HomeMy WebLinkAboutInsurance Certificate: Mountain View Paving Q ® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY)
10/4/2018
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 have ADDITIONAL INSURED provisions or be endorsed.
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on
this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
PRODUCER CONTACT
NAME:
Ward Insurance Agency Inc. PHONE FAX
PO Box 10167 IA/C.No.Ext): 541-687-1117 (A/C,No):541-342-8280
Eugene OR 97440
E-MAIL kim @wardinsurance.net
INSURER(S)AFFORDING COVERAGE NAIC#
INSURER A:Cincinnati Insurance Company 10677
INSURED 14229 INSURER B:
Mountain View Paving Inc
PO Box 508 INSURER C:
Talent OR 97540 INSURER D:
INSURER E:
INSURER F:
COVERAGES CERTIFICATE NUMBER:446447296 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 INSD WVD POLICY NUMBER NM/DO/MY) (MM/DD/YYYY)
A X COMMERCIAL GENERAL LIABIUTY Y Y EPP 0404007 9/25/2018 9/25/2019 EACH OCCURRENCE $1,000,000
DAMAGE TO RENTED
CLAIMS-MADE X OCCUR PREMISES(Ea occurrence) $500,000
MED EXP(Any one person) $10,000
PERSONAL&ADV INJURY $1,000,000
GE 'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000
POLICY X 128,-- LOC PRODUCTS-COMP/OP AGG $2,000,000
OTHER:
A AUTOMOBILE LIABILITY Y Y EPP 0404007 9/25/2018 9/25/2019 COMBINED SINGLE LIMIT $1,000,000
(Ea accident)
X ANY AUTO BODILY INJURY(Per person) $
OWNED SCHEDULED BODILY INJURY(Per accident) $
AUTOS ONLY AUTOS
X HIRED X NON-OWNED PROPERTY DAMAGE $
AUTOS ONLY _ AUTOS ONLY (Per accident)
$
A X UMBRELLA LIAB X OCCUR EPP 0404007 9/25/2018 9/25/2019 EACH OCCURRENCE $1,000,000
EXCESS LIAB CLAIMS-MADE AGGREGATE $1,000,000
DED RETENTION$ $
WORKERS COMPENSATION PER
AND EMPLOYERS'LIABILITY Y/N STATUTE ERH
ANYPROPRIETOR/PARTNER/EXECUTIVE N/A E.L.EACH ACCIDENT $
OFFICER/MEMBEREXCLUDE07
(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)
Certificate holder and all entities required by written contract are included as additional insureds on a primary and non-contributory basis with waiver of
subrogation as respects to the general liability including completed operations and auto liability,including waiver of subrogation as required by written contract
per attached endorsements.Subject to policy limits,terms,conditions and exclusions.
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
City of Ashland ACCORDANCE WITH THE POLICY PROVISIONS.
90 N. Mountain
Ashland OR 97520 AUTHORIZED REPRESENTATIVE
USA --,—• �f o-
�C''
I
@ 1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD
THIS ENDORSEMENT CHANGES THE POLICY.PLEASE READ IT CAREFULLY, 6. Voluntary Property Damage(Coverage a.)and Care,Custody or Control Liability Coverage
(Coverage b.)
OREGON CONTRACTORS' COMMERCIAL GENERAL LIABILITY Limits of Insurance(Each Occurrence)
BROADENED ENDORSEMENT Coverage a.$1,000 Coverage b.$5,000 unless otherwise stated $
Deductibles(Each Occurrence)
This endorsement modifies insurance provided under the following: Coverage a.$250
Coverage b.$250 unless otherwise stated $
COMMERCIAL GENERAL LIABILITY COVERAGE PART
COVERAGE PREMIUM BASIS RATE ADVANCE PREMIUM
A. Endorsement-Table of Contents: a Area
(For Limits in Excess of (For Limits in Excess of
Coverage; Begins on Page: b) Payroll $5,000) $5,000)
(c) Gross Sales
1. Employee Benefit Liability Coverage.. 2 (d) Units
2. Unintentional Failure to Disclose Hazards 8 (e) Other
3. Damage to Premises Rented to You s b. Care, Custody
4. Supplementary Payments 10 or Control $
5. Medical Payments TOTAL ANNUAL PREMIUM $
6. Voluntary Property Damage(Coverage a.)and Care,Custody or Control
Liability Coverage(Coverage b.) 10 11. Property Damage to Borrowed Equipment
7. 180 Day Coverage for Newly Formed or Acquired Organizations 10
8. Waiver of Subrogation 10 Each Occurrence Limit $ 10,000
9. Autcmalic Additional Insured-Specified Relationships: 11 Deductible: $ 250
x Managers or Lessors of Premises;
x Lessor of Leased Equipment;
x Vendors; C. Coverages:
x State or Political Subdivisions-Permits Relating to Premises; 2) Our right and duty to
x Slate or Political Subdivisions-Permits;and 1. Employee Benefit Liability Coverage defend ends when we
x Contractors'Operations have used up the appli-
10. Broadened Contractual Liability-Work Within 50'of Railroad Property 16 a. The following is added to SECTION I cable limit of insurance
11. Property Damage to Borrowed Equipment 16 -COVERAGES: Employee Benefit in the payment of
12. Employees as Insureds-Specified Health Care Services: 16 Liability Coverage. judgments or settle-
x Nurses; (1) Insuring Agreement menis.
x Emergency Medical Technicians;and No other obligation or liabd-
x Paramedics (a) We will pay those sums that
13. Broadened Notice of Occurrence 16 the insured becomes legally ity to pay sums or perform
obligated to pay as dam- acts or services is covered
ages caused by any act,er- unless explicitly provided for
ror or omission of the in- under Supplementary Pay-
B. Limits of Insurance: sured, or of any other per- menis.
son for whose acts the in-
The Commercial General Liability Limits of Insurance apply to the insurance provided by this endorsement, (b) This insurance applies to
except as provided below sured is legally liable, to damages only if the act,er-
which this insurance ap- ror or omission, is negli-
1. Employee Benefit Liability Coverage plies.We will have the right gently committed in the
Each Employee Limit: $ 1,000,000 and duty to defend the in- "administration" of your
Aggregate Limit: $ 3,000,000 sured against any "suit" "employee benefit program";
seeking those damages. and
Deductible: $ 1,000 However, we veil have no
3. Damage to Premises Rented to You duty to defend against any 1) Occurs during the pol-
"suit" seeking damages to icy period;or
The lesser of which this insurance does
not apply. We may,at our 2) Occurred prior to the
a. The Each Occurrence Limit shown in the Declarations;or discretion, investigate any effective date of this
b. $500,000 unless otherwise stated$ report of an act, error or endorsement provided:
omission and settle any a) You did not have
4. Supplementary Payments claim or"suit"that may re- knowledge of a
suit.But: claim or"suit' on
a. Bail bonds: $ 1,000 or before the ef-
t) The amount we will pay
b. Loss of earnings: $ 350 for damages is limited fective date of this
as described in SEC- endorsement.
