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HomeMy WebLinkAboutInsurance Certificate: Chown Inc (2) Fax Server 3/6/2017 10:29:08 AM PAGE 2/020 Fax Server Client: 325772 CHOWNINC ACORDTM CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) 3/02/2017 THIS CERTIFICATE IS'JSSUED 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 OP. 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 I~u of such endorsement(s). PRODUCER CONTACT NAME Bambi Brown, CIC, CRM PHONE (AJC, No, HONE Ext): (A/C 503.295.8312 , NoY 610.362.8189 USI Northwest CL1 P 700 NE Multnomah, Suite 1300 E-MAIL bambi.brown~usi.com Portland, OR 97232 ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC P 503 224-8390 INSURERA: Ohio Security Insurance Company 24082 INSURED INSURER B : Ohio Casualty Insurance Company 24074 Chown, Inc. INSURER C P O BOX 2888 INSURER D Portland, OR 97208 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 ADDLSUBR POLICY EFF POLICY EXP LIMITS LTR TYPE OF INSURANCE POLICY NUMBER MMIDD/YYYY MM/DD/YYYY A X COMMERCIAL GENERAL LIABILITY B KS57116175 3/01/2017 03/01/201 EACH OCCURRENCE $1,000,000 CLAIMS-MADE ~ OCCUR PREMISES EaaEoNocurrrenoe $11000,000 X WA Stop Gap Included MED EXP (Any one person) $15,000 PERSONAL a ADV INJURY $1 ,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY JEf~ LOC PRODUCTS-COMP/OPAGG $2,000,000 OTHER: A $1,000,000 AUTOMOBILE LIABILITY BAS57116175 310112017 03101/201 (EeeMixxident SINGLE LIMIT X ANY AUTO BODILY INJURY (Per person) $ ALL OWNED SCHEDULED BODILY INJURY (Per accident) $ AUTOS NAUTOS ON-OWNED PROPERTY DAMAGE $ X HIRED AUTOS X AUTOS Per socldent _ - - - $ B X UMBRELLA LIAB X OCCUR US057116175 3/0112017 03/011201 EACH OCCURRENCE $5,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $6,000,000 DED X RETENTION $O $ WORKERSCOMPENSATION PER OTH- AND EMPLOYERS' LIABI ITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y / N E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? F-1 N/A (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ If yes describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Re: Parks restroom door and security lock replacement project for select restrooms at various parks throughout the City. The General Liability and Automobile Liability policies include an automatic Additional Insured endorsement (CG8810, CG8583 and CA8810) that provides Additional Insured status to the Certificate Holder, Oregon and its elected officials, officers and employees, onlywhen there is a written contract that requires such (See Attached Descriptions) 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 20 East Main Street ACCORDANCE WITH THE POLICY PROVISIONS. Ashland,, OR 97520 AUTHORIZED REPRESENTATIVE © 19BB-2014ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) 1 of 2 The ACORD name and logo are registered marks of ACORD #S19988274/M19968662 LKMZP Fax Server 3/6/2017 10:29:08 AM PAGE 3/020 Fax Server DESCRIPTIONS (Continued from Page 1) status, and only with regard to work performed on behalf of the named insured. The General Liability policy contains a special en orsement (CG8810) with Primary and Noncontributory wording. A 30 day notice of cancellation applies( 10 days for non-payment of premium ) to the Named Insured. SAG ITTA 25.3 (2014/01 ` 2 of 2 #S19988274/1VII19968662 Fax Server 3/6/2017 10:29:08 AM PAGE 4/020 Fax Server COMMERCIAL GENERAL LIABILITY' CG 88 10 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ ITT CAREFULLY: COMMERCIAL GENERAL LIABILITY EXTENSION This endorsement modifies insurance provided under the f6llowing. COMMERCIAL GENERAL UAB Li`tY COVERAGE PART INDEX SUBJECT PAGE NON-OWNED AIRCRAFT 2 NON-OWNED WATERCRAFT 2 PROPERTY DAMAGE LIABILITY - ELEVATORS 2 EXTENDED DAMAGE TO PROPERTY RENTED TO YOU (Tenant's Property Damage) 2 MEDICAL PAYMENTS` EXTENSION 3 EXTENSION OF SUPPLEMENTARY PAYMENTS -COVERAGES A AND B 3 ADDITIONAL INSUREDS - BY CONTRACT, AGREEMENT OR PERMIT 3 PRIMARY AND NONCONTRIBUTORY- ADDITIONAL INSURED EXTENSION 5 ADDITIONAL INSUREDS EXTENDED PROTECTION OF YOUR "LIMITS OF INSURANCE" 6 WHO IS AN INSURED -.INCIOE NTAL MEDICAL ERRORSIMALPRACTICE AND WHO IS AN INSURED - FELLOW EMPLOYEE EXTENSION - MANAGEMENT EMPLOYEES 6 NEWLY FORMED OR ADDITIONALLY ACQUIRED ENTITIES 7 FAILURE TO DISCLOSE HAZARDS ADD PRIOR OCCURRENCES 7 KNOWLEDGE OF OCCURRENCE, OFFENSE, CLAIM OR. SUIT 7 LIBERALIZATION CLAUSE 7 BODILY [INJURY REDEFINED 7 EXTENDED PROPERTY DAMAGE 0 WAIVER OF TRANSFER. OF RIGHTS OF RECOVERY AGAINST OTHERS TO US $ WHEN REQUIRED IN A.CONTRACT OR AGREEMENT WITH YOU 2~1~~.iberty Pviu~al.Insur~rac~ CG 88 10 04 13 1nclodesoopyrighied rra,,erW of IrasurartiC erw;c SOf ce ;nc,,wiih its perrr;ission: Page 1 of 8 Fax Server 3/6/2017 10:29:08 AM PAGE 5/020 Fax Server Witt— respect try .coverage afforded by this endorsement. the provisions of the policy apply unless modified by the erlttc~rsemrtt. A. None-O t.ED AIRCRAFT Linder Paragraph 2. Exclusions of Section I - Coverage A - Bodily. Injury.And Property Damage Liabiiity, exclusion; g. Aircraft Auto Or Watercraft cues not apply to an aircraft provided: 1. It is not darned by any insured-, 2. It is hired, chartered or loaned with a grained paid -rev; 3. The pilot i,n commard holds a currently effective certificate, issued by the duly constituted autoor'ity of the United Mates of America or Canada, designating her or trim a commercial or airline pilot: and 4, It is not being used to carry persons or broperty for a charge. _ however the insurance afforded by t-,is provision does not apply if there is avaJlable to the insured other valid and col ect ble ir)surancea, whethor primary., excess (01her than insuramC3 written to apply specifically in excess of this policy). contir€gent or on any other basis., that would also apply to the loss covered under this proviGion. B. NON-OWNED WATERc.RAI=T Gunder Poragraph 2. 