professional nursing and funeral services.

2. Exclusions
We will not pay expenses for "bodily injury":
a. Any Insured
To any insured, except "volunteer workers".
b. Hired Person
To a person hired to do work for or on behalf of
any insured or a tenant of any insured.
c. Injury On Normally Occupied Premises
To a person injured on that part of premises
you own or rent that the person normally
occupies.
d. Workers' Compensation And Similar Laws
To a person, whether or not an "employee" of
any insured, if benefits for the "bodily injury"
are payable or must be provided under a
workers' compensation or disability benefits
law or a similar law.
e. Athletics Activities
To a person injured while practicing, instructing
or participating in any physical exercises or
games, sports, or athletic contests.
f. Products-Completed Operations Hazard
Included within the "products-completed
operations hazard".
g. Coverage A Exclusions
Excluded under Coverage A.

SUPPLEMENTARY PAYMENTS – COVERAGES A
AND B

1. We will pay, with respect to any claim we
investigate or settle, or any "suit" against an
insured we defend:
a. All expenses we incur.
b. Up to $250 for cost of bail bonds required
because of accidents or traffic law violations
arising out of the use of any vehicle to which
the Bodily Injury Liability Coverage applies. We
do not have to furnish these bonds.
c. The cost of bonds to release attachments, but
only for bond amounts within the applicable
limit of insurance. We do not have to furnish
these bonds.
d. All reasonable expenses incurred by the
insured at our request to assist us in the
investigation or defense of the claim or "suit",
including actual loss of earnings up to $250 a
day because of time off from work.
e. All court costs taxed against the insured in the
"suit". However, these payments do not include
attorneys' fees or attorneys' expenses taxed
against the insured.
f. Prejudgment interest awarded against the
insured on that part of the judgment we pay. If
we make an offer to pay the applicable limit of
insurance, we will not pay any prejudgment
interest based on that period of time after the
offer.

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that accrues after entry of the judgment and
before we have paid, offered to pay, or
deposited in court the part of the judgment that
is within the applicable limit of insurance.

These payments will not reduce the limits of
insurance.

2. If we defend an insured against a "suit" and an
indemnitee of the insured is also named as a party
to the "suit", we will defend that indemnitee if all of the following conditions are met:
a. The "suit" against the indemnitee seeks
damages for which the insured has assumed
the liability of the indemnitee in a contract or
agreement that is an "insured contract";
b. This insurance applies to such liability
assumed by the insured;
c. The obligation to defend, or the cost of the
defense of, that indemnitee, has also been
assumed by the insured in the same "insured
contract";
d. The allegations in the "suit" and the information
we know about the "occurrence" are such that
no conflict appears to exist between the
interests of the insured and the interests of the
indemnitee;
e. The indemnitee and the insured ask us to
conduct and control the defense of that
indemnitee against such "suit" and agree that
we can assign the same counsel to defend the
insured and the indemnitee; and
f. The indemnitee:
(1) Agrees in writing to:
(a) Cooperate with us in the investigation,
settlement or defense of the "suit";
(b) Immediately send us copies of any
demands, notices, summonses or legal
papers received in connection with the
"suit";
(c) Notify any other insurer whose coverage
is available to the indemnitee; and
(d) Cooperate with us with respect to
coordinating other applicable insurance
available to the indemnitee; and
(2) Provides us with written authorization to:
(a) Obtain records and other information
related to the "suit"; and
(b) Conduct and control the defense of the
indemnitee in such "suit".

So long as the above conditions are met,
attorneys' fees incurred by us in the defense of
that indemnitee, necessary litigation expenses
incurred by us and necessary litigation expenses
incurred by the indemnitee at our request will be
paid as Supplementary Payments.

Notwithstanding the provisions of Paragraph

2.b.(2) of Section I – Coverage A – Bodily Injury
And Property Damage Liability, such payments will
not be deemed to be damages for "bodily injury"
and "property damage" and will not reduce the
limits of insurance.

Our obligation to defend an insured's indemnitee
and to pay for attorneys' fees and necessary
litigation expenses as Supplementary Payments
ends when we have used up the applicable limit of
insurance in the payment of judgments or
settlements or the conditions set forth above, or
the terms of the agreement described in
Paragraph f. above, are no longer met.

SECTION II – WHO IS AN INSURED

1. If you are designated in the Declarations as:
a. An individual, you and your spouse are
insureds, but only 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 only with
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, but only with respect
to their duties as your managers.
d. An organization other than a partnership, joint
venture or limited liability company, you are an
insured. Your "executive officers" and directors
are insureds, but only with respect to their
duties as your officers or directors. Your
stockholders are also insureds, but only with
respect to their liability as stockholders.
e. A trust, you are an insured. Your trustees are
also insureds, but only with respect to their
duties as trustees.

