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HomeMy WebLinkAboutInsurance Certificate: Butlers Glass Service Inc, Bills Glass & Windshields AC ® DATE(MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 02/23/2022 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(les)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: Hart Insurance Agency PHONE Kristi Dolmage FAX PO Box 1240 (A/C.No.Extt: (541) 779-4232 (A/C,No):(541) 772-3963 EMAIL kdolmage@hartinsurance.com Grants Pass OR 97528 ADDRESS: g @hartinsurance.com INSURER(S)AFFORDING COVERAGE NAIC# INSURERA:Cincinnati Specialty Underwriter 13037 INSURED (591) 773-5881 Butlers Glass Service Inc INSURER B Bills Glass & Windshields INSURER C: 319 E McAndrews Road INSURERD: Medford OR 97501 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:Cert ID 21900 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 LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MM/DD/YYYY) (MMIDD/YYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY `EACH OCCURRENCE $ 1,000,000 AMAGE TO RENTED CLAIMS-MADE X OCCUR Y Y CSU0079916 02/19/2022 02/19/2023 PREM SES Ea occurrence) $ MED EXP(Any one person) $ X Products & Completed PERSONAL&ADV INJURY $ GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY X jEC • LOC PRODUCTS-COMP/OPAGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY (Per accident) $ A X UMBRELLA LIAB X OCCUR CSU0086650 02/19/2022 02/19/2023 EACH OCCURRENCE $ 1,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $ 1,000,000 _ DED RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N _ STATUTE ER ANYPROPRIETOR/PARTNERIEXECUTIVE N/A E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ $ $ DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) Certificate holder is listed as additional insured including waiver of subrogation where required by written contract per attached forms CSIA405 08/09 and CSGA4087 12/12 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Ashland 51 Winburn Way AUTHORIZED REPRESENTATIVE aeo Ashland OR 97520 c� I ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD Page 1 of 1 • • A`cw r3 DATE(MM/DD/YY11) ® CERTIFICATE OF LIABILITY INSURANCE 02/23/2022 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: Kristi Dolmage Hart Insurance Agency PHONE FAX PO Box 1240 (NC.No.Ext): (541) 779-4232 (A/c,No):(541) 772-3963 E-MAIL Grants Pass OR 97528 ADDRESS: kdolmage@hartinsurance.com INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Cincinnati Insurance'Company 10677 INSURED (541) 773-5881 INSURER B Butlers Glass Service Inc Bills Glass & Windshields INSURER C: 319 E McAndrews Road INSURERD: Medford OR 97501 INSURERE: INSURER F: COVERAGES CERTIFICATE NUMBER:Cert ID 21899 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 TYPE OF INSURANCE ADDL SUER POLICY EFF POLICY EXP LIMITS LTR INSD WVD POLICY NUMBER (MM/DD/YYYY). (MMIDD/YYYY) A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED CLAIMS-MADE X OCCUR Y Y EPP 0374731 02/19/2022 02/19/2023 PREMISES(Ea occurrence) $ 500,000 MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY JECT LOC PRODUCTS-COMP/OPAGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITYCOMBINED SINGLE LIMIT $ 1,000,000 (Ea accident) A X ANY AUTO Y Y ESA,0374731 02/19/2022 02/19/2023 BODILYINJURY(Perperson) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY (Per accident) A X UMBRELLALIAB X OCCUR EPP 0374731 02/19/2022 02/19/2023 EACH OCCURRENCE $ 1,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $ 1,000,000 DED RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANYPROPRIETOR/PARTNER/EXECUTIVEN/A E.L.EACH ACCIDENT $ OFFICER/MEMBEREXCLUDED? (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 is listed as additional insured per attached forms GA472 09/18, GA210 09/17 and AA288 01/16 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Ashland 51 Winburn Way AUTHORIZED/RE,P�RESE�NTA Ashland OR 97520 Y�t1ATIVE !�7_O ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD Page 1 of 1 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. • CONTRACTORS ADDITIONAL INSURED - AUTOMATIC STATUS AND AUTOMATIC WAIVER OF SUBROGATION WHEN REQUIRED IN WRITTEN CONTRACT, AGREEMENT, PERMIT OR AUTHORIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Additional insured - Owners, Lessees Or cluded in the "products-completed Contractors - Automatic Status For Other operations hazard",but only if: Parties When Required In Written Contract Or Agreement With You (1) The Coverage Part to which this endorsement is attached pro- 1. Section II - Who Is An Insured is vides coverage for"bodily injury" amended to include as an additional in- or "property damage" included sured any person or organization you within the "products-completed have agreed in writing ina contract or operations hazard"; and agreement to add as an additional in- sured on this Coverage Part. Such per- (2) The written contract or written son(s) or organization(s) is an additional agreement requires you to pro- insured only with respect to liability for: vide additional insured coverage included within the "products- a. "Bodily injury", "property damage" or completed operations .hazard" "personal and advertising injury" for that person or organization. caused, in whole or in part, by the I performance of your ongoing opera- If the written contract or written tions by you or on your behalf, under agreement requires you to provide that written contract or written additional insured coverage included agreement. Ongoing operations does within the "products-completed oper- not apply to "bodily injury"or"proper- ations hazard" for a specified length ty damage"occurring after: of time for that person or organiza- tion, the "bodily injury" or "property (1) All work, including materials, damage" must occur prior to the ex- parts or equipment furnished in piration of that period of time in order connection with such work, on for this insurance to apply. the project (other than service, maintenance or repairs) to be If the written contract or written performed by or on behalf of the agreement requires you to provide additional insured(s) at the loca- additional insured coverage for a tion of the covered operations person or organization per only ISO has been completed:or additional insured endorsement form number CG 2010, without specifying (2) That portion of'your work"out of an edition date, and without specifi- which the injury or damage anis- cally requiring additional insured • es has been put to its intended coverage included within the "prod- use by any person or organize- ucts-completed operations hazard", tion other than another contrac- this Paragraph b. does not apply to tor or subcontractor engaged in that person or organization. performing operations for a prin- cipal as a part of the same pro- 2. If the written contract or written agree- jest;and ment described in Paragraph 1. above specifically requires you to provide addi- b. "Bodily injury" or "property damage" tional insured coverage to that person or caused, in whole or in part, by"your organization: work" performed under that written a. Arisingout ofyour ongoing opera- tions or written agreement and in9 9 or arising out of'your work";or Includes copyrighted material of Insurance GA 472 0918 Services Office, Inc.,with its permission. Page 1 of 3 b. By way of an edition of an ISO addi- 2. 'With respect to the insurance afforded to tional insured endorsement that in- the additional insureds described in Para- cludes arising out of your ongoing graph B.1„ the following additional exclu- operations .or arising out of "your sions apply: work"; This insurance does not apply to: then the phrase caused, in whole or in part, by in Paragraph A.1.a.and/or Para- . a. "Bodily injury", "property damage" or graph A.1.b. above,whichever applies, is "personal and advertising injury"aris- replaced by the phrase arising out of. ing out of operations performed for the federal government, state or mu- 3. With respect to the insurance afforded to nicipality;or the additional insureds described in Para- graph Al.,the following additional exclu- b. "Bodily injury" or "property damage" sion applies: included within the "products- completed operations hazard." This insurance does not apply to "bodily injury", "property damage" or "personal C. The insurance afforded to additional insureds and advertising injury" arising out of the described in Paragraphs A.and B.: rendering of, or the failure to render, any , 1, , ,Only,,applies_.to .thei:extent permitted by .._ .professional architectural, engineering or law;and surveying services,including: . The preparing, approving or failing to 2. Will not be broader than that which you a or approve, maps, shop are required by the written contract, writ- prepareten agreement written permit or written drawings„opinions, reports, surveys, authorization to provide for such addition- field orders, change orders or draw- - , al insured;and ings and specifications;or b. Supervisory, architectural 3. Does not.apply to any person, organiza- Supervienginesory, inspection,g activition. tion, state, governmental agency or sub- ordivision or political subdivision specifically This exclusion applies even if the claims named as an additional insured for the against any insured allege negligence or same project in the schedule of an en- other wrongdoing in the supervision, hir- dorsement added to this Coverage Part. ing,employment,training or monitoring of D. With respect to the insurance afforded to the others by that insured,if the"occurrence" which caused the"bodily injury" or"prop- additional insureds described in Paragraphs erty damage", or the offense which A.and B., in surfollowing is added to Section III caused the"personal and advertising inju- •Limits Of insurance: . ' ry", involved the rendering of, or the fail- The most we will pay on behalf of the addi- ure to render, any professional architec- tional insured is the amount of insurance: tural,engineering or surveying services. .