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HomeMy WebLinkAboutInsurance Certificate: Bear Creek Lock & Safe, Inc (2) ADO o® CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) 4/29/2019 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Dianna Sealy-Gipner NAME: Redwoods Leavitt Insurance Agency INCNNo.Exn: (541)479-2667 FAX Redwoods 122 NE Beacon Dr. E-MAIL ADDRESS: dianna-sealygipner@leavitt.com INSURER(S) AFFORDING COVERAGE NAIC# Grants Pass OR 97526 INSURERA:UNIFI Group 11121 INSURED INSURER B:SAIF Corporation 36196 Bear Creek Lock & Safe, Inc. INSURERC: 1650 Ashland St. INSURERD: INSURER E: Ashland OR 97520 INSURERF: — COVERAGES CERTIFICATE NUMBER:19-20 GL,AU,WC 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 (MM/DD/YYYY) IMM/DD/YYYY) X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE A CLAIMS-MADE X OCCUR PREMISES O(Ea occurrrrence) 100,000 60492399 5/24/2019 5/24/2020 MED EXP(Any one person) $ 5,000 PERSONAL &ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ 2,000,000 X POLICY PRO- JECT LOC PRODUCTS-COMP/OPAGG $ 2,000,000 - OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 (Ea accident) X ANY AUTO BODILY INJURY(Per person) $ A ALL OWNED SCHEDULED AUTOS AUTOS 60492399 5/24/2019 5/24/2020 BODILY INJURY(Per accident) $ NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS _ AUTOS Uninsured motorist BI-single limit $ 1,000,000 UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE _ $ I DED RETENTION $ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY I STATUTE ER YIN ANY PROPRIETOR/PARTNER/EXECUTIVE NIA E.L.EACH ACCIDENT $ 500,000 OFFICER/MEMBER EXCLUDED? B (Mandatory in NH) 496215 4/1/2019 4/1/2020 E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Certificate holder is additional insured in respect to commercial auto liability per form CA7109 0117 General Liability additional insured, Primary including completed operations and Waiver of Subrogation per form CG201OR 12/11, General Aggregate applies per project per form CG2503, Waiver of Subrogation for workers compensation applies per endorsement WC000313 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Ashland THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN 20 East Main Street ACCORDANCE WITH THE POLICY PROVISIONS. Ashland, OR 97520 AUTHORIZED REPRESENTATIVE �/ D Sealy-Gipner/DISEAL ,aCJl.oc�i ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD INS025(201401) • POLICY NUMBER: CG 20 1OR 12 11 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS (WITH LIMITED COMPLETED OPERATIONS COVERAGE) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART BUSINESSOWNERS COVERAGE FORM SCHEDULE NAME OF PERSON OR ORGANIZATION the qualifying language above because of Any person or organization to whom or to which payments we make for injury. the named insured is obligated by a virtue of a written contract to provide insurance that is LOCATION OF JOB: afforded by this policy. Where required by The job location must be within the State of contract, the officers, officials, employees, domicile of the named insured, or within any directors, subsidiaries, partners, successors, contiguous State thereto. parents, divisions, architects, surveyors and engineers are included as additional insureds. DESCRIPTION OF WORK: All other entities, including but not limited to The type of work performed must be that as agents, volunteers, servants, members and described under classifications in the CGL partnerships are included as additional insureds, Coverage Part Declarations. if required by contract, only when acting within the course and scope of their duties controlled and supervised by the primary (first) additional insured. If an Owner Controlled Insurance Program is involved, the coverage applies to off- PRIMARY CLAUSE: site operations only. If the purpose of this When this endorsement applies and when endorsement is for bid purposes only, then no required by written contract, such insurance as coverage applies. is afforded by the general liability policy is primary insurance and other insurance shall be WHO IS AN INSURED: (Section II) excess and shall not contribute to the insurance This section is amended to include as an afforded by this endorsement. insured the person or organization within the scope of the qualifying language above, but only EXCLUSION to the extent that the person or organization is This insurance provided to the additional insured held liable for your acts or omissions in the does not apply to "bodily injury", "property course of "your work" .for that person or damage" or "personal and advertising injury" organization by or for you. The "products- arising out of an architect's, engineer's or completed operations hazard" portion of the surveyor's rendering or failure to render any policy coverage as respects the additional professional services, including: insured does not apply to any work involving or 1. The preparing, approving, or failing to related to properties intended for residential or prepare or approve, maps, designs, habitational occupancy (other than apartments). shop drawings, opinions, reports, This clause does not affect the "products- surveys, field orders, change orders, or completed operations" coverage provided to the drawings and specifications; and named insured(s). 