'Exclusions of Section [-Coverage A- Bodily Injury And Propert=y Damage Liability, Subparagraph (2) of excluvion g. Aircraft, Auto Or Watercraft is replaced by the followirig: This exclusion does not apply to; (2) A wat,' rcraft you do not :own that is: (a) Less than _1~2 feet lung: and (b) Not being used to carry persists or property for a charge. . C PROPERTY DAMAGE LIABILITY -ELEVATORS 1. Under Paragraph 2.. Exclusions of Section. I - Coverage A. - Bodily Injury And Property Damage Liabil- ity; Subparagraphs (3)1 (4) and (s) of exclusion j, Darnage To Property do not apply if such "property darnoge" resuits frorn the use of elevators. For the ?urmose cf this provision, elevators do not include vehicle lifts. Vehicle lifts are lifts or.hosts used in automobile service br repair operators. 2, The following is added to Section. Iv - Commercial General Liability Conditions, Condition 4, Otter Insurance. Paragraph b. Excess Insurance: The insurance afforded by this provision of th• s- endorsement is excess over any property insurance, Whether primarv; excess: contingent or on, any other basis. D. EXTENDED DAMAGE TO PROPERTY RENTED TO YOU (Tenant's Property Damage) 3f Damage To Premises Rontetl To You is not otherwise exciudwd from this Coverage Part: 1. Under Paragraph 2. Exclusions of Section. I - Coverage A - Bodiily Injury and Property Damage Liability: a. The foudh from the last Paragraph of exclusion j. Darnage To Property is replaced by the follow- Paragraphs (t), 43) and (4) of this exclusion de not apply to "property damage," (other than damage by fire, ?ightriing, explosion, smoke, & leakage from an automatic fire protection system) ta: (i) Premises rented to you for a period of 7 or fewer consecutive days; or (ii) Contents that you rant or lease as part of a premises renal or lease agreement for a period, of more than 7 days. Paragraphs (1), (3) and (4) of this exclusion do not apply. to "property damage" to contents of premises rented to you for a period of 7 or fewer consecutive days- A sepaFate limit of insurance applies to tNs coverage as described in Section Ill Limits of Insurance. 2013 Liberty Mu.kial insurance CG 38 10 04 13 I acludes ou,Pyrighled malw`W of l rasurance derv;cis Office iric" V0ih its permission, Page 2 of 8 Fax Server 3/6/2017 10:29:08 AM PAGE 6/020 Fax Server b. Lm e last paragraph of subsection 2, Exclusions is replaced by the fotlowing: clusians c, through n du -iot apply to damage by7 fire, lightning, explosion. smoke or leakage automatic fire protection systems to prerr€ises while ren`Eed to you or temporarily occupied by you with permissio of the courier- A separate IirTiit of insurance :applies to Darnacge To Prernises Rented To You as described in. Section III - Limits Of Insurance-.. 2 Paragraph 6, under Section III -Limits Of Insurance is replaced by the following.: 6. ;Subject to Paragraph 5. above. the Damage To Premises Rented To You Lir4t is fhe most we will pay under Coyerage A for damages because of, "Property damage" to: a. Any one premise: (1) While rented to you; or (2) While rented to you or ternporarily occupied by you with permission of the owner for damage by fire, lightping, explostor . smke or leakage frorn automatic protection sys- tems: or b. Contents that you rent. or lease as part of a premises rental or lease agreement. :3. As regards coverage provided by this provision D.. EXTENDED DAMAGE. TO PROPERTY RENTED TO YOU (Tenant's Property Damage) - Paragraph 9.a. of Definitions is replaced with the follcowing 9.a. A contract for a lease of premises. However, that portion of the currtrad for a lease of premises that indemnifies any person or organization for damage by fire, lightning. explosion, smoke, or leakage from automatic fire protection systems to promises whi€e rented to you er te€ porarily occupied by you Viith the permission of the owner. or for damage to contents of such premises that are included n your premises rental or lease agreement, is.not an "insured contract'. E. MEDICAL PAYMENTS EXTENSION if Coverage C Medical Payments is not utherviise excluded, the Medical Payments provided by this policy are amended as follows; Under Paragraph 1. Insuring Agreement of Section I - Coverage C - Medical. Payments, Subparagraph, {b) of Paragraph a. is replaced by the follov~irg: (b) The expenses are incurred and reported within three wears of the date of the accident: and F, EXTENS1,0N OF SUPPLEMENTARY PAYMENTS - COVERAGES A AND B 1. Ureter Supplementary Payments -Coverages A.and B. Paragraph 1.b, is replaced by the following: b. Up to $U00 for cost of bail bones required becaLl-se of accidents or traffic isw violations arising out of the use of any vehicle to which the Bodily Injury Liability Cmrerage applies. We do not have to furnish these bonds. 