• 1. Required by the written contract, written 4. This Paragraph A. does not apply to addi- agreement, written permit or written au- tional insureds described in Paragraph B. thorization described in Paragraphs A. 8. Additional Insured-State Or Governmental and B. or Agency Or Subdivision Or`•Pollticaf Subdi- , 2. Available under the'applicable)Limits of `vision=;Automatic'Status When Acquired Insurance shown in,the Declarations; hi Written Permits Or Authorizations ' whichever is less. 1. Section II - Who Is An Insured is amended to include as an additional in- This endorsement shall not increase the appli- sured any state or governmental agency cable Limits of Insurance shown in the Decla- or subdivision or political subdivision you rations. have agreed in writing in a contract, E. Section IV - Commercial General Liability agreement,permit or authorization to add Conditions is amended to add the following: as an additional insured on this Coverage Part. Such state or governmental agency Automatic Additional Insured Provision or subdivision or political subdivision is an additional insured only with respect to op- This insurance applies only if the "bodily inju- erations performed by you or on your be- ry" or "property damage" occurs, or the "per- half for which the state or governmental sonal and advertising injury" offense is corn- agency or subdivision or political subdivi- miffed: sion issued, in writing, a contract, agree- 1. During the policy period;and ment,permit or authorization. Includes copyrighted material of Insurance GA 472 0918 Services Office, Inc.,with its permission. Page 2 of 3 2. Subsequent to your execution of the writ- As used in this endorsement, wrap-up insur- ten contract or written agreement, or the ance means any insurance provided by a con- issuance of a written permit or written au- solidated(wrap-up)insurance program. thorization, described in Paragraphs A. and B. Primary And Noncontributory Insurance When Required By Written Contract, F. Except when G.below applies,the following is Agreement,Permit Or Authorization added to Section IV'- Commercial General Liability Conditions, 5. Other Insurance, Except when wrap-up insurance applies to the and supersedes any provision to the contrary: . claim or "suit" on behalf of the additional in- sured, this insurance is primary to and will not When Other Additional Insured Coverage seek contribution from any other insurance Applies On An Excess Basis available to the additional insured described in This insurance is primary to other insurance Paragraphs A.and B.provided that: available to the additional insured described in 1. The additional insured is a Named In- Paragraphs A.and B.except: sured under such other insurance;and 1. As otherwise provided in Section IV - 2. You have agreed in writing in a contract, Commercial General Liability Condi- agreement, permit or authorization de- tior6s;.5,Other-Insurance, b.Excess In- ;.. scribed ip,Paragraph A. or B...that this in- surance;or sur'ance would be primary and would not 2. For any other valid and collectible incur- seek contribution from any other insur- ance available to the additional insured as ance available to the additional insured. an additional insured by attachment of an. As used in this endorsement, wrap-up insur- endorsement to another insurance policy ance means any insurance provided by a con- that is written on an excess basis. In such solidated(wrap-up)insurance program. case,this insurance is also excess. H. Section IV - Commercial General Liability G. The following is added to Section IV -Corn- Conditions, 9. Transfer Of Rights Of Re- merclal General Liability Conditions, 5. covery Against Others To Us is amended by Other Insurance, and supersedes any provi- .. . the addition of the following: sion to the contrary: . We waive any right of recovery we may have Primary Insurance When Required By Writ- against any additional insured under this en- ten Contract, Agreement, Permit'Or Au- dorsement against whom you have agreed to thorization waive such right of recovery in a written Except insurance applies to con- tract,written agreement,written permit or writ- Except towhen wrap-upobehalf of the additional ieonal thein- ten authorization because of payments we claimmake for injury or damage arising out of your sured. this insurance is primary to any other ongoing operations or'your work"done under insurance available to Vthe additional insured a written contract, written agreement, written described in Paragraphs A. and B. provided permit or written authorization. However, our that: rights may only be waived prior to the "occur- 1. The additional insured is a Named In- rence" giving rise to the injury or damage for . sured under such other insurance;and which we make payment under this Coverage Part. The insured must do nothing after a loss 2. You have agreed in writing in a contract, to impair our;rights.At"our request,the.insured •agreement, permit or atithorizatirn de- ' will brig "suit" or transfer those rights to us scribed in Paragraph A.or B.thatAthis in- and help us enforce those rights. V surance would be primary to any other in- surance available to the additional in- sured. • Includes copyrighted material of Insurance GA 472 0918 Services Office,Inc.,with its permission. Page 3 of 3 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. COMMERCIAL GENERAL LIABILITY BROADENED ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Endorsement-Table of Contents: Coverage: Begins on Page; 1. Employee Benefit Liability Coverage 3 2. Unintentional Failure To Disclose hazards 9 3. Damage To Premises Rented To You 9 4. Supplementary Payments 10 5. Medical Payments ....._ 10 6. 180 Day Coverage For Newly Formed Or Acquired Organizations 10 7. Waiver Of Subrogation 11 8. Automatic Additional Insured-Specified Relationships: 11 • Managers Or Lessors Of Premises; • Lessor Of Leased Equipment; • Vendors; • State Or Governmental Agency Or Subdivision Or Political Subdivision-Permits Or Authorizations Relating To Premises; and • Mortgagee,Assignee Or Receiver 9. Property Damage To Borrowed Equipment 14 10. Employees As Insureds-Specified Health Care Services And Good Samaritan Services ....15 11. Broadened Notice Of Occurrence 15 12. Nonowned Aircraft 15 13. Bodily Injury Redefined 15 14. Expected Or Intended Injury Redefined.......... 15 15. Former Employees As Insureds 15 B. Limits Of Insurance: The Commercial General Liability Limits of Insurance apply to the insurance provided by this endorse- ment, except as provided below: 1. Employee Benefit Liability Coverage Each Employee Limit: $1,000,000 Aggregate Limit: $3,000,000 Deductible Amount: $ 1,000 3. Damage To Premises Rented To You The lesser of: a. The Each Occurrence Limit shown in the Declarations;or b. $500,000 unless otherwise stated$ 4. Supplementary Payments a. Bail Bonds: $2,500 b. Loss Of Earnings:$ 500 Includes copyrighted material of Insurance GA 210 0917 Services Office, Inc.,with its permission. Page 1 of 15 5.