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2. Each of the following is also an insured:
a. Your "volunteer workers" only while performing
duties related to the conduct of your business,
or your "employees", other than either your
"executive officers" (if you are an organization
other than a partnership, joint venture or limited
liability company) or your managers (if you are
a limited liability company), but only for acts
within 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, to 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 duties related
to the conduct of your business, or to
your other "volunteer workers" while
performing duties related to the conduct
of your business;
(b) To the spouse, child, parent, brother or
sister of that co-"employee" or
"volunteer worker" as a consequence of
Paragraph (1)(a) above;
(c) For which there is any obligation to
share damages with or repay someone
else who must pay damages because of
the injury described in Paragraph (1)(a)
or (b) above; or
(d) Arising out of his or her providing or
failing to provide professional health
care services.
(2) "Property damage" to property:
(a) Owned, occupied or used by;
(b) Rented to, in the care, custody or
control of, or over which physical control
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. Any person (other than your "employee" or
"volunteer worker"), or any organization while
acting as your real estate manager.
c. Any person or organization 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 that property; and
(2) Until your legal representative has been
appointed.
d. Your legal representative if you die, but only
with respect to duties as such. That
representative will have all your rights and
duties under this Coverage Part.

3. Any organization you newly acquire or form, other
than a partnership, joint venture or limited liability
company, and over which you maintain ownership
or majority interest, 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
until the 90th day after you acquire or form the
organization or the end of the policy period,
whichever is earlier;
b. Coverage A does not apply to "bodily injury" or
"property damage" that occurred before you
acquired or formed the organization; and
c. Coverage B does not apply to "personal and
advertising injury" arising out of an offense
committed before you acquired or formed the
organization.

No person or organization is an insured with respect
to the conduct of any current or past partnership, joint venture or limited liability company that is not shown
as a Named Insured in the Declarations.

SECTION III – LIMITS OF INSURANCE

1. The Limits of Insurance shown in the Declarations
and the rules below fix the most we will pay
regardless of the number of:
a. Insureds;
b. Claims made or "suits" brought; or
c. Persons or organizations making claims or
bringing "suits".

2. The General Aggregate Limit is the most we will
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 operations
hazard"; and
c. Damages under Coverage B.

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3. The Products-Completed Operations 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
operations hazard".

4. Subject to Paragraph 2. above, the Personal And
Advertising Injury Limit is the most we will pay
under Coverage B for the sum of all damages
because of all "personal and advertising injury"
sustained by any one person or organization.

5. Subject to Paragraph 2. or 3. above, whichever
applies, the Each Occurrence Limit 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. Subject to Paragraph 5. above, the Damage To
Premises Rented To You Limit is the most we will
pay under Coverage A for damages because of
"property damage" to any one premises, while
rented to you, or in the case of damage by fire,
while rented to you or temporarily occupied by you
with permission of the owner.

7. Subject to Paragraph 5. above, the Medical
Expense Limit is the most we will pay under
Coverage C for all medical expenses because of
"bodily injury" sustained by any one person.

The Limits of Insurance of this Coverage Part apply
separately to each consecutive annual period and to
any remaining period of less than 12 months, starting
with the beginning of the policy period shown in the
Declarations, unless the policy period is extended
after issuance for an additional period of less than 12 months. In that case, the additional period will be
deemed part of the last preceding period for purposes
of determining the Limits of Insurance.

SECTION IV – COMMERCIAL GENERAL LIABILITY

CONDITIONS

1. Bankruptcy
Bankruptcy or insolvency of the insured or of the
insured's estate will not relieve us of our
obligations under this Coverage Part.

2. Duties In The Event Of Occurrence, Offense,
Claim Or Suit
a. You must see to it that we are notified as soon
as practicable of an "occurrence" or an offense
which may result in a claim. To the extent
possible, notice should include:
(1) How, when and where the "occurrence" or
offense took place;
(2) The names and addresses of any injured
persons and witnesses; and
(3) The nature and location of any injury or
damage arising out of the "occurrence" or
offense.
b. If a claim is made or "suit" is brought against
any insured, you must:
(1) Immediately record the specifics of the
claim or "suit" and the date received; and
(2) Notify us as soon as practicable.

You must see to it that we receive written
notice of the claim or "suit" as soon as
practicable.
c. You and any other involved insured must:
(1) Immediately send us copies of any
demands, notices, summonses or legal
papers received in connection with the
claim or "suit";
(2) Authorize us to obtain records and other
information;
(3) Cooperate with us in the investigation or
settlement of the claim or defense against
the "suit"; and
(4) Assist us, upon our request, in the
enforcement of any right against any
person or organization which may be liable
to the insured because of injury or damage
to which this insurance may also apply.
d. No insured will, except at that insured's own
cost, voluntarily make a payment, assume any
obligation, or incur any expense, other than for
first aid, without our consent.

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 terms have been fully complied with.

A person or organization may sue us to recover on
an agreed settlement or on a final judgment
against an insured; but we will not be liable for
damages that are not payable under the terms of
this Coverage Part or that are in excess of the
applicable limit of insurance. An agreed settlement
means a settlement and release of liability signed
by us, the insured and the claimant or the
claimant's legal representative.

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4. Other Insurance
If other valid and collectible insurance is available
to the insured for a loss we cover under
Coverages A or B of this Coverage Part, our
obligations are limited as follows:
a. Primary Insurance
This insurance is primary except when
Paragraph b. below applies. If this insurance is
primary, our obligations are not affected unless
any of the other insurance is also primary.

