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HomeMy WebLinkAboutInsurance Certificate: Copeland Construction (2) DATE (MMIDDIYYYY) ,d►C.~O CERTIFICATE OF LIABILITY INSURANCE 6/2/2017 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT JeSSlca Embree NAME: Zarosinski-Leavitt Ins Agency of Oregon, Inc,' PHONE (503) 639-4220 F'~ (503)639-4449 AIC No Ext : (AIC, No): _ Leavitt Group of Portland EMAIL Jessica-embree@leavitt.com ADDRESS: - i 8285 Sw Nimbus Ave, Ste 120 INSURERS AFFORDING COVERAGE _ NAIC # v rton OR 97008 r nce Com an 10677 Bea a INSURER A :Cincinnati Insu a p y INSURED INSURER B :SAIF 036196 Copeland Construction LLC INSURER C : 321 Pruett Rd. INSURERD: INSURER E Eagle Point OR 97524 INSURER F COVERAGES CERTIFICATE NUMBER:17/18 Pckg REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDL SUBR POLICY EFF POLICY EXP ~ LIMITS LTR TYPE OF INSURANCE POLICY NUMBER MMIDDIYYYY MMIDDIYYYY ' X COMMERCIAL GENERAL LIABILITY ~ EACH OCCURRENCE $ 1, 000, 000 I i I ~ I DAMAGE TO RENTED ~ 100 000 A _ ~ CLAIMS-MADE OCCUR I PREMISES Ea occurrence $ ' X i EPP0441387 I~ 6/3/2017 I 6/3/2018 MED EXP (Any one person) ~ $ 10, 000 j I PERSONAL & ADV INJURY $ 1, 000, 000 - - i ~ - i GEN'L AGGREGATE LIMIT APPLIES PER; ~ ~I GENERAL AGGREGATE $ 2,,000, 000 r~ r PRO- ~ 2,000,000 X ~ i I PRODUCTS - COMPlOP AGG i $ POLICY ~ JECT I,~ LOC i _ OTHER: ~ ~ $ AUTOMOBILE LIABILITY ~I I COMBINED SINGLE LIMIT - I$ 1,000,000 _ Ea accident X ~ ~I I BODILY INJURY (Per person A ~ ANY AUTO ~ _ _ _ i ALL OWNED SCHEDULED ~ ~ EBA0441387 I 6/3/2017 ~ 6/3/2018 BODILY INJURY (Peraccident)I $ AUTOS ~ AUTOS ~ I NON-OWNED ~ 1 PROPERTY DAMAGE $ ~I, HIRED AUTOS AUTOS Per accident $ i i X UMBRELLA LIAB X OCCUR i i EACH OCCURRENCE _ $ 1, 000, 000 EXCESS LIAB CLAIMS-MADE ii ! I AGGREGATE $ 1, 000, 000 A _ DED RETENTIONS ~ EPP0441387 II 6/3/2017 6/3/2018 ~ $ i PER TH- I WORKERS COMPENSATION ~ I li AND EMPLOYERS' LIABILITY ~ X 'STATUTE I~ ER YINI ANY PROPRIETOWPARTNERIEXECUTIVE ! ~ E.L. EACH ACCIDENT $ _ 500. 000 OFFICERIMEMBER EXCLUDED? nI ~ N 1 A B Mandato in NH I 980838 1/1/2017 ~ 1/1/2018 E.L. DISEASE - EA EMPLOYE $ 500, 000 ( ry ) I ~ i ~ If yes, describe under ~ ~ DESCRIPTION OF OPERATIONS beloN~ ~ i ~ ~ E.L. DISEASE -POLICY LIMIT 'i $ 500 000 ail i i I ~ III ~I I 'I i DESCRIPTION OF OPERATIONS 1 LOCATIONS 1 VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) The City of Ashland, Oregon and its elected officials, officers and employees are named as additional insured in regards to the general liability coverage per written contract or agreement per form GA2330R0910 attached. Coverage is primary and non contributory. 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 E Main St ACCORDANCE WITH THE POLICY PROVISIONS. Ashland, OR 97520 AUTHORIZED REPRESENTATIVE J Embree, Exec/JDE (~~~.QC~1C0~ ©1988.2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD INS025 (201401) i F r` r' f r TNI E~t~C~IEMEI'~T ~~~NGE~ ~E PC~~.IC'~. P~.EASE i~EEA~3 I"~" Cl~RfFUL~.l~. ~0 OTR~`O~# ~OlME~~~ EERY ROE~E~ E~~~~EET This endorsement modifies insurance provided under the fallowing: Cah~1~lERCiJ~L GEI~tER~►L U~BILITY Gt~ER~GE Rl~RT ~ Endorsemeht - Tabl+~ ~ CorNten#s: ~eoins o„_,n Pale; Employee Benefit i_iability Coverage...,..♦a..a,.....r.o...ra,..N...t{..........u►........r..►i.....u„rr../.. w........u..,,.*..~ Unintentional Failure to Disclose Hazards ...................N.......r..........►................N........►........,.......»....~ 3. Damage to Premises Rented to You ....N.H....♦NN.HY..q.NNV..l...l.UY.l..H.N.H...LH.l... kt.,. H........A.,. N.p.... ~.SjWu~pp[ylYe1men1t(/a~ry./~~~.Y~Payments l..!!.•.{.s).f).i.)►il.1N..,.lif...N.►.N!{l./...MS.ft..a.is...1.N...Itt.sl/i,Y..a•t.tlii..)t/.. i1......i.1...~ ~i I~edlcal ~a.~i r..i.a.~.►ifM.ll....i.i1{/tN.i1r..../R.tU.I.M.Y.IYf..f.t,.t.....1i.►.,......1..\NY.IN..i.1.\IM..YN1......./1... N.11... ../N.! Vc~I~yy(un~~jt.~aj~rj///y~~.'/~P~yr~/oa pert Damag'ei./..i~+Co►rerage a.) and Care, Custody or Con~of L~M~~I.►i y~Y~~/]yyy.+~(~/~y~re ~Go J~~~j a~y ~yy~.(~.(yY~~.,./.1A...fAN.....1...1■•/y.`/1.N.■.Y(./~1■..1.~M.~.%yM~,~...~~\J.....*.,.1N..\N.►l..Ml.aNi..ie..t.,{.iN.t..tle..fal~o Day VvfAI!\Ag~ for )'~e~l~ ~fffrl}.~ YrJ .~~~1reY ~i#!a~•i.1+~1TIn~ ../iH/t.1l.f.w..tf. M..N..,).........f y~~e~t tp(+lra~/i'ver }o~/f'+SlpubragVa~tion}~l{t~.~f.,.~1/1.i.fw~.~rs.1i~./.~,)/.~y...i.Q.f...+~..7i.~.4.1M......Y..►NM..M..l..I..II.N,....11..H.M.H 1.. N.f... ,.)...t...11 ►..N.M..f .d'• i 1uW~}14 r ~I~d~~llal 111.7LIred w/pTi1w~G~ )1~~iiMon~l~~p~. ..•......NS.....«.H/r.H......a..rNr..... r+.. r....... •..•s...• x Managers or Lessors of Prerryses; X Lessor of Leaned EquipmerrG x Vendors, x State or Pol~ical Subdivisions • Permits Relating to Premises; x State or PolidcalSubdivisions - PermiLL~; and X Contractors" Operations 10. Broadened Contractual Liab~i~ -1+~ork VI~tthin SO' of Ra~road Propert3r ..............................1.,.....,...16 't1. Property► Damage to Borrowed Equipment.....•.+..N,..,..1.N...N...N...UN..M.../NN1.....q.UM..,.... r. U..N.N..•I. Employees as Insureds -Specified Health Care S~er~rice►s:.,..~...,,...H..,..,..~......L,.....,N..,...1,.....,.... x I'~urses; x Emergency Medical Technicians; anal x Paramedics Broadened Notice of Uccurrence.....•...i....f.....1.1........1.....a...,.f..a.t.R..f.•.....»........i.... t......H..•..,..N...... B. Ltmi~ of Insurance: The Commercial General Liabiidjr Limb of Insurance applyto the insurance provided by the end©rsement, except as provided below; 1. Ernpd~ ~Enef~# l.iabili~ Coverag+~ Each Employee Limit ~ i,o~0,i}~D Aggregate Limit: $ 3,oDt7,DUD Deductible: $ 1,oQg 3. Qame to Premiscs Rented: to You The lesser of: a. `ihe Each Occurrence Limit shown in the Declarations; or b. $SO0,Ug0 unless ofiherwise stated $ Suppleh~erttar~ P~,y►ments a. Bail bonds: $ 1,000 b. Loss of +earnings: $ 350 5. Medical Payment Medical Expense limit; $ 10,go0 Includes copyrighted material of Insurance G t~R Services Crlfi+ce, Inc., with i~ permission. Page 'I ~ 1~ 1~oluntar~► ProperEy Damage {Coverage a.) and Care, Cust~dy► or Control Liab#!