5. Medical Payments TION III - LIMITS OF
You will be
Medical Expense Limit: $ 10,000 INSURANCE;and
deemed to have
Includes copyrighted material of Insurance Includes copyrighted material of Insurance
GA 233 OR 09 10 Services Office,Inc.,with its permission. Page 1 of 16 GA 233 OR 09 10 Services Office,Inc.,with its permission. Page 2 of 16
knowledge of a 1) Failure of any invest- (3) Coercion, demotion, tors are insureds, but only
claim or "suit" meet to perform; evaluation, reassign- with respect to their duties
when any"author- meet, discipline, defa- as your officers or diredors.
ized representa- 2) Errors in providing in- matron, harassment, Your stockholders are also
five'; formation on past per- humiliation, discrimina- insureds, but only with re-
formance of investment lion or other employ- sped to their liability as
i) Reports all, or vehicles;or
any part,of the ment-related practices, stockholders.
act, error or 3) Advice given to any acts or omissions;or
person with respect to
omission to us P P (4) Consequential liability (e) A trust,you are an insured.Your trustees are also in-
or any other that person's decision as a result of(1),(2)or sureds,but only with respect
insurer; to participate or not to (3)above. to their duties as trustees.
participate in any plan
ii) Receives a included in the "em- This exclusion applies (2) Each of the following is also an
written or ver- ployee benefit pro- whether the insured may be insured:
bat demand or gram". held liable as an employer
claim for dam- or in any other capacity and (a) Each of your "employees"
ages because (f) Workers' Compensation to any obligation to share who is or was authorized to
of the act,error and Similar Laws damages with or repay administer your "employee
or omission; Any claim arising out of your someone else who must benefit program".
and pay damages because of
failure to comply with the (b) Any persons, organizations
mandatory of an
b) There is no other ry P rovisions any the injury. or "employees" having
applicable insur- workers'compensation, un- (3) Supplementary Payments proper temporary authoriza-
ance. employment compensation lion to administer your"em-
insurance,social security or SECTION I - COVERAGES, ployee benefit program" if
(2) Exclusions disability benefits law or any SUPPLEMENTARY PAY- you die, but only until your
similar law. MENTS-COVERAGES A AND
This insurance does not apply to: legal representative is ap-
(a) Bodily Injury, Property
(g) ERISA B also apply to this Coverage. pointed.
Damage or Personal and Damages for which any in- b. Who is an Insured (c) Your legal representative if
Advertising Injury sired is liable because of li- As respects Employee Benefit Liabil- you die, but only with re-
sped to duties as such.
ability imposed on a fidud- ity Coverage,SECTION II-WHO IS That representative will
"Bodily injury', "property cry by the Employee Re- AN INSURED is deleted in its entirely P
damage" or "personal and have all your rights and du-
advertisin i u lirement Income Security and replaced by the following: ties under this Coverage
g ry ry Act of 1974, as now or
(b) Dishonest, Fraudulent, hereafter amended, or by (1) If you are designated in the Dec.- Part.
Criminal or Malicious Act any similar federal, state or !orations as: (3) Any organization you newly ac-
local laws. (a) An individual,you and your quire or form,other than a part-
Damages arising out of any spouse are insureds, but nersldp,joint venture or limited
part-
intentional,un dishonest, (h) Available Benefits only with respect to the con- liability company,and over which
fraudulent,,criminal or mat- Any claim for benefits to the duct of a business of which you maintain ownership or ma-
cious act,error or omission, extent that such benefits are you are the sole owner.
jority interest, will qualify as a
committed by any insured, available, with reasonable Named Insured if no other simi-
including the willful or reck- effort and cooperation of the (b) A partnership or joint ven- lar insurance applies to that or-
less vitiation of any statute. insured,from the applicable Lure, you are an insured. ganization. However, coverage
(c) Failure to Perform a Con- funds accrued or other col- Your members, your part- under this provision:
tract ledible insurance. ners,and their spouses are
also o insureds ds o
but only with (a) Is afforded only until the
(i) Taxes,Fines or Penalties respect to the conduct of 180th day after you acquire
Damages arising out of fail- () P or form the organization or
ire of performance of con- your business.
tract by any insurer. Taxes, fines or penalties, the end of the policy period,
including those imposed (c) A limited liability company, whichever is earlier,and
(d) Insufficiency of Funds under the Internal Revenue you are an insured. Your (b) Does not apply to any act,
Code or any similar state or members are also insureds,
Damages arising out of an local law. but only with respect to the error or omission that was
insufficiency of funds to conduct of your business. committed before you ac-
meet any obligations under (j) Employment-Related Your managers are insur- quired or formed the organi-
any plan included in the Practices eds,but only with respect to zaticn.
"employee benefit program". Any liability arising out of their duties as your manag- c. Limits of Insurance
(e) Inadequacy of Perform- any ens.
ante of Investment /Ad- d An organizatim other than a As respects Employee Benefit Liabil-
vice Given With Respect (1) Refusal to employ; ( ) partnership, ity Coverage, SECTION III-LIMITS
p p p,joint venture or OF INSURANCE is deleted in its en-
to Participation (2) Termination of em- limited liability company,you tirety and replaced by the following:
ployment; are an insured. Your "ex-
Any claim based upon: ecutive officers" and direc-
Includes copyrighted material of Insurance Includes copyrighted material of Insurance
GA 233 OR 09 10 Services Office,Inc.,with its permission. Page 3 of 16 GA 233 OR 09 10 Services Office,Inc.,with its permission. Page 4 of 16
(1) The Limits of Insurance shown in amount stated in the Deda- may result in a daim. surance may also
Section B.Limits of Insurance, rations as applicable to To the extent possible, apply.
1. Employee Benefit Liability Each Employee. The limits notice should include:
Coverage and the rules below of insurance shall not be re- d. No insured will, except
fix the most we will pay regard- duced by the amount of this (1) What the act,error at that insured's own
less of the number of deductible. or omission was cost,voluntarily make a
and when it oc- payment, assume any
(a) Insureds; (b) The deductible amount curred;and obligation,or incur any
b Claims made or "suits" staled in the Declarations (2)) expense without our
(b) applies to all damages sus- 2 The names and
brought; tained by any one "em_ addresses of any-
ployee", including such one who may suf- (2) Item 5.Other Insurance is de-
(c) makings claims organizations ter damages as a leted in its entirety and replaced
"suiting claims or bringing "employee's"
nd ben a beneficiaries,dependents result of the act, by the following:
"suits"; and bac s, errors because error or omission.
of all acts, errors or orris- 5. Other Insurance
(d) Acts,errors or omissions;or sions to which this insur- b. If a claim is made or
once applies. "suit"is brought against If other valid and collectible
(e) Benefits included in your insurance is available to the
"employee benefit program". (c) The including those of this insurance, any insured,you must:
includin those with respect insured for a loss we cover
(2) The Aggregate Limit shown in g p (1) Immediately re- under this Coverage Part,
to: cord the spedfics our obligations are limited
Section Limits en a Insurance,
1. Employee Befit Liability 1) Our right and duty to of the claim or as follows:
Coverage of this endorsement is defend the insured "suit"and the date
the most we will pay for all dam- against any "suits" received;and a. Primary Insurance
ages because of acts, errors or seeking those dam- (2) Notify us as soon This insurance is pri-
omissions negligently committed ages;and as practicable. mary except when c.
