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HomeMy WebLinkAboutInsurance Certificate: SCJ Alliance PROPEL INSURANCE PAGE 3 OF 16 Client#:116497 SHEACARR DATE (MMNDIYYYY) ACORDTM CERTIFICATE OF LIABILITY INSURANCE 0612012017 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOTAFFIRMATIVELY ORNEGATIVELY 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 Suzanne Paschke NAME: Propel Insurance PHONE 800 499-0933 FAX 866 577-1326 {A/C, No, Ext): (A/C, No): Tacoma Commercial Insurance E~AAIL Suzanne. aschke ro elinsurance.com ADDRESS: p ~p p 1201 Pacific Ave, Suite 1000 INSURER{S) AFFORDING COVERAGE NAIC # Tacoma, WA 98402 American Casualty Co of Reading 20427 INSURER A INSURED INSURER B ; Continental Casualty Company 20443 Shea,Carr 8~ Jewell Inc dba SGJ Alliance INSURER c : Beazley Insurance Company, Inc. 37540 8730 Tallon Lane NE, Suite 200 Hartford Fire Insurance Com an INSURER D : p y Lacey, WA 98516 I 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 TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LTR INSR WVD POLICY NUMBER {MMlDD1YYYY) (MMIDDIYYYY) LIMITS A GENERAL LIABILITY Y Y 2090667295 611512017 0611512018 EACH OCCURRENCE $ 2,000,000 X COMMERCIAL GENERAL LIABILITY PREMISESa a oNcurrDence $ 300,000 CLAIMS~vIADE ~ OCCUR MED EXP (Any one Derson) _ $1 O OOO _ ' - PERSONAL & ADV INJURY $ 2,000,000 GENERAL AGGREGATE $4,000,000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS -COMP/OP AGG $4,000,000 POLICY X jR~ LOC $ AUTOMOBILE LIABILITY Y Y 4012152794 611512017 06115!2018 Ee aBadeDtSINGLE LIMIT $1,000,000 A BODILY INJURY (Perperson) $ X ANY AUTO ALL OWTJED SCHEDULED BODILY INJURI' (Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ X HIRED AUTOS X AUTOS Per accident B X UMBRELLA LIAB X OCCUR Y Y 4016829451 6115/2017 0611512018 EACH OCCURRENCE _ $3,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $3,000,000 DED RETENTION $ $ D WORKERS COMPENSATION 52WECJY4968 3119!2017 03119/2018 X ToRYTLAiMITS o~H- AND EMPLOYERS' LIABILITY D OFFICER/MEMBER EXCLUDED? ECUTIVE YN N lA 52WECJY4968 3/19/2017 0311912018 E.L. EACH ACCIDEfJT $1,000,000 (Mandatory in NH) ❑ E.L. DISEASE - EA EMPLOYEE $1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE-POLICY LIMIT $1,000,000 C Professional V10BC2170801 6/1712017 0611712018 Each Claim-$1,000,000 Liability Aggreg ate-$2,000,000 Ded: $60,000 DESCRIPTION OF OPERATIONS 1 LOCATIONS /VEHICLES {Attach ACORD 101, Additional Remarks Schedule, if more space is required) RE: project number 0722.02. The City of Ashland, Oregon, and its elected officials, officers and employees See attached endorsements. CERTIFICATE HOLDER CANCELLATION Clt of Ashland, Public Works SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE y THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Department ACCORDANCE WITH THE POLICY PROVISIONS. 20 East Main Street Ashland, OR 97520 AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) 1 of 1 The ACORD name and logo are registered marks of ACORD #527479201M2747772 SDP00 PROPEL INSURANCE PAGE 4 OF 16 This page has been left blank intentionally. PROPEL INSURANCE PAGE 5 OF 16 SB-146932-E ~NA (Ed. 06111) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED -LIABILITY EXTENSION This endorsement modifies insurance provided under the following: BUSINESSOWNERS LIABILITY COVERAGE FORM Coverage afforded under this extension of coverage endorsement does not apply to any person or organization covered as an additional insured on any other endorsement now or hereafter attached to this Policy. 1. ADDITIONAL INSURED -BLANKET VENDORS own acts or omission or those of its employees or anyone else acting on its WHO IS AN INSURED is amended to include as an behalf. However, this exclusion does not additional insured any person or organization (referred apply to: to below as vendor) with whom you agreed, because 1 The exce tions contained in of a written contract ar agreement to provide p insurance, but only with respect to bodily injury or Subparagraphs d. or f.; ar "property damage" arising out of "your products" which (2) Such inspections, adjustments, tests or are distributed or sold in the regular course of the servicing as the vendor has agreed to vendors business, subject to the following additional make or normally undertakes to make in exclusions: the usual course of business, in 1. The insurance afforded the vendor does not apply connection with the distribution or sale of to: the products. a. "Bodily injury" or "property damage" for which 2. This insurance does not apply to any insured the vendor is obligated to pay damages by person or organization, from wham you have reason of the assumption of