2. Supervisory, inspection, architectural or engineering activities. WAIVER OF SUBROGATION: We waive any right of recovery, when required Endorsement EFFECTIVE DATE: SEE DEC by written contract, that we may have against the person or organization within the scope of Endorsement EXPIRATION DATE: SEE DEC CG 20 101112 11 Page 1 of 1 Includes copyrighted material of Insurance Services Office,Inc.,with its permission www.saif.com sai Fcorpora t i on Carrier No: 20001 Endorsement No: WC000313 Policy No: 496215 Agency: BEAR CREEK LOCK & SAFE INC REDWOODS LEAVITT INS (GRANTS PASS) 1650 ASHLAND ST Redwoods Leavitt Ins Agency ASHLAND, OR 97520-2327 122 NE BEACON DR GRANTS PASS, OR 97526 Waiver of Our Right to Recover From Others Endorsement We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. Schedule Description: ALL OPERATIONS Contractor Name: PERSONS AND/OR ORGANIZATIONS WITH WHOM THE INSURED-EMPLOYER IS REQUIRED BY WRITTEN CONTRACT TO WAIVE SUBROGATION RIGHTS This endorsement does not alter the rights of an injured worker to pursue recovery from another party or SAIF to receive a statutory share of recoveries by an injured worker, even from the party listed in the schedule. The premium charge for this endorsement is based on one (1) percent of your manual premium. Effective Date: 04-01-2019 This endorsement is part of your policy. This endorsement amends and controls anything to the contrary. It is otherwise subject to all other terms of your policy. Countersigned 02-25-2019 at Salem, Oregon )(g)430b Kerry arnett, President and Chief Executive Officer 400 High St SE I Salem,OR 97312 I P: 800.285.8525 POLICY NUMBER: COMMERCIAL GENERAL LIABILITY CG 25 03 05 09 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED CONSTRUCTION PROJECT(S) GENERAL AGGREGATE LIMIT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Designated Construction Project(s): IF REQUIRED BY WRITTEN CONTRACT Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. For all sums which the insured becomes legally 3. Any payments made under Coverage A for obligated to pay as damages caused by damages or under Coverage C for medical "occurrences" under Section I —Coverage A, and for expenses shall reduce the Designated all medical expenses caused by accidents under Construction Project General Aggregate Limit Section I — Coverage C, which can be attributed for that designated construction project. Such only to ongoing operations at a single designated payments shall not reduce the General construction project shown in the Schedule above: Aggregate Limit shown in the Declarations nor 1. A separate Designated Construction Project shall they reduce any other Designated General Aggregate Limit applies to each Construction Project General Aggregate Limit designated construction project, and that limit is for any other designated construction project equal to the amount of the General Aggregate shown in the Schedule above. Limit shown in the Declarations. 4. The limits shown in the Declarations for Each 2. The Designated Construction Project General Occurrence, Damage To Premises Rented To Aggregate Limit is the most we will pay for the You and Medical Expense continue to apply. sum of all damages under Coverage A, except However, instead of being subject to the damages because of "bodily injury " or "property General Aggregate Limit shown in the damage" included in the "products-completed Declarations, such limits will be subject to the operations hazard", and for medical expenses applicable Designated Construction Project under Coverage C regardless of the number of: General Aggregate Limit. a. Insureds; b. Claims made or"suits" brought; or c. Persons or organizations making claims or bringing "suits". CG 25 03 05 09 © Insurance Services Office, Inc., 2008 Page 1 of 2 CG 25 03 05 09 B. For all sums which the insured becomes legally C. When coverage for liability arising out of the obligated to pay as damages caused by "products-completed operations hazard" is provided, "occurrences" under Section I —Coverage A, and for any payments for damages because of "bodily