in the "administration" of your below applies.If this in-
"employee benefit program". 2) Your duties, and the You must see to it that surance is primary,our
duties of any other in- we receive written no- obligations are not af-
(3) Subject to the limit described in volved insured, in the lice of the claim or fected unless any of the
(2) above, the Each Employee event of an act,error or "suit"as soon as practi- other insurance is also
Limit shown in Section B.Limits omission,or claim, cable. primary. Then, we will
of Insurance, 1. Employee share with all that other
Benefit Liability Coverage of apply irrespective of the ap- c. You and any other in- insurance by the
this endorsement is the most we plication of the deductible volved insured must: method described in b.
will pay for all damages sus- amount. below.
tained by any one "employee", d We may pay any part or all (1) Immediately send
including damages sustained by ( ) Y p Y Y P us copies of any b. Method of Sharing
9 9 s of the deductible amount any demands, notices,
such "employee's' dependents effect settlement of any summonses or le- If all of the other insur-
and beneficiaries,as a result of: claim or"suit"and,upon no- gal papers re- once permits conlribu-
(a) An act,error or omission;or lification of the action taken, ceived in connec- lion by equal shares,
you shall promptly reim- lion with the claim we wig follow this
(b) A series of related acts,er- burse us for such pad of the or"suit', method also.Under this
rots or omissions, regard- deductible amount as we approach each insurer
less of the amount of time have paid. (2) Authorize us to ob- contributes equal
that lapses between such lain records and amounts until it has
acts,errors or omissions, d. Additional Conditions other information; paid its applicable limit
As respects Employee Benefit Li- Cooperate with us of insurance or none of
negligently committed in the (3) P
"administration" of your "em_ ability Coverage, SECTION IV - in the investigation the loss remains,
ployee benefit program". COMMERCIAL GENERAL LIABIL- or settlement of whichever comes first.
ITY CONDITIONS is amended as fit- the claim or de-
However,the amount paid under lows: tense a ainst the If any of the other in-
this endorsement shall not ex- "suit";and surance does not per-
ched, and will be subject to the (1) Item 2.Duties in the Event of mit contribution by
limits and restrictions that apply Occurrence,Offense,Claim or (4) Assist us, upon equal shares, we will
to the payment of benefits in any Suit is deleted in its entirety and our request,in the contribute by limits.
Ian included in the "employee replaced by the following: enforcement of Under this method,
P each insurer's share is
benefit program". 2. Duties in the Event of an any right against based on the ratio of its
Act,Error or Omission,or any person or or- applicable limit of in-
(4) Deductible Amount ganization which
Claim or Suit surance to the total ap-
ages Our obligation behalf pay dam- they ns liable to
ages on behalf of the in- a. You must see to it that the insured be- plicable limits of insur-
sured applies only to the we are notified as soon cause of an act, ante of at insurers.
amount of damages in ex- as practicable of an act, error or omission c. No Coverage
cess of the deductible error or omission which to which this in-
Includes copyrighted material of Insurance Includes copyrighted material of Insurance
GA 233 OR 09 10 Services Office,Inc.,with its permission. Page 5 of 16 GA 233 OR 09 10 Services Office,Inc.,with its permission. Page 6 of 16
This insurance shall not providing some or all of the ages are claimed and The exclusions under SECTION
cover any loss for following benefits to "em- to which the insured I -COVERAGES, COVERAGE
which the insured is en- ployaes", whether provided must submit or does A. BODILY INJURY AND
tilled to recovery under through a"cafeteria plan"or submit with our con- PROPERTY DAMAGE LIABIL-
any other insurance in otherwise: sent; ITY,2.Exclusions,other than i.
force previous to the ef- War and the Nuclear Energy
festive dale of this a. Group life insurance: b. Any other alternative
group accident or dispute resolufion pro- Liability Exclusion,are deleted
Coverage Part. and the following are added:
health insurance; den- ceeding in which such
. e. Additional Definitions tat, vision and hearing damages are claimed This insurance does not apply to:
plans; and flexible and to which the in-
As respects Employee Benefit Li- sp end ing accounts; sired submits with our (a) "Property damage":
ability Coverage, SECTION V - provided that no one consent;or
DEFINITIONS is amended as fol- other than an "em- 1) Assumed in any con-
lows: ployee" may subscribe C. An appeal of a civil pro- trod;or
•
(1) The following definitions are to such benefits and seeding. 2) Loss caused by or re-
added: such benefits are made 8. "Employee"means a person suiting from any of the
generally available to following:
1. "Administration"means: those"employees"who actively employed, formerly
employed, on leave of ab- a
a. Providing information to a) Wear and tear;
satisfy the plan's eligi-
bility requirements; sense or o e n, or re-
"employees", including tired."Empltoyee""includes a b) Rust, corrosion,
their dependents and b. Profit sharing plans, 'leased worker"."Employee" fungus,decay,de-
benefdanes, with re- employee savings does not include a"tempo- terioration, hidden
sped to eligibility for or plans, employee stock vary worker". or latent defect or
any quality in
scope of "employee ownership plans, pen- 2. Unintentional Failure to Disclose Haz- property that
benefit programs"; shoo plans and stock ards causes it to dam-
subscription plans,pro-
b. Interpreting the "em- vided that no one other SECTION IV-COMMERCIAL GENERAL age or destroy it-
ployee benefit pro- than an "employee" LIABILITY CONDITIONS, 7. Represen- self;
grams"; may subscribe to such tatlons is hereby amended by the addi- c) Smog;
c. Handling records in benefits and such Lion of the following:
connection with the benefits are made gen- d) Mechanical break-
"em to ee benefit ro- erally available to all Based on our dependence upon your rep- down including
p y p "employees" who are resentahons as to existing hazards,if un- rupture or bursting
grams";or eligible under the plan intentionally you should fail to disdose all caused by sen-
d. Effecting,continuing or for such benefits; such hazards at the inception dale of your trifugal force;
terminating any "em- policy, we will not reject coverage under
ployee's" participation c. Unemployment insur- this Coverage Part based solely on such e) Settling, cracking,
in any benefit included ance, nodal security failure. shrinking or ex-
benefits,workers'corn- pension;or
pensation and disability 3. Damage to Premises Rented to You
fit program". Nesting or infesta-
benefits;and
However, "administration" a. The last Subparagraph of Paragraph lion, or discharge
does not include: . plans, 2. SECTION I - COVERAGES,
d Vacation or release of waste
lans indud-
ing buy and sell pro- COVERAGE A. -BODILY INJURY products or secre-
a. Handling payrol deduc- grams; leave of ab- AND PROPERTY DAMAGE, 2. LI- tions, by insects,
tions;or Bence programs, in- ABILITY Exclusions is hereby de- birds, rodents or
cluding military, mater- leted and replaced by the following: other animals.