Then, we will share with all that other
insurance by the method described in
Paragraph c. below.
b. Excess Insurance
(1) This insurance is excess over:
(a) Any of the other insurance, whether
primary, excess, contingent or on any
other basis:
(i) That is Fire, Extended Coverage,
Builder's Risk, Installation Risk or
similar coverage for "your work";
(ii) That is Fire insurance for premises
rented to you or temporarily
occupied by you with permission of
the owner;
(iii) That is insurance purchased by you
to cover your liability as a tenant for
"property damage" to premises
rented to you or temporarily
occupied by you with permission of
the owner; or
(iv) If the loss arises out of the
maintenance or use of aircraft,
"autos" or watercraft to the extent not
subject to Exclusion g. of Section I –
Coverage A – Bodily Injury And
Property Damage Liability.
(b) Any other primary insurance available to
you covering liability for damages
arising out of the premises or
operations, or the products and
completed operations, for which you
have been added as an additional
insured.
(2) When this insurance is excess, we will have
no duty under Coverages A or B to defend
the insured against any "suit" if any other
insurer has a duty to defend the insured
against that "suit". If no other insurer
defends, we will undertake to do so, but we
will be entitled to the insured's rights
against all those other insurers.
(3) 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:
(a) The total amount that all such other
insurance would pay for the loss in the
absence of this insurance; and
(b) The total of all deductible and selfinsured amounts under all that other insurance.
(4) We will share the remaining loss, if any,
with any other insurance that 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 Declarations of this Coverage
Part.
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 method, 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.

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 period 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;
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representations you made to us; and
c. We have issued this policy in reliance upon
your representations.

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 notice 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 web sites, only that part of a web
site that is about your goods, products or
services for the purposes of attracting
customers or supporters is considered an
advertisement.

2. "Auto" means:
a. A land motor vehicle, trailer or semitrailer
designed for travel on public roads, including
any attached machinery or equipment; or
b. Any other land vehicle that is subject to a
compulsory or financial responsibility law or
other motor vehicle insurance law where it is
licensed or principally garaged.

However, "auto" does not include "mobile
equipment".

3. "Bodily injury" means bodily injury, sickness or
disease sustained by a person, including death
resulting from any of these at any time.

4. "Coverage territory" means:
a. The United States of America (including its
territories and possessions), Puerto Rico and
Canada;
b. International waters or airspace, but only if the
injury or damage occurs in the course of travel
or transportation between any places included
in Paragraph a. above; or
c. All other parts of the world if the injury or
damage arises out of:
(1) Goods or products made or sold by you in
the territory described in Paragraph a.
above;
(2) The activities of a person whose home is in
the territory described in Paragraph a.
above, but is away for a short time on your
business; or
(3) "Personal and advertising injury" offenses
that take place through the Internet or
similar electronic means of communication;
provided the insured's responsibility to pay
damages is determined in a "suit" on the merits, in
the territory described in Paragraph a. above or in
a settlement we agree to.

5. "Employee" includes a "leased worker".
"Employee" does not include a "temporary
worker".

6. "Executive officer" means a person holding any of
the officer positions created by your charter,
constitution, bylaws or any other similar governing
document.

7. "Hostile fire" means one which becomes
uncontrollable or breaks out from where it was
intended to be.

8. "Impaired property" means tangible property, other
than "your product" or "your work", that cannot be
used or is less useful because:
a. It incorporates "your product" or "your work"
that is known or thought to be defective,
deficient, inadequate or dangerous; or
b. You have failed to fulfill the terms of a contract
or agreement;
if such property can be restored to use by the
repair, replacement, adjustment or removal of
"your product" or "your work" or your fulfilling the
terms of the contract or agreement.

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9. "Insured contract" means:
a. A contract for a lease of premises. However,
that portion of the contract for a lease of
premises that indemnifies any person or
organization for damage by fire to premises
while rented to you or temporarily occupied by
you with permission of the owner is not an
"insured contract";
b. A sidetrack agreement;
c. Any easement or license agreement, except in
connection with construction or demolition
operations on or within 50 feet of a railroad;
d. An obligation, as required by ordinance, to
indemnify a municipality, except in connection
with work for a municipality;
e. An elevator maintenance agreement;
f. That part of any other contract or agreement
pertaining to your business (including an
indemnification of a municipality in connection
with work performed for a municipality) under
which you assume the tort liability of another
party to pay for "bodily injury" or "property
damage" to a third person or organization. Tort
liability means a liability that would be imposed
by law in the absence of any contract or
agreement.

Paragraph f. does not include that part of any
contract or agreement:
(1) That indemnifies a railroad for "bodily injury"
or "property damage" arising out of
construction or demolition operations, within
50 feet of any railroad property and
affecting any railroad bridge or trestle,
tracks, road-beds, tunnel, underpass or
crossing;
(2) That indemnifies an architect, engineer or
surveyor for injury or damage arising out of:
(a) Preparing, approving, or failing to
prepare or approve, maps, shop
drawings, opinions, reports, surveys,
field orders, change orders or drawings
and specifications; or
(b) Giving directions or instructions, or
failing to give them, if that is the primary
cause of the injury or damage; or
(3) Under which the insured, if an architect,
engineer or surveyor, assumes liability for
an injury or damage arising out of the
insured's rendering or failure to render
professional services, including those listed
in (2) above and supervisory, inspection,
architectural or engineering activities.