#~ Ctarerage {Coverage b,~ Limits of Insurance {Each Occurrence (:overage a. $1,OO0 Coverage b. $5,000 unless otherwise stated $ Deductibles {Each Occurrence Co~retage a. $250 Coverage b. $250 unless otherwise stated $ .r COVERAGE PRENi1UM BASIS RATE AUiIANCE PRBh~IUi~ raj Area {For Limns in Excess of For Limn in Excess of {b~ Payroll $5,000 $5,000 tc~ Gross Sales unit e Other b. Care, Custody $ or Control TOTAL ANNUM. PRENIIU>VI 11. Property Damage to Borrowed Equipment Each t~currence Limit $ 10,000 Deductib~: $ 250 C. Coverages; Our right and duty to 1, Employee Benefiit Llabilhy Coverage defend ends when we have used up tfie app~- a, The folbwing is added to SECT1flN I cable limit of insurance - COVERAGES: Employee Benefit in the payment of Liability Coveraee. judgments flr settle- {1} Insuring Agreerner~ meas. ~a) 1~Ve will pay those sums that No other obligation or liabil- the insured becomes legally ~ to pay sums or perform obligated to pay as dam- acts or services is covered ages caused by any act, er- unless expl"~citl~r provided for ror ~or omission of the in- under Supplementary Pad cured, or of any other per- ments, son for whose acts the in- fib, This insurance applies to cured is legally liable, to damages only ~ the act, er- which this insurance ap- ror or omission, is neg~- plies. We will have the right ger~#y committed in the and duty to defend the in- "administration" of yAUr cured against any "suit" "employee benefit program", seelang those damages. and However, we will have no duty to defend against any ~ Occurs during the poi- usuit" seeking damages to icy period; or which this insurance does ~ Occurred riot to the P not apply. 1Ne may, at our discretion, investigate any ~ date ~ this report of an act, error or endorsement provided: omission and settle any aj You did not have claim or "suit" that may re- knowledge of a cult. but claim or "su'~t" an 1) The amount we will pay of be~re the of for damages is limited fective date of this as described in SEC- endorsement TIQhI Ili - LIMITS OF You will be INSURAP+ICE; and deemed to have Includes copyrighted material of Insurance CA 233 OR Qg 'l0 Services Office, Inc., with i~ permission. Pa+~e 2 of 1~ knowledge of a 1~ Failure of any invest- claim or "suit" meat to perform; when any "author- ized represents- Errors in providing in- tive"; fom~afion on past per- i) Reports all, of formance of investment any part, of the vehicles; or act, error or 3~ Advice given to any omission to us person with respect to or any other that person's decision insurer; to participate or not to iii Receives a par~cipate in any plan included in the "em- written or ver- ployee benefit pro- bai demand or gmm" claim for dam- ages because (fj 1~►oricers' Compensa#on of the act, error and Similar Laws or omission; and Anyclaim arising out ofyour failure to comply with the bj There is no other mandatory provisions of any applicable incur- workers compensation, un- ance. employment compensation Exclusions insurance, social security or disability benefits law or any This insurance does not apply to: similar law. {aj Bodily Injury, Property {91 ERISA Damage nr Personal and Damages for which any in- ~+°er4sing ln~ury sured is liable because of li- "Bodily injury", "pr©perty ability imposed on a fidua- damage" or "personal and ~ ~ by the Empbyee Re- adyertising injury. merit Income Securihr Act of 1974, as now or (b~ Cishonest, Fraudulent, hereafter amended, or by riminal or i~aliclous ~ic# any similar federal, state or Damages arising out of any local laws. intentional, dishonest, {h) /~i~ilable Benefftf fraudulent, criminal or mali- cious act, error or omission, ~ Any claim for benefi#s to the committed by any insured, +extent that such benefits are ~rtcluding the willful or neck available, with reasonab~ less violation of any statute. effort and cooperation of the insured, from the applicable Failure #o Perfo~n a. funds accrued or other col- lectible insurance, Damages arising out of fail- {i} Taxes, Rnes or penalties ure of performance of con- tract by any insurer, Taxes, fines or penal~e5, including those imposed {d~ Instrfflciency of Purrds under the internal Revenue Damages arising out of an Code or any similar state or msuffic~ency of funds to local law, meet any ot~ligatans under Employment-Rtla#ed any plan included in the Practices 'employee benefit program". Any liability arising out. of {e) Inadequacy of Perform- any, ante of Irnresfinent ! Ad- vice Gjven With Respect (1, Refusal to employ; to Partlcipa#ion Termination of errs Any claim based upon; ployrnen~ Includes copyrighted material of Insurance GA 233 4R o~ ~o Services mice, Inc., with its permission. Page 3 of 1 ~ {3) Coercion, demotion, tors are insureds, but only evaluation, reassign- with respect to their duties went, discipline, defa- as your ofbcers or directors. mation, harassment, Your stockholders are also humiliation, discrimina- insureds, but only with re- tion or other empty- sped to their liabili~ as meat related practices, stockholders. acts or omissions; or {Ej A trust, you are an insured, {4j Consequential Lability Your trustees are also in- ns aresult of {~j, or sureds, but only with respect {~j above. to their duties as tn~stees. This exclusion applies t2j Each of the following is also an whether the insured may be insured: held liable as an employer or in any other capacit}r and {a) Each of your "employees" to any obligation to share who is or was authorized to damages with or repay administer your "employee someone else who must benefit program". pay damages because of {b) Any persons, organ¢ations the intury. or ~empioyees" having {3) Supplementary Paymterr~ proper temporary author¢a- tion to administer your Mem- SECTION I - COYEi~tGES, ployee benefd program" if SUPPLEMENTARY PAY- you die, but only until your MENTS - Ct~ERA~ES A AND legal representative is ap- B also apply to this Coverage. pointed. b. Il~ho Is an Insured {cj Your legs! representative if you die, but only with re- As respects Employee Benefit Liabil- sped to duties as