- Medical Payments - Medical Expense Limit:$10,000 9. Property Damage To Borrowed Equipment Each Occurrence Limit: $10,000 Deductible Amount: $ 250 • I. • • • Includes copyrighted material of Insurance GA 210 0917 Services Office, Inc.,with its permission. Page 2 of 15 C. Coverages 2) Occurred prior to the 1. Employee Benefit Liability Coverage "first effective date" of this endorsement pro- a. The following is added to Section 1- vided: Coverages: Employee Benefit Liability Cover- a) You dknowledge of a d not have age claim or"suit"on or (1) Insuring Agreement before the "first ef- fective date"of this (a) We will pay those sums that endorsement. the insured becomes legally obligated to pay as damag- You will be es caused by any act, error deemed to have or omission of the insured, knowledge of a or of any other person for claim or "suit" whose acts the insured is when any "author- legally liable, to which this ized representa- insurance applies. We will tive"; have the right and duty to i) Reports all, or defend the insured against any "suit' seeking those act,part, the r damages. However, we will act, error omission us have no duty to defend or ission against any "suit" seeking any other in damages to which this In- surance insurer; does not apply. We ii) Receives a may, at our discretion, in- written or ver- vestigate any report of an bal demand or act, error or omission and claim for dam- settle any claim or"suit'that ages because may result. But - of the act, er- ror or orris- 1) The amount we will pay sion;and for damages is limited as described in Section b) There is no other III - Limits Of Insur- applicable insur- ance;and ance. 2) Our right and duty to (2) Exclusions defend ends when we have used up the appli- This insurance does not apply to: cable limit of insurance (a) Bodily Injury, Property in the payment of judg- Damage Or Personal And ments or settlements. Advertising Injury No other obligation or liabil- "Bodily injury', "property ity to pay sums or perform damage" or "personal and acts or services is covered unless explidtly provided for advertising injury". under Supplementary (b) Dishonest, Fraudulent, Payments. Criminal Or Malicious Act (b) This insurance applies to Damages arising out of any damages only if the act, er- intentional, dishonest, ror or omission, is negligent- fraudulent, criminal or mali- ly committed in the "admin- cious act, error or omission, istration" of your "employee committed by any insured, benefit program";and including the willful or reck- less violation of any statute. period; or Includes copyrighted material of Insurance GA 210 0917 Services Office,Inc.,with its permission. Page 3 of 15 (c) Failure To Perform A Con- effort and cooperation of the tract Insured, from the applicable Damages arising out of fail- funds accrued or other col- !edibleure of performance of con- tract insurance. by any insurer. (i) Taxes, Fines Or Penalties (d) Insufficiency Of Funds Taxes,fines or penalties,un- Damagesin- arising out of an in- cluding those imposed insufficiency funds to der the Internal Revenue meet any obligations under Code or any similar state or any plan induded in the foga!law. "employee benefit program". (j) Employment-Related Prac- tices(e) Inadequacy Of Perfor- mance Of Invest- Any liability arising out of ment/Advice Given With any: Respect To Participation (1) Refusal to employ; Any claim based upon: (2) Termination of employ. 1) Failure of any invest- ment; ment to perform; (3) Coercion, demotion, 2) Errors in providing in- evaluation, reassign- formation on past per- ment, discipline, defa- formance of investment merlon, harassment, vehicles;or humiliation, employ- 3) discrimina- Advice given to any tion or other meat-related practices, person with respect to that person's decision to acts or omissions;or participate or not to par- (4) Consequential liability tidpate in any plan in- as a result of(1), (2)or cluded in the"employee , (3)above. benefit program". This exclusion applies (f) Workers' Compensation whether the insured may be And Similar Laws held liable as an employer Any claim arising out of your or in any other capacity and to any obligation to share failure to comply with the mandatory provisions of any damageswith or repay workers' compensation, un- daomagese else who must pay employment compensation damages because of the In- • insurance, social security or fury' • disability benefits law or any (3) Supplementary Payments similar law. d: Y , : Section I ,- Coverages, Sup- (g) ERISA plementary Payments -Cover- Damages for which any in- ages A And B also apply to this sured is liable because of li- Coverage. ability imposed on a fidud- b. Who Is An Insured ary by the Employee Re- tirement Income Security As respects Employee Benefit Lia- Act of 1974, as now or bility Coverage,Section II-Who Is .• hereafter amended, or by An Insured is replaced by the follow- any similar federal, state or ing: local laws. (1) If you are designated in the Dec- (h) Available Benefits larations as: Any claim for benefits to the (a) An individual, you and your • extent that such benefits are spouse are insureds,but on- available, with reasonable ly with respect to the con- Includes copyrighted material of Insurance GA 210 0917 Services Office, Inc.,with its permission. Page 4 of 15 • duct of a business of which liability company,and over which you are the sole owner. you maintain ownership or major- (b) A parity interest, will qualify as a Named Insured if no other similar ture, you are an insured. insurance applies to that organi- Your members, your part- zation. However,coverage under ners, and their spouses are this provision: also insureds but only with respect to the conduct of (a) Is afforded only until the your business. 180th day after you acquire or form the organization or (c) A limited liability company, the end of the policy period, you are an insured. Your whichever is earlier;and members are also insureds, but only with respect to the (b) Does not apply to any act, conduct of your business. error or omission that was Your managers are in- committed before you ac- sureds,but only with respect quired or formed the organi- . - .:.:w..,i.,to,their duties as your man- zation. agars c. Limits Of Insurance (d) An organization other than a partnership,joint venture or As respects Employee Benefit Lia- limited liability company,you bility Coverage, Section III -Limits are an insured.Your"execu- Of Insurance is replaced by the fol- tive officers" and directors lowing: are insureds, but only with (1) The Limits of Insurance shown in respect to their duties as Section B.Limits Of Insurance, your officers or directors. 1. Employee Benefit Liability Your stockholders are also Coverage and the ruses below fix insureds, but only with re- the most we will pay regardless spect to their liability as of the number of- stockholders. (e) A trust, you are an insured. (a) Insureds; Your trustees are also in- (b) Claims made or "suits" sureds,but only with respect brought; to their duties as trustees. (c) Persons or organizations (2) Each of the following is also an making daims or bringing insured: "suits"; (a) Each of your "employees" (d) Acts,errors or omissions;or who is or was authorized to administer your "employee (e) Benefits included In your benefit"program"; "employee benefit program". (b) Any persons, organizations (2) The Aggregate Limit shown in f , . or"employees"having prop- Section B.Limits Of Insurance, er temporary authorization 1. Employee Benefit Liability to administer your "employ- Coverage of this endorsement Is ee benefit program" if you the most we will pay for all dam- die, but only until your legal ages because of acts, errors or representative is appointed; omissions negligently committed or in the "administration" of your "employee benefit program". (c) Your legal representative if you die, but only with re- (3) Subject to the limit described in spect to duties as such.That (2) above, the Each Employee representative will have all 'Limit shown in Section B. Limits your rights and duties under Of Insurance, 1. Employee this Coverage Part. Benefit Liability Coverage of • this endorsement is the most we (3) Any organization you newly ac- _ will pay for all damages sus- quire or form, other than a part- tamed by any one "employee", nership, joint venture or limited . including damages sustained by Includes copyrighted material of Insurance GA 210 0917 Services Office, Inc.,with its permission. Page 5 of 15 i such "employee's" dependents (d) We may pay any part or all and benefidaries,as a result of: of the Deductible Amount to effect settlement of any (a) An act error or omission;or claim or"suit"and, upon no- (b) A series of related ads, er- tiflcation of the action taken, rors or omissions, regard- you shall promptly reim- less of the amount of time burse us for such part of the that lapses between such Deductible Amount as we ads, errors or omissions; have paid. negligently committed in the d. Additional Conditions "administration"of your"employ. As respects Employee Benefit Lia- ee benefit program". bility Coverage, Section IV- Com- However, the amount paid under mercial General Liability Condi- this endorsement shall not ex- tions is amended as follows: ceed, and will be subject to the (1) Item 2. Duties In The Event Of limits and restrictions that apply _ Occunence, Offense,Claim Or to the payment of benefits in any Suit is replaced by the following: plan included In the "employee benefit program." 