10."Leased worker" means a person leased to you by
a labor leasing firm under an agreement between
you and the labor leasing firm, to perform duties
related to the conduct of your business. "Leased
worker" does not include a "temporary worker".

11."Loading or unloading" means the handling of
property:
a. After it is moved from the place where it is
accepted for movement into or onto an aircraft,
watercraft or "auto";
b. While it is in or on an aircraft, watercraft or
"auto"; or
c. While it is being moved from an aircraft,
watercraft or "auto" to the place where it is
finally delivered;
but "loading or unloading" does not include the
movement of property by means of a mechanical
device, other than a hand truck, that is not
attached to the aircraft, watercraft or "auto".

12."Mobile equipment" means any of the following
types of land vehicles, including any attached
machinery or equipment:
a. Bulldozers, farm machinery, forklifts and other
vehicles designed for use principally off public
roads;
b. Vehicles maintained for use solely on or next to
premises you own or rent;
c. Vehicles that travel on crawler treads;
d. Vehicles, whether self-propelled or not,
maintained primarily to provide mobility to
permanently mounted:
(1) Power cranes, shovels, loaders, diggers or
drills; or
(2) Road construction or resurfacing equipment
such as graders, scrapers or rollers;
e. Vehicles not described in Paragraph a., b., c.
or d. above that are not self-propelled and are
maintained primarily to provide mobility to
permanently attached equipment of the
following types:
(1) Air compressors, pumps and generators,
including spraying, welding, building
cleaning, geophysical exploration, lighting
and well servicing equipment; or
(2) Cherry pickers and similar devices used to
raise or lower workers;
f. Vehicles not described in Paragraph a., b., c.
or d. above maintained primarily for purposes
other than the transportation of persons or
cargo.

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following types of permanently attached
equipment are not "mobile equipment" but will
be considered "autos":
(1) Equipment designed primarily for:
(a) Snow removal;
(b) Road maintenance, but not construction
or resurfacing; or
(c) Street cleaning;
(2) Cherry pickers and similar devices mounted
on automobile or truck chassis and used to
raise or lower workers; and
(3) Air compressors, pumps and generators,
including spraying, welding, building
cleaning, geophysical exploration, lighting
and well servicing equipment.

However, "mobile equipment" does not include
any land vehicles that are subject to a compulsory
or financial responsibility law or other motor
vehicle insurance law where it is licensed or
principally garaged. Land vehicles subject to a
compulsory or financial responsibility law or other
motor vehicle insurance law are considered
"autos".

13."Occurrence" means an accident, including
continuous or repeated exposure to substantially
the same general harmful conditions.

14."Personal and advertising injury" means injury,
including consequential "bodily injury", arising out
of one or more of the following offenses:
a. False arrest, detention or imprisonment;
b. Malicious prosecution;
c. The wrongful eviction from, wrongful entry into,
or invasion of the right of private occupancy of
a room, dwelling or premises that a person
occupies, committed by or on behalf of its
owner, landlord or lessor;
d. Oral or written publication, in any manner, of
material that slanders or libels a person or
organization or disparages a person's or
organization's goods, products or services;
e. Oral or written publication, in any manner, of
material that violates a person's right of
privacy;
f. The use of another's advertising idea in your
"advertisement"; or
g. Infringing upon another's copyright, trade dress
or slogan in your "advertisement".

15."Pollutants" mean any solid, liquid, gaseous or
thermal irritant or contaminant, including smoke,
vapor, soot, fumes, acids, alkalis, chemicals and
waste. Waste includes materials to be recycled,
reconditioned or reclaimed.

16."Products-completed operations hazard":
a. Includes all "bodily injury" and "property
damage" occurring away from premises you
own or rent and arising out of "your product" or
"your work" except:
(1) Products that are still in your physical
possession; or
(2) Work that has not yet been completed or
abandoned. However, "your work" will be
deemed completed at the earliest of the
following times:
(a) When all of the work called for in your
contract has been completed.
(b) When all of the work to be done at the
job site has been completed if your
contract calls for work at more than one
job site.
(c) When that part of the work done at a job
site has been put to its intended use by
any person or organization other than
another contractor or subcontractor
working on the same project.

Work that may need service, maintenance,
correction, repair or replacement, but which
is otherwise complete, will be treated as
completed.
b. Does not include "bodily injury" or "property
damage" arising out of:
(1) The transportation of property, unless the
injury or damage arises out of a condition in
or on a vehicle not owned or operated by
you, and that condition was created by the
"loading or unloading" of that vehicle by any
insured;
(2) The existence of tools, uninstalled
equipment or abandoned or unused
materials; or
(3) Products or operations for which the
classification, listed in the Declarations or in
a policy Schedule, states that productscompleted operations are subject to the General Aggregate Limit.

