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HomeMy WebLinkAboutInsurance Certificate: JM Construction Client#: 176257 JMCONS ACORDTM CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 9/14/2016 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 NAME: Linda Shaddon Propel Insurance PHONE No, Ext : 541 494-7728 A/c, No): 866 577-1326 Medford Commercial Insurance E-MAIL linda.shaddonnpropelinsurance.com P O Box 936 ADDRESS: linda.shaddon@propelinsurance.com AFFORDING COVERAGE NAIC # Medford, OR 97501 INSURER A : Western National Assurance Co 24465 INSURED INSURER B : JM Construction, Inc. INSURER C : P O Box 1637 INSURER D : Shady Cove, OR 97539 - - 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 CONTRACTOR 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 ADDL SUBR LTR TYPE OF INSURANCE INSR WVD _ POLICY NUMBER POLICY EFF (MM/DD/YYYY POLICY EXP LIMITS MM/DD/YYYY A GENERAL LIABILITY CPP108011303 9/15/2016 09/15/201 EACH OCCURRENCE $1,000,000_ DAMAGE TO RENTED X COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $300,000 CLAIMS-MADE E~ OCCUR MED EXP (Any one person) $10,000 X F$500 PD Ded. PERSONAL & ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000 POLICY X PRJE iL CTOnLOC $ - COMBINED SINGLE LIMIT A AUTOMOBILE LIABILITY CPP107975003 9/15/2016 09/15/201 Ea accident $1,000,000 ANY AUTO BODILY INJURY (Per person) $ ALL OWNED SCHEDULED BODILY INJURY (Per accident) $ X AUTOS AUTOS PROPERTY DAMAGE $ OWNED X HIRED AUTOS X NON-AUTOS Per accident $ A X UMBRELLA LIAB X OCCUR UMB101331603 9/15/2016 09/15/201 EACH OCCURRENCE $1,0002000 EXCESS LIAB CLAIMS-MADE AGGREGATE $1,000 000 DED X RETENTION $10,000_ $ - - i WORKERS COMPENSATION ! WC STATU- OTH AND EMPLOYERS' LIABILITY YIN TORY LIMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVES E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N I A (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ If yes, describe under DESCRIPTION OF OPERATIONS below E.L DISEASE -POLICY LIMIT $ I DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Additional Interest per the attached endorsement(s). RE: Chautauqua Walkway Project - City of Ashland, its elected officials, officers and employees CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Ashland THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 90 N. Mountain Ave. ACCORDANCE WITH THE POLICY PROVISIONS. Ashland, OR 97520-2014 AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) 1 of 1 The ACORD name and logo are registered marks of ACORD #S2371157/M2371148 DMB00 COMMERCIAL GENERAL LIABILITY WN GL 49 07 15 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - AUTOMATIC STATUS WHEN REQUIRED IN CONSTRUCTION AGREEMENT WITH YOU PRIMARY AND NONCONTRIBUTORY This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Section II - Who Is An Insured is amended to B. With respect to the insurance afforded to these include as an additional insured any person or or- additional insureds, the following additional exclu- ganization for whom you are performing opera- sion applies: tions when you and such person or organization This insurance does not apply to: have agreed in writing in a contract or agreement 1. "Bodily injury", "property damage" or "personal that such person or organization be added as an and advertising injury" arising out of the ren- additional insured on your policy. Such person or dering of, or the failure to render, any profes- organization is an additional insured only with re- sional architectural, engineering or surveying spect to liability for "bodily injury", "property dam- services, including: age" or "personal and advertising injury" caused, a. The preparing, approving, or failing to pre- in whole or in part, by: pare or approve, maps, shop drawings, 1. Your acts or omissions; or opinions, reports, surveys, field orders, 2. The acts or omissions of those acting on your change orders or drawings and specifica- behalf; tions; or in the performance of your ongoing operations for b. Supervisory, inspection, architectural or the additional insured. engineering activities. A person's or organization's status as an additional This exclusion applies even if the claims insured under this endorsement ends when your against an additional insured allege negli- operations for that additional insured are complet- gence or other wrongdoing in the supervision, ed. hiring, employment, training or monitoring of However: others by that insured, if the "occurrence" 1. The insurance afforded to such additional in- which caused the "bodily injury" or "property damage", only applies to the extent permitted by or the offense which caused the law; and "personal and advertising injury", involved the rendering of or failure to render any profes- 2. If coverage provided to the additional insured sional services by you with respect to your is required by a contract or agreement, the in- providing engineering, architectural or survey- surance afforded to such additional insured ing services in your capacity as an engineer, will not be broader than that which you are re- architect or surveyor. quired by the contract or agreement to provide for such additional insured. WN GL 49 07 15 Page 1 of 2 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 2. "Bodily injury" or "property damage" occurring D. The following is added to the Other Insurance after: Condition and supersedes any provision to the a. All work, including materials, parts or contrary: equipment furnished in connection with Primary And Noncontributory Insurance such work, on the project (other than ser- This insurance is primary to and will not seek vice, maintenance or repairs) to be per- any contribution from any other insurance formed by or on behalf of the additional in- sured( available to an additional insured under your s) at the location of the covered operations has been completed; or policy provided that: b. That portion of "your work" out of which (1) The additional insured is a Named Insured the injury or damage arises has been put under such other insurance; and to its intended use by any person or or- (2) You have agreed in writing in a contract or ganization other than another contractor or agreement that this insurance would be subcontractor engaged in performing op- primary and would not seek contribution erations for a principal as a part of the from any other insurance available to the same project. additional insured. C. With respect to the insurance afforded to these additional insureds, the following is added to Sec- tion III - Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is: 1. The minimum amount required by the contract or agreement; or 2. The Limits of Insurance shown in the Declara- tions; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. WN GL 49 07 15 Page 2 of 2 Includes copyrighted material of Insurance Services Office, Inc., with