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HomeMy WebLinkAboutInsurance Certificate: Carol's Colors dba Ashland Flower Shop & Greenhouses ASHL05C OP ID: DB A~OR~ F DATE (MMIDD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 08131/2015 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Dana Brinkley United Risk Solutions, Inc. PHONE Ext :541-245-1111 (acFAx, No): PO Box 936 AIC No 541-245-1112 Medford, OR 97501-0067 EE-MDRe Jackie K. Anderberg ss: dana.brinkley@unitedrisk.com INSURER(S) AFFORDING COVERAGE NAIC # INSURER A : The Cincinnati insurance I 1 0677 INSURED Ashland Flower Shop & INSURER B Green Houses, Inc. dba: Carol's Colors INSURER C 87 W. Nevada St. INSURER D : Ashland, OR 97520-1027 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. ADDL SUB- Ri INSR TYPE OF INSURANCE I POLICY EFF POLICY EXP LIMITS POLICY NUMBER MM/DDIYYYY MM/DDIYYYY : GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 TO RENTED A X COMMERCIAL GENERAL LIABILITY X ECP0347703 DAMAGE 09/01/2015 09/01/2016 PREMISES (Ea occurrence) $ 100,000 CLAIMS-MADE EX OCCUR MED EXP (Any one person) $ 5,000 - _ - PERSONAL & ADV INJURY__ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GE_N'L AGGREGATE LIMIT APPLIES PER:' irPRODUCTS - COMP/OP AGG $ 2,000,00 X POLICY F-1 JECT PRO- : LOC I $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident 1,000,000 - $ _ A X I ANY AUTO X EBA0347703 0910112015 0910112016 BODILY INJURY (Per person) $ ALL OWNED SCHEDULED BODILY INJURY (Per accident) $ AUTOS AUTOS NON-OWNED I PROPERTY DAMAGE $ HIRED AUTOS (PER ACCIDENT) AUTOS $ UMBRELLA LIAB OCCUR EACH OCCURRENCE ! $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION $ $ WORKERS COMPENSATION WCSTATU- OTH-. AND EMPLOYERS' LIABILITY YIN TORY LIMITS ER ANY PRin NHwPARTNE'EXECUTIVE N I A E L EACH ACCIDENT OFFICER/MEMBER EXCLUDED. E.L. DISEASE - EA EMPLOYEF~ $ (Mandatory ) If yes describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ I ! I DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Certificate holder is Additional Insued as provided by Endts. GCP204OR 05/12 and AA4171 11/05. Coverage is primary & non-contributory as provided by Endt. GCP204OR 05/12. CERTIFICATE HOLDER CANCELLATION CITAS03 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Ashland THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Y ACCORDANCE WITH THE POLICY PROVISIONS. 20 E. Main St. Ashland, OR 97520-1814 AUTHORIZED REPRESENTATIVE ©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. CinciPakT"" CONTRACTORS' COMMERCIAL GENERAL LIABILITY BROADENED ENDORSEMENT - OREGON 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. Medical Payments 8 4. Voluntary Property Damage (Coverage a.) and Care, Custody or Control Liability Coverage (Coverage b.) 8 5. 180 Day Coverage for Newly Formed or Acquired Organizations 9 6. Waiver of Subrogation 9 7. Automatic Additional Insured - Specified Relationships: 9 • Managers or Lessors of Premises; • Lessor of Leased Equipment; • Vendors; • State or Political Subdivisions - Permits Relating to Premises; • State or Political Subdivisions - Permits; and • Contractors' Operations 8. Broadened Contractual Liability -Work Within 50' of Railroad Property- 14 9. Property Damage to Borrowed Equipment 14 10. Employees as Insureds - Specified Health Care Services: 15 • Nurses; • Emergency Medical Technicians; and • Paramedics 11. Broadened Notice of Occurrence 15 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. Medical Payments Medical Expense Limit: $ 10,000 Includes copyrighted material of Insurance GCP 204 OR 05 12 Services Office, Inc., with its permission. Page 1 of 15 4. Voluntary Property Damage (Coverage a.) and Care, Custody or Control Liability Coverage (Coverage b.) Limits of Insurance (Each Occurrence) Coverage a. $1,000 Coverage b. $5,000 unless otherwise stated $ Deductibles (Each Occurrence) Coverage a. $250 Coverage b. $250 unless otherwise stated $ COVERAGE PREMIUM BASIS RATE ADVANCE PREMIUM (a) Area (For Limits in Excess of (For Limits in Excess of (b) Payroll $5,000) $5,000) (c) Gross Sales (d) Units e Other b. Care, Custody $ or Control TOTAL ANNUAL PREMIUM $ 9. Property Damage to Borrowed Equipment Each Occurrence Limit: $ 10,000 Deductible: $ 250 C. Coverages: TION III - LIMITS OF 1. Employee Benefit Liability Coverage INSURANCE; and a. The following is added to SECTION I 2) Our right and duty to g defend ends when we - COVERAGES: Employee Benefit have used up the appli- Liability Coverage. cable limit of insurance (1) Insuring Agreement in the payment of judgments or settle- (a) We will pay those sums that ments. the insured becomes legally obligated to pay as dam- No other obligation or liabil- ages caused by any act, er- ity to pay sums or perform ror or omission of the in- acts or services is covered sured, or of any other per- unless explicitly provided for son for whose acts the in- under Supplementary Pay- sured is iegally liable, to ments. which this insurance ap- (b) This insurance applies to plies. We will have the right damages only if the act, Br- and duty to defend the in- ror or omission, is negli- sured against any "suit' gently committed in the seeking those damages. "administration" of your However, we will have no "employee benefit program"; duty