2. Duties In The Event Of An (4) Deductible Amount Act,Error Or Omission,Or Claim Or Suit • (a) Our obligation to pay dam- ages on behalf of the in- a. You mustsee to it that we are notified sured applies only to the as soon amount of damages in ex- • asr practicablermis iooanw which cess of the Deductible error or omission which Amount stated in the Deda- may result in a daim. To the extent possible, rations as applicable to Each Employee. The limits notice should include: of insurance shall not be re- (1) What the act, error duced by the amount of this or omission was deductible. _`>, and when it oc- ,, (b) The Deductible Amount carred;and stated in the Declarations (2) The ,names and • applies to all damages sus- addresses of any- tamed by any one "employ- one who may suf- ee",including such"employ- fer damages as a ee's"dependents and bene- result of the ad, fiaaries, because of all acts, error or omission. errors or omissions to which this insurance applies. b. If a daim is made or . "suit"is brought against (c) The terms of this insurance, r any insured,you must: • including those with respect ,to: a (1) Immediately record the specifics of the 1) Our right and duty to claim or "suit" and defend the insured the date received; against any "suits" and seeking those damag- es;and (2) Notify us as soon as practicable. 2) Your duties,and the du- ties of any other In- You must see to it that volved insured, in the we receive written no- event of an act,error or tics of the daim or"suit' omission,or daim; as soon as practicable. • apply irrespective of the ap- c. You and any other in- plication of the Deductible volved insured must: Amount. .Includes copyrighted material of Insurance GA 210 0917 Services Office, Inc.,with its permission. Page 6 of 15 (1) Immediately send b. Method Of Sharing us copies of any demands, notices, If all of the other insur- summonses or le- ance permits contribu- gal papers re- tion by equal shares, ceived in connec- we will follow this meth- tion with the claim od also. Under this ap- or"suit"; proach each insurer contributes equal (2) Authorize us to ob- amounts until it has tain records and paid its applicable limit other information; of Insurance or none of (3) Cooperate with us the loss remains, in the investigation whichever comes first. or settlement of the If any of the other in- claim or defense surance does not permit against the "suit"; contribution by equal f and ,. ) 4 •: shares, we will contrib- (4) Assist us, upon our . rite by limits. Under this uin then en- method, each insurer's forcement request, of any share is based on the right ent of any ratio of its applicable person or organi-y limit of insurance to the eon which may total applicable limits of be liable to the in- insurance of all insur- sured because of ers. an act, error or c. No Coverage omission to which this insurance may This Insurance shall not also apply. cover any toss for which the insured is entitled to d. No insured will, except recovery under any at that insured's own other insurance in force cost, voluntarily make a previous to the effective payment, assume any date of this Coverage obligation, or incur any Part. expense without our consent. e. Additional Definitions (2) Item 5. Other Insurance is re- As respects Employee Benefit Lia • - placed by the following: bility Coverage, Section V -Defini- tions is amended as follows: 5. Other Insurance • (1) The following definitions are If other valid and collectible gadded: , insurance is available to the , r insured for a loss We cover 1. Administration"means: under this Coverage Part, a. Providing information to our obligations are limited as "employees", including follows: their dependents and a. Primary Insurance beneficiaries, with re- spect to eligibility for or This insurance is prima- scope of "employee Ty except when c.below benefit programs"; applies.If this insurance is primary, our oblige- b. Interpreting the "em- tions are not affected ployee benefit pro- unless any of the other grams"; insurance is also prima- c. Handling records in ry. Then, we will share connection with the with all that other insur- "employee benefit pro- ance by the method de- grams";or scribed in b.below. Includes copyrighted material of Insurance GA 210 0917 Services Office, Inc.,with its permission. Page 7 of 15 d. Effecting, continuing or ees" who are eligible terminating any "em- under the plan for such pioyee's"participation in benefits; any benefit included in the "employee benefit c. Unemployment insur- program". ance, social security benefits, workers' corn- However, "administration" pensation and disability does not include: benefits,and a. Handling payroll deduc- d. Vacation plans, includ- tions; or ing buy and sell pro- grams; leave of ab- b. The failure to effect or sence programs,indud- maintain any insurance ing military, maternity, or adequate limits of family, and civil leave; coverage of insurance, tuition assistance plans; including but not limited transportation and to unemployment insur- healtlydgb subsidies. w ,„ ance, social security benefits, workers' corn- 4. "First effective date" means • pensation and disability the date upon which cover- benefits. age was first effected in a 2. "Cafeteria plans" means series of uninterrupted cover- plansre- authorized by applica- re- newels of insurance ble law to allow"employees" age. to elect to pay for certain (2) The following definitions are de- benefits with pre-tax dollars. leted in their entirety and re- 3. "Employee benefit pro- placed by the following: • grams" means a program 8. "Employee"means a person providing some of all of the actively employed, formerly following benefits to "em- employed, on leave of ab- pioyees", whether provided sence or disabled,or retired. through a"cafeteria plan"or "Employee" includes a otherwise: s leased worker".'Employee" does not include a "tempo- a. Group life insurance; • nary worker" group accident or health insurance;dental,vision 21. "Suit"means a civil proceed- and hearing plans; and ing in which money damag- flexible spending ac- es because of an act, error counts;provided that no or omission to which this in- one other than an "em- surance applies are alleged. ployee" may subscribe "Suit"includes: . to such benefits and • - such benefits are madea. An arbitration proceed- generally available to 1, ;` r ing in which such dam- those "employees" who •ages are claimed and to satisfy the plan's eligibil- which the insured must ity requirements; submit or does submit b. Profit sharingwith our consent; plans, employee savings b. Any other alternative plans, employee stock dispute resolution pro- ownership plans, pen- seeding in which such sion plans and stock damages are daimed subscription plans, pro- and to which the in- vided that no one other sured submits with our than an "employee" consent;or may subscribe to such c, An appeal of a civil pro- benefits and such bene- seeding. fits are made generally available to all "employ- indudes copyrighted material of Insurance GA 210 0917 Services Office,.Inc.,with its permission. Page 843115 2. Unintentional Failure To Disclose Haz- 2) Rust or other cor- aids rosion, decay, de- terioration, en Section IV-Commercial General Liabil- orattehic or ity Conditions, 7. Representations is or latent detect or amended by the addition of the following: any quality in property that caus- Based on our dependence upon your rep- es it to damage or resentations as to existing hazards, if un- destroy itself; intentionally you should fail to disclose all 3) Smog; such hazards at the inception date of your policy, we will not reject coverage under 4) Mechanical break- this reakthis Coverage Part based solely on such down, including failure_ rupture or bursting 3. Damage To Premises Rented To You caused by centrif- ugal force; a. The last Paragraph of 2. Exclusions 5) Settling, cracking, underSection I-Coverage A-Rod- shrinking or ex- ily Injury-And Property Damage Li- - , 7 �. pension; ability is replaced by the following: Exclusions c.through q. do not apply 6) Nesting or infesta- tion,to "property damage" by fire, explo- or ror discharge or release of waste sion, lightning, smoke or soot to products or secre- premises while rented to you or tem- orarii occupied tions, by Insects, p y p' by you with pennis- birds, rodents or sion of the owner, for which the other animals;or amount we will pay is limited to the Damage To Premises Rented To 7) Presence, growth, You Limit as described In Section 111 proliferation, -Limits Of Insurance. spread or any ac- tivityin- b. The insurance provided under Sec- cgofungus, r tion I -Coverage A -Bodily Injury mildew, w mold y And Property Damage Liability ap- mycotoxins,mcoand any plies to"property damage"arising out of water damage to premises that are spores, scents o- pro- both rented to and occupied by you. byproducts _ sed duced or released (1) As respects Water Damage Le- by fungi. gal Liability,as provided in Para- (b) "Property damage" caused graph 3,b.above: , directly or indirectly by any The exclusions under Section 1- of the following: Coverage A-Bodily Injury And (I) Earthquake, volcanic Property Damage Liability, 2. y eruption, landslide or ._.Exclusions, other than i. War any other earth move- and the Nuclear