17."Property damage" means:
a. Physical injury to tangible property, including
all resulting loss of use of that property. All
such loss of use shall be deemed to occur at
the time of the physical injury that caused it; or
b. Loss of use of tangible property that is not
physically injured. All such loss of use shall be
deemed to occur at the time of the
"occurrence" that caused it.

For the purposes of this insurance, electronic data
is not tangible property.

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As used in this definition, electronic data means
information, facts or programs stored as or on,
created or used on, or transmitted to or from
computer software, including systems and
applications software, hard or floppy disks, CDROMs, tapes, drives, cells, data processing devices or any other media which are used with
electronically controlled equipment.

18."Suit" means a civil proceeding in which damages
because of "bodily injury", "property damage" or
"personal and advertising injury" to which this
insurance applies are alleged. "Suit" includes:
a. An arbitration proceeding in which such
damages are claimed and to which the insured
must submit or does submit with our consent;
or
b. Any other alternative dispute resolution
proceeding in which such damages are
claimed and to which the insured submits with
our consent.

19."Temporary worker" means a person who is
furnished to you to substitute for a permanent
"employee" on leave or to meet seasonal or shortterm workload conditions.

20."Volunteer worker" means a person who is not
your "employee", and who donates his or her work
and acts at the direction of and within the scope of
duties determined by you, and is not paid a fee,
salary or other compensation by you or anyone
else for their work performed for you.

21."Your product":
a. Means:
(1) Any goods or products, other than real
property, manufactured, sold, handled,
distributed or disposed of by:
(a) You;
(b) Others trading under your name; or
(c) A person or organization whose
business or assets you have acquired;
and
(2) Containers (other than vehicles), materials,
parts or equipment furnished in connection
with such goods or products.
b. Includes:
(1) Warranties or representations made at any
time with respect to the fitness, quality,
durability, performance or use of "your
product"; and
(2) The providing of or failure to provide
warnings or instructions.
c. Does not include vending machines or other
property rented to or located for the use of
others but not sold.

22."Your work":
a. Means:
(1) Work or operations performed by you or on
your behalf; and
(2) Materials, parts or equipment furnished in
connection with such work or operations.
b. Includes:
(1) Warranties or representations made at any
time with respect to the fitness, quality,
durability, performance or use of "your
work"; and
(2) The providing of or failure to provide
warnings or instructions.

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IL 00 17 11 98
IL 00 17 11 98 Copyright, Insurance Services Office, Inc., 1998 Page 1 of 1

COMMON POLICY CONDITIONS
All Coverage Parts included in this policy are subject to the following conditions.

A. Cancellation

1. The first Named Insured shown in the Declarations may cancel this policy by mailing or delivering to us advance written notice of cancellation.

2. We may cancel this policy by mailing or delivering to the first Named Insured written notice of cancellation at least:
a. 10 days before the effective date of cancellation if we cancel for nonpayment of premium; or b. 30 days before the effective date of cancellation if we cancel for any other reason.

3. We will mail or deliver our notice to the first
Named Insured's last mailing address known to
us.

4. Notice of cancellation will state the effective
date of cancellation. The policy period will end
on that date.

5. If this policy is cancelled, we will send the first
Named Insured any premium refund due. If we
cancel, the refund will be pro rata. If the first
Named Insured cancels, the refund may be
less than pro rata. The cancellation will be effective even if we have not made or offered a refund.

6. If notice is mailed, proof of mailing will be sufficient proof of notice.

B. Changes
This policy contains all the agreements between
you and us concerning the insurance afforded.

The first Named Insured shown in the Declarations
is authorized to make changes in the terms of this
policy with our consent. This policy's terms can be
amended or waived only by endorsement issued
by us and made a part of this policy.

C. Examination Of Your Books And Records
We may examine and audit your books and records as they relate to this policy at any time during the policy period and up to three years afterward.

D. Inspections And Surveys

1. We have the right to:
a. Make inspections and surveys at any time;
b. Give you reports on the conditions we find;
and
c. Recommend changes.

2. We are not obligated to make any inspections,
surveys, reports or recommendations and any
such actions we do undertake relate only to insurability and the premiums to be charged. We do not make safety inspections. We do not undertake to perform the duty of any person or organization to provide for the health or safety
of workers or the public. And we do not warrant
that conditions:
a. Are safe or healthful; or
b. Comply with laws, regulations, codes or
standards.

3. Paragraphs 1. and 2. of this condition apply not
only to us, but also to any rating, advisory, rate
service or similar organization which makes insurance inspections, surveys, reports or recommendations.

4. Paragraph 2. of this condition does not apply to
any inspections, surveys, reports or recommendations we may make relative to certification, under state or municipal statutes, ordinances or regulations, of boilers, pressure vessels or elevators.

E. Premiums
The first Named Insured shown in the Declarations:

1. Is responsible for the payment of all premiums;
and

2. Will be the payee for any return premiums we
pay.

F. Transfer Of Your Rights And Duties Under This
Policy
Your rights and duties under this policy may not be
transferred without our written consent except in
the case of death of an individual named insured.

If you die, your rights and duties will be transferred
to your legal representative but only while acting
within the scope of duties as your legal representative. Until your legal representative is appointed, anyone having proper temporary custody of your
property will have your rights and duties but only
with respect to that property.

