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HomeMy WebLinkAboutInsurance Certificate: Pacific Electrical i~ PAC107C OP ID: DB .4coRO CERTIFICATE OF LIABILITY INSURANCE DATE 1 Y014 06/26124 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements . PRODUCER Phone: 541-245-1111 NAME' Mracr Marcia Aho United Risk Solutions, Inc. NA PO Box 936 Fax: 541-245-1112 ac°N Es,:541-245-1111 FAX, Na: 541-245-1112 Medford, OR 97501-0067 E-MAIL Jim R. Cox ADDRESS: marcia.aho@unitedrisk.com INSURERS AFFORDING COVERAGE NAIL d INSURER A: Cincinnati Insurance company 10677 INSURED Pacific Electrical INSURER B: Contractors, Inc. 920 S. Grape St. INSURER C : Medford, OR 97501-3631 INSURER D INSURER E INSURER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL UB POLICY NUMBER MNUDDYIYYEFF YY MID POLICY UNITS LTR GENERAL LIABILITY EACH OCCURRENCE $ 1,000,08 A X COMMERCIALGENERALLIABILITY EPP0260135 07/01/2014 07/01/2015 PREMISES Ea occurrence $ 588,88 CLAIMS-MADE FxIOCCUR MED EXP Any one person) $ 10,08 PERSONALS ADV INJURY $ 1,000,08 GENERALAGGREGATE $ 2,088,88 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP/OP AGG $ 2,000,00 POLICY X PRO LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,00 Ea accident $ A X ANY AUTO EBA0260135 07/01/2014 07/01/2015 BODILY INJURY (Per Person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Par accident) $ NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accitlent $ X UMBRELLA LIAB X OCCUR =E OCCURRENCE $ 5,088,08 A EXCESS LIAR CLAIMS-MADE EPP0260136 07/01/2014 07/01/2015 GATE S 5,000,00 DED RETENTIONS Incl EL $ L'. T WORKERS COMPENSATION WC STATU- OTH- ER y/N AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVEâť‘ E.L. EACH ACCIDENT E OFFICER/MEMBER E%CLUDED? NIA (Mandatory in NH) E.L. DISEASE -EA EMPLOYE $ Ii Yes, aeac,me unaer DESCRIPTION OF OPERATIONS OeIOa E.L. DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONSI LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) CERTIFICATE HOLDER CANCELLATION CITAS01 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Ashland THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 90 N. Mountain Ave. Ashland, OR 97520-2014 AUTHORIZED REPRESENTATIVE ©1988.2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD PAC107C OP ID: DB ACoR° CERTIFICATE OF LIABILITY INSURANCE 06/2612014 D Y) s/zs/zola THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements . PRODUCER Phone: 541-245-1111 COONEACT Marcia Aho United Risk Solutions, Inc. Fax: 541-245-1112 PHONE ,641-245-1111 Fa N.11 541-245-1112 936 MeBoxdford, , O OR 97501-0067 E-MAIL Me Jim R. Cox ADDRESS: marcia.aho unitedrisk.com INSURERS AFFORDING COVERAGE NAIC M INSURER A: Cincinnati Insurance Company 10677 INSURED Pacific Electrical INSURER B: Contractors, Inc. 928 S. Grape St. INSURER C : Medford, OR 97501-3631 INSURER D: INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE IN= SUB POLICY NUMBER POL 6 EFF POLICY rDDC(YYYI LIMITS LTR GENERAL LIABILITY EACH OCCURRENCE $ 1,000,08 A X COMMERCIAL GENERAL LIABILITY X EPP0260135 0710112014 0710112015 PREMISES Ea occurrence $ 600108 CLAIMS-MADE Fx_1OCCUR MED EXP (Any one person) $ 10,00 PERSONAL B ADV INJURY $ 1,000,08 GENERAL AGGREGATE $ 2,000,00 GENT AGGREGGATTE LIMIT APPLIES PER'. PRODUCTS - COMP/OP AGG $ 2,000,00 POLICY ,l PIFr.T RO- n LOC $ AUTO MOBILE LIABILITY Ea accdentSINGLE LIMIT $ 1,000,00 A X ANYAUTO X EBA0260135 07/01/2014 07101/2015 BODILY INJURY (Per person) $ ALLOWNED H SCHEDULED BODILY INJURY (Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident $ X UMBRELLA LIAR X OCCUR EACH OCCURRENCE $ 5,000,08 A EXCESS LIAB CLAIMS-MADE EPP0260135 07101/2014 07101/2015 AGGREGATE $ 6,000,08 DIED RETENTIONS Incl EL $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS' LIABILITY YIN IMIT R ANY PROPRIETOR/PARTNERIEXECUTIVE E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? NIA (Mandetoryln NH) E.L. DISEASE - EA EMPLOYE $ If yes, describe under DESCRIPTION OF OPERATIONS Wow E.L. OISEA$E-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) Project: Ashland Substation Modifications The City of Ashland, Oregon, and its elected officials, officers and employees are Additional Insured as provided by Endts. GA2330R 9/10 and AA4171 11/05. Coverage is primary and non-contributory as provided by Endt. CA2330R 09/10. CERTIFICATE HOLDER CANCELLATION CITAS01 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Ashland THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 90 N. Mountain