to defend against any and "suit' seeking damages to which this insurance does 1) Occurs during the pol- not apply. We may, at our icy period; or discretion, investigate any report of an act, error or 2) Occurred prior to the omission and settle any "first effective date" of claim or "suit' that may re- this endorsement pro- sult But: vided: 1) The amount we will pay a) You did not have for damages is limited knowledge of a as described in SEC- claim or "suit' on or before the "first Includes copyrighted material of Insurance GCP 204 OR 05 12 Services Office, Inc., with its permission. Page 2 of 15 effective date" of (e) Inadequacy of Perform- this endorsement. ance of Investment / Ad- You will be vice Given With Respect deemed to have to Participation knowledge of a Any claim based upon: claim or "suit" when any "author- 1) Failure of any invest- ized representa- ment to perform; tive"; 2) Errors in providing in- i) Reports all, or formation on past per- any part, of the formance of investment act, error or vehicles; or omission to us 3) Advice given to any or any other person with respect to insurer; that person's decision ii) Receives a to participate or not to written or ver- participate in any plan bal demand or included in the "em- claim for dam- ployee benefit pro- ages because gram". of the act, error (f) Workers' Compensation or omission; and Similar Laws and b There is no other Any daim arising out of your failure to comply with the applicable insur- mandatory provisions of any ance. workers' compensation, un- (2) Exclusions employment compensation insurance, social security or This insurance does not apply to: disability benefits law or any (a) Bodily Injury, Property similar law. Damage or Personal and (g) ERISA Advertising Injury Damages for which any in- "Bodily injury", "property sured is liable because of li- damage" or "personal and ability imposed on a fiduci- advertising injury". ary by the Employee Re- tirement Income Security (b) Dishonest, Fraudulent, Act of 1974, as now or Criminal or Malicious Act hereafter amended, or by Damages arising out of any any similar federal, state or intentional, dishofiest, local laws. fraudulent, criminal or mali- (h) Available Benefits cious act, error or omission, committed by any insured, Any claim for benefits to the including the willful or reck- extent that such benefits are less violation of any statute. available, with reasonable effort and cooperation of the (c) Failure to Perform a Con- insured, from the applicable tract funds accrued or other col- Damages arising out of fail- lectible insurance. ure of performance of con- (1) Taxes, Fines or Penalties tract by any insurer. Taxes, fines or penalties, (d) Insufficiency of Funds including those imposed Damages arising out of an under the Internal Revenue insufficiency of funds to Code or any similar state or meet any obligations under local law. any plan included in the "employee benefit program". Includes copyrighted material of Insurance GCP 204 OR 05 12 Services Office, Inc., with its permission. Page 3 of 15 (j) Employment-Related conduct of your business. Practices Your managers are insur- eds, but only with respect to Any liability arising out of their duties as your manag- any: ers. (1) Refusal to employ, (d) An organization other than a (2) Termination of em- partnership, joint venture or ployment-, limited liability company, you are an insured. Your "ex- (3) Coercion, demotion, ecutive officers" and direc- evaluation, reassign- tors are insureds, but only ment, discipline, defa- with respect to their duties mation, harassment, as your officers or directors. humiliation, discrimina- Your stockholders are also tion or other employ insureds, but only with re- ment-related practices, spect to their liability as acts or omissions; or stockholders. (4) Consequential liability (e) A trust, you are an insured. as a result of (1), (2) or Your trustees are also in- (3) above. sureds, but only with respect to their duties as trustees. This exclusion applies whether the insured may be (2) Each of the following is also an held liable as an employer insured: or in any other capacity and to any obligation to share (a) Each of your "employees" damages with or repay who is or was authorized to someone else who must administer your "employee pay damages because of benefit program". the injury. (b) Any persons, organizations (3) Supplementary Payments or "employees" having proper temporary authoriza- SECTION I - COVERAGES, tion to administer your "em- SUPPLEMENTARY PAY- ployee benefit program" if MENTS - COVERAGES A AND you die, but only until your B also apply to this Coverage. legal representative is ap- b. Who is an Insured pointed. As respects Employee Benefit Liabil- (c) Your legal representative if you die, but only with re- ity Coverage, SECTION II - WHO IS spect to duties as such. AN INSURED is deleted in its entirety That representative will and replaced bythe following: have all your rights and du- (1) If you are designated in the Dec- ties under this Coverage larations as: Part. (a) An individual, you and your (3) Any organization you newly ac- spouse are insureds, but quire or form, other than a part- only with respect to the con- nership, joint venture or limited duct of a business of which liability company, and over which you are the sole owner. you maintain ownership or ma- jority interest, will qualify as a (b) A partnership or joint ven- Named Insured if no other simi- ture, you are an insured. lar insurance applies to that or- Your members, your part- ganization. However, coverage ners, and their spouses are under this provision: also insureds but only with respect to the conduct of (a) Is afforded only until the your business. 