such. iky Coverage, SECTION II - wH0 IS That representative wit! AN INSURED is deleted in its entirety have all your rights and du- and replaced by the following: des under this Coverage {1} If you are designated in the Dec- Pad' larations as: {~j Any organization you newly ac- {aj An individual, you and your quire or form, other than apart- spouse are insureds, but nership, joint venture or limited only with respect to the con- liability company, and over which duct of a business of which you maintain ownership or ma- youare the sole owner, jority interest, will qualify as a named Insured rf no other simi- {bj Apartnership or joint ven- lar insurance applies to that or- ture, you are an insured. gan¢ation. However, coverage Your members, your part- under this provision: Hers, and their spouses are also insureds but only with ~a) Is afforded only until the respect to the conduct of 180th day after you acquire your business. or form the organ¢ation or the end of the policy period, {c) A limited liability company, whichever is earlier, and you are an insured. Your members are also insureds, {b) Does not apply to any act, but only with respect to the error or o mission that was conduct of your business. committed before you ac- Your managers are incur- qurred or formed the organi- eds, but only with respect to nation. their duties as your manag- c, Limlta of Insurance ers. td) An organization other than a As respects Employee Benefit Liabil- artnershi , oint venture or ~ Coverage, SECTIt?N 111 LIMITS p p ~ OF INSUR~[VC~ is deleted in its en- limited liability company, you tirety and replaced by the folbwing: are an insured. Your ex- ecutive officers" and direc- Includes copyrighted material of Insurance GA ?.33 OR Og 10 Services Office, Inc., with ~ permission. Page ~ of The Limits of Insurance shown in amount stated in the Decla- Section B. Limi#s of insurance, rations as applicable to Employee 8en+efit tiabiii#y Each Empbyee. The limits Coverage and the rules below of insurance shall not be re- fur the most we gill pay regard- duced by the amount of this Tess of the number of: deducible, ~a} Insureds; fib} The deductible amount stated in the declarations fib} Claims made or "suits" applies to all damages sus- brought; tamed by any one "em- ~c} Persons or organ¢ations ployee", including such making clams or bringing employees dependents "suits"; and beneficiaries, because of all acts, errors or omis- {d} Acts, errors or omissions; or sions to which this insur- ance applies. fie} Benefits included in your "employee benefit program". (c} The terms of this insurance, including those with respect t~} ~'he Aggregate limit shown in to: Section E. Limits of insurance► Cur ht and du to Employee Benefit Liability ~ ~ Coverage of this endorsement is defend the insured the most we wilC pay for all dam- against any "suits" ages because of acts, errors or seeking those dam- omissions negligently committed ages; and in the "administration" Qf your Your duties, and the "employee benefit program". duties of any other ir,- {3} Subject to the Jimit described in volved insured, in the above, the Each Employee event of an act, error or ~.im`rt shown in Section B. limits omission, or claim, of insurance, 'I. Employee apply irrespective of the ap- B~neft Liabiil~ Coverage of p1'Kation of the deductible thrs endorsement is the most we amount. will pay for all damages sus- tained by any one "emprbyeeb", {d} ~+Ve may pay any part or all ~ncludmg damages susta ed y of the deductible amount to such "employee's" dependents efFect settlement of any and beneficiaries, as a result of. claim or "suit" and, upon no- ~a} An act, error or emission, or tification of the action taken, you shall promptly rerm- (b} A series of related arts, er- bursa us for such part of the rots or omissions, regard- deductible amount as we less of the amount of time have paid. that lapses between such d, Addltxonai Conditlc~ns acts, errors or omissions, negii~entl~r commixed in the As respects Employee f~nefit i.i- "admm~strativn" Of your "erT?- ability Coverage, SECTIaI~ ill - ployee benefit program" Ct}l~iNiE~,Ci#ri~. t~Ei~E~At. i.IABiL- ITY COhtDiTIQf~S is amended as fol- However, the amount paid under lows: this endorsement shall not ex- ceed, and will be subject to the Item 2. Duti+~ in the Event of limits and restrictions that apply t3ccurrence, t~ffaense, Claim or to the payment of benef~s in any Suit is deleted in lt~s enfirety and plan included in the "employee replaced by following: benefit program". t~uties in the Event of an deductible Amount Act, Error or ©mis~ion, or Claim or Snit ~a} Our obligatit~n to pay darn- s,, You must see to it that ages on behalf of the in- we are notified as soon sated applies only to the as practicable of an act amount of damages in ex- error or omission which cess of the deductible includes copyrighted material of Insurance X33 O~ o~ Services Office, Inc„ with i~ permission. Pagf ~ of may result in a claim, surance may also To the extent possible, appty. notice should include: d, Flo insured will, except 1Nhat the a~, error at that insured's own or omission was cost, volun#arily make a and when ~ oc- payment, assume an}r curved; and obligation, or incur any expense without our ~j The names and consent addresses of any- one who may suf {~j Item 5.Other Insurance is de- fer damages as a letet9 in its errdrety and replaced result of the act, by the following; error or omission. 