its permission. WN GL 39 07 15 COMMERCIAL GENERAL LIABILITY ENHANCEMENT ENDORSEMENT The Commercial General Liability Enhancement Endorsement is an optional endorsement that provides coverage en- hancements. The following is a summary of broadened coverages provided by this endorsement. No coverage is pro- vided by this summary, refer to following endorsement for changes in your policy. SUMMARY OF COVERAGES PAGE Bodily Injury And Property Damage Liability • Non Owned Watercraft Up To 50 Feet ......................................................................................2 Property Damage Liability • Elevators ....................................................................................................................................3 • Fire, Lightning, Explosion Or Sprinkler Leakage Exception .......................................................3 • Borrowed Equipment ($25,000 Per Occurrence, $50,000 Aggregate, $2,500 Deductible Per Occurrence .........................................................................................3 Supplementary Payments - Amended • Bail Bonds Up To $5,000 ...........................................................................................................4 • Loss of Earnings Up To $500/Day ............................................................................................4 Who Is An Insured Amendments • Employee Bodily Injury To A Co-Employee ...............................................................................4 • Newly Formed Or Acquired Organizations For Up To 180 Days ...............................................4 • Blanket Additional Insured - Vendors - As Required By Contract ............................................4 • Blanket Additional Insured - Lessor Of Leased Equipment ......................................................6 • Blanket Additional Insured - Managers Or Lessors Of Premises ..............................................6 • Blanket Additional Insured - State Or Governmental Agency Or Subdivision Or Political Subdivision - Permits Or Authorizations ..............................................................7 • Blanket Additional Insured - State Or Governmental Agency Or Subdivision Or Political Subdivision - Permits Or Authorizations Relating To Premises ...........................8 Damage To Premises Rented To You - $300,000 ...............................................................................9 Medical Payments Increased Limit - $10,000 Or Amount Shown on Declarations .............................9 Conditions • Knowledge of Occurrence, Offense, Claim Or Suit Amended ...................................................9 • Unintentional Failure To Disclose Hazards ................................................................................9 • Waiver of Subrogation ..............................................................................................................10 Insured Contract Amended ...................................................................................................................10 Personal And Advertising Injury Redefined • Televised, Videotaped Or Electronic Publication .....................................................................10 WN GL 39 07 15 Includes copyrighted material of the Insurance Service Office, Inc., with its permission. Page 1 of 10 WN GL 39 07 15 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY COMMERCIAL GENERAL LIABILITY ENHANCEMENT ENDORSEMENT This endorsement modifies the insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE FORM With respect to the coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by this endorsement. The SECTIONS of the Commercial General Liability Coverage Form identified in this endorsement will be amended as shown below. SECTION I - COVERAGES AMENDMENTS (4) Liability assumed under any "insured con- COVERAGE A - BODILY INJURY AND PROPERTY tract" for the ownership, maintenance or use DAMAGE LIABILITY of aircraft or watercraft; or (5) "Bodily injury" or "property damage" arising A. Non Owned Aircraft Or Watercraft out of: Item 2. Exclusions, Paragraph g. is replaced by the (a) The operation of machinery or equip- following: ment that is attached to, or part of, a g. Aircraft, Auto Or Watercraft land vehicle that would qualify under the "Bodily injury" or "property damage" arising out definition of "mobile equipment" if it were of the ownership, maintenance, use or entrust- not subject to a compulsory or financial ment to others of any aircraft, "auto" or water- responsibility law or other motor vehicle craft owned or operated by or rented or loaned insurance law where it is licensed or to any insured. Use includes operation and principally garaged; or "loading or unloading". (b) The operation of any of the machinery This exclusion applies even if the claims against or equipment listed in Paragraph f. (2) any insured allege negligence or other wrong- or f. (3) of the definition of "mobile doing in the supervision, hiring, employment, equipment". training or monitoring of others by that insured, if B. Damage To Property Coverage Extensions the "occurrence" which caused the "bodily injury" Item 2. Exclusions Paragraph j. is replaced by the or "property damage" involved in the ownership, following: maintenance, use or entrustment to others of any aircraft, "auto" or watercraft that is owned or j. Damage To Property operated by or rented or loaned to any insured. "Property damage" to: This exclusion does not apply to: (1) Property you own, rent, or occupy, including (1) A watercraft while ashore on premises you any costs or expenses incurred by you, or own or rent; any other person, organization or entity, for (2) A watercraft you do not own that is: repair, replacement, enhancement, restora- tion or maintenance of such property for any (a) Less than 50 feet long; and reason, including prevention of injury to a (b) Not being used to carry persons or prop- person or damage to another's property; erty for a charge; (2) Premises you sell, give away or abandon, if This Subparagraph (2) applies to any per- the "property damage" arises out of any part son, who with your expressed or implied of those premises; consent, either uses or is responsible for the (3) Property loaned to you; use of the watercraft; (4) Personal property in the care, custody or (3) Parking an "auto" on, or on the ways next to, control of the insured; premises you own or rent, provided the "auto" is not owned by or rented or loaned to you or the insured, WN GL 39 07 15 Includes copyrighted material of the Insurance Service Office, Inc., with its permission. Page 2 of 10 (5) That particular part of real property on which Paragraph (6) of this exclusion does not apply to you or any contractors or subcontractors "property damage" included in the "products-com- working directly