180th day after you acquire or form the organization or (c) A limited liability company, the end of the policy period, you are an insured. Your whichever is earlier; and members are also insureds, but only with respect to the Includes copyrighted material of Insurance GCP 204 OR 05 12 Services Office, Inc., with its permission. Page 4 of 15 (b) Does not apply to any act, However, the amount paid under error or omission that was this endorsement shall not ex- committed before you ac- ceed, and will be subject to the quired or formed the organi- limits and restrictions that apply zation. to the payment of benefits in any c. Limits of Insurance plan included in the "employee benefit program". As respects Employee Benefit Liabil- (4) Deductible Amount ity Coverage, SECTION III - LIMITS OF INSURANCE is deleted in its en- (a) Our obligation to pay dam- tirety and replaced by the following: ages on behalf of the in- 1 The Limits of Insurance shown in sured applies only to the amount of damages in ex- Section B. Limits of Insurance, cess of the deductible 1. Employee Benefit Liability amount stated in the Decla- Coverage and the rules below rations as applicable to fix the most we will pay regard- Each Employee. The limits less of the number of of insurance shall not be re- (a) Insureds; duced by the amount of this deductible. (b) Claims made or "suits" brought; (b) The deductible amount stat- ed in the Declarations ap- (c) Persons or organizations plies to all damages sus- making claims or bringing tained by any one "em- "suits"; ployee", including such "em- ployee d Acts, errors or omissions; or 's" dependents and ( ) beneficiaries, because of all (e) Benefits included in your ads, errors or omissions to "employee benefit program". which this insurance ap- plies. (2) The Aggregate Limit shown in Section B. Limits of Insurance, (c) The terms of this insurance, 1. Employee Benefit Liability including those with respect Coverage of this endorsement is to: the most we will pay for all dam- 1) Our right and duty to ages because of acts, errors or defend the insured omissions negligently committed against any "suits" in the "administration" of your seeking those dam- "employee benefit program". ages; and (3) Subject to the limit described in 2) Your duties, and the (2) above, the Each Employee duties of any other in- Limit shown in Section B. Limits volved insured, in the of Insurance, 1. Employee event of an act, error or Benefit Liability Coverage of omission, or claim, this endorsement is the most we will pay for all damages sus- apply irrespective of the ap- tained by any one "employee", plication of the deductible including damages sustained by amount. such "employee's" dependents and beneficiaries, as a result of: (d) We may pay any part or all of the deductible amount to (a) An act, error or omission; or effect settlement of any claim A series of related acts, er- or "suit"and, upon no- (b) tification of the action taken, rors or omissions, regard- you shall promptly reim- less of the amount of time burse us for such part of the that lapses between such deductible amount as we acts, errors or omissions, have paid. negligently committed in the d. Additional Conditions administration" of your em- ployee benefit program". As respects Employee Benefit Li- ability Coverage, SECTION IV - Includes copyrighted material of Insurance GCP 204 OR 05 12 Services Office, Inc., with its permission. Page 5 of 15 COMMERCIAL GENERAL LIABIL- d. No insured will, except at that in- ITY CONDITIONS is amended as fol- sured's own cost, voluntarily lows: make a payment, assume any of obligation, or incur any expense (1) Item 2. Duties in the Event without our consent. Occurrence, Offense, Claim or Suit is deleted in its entirety and (2) Item 5. Other Insurance is de- replaced by the following: leted in its entirety and replaced 2. Duties in the Event of an Act, Error by the following: or Omission, or Claim or Suit 5. Other Insurance a. You must see to it that we are If other valid and collectible notified as soon as practicable of insurance is available to the an act, error or omission which insured for a loss we cover may result in a claim. To the ex- under this Coverage Part, tent possible, notice should in- our obligations are limited clude: as follows: (1) What the act, error or omis- a. Primary Insurance sion was and when it oc- curred; and This insurance is pri- mary except when c. (2) The names and addresses below applies. If this in- of anyone who may suffer surance is primary, our damages as a result of the obligations are not af- act, error or omission. fected unless any of the other insurance is also b. If a claim is made or "suit' is primary. Then, we will brought against any insured, you share with all that other must: insurance by