2. Paragraph 1A. is replaced by the fo?lovviriig: d. All reasonable expenses incurred by the. insured at our request to assist its in the investigation or defense of the claim OF "sa€it"including actual loss of eamings up to $500 a day because of dine. off frorn work. G, ADDITIONAL. INSUREDS BY CONTRACT, AGREEMENT OR PERMIT graph 2. under Section tI - Who Is An Insured is amended to include as an insured, any person or 1. Para organization .vharn you have agreed to . add as an additional .insured in .a w,rrlieri contract, written agreement or permit. Such person o.r organization is an additional insured but only with :respect to liability for "bodily injury "property damage" or "personal and adveTtisirig rijury" caused if) whole or In part by: a. Your acts or omissions, or the aids ur omissions of those actirg on your behalf. in the performance of your do going operat ons for the additional insured that are the subject of the written contract or v+iritten agreement provided that the "bodily injury" or "property damage" occurs, or' the "per- sonal and advertising in-ury" is corrirY►itted. subsequent to the signing of si:,ch wnften contract or written agreement;, or 201 ~ Liberty. Mutxial Insurance CG 38 10 04 13 1nclodescopyciighlea rria,eriat or Insurancn Services Office inc,.vvith its perrnis-:~ion: Page 3 of 8 Fax Server 3/6/2017 10:29:08 AM PAGE 7/020 Fax Server b, ~remlses or facilities rented by you or used by you; or C. he maintenance, operation or use by you of equipment rented or leased to you by such person ©r ~rgan!7_ation, or d. Operations performed by you or can your behalf for which the state. or politica, subdivision has issued a petmit subject to the following additional provision5: (1) This insurance does not. apply to "bodily injury".'property damage"', or "personal and ad- vertisirg injury" arising out of the operations performed for the state or political subdivision, 2) This insurance elves not apply to "bodily injuiry" or "property damage" included within the "completed operations hazard". (3), Insurance applies to premises you own, rent, or rantrol taut any with respect to the folloMng hazards: r (a) The existence, maintenance; repair, construction. erection, or removal of advertising signs, avunin~s, canopies. cellar entrances, coal holes, driveways, manholes, marquees, hoist away openings. sidewalk vaults. street banners, or decorations and similar expo- sures: or (b) The construction. erection, or removal of. elevators: or _ (c) The ow iership, maintenance, or use of any elevators covered by this insurance. However: 1, The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additiaral insured is required by a contract or agreement, the insur- ance affordec to such additional insured. witi not be broader than that which you are required by the contract or agreernent to provide for such additional insured_ With respect to Paragraph 1.a. above. a per:3bn s or organization's status as an additional insured under this endorsement ends when: (1) All work, including materials; parts or equipment furnished in connection with such work, on the project bother than service, maintenance or repairs). to be performed by. or on behalf of the additional i sured(s) at the locatior) of the covered anerations has beer: completed, or (2) That portion of "your work but of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations fair' a prl;ncipal is a part of the same project: Mth respect to Paragraph 1.b. above, a person`s or organization's status as an additional insured under this endurserrient ends w'nen their wolfitterp cuntrad or written agreement vMh you for siuch prernises or facilities ends, With respects to Paragraph 1.e. above,.Ihis insurance does not apply tc any "occurrence" which takes place after tt,p equipment rental or lease agreement has expired or you have rellorned such equipment to the lessor. The insurance provided by this endorsement applies only if the written contract or kniritten agreernent is signed prior to the "bodily injury" or "property damage". We have no duly to defend on a.ddit oral mw.red under thus endorsement until we receive written notice of a "suit" by the additional insured as required in Paragraph b, of Condition 2, Duties In the Event Of Occurrence, Offense, Claim Or Suit under Section [V _ Commercial General Liability Condi_ tics nos. 20-IaUberty Mutual insurance CG 88 10 04 13 1ncludescepyc~ghled rrmaierial of InsuranccServ;cesOffice lnc,,af~,iih its ppr rmission: Page 4 of 8 Fax Server 3/6/2017 10:29:08 AM PAGE 8/020 Fax Server 2. With respell to the insurance provided by this endorsement, trie fellovying are added to Paragraph 2. Excl sions trader Section I - Coverage A - Bodily Injury And Property Darnage Liability: This insurance does not apply to, a. ''Bodily injury" or "property damage arising from the sole negiigerce. of the .additional insured. b "Bodily injuryn or "property damage" that occurs prior to you commencing operations at the location where such. "bodily injury" or "property damage" occurs, t. "Bodily injury", "property damage'' or "personal and advertising injury" arising out of tie render- ing of, or the fai[ur:e to render, any professional architectural; engineering or surveying services. including: (1) The preparing- approving. or failing to prepare or approve, maps,_ shop drawings, opinions, reports_ surveys, field orders, change orders Qr drawings