all medical expenses caused by accidents under injury" or "property damage" included in the Section I — Coverage C, which cannot be attributed "products-completed operations hazard" will reduce only to ongoing operations at a single designated the Products-completed Operations Aggregate construction project shown in the Schedule above: Limit, and not reduce the General Aggregate Limit nor the Designated Construction Project General 1. Any payments made under Coverage A for Aggregate Limit. damages or under Coverage C for medical expenses shall reduce the amount available D. If the applicable designated construction project has under the General Aggregate Limit or the been abandoned, delayed, or abandoned and then Products-completed Operations Aggregate restarted, or if the authorized contracting parties Limit, whichever is applicable; and deviate from plans, blueprints, designs, specifications or timetables, the project will still be 2. Such payments shall not reduce any Designated deemed to be the same construction project. Construction Project General Aggregate Limit. E. The provisions of Section III — Limits Of Insurance not otherwise modified by this endorsement shall continue to apply as stipulated. CG 25 03 05 09 © Insurance Services Office, Inc., 2008 Page 2 of 2 COMMERCIAL AUTO CA 71 09 01 17 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BUSINESS AUTO ULTRA ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM COMMON POLICY CONDITIONS COVERAGE INDEX DESCRIPTION PAGE Temporary Substitute Auto Physical Damage 2 Broad Form Insured 2 Employee as Insureds 2 Additional Insured Status by Contract, Agreement or Permit 2 Bail Bond Coverage 3 Loss of Earnings Coverage 3 Amended Fellow Employee Coverage 3 Towing and Labor 3 Physical Damage Additional Transportation Expense Coverage 3 Extra Expense -Theft 3 Rental Reimbursement and Additional Transportation Expense 4 Personal Effects Coverage 4 Personal Property of Others 4 Locksmith Coverage 4 Vehicle Wrap Coverage 5 Airbag Accidental Discharge 5 Audio, Visual and Data Electronic Equipment Coverage 5 Auto Loan/Lease Total Loss Protection 5 Glass Repair — Deductible Amendment 5 Amended Duties in the Event of Accident, Claim, Suit or Loss 6 Waiver of Subrogation Required by Contract 6 Unintentional Failure to Disclose 6 Hired, Leased, Rented or Borrowed Auto Physical Damage 6 Mental Anguish 7 Extended Cancellation Condition 7 The COVERAGE INDEX set forth above is informational only and grants no coverage. Terms set forth in (Bold Italics) are likewise for information only and by themselves shall be deemed to grant no coverage. CA 71 09 01 17 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 7 (Temporary Substitute Auto Physical Damage) A. TEMPORARY SUBSTITUTE AUTO PHYSICAL DAMAGE SECTION I — COVERED AUTOS, paragraph C. Certain Trailers, Mobile Equipment and Temporary Substitute Autos is amended by adding the following at the end of the existing language: If Physical Damage Coverage is provided under this Coverage form for an "auto" you own, the Physical Damage coverages provided for that owned "auto" are extended to any "auto" you do not own while used with the permission of its owner as a temporary substitute for the covered "auto" you own that is out of service because of its breakdown, repair, servicing, "loss", or destruction B. BROADENED LIABILITY COVERAGES SECTION II — LIABILITY COVERAGE in Paragraph A. Coverage at 1. Who Is An Insured is amended to include the following: (Broad Form Insured) d. Any legally incorporated subsidiary in which you own more than 50% of the voting stock on the effective date of the Coverage Form. However, the Named Insured does not include any subsidiary that is an "insured" under any other automobile policy or would be an "insured" under such a policy but for its termination or the exhaustion of its Limit of Insurance. e. Any organization that is acquired or formed by you, during the term of this policy and over which you maintain majority ownership. However, the Named Insured does not include any newly formed or acquired organization: (1) That is a joint venture or partnership, (2) That is an "insured" under any other policy, (3) That has exhausted its Limits of Insurance under any other policy, or (4) 180 days or more after its acquisition or formation by you, unless you have given us notice of the acquisition or formation Coverage does not apply to "bodily injury" or "property damage" that results from an accident that occurred before you formed or acquired the organization. (Employee as Insureds) f. Any employee of yours while acting in the course of your business or your personal affairs while using a covered "auto" you do not own, hire or borrow. (Additional Insured Status by Contract, Agreement or Permit) g. Any person or organization whom you are required to add as an additional insured on this policy under a written contract or agreement; but the written contract or agreement must be: (1) Currently in effect or becoming effective during the term of this policy; and (2) Executed prior to the "bodily injury" or "property damage." The additional insured status will apply only with respect to your liability for "bodily injury" or "property damage" which may be imputed to that person(s) or organization(s) directly arising out of the ownership, maintenance or use of the covered "autos" at the location(s) designated, if any. Coverage provided by this endorsement will not exceed the limits of liability required by the written contract or written agreement even if the limits of liability stated in the policy exceed those limits. This endorsement shall not increase the limits stated in Section II. C. Limits of Insurance. For any covered "auto" you own this Coverage Form provides primary coverage. Page 2 of 7 Includes copyrighted material of Insurance Services Office, Inc., with its permission. CA 71 09 01 17 C. BROADENED SUPPLEMENTARY PAYMENTS SECTION II. LIABILITY A. Coverage 2. Coverage Extensions a. Supplementary Payments (2) and (4) are replaced by the following: (Bail Bond Coverage) (2) Up to $5,000 for cost of bail bonds (including bonds for related traffic violations) required because of an "accident" we cover. We do not have to furnish these bonds. (Loss of Earnings Coverage) (4) All reasonable expenses incurred by the "insured" at our request, including actual loss of earning up to $500 a day because of time off from work. (Amended Fellow Employee Exclusion) D. AMENDED FELLOW EMPLOYEE EXCLUSION Only with respect to your"employees" who occupy positions which are supervisory in nature, SECTION II. LIABILITY B. Exclusion 5. Fellow Employee is replaced by: 5. Fellow Employee "Bodily Injury": - a. To you, or your partners or members Of you are a partnership or joint venture), or to your members Of you are a limited liability company); b. To your "executive officers" and directors Of you are an organization other than a partnership, joint-venture, or limited liability company) but only with respect to performance of their duties as your officers or directors; c. For which there is an obligation to share damages with or repay someone else who must pay damages because of the injury described in paragraph a and b above; or d. Arising out of his or her providing or failing to provide professional health care services. For purposes of this endorsement, a position is deemed to be supervisory in nature if that person performs principle work which is substantially different from that of his or her subordinates and has authority to hire, transfer, direct, discipline or discharge. E. BROADENED PHYSICAL DAMAGE COVERAGES SECTION III —PHYSICAL DAMAGE COVERAGE A. Coverage is amended as follows: (Towing and Labor) 2. Towing is deleted and replaced with the following: 2. Towing and Labor We will pay towing and labor costs incurred, up to the limits shown below, each time a covered "auto" is disabled: a. For private passenger type vehicles we will pay up to $100 per disablement. b. For all other covered "auto's" we will pay up to $500 per disablement However, the labor must be performed at the place of disablement. (Physical Damage Additional Transportation Expense Coverage) 4. Coverage Extensions a. Transportation Expenses is amended to provide the following limits: We will pay up to $60 per day to a maximum of $1,800. All other terms and provisions of this section remain applicable. The following language is added to 4. Coverage Extensions: (Extra Expense— Theft) c. Theft Recovery Expense If you have purchased Comprehensive Coverage on an "auto" that is stolen, we will pay the expense of returning that stolen auto to you. The limit for this coverage extension is $5,000. CA 71 09 01 17 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 3 of 7 (Rental Reimbursement and Additional Transportation Expense) d. Rental Reimbursement We will provide Rental Reimbursement and Additional Expense coverage only for those Physical Damage coverages for which a premium is shown in the Declarations or schedule pages. Coverage applies only to a covered "auto". (1) We will pay for auto rental expense and the expense incurred by you because of "loss" to remove and transfer your materials and equipment from a covered "auto" to a covered "auto." Payment applies in addition to the otherwise applicable coverage you have on a covered "auto." No deductible