b. The failure to effect or nity, family, and civil
Exclusions c.through q,do not apply
maintain any insurance leave;tuition assistance (b) Loss caused directly or low-
or adequate limits of to damage by fire, explosion, light- redly by any of the follow
eq and h club ning, smoke or soot to premises y Y y
coverage of insurance, and health club subsi- ing:
including but not limited dies. while rented to you or temporarily oc-
to unemployment in- cupied by you with permission of the 1) Earthquake, volcanic
surance,social security (2) The following definitions are de- owner. eruption, landslide or
benefits, workers'corn- leted in their entirety and re- b. The insurance provided under SEC- any other earth move-
pensation and disability placed by the following: TION I-COVERAGES,COVERAGE ment,
benefits. A. BODILY INJURY AND PROP- 2) Water that backs up or
21. "Suit" means a civil pro- ) P
2. "Cafeteria plans" means ceeding in which money ERTY DAMAGE LIABILITY applies overflows from a sewer,
plan authorized by applica- damages because of an act, to "property damage" arising out of drain or sump;
ble law to allow"employees" error or omission to which water damage to premises that are
to elect to pay for certain this insurance applies are both rented to and occupied by you. 3) Water under the ground
surface pressing on,or
benefits with pre-tax dollars. alleged."Suit"includes: (1) As respeds Water Damage Le- flowing or seeping
3. 'Employee benefit pro- a. An arbitration proceed- gal Liability,as provided in Pam- through:
grams" means a program ing in which such dam- graph 3.b.above:
Includes copyrighted material of Insurance Includes copyrighted material of Insurance
GA 233 OR 09 10 Services Office,Inc.,with its permission. Page 7 of 16 GA 233 OR 09 10 Services Office,Inc.,with its permission. Page 8 of 16
a) Foundations, one "occurrence' to which b. Care, Custody or Control Liability deductible amount as has been
walls, floors or this insurance applies. Coverage paid by us.
paved surfaces;
(3) The amount we will pay is limited SECTION I - COVERAGES, COV- 7. 180 Day Coverage for Newly Formed or
b) Basements, as described in Section B.Lim- ERAGE A. BODILY INJURY AND Acquired Organizations
whether paved or its of Insurance,3.Damage to PROPERTY DAMAGE LIABILITY,2. SECTION II -WHO IS AN INSURED is
not;or Premises Rented to You of this Exclusions,j.Damage to Property, SECTION a II f-WH
endorsement. Subparagraphs(3),(4)and(5)do not
c) Doors,windows or apply to "property damage" to the
other openings. 4. Supplementary Payments of others described therein. hereby deleted a. of Paragraph 4. l-
property hereby deleted and replaced by the fol-
(c) Loss caused by or resulting Under SECTION I -COVERAGE, SUP- With respect to the insurance provided by lowing:
from water that leaks or PLEMENTARY PAYMENTS - COVER- this section of the endorsement,the fol- a. Insurance under this provision is af-
flows from plumbing, heat- AGES A AND B: lowing additional provisions apply:
ing, air conditioning, or fire forded only until the 180th day after
protection systems caused a. Paragraph 2, is replaced by the fit- you acquire or form the organization
a. The Limits of Insurance shown in the
by or resulting from freezing, lowing: Declarations are replaced by the lim- or the end of the policy period,
•
unless: Up to the limit shown in Section B. its designated in Section B.Limits of whichever is earlier;
1) You did your best to Limits of Insurance,4.a.Bail Bonds Insurance, 6. Voluntary Property 8. Waiver of Subrogation
of this endorsement for cost of bat Damage and Care, Custody or
maintain heat in the Control Liability Coverage of this SECTION IV-COMMERCIAL GENERAL
building or structure;or bonds required because of accidents
9 endorsement with respect to cover- LIABILITY CONDITIONS,9.Transfer of
or traffic law violations arising out of age provided by this endorsement. Rights of Recovery Against Others to
2) You drained the equip- the use of any vehicle to which the These limits are inclusive of and not Us is hereby amended by the addition of
meet and shut off the Bodily Injury Liability Coverage ap-
water supply if the heat plies. We do not have to fumish in addition to the limits being re- the following:
was not maintained. these bonds. placed. The Limits of Insurance
shown in Section B.Limits of Insur- We waive any right of recovery we may
(d) Loss to or damage to: b. Paragraph 4. is replaced by the fol- ance, 6.Voluntary Property Dam- have because of payments we make for
lowing: age and Care,Custody or Control injury or damage arising out of your ongo-
1) Plumbing, heating, air Liability Coverage of this endorse- ing operations or"your work"done under
conditioning, fire pro- All reasonable expenses incurred by ment fix the most we will pay in any a written contract requiring such waiver
tedion systems, or the insured at our request to assist us one "occurrence"regardless of the with that person or organization and in-
other equipment or ap- in the investigation or defense of the number of eluded in the"products-completed opera-
pliances;or claim or"suit',including actual loss of tions hazard". However, our rights may
earnings up to the limit shown in Sec- (1) Insureds; only be waived prior to the"occurrence"
2) The interior of any Lion B. Limits of Insurance. 4.b. giving rise to the injury or damage for
building or structure,or Loss of Earnings of this endorsement (2) Claims made or"suit 'brought; which we make payment under this Cov-
to personal property in per day because of time off from or erage Part.The insured must do nothing
the building or structure „ork after a loss to impair our rights.At our re-
caused by or resulting (3) Persons or organizations making quest,the insured will bring"suit'or trans-
from rain, snow, sleet 5. Medical Payments claims or bringing"suits'. for those rights to us and help us enforce
or ice, whether driven b. Deductible Clause those rights.
by wind or not The Medical Expense Limit of Any One
Person as stated in the Declarations is (1) Our obligation to pay damages 9. Automatic Additional Insured -Speci-
c. Limit of Insurance amended to the limit shown in Section B. on your behalf applies only to the Pied Relationships
Limits of Insurance, 5. Medical Pay- amount of damages for each
The Damage to Premises Rented to ments of this endorsement. "occurrence"which are in excess a. The following is hereby added to
You Limit as shown in the Declare-
of the deductible amount staled SECTION II-WHO IS AN INSURED:
lions is amended as follows: 6. Voluntary Property Damage and Care,
in Section B.Limits of staled
Custody or Control Liability Coverage (1) Any person or organization de-
(2) Paragraph 6. of SECTION III - ance, 6. Voluntary Property scribed in Paragraph 9.a.(2)be-
LIMITS OF INSURANCE is a. Voluntary Property Damage Cov- Damage and Care,Custody or low (hereinafter referred to as
hereby deleted and replaced by erage Control Liability Coverage of additional insured)whom you are
the following: this endorsement. The limits of required to add as an additional
We will pay for"property damage"to insurance will not be reduced by
6. Subject to 5. above, the property of others arising out of op- the application of such deducti- insured under this Coverage Part
Damage to Premises erations incidental to the insured's Po by reason of:
ble amount.