Ave. Ashland, OR 97520-2014 AUTHORIZED REPRESENTATIVE I C 1988.2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. OREGON CONTRACTORS' COMMERCIAL GENERAL LIABILITY BROADENED ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Endorsement - Table of Contents: Coverage: Begins on Page: 1. Employee Benefit Liability Coverage ..................................................................................................2 2. Unintentional Failure to Disclose Hazards .........................................................................................8 3. Damage to Premises Rented to You .................................................................................................8 4. Supplementary Payments .........:........................................................................................................9 5. Medical Payments ............................................................................................................................10 6. Voluntary Property Damage (Coverage a.) and Care, Custody or Control Liability Coverage (Coverage b.) ......................................................................................................10 7. 180 Day Coverage for Newly Formed or Acquired Organizations ...................................................10 8. Waiver of Subrogation .....................................................................................................................10 9. Automatic Additional Insured - Specified Relationships: 11 x Managers or Lessors of Premises; x Lessor of Leased Equipment; x Vendors; x State or Political Subdivisions - Permits Relating to Premises; x State or Political Subdivisions - Permits; and x Contractors' Operations 10. Broadened Contractual Liability -Work Within 50' of Railroad Property ..........................................16 11. Property Damage to Borrowed Equipment ......................................................................................16 12. Employees as Insureds - Specified Health Care Services: 16 x Nurses; x Emergency Medical Technicians; and x Paramedics 13. Broadened Notice of Occurrence .....................................................................................................16 B. Limits of Insurance: The Commercial General Liability Limits of Insurance apply to the insurance provided by this endorsement, except as provided below: 1. Employee Benefit Liability Coverage Each Employee Limit: $ 1,000,000 Aggregate Limit: $ 3,000,000 Deductible: $ 1,000 3. Damage to Premises Rented to You The lesser of: a. The Each Occurrence Limit shown in the Declarations; or b. $500,000 unless otherwise stated $ 4. Supplementary Payments a. Bail bonds: $ 1,000 b. Loss of earnings: $ 350 5. Medical Payments Medical Expense Limit: $ 10,000 Includes copyrighted material of Insurance GA 233 OR 09 10 Services Office, Inc., with its permission. Page 1 of 16 b. Care, Custody or Control Liability deductible amount as has been Coverage paid by us. SECTION I - COVERAGES, COV- 7. 180 Day Coverage for Newly Formed or ERAGE A. BODILY INJURY AND Acquired Organizations PROPERTY DAMAGE LIABILITY, 2. SECTION II -WHO IS AN INSURED is Exclusions, j. Damage to Property, Subparagraphs (3), (4) and (5) do not amended as follows: apply to "property damage" to the Subparagraph a. of Paragraph 4. is property of others described therein. hereby deleted and replaced by the fol- With respect to the insurance provided by lowing: this section of the endorsement, the fol- a. Insurance under this provision is af- lowing additional provisions apply: forded only until the 180th day after a. The Limits of Insurance shown in the you acquire or form the organization Declarations are replaced by the lim- or the end of the policy period, its designated in Section B. Limits of whichever is earlier; Insurance, 6. Voluntary Property 8. Waiver of Subrogation Damage and Care, Custody or Control Liability Coverage of this SECTION IV -COMMERCIAL GENERAL endorsement with respect to cover- LIABILITY CONDITIONS, 9. Transfer of age provided by this endorsement. Rights of Recovery Against Others to These limits are inclusive of and not Us is hereby amended by the addition of in addition to the limits being re- the following: placed. The Limits of Insurance shown in Section B. Limits of Insur- We waive any right of recovery we may ance, 6. Voluntary Property Dam- have because of payments we make for age and Care, Custody