and spec€fcatiorS, or (2) Supervisory, inspection, architectural or engineering activities. This exclusion, applies even it tie claims against any insured allege necgltgenee or other wrongdoing in the supervision- hiring. employment. training or monitoring of otters by that insured, if tree 'occur- rence" -vYhich caused the ,:bodily injury" or "property damage"; or the offense which caused the ,persona; arc; advertising injury9, involverd the rendering of. or the failure to render, any professional architectural. engineering yr surveying services. d. "Bodily injury" or "property damage' occurring after: (1) All work, including materials, ?arts or squipnlent turraisheQ in connection with such work., on the project ~other° than service, maintenance or repairs) to be performed by or an behalf, of Ehe additional insured(s) at the location of the. covered operations has been completed, or (2) That portion of "your work." out of wi`,ich the injury or damarue arises has been put to its intended use by any person or o:rganizatign other than another contractor or subco.nrtractor engaged in performing operations for a painc ;pal as a {sari of the sane project .e, Atiy person or organization specifically designated as an additional insured for ontpomg operations by a separate ADDITIONAL INSURED -OWNERS, LESSEES OR CONTRACTORS endorsement is- sued by us and made apart of this policy. 3. With respect to Ve insurance afforded to these additional insureds. the fc ioWing is added to Section III .1-hits Of Insurance: If coverage provided to the additional insured is required by a contract or agrearneni, the most we will, pay on behalf of the additional Insured is the arnount of insurance a. Required by the contract or agreement: or b, ,Available under the applicable. Limas of Insurance shown in the Declarations. whichever is less; This endorsement shall riot increase the applicable Umits of Insurance sE ow i in the Declaratio ns_ H.. PRIMARY AND RON-CONTRIBUTORY ADDITIONAL INSURED EXTENSION This arevision applies. to any person or- organization who qualifies as an additional insured under any form or endorsement LifIder tt?is policy. Condition A. Other Insurance of SECTION IV - COMMERCIAL GENERAL LIABILITY COI'dDITIONS is amend- ed as follows: a. The, following is added to Paragraph a. Primary Insurance: If, air additional insured's policy has an {ether Insurance provision making its, policy excess. and you have agreec in a written contract or v+rritten. agreement to provide the additional insured coverage on a prirrtary and noncontiributory basis, this policy shall be prima'y and we will not seek conlributicr from the additional insared's PQIirty f0f ttarnages we cover, 201aUberty Mu.kial insurance CG 88 10 04 13 irncludesoopyr heed rialr: W of lasurarceSeMc, es Office nc,,Vliih its permission, Page 5 of 8 Fax Server 3/6/2017 10:29:08 AM PAGE 9/020 Fax Server b. The ollowing is adders to Paragraph b. Excess Insurance: Whe a written contract or written acdreernent. other than a premises lease, facilities rental contract or agreement, an equipment rental or lease contract or agreement, or permit issued by a state or political subdivision betdveen you and an additional insured does not require this insurance is be primary or primary and non-cor,tribullory, this. insurance is excess. over any other insurance for which the addi- tional insured is designated as a Named Insured, Regardless of the written agreement between you and an additional insured, this insurartce is excess over any other insurance whether primary, excess, contingent or on any other basis for which the additional irsured has been added as an additional insured on other policies. 1. ADDITIONAL INSUREDS - EXTENDED PROTECTION OF YOUR. "LIMITS OF INSURANCE" This provision applies to any person or organi ation vvho qualities as an additional insured under any form or endorsernert under this pc6icy. 1. The following is added to Condition 2. Duties In.The Event Of Occurrence, Offense, Claim or Suit: n An additional insured under this endorsement will as soon as practicable: a. {give written notice of an "occurrence or an offense that may result in a clairn or "suit" under this insurancQ to us; b, Tender the defense and i.ndemnity of any claim or "suit" to all insurers wham also have insurance available to the additional insured; and c, Agree to. ~e available any other insurance which the additional insured has for a loss we cover under this Coverage Fart. d. We have no duty to defend ur indemnify an additional insured under this endorsement until dive receive written notice of a "su t' by. the additional insured. 