Rented to You Limit is the business when: (a) A written contract or agree-
most we will pay under (2) Condition 2.Duties in the Event ment;or
COVERAGE A. BODILY (1) Damage is caused by the in- of Occurrence,Offense,Claim
INJURY AND PROPERTY sired;or or Suit,applies to each claim or (b) An oral agreement or con-
DAMAGE LIABILITY, for (2) Damage occurs while in the in- "suit"irrespective of the amount. tract where a certificate of
damages because of"prop- insurance showing that per-
sured's possession. (3) We may pay any part or all of the
erty damage" to premises O y p y y p son or organization as an
while rented to you or tern- With your consent, we will make deductible amount to effect set- additional insured has been
porarily occupied by you these payments regardless of fault. llemenl of any claim or "suit" issued,
with permission of the and,upon odification of the ac-
owner, arising out of any lion taken,you shall promptly re- is an insured,provided:
imburse us for such part of the
Includes copyrighted material of Insurance Includes copyrighted material of Insurance
GA 233 OR 09 10 Services Office,Inc.,with its permission. Page 9 of 16 GA 233 OR 09 10 Services Office,Inc.,with its permission. Page 10 of 16
(a) The written or oral contract or use of equipment leased e) Any failure to Part with respect
or agreement is to you by such person(s)or make such inspec- to such products.
organizaticns(s). However, lions,adjustments,
1) Currently in effect or (d)insurance does not ap- tests or servicing Any state or political subdi-
becomes effective dur- vision with which you have
inn the policy period; ply to any "occurrence" as the vendor has agreed per Paragraph
which takes place after the agreed to make or
and equipment lease expires. normally under- 9 .( )above
subject t provide
o the fin-
2) Executed prior to an takes to make in
(c) Any person or organization the usual course of lowing additional provision:
"occurrence"or offense (referred to below as ven-
to which this insurance ( business, in con- applies y
dor) with whom you have This insurance a lies onl
would apply;and agreed per Paragraph nedion with the with respect to the following
9.a.
agreed
above to provide in- distribution or sale hazards for which the state
(b) They are not specifically ( ) P of the products; or political subdivision has
named as an additional in- surance, but only with re-
sued under an other pro- sped to "bodily injury' or f) Demonstration, in-
issued a permit in connec-
vision 'property damage" arising stallation,servicing lion with premises you own,
vision of, or endorsement out of"your products"which or repair opera- rent or control and to which
added to, this Coverage
Part are distributed or sold in the lions, except such this insurance applies:
regular course of the wen- operations per- 1) The existence, mainte-
(2) Only the following persons or or- dots business, subject to formed at the ven- nance,repair,censtruc-
ganizations are additional insur- the following additional ex- dors premises in lion, erection, or re-
edsunder this endorsement,and elusions: connection with moval of advertising •
insurance coverage provided to the sale of the awnings, cano-
such additional insureds is lim- 1) The insurance afforded product;roduct;
fled as provided herein: the vendor does not coal holes cellar driveways,
apply to: g) Products which, manholes, marquees,
(a) The manager or lessor of a after distribution or
a) injury" or
premises lease to you with ) "Bdil jury sale by you, have hoist away openings,
whom you have agreed per "property damage" been labeled or re- sidewalk vaults, street
for which the wen- banners,or decorations
Paragraph insurance,above only dor is obligated to labeled or ,part a r and similar exposures;
provide insurance, but only g a container,part or
with respect to liability iris- pay damages by ingredient of any or
Mg out of the ownership, reason of the as- other thing or sub- 2) The construction,erec-
maintenance or use of that sumption of liability stance by or for
part of a premises leased to in a contract or the vendor;or lion,s ror removal of ale-
you,subject to the following agreement. This
additional exclusions: exdusion does not h) 'Bodily injury" or 3) The ownership, main-
apply to liability for "property damage" tenance, or use of any
This insurance does not ap- damages that the arising out of the elevators covered by
ply to: vendor would have negligence,acts or this insurance.
in the absence of omissions of the
1) Any"occurrence"which the contract or vendor, its em- (e) Any state or political subdi-
lakes place after you agreement; ployees or anyone vision with which you have
cease to be a tenant in else acting on its agreed per Paragraph
that premises. b) Any express war- behalf. 9.a.(1)above to provide in-
2 Slmctural alterations, ranly unauthorized skrance, subject to the fol-
by you; 2) This insurance does not lowing provisions:
new construction or apply to any insured
demolition operations c) Any physical or person or organization: 1) This insurance applies
performed by or on be- chemical change only with respect to op-
half of such additional in the product a) From whom you erations performed by
insured. made intentionally have acquired you or on your behalf
b Any person or organization by the vendor; such products, or for which the state or
(b) Y P 9 any ingredient, political subdivision has
from which you lease d) Repackaging, ex- part or container,
equipment with whom you cept when un- a issued a permit.
Y P entering into, ac-
have agreed per Paragraph packed solely for companying or 2) This insurance does not
9.a.(1)above to provide in- the purpose of in- containing such apply to"bodily injury",
surance.Such person(s)or spedion, demon- products;or "property damage" or
organization(s)are insureds, stralion,testing,or "personal and advertis-
but only to the extent that the substitution of b) When liability in- ing injury"arising out of
the liability for'bodily injury", parts under in- eluded within the operations performed
"property damage"or"per- strudions from the "products- for the state or political
sonar and advertising injury" manufacturer, and completed opera- subdivision,
is caused by your negh- then repackaged lions hazard" has
gence,acts or omissions in in the original con- been excluded un- (f) For "your work" performed
the maintenance, operation tainer; der this Coverage in Oregon, any person or
Includes copyrighted material of Insurance Includes copyrighted material of Insurance
GA 233 OR 09 10 Services Office,Inc.,with its permission. Page 11 of 16 GA 233 OR 09 10 Services Office,Inc.,with its permission. Page 12 of 16
organization with which you (a) Subparagraphs (e), (f) and chitectural or engi- primary to other insurance
have agreed per Paragraph (g)do not apply to"bodily in- neering activities. available to the additional
9.a.(1)above to provide in- jury' or "property damage" insured except:
surance,but only to the ex- included within the "prod- 3) Professional services
tent that the liability is ucts-completed operations do not indude services 1) As otherwise provided
caused by"your wort('per- hazard'; within construction in SECTION IV
formed for that additional in- means, methods, tech- COMMERCIAL GEN-
sured and only to the extent (b) Subparagraphs (a), (d), (e) niques, sequences and ERAL LIABILITY
that such liability is caused and(g)do not apply to"bod- procedures employed CONDITIONS, 5.
by your negligence or the ily injury", 'property dam- by you in connection Other Insurance, b.