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POLICY NUMBER: COMMERCIAL GENERAL LIABILITY
CG 21 35 10 01
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

CG 21 35 10 01 © ISO Properties, Inc., 2000 Page 1 of 1
EXCLUSION – COVERAGE C – MEDICAL PAYMENTS
This endorsement modifies insurance provided under the following:

COMMERCIAL GENERAL LIABILITY COVERAGE PART

SCHEDULE
Description And Location Of Premises Or Classification:
(If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.)
With respect to any premises or classification shown
in the Schedule:

1. Section I – Coverage C – Medical Payments
does not apply and none of the references to it
in the Coverage Part apply: and

2. The following is added to Section I – Supplementary Payments:
h. Expenses incurred by the insured for first
aid administered to others at the time of an
accident for "bodily injury" to which this insurance applies.

H25SE10374
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COMMERCIAL GENERAL LIABILITY
CG 21 46 07 98
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

CG 21 46 07 98 Copyright, Insurance Services Office, Inc., 1997 Page 1 of 1

ABUSE OR MOLESTATION EXCLUSION
This endorsement modifies insurance provided under the following:

COMMERCIAL GENERAL LIABILITY COVERAGE PART
The following exclusion is added to Paragraph 2.,
Exclusions of Section I – Coverage A – Bodily
Injury And Property Damage Liability and Paragraph 2., Exclusions of Section I – Coverage B – Personal And Advertising Injury Liability:

This insurance does not apply to "bodily injury",
"property damage" or "personal and advertising
injury" arising out of:

1. The actual or threatened abuse or molestation by
anyone of any person while in the care, custody
or control of any insured, or

2. The negligent:
a. Employment;
b. Investigation;
c. Supervision;
d. Reporting to the proper authorities, or failure
to so report; or
e. Retention;
of a person for whom any insured is or ever was
legally responsible and whose conduct would be
excluded by Paragraph 1. above.

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ENDORSEMENT
THIS ENDORSEMENT EFFECTIVE:

FORMS A PART OF POLICY NO.:

ISSUED TO:
%<

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ CAREFULLY.

ASSAULT AND BATTERY EXCLUSION
This endorsement modifies insurance under the following:

COMMERCIAL GENERAL LIABILITY COVERAGE PART
This Policy shall not apply to "bodily injury”, “property damage", "personal injury", "advertising injury", or medical expense arising out of Assault and Battery or out of any act or omission in connection with the prevention or suppression of such acts, whether caused or at the instigation or direction the insured, his employees, patrons or any other person. All other terms, conditions, and exclusions shall remain unchanged.

Authorized Representative

H AB EX
Houston Casualty Company
H25SE10374
Reeve Wines LLC DBA BloodRoot Wines
May 06, 2025
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THIS ENDORSEMENT EFFECTIVE:

FORMS A PART OF POLICY NO.:

ISSUED TO:

BY:

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ CAREFULLY.

COLLAPSE OF TEMPORARY STRUCTURE EXCLUSION ENDORSEMENT
This endorsement modifies insurance under the following:

COMMERCIAL GENERAL LIABILITY COVERAGE PART
In consideration of the premium charged, it is agreed that this policy does not apply to any damage arising out of the collapse of any temporary grandstand, tent, bleacher, stage and/or any other temporary structure.

All other terms, conditions and exclusions remain the same.

____________________________
Authorized Representative

H CTS EX
Houston Casualty Company
H25SE10374
Reeve Wines LLC DBA BloodRoot Wines
May 06, 2025
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- 1 -
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

GENERAL LIABILITY EXTENSION ENDORSEMENT
This endorsement modifies insurance provided under the following:

COMMERCIAL GENERAL LIABILITY COVERAGE FORM
A. EMPLOYMENT RELATED PRACTICES

EXCLUSION
The following exclusion is added to paragraph 2.,
Exclusions of COVERAGE A – BODILY INJURY
AND PROPERTY DAMAGE LIABILITY (Section ICoverages) and to paragraph 2., Exclusions of COVERAGE B – PERSONAL AND
ADVERTISING INJURY LIABILITY (Section ICoverages):

This insurance does not apply to:
“Bodily injury” or “Personal and advertising
injury” to: A person arising out of any:
(1) Refusal to employ a person;
(2) Termination of a person’s employment;
(3) Coercion, demotion, evaluation,
reassignment, discipline, defamation,
harassment, humiliation or discrimination
directed at a person; or
(4) Consequential “bodily injury” or “personal
an advertising injury” as a result of (1)
through (3) above.

This exclusion applies:
(1) Whether the insured may be liable as an
employer or in any other capacity; and
(2) To any obligation to share damages with
or repay someone else who must pay
damages because of the injury.