liability in a acquired such products, or any ingredient, part or contract or agreement. This exclusion does container, entering into, accompanying or not apply to liability for damages that the containing such products. vendor would have in the absence of the 3. This provision 2. does not apply to any vendor contract or agreement; included as an insured by an endorsement issued b. Any express warranty unauthorized by you; by us and made a part of this Policy. c. Any physical or chemical change in the 4. This provision 2. does not apply if "bodily injury" or product made intentionally by the vendor; "property damage" included within the "products- completed operations hazard is excluded either d. Repackaging, except when unpacked solely by the provisions of the Policy or by endorsement. for the purpose of inspection, demonstration, testing, or the substitution of parts under 2. MISCELLANEOUS ADDITIONAL INSUREDS instructions from the manufacturer, and then WHO IS AN INSURED is amended to include as an repackaged in the original container; insured any person or organization (called additional e. Any failure to make such inspections, insured) described in paragraphs 2.a. through 2.h. adjustments, tests or servicing as the vendor below whom you are required to add as an additional has agreed to make or normally undertakes to insured on this policy under a written contract or make in the usual course of business, in agreement but the written contract or agreement must connection with the distribution or sale of the be: products; 1. Currently in effect or becoming effective during the f. Demonstration, installation, servicing or repair term of this policy; and operations, except such operations performed 2. Executed prior to the "bodily injury," "property at the vendor's premises in connection with damage" or "personal and advertising injury," but the sale of the product; Only the following persons ar organizations are g. Products which, after distribution or sale by additional insureds under this endorsement and you, have been labeled or relabeled or used coverage provided to such additional insureds is as a container, part or ingredient of any other limited as provided herein: thing or substance by or for the vendor; or a. Additional Insured -Your Work h. "Bodily injury" or "property damage" arising out of the sole negligence of the vendor for its That person or organization for whom you do work is an additional insured solely for liability SB-146932-E Page 1 of 5 (Ed. 06111) PROPEL INSURANCE PAGE 6 OF 16 SB-146932-E C~A (Ed. 06111) due to your negligence specifically resulting This insurance does not apply to "bodily from your work for the additional insured injury," "property damage" or "personal and which is the subject of the written contractor advertising injury" arising out of operations written agreement. No coverage applies to performed for the state or municipality. liability resulting from the sole negligence of c. Controlling Interest the additional insured. The insurance provided to the additional Any persons or organizations with a insured is limited as follows: controlling interest in you but only with respect to their liability arising out of: (1) The Limits of Insurance applicable to the additional insured are those specified in ~1) Their financial control of you; or the written contract or written agreement (2) Premises they own, maintain or control or in the Declarations of this policy, while you lease or occupy these whichever is less. These Limits of premises. Insurance are inclusive of, and not in addition to, the Limits of Insurance shown This insurance does not apply to structural in the Declarations. alterations, new construction and demolition operations performed by or for such additional ~2) The coverage provided to the additional insured. insured by this endorsement and paragraph F.9. of the definition of "insured d. Managers or Lessors of Premises contract" under Liability and Medical A manager or lessor of premises but only with Expenses Definitions do not apply to respect to liability arising out of the ownership, "bodily injury" or "property damage" maintenance or use of that specific part of the arising out of the "products-completed premises leased to you and subject to the operations hazard" unless required by the following additional exclusions: written contract or written agreement. This insurance does not apply to: ~3) The insurance provided to the additional insured does not apply to "bodily injury," (1) Any "occurrence" which takes place after "property damage," or "personal and you cease to be a tenant in that premises; advertising injury" arising