5. Other Insurance b. if a claim is made or If other valid and collectible "suit" is brought against insurance is available fo the any insured, you must; insured for a bss we cover ~1j Immediate{y re- under this Coverage Pact, cord the specifics our ©bligations are limited of the claim or as follows: "suit" and the date a, prima Insurance received; and ~ ~~j Notify us as soon This surance is pri- gs pt~cticable, many xcept wizen c. be{ow applies. If this m- You must see to it that surance is primary, our we receive written no- obligations ate not of ice of the claim or ~ fatted unless any of the "suit" as soon as practi- other insurance is also cable. primary. Then, we will share with all that other c. You and any other in- insurance by the valved insured must method described in b. ~~j Immediately send below. us copies of any b, method ofi Sharing demands, notices, summonses or le- If all of the other insut- gal papers re- ante pem~i~ contribu- ceived in conneo- flan by equal shares, Lion with the claim we will fo{bu~° this or "suit"; method ado. Under this (2j Authorize us to ob- approach each insurer contnbutes equal fain records and amounts until it has other information; paid its applicable limit ~~j Cooperate with us of insurance or none of in the investigation ~e bss remains, or settlement of whichever comes first. the claim or der If any of the other in- fense against the surance does not per- ~suit"; and mit contribution by 44j ~4ssist us, upon equal shares, we will our request, in the contribute by limits. enforcement of Under this method, any right against each insurer's share is any person or or- based on the ratio of its ganization which applicable limit of in- may be liable to surance to the total ap- the insured be- pliable limits of insur- cause of an act, ante of all insurers. error or omission c, ~a Ccvcra to which this in- Includes copyrighted material of Insurance G~► Z3~ O~ o~ 'l ~ Services Office, Inc,, with ifs permission. pale ~ ~ ~ ~ This insurance shall not providing some ar all of the cover any loss for ~ following benefits to "ern- which the insured is en- ployees", whether provided tided to recovery under through a "cafeteria plan" or any other insurance an otherwise: force previous to the e# fictive date of this a. Group life insurance; Coverage Para. group accident or E. l~dditionai Defini~ons health insurance; den- tal, vision and hearing As, respects Empio~Cee benefit Li- plans; and flexible D rl Coverage, SECTICiAI V - spending accounts; FlNi710bIS rs amended as fal+ p~hvided that no one lows: er than an *em- ploy~e" may subscribe The following definitions are to such benefits and added: such benefits are made "AdmJnistrata©n" means: generally available to these employees who a. Providing information to satisfy the plan's eligi- "ernployees", including b~iry requRerr~nt~; their dependents and b. Profit sharing plans, beneficiaries, with re- employee savings sped to eiigibilihr for or plans, employee stock scope of "employee ownership plans, pen- benefrtprograms"; lion plans and stock b, Interpreting the "em- subscription plans, pro- ployee benefit pro- vided that no one other grams"; ~ than an "employee" may subscribe to such t. Handling records in benefitss and such connection with the benefits are made gen- "employee benefit pro- ~ erally available to all grams"; or "employees" who are tl. Eftectin , continuin or eligible under the plan 9 g for such benefits; terminating any "em- ployee's" participation c. Unemployment insur- in any benefit included ance. social security in the "employee bane- beneft~, workers' com- fitprogram". pensation and d~ability However, "administrationN benefits; and does not include: d, Vacation plans, includ- e. Handling payroll deduc- ing buy and sell pro- grams, leave of ab- tions; or Bence programs, in- b. The failure to effect or chiding military, mater- maintain any insurance Wiry, family, and civil or adequate limits of leave; tuition assistance cgverage of insurance, plans; transportatron including but not limited and heal#h club subsi- to unemployment in- d~s• surance, social security The following defi~nidons are de" benefit, workers' com- leted in their entirety and re- pensation and disabil'rrjr placed by the following: benefits. ~'l. "Suit" means a ci~l pro- . "Cafeteria plans" means seeding in which money blen authorized by applicap damages because of an act, law to allaw employees error or omission to which to elect to pay for certain this insurance applies are benefits with pre-tax dollars. a~eged. "Suif' includes: "Employee benefit pro- a, ~n arbitration proceed- grams" means a program ing in which such dam- lncludes copyrigi~Qd material of Insurance G~ 4f~. o~ ~a Services 4fiice, lnc., with its permission. Pale ~ of ages are claimed and The exclusions under SECTION to which the insured I -COVERAGES, COVERAGE must submit or does A. BODILY INJURY ~,ND submit with our con- PROPERTY DAM~4GE LIABIL- sent; ITY, 2. Exclusions, other than i, b. Any other alternative vl~ar and the Nuclear Energy Liability Exclusion, are deleted dispute resolution pro- and the following are added: seeding in which such damages are claimed This insurance does not apply to; and to which the in- sured submits with our ~a} "Property damage°; consent; or Assumed in any con- c. An appeal of a civil pro- or seeding. Loss caused by or re- 8. "Employee" means a person suiting from any of the actively employed, formerly following: employed, on leave of ab- a} tYear and tear, sense or disabled, or re- tired. "Employee" includes a b) Rust, corrosion, "leased worker". "Employee" fungus, decay, de- does not include a"tempo- terioration, hidden racy worker". or latent defect or Uninter~tiartai Failure to Disclose Haz- anY quality in p roperty► that a~ causes it to dam- SECI`ION ~ - CO1wMERCIAL GENERAL age or destroy it- L1~tBiLITY CONDITIONS, Represerr sef~ tations is hereby amended by the addi- c} Smog; tion of the following; d} Mechanical break- Based on our dependence upon your rep- down including resentations as to existing hazards, if un- rupture or bursting intent~Onal you should fail to disclose all caused by cen- such azar s at the ~ncept~on date of your trtfugal force; policy, we will not reject coverage under this Coverage Part based solely on such e} Setting, cracking, failure. shrinking or ex Damage to Prerrt#ses Rented to You pansion; or ~ Nesting or infesta- a. The last Subparagraph of Paragraph #ion, or discharge SEC'TIOl~ 1 -COVERAGES, or release of waste COVERI~GE A. -BODILY INJURY products or secre- AND PROPERTY DAt~J~GE, LI- tans, by insects, I~B1LlTY Exclusions is hereby de- birds, rodents or feted' and