or indirectly on your behalf pleted operations hazard", are performing operations, if the "property The insurance provided for "property damage" from damage" arises out of those operations; or the use of elevators and for "property damage" to (6) That particular part of any property that must borrowed equipment is excess over any other valid be restored, repaired or replaced because and collectible property insurance (including any de- "your work" was incorrectly performed on it. ductible portion thereof) available to the insured Paragraphs (1), (3) and (4) of this exclusion do not whether primary, excess, contingent or on any other apply to "property damage" (other than damage by basis. fire, lightning, explosion or sprinkler leakage) to C. Damage To Premises Rented To You premises, including the contents of such premises, Item 2. Exclusions, the last paragraph is replaced rented to you for a period of seven or fewer by the following: consecutive days. A separate limit of insurance applies to Damage To Premises Rented To You as Exclusions c. through n. do not apply to damage by described in SECTION III - LIMITS OF fire, lightning, explosion or sprinkler leakage to INSURANCE. However, the provisions of this premises while rented to you or temporarily occupied paragraph do not apply if coverage for Damage To by you with permission of the owner. A separate Premises Rented To You is excluded by en- limit of insurance applies to this coverage as de- dorsement. scribed in Paragraph 6. of SECTION III - LIMITS OF Paragraph (2) of this exclusion does not apply if the INSURANCE. premises are "your work" and were never occupied, COVERAGE B - PERSONAL AND ADVERTISING rented or held for rental by you. INJURY LIABILITY Paragraphs (3) and (4) of this exclusion do not apply D. Personal And Advertising Injury to the use of elevators. Sub- Item 2. Exclusions is amended by replacing Sub- paragraphs (3), (4), (5) and (6) of this exclusion do paragraphs b. and c. with the following: not apply to liability assumed under a sidetrack agreement. b. Material Published With Knowledge Of Paragraph (4) of this exclusion does not apply to Falsity "property damage" to borrowed equipment while not "Personal and advertising injury" arising out of being used to perform operations at the jobsite. oral, written, televised, videotaped or electronic Subject to Paragraph 2. of SECTION III - LIMITS publication, in any manner, of material, if done OF INSURANCE, the rules below fix the most we by or at the direction of the insured with will pay for "property damage" under this provision: knowledge of its falsity. (1) $25,000 any one "occurrence", regardless of the c. Material Published Prior To Policy Period number of persons or organizations who sustain "Personal and advertising injury" arising out of damages because of that "occurrence"; oral, written, televised, videotaped or electronic publication, in any manner, of material whose (2) $50,000 annual aggregate; and first publication took place before the beginning (3) We will pay only for damages in excess of of the policy period. $2,500 as a result of any one "occurrence", re- gardless of the number of persons or organiza- tions who sustain damages because of that "oc- currence". We may, or if required by law, pay all or any part of any deductible amount, if applica- ble, to effect settlement of any claim or "suit". Upon notice of our payment of a deductible amount, you shall promptly reimburse us for the part of the deductible amount we paid. WN GL 39 07 15 Includes copyrighted material of the Insurance Service Office, Inc., with its permission. Page 3 of 10 SUPPLEMENTARY PAYMENTS - COVERAGES A The following are added: AND B C. Blanket Additional Insured - Vendors - As Re- E. Supplementary Payments - Coverages A and B quired By Contract Item 1. is amended by replacing Subparagraphs b. 1. Section II - Who Is An Insured is amended to and d. with the following: include as an additional insured any person(s) or b. Up to $5,000 for cost of bail bonds required be- organization(s) (referred to throughout this cause of accidents or traffic law violations aris- endorsement as vendor) with whom you have ing out of the use of any vehicle to which the agreed in a written contract, executed prior to Bodily Injury Liability Coverage applies. We do loss, to name as an additional insured, but only not have to furnish these bonds. with respect to "bodily injury" or "property damage" arising out of "your products" which are d. All reasonable expenses incurred by the insured distributed or sold in the regular course of the at our request to assist us in the investigation or vendor's business. defense of the claim or "suit", including actual However, loss of earnings up to $500 a day because of time off from work. a. The insurance afforded to such vendor only applies to the extent permitted by law; and b. If coverage provided to the vendor is SECTION II - WHO IS AN INSURED AMENDMENTS required by a contract or agreement, the A. Employee Bodily Injury To A Co-Employee insurance afforded to such vendor will not be broader than that which you are required Paragraph 2. a. (1) is replaced by the following: by the contract or agreement to provide for (1) "Bodily injury" or "personal and advertising such vendor. injury": 2. With respect to the insurance afforded to these (a) To you, to your partners or members (if you vendors, the following additional exclusions are a partnership or joint venture), to your apply: members (if you are a limited liability com- a. The insurance afforded the vendor does not pany), or to your other "volunteer workers" apply to: while performing duties related to the con- (1) "Bodily injury" or "property damage" for duct of your business; which the vendor is obligated to pay (b) For which there is any obligation to share damages by reason of the assumption damages with or repay someone else who of liability in a contract or agreement. must pay damages because of the injury This exclusion does not apply to liability described in Paragraph (1) (a) above; or for damages that the vendor would have (c) Arising out of his or her providing or failing to in the absence of the contract or provide professional health care services. agreement; B. Newly Acquired Organizations (2) Any express warranty unauthorized by Paragraph 3. a. is replaced by the following: you; a. Coverage under this provision is afforded only (3) Any physical or chemical change in the product made intentionally by the until the 180 day after you acquire or form the vendor; organization or the end of the policy period, whichever is earlier (4) Repackaging, except when unpacked ; solely for the purpose of inspection, demonstration, testing, or the substitution of parts under instructions from the manufacturer, and then repackaged in the original container; WN GL 39 07 