Energy Liabil- ment ity Exclusion(Broad Form),are deleted and the following are (i) Water that backs up or added: overflows or is other- wise discharged from a This insurance does not apply to: sewer, drain, sump, (a) "Property damage" sump pump or related equipment; (i) Assumed in any con- tract or agreement;or • (iii) Water under the ground (II) Caused by or resulting _ surface pressing seeping from any of the follow- through: ing: 1) Foundations,walls, 1) Wear and tear; floors or paved surfaces; Includes copyrighted material of Insurance GA 210 0917 Services Office, Inc.,with its permission. Page 9 of 15 2) Basements, you with permission of whether paved or the owner; not or b. In the case of damage 3) Doors, windows or by fire, explosion, light- other openings. Hing, smoke or soot, while rented to you;or (c) Property damage" caused by or resulting from water ' C. In the case of damage that leaks or flows from by water, while rented plumbing, heating, air condi- to and occupied by you. boning, fire protection sys- tems, or other equipment, (2) pay is limited as caused by or resulting from described in Section B. Limits freezing, unless: e To Premisues Rented To You of this (i) You did your best to endorsement. maintain heat in the ,4Supplementary building or structure;or Payments ' Under''Section I Supplementary Pay- ments You drained the equip- ments-Coverages A And B: ment and shut off the g water supply If the heat a. Paragraph 2. is replaced by the fol- was not maintained. lowing: (d) "Property damage"to: Up to the limit shown in Section B. (i) Plumbing, heating, air Limits Of Insurance,4a.Bail Bonds conditioning,fire protea of this endorsement for cost of bail tion systems, or other bonds required because of accidents equipment or applianc- or traffic law violations arising out of es;or the use of any vehicle to which the Bodily Injury Liability Coverage ap- ' (ii) The interior of any plies.We do not have to furnish these building or structure, or bonds. to personal property in the building or structure, ° 1:11 Paragraph 4. is replaced by the fol- caused by or resulting lowing: from rain,snow,sleet or All reasonable expenses Incurred by ice, whether driven by the insured at our request to assist us wind or not. in the Investigation or defense of the c. Limit Of Insurance claim or"suit',Including actual loss of earnings up to the limit shown In Sec- With respect to the insurance afford- tion B. Limiits Of Insurance, 4.b. ed in Paragraphs 3a.and 3.b.above, Loss Of Earnings of this endorsement the Damage To Premises Rented per day because of tine off from To You Limit as shown in the Decla- work. . =rations is amended as follows: (1) Paragraph 6. of Section III - 5. Medical Payments Limits Of Insurance is replaced The. Medical Expense Limit of Any One by the following: Person as stated in the Declarations is amended to the limit shown in Section B. 6. Subject to Paragraph 5. Limits Of Insurance, 5. Medical Pay- above, the Damage To ments of this endorsement. Premises Rented To You 6. 180 DayCoverage For NewlyFormed Limit 9 is the most we will pay under Coverage A -Bodily Or Acquired Organizations Injury And Property Dam- Section II - Who Is An Insured is age Liability for damages amended as follows: because of "property dam- age"to any one premises: Subparagraph a. of Paragraph 3. is re- a. While rented to you, or placed by the following: temporarily occupied by a. Insurance under this provision is af • - forded only until the 180th day after Includes copyrighted material of Insurance GA 210 0917 Services Office, Inc,with its permission. Page 10 of 15 . you acquire or form the organization use of that part of the prem- or the end of the policy period, ises leased to you, subject whichever is earlier; to the following additional 7. Waiver Of Subrogation exclusions: Section IV-Commercial General Uabil- This insurance does not ap- plyity Conditions,9.Transfer Of Rights Of to: Recovery Against Others To Us is (i) Any"occurrence"which amended by the addition of the following: takes place after you We waive any right of recovery we may cease to be a tenant in against anythat premises; have person or organization against whom you have agreed to waive (ii) Structural alterations, such right of recovery in a written contract new construction or or agreement because of payments we demolition operations make for injury or damage arising out of performed by or on be- your ongoing operations or "your work" half of such additional done under a written contract`or agree- r insured. ment with that person or,organization and included in the"products-completed oper- (b) Lessor Of Leased Equip- ations hazard". However, our rights may ment only be waived prior to the "occurrence" giving rise to the injury or damage for Any person or organization which we make payment under this Coy- from whom you lease erage Part. The insured must do nothing equipment per when you and after a loss to impair our rights.At our re- such person(s)agreedr oper Par- quest, have per Par- quest,the insured will bring"suit"or trans- agraph 8.a.(1) of this en- fer those rights to us and help us enforce dorsement to provide insur- those rights. arca. Such person(s) or or- b. Automatic Additional Insured - Speci- ganization(s) are insureds fled Relationships only with respect to liability for "bodily injury', "property a. The following is added to Section II- damage" or "personal and Who Is An Insured: advertising injury'caused,in (1) Any person(s) or organization(s) whole or in part, by your or described in Paragraph 8.a.(2)of use ofnan ip, nt leased to use of equipment leased to this endorsement (hereinafter re- you by such person(s)or or- ferred to as additional insured) ganization(s). A person's or ' whom you are required to add as organization's status as an an additional insured under this additional insured under this Coverage Part by reason of a endorsement ends when written contract, written agree- their contract or agreement ment, written permit or written with you for such leased authorization. ° equipment ends. However, (2) Only the following persons or or- this insurance does not ap- ganizations are additional in- ply to any "occurrence" sureds under this endorsement, which takes place after the and insurance coverage provided equipment lease expires. to such additional insureds is lira- • (c) Vendors ited as provided herein: Any person or organization (a) Managers Or Lessors Of Premises (referred to below as ven- dor) with whom you have • The manager or lessor of a agreed per Paragraph premises leased to you with 8.a.(1) of this endorsement whom you have agreed per to provide insurance, but on- Paragraph 8.a.(1)of this en- ly with respect to 'bodily in- dorsement to provide insur- ' jury" or 'property damage" anoe, but only with respect arising out of"your products" to-liability arising out of the - which are distributed or sold ownership, maintenance or in the regular course of the Includes copyrighted material of Insurance GA 210 0917 Services Office,Inc.,with its permission. Page 11 of 15 vendors business, subject or repair opera- to the following additional tions, except such exclusions: operations per- (i) The insurance afforded formed at the ven- the vendor does not dors premises in connection with the apply ix • sale of the product; 1) 'Bodily injury' or "property damage" er dudistribution which,af or t for which the van- ter try ibutionr dor is obligated to sale by you, have by been labeled or re- pay pay damages of the bys- labeled or used as reasonsumption of liability a container, part or o in a contract or ingredient of any agreementThis other thing or sub- •exdusion does not vor for the apply'to liability for 4a"5; veenn o3 dor, r• damages that the • r 9 ' "' 8$ "Bodily injury' or • vendor would have "property damage" In the absence of arising out of the the contract or sole negligence of agreement; the vendor for its 2) Any express war- own acts or omis- ranty unauthorized sions or those of byits anyone elseemployees actingor 3) Any physical or on its behalf. How- chemical change in ever,this exclusion the product made does not apply to: intentionally by the a) The exce • vendor; tions contained • • 4) Repackaging, ex- in Paragraphs cept when un- (c) (i) 4) or 6) • packed solely for of. this en- the purpose.of in- dorsemen4 or spection, demon- b) Such inspec- stration, testing, or tions, adjust- the substitution of ments,tests or parts under servicing as structions from the the vendor has manufacturer, and agreed to • then repackaged in • the original con- make or r- many undeder- tainer;. takes to make 5) Any failure to make in the usual such inspections, course of aclustments, tests business, in or servicing as the connection vendor has agreed with the to make or normal-. bution or sale sale ly undertakes to of the prod- make in the usual ucts. course of busi- (il) This insurance does not ness, in connection apply to any insured with the distribution person or organization: or sale of the products; 1) From whom you 6) Demonstration, in- have acquired stallation, servicing such products, or any ingredient,part • • Includes copyrighted material of Insurance GA 210 0917 Services Office, Inc.,with its permission. Page 12 of 15 or container, enter- (e) Mortgagee, Assignee Or ing into, accompa- Receiver nying or containing such products; or Any person va om you h rgiz s Aon 2) When liability in- per Paragraph 8.a.