replaced by the following: other animals. Exclusans c, through do not apply {b} Loss caused directly or indi- to damage by fire, explosion, light- rectly by any of the follow- ning, srnoke or soot to premises ing: while rented to you or temporarily oc- cupied by you wig permission of the Earthquake, volcanic owner. eruption, landslide or any other earth move- b. The insurance provided under SEC- went; T10N I -COVERAGES, COVERAGE A` BODILY INJURY AND PROP- Water that backs up or ERTY DJUiIIAGE LIl~ILCT1d' applies over~ows from a sewer, to "property damage" arising out of drain or sump; water damage to premises that are both rented to and occupied by you. 3} Water under the ground surface pressing on, or ~1} As respects Water Damage Le- flowing or seeping gal Liability, as provided in Para- through: graph 3.b. above: Includes copyrighted material of Insurance Gl~ X33 OR QS ~ 0 Services tlfftce, Inc., with its permission. Page ~ of 1 ~ aj Foundations, one "occurrence" to which wails, floors ar this insurance applies. paved surfaces; {3~ The amount we will pay is limited b} Basements, as described in Section B. I.im- whether paved or its of lnsurancE, 3. Damage to not; or Premises Rented to y'ou ofth~s endorsement c} Doors, windows ar other openings. ~ Supplementary payments ~c~ Loss caused by or resulting Under SECTION ! - CO1~ER14GC01dEl~- from water that leaks or PLEMEN'TA~.Y PA'~(I~IEI~tT flows from plumbing, heat- AGES Al~ND B: ing, air conditioning, or fire Paragraph is replaced by the fol- pratectaon systems caused lowing. by or resulting from freezing, unless: Up to the limit shown in Section B. You drcl your best to Limits of Insurance, 4.a. Bail Bonds maintain heat in the of this endorsement for cost of bail building ar structure; or bonds required because of accidents or traffic !aw violations arising out of You drained the equip- the use of any vehicle to which the meat and shut off the Bodily Injury Liability Coverage ap- water supply if the heat plies. v~Ve do not have to famish was not maintained. these bonds, {d} Loss to or damage to: b. Paragraph is replaced by the fal- lowing: } Plumbing, heating, air , cond~twnang, fire pro- All reasonable expenses incurred by tertian systems, or the insured at our request to assist us other equipment or ap~ in the investigation ar defense of the pliances; or claim ar "suit", including actual lass of earnings up to the limit sht~wn in 5ec- The interior of any tion B, Limits of Insurance► 4.b. buiidinr~ or { tru~duere, on Loss of Earnings of this endorsement to pe ono p p rtY per day because of time off from the building or structure work caused by or resulting from rain, snow, sleet 5. ~dledical Rayrnents or ice, whether dtrven The Medical Expense limit of Any One by wind ar not. Person as stated in the Declarations is c. Limit of Insurance amended to the limit shown in Se~ion B. I.In'1i#~fi of Insurance, 3. NEedical Pay- The Damage to Premises Rented to m$nts of this endorsement. You Limit as shaven in the Declara- tions is amended as foikrws: volur~ry Rroper Dar~a+ge and Care, Cody or Ct~t~t't~ Liabili~ Cov+~rage Paragraph of SECTION III - LIMITS OI` 1~ISt1RANCE is a. vt~untary Proper ®amage Cov- hereby deleted and replaced by stage the following: yVe will pay far "property damage" to Subject to above, the property of others ar~s~ng out of ap- Damage to Premises stations incidental to the insured's Rented to You Limit is the business when: most we will pay under Damage is caused by the in- CQVEI~E A, B~OdiLY cured; or Il~,ltlR~' JRhlD PI~OPEI~T1l' DAI~A:GE LIABILITY► for Damage occurs while in the in- damages because of "prop- sured's possession. arty damage" to premises while rented to you or rem- 1~ith your consent, we will make porariiy occupied by you these payments regardless of fain. with pem~ission of the owner, arising out of any Includes copyrighted material of Insurance GA 233 Op. '10 Services OfCce, inc., with its permission. Page ~ of t6 b. Care, Custod~r or Cor~rol Liability deductible amount as has been Coverage paid by us. SECTION I - CQVER~►GES, CQV- 180 Day Coverage for Newly Formed yr ERAGE A. BODILY INJURY ~iND Acquired Organiza~ivns PRIJPERTY DANtAGE LU~B1LlT'Y, Z. SECTroN II - ~ ~N INSURED is Exclusions, ).Damage to Property, amended as follows: Subparagraphs ~3), ~4}and (5) do not apply to "property damage" to the Subparagraph a, of Paragraph is property of others described therein. hereby deleted and replaced by the fol- With respect to the insurance provided by lowing: this section of the endorsement, the fol- a, Insurance under this provvision is af= lowing additional provisions apply; forded only until the 180th day after a. The Limits of Insurance shown in the ynu acquire or form the organization Declarations are replaced by the lim- or the end of the policy period, its designated in Section B. Limits of whichever is earlier; Insurance, V'viurrtaty Property l~aiver of Subrogation Damage and Care, Custody or Control Liability Coverage of this SECTION N • COI~i~ERCI~t. GENERA., endorsement with respect to cover- L,.I~~~ILtT'il' t'dND1Tt~NS, Transfier of age provided by this endorsement. Rights of Recovery Against Others tv These limits are inclusive of and not Us is hereby amended by the addition of in addition to the limits being re- the following: placed. The limits of Insurance shown in Section B. Limits of. incur- We waive any right of recovery we may ante, 6. Voluntary Propergr Darn- have because of payments we make #or age and Care, Custody or Control injury or damage arising out ofyour ongo- l.iabiiii~r Coverage of this endorse- ing operations or'~rour work" done under meet fix the most we will pay in any a wri~en contract requiring such waiver one "occurrence" regardless of the with that person or organ¢atron and in- number oi: eluded in the "products-completed opera- tions hazard". However, ou ~ fights may X13 Insureds; only be waived prior to the occurrence ~~j Claims made or "suits" brought giving rise to the injury or damage for which we make payment under this Cov- or stage Part. The insured must do nothing (3) Persons or organizations making after a loss to impair our rights. At our re- claims orbringing "suits". ques#, the insured will bring "suit"or trans- fer those rights to us and help us enforce t~. Deductible Clause those righ#s. {1~ Our obligation to pay damages Automatic I~dditional Insured - Speci- onyour behalf applies only to the fled Reimonships amount of damages for each "occurrence" which are in excess a. The following is hereby added to of the deductible amount stated SECTION II - ilt~0 IS Alld II'~SURED. in Section B. Limits of Incur- Any person or organization de- ancE, ltoluntary Property scribed in Paragraph ~,a.