out of the or rendering or failure to render any (2) Structural alterations, new construction or professional services. demolition operations performed by or on b. State or Political Subdivisions behalf of such additional insured. A state or political subdivision subject to the e. Mortgagee, Assignee or Receiver following provisions: A mortgagee, assignee ar receiver but only (1) This insurance applies only with respect with respect to their liability as mortgagee, to the following hazards for which the assignee, or receiver and arising out of the state or political subdivision has issued a ownership, maintenance, or use of a premises permit in connection with premises you by you. own, rent, or control and to which this This insurance does not apply to structural insurance applies: alterations, new construction or demolition (a) The existence, maintenance, repair, operations performed by or far such additional construction, erection, or removal of insured. advertising signs, awnings, canopies, f. Ownersl0ther Interests -Land is Leased cellar entrances, coal holes, driveways, manholes, marquees, An owner or other interest from whom land hoistaway openings, sidewalk vaults, has been leased by you but only with respect street banners, or decorations and to liability arising out of the ownership, similar exposures; or maintenance or use of that specific part of the land leased to you and subject to the following (b) The construction, erection, or additional exclusions: removal of elevators; ar ~2) This insurance applies only with respect This insurance does not apply to: to operations performed by you or on your (1) Any "occurrence" which takes place behalf for which the state or political after you cease to lease that land; or subdivision has issued a permit. SB-146932-E Page 2 of 5 (Ed. 06111) PROPEL INSURANCE PAGE 7 OF 16 SB-146932-E ~HA (Ed. 061' 1) (2) Structural alterations, new Damage To Property, is replaced by the construction or demolition operations following: performed by or on behalf of such k. Damage To Property additional insured. g. Co-owner of Insured Premises "Property damage" to: A co-owner of a premises co-owned by you 1• Property you own, rent or occupy, and covered under this insurance but only including any costs or expenses with respect to the co-owners liability as co- incurred by you, or any other person, owner of such premises. organization or entity, for repair, replacement, enhancement, h. Lessor of Equipment restoration ar maintenance of such Any person or organization from whom you property for any reason, including prevention of injury to a person or lease equipment. Such person or organization damage to another's property; are insureds only with respect to their liability arising out of the maintenance, operation or 2. Premises you sell, give away or use by you of equipment leased to you by abandon, if the "property damage" such person or organization. A person's or arises out of any part of those organization's status as an insured under this premises; endorsement ends when their written contract or agreement with you for such leased 3. Property loaned to you; equipment ends. 4. Personal property in the care, With respect to the insurance afforded these custody or control of the insured; additional insureds, the following additional 5. That particular part of any real exclusions apply: property on which you or any This insurance does not apply: contractors or subcontractors working directly or indirectly in your behalf are (1) To any "occurrence" which takes place performing operations, if the "property after the equipment lease expires; or damage" arises out of those (2) To "bodily injury," "property damage" or operations; or "personal and advertising injury" arising 6. That particular part of any property out of the sole negligence of such that must be restored, repaired or additional insured. replaced because "your work" was Any insurance provided to an additional insured incorrectly performed on it. designated under paragraphs b. through h. above Paragraph 2 of this exclusion does not does not apply to "bodily injury" or "property apply if the premises are "your work" and damage" included within the "products-completed were never occupied, rented or held for operations hazard." rental by you. 3. The following is added to Paragraph H. of the Paragraphs 1, 3, and 4, of this exclusion BUSINESSOVIlNERS COMMON POLICY do not apply to "property damage" (other CONDITIONS: than damage by fire or explosion} to premises: H. Other Insurance (1) rented to you: 4. This insurance is excess over any other insurance naming the additional insured (2) temporarily occupied by you with the as an insured whether primary, excess, permission of the owner, or contingent or on any other basis unless a (3) to the contents of premises rented to written contract or written agreement you for a period of 7 or fewer specifically requires that this insurance be consecutive days. either primary or primary and noncontributing. A separate limit of insurance applies to Damage To Premises Rented To You as 4. LEGAL LIABILITY - DAMAGE TO PREMISES described in Section D -Liability and Medical Expenses Limits of Insurance. A. Under B. Exclusions, 1. Applicable to Business Liability Coverage, Exclusion k. SB-146932-E Page 3 of 5 (Ed. 06111) PROPEL INSURANCE PAGE 8 OF 16 SB-146932-E CH~ (Ed. 06/11} Paragraphs 3, 4, 5, and 6 of this ~2) Any partner, if you or an additional exclusion do not apply to liability insured is a partnership; assumed under a sidetrack agreement. ~3) Any manager, if you or an additional Paragraph 6 of this exclusion does not insured is a limited liability company; apply to "property damage" included in (4) Any "executive officer" or insurance the "products-completed operations hazard." manager, if you or an additional insured is a corporation; B. Under B. Exclusions, 1. Applicable to (5) Any trustee, if you or an additional Business Liability Coverage, the last paragraph of 2. Exclusions is deleted and insured is a trust; or replaced by the following: (6) Any elected or appointed official, if you or Exclusions c, d, e, f, g, h, i, k, I, m, n, and o, an additional insured is a political do not apply to damage by fire to premises subdivision or public entity. while rented to you or temporarily occupied by This paragraph e. applies separately to you you with permission of the owner or to the and any additional insured. contents of premises rented to you for a period of 7 or fewer consecutive days. A 7. Bodily Injury separate limit of insurance applies to this Section F. Liability and Medical Expenses coverage as described in Section D. Liability Definitions, item 3. "Bodily Injury" is deleted and And Medical Expenses Limits Of replaced with the following: Insurance. "Bodily injury" means bodily injury, sickness or C. The first Paragraph under item 5. Damage To disease sustained by a person, including death, Premises Rented To You Limit of Section humiliation, shock, mental anguish or mental D. Liability And Medical Expenses Limits injury by that person at any time which results as Of Insurance is replaced by the following: a consequence of the bodily injury, sickness or The most we will pay under Business Liability disease. for damages because of "property damage" g. Expanded Personal and Advertising Injury to any one premises, while rented to you, or Definition temporarily occupied by you, with the permission of the owner, including contents of a. The following is added to Section F. Liability such premises rented to you for a period of 7 and Medical Expenses Definitions, item 14. or fewer consecutive days, is the Damage to Personal and Advertising Injury, in the Premises Rented to You limit shown in the Businessowners General Liability Declaration. Coverage Form: 5. Blanket Waiver of Subrogation h. Discrimination or humiliation that results in injury to the feelings or reputation of a natural We waive any right of recovery we may have person, but only if such discrimination or against: humiliation is: a. Any person or organization with whom you 1. Not done intentionally by or at the have a written contract that requires such a direction of: waiver. a. The insured; or 6. Broad Knowledge of Occurrence b. Any "executive officer," director, The following items are added to E. stockholder, partner, member or Businessowners General Liability Conditions manager (if you are a limited liability in the Businessowners Liability Coverage company} of the insured; and Form: 2. Not directly or indirectly related to the e. Paragraphs a. and b. apply to you or to any employment, prospective employment, additional insured only when such ast em to meet or termination of "occurrence "offense claim or "suit" is known p p y employment of any person or person by to: any insured. ~1) You or any additional insured that is an b. The following is added to Exclusions, Section individual; g,; SB-146932-E Page 4 of 5 (Ed. 06111 } PROPEL INSURANCE PAGE 9 OF 16 SB-146932-E ~NA (Ed. 06111) (15) Discrimination Relating to Room, Personal and Advertising Injury Liability is Dwelling or Premises excluded either by the provisions of the Policy Caused by discrimination directly or or by endorsement. indirectly related to the sale, rental, lease 9. Personal and