2. The limits of insurance applicable to the additional insured are those specified. in a.writter, contract or written agreement or the limits. of insurance as. stated in the Declarations of this policy and defined in. Seetlon. III - Limits of Insurance of this policy, whichever are less, These limits are inclusive of and not Jr, add;tion 1o tie limits of insuranme available under this polity: J, WHO IS AN INS, URED -INCIDENTAL MEDICAL ERRORSi MALPRACTICE WHO IS AN INSUREDS -FELLOW EMPLOYEE EXTENSION - MANAGEMENT EMPLOYEES Paragraph 2.a,(I) of Section It -Who Is An Insured is repiaced with the following: (1) "Bodily injury" or "personal and advertising injury": (a) To you. to your partners or merribery (if you are a partner-ship or Joint venlure), to your mernbers (if you are a. limited liability company), to a co "employee while in the course of his or her employ- ment or performing. duties related to th•e conduct of your husiness, or to your ether "'volunteer Avorkerbs" while perform€ng duties related to the conduct of your business; (a) To the spouse. child. parent; brother or sister of that oo-"ernplayee" or "volunteer worker" as a consequence of Paragraph (1) (a) above: (c) For which. there is any abligatioi fo share darnages With or repay so veone ese who Must pay damages because of the injury described it Paragraphs (1) (a) or (b) above;; or (d) Ai°ising out of his or: her providing or failing to prev;de professional l;ealth care: services. However. if you are niot in the bi-isiness of pcoiA- ding professional health care services or providing profes signal health care personnel to others; or if coverage for providing professional. health care sef- vices is not otherwise excluded by separate endorsement, this prosrviprj (Paragraph (d) does not amply. Paragraphs (a) and (la) above do not apply to "bodily injury" or „personal arid ad'verfising lnjury° caused by an "eirip Faye-a" who is acting in a supervisia-y capacity for you. Supervisory capacity as used herein means the "ern loyee`s" jab resporisibilities assigned by pu, includes the direct super%rjsidn of other 'cernploy- ees" of yours. However, more of these "employees" are insureds for ".bodily injury" or "personal and 2D1 Liberty Mutual insurance CG 88 10 04 1 includes~o,~yr~glalea rriaiatAl of l surana~ erw;c~5t7ffcce Inc,,Vvilh its perrnission, Page 6 of 8 Fax Server 3/6/2017 10:29:08 AM PAGE 10/020 Fax Server advertisi g injury" arising out of their willful conduct, which is.defined as the purposeful or willful intent to cause "bodily injury" or "personal. and advertising injury or caused in whole or in part by their intokcra- fion by liquor or contcotled substances. The covorage- provided by pimvision J is excess over any other valid and collectable insurance available to your `employee`. K. NEWLY DORMER OR ADDITIONALLY ACQUIRED ENTITIES Paragraph 3. of Section II.-Who Is An Insured is replaced by the following: 3. Any organization you newly acquire or fsrrrl and over which you maintain ownership or majerity interest, will quality as a Named Insured if there is no ether similar irsurance availab'~e to that organization, However: a. Coverage under this provision is afforded only until the expiration of the policy period in which the entity was acquired or formed by you; b, Coverage A does not apply to "bodily injury" ar "propertydamage" that occurred before you accuired or formed the organization: and c. Coverage B does not apply to "personal and advertising injury" arising out of an Offense comrilited before you acquired or formed the organization: d. Records and descripticyns of opwations must be maintained by the first Named In,sureci No pennson or organization is are insured with respect to the conduct of any current or past partnership; joint venture or limited. liability company tnat is not shmvn as a famed Insured in the Declarations or qualifies. as an insured under this provision. L. FAILURE TO DISCLOSE HERDS AND PRIOR OCCURRENCES Under Section IV' - Commercial General Liability Conditions, the foliowing is added to Condition f. Repre- sentations: Your failure to disclose all hazards or prior `occurrer~:es" existing as. of the inception date of the policy shall not prejudice the coverage afforded by this policy provided such failure to disclose all hazards or prior "eccurrLrnces" is not mtentional- M.. KNOWLEDGE OF OCCURRENCE, OFFENSE, CLAIM OR SUIT Under Section ICI -Commercial General Liability Conditions, the following is added to Condition 2. Duties In The Event of Occurrenpe, Offense: Claim Or Snit: Knowledge. of an "occurrence",, offense, claim or "suit by an agerit. servant or "employee" of- any insured shall not in itself constitute knovv edge of the insured unless an insured listed. under Paragraph 1, of Section Ii Who is An 'Insured or a person who has beer, designated by them to receive reports of "occurrences": offenses., claims or "suits" shall haite received such notice from the agent, servant or „employee". N. LIBERALIZ-ATION CLAUSE If We guise this Co:mmercial general Liability Extersion Endorsement to provide more covera-ge vilh:out additional premium charge, your policy vvill automatically provide the coverage as of the day the revision is effective in your state. 0. BODILY INJURY REDEFINED Under Section V - Definitions, Definition 3. is replaced by the following: 3. "Bodily lnjvy" means physical injury, sickness or disease sustained by a person. This includes mental anguish, mental injury, shuck. fright or death that results from such physical 'Injury, sick- ness or disease 20-laUbec?y Mutual insurance CG 38 10 04 13 hicludesco,pyrighled rria wW of lrasurarcoserv;cesOffice nc,,~lilh its permissio7: Page 7 of 8 Fax Server 3/6/2017 10:29:08 AM PAGE 11/020 Fax Server P. EXTENDED PROPERTY DAMAGE Exclusion ac. of COVERAGE A, BODILY INJURY AND PROPERTY DAMAGE LIABILFTY is replaced by the foli®iwir~g:'. a. Expected Or Intended Injury "Bodily injury" or "property, damage" expected or intended from the standpoint of the insured. This exclusion does not apply to "bodily