the meth- (1) Immediately record the spe- od described in b. be- cifics of the claim or "suit" low. and the date received; and b. Method of Sharing (2) Notify us as soon as practi- If all of the other insur- cable. ance permits contribu- You must see to it that we re- tion by equal shares, ceive written notice of the claim we will follow this meth- or "suit' as soon as practicable. od also. Under this ap- proach each insurer c. You and any other involved in- contributes equal sured must: amounts until it has paid its applicable limit (1) Immediately send us copies of insurance or none of of any demands, notices, the loss remains, summonses or legal papers whichever comes first. received in connection with the claim or "suit"; If any of the other in- surance does 2 Authorize us to obtain re- not per- mit contribution by cords and other information; equal shares, we will (3) Cooperate with us in the in- contribute by limits. vestigation or settlement of Under this method, the claim or defense against each insurer's share is the "suit"; and based on the ratio of its applicable limit of in- (4) Assist us, upon our request, surance to the total ap- in the enforcement of any plicable limits of insur- right against any person or ance of all insurers. organization which may be liable to the insured be- c. No Coverage cause of an act, error or This insurance shall not omission to which this in- cover any loss for surance may also apply. which the insured is en- Includes copyrighted material of Insurance GCP 204 OR 05 12 Services Office, Inc., with its permission. Page 6 of 15 titled to recovery under following benefits to "em- any other insurance in ployees", whether provided force previous to the ef- through a "cafeteria plan" or fective date of this otherwise: Coverage Part. a. Group life insurance; e. Additional Definitions group accident or health insurance; den- As respects Employee Benefit Li- tal, vision and hearing ability Coverage, SECTION V - plans; and flexible DEFINITIONS is amended as fol- spending accounts; lows: provided that no one (1) The following definitions are other than an "em- added: ployee" may subscribe to such benefits and 1. "Administration" means: such benefits are made a. Providing information to generally available to "employees", including those employees" who their dependents and satisfy the plans eligi- beneficiaries, with re- bility requirements; sped to eligibility for or b. Profit sharing plans, scope of "employee employee savings benefit programs"; plans, employee stock b. Interpreting the "em- ownership plans, pen- ployee benefit pro- sion plans and stock subscription plans, pro- grams"; vided that no one other c. Handling records in than an "employee" connection with the may subscribe to such "employee benefit pro- benefits and such grams"; or benefits are made gen- erally available to all d. Effecting, continuing or "employees" who are terminating any "em- eligible under the plan ployeeV' participation for such benefits; in any benefit included in the "employee bene- c. Unemployment insur- fit program". ance, social security benefits, workers' com- However, "administration" pensation and disability does not include: benefits; and a. Handling payroll deduc- d. Vacation plans, includ- tions; or ing buy and sell pro- b. The failure to effect or grams; leave of ab- maintain any insurance sence programs, in- or adequate limits of cluding military, mater- coverage of insurance, nity, family, and civil leave; tuition assistance including but not limited plans; transportation to unemployment in- and health club subsi- surance, social security dies. benefits, workers' com- pensation and disability 4. "First effective date" means benefits. the date upon which cover- 2. "Cafeteria plans" means age was first effected in a series of uninterrupted re- plan authorized by applica- newals of insurance cover- to law to allow "employees" age. to elect to pay for certain benefits with pre-tax dollars. (2) The following definitions are de- 3. "Employee benefit pro- leted in their entirety and re- grams means a program placed by the following: providing some or all of the Includes copyrighted material of Insurance GCP 204 OR 05 12 Services Office, Inc., with its permission. Page 7 of 15 21. "Suit" means a civil pro- erations incidental to the insured's ceeding in which money business when: damages because of an act, error or omission to which (1) Damage is caused by the in- this insurance applies are sured; or alleged. "Suit" includes: (2) Damage occurs while in the in- a. An arbitration proceed- sured's possession. ing in which such dam- With your consent, we will make ages are claimed and these payments regardless of fault. to which the insured must submit or does b. Care, Custody or Control Liability submit with our con- Coverage sent; SECTION 1 - COVERAGES, COV- b. Any other alternative ERAGE A. BODILY INJURY AND dispute resolution pro- PROPERTY DAMAGE LIABILITY, 2. ceeding in which such Exclusions, j. Damage to Property, damages are claimed Subparagraphs (3), (4) and (5) do not and to which the in- apply to "property damage" to the sured submits with our property of others described therein. consent; or With respect to the insurance provided by c. An appeal of a