(1) of this cluded within the endorsement to provide in- "products- surance, but only with re- completed opera- spect• to their liability as tions hazard" has mortgagee, assignee, or re- been excluded un- ceiver and arising out of the der this Coverage ownership, maintenance, or Part with respect to use of the premises by you. such products. However, this insurance (d) State Or Governmental does not apply to structural alterations,new construction Agency Or Subdivision Or and demolition operations Political Subdivision performed by or for that per- Permits Or Authorizations s son or organization. Relating To Premises Arty state or governmental (3) The insurance afforded to addi- tional insureds described in Par- agency or subdivision or po- agraph 8.a.(1) of this endorse- litical subdivision with which meet: you have agreed per Para- graph 8.a.(1) of this en- (a) Only applies to the extent dorsement'to provide insur- permitted by law; and ance, subject to the follow- ing additional provision: (b) Will not be broader than that which you are required by This insurance applies only the written contract, written with respect to the following agreement, written permit or hazards for which the state written authorization to pro- or governmental agency or vide for such additional in- subdivision or political sub- sured; and division has issued a permit or authorization in connec- (c) Does notapply to any per- tion with premises you own, son, organization, vendor, • rent or control and to which state, governmental agency • this insurance applies: or subdivision or political • subdivision, spedfically (i) The existence, mainte- named as an additional in- nance, repair, construc- sured under any other provi- ' tion,erection or removal ,. sion of, or endorsement of advertising signs, added to, this Coverage awnings, canopies, cel- Part, provided such other ' lar entrances,• coal .,t <•. provision or endorsement holes, driveways, man- covers the injury or damage holes, marquees, hoist for which this insurance ap- away openings, side- plies. walk vaults, street ban- ners or decorations and b. With respect to the insurance afford- similar exposures;or ed to the additional insureds de- scribed in Paragraph 8.a.(1) of this (ii) The construction, erec- endorsement,,the following is added tion or removal of eleva- to Section III—Limits Of Insurance: tors;or _ The most we will pay on behalf of the (ii) The ownership, mainte- additional insured is the amount of in- nance or use of any el- surance: evators covered by this V insurance. (1) Required by the written contract, written agreement,written permit • or written authorization described • Includes copyrighted material of Insurance , GA 210 0917 Services Office, Inc.,with its permission. Page 13 of 15 in Paragraph 8.a.(1) of this en- • tion i -Coverage A -Bodily Injury dorsement or And Property Damage Liability: (2) Avail able under the applicable Paragraphs (3) and (4) of this exclu- Limits of Insurance shown in the sion do not applyto tools or equip- Declarations; ment loaned to you,provided they are not being used to perform operations whichever Is less. at the time of loss. This endorsement shall not increase b. With respect to the insurance provid- the applicable Limits of Insurance ed by this section of the endorse- shown in the Declarations. ment, the following additional provi- c. Section IV - Commercial General sions apply: Liability Conditions is amended to (1) The Limits of Insurance shown in include the following: the Declarations are replaced by Automatic Additional Insured Pro- the limits designated in Section vision B.., Litaits1 Of Insurance, 9. Property Damage To Borrowed This insurance applies only if the t: •., Equipment ofethis endorsement "bodily injury of "property damage" 'with respect to coverage provid- occurs,or the "personal and advertis- , ed by this endorsement. These ing injury'offense is committed: limits are inclusive of and not in (1) During the policy period;and addition to the limits being re- placed, The Limits of Insurance (2) Subsequent to your execution of .shown.in Section B. Limits Of the written contract or written Insurance, 9:Property Damage agreement, or the Issuance of a To Borrowed Equipment of this written permit or written authori- endorsement fix the most we will zation, described in Paragraph pay in any one "occurrence" re- 8.a.(1). gardless of the number of: d. Section IV - Commercial General (a) Insureds; Liability Conditions is amended as (b) Claims made or "suits" follows: ,.\ brought;or Condition 5. Other Insurance is (c) Persons or organizations amended to include: making claims or bringing Primary And Noncontributory in- "suits". surance (2) Deductible Clause This insurance is primary to and will • (a) Our obligation to pay dam- not seek contribution from any other ages on your behalf applies insurance available to an additional only to the amount of dam- insured per Paragraph 8.a.(1) of this ages for each "occurrence" endorsement provided that: ,. which are in.excess of the (1) The additional insured is a Deductible Amount stated in Named Insured under such other Section B. Limits Of Insur- insurance;and ance, 9. Property Damage To Borrowed Equipment of (2) You have agreed in writing in a this endorsement. The limits contract, agreement, permit or of insurance will not be re • - authorization described in 8.a.(2) duced by the application of of this endorsement that this in- such Deductible Amount. surance would be primary and • would not seek contribution from (b) Section IV - Commercial any other insurance available to General Liability Condi- the additional insured. tions, 2. Duties In The Event Of Occurrence, Of- 9. Property Damage To Borrowed Equip- fense, Claim Or Suit, ap- ment plies to each claim or "suit' irrespective of the amount. a. The following is added to Exclusion 2.j.Damage To Property under Sec- • includes copyrighted material of Insurance GA 210 0917 Services Office, Inc.,with its permission. Page 14 of 15 f (c) We may pay any part or all 12. Nonowned Aircraft of the deductible amount to effect settlement of any The following is added to Exclusion 2.g. claim or'Suit'and, upon no- Aircraft, Auto Or Watercraft under Sec- tification of the action taken, tion I -Coverage A-Bodily Injury And you shall promptly reim- Property Damage Liability: burse us for such part of the This exclusion does not apply to an air- deductible amount as has craft ycu do not own, provided that: been paid by us. 10. Employees As Insureds - Specified a. The pilot in command holds a current Health Care Services And Good Samar- effective certificate, issued by a duly itan Services constituted authority of the United States of America or Canada, desig- Paragraph 2.a.(1Xd) under Section II - nating that person as a commercial or Who Is An Insured does not apply to: airline transport pilot a. Your,."errwpl ;� s" who provide pro- fessional healthcare services on your paid crew;and behalf as a• duly licensed nurse, C .. The isaircraft does not;�transport per- emergency medical technician or sons or cargo for a charge. paramedic in the jurisdiction where an "occurrence" or offense to which this 13. Bodily Injury Redefined insurance applies takes place;or Section V-Definitions,4. "Bodily injury' b. Your"employees"or"volunteer work- is replaced by the following: ers", other than an employed or vol- unteer doctor, providing first aid or 4. "Bodily injury" means bodily harm or good samaritan services during their injury, sickness, disease, disability, work hours for you will be deemed to humiliation, shock, fright, mental an- be acting within the scope of their guish or mental injury, induding care, employment by you or performing du- loss of services or death resulting ties related to the conduct of your from any of these at any time. business. 