15 Includes copyrighted material of the Insurance Service Office, Inc., with its permission. Page 4 of 10 (5) Any failure to make such inspections, 4. With respect to the insurance afforded to these adjustments, tests or servicing as the vendors, the following is added to Section III - vendor has agreed to make or normally Limits Of Insurance: undertakes to make in the usual course of business, in connection with the If coverage provided to the vendor is required by distribution or sale of the products, a contract or agreement, the most we will pay on (6) Demonstration, installation, servicing or behalf of the vendor is: repair operations, except such a. The minimum amount required by the operations performed at the vendor's contract or agreement; or premises in connection with the sale of b. The Limits of Insurance shown in the the product; Declarations; (7) Products which, after distribution or sale whichever is less. by you, have been labeled or relabeled or used as a container, part or This endorsement shall not increase the ingredient of any other thing or applicable Limits of Insurance shown in the substance by or for the vendor; or Declarations. (8) "Bodily injury or "property damage" 5. With respect to the insurance afforded to these arising out of the sole negligence of the additional insureds, the following additional vendor for its own acts or omissions or exclusion applies: those of its employees or anyone else This insurance does not apply to: acting on its behalf. However, this exclusion does not apply to: a. "Bodily injury", "property damage" or (i) The exceptions contained in "personal and advertising injury" arising out Subparagraphs (4) or (6); or of the rendering of, or the failure to render, any professional architectural, engineering (ii) Such inspections, adjustments, tests or surveying services, including: or servicing as the vendor has agreed to make or normally (1) The preparing, approving' or failing to undertakes to make in the usual prepare or approve, maps, shop course of business, in connection drawings, opinions, reports, surveys, with the distribution or sale of the field orders, change orders or drawings products. and specifications; or 3. This Provision C. does not apply: (2) Supervisory, inspection, architectural or engineering activities. a. To any insured person or organization from This exclusion applies even if the claims whom you have acquired such products, or against an additional insured allege any ingredient, part or container, entering negligence or other wrongdoing in the into, accompanying or containing such supervision, hiring, employment, training products; or monitoring of others by that insured, if b. To any vendor for which coverage as an the "occurrence" which caused the additional insured specifically is scheduled "bodily injury" or "property damage", or by endorsement; or the offense which caused the "personal c. When liability included within the "products- and advertising injury", involved the completed operations hazard" has been ex- rendering of or failure to render any cluded for such product either by the provi- professional services by you with sions of the coverage part or by endorse- respect to your providing engineering, ment. architectural or surveying services in your capacity as an engineer, architect or surveyor. WN GL 39 07 15 Includes copyrighted material of the Insurance Service Office, Inc., with its permission. Page 5 of 10 D. Blanket Additional Insured - Lessor Of Leased 4. With respect to the insurance afforded to these Equipment additional insureds, the following additional exclusion applies: 1. Section II -Who Is An Insured is amended to This insurance does not apply to: include as an additional insured any person(s) or organization(s) from whom you lease equipment a. "Bodily injury", "property damage" or when you and such person(s) or organization(s) "personal and advertising injury" arising out have agreed in writing in a contract or of the rendering of, or the failure to render, agreement, executed prior to loss, that such any professional architectural, engineering person(s) or organization(s) be added as an or surveying services, including: additional insured on your policy. Such (1) The preparing, approving, or failing to person(s) or organization(s) is an insured only prepare or approve, maps, shop with respect to liability for bodily injury", drawings, opinions, reports, surveys, "property damage" or "personal and advertising field orders, change orders or drawings injury caused, in whole or in part, by your and specifications; or maintenance, operation or use of equipment leased to you by such person(s) or (2) Supervisory, inspection, architectural or organization(s). engineering activities. However, the insurance afforded to such This exclusion applies even if the claims additional insured: against an additional insured allege a. Only applies to the extent permitted by law; negligence or other wrongdoing in the and supervision, hiring, employment, training or monitoring of others by that insured, if the b. Will not be broader than that which you are "occurrence" which caused the "bodily required by the contract or agreement to injury" or "property damage", or the offense provide for such additional insured. which caused the "personal and advertising A person's or organization's status as an addi- injury", involved the rendering of or failure to tional insured under this endorsement ends render any professional services by you with when their contract or agreement with you for respect to your providing engineering, such leased equipment ends. architectural or surveying services in your 2. With respect to the insurance afforded to these capacity as an engineer, architect or additional insureds, this insurance does not ap- surveyor. ply to any "occurrence" which takes place after E. Blanket Additional Insured - Managers Or Les- the equipment lease expires. sors Of Premises 3. With respect to the insurance afforded to these 1. Section II - Who Is An Insured is amended to additional insureds, the following is added to include as an additional insured any person(s) or Section III - Limits Of Insurance: organization(s) with whom you have agreed in a If coverage provided to the additional insured is written contract, executed prior to loss, to name required by a contract or agreement, the most as an additional insured, but only with respect to we will pay on behalf of the additional insured is: liability arising out of the ownership, a. The minimum amount required by the maintenance or use of that part of the premises contract or agreement; or leased to you, subject to the following additional exclusions: b. The Limits of Insurance shown in the Declarations; This insurance does not apply to: whichever is less. a. Any "occurrence" which takes place after This endorsement