civil pro- this section of the endorsement, the fol- ceeding. lowing additional provisions apply: 8. "Employee" means a person a. The Limits of Insurance shown in the actively employed, formerly Declarations are replaced by the lim- employed, on leave of ab- its designated in Section B. Limits of sence or disabled, or re- Insurance, 4. Voluntary Property tired. "Employee" includes a Damage and Care, Custody or 'leased worker". "Employee" Control Liability Coverage of this does not include a "tempo- endorsement with respect to cover- rary worker". age provided by this endorsement. These limits are inclusive of and not 2. Unintentional Failure to Disclose Haz- in addition to the limits being re- ards placed. The Limits of Insurance SECTION IV - COMMERCIAL GENERAL shown in Section B. Limits of Insur- LIABILITY CONDITIONS, 7. Represen- ance, 4. Voluntary Property Dam- tations is hereby amended by the addi- age and Care, Custody or Control tion of the following: Liability Coverage of this endorse- ment fix the most we will pay in any Based on our dependence upon your rep- one "occurrence" regardless of the resentations as to existing hazards, if un- number of: intentionally you should fai! to disclose all such hazards at the inception date of your (1) Insureds; policy, we will not reject coverage under (2) Claims made or "suits" brought; this Coverage Part based solely on such or failure. 3. Medical Payments (3) Persons or organizations making claims or bringing "suits". The Medical Expense Limit of Any One b. Deductible Clause Person as stated in the Declarations is amended to the limit shown in Section B. (1) Our obligation to pay damages Limits of Insurance, 3. Medical Pay- on your behalf applies only to the ments of this endorsement. amount of damages for each "occurrence" which are in excess 4. Voluntary Property Damage and Care, of the deductible amount stated Custody or Control Liability Coverage in Section B. Limits of Insur- a. Voluntary Property Damage Cov- ance, 4. Voluntary Property erage Damage and Care, Custody or Control Liability Coverage of We will pay for "property damage" to this endorsement. The limits of property of others arising out of op- insurance will not be reduced by Includes copyrighted material of Insurance GCP 204 OR 05 12 Services Office, Inc., with its permission. Page 8 of 15 the application of such deducti- insured under this Coverage Part ble amount. by reason of: (2) Condition 2. Duties in the Event (a) A written contract or agree- of Occurrence, Offense, Claim ment; or or Suit, applies to each claim or "suit irrespective of the amount. (b) An oral agreement or con- tract where a certificate of (3) We may pay any part or all of the insurance showing that per- deductible amount to effect set- son or organization as an tlement of any claim or "suit" additional insured has been and, upon notification of the ac- issued, tion taken, you shall promptly re- imburse us for such part of the is an insured, provided: deductible amount as has been (a) The written or oral contract paid by us. or agreement is: 5. 180 Day Coverage for Newly Formed or 1) Currently in effect or Acquired Organizations becomes effective dur- SECTION II - WHO IS AN INSURED is ing the policy period; amended as follows: and Subparagraph a. of Paragraph 4. is here- 2) Executed prior to an by deleted and replaced by the following: "occurrence" or offense to which this insurance a. Insurance under this provision is af- would apply; and forded only until the 180th day after you acquire or form the organization (b) They are not specifically or the end of the policy period, named as an additional in- whichever is earlier; sured under any other pro- vision of, or endorsement 6. Waiver of Subrogation added to, this Coverage SECTION IV - COMMERCIAL GENERAL Part. LIABILITY CONDITIONS, 9. Transfer of (2) Only the following persons or or- Rights of Recovery Against Others to ganizations are additional insur- Us is hereby amended by the addition of eds under this endorsement, and the following: insurance coverage provided to such additional insureds is lim- We waive any right of recovery we may ited as provided herein: have because of payments we make for injury or damage arising out of your ongo- (a) The manager or lessor of a ing operations or 'your work" done under premises leased to you with a written contract requiring such waiver whom you have agreed per with that person or organization and in- Paragraph 7.a.(1) above to cluded in the "products-completed opera- provide insurance, but only tions hazard". However, our rights may with respect to liability aris- only be waived prior to the "occurrence" ing out of the ownership, giving rise to the injury or damage for maintenance or use of that which we make payment under this Cov- part of a premises leased to erage Part. The insured must do nothing you, subject to the following after a loss to impair our rights. At our re- additional exclusions: quest, the insured will bring "suit" or trans- fer those rights to us and help us enforce This insurance does not ap- those rights. ply to:. 7. Automatic Additional Insured - Speci- 1) Any "occurrence" which fied Relationships takes place after you cease to be a tenant in a. The following is hereby added to that premises. SECTION II -WHO IS AN INSURED: 2) Structural alterations, (1) Any person or organization de- new construction or scribed in Paragraph 7.a.