or Control injury or damage arising out of your ongo- Liability Coverage of this endorse- ing operations or "your work" done under ment fix the most we will pay in any a written contract requiring such waiver one "occurrence" regardless of the with that person or organization and in- number of: cluded in the "products-completed opera- tions hazard". However, our rights may (1) Insureds; only be waived prior to the "occurrence" (2) Claims made or "suits" brought; giving rise to the injury or damage for which we make payment under this Cov- or erage Part. The insured must do nothing (3) Persons or organizations making after a loss to impair our rights. At our re- claims or bringing "suits". quest, the insured will bring "suit' or trans- fer those rights to us and help us enforce b. Deductible Clause those rights. (1) Our obligation to pay damages 9. Automatic Additional Insured - Speci- on your behalf applies only to the fied Relationships amount of damages for each "occurrence" which are in excess a. The following is hereby added to of the deductible amount stated SECTION II -WHO IS AN INSURED: in Section B. Limits of Insur- (1) Any person or organization de- ance, 6. Voluntary Property scribed in Paragraph 9.a.(2) be- Damage and Care, Custody or low (hereinafter referred to as Control Liability Coverage of additional insured) whom you are this endorsement. The limits of required to add as an additional insurance will not be reduced by insured under this Coverage Part the application of such deducti- by reason of: ble amount. (2) Condition 2. Duties in the Event (a) m nt or contract or agree- of Occurrence, Offense. Claim or Suit, applies to each claim or (b) An oral agreement or con- "suit" irrespective of the amount. tract where a certificate of all of the insurance showing that per- (3) We may pay any part or son or organization as an deductible amount to effect set- additional insured has been tlement of any claim or "suit" issued, and, upon notification of the ac- tion taken, you shall promptly re- is an insured, provided: imburse us for such part of the Includes copyrighted material of Insurance GA 233 OR 09 10 Services Office, Inc., with its permission. Page 10 of 16 (a) The written or oral contract or use of equipment leased or agreement is: to you by such person(s) or 1 Current organizations(s). However, Currently in effect or this insurance does not ap- becomes effective dur- ply to any "occurrence" ing the policy period; which takes place after the and equipment lease expires. 2) Executed prior to an (c) Any person or organization "occurrence" or offense (referred to below as ven- to which this insurance dor) with whom you have would apply; and agreed per Paragraph (b) They are not specifically 9.a.(1) above to provide in- named as an additional in- surance, but only with re- sured under any other pro- spect to "bodily injury' or vision of, or endorsement "property damage" arising added to, this Coverage out of "your products" which partare distributed or sold in the regular course of the ven- (2) Only the following persons or or- does business, subject to ganizations are additional insur- the followin'g` additional ex- eds under this endorsement, and clusions: 'insurance coverage provided to such additional insureds is lim- 1) The insurance afforded ited as provided herein: the vendor does not apply to: (a) The manager or lessor of a premises leased to you with a) "Bodily injury" or whom you have agreed per "property damage" Paragraph 9.a.(1) above to for which the ven- provide insurance, but only dor is obligated to with respect to liability aris- pay damages by ing out of the ownership, reason of the as- maintenance or use of that sumption of liability part of a premises leased to in a contract or you, subject to the following agreement. This additional exclusions: exclusion does not apply to liability for This insurance does not ap- damages that the ply to: vendor would have in the absence of 1) Any "occurrence" which the contract or takes place after you agreement; cease to.be'a tenant in that premises. b) Any express war- t) Structural alterations, rby youunauthor¢ed new construction or y demolition operations c) Any physical or performed by or on be- chemical change half of such additional in the product insured. made intentionally (b) Any person or organization by the vendor; from which you lease d) Repackaging, ex- equipment with whom you cept when un- have agreed per Paragraph packed solely for 9.a.