shall not increase the you cease to be a tenant in that premises. applicable Limits of Insurance shown in the b. Structural alterations, new construction or Declarations. demolition operations performed by or on behalf of such additional insured. WN GL 39 07 15 Includes copyrighted material of the Insurance Service Office, Inc., with its permission. Page 6 of 10 However: F. Blanket Additional Insured - State Or a. The insurance afforded to such additional Governmental Agency Or Subdivision Or Politi- insured only applies to the extent permitted cal Subdivision - Permits Or Authorizations by law; and Section II - Who Is An Insured is amended to in- b. If coverage provided to the additional clude as an additional insured any state or insured is required by a contract or governmental agency or subdivision or political agreement, the insurance afforded to such subdivision with whom you have agreed in a written additional insured will not be broader than contract, executed prior to loss, to name as an that which you are required by the contract additional insured, subject to the following or agreement to provide for such additional provisions: insured. 1. This insurance applies only with respect to op- 2. With respect to the insurance afforded to these erations performed by you or on your behalf for additional insureds, the following is added to which the state or governmental agency or sub- Section III - Limits Of Insurance: division or political subdivision has issued a If coverage provided to the additional insured is permit or authorization. required by a contract or agreement, the most However: we will pay on behalf of the additional insured is: a. The insurance afforded to such additional a. The minimum amount required by the insured only applies to the extent permitted contract or agreement; or by law; and b. The Limits of Insurance shown in the b. If coverage provided to the additional insured is required by a contract or Declarations; agreement, the insurance afforded to such whichever is less. additional insured will not be broader than This endorsement shall not increase the that which you are required by the contract applicable Limits of Insurance shown in the or agreement to provide for such additional Declarations. insured. 3. With respect to the insurance afforded to these 2. This insurance does not apply to: additional insureds, the following additional a. "Bodily injury", "property damage" or "per- exclusion applies: sonal and advertising injury" arising out of This insurance does not apply to: operations performed for the federal govern- a. "Bodily injury", "property damage" or ment, state or municipality; or "personal and advertising injury" arising out b. "Bodily injury" or "property damage" in- of the rendering of, or the failure to render, cluded within the "products-completed op- any professional architectural, engineering erations hazard". or surveying services, including: 3. With respect to the insurance afforded to these (1) The preparing, approving, or failing to additional insureds, the following is added to prepare or approve, maps, shop Section III - Limits Of Insurance: drawings, opinions, reports, surveys, If coverage provided to the additional insured is field orders, change orders or drawings required by a contract or agreement, the most and specifications; or we will pay on behalf of the additional insured is: (2) Supervisory, inspection, architectural or a. The minimum amount required by the engineering activities. contract or agreement; or This exclusion applies even if the claims b. The Limits of Insurance shown in the against an additional insured allege Declarations; negligence or other wrongdoing in the supervision, hiring, employment, training or whichever is less. monitoring of others by that insured, if the This endorsement shall not increase the "occurrence" which caused the "bodily applicable Limits of Insurance shown in the injury" or "property damage", or the offense Declarations. which caused the "personal and advertising injury", involved the rendering of or failure to render any professional services by you with respect to your providing engineering, architectural or surveying services in your capacity as an engineer, architect or surveyor. WN GL 39 07 15 Includes copyrighted material of the Insurance Service Office, Inc., with its permission. Page 7 of 10 4. With respect to the insurance afforded to these b. The construction, erection or removal of additional insureds, the following additional elevators; or exclusion applies: c. The ownership, maintenance or use of any This insurance does not apply to: elevators covered by this insurance. a. "Bodily injury", "property damage" or However, "personal and advertising injury" arising out a. The insurance afforded to such additional of the rendering of, or the failure to render, insured only applies to the extent permitted any professional architectural, engineering by law; and or surveying services, including: b. If coverage provided to the additional (1) The preparing, approving, or failing to insured is required by a contract or prepare or approve, maps, shop agreement, the insurance afforded to such drawings, opinions, reports, surveys, additional insured will not be broader than field orders, change orders or drawings that which you are required by the contract and specifications; or or agreement to provide for such additional (2) Supervisory, inspection, architectural or insured. engineering activities. 2. With respect to the insurance afforded to these This exclusion applies even if the claims additional insureds, the following is added to against an additional insured allege Section III - Limits Of Insurance: negligence or other wrongdoing in the If coverage provided to the additional insured is supervision, hiring, employment, training or required by a contract or agreement, the most monitoring of others by that insured, if the we will pay on behalf of the additional insured is: "occurrence" which caused the "bodily injury" or "property damage", or the offense a. The minimum amount required by the which caused the "personal and advertising contract or agreement; or injury", involved the rendering of or failure to b. The Limits of Insurance shown in the render any professional services by you with Declarations; respect to your providing engineering, whichever is less. architectural or surveying services in your capacity as an engineer, architect or This endorsement shall not increase the surveyor. applicable Limits of Insurance shown in the Declarations. G. Blanket Additional Insured - State Or 3. With respect to the insurance afforded to these Governmental Agency Or Subdivision Or Politi- additional insureds, the following additional cal Subdivision - Permits Or Authorizations Re- exclusion applies: lating To Premises This insurance does not