applies to this coverage. (2) We will pay only for expenses incurred during the policy period and beginning 24 hours after the "loss" and ending, regardless of the policy's expiration, with the lesser of the following number of days: (a) The number of days reasonably required to repair or replace the covered "auto." If "loss" is caused by theft, this number of days is added to the number of days it takes to locate the covered "auto" and return it to you, or (b) 30 days. (3) Our payment is limited to the lesser of the following amounts: (a) Necessary and actual expenses incurred; or (b) $75 per day. (c) This coverage does not apply while there are spare or reserve "autos" available to you for your operations. (d) If "loss" results from the total theft of a covered "auto" of the private passenger or light truck type, we will pay under this coverage only that amount of your rental reimbursement expense which is not already provided for under the SECTION III — PHYSICAL DAMAGE COVERAGE, A. Coverage, 4. Coverage Extensions, a. Transportation Expenses. (Personal Effects Coverage) e. Personal Effects If you have purchased Comprehensive Coverage on this policy for an "auto" you own and that "auto" is stolen, we will pay, without application of a deductible, up to $500 for Personal Effects stolen with the "auto". The insurance provided under this provision is excess over any other collectible insurance. For this coverage extension, Personal Effects means tangible property that is worn or carried by an "insured". (Personal Property of Others) f. Personal Property of Others We will pay up to $500 for loss to personal property of others in or on your covered "auto." This coverage applies only in the event of "loss" to your covered "auto" caused by fire, lightning, explosion, theft, mischief or vandalism, the covered "auto's" collision with another object, or the covered "auto's" overturn. No deductibles apply to this coverage. (Locksmith Coverage) g. Locksmith Coverage We will pay up to $250 per occurrence for necessary locksmith services for keys locked inside a covered private passenger "auto". The deductible is waived for these services. Page 4 of 7 Includes copyrighted material of Insurance Services Office, Inc., with its permission. CA 71 09 01 17 (Vehicle Wrap Coverage) h. Vehicle Wrap Coverage • If you have Comprehensive or Collision coverage on an "auto" that is a total loss, in addition to the actual cash value of the "auto", we will pay up to $1,000 for vinyl vehicle wraps which are displayed on the covered "auto" at the time of total loss. Regardless of the number of autos deemed a total loss, the most we will pay under this Vehicle Wrap Coverage for any one "loss" is $5,000. For purposes of this coverage provision, signs or other graphics painted or magnetically affixed to the vehicle are not considered vehicle wraps. (Airbag Accidental Discharge) F. SECTION III — PHYSICAL DAMAGE COVERAGE, B. Exclusions is amended at 3. to include the following language: If you have purchased Comprehensive or Collision Coverage under this policy, this exclusion does not apply to mechanical breakdown relating to the accidental discharge of an air bag. This coverage applies only to a covered auto you own and is excess of any other collectible insurance or warranty. No deductible applies to this coverage. G. BROADENED LIMITS OF INSURANCE (Audio, Visual and Data Electronic Equipment Coverage) SECTION III — PHYSICAL DAMAGE COVERAGE — C. Limit of Insurance at 1.b. is amended to provide the following limits: b. Limits of $1,000 per "loss" is increased to $5,000 per "loss". All other terms and provisions of this section remain applicable. (Auto Loan/Lease Total Loss Protection) SECTION III — PHYSICAL DAMAGE COVERAGE — C. Limit of Insurance is amended by adding the following language: 4. In the event of a total "loss" to a covered "auto" shown in the Schedule pages, subject at the time of the "loss" to a loan.or lease, we will pay any unpaid amount due including up to a maximum of $500 for early termination fees or penalties on the lease or loan for a covered"auto" less: a. The amount paid under the Physical Damage Coverage Section of the policy; and b. Any: (1) Overdue lease /loan payments at the time of the "loss"; (2) Financial penalties imposed..under a lease for excessive use, abnormal wear and tear or high mileage; (3) Security deposits not returned by the lessor; (4) Costs for extended warranties, Credit Life Insurance, Health, Accident or Disability Insurance purchased with the loan or lease; and .. . • (5) Carry-over balances from previous loans or leases. (Glass Repair—Deductible Amendment) H. GLASS REPAIR — DEDUCTIBLE SECTION