negligence of those acting age" or "personal and ad- with construction work Excess Insurance;or
on your behalf.A person or vertising injury' arising out you perform. 2) For any other valid and
organization's status as an of the sae negligence or (d) Subparagraphs (f) and (g) collectible insurance
insured under this provision willful misconduct of the ad-
P do not apply to "bodily in- available to the addi-
u this only the period riodtiof dilional insured or its "em-
ployees";or jury' or "property damage" tional insured as an ad-
arising for only the period of arising out of"your work"for ditional insured by at-
time required by the written (c) Subparagraph(f)and(g)do which a consolidated(wrap- tadiment of an en-
contract or agreement, but not apply to "bodily injury", up) insurance program has dorsement to another
in no event beyond the expi- "property damage" or "per- been provided by the prime insurance policy that is
ration date of this Coverage sonal and advertising injury" contractor/project manager written on an excess
Part. If there is no written arising out of: or owner of the construction basis.In such case,the
contract or agreement,or if project in which you are in- coverage provided un-
no period of time is required 1) The rendering of, or volved. der this endorsement
by the written contract or failure to render, any shall also be excess.
agreement, a person or or- professional services b. Only with regard to insurance pro-
ganization's status as an in- by you or on your be- vided to an additional insured desig- (2) Condition 11. Conformance to
sured under this endorse- half, but only with re- nated under Paragraph 9.a.(2)Sub- Specific Written Contract or
ment ends when your op- sped to either or both paragraphs(f)and(g)above,SEC- Agreement is hereby added:
erations for that insured are of the following opera- TION III-LIMITS OF INSURANCE is
completed. lions: amended to include: 11. Conformance to Specific
Written Contract or
(g) For "your work" performed a) Providing engi- The limits applicable to the additional Agreement
in the "coverage territory" nearing, architec- insured are those specified in the
but not in Oregon,any per- tural or surveying written contract or agreement or in a. Willi respect to addi-
son or organization with services to others; the Declarations of this Coverage tional insureds de-
which you have agreed per and Part,whichever are less. If no limits scribed in Paragraph
Paragraph 9.a.(1) above to are speafied in the written contract or 9.a.(2)(f)above only:
provide insurance, but only b) Providing,or hiring agreement, or if there is no written
with respect to liability ads- independent pro- contract or agreement,the limits ap- ag agreement contract
between
ing out of"your work" per- fessionals to pro- livable to the additional insured are
g P� vide, engineering, P you and the additional
formed for that additional in- those specified in the Declarations of insured species that
sured by you or on your be- architectural or this Coverage Part.The limits of in- coverage for the addi-
half. A or erson organize- surveying services surance are inclusive of and not in
P g in connection with tional insured:
lion's status as an insured addition to the limits of insurance
under this provision of this construction work shown in the Declarations. (1) Be provided by the
endorsement continues for you perform. Insurance Ser-
only the period of time re- 2 Subject to Paragraph ra h 3 c. SECTION IV-COMMERCIAL GEN- vices Office addi-
quired by the written con- ) g P 3) ERAL LIABILITY CONDITIONS is
tract or agreement,the wr but in no below, professional hereby amended as follows: tional insured form
services include: y number CG 32 61,
event beyond the expiration (1) Condition 5.Other Insurance is CG 32 62 or CG
date of this Coverage Part. a) Preparing,approv- amended to include: 32 63;or
If there is no written contract ing, or failing to
or agreement,or if no period prepare or ap- (a) Where required by a written (2) Include coverage
of time is required by the prove,maps,shop contract or agreement, this for completed op-
written contract or agree- drawings, opin- insurance is primary and/or erations;or
ment,a person or organiza- ions, reports, sur- noncontributory as respects (3) Include coverage
lion's status as an insured veys, field orders, any other insurance policy for"your work";
under this endorsement change orders, or issued to the additional in-
ends when your operations drawings and sured, and such other in- and where the limits or
for that insured are com- specifications;and surance policy shall be ex- coverage provided to
pleted. cess and/or noncontdbut- the additional insured is
b) Supervisory or in- ing,whichever applies, with more restrictive than
(3) Any insurance provided to an spedion activities this insurance. was speafically re-
additional insured designated performed as part quired in that written
under Paragraph 9.e.(2): of any related ar- (b) Any insurance provided by contract or agreement,
this endorsement shall be the terms of Para-
Includes copyrighted material of Insurance Includes copyrighted material of Insurance
GA 233 OR 09 10 Services Office,Inc.,with its permission. Page 13 of 16 GA 233 OR 09 10 Services Office,Inc.,with its permission. Page 14 of 16
S.
graphs 9.a.(3)(a)or 9.b. agreement specifies (2) Deductible Clause a. Nurses;
above,or any combina- the Insurance Services
lion thereof,shall be in- Office additional in- (a) Our obligation to pay dam- b. Emergency Medical Technicians;or
terpreted as providing sured form number CG ages on your behalf applies c. Paramedics,
the limits or coverage 20 10 but does not only to the amount of dam-
required by the terms of specify which edition,or ages for each "occurrence" in the jurisdiction where an"occurrence"
the written contract or specifies an edition that which are in excess of the or offense to which this insurance applies
agreement, but only to does not exist, Para- Deductible amount staled in takes place.
the extent that such lim- graphs 9.a.3.b. and Section B.Limits of Insur-
ts or coverage is in- 9.b. of this endorse- ance. 11. of this endorse- 13. Broadened Notice of Occurrence
ment. The limits of inuu-
cluded within the terms ment shall not apply Paragraph a.of Condition 2. Duties in anoe will not be reduced by
of the Coverage Part to and Paragraph the application of such De- the Event of Occurrence, Offense,
which this endorsement 9.a.(3)(a) of this en- ductible amount. Claim or Suit(SECTION IV-COMMER-
is attached. dorsement shall apply. CIAL GENERAL LIABILITY CONDI-
b. With respect to addi- 10. Broadened Contractual Liability-Work (b) Condition 2. Duties in the TIONS)is hereby deleted and replaced by
tional insureds de- Within 50'of Railroad Property Event of Occurrence, Of- the following.
scribed in Paragraph fense, Claim or Suit, ap-
9.a.2 above only: It is hereby agreed that Paragraph f.(1)of plies to each claim or"suit" a. You must see to it that we are notified
( )(g) y: as soon as practicable of an"occur-
Definition 12. "Insured contract" (SEC- irrespective of the amount.
If a written contract or TION V-DEFINITIONS)is deleted. Fence"or an offense which may result
agreement between (c) We may pay any part or all in a claim.To the extent possible,no-
you and the additional 11. Property Damage to Borrowed Equip- of the deductible amount to tice should include:
ment effect settlement of any
insured specifies that claim or"suit"and,upon no- (1) How,when and where the "oc-
coverage for the addi- a. The following is hereby added to Ex- tification of the action taken, currence"or offense took place;
tional insured: clusion j. Damage to Property of you shall promptly reim- (2) The names and addresses of
a. Be provided by the Paragraph 2., Exclusions of SEC- burse us for such part of the ( )
Insurance Ser- TION I-COVERAGES,COVERAGE deductible amount as has any injured persons and wit-
vices Office addi- A. BODILY INJURY AND PROP- been paid by us. nesses;and
ERTY DAMAGE LIABILITY:
tional insured form (3) The nature and location of any
12. Employees as Insureds - Specified
number CG 20 10 Paragraphs 3 and 4 of this exdu- p injury or damage arising out of
or CG 20 37 (3) (4) Health Care Services the"occurrence"or offense.