B. EXCLUSIONS
The following paragraphs are added to Section I –
Coverage A – 2. Exclusions:
p. Asbestos
(1) The manufacture of, mining of, use of,
sale of, installation of, removal of,
distribution of or exposure to asbestos,
asbestos products, asbestos fibers or
asbestos dust;
(2) Any obligation of the insured to indemnify
any party because of damages arising out
of such “bodily injury”, “property damage”,
“personal and advertising injury” as a
result of the manufacture of, mining of,
use of, sale of, installation of, removal of,
distribution of or exposure to asbestos,
asbestos products, fibers or asbestos
dust;
(3) Any obligation to defend any claim or suit
against the insured alleging “bodily injury”,
“property damage”, “personal and
advertising injury” and seeking damages,
if such claim or suit arises from “bodily
injury”, “property damage”, “personal and
advertising injury” as a result of the
manufacture of, mining of, use of, sales
of, installation of, removal of, distribution
of or exposure to asbestos, asbestos,
asbestos products, asbestos or asbestos
dust; or
(4) To any loss, cost, expense, fine, or
penalty arising out of any of the foregoing
items 1., 2., or 3.
q. Fungus
This insurance does not apply to “bodily
injury”, “property damage”, “personal and
advertising injury”, or any other loss, cost or
expense, including, but not limited to losses,
costs or expenses related to, arising from or
associated with clean-up, remediation,
containment, removal or abatement, caused
directly or indirectly, in whole or in part, by:
(1) Any “fungus(i)”, “mold(s)”, mildew or
yeast, or
(2) Any “spore(s)” or toxins created or
produced by or emanating from such
“fungus(i)”, “mold(s)”, mildew or yeast, or
(3) Any substance, vapor, gas, or other
emission or organic or inorganic body or
substance produced by or arising out of
any “fungus(i)”, “mold(s)”, mildew or
yeast, or
(4) Any material, product, building
component, building or structure, or any
concentration of moisture, water or other
liquid within such material, product,
building component, building or structure,
that contains, harbors, nurtures or acts as
a medium for any “fungus(i)”, “mold(s)”,
mildew, yeast or “spore(s)” or toxins
emanating therefrom.
regardless of any other cause, event,
material, product and/or building component
that contributed concurrently or in any
sequence to that “bodily injury”, “property
damage”, “personal and advertising injury”,
loss, cost or expense.

For purposes of this exclusion, the following
definitions are added to the Policy:

H GL EXT
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(1) “Fungus(i)” includes, but is not limited to,
any of the plants or organisms belonging
to the major group Fungi, lacking
chlorophyll, and including molds, rusts,
mildews, smuts, and mushrooms.
(2) “Mold(s)” includes, but is not limited to,
any superficial growth produced on damp
or decaying organic matter or on living
organisms, and fungi that produce molds.
(3) “Spore(s)” means any dormant or
reproductive body produced by or arising
or emanating out of any “fungus(i)”,
“mold(s)”, mildew, plants, organisms or
microorganisms.

This exclusion does not apply to any "fungi" or
bacteria that are, are on, or are contained in,
a good or product intended for bodily
consumption.

This fungus exclusion DOES NOT apply in
the States of Alaska, California, Louisiana,
New York or Washington.

C. KNOWLEDGE OF OCCURRENCE
As respects any loss reporting requirements
under this policy, it is understood and agreed that
knowledge of an accident or incident by an agent,
servant or employee of yours or any other person
shall not in itself constitute knowledge by you,
unless a corporate officer of yours shall have
received notice from said agent, servant,
employee or any other person.

D. LIBERALIZATION CLAUSE
If we adopt a change in our forms or rules which
would broaden your coverage without an
additional premium charge, your policy will
automatically provide the additional coverages as
of the date the revision is effective in your state.

E. NON-OWNED WATERCRAFT EXCLUSION
Paragraph g.(2) of Section I – Coverage A – 2.

Exclusions is deleted and replaced by the
following:
(2) A watercraft you do not own that is:
(a) Less than 52 feet long; and
(b) Not being used to carry persons or
property for a charge.

F. NOTICE OF OCCURRENCE
Your failure to give first report of a claim to us
shall not invalidate coverage under this policy if
the loss was inadvertently reported to another
Insurer. However, you shall report any such
“Occurrence” to us within a reasonable time once
you become aware of such error.

G. SUPPLEMENTARY PAYMENTS

1. Paragraph 1. b. of SUPPLEMENTARY PAYMENTS SUPPLEMENTARY PAYMENTS – COVERAGES A and B – COVERAGES A and B COVERAGES A and B (SECTION I) (SECTION I)(SECTION I) (SECTION I) is deleted and replaced by the following:
b. Up to $2,500 for cost of bail bonds
required because of accidents or traffic
law violations arising out of the use of any
vehicle to which the Bodily Injury Liability
Coverage applies. We do not have to
furnish these bonds.

2. Paragraph 1. d. of SUPPLEMENTARY PAYMENTS SUPPLEMENTARY PAYMENTS – COVERAGES A and B – COVERAGES A and B COVERAGES A and B (SECTION I) (SECTION I)(SECTION I) (SECTION I) is deleted and replaced by the following:
d. All reasonable expenses incurred by the
insured at our request to assist us in the
investigation or defense of the claim or
“suit,” including actual loss of earnings up
to $350 a day because of time off from
work.