(~} be- Damage and Care, Custody or low thereinafter referred to as Control Liability Coverage of additional insured) whom you are thrs endorsement. The limbs of required to add as an additional insurance will not be reduced by insured under this Coverage Part the application of such dedudi- by reason c~fi ble amount. Condition Duties in the Even ~$3 A written contract or agree- ment; or of ~currence, fJffense, Claim or quit, applies to each claim or {bl An oral agreemen# or con- "sui#" irrespective of the amount. tract others a certificate of ~3j ~Ye may pay any part or all of the insurance showing that per- son or organization as an deductible amount to effect set; additional insured has been tlemertt of any claim or ~sur~ issued, and, upon no~fication of the ac- tion taken, you shall promptly re- is art insured, provided: imburse us for such park of the Includes copyrighted material of Insurance GA 23~ aR Q~ 10 Services Office, Inc., with its permission. Page of {a) The written or oral contract or use of equipment leased or agreement is; to you by such persons} or organizations(sy. However, ~ j Currentljt in efifect ar this insurance does not ap- becomes effective dur- ply to any "occurrence, ing the policy period; which takes place after the and equipment lease expires. Executed prior to an ~e3 Any person or organization "occurrence" or offense preferred to below as ven- to which this insurance dor} with wham you have waukf apply; and agreed per Paragraph {b) They are not specifically 9~.a,{'l) above to provide in- narned as an additional in- surance, but only wc~ re- sured under any other pro- sped to "bodily injury` , or vision of, or endorsement "property damage" arising added to, this Coverage nut of'~rour products" u~hich Part. are distributed or solo in the regular course of the ven- t~l Only the following persons or or- dot's business, subject to gani¢ations are additional insur- the following addit~nal ex- eds u~d~r th,~ u~ndorsernent, and cius~ons: insurance coverage provided to The insurance afforded such additonal Insureds is i:rn- the vendor does not ited as provided herein; aPP~ to: {a~ The manager or lessor of a a~ "bodily injury" or premises leased to you with "property damage" whom you have agreed per for which the ven- Paragraph ~.a,.~~~ above to dor ~ obligated to provide insurance,-but only pay damages by with respect tQ liability aril- reason of the ac- ing aut of the ownership, sumptian of liab~ity maintenance or use of that in a contract ar part of a premises leased to agreement. This you, subject to the following exclusion does not additional exclusions. apply to liability far This insurance does not ap- damages that the ply ta: vendor would have in the absence of 1~ Any "occurrence" which the contra. or takes place after you agreement; cease to be a tenant in that premises. b~ Any express war- ranty unauthorized ~trudural alterations, by yqu; new construction or demolition operations c~ Any physical or performed by or an be- chemical change half of such additional in the product insured, made irrtentionaliy by the vendor ~b~ Any person or organization from which you lease d~ Repackaging, ex equipment ~°ith whom you ceps when un- have agreed per Paragraph Packed solely for ~,a.(~} above to provide in- the purpose of in- surance. Such person(s~ or spection, deman- organ¢ation(s)are insureds, station, testing, ar but only to the extent that the substitution of the 1rabilityfor "bodilyinju~'"', parts under in- "propertjr damage" or "per- structions from the sonal and advertising injury" manufacturer, and is caused by your negli- then repackaged Bence, acts or omissions in in the original con- tne maintenance, operation tamer Includes copyrighted material of Insurance ~A ~~3 t71~. fl~ 'lo Services t~`ice, lnc,, with its permission, Page '1"10 "l~ e~ Any fiailure to Part with respect make such inspec- to such products. bons, adjustments, tests or servicing Any state or poli~cal subdi- as the vendor has vision with which you have agreed to make or agreed per Paragraph normally under- ~.a.(1~ above to provide in- takes to make in surance, subject to the fol- theusualcourse of lowing additional provision: business, in con- This insurance applies only nection with the with nespect to the folbwing distribution or sale hazards for which the state of the products; or political subdivision has f) Demonstration, in- issued a Permit in connec- stallation, servicing tion with premises you own, or repair opera- rent or control and to which lions, except such this insurance applies: opera~ons per- 1~ The existence, mainte- formed at the ven- Hance, repair, const~vc- dor's premises in tion, erection, or re- connection with ~ moval of advoertising the sale of the signs, awnings, cano- product; pies, cellar entrances, g~ Products which, coal holes, driveways, manholes, mar uees, after distribution or hoist away openings, sale by ynu, have sidewalk vau~s, street been labeled or re- banners, or decorations labeled or used as and similar ex osures; a container, part or p ingredient of any °r other thing or sub- The construction, erec- stance by or for Lion, or removal of ele- thevendor, or vators; or h~ "bodily injury" or The ownership, main- "property damage" tenance, or use of any arising out of the elevators covered by negligence, acts or this insurance. omissions of the vendor, its em- (e~ Any state or political subdi- ployees or anyone vision with which you have else acting on its agreed per Paragraph behalf. 