Sion do not apply to tools or equip-
(where edition ment loaned to you,provided they are It is hereby agreed that Paragraph
specified);or not being used to perform operations 2.a.1 d of SECTION II-WHO IS AN This requirement applies only when
g p °p ( )( ) the"occurrence"or offense is known
at the time of loss. INSURED, does not apply to your"em-
b. Include coverage to an"authorized representative".
for completed op- b. With respect to the insurance pro- care services who provide professional health
e p care services on your behalf as duly It-
erations;or
sided by this section of the endorse- tensed:
c. Include coverage ment, the following additional provi-
for"your work"; sions apply
and where the limits or (1) The Limits of insurance shown in
coverage provided to the Declarations are replaced by
the additional insured is the limits designated in Section
more restrictive than B. Limits of Insurance, 11.of
was specifically re- this endorsement with respect to
quired in that written mcoverage provided by this en-
contract or agreement,
dorsement.These limits are in-
the terms of Para- elusive of and not in addition to
graphs 9.a.(3)(a), the limits being replaced. The
9.a.(3)(b)or 9.b.above, Limits of Insurance shown in
or any combination Section B.Limits of Insurance,
thereof, shall be inter- 11. of this endorsement fix the
preted as providing the most we will pay in any one"oc-
limits or coverage re- currence" regardless of the
quired by the terms of number of:
the written contract or (a) Insureds;
agreement, but only to
the extent that such lim- (b) Claims made or "suits"
its or coverage is in- brought;or
cluded within the terms
of the Coverage Part to (c) Persons or organizations
which this endorsement making claims or bring
is attached.If,however, "suits".
the written contract or
Includes copyrighted material of Insurance Includes copyrighted material of Insurance
GA 233 OR 09 10 Services Office,Inc.,with its permission. Page 15 of 16 GA 233 OR 09 10 Services Office,Inc..with its permission. Page 16 of 16
THIS ENDORSEMENT CHANGES THE POLICY.PLEASE READ IT CAREFULLY. However, any "auto" that is leased, a. Is effective on the date of acquisition
hired,rented or borrowed with a driver or formation,and is afforded for 180
is not a covered"auto". days after such date;
CinciPlus° E. Audio, Visual and Data Electronic Equip- b. Does not apply to "bodily
BUSINESS AUTO XC+® merit "property damage"resulting an
"accident" that occurred before you
(EXPANDED COVERAGE PLUS) SECTION III - PHYSICAL DAMAGE COV- acquired or formed the organization;
ERAGE, C. Limit of Insurance is amended
ENDORSEMENT by adding the following: c. Does not apply to any newly acquired
or formed organization that is a joint
4. The most we will pay for all"loss"to au- venture or partnership;and
dio, visual or data electronic equipment
This endorsement modifies insurance provided by the following: and any accessories used with this d. Does not apply to an insured under
equipment as a result of any one "acci- any other automobile liability policy,
BUSINESS AUTO COVERAGE FORM dent"is the lesser of: or would be an insured under such a
a. The actual cash value of the dam- policy but for the termination of such
aged or stolen property as of the time policy of the exhaustion of such poli-
With respect to the coverage provided by this endorsement,the provisions of the Coverage Form apply unless of the"accident'; cy's limits of insurance.
modified by this endorsement. 3. Any of your "employees" while using a
b. The cost of repairing or replacing the covered "auto" in your business or your
A. Blanket Waiver of Subrogation This provision does not apply unless the valid damaged or stolen property with oth- personal affairs,provided you do not own,
SECTION IV - BUSINESS AUTO CONDI- written contract has been: er property of like kind and quality;or hire or borrow that"auto".
$2
TIONS,A. Loss Conditions, 5.Transfer of 1. Executed prior to the accident causing c.
$2,500. G. Liability Coverage Extensions - Supple-
Rights of Recovery Against Others to Us is "bodily injury'or"property damage":and Provided the equipment,at the time of the mentary Payments-Higher Limits
amended by the addition of the following: "loss"is:
2. Is still in force at the time of the"accident" SECTION II - LIABILITY COVERAGE, A.
We waive any right of recovery we may have causing "bodily injury" or "property dam- a. Permanently installed in or upon the Coverage,2.Coverage Extensions,a.Sup-
against any person or organization because of age". covered"auto"in a housing,opening plementary Payments is amended by:
payments we make for "bodily injury" or or other location that is not normally
"property dama e"arising out of the operation D. Employee Hired Auto 1. for bail Replacing the with$0 Limit o)Insurance
9 9 P used by the "auto" manufacturer for for bail bonds with$4,000 in(2);and
of a covered"auto"when you have assumed 1. Changes in Liability Coverage the installation of such equipment;
liability for such "bodily injury" or "property 2. Replacing the$250 Limit of Insurance for
damage"under an"insured contract", provid- The following is added to the Section II- b. Removable from a permanently in- reasonable expenses with$500 in(4).
ed the"bodily injury"or"property damage"oc- Liability Coverage, A. Coverage, 1. stalled housing unit as described in
curs subsequent to the execution or the "in- Who is an Insured: Paragraph 2.a.above;or H. Amended Fellow Employee Exclusion
shred contract". c. An integral part of such equipment. SECTION II-LIABILITY COVERAGE,B.Ex-
An "employee" of yours is an "insured" 9 P
B. Noncontributory Insurance while operating an"auto" hired or rented F. Who is an Insured-Amended follow ns,5.Fellow Employee is modified as
under a contract or agreement in that follows:
SECTION IV - BUSINESS AUTO CONDI- "employee's"name,with your permission, SECTION II - LIABILITY COVERAGE, A. Exclusion 5.Fellow Employee is deleted.
TIONS,B.General Conditions,5.Other In- while performing duties related to the Coverage,1.Who is an Insured is amended
surance c.is replaced by the following: conduct of your business. by adding the following: I. Hired Auto-Physical Damage
c. Regardless of the provisions of Par- 2. Changes in General Conditions The following are"insureds": If hired"autos"are covered"autos"for Liability
agraph a. above, this Coverage Coverage, then Comprehensive and Collision
Form's Liability Coverage is primary SECTION IV - BUSINESS AUTO CON- 1. Any subsidiary which is a legally incorpo- Physical Damage Coverages as provided un-
and we will not seek contribution DITIONS, B. General Conditions, 5. rated entity of which you own a financial der SECTION III - PHYSICAL DAMAGE
from any other insurance for any ha- Other Insurance is amended by replac- interest of more than 50% of the voting COVERAGE of this Coverage Part are ex-
bility assumed under an "insured ing Paragraph 5.b.with the following: stock on the effective date of this cover- tended to"autos"you hire, subject to the fol-
contract" that requires liability to be age form. lowing:
assumed on a primary noncontributo-
ry b. For Hired Auto Physical Damage g 9
Coverage the following are deemed However, the insurance afforded by this
basis. g g Y 1. The most we will pay for "loss" to any
to be covered"autos"you own: provision does not apply to any subsidiary hired"auto"is$50,000 or the actual cash
C. Additional Insured by Contract that is an "insured"under any other au- value or cost to repair or re
(1) Any covered "auto" you lease. tomobile liability policy, or would be an replace,which-
(1)II - LIABILITY COVERAGE, A. hire,rent or borrow;and y P Y ever is the least,mi nus a deductible.