H. TOTAL POLLUTION EXCLUSION WITH A

HOSTILE FIRE EXCEPTION
Exclusion f. under Paragraph 2., Exclusions of
Section I – Coverage A is deleted and replaced by
the following:
f. Pollution
(1) “Bodily injury” or “property damage” which
would not have occurred in whole or part
but for the actual, alleged or threatened
discharge, dispersal, seepage, migration,
release or escape of “pollutants” at any
time.

This exclusion does not apply to “bodily
injury” or “property damage” arising out of
heat, smoke or fumes from a “hostile fire”
unless that “hostile fire” occurred or
originated:
(a) At any premises, site or location
which is or was at any time used by or
for any insured or others for the
handling, storage, disposal,
processing or treatment of waste; or
(b) At any premises, site or location on
which any insured or any contractors
or subcontractors working directly or
indirectly on any insured’s behalf are
performing operations to test for,
monitor, clean up, remove, contain,
treat, detoxify, neutralize or in any
way respond to, or assess the effects
of, “pollutants”.
(2) Any loss, cost or expense arising out of
any:
(a) Request, demand, order or statutory

H GL EXT
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or regulatory requirement that any
insured or others test for, monitor,
clean up, remove, contain, treat,
detoxify or neutralize, or in any way
respond to, or assess the effects of
“pollutants”; or
(b) Claim or suit by or on behalf of a
governmental authority for damages
because of testing for, monitoring,
cleaning up, removing, containing,
treating, detoxifying for neutralizing,
or in any way responding to, or
assessing the effects of, “pollutants”.

I. UNINTENTIONAL FAILURE TO DISCLOSE

HAZARDS
The following is added to paragraph 6.,
Representations of Section IV – Commercial
General Liability Conditions:

Your failure to disclose all hazards existing as of
the inception date of the policy shall not prejudice
you with respect to the coverage afforded by this
policy provided such failure or any omission is not
intentional.

H GL EXT
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THIS ENDORSEMENT EFFECTIVE:

FORMS A PART OF POLICY NO.:

ISSUED TO:
BY:

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ CAREFULLY.

FIREWORKS EXCLUSION
This endorsement modifies insurance under the following:

COMMERCIAL GENERAL LIABILITY COVERAGE PART
This policy does not apply to any damage arising out of the use of any explosives, fireworks, or pyro-technic devices.

However, for the purposes of this endorsement, flash boxes shall not be considered fireworks. Flash boxes are devices used to create a visual effect along with an explosive noise. They are induced electronically in a cylinder with no projectile, wadding or wrapping.

All other terms, conditions and exclusions remain the same.

Authorized Representative

H FW/PT EX
Houston Casualty Company
H25SE10374
Reeve Wines LLC DBA BloodRoot Wines
May 06, 2025
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INTERLINE
IL 00 21 05 04
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

IL 00 21 05 04 © ISO Properties, Inc., 2001 Page 1 of 2

NUCLEAR ENERGY LIABILITY EXCLUSION

ENDORSEMENT
(Broad Form)
This endorsement modifies insurance provided under the following:

COMMERCIAL AUTOMOBILE COVERAGE PART

COMMERCIAL GENERAL LIABILITY COVERAGE PART

FARM COVERAGE PART

LIQUOR LIABILITY COVERAGE PART

OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE PART

POLLUTION LIABILITY COVERAGE PART

PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART

PROFESSIONAL LIABILITY COVERAGE PART

RAILROAD PROTECTIVE LIABILITY COVERAGE PART

1. The insurance does not apply:

A. Under any Liability Coverage, to "bodily injury"
or "property damage":
(1) With respect to which an "insured" under
the policy is also an insured under a nuclear
energy liability policy issued by Nuclear Energy Liability Insurance Association, Mutual Atomic Energy Liability Underwriters, Nuclear Insurance Association of Canada or any of their successors, or would be an insured under any such policy but for its termination upon exhaustion of its limit of liability; or (2) Resulting from the "hazardous properties"
of "nuclear material" and with respect to
which (a) any person or organization is required to maintain financial protection pursuant to the Atomic Energy Act of 1954, or any law amendatory thereof, or (b) the "insured" is, or had this policy not been issued would be, entitled to indemnity from the
United States of America, or any agency
thereof, under any agreement entered into
by the United States of America, or any
agency thereof, with any person or organization.

B. Under any Medical Payments coverage, to
expenses incurred with respect to "bodily injury"
resulting from the "hazardous properties" of
"nuclear material" and arising out of the operation of a "nuclear facility" by any person or organization.

C. Under any Liability Coverage, to "bodily injury"
or "property damage" resulting from "hazardous
properties" of "nuclear material", if:
(1) The "nuclear material" (a) is at any "nuclear
facility" owned by, or operated by or on behalf of, an "insured" or (b) has been discharged or dispersed therefrom; (2) The "nuclear material" is contained in "spent
fuel" or "waste" at any time possessed,
handled, used, processed, stored, transported or disposed of, by or on behalf of an "insured"; or
(3) The "bodily injury" or "property damage"
arises out of the furnishing by an "insured"
of services, materials, parts or equipment in
connection with the planning, construction,
maintenance, operation or use of any "nuclear facility", but if such facility is located within the United States of America, its territories or possessions or Canada, this exclusion (3) applies only to "property damage" to such "nuclear facility" and any property
thereat.

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