9~.a,{~~ above to provide in- surance, subject to the fol- This insurance does not lowing provisions: apply #o any insured person or organisation: 1} This insurance applies a~ From whom you Only with respect to op- erations performed by have acquired you or on your behalf such products, or for which the state or any ingredient, political subdivision has part or container, issued a permit. entering into, ac- companying or This insurance does not containing such apply to "bodily injury', products; or "property damage" or bj When liability in- "personal and advertis- cluded within the ing injury" arising out of "products- operations perfi~rmed for the state or political completed opera- 5Ubd)v151on. Lions hazard" has been excluded un- (f} For '~rour work° performed der this Coverage in Oregon, any person or Includes copyrighted material of Insurance - GA ~3~ p~ o~ t~ Services OfriCe, Inc„ with ~ perml5sion. Page of 1~ organization wi#h which you ~a~ Subparagraphs ~e~, t'~, and have agreed per Paragraph tg} do not apply to ~ duly 9.a.~'t~ above to prav~de m- jury" ar property amag surance, but only to the ex- included within the "pr4d- tent that the liability is acts-completed aperat~ons caused by 'dour work" per- hazard"; formed for that additional in- sured and only to the extent {b~ Subparagraphs tai, ~cl~, del that such liability is caused and do not apply ts~ "bod- by your negligence or the sly Kn1u~' "ProPeny dam- negligence of those wing age ar personal and ad- an your behafr. A person ar vertising injury" arising out organization's status as an of the sale negligence or insured under this provision wilful misconduct of the ad- af this endorsement canon- ditional insured or its "em- ues for only the period of playees'; ar time required by the w~r`r~en ~,c~ Subparagraph"4~ and do contract or agreement, but not apply to bod~r m~ur~', in no event beyondthe expi- "property damage" or "per- ration date of this Coverage sonal and advertising injury" Part, 1f there is no written arising out afi cor~ot or agreement, or if no period of tirrte is required The rendering af, or by the written contract or failure to render, any agreement, a person or or- professional services ganization's status as an in- by you or an your be- sured under this endorse- half, but only with ce- ment ends when your op4 sped to either or both erations for that insured are of the following apera- completed. Lions: ~g~ For '~rour work" performed aj Providing engi- in the "coverage tetYitary" veering, arch'itec- but not in Oregon, any per- fatal or surveying son ar organization wig services to others; which you have agreed per and Paragraph +~.a,~1} above to b, Providing, or hiring pro~nde insurance, bu only with res~ct to liability axis- independer~ pra~- ing out of "y~aur work'" per fess~onals a p formed f©r that addiaonal in- vide, engineering, cured by you ar an your be` archrtectural ar halF. A person or arganiza, surveying services Lion's status as an insured ~n cannect~an w~h under this provision of this construction work endorsement continues for ~u ~'~'m''. only the period of time re- Sub}ect to Paragraph gaited by the written con- below, professional tracer agree the ex~i'ratian services include. ven beyond p date of this Coverage Park a~ Preparing, approv- lfthere is no written contract ing, or failing to or agreement, or if no period prepare or ap- af time is required by the prove, maps, shop wri~en contract ar agree- drawings, opin- ment, aperson ar arganiza- ions, reports, suc- tion's status as an insurers veys, field orders, under this endorsement change orders, or ends when your operations drawings and for fat insured are cam- specifications; and pleted. b~ Supervisory or in- Any insurance provided to an spectian actswties additional insured designated performed as part under Paragraph g.a.~2~: of any related ar- Includes copyrighted material of Insurance ~3~ ~ G~ Services C3ffice, lnc,, with ks permission. Pale ofi 1~ chitectura! or engi- primary to other insurance nearing activities. available to the additional insured except 3} Professional services do not include services 'I, As otherwise provided within construeion in SECTI©N ~ . means, methods, tech- COMMERCIAL. GEf+I- niques, sequences and Ertl. LIABILITY prflcedures employed CONDITIONS, by you in connection Oth®r Insurance, b. with construction work Excess Insurance; or you perForm. For any other valid and ~d} Subparagraphs {f} and fig} collettib}e insurance do not apply to "bodily in- available to the addi- jury~ or "property damage" tional insured as an ad- arising out of'~our work" for ditional insured by at- which aconsolidated wrap- tachment of an en- up) insurance program has dorsement to another been provided by the prime insurance policy that is contractor !project manager written on an excess or owner of the construction basis. In such case, the project in which you are in- coverage provided un- volved, der this endorsement b. Only with regard to insurance pro- shall also be excess. vided to an additional insured desig- t~} Condition 11. Conformance to Hated under Paragraph ~.a.~~} Sub- Specific Written Contract or paragraphs (t} and above, SEC- kgreemettt is hereby added; TI01~ Ill -UNITS OF Il~SURRNCE is ~ Conformance to Specific amended to include: 11~ritben Contract or The limits applicable to the additional Agreement insured are those specified in the written contract or agreement or in a. ~~'h respeu to addi- the Declarations of this Coverage Hal ms eds de- part, whichever are less. If no limits scribed in Paragraph are specified in the written contractor ~•a.{~}4~ above only: agreement, or if there is no written If a written contract or contract or agreement, the limits ap- agreement between pliable to the additional insured are you and the additional those specfied m the Declarations of insured specifies that this Coverage Part. The limits of in- coverage for the addi- surance are inclusive of and not in tional insured: addition to the limits of insurance shown in the Declarations, Be provided by the Insurance Ser- c, SECTIQbI ~ - COMERCIAI., GEh!