injury" or '"property. damage" resulting from the use of reasonable farce to . protect persons or: property. Q, WAIIVER OF TRANSFER OF RIGHTS OF REQOVERY AGAINST OTHERS TO US WHEN REQUIRED IN A CONTRACT OR AGREEMENT WITH YOU U nder Section IV - Commercial General Liability Conditions, the following is added to Condition 8_. Trans- fer Of Rights Of Recovery Against Others To U9: We waive any right of recouary we may have against a ~3ersor or organization because of payments we make for in ury or damage arising out of your ongoing operations or "your wcark~' done under a contract with ihat person or organization and included in the "producls-completed operations hazard" provided: 1, You and that person or organization have agreed in wilifing in a dontrad or agreement that you waive such rights against that person or organization; and 2. The injury or da.mane occurs subsequent to the executron of the written contract. or w1ntten agree- ment. 9) 2013 Liberv Mukial insurance CG 88 10 04 13 includcscupyraglalad rra'Latfal, of Iasuraw" _ckrv;cesOfrice inc"vviih its pcermiss~ion. Page 3 of 8 Fax Server 3/6/2017 10:29:08 AM PAGE 12/020 Fax Server COMMERCIAL GENERAL LIMB LITY CG 8s 83 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED CONTRACTORS -PROD U CTSICOMP L ETED OPERATIONS This endorsement modifies insurance provided under the following-, COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Paragraph 2. under Section II Who Is An Insured is amended to include as an insured any person or organization whom. you have agreed to add as .an addit}onal insured `in .a written contract or written agreement. Si person or organization is an adidRional insured but only w ith respect to liability for "bodily injury" or "property. damage'": 1. Caused by "your work" perforated for that additional insured that is the subject of the written contract Or written agreemert: and 2. Included in the "products-completed operations hazard". However.- a) The insurance afforded to such additional insured only applies to the extent permitted by law: and b) if coverage provided to the additional insured is required by a contract or agreernenf, the insurance afforded to Si additional insured will not be broader -than that which you are required by the contract or agreement to provide for such additional insured The insurance providers by this endorsement applies only if the written contract or written agreement is sips prior ti tie "bodily injurycar "property damage'". We have no duty to defend an additional insured under this endorsernent until vie receive written. notice of a "suit" by the addi#ional insured as required in Paragraph b. of Condition 2. Duties In The Event Of Occurteri Offense, Claire Or Suit udder Section IV - Commercials Generat Liability Conditions, B. With respect to the insurance :provided by. this endorsement. the following are added to Paragraph 2. Exclusions under Section I - Coverage A - Bodily injury And Property Damage Uabiiity: This iriisurance does not apply to: 1, "Bodily injury or "property. clarnage" that incurs prior to you commencing operations at the !ovation where such "bodily injury"' or 'property dar-oage" occurs. 2, "Bodily injury" or "property damage" arising out of the rendering of. or the failure to render, any professional archifectdrai,. ergmeerinq or surveying services including: a. The preparing., approving or failure to prepare or approve, maps, shop drawings, a inians, reports, surveys, field orders. change orders or drawing and specifications. and b Supervisory, inspection. architectural or engineering activities. 2013L&oo y Mutuai Inszrraacc CG 85.83 04 13 11 descopyright-rid material Of Insurance ServIcr--s Ohcc. Ire with its per- ission _ Page 1 of 2 Fax Server 3/6/2017 10:29:08 AM PAGE 13/020 Fax Server C, With r spect to the insurance afforded by this endorsement, exclusion I, Darnage To Your Work of Parav ph, 2: Exclusions Lir~der Section I - GQVeraye A - Bodily Injury And Property Dam _,e Liability is replaced by the follovring: I. Damage To Your Work "Properly damage,' to .:veu'r work" arising out of it cr any part of f and included in the "products- Completed operations hazard", D. With respect to the ins~tranue afforded to these additional insureds, the following 1: 5, to Section ll - Limits of Insurance: If coverage provided In the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by contract or agreement: or ,2> Available under the applicable Urnits of Insurance shewn in the Declaration, whichever is less, This end~)rsement stall not increase the applicable Limits of Insurance shorn in the Declaratio ins. ® E. With Vspec,t to the insurance afforded by this endars inert; S rdtiort tv - ontr7 er ial General Liability Y' = Conditions is amended as follows: ~ w 1. The following iq added to Paragraph 2, Duties In The Event 0f Occurrence, Offense, Claims Or Suit, An additional insured under this endarsemera . will as soon as practicable: a;. Give written notice of are "occurrence" or an offense that may result In a claim or "'suit" under this insurance to us: b. Tender the defense and indemnity of any claim or "suit" to all insurers whorn. also have OSLIrance available to the additional instirevi and c. Agree to make available any other insurance which the additional insured has for a.loss vie cover under this Goverage Part. d We have no duty to defend o incler-unify an additional insured under this endorsement until we receive written notice of a "suit" ley .the. additional insured. 