apply to: Section II - Who Is An Insured is amended to in- a. "Bodily injury", "property damage" or clude as an additional insured any state or "personal and advertising injury" arising out governmental agency or subdivision or political of the rendering of, or the failure to render, subdivision with whom you have agreed in a written any professional architectural, engineering contract, executed prior to loss, to name as an or surveying services, including: additional insured, subject to the following provision: (1) The preparing, approving, or failing to 1. This insurance applies only with respect to the prepare or approve, maps, shop following hazards for which the state or drawings, opinions, reports, surveys, governmental agency or subdivision or political field orders, change orders or drawings subdivision has issued a permit or authorization and specifications; or in connection with premises you own, rent or (2) Supervisory, inspection, architectural or control and to which this insurance applies: engineering activities. a. The existence, maintenance, repair, construction, erection or removal of advertising signs, awnings, canopies, cellar entrances, coal holes, driveways, manholes, marquees, hoist away openings, sidewalk vaults, street banners or decorations and similar exposures; or WN GL 39 07 15 Includes copyrighted material of the Insurance Service Office, Inc., with its permission. Page 8 of 10 This exclusion applies even if the claims against an additional insured allege SECTION IV - COMMERCIAL GENERAL LIABILITY negligence or other wrongdoing in the CONDITIONS AMENDMENTS supervision, hiring, employment, training or A. Knowledge Of Occurrence monitoring of others by that insured, if the "occurrence" which caused the "bodily Item 2. Duties In The Event Of Occurrence, Of- injury" or "property damage", or the offense fense, Claim or Suit is amended by adding the fol- which caused the "personal and advertising lowing: injury", involved the rendering of or failure to e. You must give us or our authorized representa- render any professional services by you with tive prompt notice of an "occurrence", claim or respect to your providing engineering, loss only when the "occurrence", claim or loss is architectural or surveying services in your known to: capacity as an engineer, architect or (1) You, if you are an individual; surveyor. (2) A partner, if you are a partnership; SECTION III - LIMITS OF INSURANCE AMEND- (3) An executive officer or insurance manager, if MENTS you are a corporation; or A. Damage To Premises Rented To You (4) A member or manager, if you are a limited Paragraph 6. is replaced by the following: liability company. 6. Subject to Paragraph 5. above, the most we will B. Other Insurance pay under Coverage A for damages because of Item 4. Other Insurance, b. Excess Insurance (1) "property damage" to any one premises, while (a) (ii) is replaced by the following. rented to you, or in the case of damage by fire, (ii) That is fire, lightning, explosion or sprinkler leak- lightning, explosion or sprinkler leakage, while age insurance for premises rented to you or rented to you or temporarily occupied by you temporarily occupied by you with permission of with permission of the owner is the greater of: the owner, a. $300,000; or C. Unintentional Failure To Disclose Hazards b. The amount shown next to the Damage To Item 6. Representations is replaced by the Premises Rented To You Limit in the Decla- following: rations. 6. Representations And Unintentional Failure However, the provisions of this paragraph do not To Disclose Hazards apply if Damage To Premises Rented To You a. By accepting this policy, you agree: Coverage is excluded by endorsement. (1) The statements in the Declarations are B. Medical Expense Limit accurate and complete; Paragraph 7. is replaced with the following: (2) Those statements are based upon 7. Subject to Paragraph 5. above, the most we will representations you made to us, and pay under Coverage C for all medical expenses (3) We have issued this policy in reliance because of "bodily injury" sustained by any one upon your representations. person is the greater of, b. If you unintentionally fail to disclose any haz- a. $10,000; or ards existing at the inception date of your b. The amount shown next to the Medical Ex- policy, we will not deny coverage under this pense Limit in the Declarations. Coverage Part because of such failure. However, this provision does not affect our This insurance does not apply if coverage for right to collect additional premium or exer- Medical Expenses is excluded either by the pro- cise our right of cancellation or non-renewal. visions of the coverage part or by endorsement. WN GL 39 07 15 Includes copyrighted material of the Insurance Service Office, Inc., with its permission. Page 9 of 10 D. Waiver of Subrogation SECTION V - DEFINITIONS AMENDMENTS Item 8. Transfer of Rights of Recovery Against A. Insured Contract Amended Others to Us is hereby amended by the addition of Paragraph 9. a. is replaced by the following: the following: We waive any right of recovery we may have be- a. A contract for a lease of premises. However, cause of payments we make for injury or damage that portion of the contract for a lease of prem- arising out of your ongoing operations or "your work" ises that indemnifies any person or organization done under a written contract, executed prior to loss, for damage by fire, lightning, explosion or sprin- requiring such waiver with that person or organiza- kler leakage to premises while rented to you or tion and included in the "products-completed opera- temporarily occupied by you with permission of tions hazard". However, our rights may only be the owner is not an "insured contract", waived prior to the "occurrence" giving rise to the B. Personal And Advertising Injury Redefined injury or damage for which we make payment under Paragraph 14. d. and e. are replaced by the follow- this Coverage Part. The insured must do nothing after a loss to impair our rights. At our request, the ing: insured will bring "suit" or transfer those rights to us d. Oral, written, televised, videotaped or electronic and help us enforce those rights. publication of material that slanders or libels a person or organization or disparages a person's or organization's goods, products or service; e. Oral, written, televised, videotaped or electronic publication of material that violates a person's right of privacy; WN GL 39 07 15 Includes copyrighted material of the Insurance Service Office, Inc., with its permission. Page 10 of 10 WN CA 27 06 16 BUSINESS AUTO ENHANCEMENT ENDORSEMENT The Business Auto Enhancement Endorsement is an optional endorsement that provides coverage enhancements. The following is a summary of broadened coverages provided by this endorsement. No coverage is provided