- vices dice addi- ERAI. LIABILITI~ CON~~ONS is tional insured form hereby amended as follows: number CC Condition 5, Other Insurance is CG or CG amended to include: 6~; or ~a} Where required by a written €Zj Include coverage contract or agreement, this for completed op- insurancE is primary and ! or erations; or noncontributory as respects Include coverage any other insurance policy for'~our work"; issued to the additional in- sured, and such other in- and where the limits or surance policy shall be ex- coverage provided to cess and ! or noncontribut- the additional insured is ing, whichever applies, with more restrictive than this insurance. was specifically re- quired in that written fib) Any insurance provided by contract or agreement, this endorsement shall be the terms of Para- Includes copyrighted material of Insurance GA 1~~ OIL ~Q Services Office, Inc., with its permission. Page 1~ of graphs s.~.(3j~a} or 9,b, above, or any combing- agreement specrhes lion thereof, shall be in- the Insurance Services terpreted as providing Office additional in- the limits or coverage sured form number CG required by the terms of ~ D but does not the written contrail or specify which edition, or agreement, but only to sd~cifies an edition that the extent that such Gm- snot exist, Para- its or coverage is in- graphs g.a~,b. and eluded within the terms g.b. of this endorse- ofthe Coverage Part to meet shall not apply which this endorsement and Paragraph is attached. 9.a.{3~aj of this en- dorsementshall apply. b. vllidi respect to addi- Broadened Contractual Liabil - W tionai insureds de- 1Arithin 50' of Railroad p e ~ scribed in Paragraph ~ g.a.(~}{gj above one; It is hereby agreed that Paragraph f.(1j of If a written contract or Definition 1~. "insured contract" {SEC- agreement between TION Y -DEFINITIONS} is deleted, - end the additional ~'i, Property Damage to Borrowed Equip. insured specifies that ment coverage for the adds tional insured: a• The following is hereby added to Ex- clusion j, Damage to Property of a, Be provided by the Paragraph Exclusions of SEC- Insurance Ser- TION I - C01t►ERJ~tiES, COVERI~GE tires Office addi- A. BODILY INJURY I~ND PR®P- tional insured form ERTY DIRGE LIABILITY: number CG ~p 10 or CG ~p ~7 Paragraphs {3) and (4) of this exclu- {where edition sion do not apply to tools or eQuip- specified); or ment loaned to you, provided they are not being used to perform operations b. include coverage at the time of foss. for completed op- erations; or b. respect to the insurance pro- vided by this section of the endorse- r. Include coverage ment, the following additional provi- for'~ur work'; lions apply. and where the limits or ('I~ The Limits of insurance shown in coverage provided to the Declarations are replaced by the add~ional insured is the limits designated in Section more restrictive than B ; Limf~ of Insurance, I1, of was specifically re- this endorsement with respect to wired in that written coverage provided b~~ this en- contract or agreement, dorsement. These limits are in- the terms of Para- elusive of and not in addition to graphs ~,a,{3}fa}, the hm~s being replaced. The ~.a.{~}(bj or 9.b, above, Limn of Jnsurance shown in or any combination Se~ion E, Limits a►f Insurance, thereof, shall be inter- ~I. of this endorsement fix the prated as providing the most we will pay in any one "oc- limits or coverage re- currence" regardless. of the quired by the terms of number of: the written contract or ~geeeement, but only to {a} Insureds; xtent that such gym- (b} Claims made or "suits" its or coverage is in- brow ht; ~ eluded within the terms g of the Coverage Park to (e) Persons or organizations which this endorsement making claims or bring is attached. lf, however, "suits". the written contract or Includes copyrighted material of Insurance GA X33 OR og 1~ Services Office, Jnc., with its ermiss' p ion. Page IS of i~ Deductible Clause a. Nurses; {aj Qur obligation to pay dam- b. Emergency h~Edical Technicians; or ages on your behalf applies c. paramedics, only to the amount of dam- ages for each "occurrence" in the jurisdiction where an "occurrence" which are in excess of the or offense to which this insurance applies Deductible amount stated in takes place. Section E. Limits of Insur- ance, 1'l, of this endorse- Broadened hlotlce of Occurrence ment. The limits ofi insur~ ante will not be reduced by Paragraph a. of Condifion Duties in the application of such De- the Event oi` Occurrence, Qffense, ductible amount Cleirn or Sult ~SECTIOhI lv - CONI~IEI~- CU~L GENERAL LIABILITY' CONDI- {b~ Condition Duties in the 11415) is hereby deleted and replaced by Event of occurrence, Of- the following: fense, Claim or Suit, ap- pl~s to each claim or "suit a. You must see to it that vie are notified irrespective of the amount. as soon as practicable of an "occur- renceu or anoffense which may result {c~ We may pay any part or all ~n To the extent possible, ho- of the deductible amount to t~ce should include: effect settlement of any claim or "suit" and, upon no- {1) How, when and where the "oc- tification of the action taken, currents" or offense took place; you shall promptly reim- Tt~e names and addresses of bursa us for such part of the any injured persons and wit- deductible amount as has nesses; and been paid by us, 1~. Em io ees as Insureds - S cified The nature and location of any P ~ injury or damage arising out of HeaRh Care Senrices the "occurrencep or offense. It is hereby agreed that ,Paragraph This requirement applies only when ~.a.{1~{dj of SECTION II -1~'HO GS Ah~ the "occurrence" or offense is known IF~SUi~ED, does not app~+ to your "em- to an "authorized representative". pfoyees" who provide professional health care services on your behalf as duly li- censed: Includes copyrighted material of Insurance GA ~ OR o~ 1~ Services Office, Inc., with its permission. pale ofi 1~