2. Rragraph 4. of section IV - Commercial . General Liability. conditions Es arrrended as (allows: a. The following its added to Paragraph a. Primary lnsurance: If.an additional insured's policy has an Other Insurance prevision making its policy excess. dad you have agreed in a aJritten contract D F written, agreerrwrit lo.provde the additional insured coverage on a prmary and noncortributcry basis, th's policy shall be primary and we will not seek aonlributien from the additional irsurmd's policy for darraages we cover. b. The following is added to Paragraph b. Excess insurance:. When a written contract or written agreement. other than a premises lease, facilities rental contract or agreement, an equipment recital or lease contract or agreement, or permit issued by a state or political subdivision between you and an additional, insured does riot require th!3 nsurance to be primary or primary and non-contributory; this insurance is excess over any other insurance for which the additional insured is designated as a gamed Insured. Regardless of the written agreement be-hAieen you and an additional insured. this insur- ance is excess over any rather insurance whether primary, excess, contingent or on any other basis for which the additional insured has neen added as an additions insured on other policies, 2f113I_iburty `Mutual (nsurancc C G.85 83 041 13 Ineludescopyrighted material of Insuranec Servil-as Ofticc_ lnc.,wO its pcmiissian _ Page 2 of 2 Fax Server 3/6/2017 10:29:08 AM PAGE 14/020 Fax Server CO1VIIPERCIAL AUTO CA 88 10 01 to THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ Tr CAREFULLY. BUSINESS AUTO COVERAGE ENHANCEMENT ENDORSEMENT This endorsement modifies insurance provided under the following; BUSINESS AUTO r OVERAGE FORM ';hCith respect to coverage afforded by this er-dorserrient, the provisions of the policy apply snless modified by tha andorsemant. COVERAGE INDEX SU_g~JECT; PROVISION NUL9~ER. ADDITIONAL INE31JRED BY C°fOh1TRAi:~T, AGREEMEN`€". OR PERMIT 3 ACCIDENTAL AIRBAG DEPLOYMENT 12 AMENDED DUTIES IN THE EVENT OF Ac.,QDENT; CLAIM, SiUIT OR LOSS AMENDED FELLOW EMPLOYEE EXCL_tUSI0IN 5 AUDIO. VISUAL AND DATA ELECTRONIC EQUIPMENT COVERAGE 13. BREAD FORM INSURED 1 BODILY INJURY REDEFINED 21 EMPLOYEES AS INSUREDS (including ernpiesyee hired ~Lft4) 2 EXTENDED CANCELLAT=OIL CONDITION 22, EXTRA EXPENSE - BROADENED COVERAGE 10. GLASS REPAIR - 'bN/AIVER F DED.UCTIB:LE 15 HIRED AUTO PHYSICAL DAMAGE(includ ng employee tared auto) 0 ~0. KREID AUTO CgiE:RACE TERRITORY LOAN { LEAST GAP 14 PARKED AUTO COLLISICW COVERAGE. (WAIVER: GF DEOUCTIBLE) 1.6 PERSONAL, EFFECTSCOVERAGE: 11 PHYSICAL DAMAGE - ADDITIONAL TRANSPORTATION EXPENSE COVERAGE. a. RENTAL REIMBURSEMENT g SUPPLEMENTARY P,AYM1ENTS 4 TOVIING. AND LABOR r IJN INTENTIONAL FAILURE TO DISCLOSE HAZARDS 17 `iNAIVE:IR CF TRANSFER O RIGHTS OF RE!"' QQ 'ERYACA'NS`T OTI-'ER8 TO U i9 SECTION IE - LIABILITY COVERAGE is amended as follovvs: I . BROAD FORM INSURED SFC:TION II , LI,ABIL.ITY COVERAGE, paragraph A.I. WHO IS AN INSURED is ameuded to include ih€, following as an in5,ured. d3 Any Iega=ly incorporateid entily of Wrlic`~ ryoij own more than ~a[l percent of the voting staar~ durinq. the policy period. Hcwever_ "insured`` does not include.any orcia ';izati€an that: (1) Is a partner-ship or pint venture; or (21 Is an insured under any other. automobile policy; or (3) Has exhaUsi:ed its Limit of InsuraWlce under any other auturnobiie policy. Paragraph d. of this pro0sion. does not apply to a policy vviitten lo apply specifiLall in excess of lh s poky- e. Any organizav r, you nowly acgLire or form; other than a partriersliip or joint venture, of which you own i than 50 i)ercent of the voting stock. This. automatic cove age is afforded oniy for 180 days from the date of acquisition or formation. however, coverage under this PMVisiOn does not apply: (1) J there 1s similar inaurajoe, or a se[f-insured retention plan available to that organization (~)201a Li`) ;rty klutual Irisurame Cornparny. All rights rtesr rvbi , CA 88 10 €1 10 15CILrlcscop, tnc~l~tc~ci inatc,ial of lrisurarico S rvicesMiesv;nc. wi,h its Flormissic5. Page 1 of 7 Fax Server 3/6/2017 10:29:08 AM PAGE 15/020 Fax Server (2) if the Limits of Insurance of any other insurance palicy nave been exhausted-. or (31 To "bodily in Jury" or "property damage" that oc . c arred k~et'ore you acquired: or farmed the d'g~ni~atinrt, 2. EMPLOYEES AS INSUREDS SECTION II - L1,4S.11-IT`S' COVERAGE, paragraphs A.I. -MHO ISO AN INSURED is amended to include the; FQIIoxpj ng as an insured_ ti. Any "empioyee" of yours while usmg a covered "auto" you do rut own, *e or bon-ow but only for acts vtithin the scope of their em.ployrneriit by you, Insurance provided by this endorse- ment is excess over any, other Insurance available to ary "employee". g. An 'ernpioyee of yours while operating ar, "auto` hired or borrowed under a writien contract or agreement in that "ompfoyees" name, tAi`ith yeLir perr~~s~icri, `WhilQ~ performing <;iulie5 re- lated to the conduct of your business and within the scope of their employment. Insurance provided by this endorse-ment is excess over any other insurance available