(2) be- demolition operations low (hereinafter referred to as performed by or on be- additional insured) whom you are half of such additional required to add as an additional insured. Includes copyrighted material of Insurance GCP 204 OR 05 12 Services Office, Inc., with its permission. Page 9 of 15 (b) Any person or organization made intentionally from which you lease by the vendor; equipment with whom you un- have agreed per Paragraph d) Repackaging, -cept Ta.(1) above to provide in- packed when solely for surance. Such person(s) or packed organization(s) are insureds, the purpose in- but only to the extent that stratio srationn, demon- but liability or "bodily injury", , testing, or "property damage" or "per- the substitution of sonal and advertising injury" parts under fin- is caused by your negli- structions from the gence, acts, or omissions in manufacturer, and the maintenance, operation then repackaged or use of equipment leased in the original con- to you by such person(s) or tainer; organization(s). However, e) Any failure to this insurance does not ap- make such inspec- ply to any "occurrence" tions, adjustments, which takes place after the tests or servicing equipment lease expires. as the vendor has (c) Any person or organization agreed to make or (referred to below as ven- normally under- dor) with whom you have takes to make in agreed per Paragraph the usual course of Ta.(1) above to provide in- business, in con- surance, but only with re- nection with the spect to "bodily injury' or distribution or sale "property damage" arising of the products; out of 'Wur products" which f) Demonstration, in- are distributed or sold in the stallation, servicing regular course of the ven- or repair opera- dor's business, subject to tions, except such the following additional ex- operations per- clusions: formed at the ven- 1) The insurance afforded dor's premises in the vendor does not connection with apply to: the sale of the product; a) "Bodily injury' or "property damage" g) Products which, for which the ven- after distribution or dor is obligated to sale by you, have pay damages by been labeled or re- reason of the as- labeled or used as sumption of liability a container, part or in a contract or ingredient of any agreement. This other thing or sub- exdusion does not stance by or for apply to liability for the vendor; or damages that the h) "Bodily Injury" or vendor would have "property damage" in the absence of arising out of the the contract or negligence, acts or agreement; omissions of the b) Any express war- vendor, its em- ranty unauthorized ployees or anyone by you; else acting on its behalf. c) Any physical or chemical change 2) This insurance does not c the product apply to any insured person or organization: Includes copyrighted material of Insurance GCP 204 OR 05 12 Services Office, Inc., with its permission. Page 10 of 15 a) From whom you 1) This insurance applies have acquired only with respect to op- such products, or erations performed by any ingredient, you or on your behalf part or container, for which the state or entering into, ac- political subdivision has companying or issued a permit. containing such products; or 2) This insurance does not apply to "bodily injury", b) When liability in- "property damage" or cluded within the "personal and advertis- "products- ing injury' arising out of completed opera- operations performed tions hazard" has for the state or political been excluded un- subdivision. der this Coverage Part with respect (f) For "your work" performed to such products. in Oregon, any person or organization with which you (d) Any state or political subdi- have agreed per Paragraph vision with which you have 7.a.(1) above to provide in- agreed per Paragraph surance, but only to the ex- 7.a.(1) above to provide in- tent that the liability is surance, subject to the fol- caused by "your work" per- lowing additional provision: formed for that additional in- sured This insurance applies only and only to the extent with respect to the following that such liability is caused hazards for which the state by your negligence or the negligence of those acting or political subdivision has on your behalf. A person or issued a permit in connec- organization's status as an tion with premises you own, insured under this provision rent or control and to which of this endorsement contin- this insurance applies: ues for only the period of 1) The existence, mainte- time required by the written nance, repair, construc- contract or agreement, but tion, erection, or re- in no event beyond the expi- moval of advertising ration date of this Coverage signs, awnings, cano- Part. If there is no written pies, cellar entrances, contract or agreement, or if coal holes, driveways, no period of time is required manholes, marquees, by the written contract or hoist away openings, agreement, a person or or- sidewalk vaults, street ganization's status as an in- banners, or decorations sured under this endorse- and similar exposures; ment ends when your op- or erations for that insured are completed. 