14. Expected Or Intended injury Redefined 11. Broadened Notice Of Occurrence The last sentence of Exclusion 2.a. Ex- Paragraph a. of Condition 2. Duties In pected Or Intended injury under Sec- The Event Of Occurrence, Offense, tion 1 -Coverage A -Bodily Injury And Claim Or Suit under Section IV- Com- Property Damage Liability is replaced by mercial General Liability Conditions is the following: replaced by the following: This exclusion does not apply to "bodily a. You must see to it that we are notified inlury"or"property damage"resulting from as soon as practicable of an "occur- the use of reasonable force to protect per- rence"or an offense which may result sons or property. • in a claim.To the extent possible,no- 15. Former Employees As Insureds .. . _ tice should include: (1) How, when and where the "oc- The following is added to Paragraph 2. currence"or offense took place; under Section II-Who Is An Insured: (2) The names and addresses of 2. Each of the following is also an anyIn- injured sured: N persons and wit- nesses;and Any of your former "employees", di- (3) The nature and location of any rectors, managers, members, part- ners or"executive officers", including injury or damage arising out of the"occurrence"or offense. but not limited to retired, disabled or those on leave of absence, but only This requirement applies only when ' for acts within the scope of their em- the"occurrence" or offense is known ployment by you or for duties related to an"authorized representative". to the conduct of your business. Includes copyrighted material of Insurance GA 210 0917 Services Office, Inc.,with its permission. Page 15 of 15 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CinciPlus® BUSINESS AUTO XC+® (EXPANDED COVERAGE PLUS) ENDORSEMENT This endorsement modifies insurance provided by the following: • BUSINESS AUTO COVERAGE FORM With respect to tin coverage provided by this endorsement,the provisions of the Coverage Form apply unless modified by this endorsement. A. Blanket Waiver of Subrogation This provision does not apply unless the valid SECTION IV - BUSINESS AUTO CONDI- written contract has been: TIONS, A. Loss Conditions; 5. Transfer of 1. Executed prior to the accident causing Rights of Recovery Against Others to Us is "bodily injury"or"property damage";and amended by the addition of the following: 2. Is still in force at the time of the"accident" We waive any right of recovery we may have causing "bodily injury" or "property dam- against any person or organization because of age". payments we make for "bodily injury" or "property damage"arising out of the operation D. Employee Hired Auto of a covered "auto"when you have assumed 1. Changes in Liability Coverage liability for such "bodily injury" or "property damage" under an "insured contract", provid- - The following is addedto the Section II - ed the"bodily injury"or"property damage"oc- Liability Coverage, A. Coverage, 1. curs subsequent to the execution or the "in- Who Is an Insured: sured contract". An "employee" of yours is an "insured" B. Noncontributory Insurance while operating an "auto" hired or rented SECTION IV - BUSINESS AUTO CONDI- under a contract or agreement in that TIONS, B. General Conditions, 5. Other In- while performing with your tpermission,tt surance c.is replaced by the following: conduct o fyour b duties related to the of your business. c. Regardless of the provisions of Par- 2. Changes in General Conditions agraph a. above, this Coverage Form's Liability Coverage is primary SECTION IV - BUSINESS AUTO CON- and we will not seek contribution DITIONS, B. General Conditions, 5. from any other insurance for any Iia- Other Insurance is amended by replac- bility assumed under an "insured ing Paragraph 5.b.with the following: contract" that requires liability tobe b. For Hired Auto Physical on a primary noncontributo- Damage ry basis. Coverage the following are deemed to be covered"autos"you own: C. Additional Insured by Contract (1) Any covered "auto" ,you lease, SECTION II - LIABILITY COVERAGE, A. hire,rent or borrow;and Coverage, I.Who is an Insured is amended to include as an insured any person or organi- (2) Any covered "auto" hired or zation with which you have agreed in a valid rented by your"employee" under written contract to provide insurance as is af- a contract in that individual "em- forded by this policy. ployee's" name,_with your per- mission, while performing duties This provision is limited to the scope of the related to the conduct of your valid written contract. business. Includes copyrighted material of ISO AA 288 01 16 Properties, Inc.,with its permission. Page 1 of 4 d, 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; E. Audio, Visual and Data Electronic Equip- b. Does not apply to "bodily injury" or merit "property damage" resulting from an SECTION III - PHYSICAL DAMAGE COV- "accident" that occurred before you ERAGE, C. Limit of Insurance is amended acquired or formed the organization; by adding the following: c. Does not apply to any newly acquired 4. The most we will pay for all "loss" to au- or formed organization that is a joint venture or partnership;and dio, visual or data electronic equipment 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. dent"is the lesser of: or would bean 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 or the exhaustion of such poli- cy's limits of ihsurafoce. i. of the"accident"; I , -3., Any,of your "employees" while using a b. The cost,of repairing or replacing the covered "auto" in your business Or your damaged-or stolen property with oth- personal affairs,provided you do not own, er property of like kind and quality;or hire or borrow that"auto". • c. $2,500. G. Liability Coverage Extensions - Supple- Provided the equipment,at the time of the mentary Payments-Higher Limits loss"is: SECTION II - LIABILITY COVERAGE, A. a. Permanently installed in or upon the Coverage,2. Coverage Extensions,a.Sup- covered "auto" in a housing, opening plementary Payments is amended by: or other location that is not normally 1. Replacing the $2,000 Limit of Insurance used by the "auto" manufacturer for for bail bonds with$4,000 in(2); and the installation of such equipment; 2. Replacing the$250 Limit of Insurance for b. Removable from a permanently in- stalled housing unit as described in reasonable expenses with$500 in(4). Paragraph 2.a.above;or H. Amended Fellow Employee Exclusion c. An integral part of such equipment. SECTION II-LIABILITY COVERAGE,B.F. Who is an Insured-Amended Ex- clusions, 5. Fellow Employee is modified as follows: SECTION II - LIABILITY COVERAGE, A. Exclusion 5. Fellow Employee is deleted. Coverage,1.Who is an Insured is amended by adding the following: I.. Hired Auto-Physical Damage The following are"insureds": If hired"autos"are covered"autos"for Liability 1. Any subsidiary which is a legally incorpo- Coverage, then Comprehensive and Collision rated ebsidiar which you own a financial Physical Damage Coverages as provided un- r interest oftyTofthan ou f a voting der SECTION 111 - PHYSICAL DAMAGE ex- stock on the moreecan da50te of theis cover-r COVERAGE of this Coverage Part are s form. tended to "autos" you hire, subject to the fol- lowing: However, the insurance afforded by this 1. The most we will pay for "loss" to any provision does not apply to any subsidiary hired"auto"is $50,000 or the actual cash that is an "insured" under any other au- value or cost to repair or replace, which • - tomobileliability policy, or would be an ever is the least,minus a deductible. insured" under such policy but for termi- nation of such policy or the exhaustion of 2. The deductible will be equal to the largest such policy's limits of insurance. deductible applicable to any owned"auto" for 2. Any organization that is newly acquired or es that coverage,or$1,000,whichever is l formed by you and over which you main- less. tain majority ownership. The insurance 3. Hired Auto - Physical Damage coverage provided by this provision: is excess over any other collectible insur- ance. Includes copyrighted material of ISO AA 288 01 16 Properties,Inc.,with its permission. Page 2 of 4 • 4. Subject to the above limit,deductible,and K. Transportation Expense-Higher Limits excess provisions we will provide cover- age equal to the broadest coverage appli- SECTION III - PHYSICAL DAMAGE COV- cable to any covered "auto" you own in- ERAGE, A. Coverage, 4. Coverage Exten- sured under this policy. sions is amended by replacing $20 per day with $50 per day, and $600 maximum with Coverage includes loss of use of that hired au- $1,500 maximum in Extension a. Transpor- to, provided it results from an "accident" for tation Expenses. which you are legally liable and as a result of which a monetary loss is sustained by the L. Airbag Coverage leasing or rental concern. The most we will SECTION III - PHYSICAL DAMAGE COV- pay for any one'accident"is$3,000. ERAGE, B. Exclusions, 3.a. is amended by If a limit for Hired Auto - Physical Damage is adding the following: shown in the Schedule, then that limit repiac- However, the mechanical and electrical es,and is not added to, the $50,000 limit indi- breakdown portion of this exclusion does not cated above. apply to the accidental discharge of an airbag. J. Rental Reia} xseeaten'i.' This coverage for airbags is excess over any other collectible insurance or warranty. SECTION iii. - . PHYSICAL -DAMAGE is amended by adding the following: M. 