(1) above to provide in- the purpose of in- surance. Such person(s) or spection, demon- organization(s) are iisureds, stration, testing, or but only to the extent that the substitution of the liability for'bodily injury", parts under in- "property damage" or "per- structions from the sonal and advertising injury" manufacturer, and is caused by your negli- then repackaged genre, acts or omissions in in the original con- the maintenance, operation tainer; Includes copyrighted material of Insurance GA 233 OR 09 10 Services Office, Inc., with its permission. Page 11 of 16 e) Any failure to Part with respect make such inspec- to such products. tans, adjustments, tests or servicing (d) Any state or political subdi- as the vendor has vision with which you have agreed to make or agreed per Paragraph normally under- 9.a.(1) above to provide in- takes to make in surance, subject to the fol- the usual course of lowing additional provision: business, in con- This insurance applies only nection with the with respect to the following distribution or sale hazards for which the state of the products; or political subdivision has f) Demonstration, in- issued a permit in connec- stallation, servicing tion with premises you own, or repair opera- rent or control and to which tions, except such this insurance applies: operations per- 1) The ebstence, mainte- formed at the ven- nance, repair, construc- does premises in lion, erection, or re- connection with ng the sale of the moval advertising roduct; signs, awnings, ceno- p pies, cellar entrances, g) Products which, coal holes, driveways, after distribution or manholes, marquees, sale by you, have hoist away openings, been labeled or re- sidewalk vaults, street labeled or used as banners, or decorations a container, part or and similar exposures; ingredient of any or other thing or sub- 2) The construction, erec- stance by or for tion, or removal of ele- the vendor; or vators; or h) "Bodily injury" or 3) The ownership, main- "property damage" tenance, or use of any arising out of the elevators covered by negligence, acts or this insurance. omissions of the vendor, its em- (e) Any state or political subdi- ployees or anyone vision with which you have else acting on its agreed per Paragraph behalf. 9.a.(1) above to provide in- surance, subject to the fol- lowing provisions: apply to any insured person or organization: 1) This insurance applies From whom only with respect to op- a you erations performed by have acquired you or on your behalf such products, or for which the state or any ingredient, political subdivision has part or container, issued a permit. entering into, ac- companying or 2) This insurance does not containing such apply to "bodily injury", products; or "property damage" or liability in- "personal and advertis- b When ing injury" arising out of cluded within the operations performed "products- for the state or political completed opera- subdivision. tions hazard" has been excluded un- (f) For "your work" performed der this Coverage in Oregon, any person or Includes copyrighted material of Insurance GA 233 OR 09 10 Services Office, Inc., with its permission. Page 12 of 16 organization with which you (a) Subparagraphs (e), (f) and have agreed per Paragraph (g) do not apply to "bodily in- 9.a.(1) above to provide in- jury" or "property damage" surance, but only to the ex- included within the "prod- tent that the liability is uds-completed operations caused by 'your work' per- hazard"; formed for that additional in- sured and only to the extent (b) Subparagraphs (a), (d), (e) that such liability is caused and (g) do not apply to "bod- by your negligence or the ily injury", "property dam- negligence of those acting age" or "personal and ad- on your behalf. A person or vertising injury" arising out organization's status as an of the sole negligence or insured under this provision willful misconduct of the ad- of this endorsement contin- ditional insured or its "em- ues for only the period of ployees"; or time required by the written (c) Subparagraph (f) and (y) do contract or agreement, but not apply to 'bodily injury", in no event beyond the expi- "property damage" or "per- ration date of this Coverage sonal and advertising injury" " Part. If there is no written g rycontract or agreement, or if arising out of no period of time is required 1) The rendering of, or by the written contract or failure to render, any agreement, a person or or- professional services ganization's status as an in- by you or on your be- sured under this endorse- half, but only with re- ment ends when your op- sped to either or both erations for that insured are of the following opera- completed. tions: (g) For "your work" performed a) Providing engi- in the "coverage territory" neering, architec- but not in Oregon, any per- tural or surveying son or organization with services to others; which you have agreed per and Paragraph 9.a.