2) The construction, erec- tion, or removal of ele- (g) For "your work" performed vators; or in the "coverage territory" but not in Oregon, any per- 3) The ownership, main- son or organization with tenance, or use of any which you have agreed per elevators covered by Paragraph 7.a.(1) above to this insurance. provide insurance, but only (e) Any state or political subdi- with respect to liability aris- ing out of your work" per- vision with which you have formed for that additional in- agreed per Paragraph sured by you or on your be- 7.a.(1) above to provide in- half. A person or organiza- surance, subject to the fol- tion's status as an insured lowing provisions: under this provision of this endorsement continues for Includes copyrighted material of Insurance GCP 204 OR 05 12 Services Office, Inc., with its permission. Page 11 of 15 only the period of time re- construction work quired by the written con- you perform. tract or agreement, but in no event beyond the expiration 2) Subject to Paragraph 3) date of this Coverage Part. below, professional If there is no written contract services include: or agreement, or if no period a) Preparing, approv- of time is required by the ing or failing to written contract or agree- prepare or ap- ment, a person or organiza- prove maps, shop tion's status as an insured drawing, opinions, under this endorsement reports, surveys, ends when your operations field orders, for that insured are com- change orders, or pleted. drawings and (3) Any insurance provided to an specifications; and additional insured designated b) Supervisory, or in- under Paragraph 7.a.(2): spection activities (a) Subparagraphs (e), (f) and performed as part of any related ar- (g) do not apply to bodily in- chitectural or engi- juryor "property damage" included within the "prod- neering activities. ucts-completed operations 3) Professional services hazard"; do not include services (b) Subparagraphs (a), (b), (d), within construction (e), (f) and (g) do not apply means, methods, tech- to "bodily injury", "property niques, sequences and damage" or "personal and procedures employed advertising injury" arising by you in connection out of the sole negligence or with construction work willful misconduct of the ad- you perform. ditional insured or its "em- (d) Subparagraphs (f) and (g) ployees"; or do not apply to "bodily in- (c) Subparagraphs (f) and (g) jury" or "property damage" do not apply to "bodily in- arising out of "your work" for jury", "property damage" or which a consolidated (wrap- "personal and advertising in- up) insurance program has jury" arising out of: been provided by the prime contractor / project manager 1) The rendering of, or or owner of the construction failure to render, any project in which you are in- professional services volved. by you or on your be- half, but only with re- b. Only with regard to insurance pro- spect to either or both vided to an additional insured desig- of the following opera- nated under Paragraph 7.a.(2) Sub- tions: paragraphs (f) and (g) above, SEC- TION III - LIMITS OF INSURANCE is a) Providing engi- amended to include: neering, architec- tural, or surveying The limits applicable to the additional services, s others; insured are those specified in the and written contract or agreement or in the Declarations of this Coverage b) Providing, or hiring Part, whichever are less. If no limits independent pro- are specified in the written contract or fessionals to pro- agreement, or if there is no written vide, engineering, contract or agreement, the limits ap- architectural or plicable to the additional insured are surveying services those specified in the Declarations of in connection with this Coverage Part. The limits of in- surance are inclusive of and not in Includes copyrighted material of Insurance GCP 204 OR 05 12 Services Office, Inc., with its permission. Page 12 of 15 addition to the limits of insurance coverage for the addi- shown in the Declarations. tional insured: c. SECTION IV - COMMERCIAL GEN- (1) Be provided by the ERAL LIABILITY CONDITIONS is Insurance Ser- hereby amended as follows: vices Office addi- tional insured form (1) Condition 5. Other Insurance is number CG 32 61, amended to indude: CG 32 62 or CG (a) Where required by a written 32 63; or contract or agreement, this (2) Include coverage insurance is primary and / or for completed op- noncontributory as respects any other insurance policy erations; or issued to the additional in- (3) Include coverage sured, and such other in- for "your work"surance policy shall be ex- cess and / or noncontribut- and where the lim- ing, whichever applies, with its or coverage this insurance. provided to the additional insured (b) Any insurance provided by is more restrictive this endorsement shall be than was specially primary to other insurance required in that available to the additional written contract or insured except: agreement, the terms of Para- 1) As otherwise provided graphs 7.a.