to the "employee 3 3. ADDITIONAL INSURED BY CONTRACT. AGREEMENT OR PERMIT SECTION 11 LIABILITY CO`1,'ERACEE, paragraph A.I. - WHO IS AN INSURED is amerded to include the f0lloV1 .rig a a in u e d: h. Any person or organization will; respect to the operation. aintenance Of use of a cove,,ed "auto`', provided that you and such person or organization have agreed in a v,ritten contract, agreement, or permit issued to you by.govern enlai or pdblic authority.. to add such person, or organization, or governmental r public arithcri'ty to this policy as ar "insured However, such person or vrganizOlon is anti "insured": (1) Only with respect to the operatcri; mainteriancs or use of a covered "auto": {2) Only for "bodily in try or °'~,roj)erty dza, mage" c.eiused by an "accident"' uvh'c-, i takes p=ace after you executed the written contract or agreernert, or the permit has been issued to you, and (3) Orly for the duratior► of that contract, agreement or p-c!rmi' 4. $UPPI*EMENTARY IPAYI F' KT$ SECTION it - LIABILITY COVERAGE: Caverage Exiensio€ s, 2.a. Supplementary Payments, para- gnr pIhs (2) and (4) are, replaced by the foiiovyV191 (2) tip to $3,000 for cost of bail bolds firicluding bonds for related traffic violations ) required because of an "accideni" we cover. We do not have to furnish t°iese bands, (4) Ali reasanaNe oxpensies :incurred by Me insured at oLr requnst, including actual lass of earn- ings up to $50 a day because of tirne off frorn work. 5. AMENDED FELLOW EMPLOYEE EXCLUSION In those urisd1cfior,s vvhere, by law, fellow ertinloyees are not entitled to the ps-oteution afforded to the employer by the workers compensation exclusivity rule, cr s1rr1::lar protection, the fallcAving provision is adder: SECTION II LIABILITY, exclusion B.5. FELLOVi,( EMPLOYEE does riot apply if the "bodily injury" results from the use of a cavered "auto" you own or hire. 4 SECTION III - PHYSICAL DAMAGE COVERAGE is an-tended as follov..S: HIRED AUTO P"YSICAL DAMAGE Extonsior}s of SECTION sl PHYSICAL DAMAGE COVERAGE., is amended Paragraph Ate. Coverage by adding the fo lowing: If hired "autos" are coverect "autos" for Liability Overage, and if Cornipr-ehensive, Specktted Opuses of Loss cer Collision coverage are provided under the Business Auto Coverage Form for an,yr „auto' you own, then the Physical Damage coverages provided are extended to '%autos': a. You hire, rent or borrow; or Q20 10:_i'be Cy k§utual [m vranc;E CDMp?, ly. All rights r .,-x ot:. Cat 88 10 01 10 I€~C1L~:c scc~;tncal~t~zi oliatcrial cif lrisumctcc S: rs~cc~ ~ftiu;nc . 4A.i h ,ts por1rds5icn_ Page 2 of 7 Fax Server 3/6/2017 10:29:08 AM PAGE 16/020 Fax Server b. Your "employee hires or rents under a written; contract or agreement in that "Employee's" narne., but on',y if the damage occurs whils the aehide is being used in tl^econduct of your business, sbb)ect to. the fcllowmc Jim it and deductible: A. The most we Vvill pay for "buss" ih any pare "acc:idenf' or "loss" Is the smallest o€: (2) The actual cash value of the damaged br stolen property as of the time of the "loss"; or (3) The cost of repairing or replacing the dammed or stolen property with other property of like kind and quali$y_ r onus a deductible. B, The deductible will be equal to the largest dedui-Ahle applicable to any owned "auto" for Lt -at coverage. C. Subject to the limit, deductibie and eNcess provisions desc ibled in. this pmvision, We will provide coverage equal to the broadest coverage appliGable ter anyi covered "auto" you own. D. Subject to ariaxirn~m of X750 per "accidenf'. eve will also cover the actual ioss:uf us- of trie hirer ,'auto" if it results from an "accident".yogi are legally liable and the lessor incurs an actual finano'al loss, E. This -overage extension does not apply to: (1} Any °auto that is hired, rented or borrowed with a driver; or .(2) Any "2100" that is hired, rented or borrowed f€om your "employee". For the purposes of this provision, SECTION V - DEFIN IT. IONS is amended b-,.~ adding the f:)llawy ng: "TGtal loss" means a "loss° in which the cyst of repairer plus the salvage value exceeds the actual 7. TOWING AND LABOR SCCTION 1,11 - IPHYSICAL DA1,!1AGE GOVERACE, Para raph A.2. Towing. is amended bthe addition of the following' ~Ne will pay towingy anc labor casts incurred, Lip to the IImIts shown below, evch time a covered "autd' classified and rated as a private passenger type, "light truGk" or „med urn truck" is dis- abled: a. For private passeneer type vehicles. we will pear up to $50 per disablefnent_ b. For "light t ticks we will pav up to S50 pe:, disat~lernent. "Light trucks" are trucks 1hiat have a gross vohk_-le Freight (GV ) cf 10,000 pounds or less. e. For "medium trucks' , we will pay up to 51,50 per disabler tent. "Nfledium to cks" are trucks tt~at have a yrOss veh cte wall ht (C-3v V) of 10,001 - 2,0,000 pounds. However, the labor must be performed at tha place of disahlement_ 8. i HYSIGAL DAINIAGE- ADDITIONAL TRANSPORTATION EXPENSE COVERAGE. Paragraph A.4.a., r;overage E~ension of SECTION III - PHYSICAL DAhv1AQE.COVERAGE, is amend- ed t~ pro-vide alimit of 550 per day and a maximurn limit of $1,500 20110 Li"berty Mutual frisurance Corr4Marly, All r-hts r~usF;rrr~u. Cie 88 10 01 10 l56i do s copyrigbtr-A. rriatcrial of lrisura pcc S rvicas Of.isua 1nc.: with its P0, r<,rqissicrk. Page 3 of 7