by this summary, refer to following endorsement for changes in your policy. SUMMARY OF COVERAGES PAGE Accidental Airbag Deployment Coverage 4 Auto Loan/Lease Gap Coverage 4 Blanket Additional Insured 2 Blanket Waiver of Subrogation 5 Broadened Definition of Insured includes: Newly Acquired Organizations for up to 180 Days 2 Employees as Insureds 2 Subsidiaries in Which You Own 50% or More 2 Deductible Waiver for Glass Repair 3 Employee Hired Auto 2,5 Fellow Employee Coverage 3 Hired Auto Physical Damage Coverage 4 Knowledge of Accident, Claim, Suit or Loss 5 Loss Of Use Expenses - Amended 3 Personal Effects 3 Rental Reimbursement Coverage 4 Supplementary Payments - Amended: Bail Bonds up to $5,000 2 Loss of Earnings up to $500/Day 2 Transportation Expense Limits - Amended 3 Unintentional Failure to Disclose Hazards 5 WN CA 27 06 16 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 5 WN CA 27 06 16 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY BUSINESS AUTO ENHANCEMENT ENDORSEMENT This endorsement modifies the insurance provided under the following: BUSINESS AUTO COVERAGE FORM With respect to the coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by this endorsement. The SECTIONS of the Business Auto Coverage Form identified in this endorsement will be amended as shown below. SECTION II - COVERED AUTOS LIABILITY g. Any "employee" of yours is an "insured" while COVERAGE AMENDMENTS operating a covered "auto" hired or rented under a contract or agreement in the A. Who Is An Insured "employee's" name, with your permission, SECTION 11 - COVERED AUTOS LIABILITY while performing duties related to the conduct COVERAGE, A. Coverage, 1. Who Is An Insured of your business. is amended to add: B. Blanket Additional Insured d. Any legally incorporated subsidiary of yours in SECTION II - COVERED AUTOS LIABILITY which you own more than 50% of the voting COVERAGE, A. Coverage, 1. Who Is An stock on the effective date of this coverage Insured, paragraph c. is amended to add the form. following: However, "insured" does not include any Any person or organization who is required under a subsidiary of yours that is an "insured" under written contract or agreement between you and any other automobile liability policy, or would that person or organization, that is signed and be an "insured" under such policy but for executed by you before the "bodily injury" or termination of such policy or the exhaustion on "property damage" occurs and that is in effect such policy's limits of insurance. during the policy period, to be named as an e. Any organization which is newly acquired or additional insured is an "insured" for Liability formed by you and over which you maintain Coverage, but only for damages to which this majority ownership. However, coverage under insurance applies and only to the extent that this provision: persons or organization qualifies as an "insured" under the Who Is An Insured provision contained in (1) is afforded only for the first 180 days after Section II. you acquire or form the organization or until the end of the policy period, C. Liability Coverage Extensions - Supplementary whichever comes first; Payments (2) does not apply to "bodily injury" or SECTION II - COVERED AUTOS LIABILITY "property damage" that results from an COVERAGE, A. Coverage, 2. Coverage "accident" that occurred before you formed Extensions, a. Supplementary Payments is or acquired the organization; amended by replacing subparagraphs (2) and (4) with the following: (3) does not apply to any newly acquired or formed organization that is a joint venture (2) Up to $5,000 for cost of bail bonds (including or partnership; and bonds for related traffic law violations) required because of an "accident" we cover. We do not (4) does not apply to an "insured" under any have to furnish these bonds. other automobile liability policy, or would be an "insured" under such a policy but for (4) All reasonable expenses incurred by the termination of such policy or the "insured" at our request, including actual loss exhaustion of such policy's limits of of earnings up to $500 a day because of time insurance. off from work. f. Any "employee" of yours is an "insured" while using a covered "auto" you don't own, hire or borrow in your business or your personal affairs. WN CA 27 06 16 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 2 of 5 D. Fellow Employee Coverage D. Glass Repair - Deductible Waiver SECTION II - COVERED AUTOS LIABILITY SECTION III - PHYSICAL DAMAGE COVERAGE, B. Exclusions, S. Fellow COVERAGE, A. Coverage, 3. Glass Breakage - Employee, the following is added: Hitting A Bird Or Animal - Falling Objects Or Missiles, is amended by adding the following: Co-Employee Lawsuit Defense Cost Reimbursement No deductible will apply to glass breakage if such glass is repaired, in a manner acceptable to us, If a suit seeking damages for "bodily injury" to any rather than replaced. fellow "employee" of the "insured" arising out of and in the course of the fellow "employee's" E. Hired Auto Physical Damage employment or while performing duties related to the conduct of your business, or a suit seeking SECTION III - PHYSICAL DAMAGE damages brought by the spouse, child, parent, COVERAGE, A. Coverage is amended by adding brother or sister of that fellow "employee", is the following: brought against you, we will reimburse reasonable S. Hired Auto Physical Damage costs that you incur in the defense of such matters. Any reimbursement made pursuant to If hired "autos" are covered "autos" for Liability this sub-section will be in addition to the limits of Coverage and if Comprehensive, Specified liability set forth in the Declarations. Causes of Loss, or Collision coverages are provided under this coverage form for any SECTION III - PHYSICAL DAMAGE COVERAGE "auto" you own, then the Physical Damage AMENDMENTS Coverages provided are extended to "autos" you hire of like kind and use, subject to the A. Transportation Expense - Limits Amended following: SECTION III - PHYSICAL DAMAGE a. The most we will pay for any one "loss" is COVERAGE, A. Coverage, 4. Coverage $50,000 or the actual cash value or cost to Extensions, a. Transportation Expenses is repair or replace, whichever is less, minus a deductible; amended by replacing $20 per day/$600 maximum limit with $50 per day/$1000 maximum. b. The deductible will be equal to the largest deductible applicable to any owned "auto" B. Hired Auto Physical Damage - Loss Of Use for that coverage. Any Comprehensive Expenses - Limits Amended deductible does not apply to "loss" caused SECTION III - PHYSICAL DAMAGE by fire or lightening; COVERAGE, A. Coverage, 4. Coverage c. Hired Auto Physical Damage coverage is Extensions, b. Loss of Use Expenses is excess over any other collectible amended by replacing the $20 per day/$600 insurance; and maximum limit