(1) above to provide insurance, but only b) Providing, or hiring with respect to liability aris- independent pro- ing out of "your work" per- fessionals to pro- formed for that additional in- vide, engineering, sured by you or on your be- architectural or half. A person or organiza- surveying services tion's status as an insured in connection with under this provision of this construction work endorsement continues for you perform. only the period of time re- 2) Subject to Paragraph 3) quired by the written con- below, professional tract or agreement, but in no services include: event beyond the expiration date of this Coverage Part. a) Preparing, approv- If there is no written contract ing, or failing to or agreement, or if no period prepare or ap- of time is required by the prove, maps, shop written contract or agree- drawings, opin- ment, a person or organiza- ions, reports, sur- tion's status as an insured veys, field orders, under this endorsement change orders, or ends when your operations drawings and for that insured are com- specifications; and pleted. 3 Any insurance provided to an b) Supervisory es Y spedion activities additional insured designated performed as part under Paragraph 9.a.(2): of any related ar- Includes copyrighted material of Insurance GA 233 OR 09 10 Services Office, Inc., with its permission. Page 13 of 16 chitectural or engi- primary to other insurance neering activities, available to the additional 3) Professional services insured except: do not include services 1) As otherwise provided within construction in SECTION IV - means, methods, tech- COMMERCIAL GEN- niques, sequences and ERAL LIABILITY procedures employed CONDITIONS, S. by you in connection Other Insurance, b. with construction work Excess Insurance; or you perform. 2) For any other valid and (d) Subparagraphs (f) and (g) collectible insurance do not apply to "bodily in- available to the addi- jury" or "property damage" tional insured as an ad- arising out of "your work" for ditional insured by at- which a consolidated (wrap- tachment of an en- up) insurance program has dorsement to another been provided by the prime insurance policy that is r "contractor / project manager written on an excess or owner of the construction basis. In such case, the project in which you are in- coverage provided un- volved. der this endorsement b. Only with regard to insurance pro- shall also be excess. vided to an additional insured desig- (2) Condition 11. Conformance to nated under Paragraph 9.a.(2) Sub- Specific Written Contract or paragraphs (fl and (g) above, SEC- Agreement is hereby added: TION III -LIMITS OF INSURANCE is amended to include: 11. Conformance to Specific Written Contract or The limits applicable to the additional Agreement insured are those specified in the written contract or agreement or in a. With respect to addi- the Declarations of this Coverage tional insureds de- Part, whichever are less. If no limits scribed in Paragraph are specified in the written contract or 9.a.(2)(f) above only: agreement, or if there is no written If a written contract or contract or agreement, the limits ap- agreement between plicable to the additional insured are you and the additional those specified in the Declarations of insured species that this Coverage Part. The limits of in- coverage for the addi- surance are inclusive of and not in tional insured: addition to the limits of insurance shown in the Declarations. (1) Be provided by the c. SECTION IV - COMMERCIAL GEN- Insurance Ser- vices Office addi- ERAL LIABILITY CONDITIONS is tional insured form hereby amended es follows: number CG 32 61, (1) Condition 5. Other Insurance is CG 32 62 or CG amended to include: 32 63; or (a) Where required by a written (2) Include coverage contract or agreement, this for completed op- insurance is primary and / or erations; or noncontributory as respects (3) Include coverage any other insurance policy for "your work"; issued to the additional in- sured, and such other in- and where the limits or surance policy shall be ex- coverage provided to cess and / or nonoontribut- the additional insured is ing, whichever applies, with more restrictive than this insurance. was specifically re- (b) Any insurance provided by contra in that written this endorsement shall be contrail or agreement, the terms of Para- Includes copyrighted material of Insurance GA 233 OR 09 10 Services Office, Inc., with its permission. Page 14 of 16 graphs 9.a.