Advertising Injury Re-defined or sub-lease or prospective sale, rental, lease or sub-lease of any room, dwelling Section F. Liability and Medical Expenses or premises by or at the direction of any Definitions, item 14, Personal Advertising Injury, insured. Paragraph c, is replaced by the following: (16) Fines or Penalties c. The wrongful eviction from, wrongful entry into, or invasion of the right of private Fines or penalties levied or imposed by a occupancy of a room dwelling or premises governmental entity because of that a person or organization occupies discrimination. committed by or on behalf of it's owner, c. This provision (Expanded Personal and landlord or lessor. Advertising Injury) does not apply if SB-146932-E Page 5 of 5 (Ed. 06/11) PROPEL INSURANCE PAGE 10 OF 16 This page has been left blank intentionally. PROPEL INSURANCE PAGE 11 OF 16 SB-146968-A CNA (Ed. 01/06} IMPORTANT: THIS ENDORSEMENT CONTAINS DUTIES THAT APPLY TO THE ADDITIONAL INSURED IN THE EUENTOF OCCURRENCE, OFFENSE, CLAIM OR SUIT. SEE PARAGRAPH C., OF THIS ENDORSEMENT FOR THESE DUTIES. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED ENDORSEMENT WITH PRODUCTS-COMPLETED OPERATIONS COVERAGE BLANKET WAIVER OF SUBROGATION Architects, Engineers and Surveyors This endorsement modifies insurance provided under the following: BUSINESSOWNERS LIABILITY COVERAGE FORM BUSINESSOWNERS COMMON POLICY CONDITIONS A. V11H0 IS AN INSURED (Section C.) of the 4. The insurance provided to the additional insured Businessowners Liability Coverage Form is amended does not apply to "bodily injury," "property to include as an insured any person or organization damage," "personal and advertising injury" arising whom you are required to add as an additional insured out of an architect's, engineer's, or surveyor's on this policy under a written contract or written rendering of or failure to render any professional agreement; but the written contract or written services including: agreement must be: a. The preparing, approving, or failing to prepare 1. Currently in effect or becoming effective during the ar approve maps, shop drawings, opinions, term of this policy; and reports, surveys, field orders, change orders or drawings and specifications by any 2. Executed prior to the "bodily injury," "property damage," or "personal and advertising injury." services on a Inro ect of whichoro P seorve lag P1 y B. The insurance provided to the additional insured is construction manager; or limited as follows: b. Inspection, supervision, quality control, 1. That person or organization is an additional engineering or architectural services done by insured solely for liability due to your negligence you on a project of which you serve as specifically resulting from "your work" for the construction manager. additional insured which is the subject of the 5. This insurance does not apply to "bodily injury," written contract or written agreement. No property damage, or personal and advertising coverage applies to liability resulting from the sole injury" arising out of: negligence of the additional insured. 2. The Limits of Insurance applicable to the a. The construction or demolition work while you additional insured are those specified in the are acting as a construction or demolition written contract or written agreement or in the contractor. This exclusion does not apply to Declarations of this policy, whichever is less. work done for or by you at your premises. These Limits of Insurance are inclusive of, and not C. BUSINESSOINNERS GENERAL LIABILITY in addition to, the Limits of Insurance shown in the CONDITIONS -Duties In The Event of Occurrence, Declarations. Offense, Claim or Suit (Section E.2.) of the 3. The coverage provided to the additional insured Businessowners Liability Coverage Form is amended within this endorsement and section titled to add the following: LIABILITY AND MEDICAL EXPENSE An additional insured under this endorsement will as DEFINITIONS - "Insured Contract" (Section soon as practicable: F.9.) within the Businessowners Liability Coverage 1. Give written notice of an occurrence or an offense dForm, does sot apply to bodily injury or property amag ari ing out of the products completed to us which may result in a claim or suit under operations hazard" unless required by the written this insurance; contract or written agreement. SB-146968-A Page 1 of 2 (Ed. 01 /06) PROPEL INSURANCE PAGE 12 OF 16 SB-146968-A (Ed. 01106) 2. Tender the defense and indemnity of any claim or against that "suit" If no other insurer defends, we "suit" to us for a loss we cover under this will undertake to do so, but we will be entitled to Coverage