with $50 per day/$750 maximum limit. d. Subject to the above limit, deductible and excess provisions we will provide C. Personal Effects Coverage coverage equal to the broadest coverage SECTION III - PHYSICAL DAMAGE applicable to any covered "auto" you own. COVERAGE, A. Coverage, 4. Coverage If a limit for Hired Auto Physical Damage is Extensions is amended by adding the following: indicated in the Declarations, then that limit replaces, and is not added to, the $50,000 limit c. Personal Effects indicated above. We will pay up to $500 for "loss" to personal effects, which are: (1) Owned by an "insured"; and (2) In or on your covered "auto." This coverage applies only in the event of the total theft of your covered "auto." No deductible applies to this coverage WN CA 27 06 16 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 3 of 5 F. Rental Reimbursement G. Accidental Airbag Deployment Coverage SECTION III - PHYSICAL DAMAGE COVERAGE SECTION III - PHYSICAL DAMAGE A. Coverage, is amended by adding the following: COVERAGE, A. Coverage is amended by adding 6. Rental Reimbursement the following: This coverage applies only to a covered "auto" 7. Accidental Airbag Deployment Coverage of the private passenger or light truck type as We will pay to reset or replace factory installed follows: airbag(s) in any covered "auto" for accidental discharge, other than discharge due to a a. We will pay for rental reimbursement collision loss. expenses incurred by you for the rental of a private passenger or light truck type This coverage is applicable only if "auto" because of "loss" to a covered comprehensive coverage applies to the private passenger or light truck type covered "auto". "auto". Payment applies in addition to the otherwise applicable amount of each This coverage is excess over any other coverage you have on a covered private collectible insurance or reimbursement by passenger or light truck type "auto." No manufacturer's warranty. deductibles apply to this coverage. H. Auto Loan/Lease Gap Coverage b. We will pay only for those expenses SECTION III PHYSICAL DAMAGE COVERAGE, incurred during the policy period beginning 24 hours after the "loss" and ending, Item A., Coverage, is amended by adding the regardless of the policy's expiration, with following: the lesser of the following number of days: g, Auto Loan/Lease Gap Coverage (1) The number of days reasonably This coverage applies only to a covered "auto" required to repair or replace the described or designated in the Schedule or in covered private passenger or light the Declarations as including physical damage truck type "auto". If "loss" is caused by theft, this number of days is added coverage. to the number of days it takes to In the event of a covered total "loss" to a locate the covered private passenger covered "auto" described or designated in the or light truck type "auto" and return it Schedule or in the Declarations, we will pay to you; or any unpaid amount due on the lease or loan (2) 30 days. for a covered "auto" less: c. Our payment is limited to the lesser of the a. The amount paid under the Physical following amounts: Damage Coverage Section on the policy; and (1) Necessary and actual expenses b. Any: incurred, or (2) $50 per day, up to a maximum of (1) Overdue lease/loan payments at the $1,000. time of the "loss"; d. This coverage does not apply while there (2) Financial penalties imposed under a are spare or reserve private passenger or lease for excessive use, abnormal light truck type "autos" available to you for wear and tear or high mileage; your operations. (3) Security deposits not returned by the e. If "loss" results from the total theft of a lessor; covered "auto" of the private passenger or light truck type, we will pay under this (4) Costs for extended warranties, Credit coverage only that amount of your rental Life Insurance, Health, Accident or reimbursement expenses which is not Disability Insurance purchased with already provided for under SECTION III - the loan or lease; and PHYSICAL DAMAGE COVERAGE, A. Coverage, 4. Coverage Extensions. (5) Carry-over balances from previous loans or leases. For the purposes of this Rental Reimbursement coverage, light truck is defined as a truck with a gross vehicle weight of 10,000 lbs. or less as defined by the manufacturer as the maximum loaded weight the auto is designed to carry. WN CA 27 06 16 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 4 of 5 SECTION IV - BUSINESS AUTO CONDITIONS C. Unintentional Failure to Disclose Hazards AMENDMENTS SECTION IV - BUSINESS AUTO CONDITIONS, A. Duties In The Event Of Accident, Claim, Suit Or B. General Conditions, 2. Concealment, Loss Amended Misrepresentation Or Fraud, is amended by SECTION IV - BUSINESS AUTO CONDITIONS, adding the following paragraph: A. Loss Conditions, 2. Duties In The Event Of If you unintentionally fail to disclose any hazards Accident, Claim, Suit Or Loss, a. is amended by existing at the inception date of the policy, or adding the following: during the policy period in connection with any additional hazards, we will not deny coverage This condition applies only when the "accident" or under this Coverage Part because of such failure. "loss" is known to: D. Employee Hired Auto (1) You, if you are an individual; (2) A partner, if you are a partnership; SECTION IV - BUSINESS AUTO CONDITIONS, B. General Conditions, 5. Other Insurance, (3) An executive officer or insurance manager, if paragraph b. is deleted and replace by the you are a corporation; or following: (4) A member or manager, if you are a limited b. For Hired Auto Physical Damage Coverage, liability company. the following are deemed to be a covered "autos" you own: But, this section does not amend the provisions relating to notification of police, protection or (1) Any covered "auto" you lease, hire, rent or examination of the property which was subject to borrow. the "loss". (2) Any covered "auto" hired or rented by your B. Blanket Waiver of Subrogation "employee" under a contract in that individual "employee's" name, with your Section IV - BUSINESS AUTO CONDITIONS, A. permission, while performing duties related Loss Conditions, S. Transfer of Rights of to the conduct of your business. Recovery Against Others to Us, is amended by adding the following exception: However, any "auto" that is leased, hired, rented or borrowed with a driver is not a However, we waive any right of recovery we may covered "auto". have against any person or organization to the extent required of you by a written contract signed and executed prior to any "accident" or "loss", provided that the "accident" or "loss" arises out of operations contemplated by such contract. The waiver applies only to the person or organization designated in such contract. WN CA 27 06 16 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 5 of 5