(3)(a) or 9.b. agreement specifies above, or any oombina- the Insurance Services tion thereof, shall be in- Office additional in- terpreted as providing sured form number CG the limits or coverage 20 10 but does not required by the terms of specify which edition, or the written contract or specifies an edition that agreement, but only to does not exist, Para- the extent that such lim- graphs 9.a.3.b. and its or coverage is in- 9.b. of this endorse- cluded within the terms ment shall not apply of the Coverage Part to and Paragraph which this endorsement 9.a.(3)(a) of this en- is attached. dorsement shall apply. b. With respect to addi- 10. Broadened Contractual Liability -Work tional insureds de- Within 50' of Railroad Property scribed in Paragraph 9.a.(2)(g) above only: It is hereby agreed that Paragraph f.(1) of Definition 12. "Insured contract" (SEC- If a written contract or TION V - DEFINITIONS) is deleted. agreement between you and the additional 11. Property Damage to Borrowed Equip- insured species that ment coverage for the addi- a. The following is hereby added to Ex- tional insured: clusion j. Damage to Property of a. Be provided by the Paragraph 2., Exclusions of SEC- Insurance Ser- TION I - COVERAGES, COVERAGE vices Office addi- A. BODILY INJURY AND PROP- tional insured form ERTY DAMAGE LIABILITY: number CG 20 10 Paragraphs (3) and (4) of this exclu- or CG 20 37 sion do not apply to tools or equip- (where edition ment loaned to you, provided they are specified); or not being used to perform operations b. Include coverage at the time of loss. for completed op- b. With respect to the insurance pro- erations; or vided by this section of the endorse- c. Include coverage ment, the following additional provi- for "your work'; sions apply: and where the limits or (1) The Limits of insurance shown in coverage provided to - 'the Declarations are replaced by the additional insured is the limits designated in Section more restrictive than B. Limits of Insurance, 11. of was specifically re- this endorsement with respect to quired in that written coverage provided by this en- contract or agreement, dorsement. These limits are in- the terms of Para- clusive of and not in addition to graphs 9.a.(3)(a), the limits being replaced. The 9.a.(3)(b) or 9.b. above, Limits of Insurance shown in or any combination Section B. Limits of Insurance, thereof, shall be inter- 11. of this endorsement fix the preted as providing the most we will pay in any one "oc- limits or coverage re- currence" regardless of the quired by the terms of number of: the written contract or (a) Insureds; agreement, but only to the extent that such lim- (b) Claims made or "suits" its or coverage is in- brought; or cluded within the terms of the Coverage Part to (c) Persons or organizations which this endorsement making claims or bring is attached. If, however, "suits". the written contract or Includes copyrighted material of Insurance GA 233 OR 09 10 Services Office, Inc., with its permission. Page 15 of 16 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED BY CONTRACT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM GARAGE COVERAGE FORM This endorsement changes the policy effective on the inception date of the policy unless another date is indi- cated below. Endorsement Effective: 07/01/14 Policy Number: EBA0260135 Named Insured: Pacific Electrical Contractors, Inc. Countersigned by: (Authorized Representative) With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. SECTION II - LIABILITY COVERAGE, A. Cover- age, I. Who is an Insured is amended to include as an insured any person or organization with which you have agreed in a valid written contract to provide insurance as is afforded by this policy. This provision is limited to the scope of the valid written contract. This provision does not apply unless the valid written contract has been executed prior to the "bodily injury" or "property damage". AA 4171 11 05