Part; the additional insured's rights against all those 3. Tender the defense and indemnity of any claim or other insurers. "suit" to any other insurer which also has When this insurance is excess over other insurance for a loss we cover under this Coverage insurance, we will pay only our share of the Part; and amount of the loss, if any, that exceeds the sum 4. Agree to make available any other insurance of: which the additional insured has for a loss we (a) The total amount that all such other insurance cover under this Coverage Part. would pay for the loss in the absence of this We have no duty to defend or indemnify an additional insurance; and insured under this endorsement until we receive (b) The total of all deductible and self-insured written notice of a claim or "suit" from the additional amounts under all that other insurance. insured. We will share the remaining loss, if any, with any D. OTHER INSURANCE (Section H. 2. & 3.) of the other insurance that is not described in this Businessowners Common Policy Conditions are Excess Insurance provision and was not bought deleted and replaced with the following: specifically to apply in excess of the Limits of Insurance shown in the Declarations of this 2. This insurance is excess over any other insurance Coverage Part. naming the additional insured as an insured whether primary, excess, contingent or on any E. TRANSFER OF RIGHTS OF RECOVERY AGAINST other basis unless a written cantract or written OTHERS TO US (Section K.2.) of the agreement specifically requires that this insurance Businessowners Common Policy Conditions is deleted be either primary or primary and noncontributing and replaced with the following: to the additional insured's own coverage. This 2 We waive any right of recovery we may have insurance is excess over any other insurance to against any person or organization against whom you which the additional insured has been added as have agreed to waive such right of recovery in a an additional insured by endorsement. written contract or agreement because of payments 3. When this insurance is excess, we will have no we make for injury or damage arising out of your duty under Coverages A or B to defend the ongoing operations or "your work" done under a additional insured against any "suit" if any other contract with that person or organization and included insurer has a duty to defend the additional insured within the "products-completed operations hazard." SB-146968-A Page 2 of 2 (Ed. 01106) PROPEL INSURANCE PAGE 13 OF 16 CNA63359XX CHA (Ed. 04112) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CONTRACTORS EXTENDED COVERAGE ENDORSEMENT -BUSINESS AUTO PLUS - This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM I. LIABILITY COVERAGE name, with your permission, while performing duties related to the conduct of your business. A. Who Is An Insured "Policy," as used in this provision A. Who Is An The following is added to Section II, Paragraph Insured, includes those policies that were in force A.1., Who Is An Insured: on the inception date of this Coverage Farm but: 1. a. Any incorporated entity of which the 1. Which are no longer in force; ar Named Insured owns a majority of the voting stock on the date of inception of 2. Whose limits have been exhausted. this Coverage Form; provided that, B. Bail Bonds and Loss of Earnings b. The insurance afforded by this provision Section II, Paragraphs A.2. ~2) and A.2. (4) are A.1. does not apply to any such entity revised as follows: that is an "insured" under any other liability "policy" providing "auto" coverage. 1. In a.(2), the limit for the cost of bail bonds is changed from $2,000 to $5,000; and 2. Any organization you newly acquire or form, other than a limited liability company, 2. In a.(4), the limit for the loss of earnings is partnership or joint venture, and over which changed from $250 to $500 a day. you maintain majority ownership interest. C. Fellow Employee The insurance afforded by this provision A.2.: Section II, Paragraph B.5 does not apply. a. Is effective on the acquisition ar formation Such coverage as is afforded by this provision C. date, and is afforded only until the end of is excess over any other collectible insurance. the policy period of this Coverage Form, or the next anniversary of its inception II. PHYSICAL DAMAGE COVERAGE date, whichever is earlier. A. Glass Breakage - Hitting A Bird Or Animal - b. Does not apply to: Falling Objects Or Missiles ~1) "Bodily injury" or "property damage" The following is added to Section III, Paragraph caused by an "accident' that A.3.: occurred before you acquired or With respect to any