"
Coverage,I.Who is an Insured is amended insured"under such policy but for fermi-
to include as an insured any person or organi- (2) Any covered "auto" hired or nation of such policy or the exhaustion of 2. The deductible will be equal to the largest
zation with which you have agreed in a valid rented by your"employee"under such policy's limits of insurance. deductible applicable to any owned"auto"
a contract in that individual"em_ for that coverage,or$1,000,whichever is
written contract to provide insurance as is af- to ee's" name, with your per- 2. Any organization that is newly acquired or less.
forded by this policy. p y Y P formed by you and over which you main-
mission,while performing duties fain majority ownership. The insurance 3. Hired Auto-Physical Damage coverage
This provision is limited to the scope of the related to the conduct of your provided by this provision: is excess over any other collectible insur-
valid written contract. business. ance.
Includes copyrighted material of ISO Includes copyrighted material of ISO
AA 288 01 16 Properties,Inc.,with its permission. Page 1 of 4 AA 288 01 16 Properties,Inc.,with its permission. Page 2 of 4
A
4. Subject to the above limit,deductible,and K. Transportation Expense-Higher Limits 2. SECTION V-DEFINITIONS is amended P. Unintentional Failure to Disclose Hazards
excess provisions we will provide cover- by adding the following, but only for the
age equal to the broadest coverage appli- SECTION III - PHYSICAL DAMAGE COV- purposes of this Loan or Lease Gap SECTION IV - BUSINESS AUTO CONDI-
cable to any covered"auto"you own in- ERAGE, A. Coverage, 4. Coverage Exten- Coverage: TIONS,B. General Conditions,2. Conceal-
sured under this policy. sions is amended by replacing $20 per day ment, Misrepresentation or Fraud is
with $50 per day, and $600 maximum with "Total loss" means a "loss"in which the amended by adding the following:
Coverage includes loss of use of that hired au- $1,500 maximum in Extension a.Transpor- cost of repairs plus the salvage value ex-
to, provided it results from an "accident" for tation Expenses. ceeds the actual cash value. However, if you unintentionally fail to disclose
which you are legally liable and as a result of any hazards existing on the effective date of
which a monetary loss is sustained by the L. Airbag Coverage N. Glass Repair-Waiver of Deductible this Coverage Form, we will not deny cover-
leasing or rental concern. The most we will SECTION III - PHYSICAL DAMAGE COV- SECTION III - PHYSICAL DAMAGE COV- age under this Coverage Form because of
a for any one"accident"is$3,000. such failure.
pay Y ERAGE,B. Exclusions, 3.a. is amended by ERAGE,D.Deductible is amended by adding
If a limit for Hired Auto-Physical Damage is adding the following: the following: Q. Mental Anguish Resulting from Bodily Inju-
shown in the Schedule,then that limit re lac- ry
P However, the mechanical and electrical No deductible applies to glass damage if the
es,and is not added to,the$50,000 limit indi- breakdown portion of this exclusion does not glass is repaired in a manner acceptable to us SECTION V-DEFINITIONS,C."Bodily inju-
cated above. apply to the accidental discharge of an airbag. rather than replaced. ry" is deleted in its entirety and replaced by
J. Rental Reimbursement This coverage for airbags is excess over any the following:
other collectible insurance or warranty. O. Duties in the Event of an Accident,Claim,
SECTION III - PHYSICAL DAMAGE is Suit or Loss-Amended "Bodily injury"means bodily injury,sickness or
M.M Loan or Lease Gap Coverage disease sustained by a person,including men-
amended by adding the following: SECTION IV - BUSINESS AUTO CONDI-
1. SECTION III - PHYSICAL DAMAGE TIONS,A.Loss Conditions,2.Duties in the tat anguish and death sustained by the same
1. We will pay for rental reimbursement ex- person that results from such bodily injury,
penses incurred by you for the rental of COVERAGE, C. Limit of Insurance is Event of Accident,Claim,Suit or Loss,a.is sickness or disease. "Bodily injury"does not
an"auto"because of a"loss"to a covered deleted in its entirety and replaced by the amended by adding the following: include mental anguish or death that does not
following, but only for private passenger result from bodily injury,sickness or disease.
"auto".Payment applies in addition to the This condition applies only when the acci-
otherwise applicable amount of each coy- type"autos"the an event of loan or lease, dent"or"loss"is known to:
erage you have on a covered"auto".No and only in the event of a "total loss"to R. Coverage for Certain Operations in Con-
deductible applies to this coverage. such a private passenger type"auto": 1. You,if you are an individual; nection with Railroads
2. We will pay only for those expenses in- a. The most we will pay for"loss"in any 2. A partner,if you are a partnership; With respect to the use of a covered"auto"in
curved during the policy period beginning one"accident"is the greater of: operations for or affecting a railroad:
3. An executive officer or insurance manag-
24 hours after the"loss"and ending, re- (1) The amount due under the terms er,if you are a corporation;or 1. Section V-Definitions,H."Insured con-
gardless of the policy's expiration, with of the lease or loan to which tract",1.c.is amended to read:
the lesser of the following number of your covered private passenger 4. A member or manager, if you are a lirn-
days: type"auto"is subject,but will not ited liability company. c. An easement or license agreement;
a. The number of days reasonably re- include: 2. Section V-Definitions,H."Insured con-
quired to repair the covered"auto".If (a) Overdue lease or loan pay- tract",2.a.is deleted.
"loss"is caused by theft,this number ments;
of days is added to the number of
days it takes to locate the covered (b) Financial penalties imposed
"auto"and return it to you;or under the lease due to high
b. 30 days. mileage, excessive use or
Y abnormal wear and tear;
3. Our payment is limited to the lesser of the (c) Security deposits not re-
following amounts: funded by the lessor;
a. Necessary and actual expenses in- (d) Costs for extended warran-
curred;or ties, Credit Life Insurance,
b. $50 per day. Health,Accident or Disabil-
ity Insurance purchased
4. This coverage does not apply while there with the loan or lease;and
are spare or reserve"autos"available to
you for your operations. (e) Carry-over balances from
previous loans or leases,or
5. We will pay under this coverage only that
amount of your rental reimbursement ex- (2) Actual cash value of the stolen
penses which is not already provided for or damaged property.
under SECTION III - PHYSICAL DAM- b. An adjustment for depreciation and
AGE COVERAGE, A. Coverage, 4. physical condition will be made in de-
Coverage Extensions. termining actual cash value at the
time of"loss".
Includes copyrighted material of ISO Includes copyrighted material of ISO
AA 288 01 16 Properties,Inc.,with its permission. Page 3 of 4 AA 288 01 16 Properties,Inc..with its permission. Page 4 of 4