'Loan ar Lease Gap Coverage 1. We will pay for rental reimbursement ex- 1. SECTION iII - PHYSICAL DAMAGE penses incurred by you for the rental of COVERAGE, C. Limit of Insurance is an"auto"because of a loss"to a covered deleted in its entirety and replaced by the "auto". Payment applies in addition to the following, but only for private passenger otherwise applicable amount of each coy- type"autos"with an original loan or lease, erage you have on a covered "auto": No and only in the event of a "total loss" to deductible applies to this coverage. such a private passenger type"auto": 2. We will pay only for those expenses in- a. The most we will pay for"loss"in any curred during the policy period beginning one"accident"is the greater of: 24 hours after the "loss" and ending, re- (1) The amount due under the terms gardless of the policy's expiration, with of the lease or loan to which the lesser of the following number of your covered private passenger days: type"auto"is subject,but will not a. The number of days reasonably re- include: quired to repair the covered"auto". If (a) Overdue lease or loan pay- "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 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- curred;or (d) Costs for extended warran- 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. temiining actual cash value at the time of"loss". Includes copyrighted material of ISO AA 288 01 16 Properties, Inc., with its permission. Page 3 of 4 . 2. SECTION V - DEFINITIONS is amended P. Unintentional Failure to Disclose Hazards by adding the following, but only for the SECTION IV - BUSINESS AUTO CONDI- purposes of this Loan or Lease Gap Coverage: TIONS, B. General Conditions, 2. Conceal- ment, Misrepresentation or Fraud is "Total loss" means a loss" in which the amended by adding the following: cost of repairs plus the salvage value ex- ceeds the actual cash value. However, if you unintentionally fail to disclose any hazards existing on the effective date of N. Glass Repair-Waiver of Deductible this Coverage Form, we will not deny cover- SECTION !II - PHYSICAL DAMAGE COV- age under this Coverage Form because of ERAGE, D. Deductible is amended by adding such failure. the following: Q. Mental Anguish Resulting from Bodily Inju- No deductible applies to glass damage if the ry glass is repaired in a manner acceptable to us SECTION V-DEFINITIONS, C."Bodily inju- rather than replaced. ry" is deleted in its entirety and replaced by O. Duties in the Event of an Accident, Claim, the following: ,; • Suit or Loss-Amended "Bodily, injury"means bodily injury,sickness or ;." disease sustained by a person,"'including men- SECTION IV - BUSINESS AUTO CONDI- tal anguish and death sustained by the same TIONS,A.Loss Conditions,2. Duties in the person that results from such bodily injury, Event of Accident,Claim,Suit or Loss,a.is sickness or disease. "Bodily injury" does not amended by adding the following: include mental anguish or death that does not This condition applies only when the "acci- result from bodily injury,sickness or disease. dent"or"loss"is known to: R. Coverage for Certain Operations In Con- 1. You,if you are an individual; nection with Railroads 2. A partner,if you are a partnership; With respect to the use of a covered "auto" in operations for or affecting a railroad: 3. An,executive officer or insurance manag- er, if you are a corporation;or 1. Section V-Definitions, H. "Insured con- tract",1.c.is amended to read: 4. A member or manager, if you are a lim- ited liability company. c. An easement or license agreement; 2. Section V-Definitions, H."Insured con- tract",2.a.is deleted. includes copyrighted material of ISO AA 288 01 16 Properties, Inc.,with its permission. Page 4 of 4 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - AUTOMATIC STATUS WHEN REQUIRED IN CONSTRUCTION AGREEMENT WITH YOU - COMPLETED OPERATIONS ONLY This endorsement modifies insurance provided under the following: I - / I t . u _ A COMMERCIAL GENERAL LIABILITY COVERAGE PART . , , ,I, A. SECTION II - WHO IS AN INSURED is Thls insurance does not apply to: amended to include as an additional insured any person or organization when you and such 1. "Bodily injury","property damage"or"per- person or organization have agreed In writing sonal and advertising injury"arising out of in a contract or agreement that such person or the rendering of, or the failure to render, organization be added as an additional inured on professional architectural, engineer- on your policy, but only with respect to "bodily Ing or surveying services,including: injury", "property damage" or "personal and a. The preparing,approving,or failing to advertising injury"caused, In whole or in part, prepare or approve, maps, shop by'your work"performed for the additional in- drawings, opinions, reports, surveys, sured and included in the"products-completed field orders, change orders or draw- operations hazard". ings and g specifications;or If not specified otherwise in the written con- b. Supervisory, Inspection, architectural tract or agreement, a person's or organize- b. architectural tlon's status as an additional Insured under this or engineering activities. endorsement ends one year after your opera- 2. 'Bodily injury"or "property damage" aris- tions for that additional Insured are completed. Ing out of"your work"for which.a consoll- The written contract or agreement must be dated (wrap-up) insurance program has currently In effect or become effective during been provided by the prime oontrac- the term of this Coverage Park The contract tor/project manager or owner of the Con- or agreement must be executed prior to the struction project in which you are involved. 'bodily injury","property damage"or"personal and advertising injury"to which this endorse- 3. 'Bodily injury","property damage"or"per- ment pertains. sonal and advertising injury" to any em- ployee of you or to any obligation of the However additional insured to indemnify another 1. The insurance afforded to such additionsl because of damages arising out of such insured only applies to the extent permit- rn�ury. ted by law,and 4. 'Bodily injury","property damage" or"per- sonal and advertising injury"for which the 2. If coverage provided to the additional in- Named Insured is afforded no coverage sured is required by a contract or agree- under this policy of insurance. . ment, the insurance afforded to such ad- ditional insured will not be broader than C. With respect to the insurance afforded to that which you are required by the con- these additional insureds, SECTION 111-LIM- tract or agreement to provide for such ad- ITS OF INSURANCE is amended to include: ditiona!insured. ed B. With respect to the insurance afforded to arheethosee s applicable to the additional insuo specified In the written contract or these additional insureds, the following add!- agreement or in the Dedarations of this Coy- tional exclusions apply: erage Part, whichever is less. If no limits are includes copyrighted material of ISO CSIA405(08/09)-A- Properties,Inc.,with its permission. Page 1 of 2 specified In the written contract or agreement, Any coverage provided herein will be excess the limits applicable to the additional Insured over any other valid and collectible Insurance are those specified in the Declarations of this available to the additional insured whether Coverage Part.The limits of insurance are In- primary, excess, contingent or on any other clusive of and not in addition to the limits of in- basis unless you have agreed in a written con- surance shown in theDeclarations. tract or written agreement executed prior to D. With respectany loss that this insurance will be primary. to the insurance afforded to This insurance will be noncontributory only if these additional insureds, SECTION IV - you have so agreed in a written contract or COMMERCIAL GENERAL LIABILITY CON- written agreement executed prior to any loss • DITIONS, 4. Other Insurance is amended to include: and this coverage is determined to be primary. Includes copyrighted material of ISO CSIA405(08/09)-A- Properties,Inc.,with its permission. Page 2 of 2 COMMERCIAL GENERAL LIABILITY CSGA 4087 12 12 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US - PER CONTRACT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to Paragraph S.Transfer of Rights of Recovery Against Others to Us of SECTION IV-CONDITIONS: If you have agreed, in a written contract or agreement, to provide a waiver of any right of recovery against a person or organization,we will waive any right of recovery we may have against that person or organization because of payments we make for injury or damage arising out of your ongoing operations or'your work"done under a contract with that person or organization and included in the"products-completed operations hazard". This waiver applies only to that person or organization for which you have agreed to in a written contract to provide said waiver. Includes copyrighted material of Insurance CSGA 4087 12 12 Services Office, Inc.,with its permission. Page 1 of 1 1