(3)(a) in SECTION IV - or 7.b. above, or COMMERCIAL GEN- any combination ERAL LIABILITY thereof, shall be CONDITIONS, 5. Oth- interpreted as er Insurance, b. Ex- providing the limits cess Insurance; or or coverage re- 2) For any other valid and quired by the collectible insurance terms of the writ- available to the addi- ten contract or tional insured as an ad- agreement, but ditional insured by at- only to the extent tachment of an en- that such limits or dorsement to another coverage is in- insurance policy that is cluded within the written on an excess terms of the Cov- basis. In such case, the erage Part to coverage provided un- which this en- der this endorsement dorsement is at- shall also be excess. tached. (2) Condition 11. Conformance to b. With respect to addi- Specific Written Contract or tional insureds de- Agreement is hereby added: scribed in Paragraph 7.a.(2)(f) above only: 11. Conformance to Specific Written Contract or If a written contract or Agreement agreement between you and the additional a. With respect to addi- insured specifies that tional insureds de- coverage for the addi- scribed in Paragraph tional insured: 7.a.(2)(f) above only: (1) Be provided by the If a written contract or Insurance Ser- agreement between vices Office addi- you and the additional tional insured form insured specifies that number CG 20 10 Includes copyrighted material of Insurance GCP 204 OR 05 12 Services Office, Inc., with its permission. Page 13 of 15 or CG 20 37 Paragraphs (3) and (4) of this exclu- (where edition sion do not apply to tools or equip- specified); or ment loaned to you, provided they are not being used to perform operations (2) Include coverage at the time of loss. for completed op- erations; or b. With respect to the insurance pro- vided by this section of the endorse- (3) 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, 9. 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 7.a.(3)(a), the limits being replaced. The 7.a.(3)(b) or 7.b. above, Limits of Insurance shown in or any combination Section B. Limits of Insurance, thereof, shall be inter- 9. 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 agreement, but only to (a) Insureds; the extent that such lim- its or coverage is in- (b) Claims made or "suits" cluded within the terms brought; or of the Coverage Part to (c) Persons or organizations which this endorsement making claims or bringing is attached. If, however, "suits". the written contract or agreement specifies (2) Deductible Clause the Insurance Services dam- Office additional in- (a) Our obligation to pay dam- red form number CG ages on your behalf applies su su 10 but does not only to the amount of dam- 20 edition, or ages for each "occurrence" specify which but specifies an edition that which are in excess of the does not exist, Para- Deductible amount stated in Section B. Limits of Insur- g and ance, 9. of this endorse- 7.arapdors.(hs hs 7.a..((3)(a) 3)(b) this shall en- not ment. The limits of insur- apply and Paragraph ance will not be reduced by 7.b. of this endorse- the application of such De- ment shall apply. ductible amount. 8. Broadened Contractual Liability - Work (b) Condition 2. Duties in the Within 50' of Railroad Property Event of Occurrence, Of- fense, Claim or Suit, ap- It is hereby agreed that Paragraph f.(1) of plies to each claim or "suit" Definition 12. "Insured contract" (SEC- irrespective of the amount. TION V - DEFINITIONS) is deleted. (c) We may pay any part or all 9. Property Damage to Borrowed Equip- of the deductible amount to ment effect settlement of any claim a. The following is hereby added to Ex- or "suit'and, upon en, clusion Damage to Property of tification of the action taken, J you shall promptly reim- Paragraph 2., Exclusions of SEC- burse us for such part of the TION I - COVERAGES, COVERAGE deductible amount as has A. BODILY INJURY AND PROP- been paid by us. ERTY DAMAGE LIABILITY: Includes copyrighted material of Insurance GCP 204 OR 05 12 Services Office, Inc., with its permission. Page 14 of 15 10. Employees as Insureds - Specified TIONS) is hereby deleted and replaced by Health Care Services the following: It is hereby agreed that Paragraph a. You must see to it that we are notified 2.a.(1)(d) of SECTION II - WHO IS AN as soon as practicable of an "occur- INSURED, does not apply to your "em- rence" or an offense which may result ployees" who provide professional health in a claim. To the extent possible, no- care services on your behalf as duly li- tice should include: censed: (1) How, when and where the "oc- a. Nurses; currence" or offense took place; b. Emergency Medical Technicians; or (2) The names and addresses of c. Paramedics, any injured persons and wit- c. in the jurisdiction where an "occurrence" (3) The nature and location of any or offense to which this insurance applies injury or damage arising out of takes place. the "occurrence" or offense. 11. Broadened Notice of Occurrence This requirement applies only when Paragraph a. of Condition 2. Duties in the "occurrence" or offense is known the Event of Occurrence, Offense, to an "authorized representative". Claim or Suit (SECTION IV - COMMER- CIAL GENERAL LIABILITY CONDI- Includes copyrighted material of Insurance GCP 204 OR 05 12 Services Office, Inc., with its permission. Page 15 of 15 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: 09/01/2015 Policy Number: EBA0347703 Named Insured: Ashland Flower Shop & Green Houses, Inc. dba: Carol's Colors 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, 1. 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