covered "auto," any deductible formed the organization; or shown in the Declarations will not apply to glass (2) Any such organization that is an breakage if such glass is repaired, in a manner "insured" under any other liability acceptable to us, rather than replaced. "policy" providing "auto" coverage. g, Transportation Expenses 3. Any person or organization that you are Section III, Paragraph A.4.a. is revised, with required by a written contract to name as an respect to transportation expense incurred by you, additional insured is an "insured" but only with respect to their legal liability for acts or to provide: omissions of a person, who qualifies as an a. $60 per day, in lieu of $20; subject to "insured" under Section II -Who Is An Insured and for whom Liability Coverage is b. $1,800 maximum, in lieu of $600, afforded under this policy. If required by C. Loss of Use Expenses written contract, this insurance will be primary and non-contributory to insurance on which Section III, Paragraph A.4.b. is revised, with the additional insured is a Named Insured. respect to loss of use expenses incurred by you, to provide: 4. An employee of yours is an Insured while operating an auto hired or rented under a a. $1,000 maximum, in lieu of $600. contract or agreement in that "employee's" CNA63359XX Copyright, CNACorporation, 2000. Page 1 of 3 (Ed. 04112} Includes copyrighted material of the Insurance Services Office used with its permission. PROPEL INSURANCE PAGE 14 OF 16 CNA63359XX (Ed. 04/12) D. Hired "Autos" d. A $100 per occurrence deductible applies to The following is added to Section III. Paragraph the coverage provided by this provision. A.: G. Diminution In Value 5. Hired "Autos" The following is added to Section III, Paragraph If Physical Damage coverage is provided under B.6.. this policy, and such coverage does not extend to Subject to the following, the "diminution in value" Hired Autos, then Physical Damage coverage is exclusion does not apply to: extended to: a. Any covered "auto" of the private a. Any covered "auto" you lease, hire, rent passenger type you lease, hire, rent or or borrow without a driver; and borrow, without a driver for a period of 30 days or less, while performing duties b. Any covered "auto" hired or rented by related to the conduct of your business; your employee without a driver, under a and contract in that individual "employee's" name, with your permission, while b. Any covered "auto" of the private performing duties related to the conduct passenger type hired or rented by your of your business. "employee" without a driver for a period of c. The most we will pay for any one 30 days or less, under a contract in that "accident" or "loss" is the actual cash individual employees name, with your value, cost of repair, cost of replacement permission, while performing duties or $75,000, whichever is less, minus a related to the conduct of your business. $500 deductible for each covered auto. c. Such coverage as is provided by this No deductible applies to "loss" caused by provision is limited to a "diminution in fire or lightning. value" loss arising directly out of d. The physical damage coverage as is accidental damage and not as a result of provided by this provision is equal to the the failure to make repairs; faulty or physical damage coverages) provided on incomplete maintenance or repairs; or the your owned "autos." installation of substandard parts. e. Such physical damage coverage far hired d. The most we will pay for "loss" to a "autos" will: covered "auto" in any one accident is the lesser of: (1) Include loss of use, provided it is the consequence of an "accident" for (1) $5,000; or which the Named Insured is legally (2) 20% of the "auto's" actual cash value liable, and as a result of which a (ACV). monetary loss is sustained by the III. Drive Other Car Coverage -Executive Officers leasing or rental concern. (2) Such coverage as is provided by this The following is added to Sections II and III: provision will be subject to a limit of 1. Any "auto" you don't own, hire or borrow is a $750 per "accident." covered "auto" for Liability Coverage while being E. Airbag Coverage used by, and for Physical Damage Coverage while in the care, custody or control of, any of your The following is added to Section III, Paragraph "executive officers," except: B.3.: a. An "auto" owned by that "executive officer" or The accidental discharge of an airbag shall not be a member of that person's household; or considered mechanical breakdown. b. An "auto" used by that "executive officer" F. Electronic Equipment while working in a business of selling, Section