III —PHYSICAL DAMAGE COVERAGE — D. Deductible is amended by adding the following: Any deductible shown in the Declarations as applicable to the covered "auto" will not apply to glass breakage if the damaged glass is repaired, rather than replaced. CA 71 09 01 17 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 5 of 7 (Amended Duties in the Event of Accident, Claim, Suit or Loss) I. AMENDED DUTIES IN THE EVENT OF ACCIDENT, CLAIM, SUIT OR LOSS Under SECTION IV — BUSINESS AUTO CONDITIONS, A. Loss Conditions , the following is added to paragraph 2. Duties In The Event of Accident, Suit or Loss: d. Knowledge of any "accident", "claim", "suit" or "loss" will be deemed knowledge by you when notice of such "accident", "claim", "suit" or "loss" has been received by: (1) You, if you are an individual; (2) Any partner or insurance manager if you are a partnership; (3) An executive officer or insurance manager, if you are a corporation; (4) Your members, managers or insurance manager, if you are a limited liability company; or (5) Your officials, trustees, board members or insurance manager, if you are a not-for-profit organization. (Waiver of Subrogation by Contract) J. WAIVER OF SUBROGATION REQUIRED BY CONTRACT Under SECTION IV, BUSINESS AUTO CONDITIONS, A. Loss Conditions 5. Transfer of Rights of Recovery Against Others to Us the following language is added: However, we waive any rights of recovery we may have against the person or organization with whom you have agreed in writing in a contract, agreement or permit, to provide insurance such as is afforded under the policy to which this endorsement is attached. This provision does not apply unless the written contract or written agreement has been executed, or permit has been issued, prior to the "bodily injury" or "property damage." (Unintentional Failure to Disclose) K. UNINTENTIONAL FAILURE TO DISCLOSE Under SECTION IV — BUSINESS AUTO CONDITIONS, B. General Conditions , the following is added to 2. Concealment, Misrepresentation Or Fraud: Your unintentional error in disclosing, or failing to disclose, any material fact existing at the effective date of this Coverage Form, or during the policy period in connection with any additional hazards, will not prejudice your rights under this Coverage Form. (Hired, Leased, Rented or Borrowed Auto Physical Damage) L. HIRED, LEASED, RENTED OR BORROWED AUTO PHYSICAL DAMAGE Under SECTION IV — BUSINESS AUTO CONDITIONS B. General Conditions 5. Other Insurance Paragraph 5.b. is replaced by the following: b. (1) For "Comprehensive" and "Collision" Auto Physical Damage coverage provided by this endorsement, the following are deemed to be covered "autos" you own: (a) Any Covered "auto" you lease, hire, rent or borrow; and (b) Any Covered "auto" hired or rented by your "employee" under a contract in that individual "employee's" name, with your permission, while performing duties related to the conduct of your business. However, any "auto" that is leased, hired, rented or borrowed with a driver is not a covered "auto" (2) Limit of Insurance For This Section The most we will pay for any one "loss" is the lesser of the following: (a) $75,000 per accident, or (b) actual cash value at the time of loss, or (c) cost of repair. Page 6 of 7 Includes copyrighted material of Insurance Services Office, Inc., with its permission. CA 71 09 01 17 • • Minus a $500 deductible. An adjustment for depreciation and physical condition will be made in determining actual cash value in the event of a total loss. No deductible applies to "loss" caused by fire or lightning. (3) This Hired Auto Physical Damage coverage is excess over any other collectible insurance. (4) Definitions For This Section (a) Comprehensive Coverage: from any cause except the covered "auto's" collision with another object or the covered "auto's" overturn. We will pay glass breakage, "loss" caused by hitting a bird or animal and, "loss" caused by falling objects or missiles. (b) Collision Coverage: caused by the covered "auto's" collision with another object or by the covered "auto's" overturn. (Mental Anguish) M. MENTAL ANGUISH Under SECTION V— DEFINITIONS, C. is replaced by the following: C. "Bodily injury", means bodily injury, sickness or disease sustained by a person including mental anguish or death resulting from bodily injury, sickness, or disease. (Extended Cancellation Condition) N. EXTENDED CANCELLATION CONDITION Under CANCELLATION, of the COMMON POLICY CONDITIONS form, item 2.b. is replaced by the following: b. 60 days before the effective date of cancellation if we cancel for any other reason. CA 71 09 01 17 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 7 of 7