III, Paragraphs B.4.c and B.4.d. are servicing, repairing or parking "autos." deleted and replaced by the following: Such Liability andlor Physical Damage Coverage c. Physical Damage Coverage on a covered as is afforded by this provision. "auto" also applies to "loss" to any (1) Equal to the greatest of those coverages permanently installed electronic equipment afforded any covered "auto";and including its antennas and other accessories. CNA63359XX Copyright, CNACorporation, 2000. Page 2 of 3 (Ed. 04112) Includes copyrighted material of the Insurance Services Office used with its permission. PROPEL INSURANCE PAGE 15 OF 16 CNA63359XX (Ed. 04112} (2) Excess over any other collectible damage, against any person or organization for insurance. whom or which you are required by written contract or agreement to obtain this waiver from 2. For purposes of this provision, executive officer us. means a person holding any of the officer positions created by your charter, constitution, by- This injury or damage must arise out of your laws or any other similar governing document, activities under a contract with that person or and, while a resident of the same household, organization. includes that person's spouse. You must agree to that requirement prior to an Such "executive officers" are "insureds" while "accident" or "loss." using a covered "auto" described in this provision. C. Concealment, Misrepresentation or Fraud IV. BUSINESSAUTO CONDITIONS The following is added to Section IV, Paragraph A. Duties In The Event Of Accident, Claim, Suit Or B.2.: Loss Your failure to disclose all hazards existing on the date The following is added to Section IV, Paragraph of inception of this Coverage Form shall not prejudice A.2.a.: you with respect to the coverage afforded provided (4) Your "employees" may know of an such failure or omission is not intentional. "accident" or "loss." This will not mean D. Other Insurance that you have such knowledge, unless The following is added to Section IV, Paragraph such "accident" or "loss" is known to you or if you are not an individual, to any of B.S.. your executive officers or partners or your Regardless of the provisions of Paragraphs 5.a. insurance manager. and 5.d. above, the coverage provided by this The following is added to Section IV, Paragraph policy shall be on a primary non-contributory A.2.b.; basis. This provision is applicable only when required by a written contract. That written (6) Your "employees" may know of contract must have been entered into prior to documents received concerning a claim "Accident" or "Loss." or "suit." This will not mean that you have E. Policy Period, Coverage Territory such knowledge, unless receipt of such documents is known to you or if you are Section IV, Paragraph B. 7.(5).(a). is revised to not an individual, to any of your executive provide: officers or partners or your insurance manager. a. 45 days of coverage in lieu of 30 days. B. Transfer Of Rights Of Recovery Against Others V. DEFINITIONS To Us Section V. Paragraph C. is deleted and replaced by The following is added to Section IV, Paragraph the following: A.S. Transfer Of Rights Of Recovery Against "Bodily injury" means bodily injury, sickness or disease Others To Us; sustained by a person, including mental anguish, UVe waive any right of recovery we may have, mental injury or death resulting from any of these. because of payments we make for injury or CNA63359XX Copyright, CNACorporation, zooo. Page 3 of 3 (Ed. 04112} Includes copyrighted material of the Insurance Services Office used with its permission. PROPEL INSURANCE PAGE 16 OF 16 This page has been left blank intentionally. PROPEL INSURANCE PAGE 1 OF 16 To: Fax Number: 5414885311 From: Certificates Fax Number: Company: Date: June 20, 2017 Subject: Certificate of Insurance Total Pages: 16 Memo: PROPEL INSURANCE PAGE 2 OF 16 To whom it may concern, You have received this email because of your relationship with Propel Insurance or one of its clients. For your convenience, the attached Certificate of Insurance has been issued to you at the request of the client referenced on the certificate. Please do not reply to this email, If you have questions, please direct your inquiry to the contact listed on the attached certificate, Regards, Propel Insurance NOTICE: This communication including any attachments may contain privileged or confidential information. If you are clot the intended recipient, or believe that you received this colrunurlication irl error, please advise the sender irrlrrlediately a~ld delete or destroy the corrlrrlurlicatiorlynu received without copying or disclosing the corlterlts. Thank you.