Loading...
HomeMy WebLinkAboutInsurance Certificate: Mountain View Paving Inc ARD® CERTIFICATE OF LIABILITY INSURANCE DATE(M AE(M oz2yy) 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 HUB International Northwest, LLC PHPHON: Kim Schnetzky PO Box 10167 (NCNr o.E:d1:541-687-1117 FAX No):541-342-8280 Eugene OR 97440 ADDRESS: kim.schnetzky@hubintemational.com INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Cincinnati Casualty 28665 INSURED 14229 INSURER B: Mountain View Paving Inc PO Box 508 INSURER C: Talent OR 97540 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:716815566 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 LTR TYPE OF INSURANCE ADDL SWVD POLICY NUMBER POLICY EFF POLICY EXP LIMITS (MMIDD/YYYI) (MM/DD/YYYY) A X COMMERCIAL GENERALLIABILITY Y Y EPP 0404007 9/25/2022 9/25/2023 EACH OCCURRENCE $1,000,000 CLAIMS-MADE X OCCUR DAMAGE TO RENTED PREMISES(Ea occurrence) $500,000 MED EXP(Any one person) $10,000 _ PERSONAL&ADV INJURY $1,000,000 GE 'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 _ POLICY X Tel: LOC PRODUCTS-COMP/OP AGG $2,000,000 OTHER: $ A AUTOMOBILE LIABILITY Y Y EPP 0404007 9/25/2022 9/25/2023 COMBINED SINGLE LIMIT $1,000,000 (Ea accident) X ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURYPer accident) $ AUTOS ONLY AUTOS ( X HIRED X NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY (Per accident) A X UMBRELLA LIAB X OCCUR EPP 0404007 9/25/2022 9/25/2023 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/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Certificate holder and all entities required by written contract are included as additional insureds on a primary and non-contributory basis with waiver of subrogation as respects to the general liability including completed operations and auto liability,including waiver of subrogation as required by written contract per attached endorsements.Subject to policy limits,terms,conditions and exclusions. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Ashland ACCORDANCE WITH THE POLICY PROVISIONS. 90 N.Mountain Ashland OR 97520 AUTHORIZED REPRESENTATIVE „try ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD THIS ENDORSEMENT CHANGES THE POLICY.PLEASE READ IT CAREFULLY. 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- CONTRACTORS ADDITIONAL INSURED-AUTOMATIC STATUS operations or arising out of "your sions apply: AND AUTOMATIC WAIVER OF SUBROGATION work"; to: This insurance does notapply then the phrase caused, in whole or in WHEN REQUIRED IN WRITTEN CONTRACT,AGREEMENT, 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- PERMIT OR AUTHORIZATION 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 This endorsement modifies insurance provided under the following: the additional insureds described in Para- b. "Bodily injury"u "propertydamage" A.1.,the following additional exclu- or dama e" sion applies: included within the "products- COMMERCIAL GENERAL LIABILITY COVERAGE PART completed operations hazard." This insurance does not apply to"bodily injury", "property damage" or "personal C. The insurance afforded to additional insureds A. Additional Insured -Owners, Lessees Or cluded in the "products-completed and advertising injury"arising out of the described in Paragraphs A.and B.: Contractors-Automatic Status For Other operations hazard",but only if: rendering of,or the failure to render,any 1. Only applies to the extent permitted by Parties When Required In Written Contract professional architectural,engineering or law,and Or Agreement With You (1) The Coverage Part to which this surveying services,including: endorsement is attached pro- 2. Will not be broader than that which you 1. Section II - Who Is An Insured is vides coverage for"bodily injury" a. The preparing,approving or failing to are required by the written contract,writ- amended to include as an additional in- or•"property damage" included prepare or approve, maps, shop ten agreement,written permit or written . sured any person or organization you within the "products-completed drawings,opinions,reports,surveys, authorization to provide for such addition- have agreed in writing in a contract or operations hazard";and field orders,change orders or draw- al insured;and agreement to add as an additional in- ings and specifications;or sured on this Coverage Part. Such per- (2) The written contract or written 3. Does not apply to any person,organiza- son(s)or organization(s)is an additional agreement requires you to pro- b. Supervisory,inspection,architectural tion,state,governmental agency or sub- insured only with respect to liability for: vide additional insured coverage or engineering activities. division or political subdivision specifically included within the "products- named as an additional insured for the a. "Bodily injury","property damage"or completed operations hazard" This exclusion applies even if the claims P P P against any insured allege negligence or same project in the schedule of an en- "personal and advertising injury" for that person or organization. other wrongdoing in the supervision,hir- dorsement added to this Coverage Part. peused,rform in wholefyour or in part, by the If the written contract or written ing,employment,training or monitoring of performance of ongoing opera- D. With respect to the insurance afforded to the tions by you or on your behalf,under agreement requires you to provide others by that insured,if the"occurrence" additional insureds described in Paragraphs that written contract or written additional insured coverage included which caused the"bodily injury"or"prop- A.and B..the following is added to Section III agreement.Ongoing operations does within the"products-completed oper- erty damage", or the offense which -Limits Of Insurance: not apply to"bodily injury"or"proper- ations hazard"for a specified length caused the"personal and advertising inju- ty damage"occurring after: of time for that person or organiza- ry",involved the rendering of,or the fail- The most we will pay on behalf of the addi- tion,the "bodily injury" or"property ure to render,any professional architec- tional insured is the amount of insurance: (1) All work, including materials, damage"must occur prior to the ex- tural,engineering or surveying services. 1. Required by the written contract,written parts or equipment furnished in piration of that period of time in order connection with such work, on for this insurance to apply. 4. This Paragraph A.does not apply to addi- agreement. written permit or written au- the project (other than service, tional insureds described in Paragraph B. thorization described in Paragraphs A. maintenance or repairs) to be If the written contract or written and B.For the purpose of determining the P B. Additional Insured-State Or Governmental performed byor on behalf of the agreement requires you to provide required amount of insurance only,we will Agency Or Subdivision Or Political Subdi- include the minimum amount of additional insured(s)at the loca- additional insured coverage for a vision-Automatic Status When Required any Um- tion of the covered operations person or organization per only ISO q brella Liability or Excess Liability cover- In In Written Permits Or Authorizations has been completed;or additional insured endorsement form age required for that additional insured in number CG 20 10,without specifying 1. Section II - Who Is An Insured is that written contract, written agreement, (2) That portion of"your work"out of an edition date,and without specifi- amended to include as an additional in- written permit or written authorization;or which the injury or damage ails- cally requiring additional insured sured any state or governmental agency 2. Available under the applicable limits of In- es has been put to its intended coverage included within the"prod- or subdivision or political subdivision you surance; use by any person or organize- ucts-completed operations hazard", have agreed in writing in a permit or au- tion other than another contrac- this Paragraph b.does not apply to thorization to add as an additional insured whichever is less. tor or subcontractor engaged in that person or organization. on this Coverage Part.Such state or gov- performing operations for a prin- emmental agency or subdivision or politi- This endorsement shall not increase the appli- cipal as a part of the same pro- 2. If the written contract or written agree- cal subdivision is an additional insured cable limits of insurance. ject;and ment described in Paragraph 1. above specifically requires you to provide addi- only with respect to operations performed E. Section IV-Commercial General Liability b, "Bodily injury"or"property damage" tional insured coverage to that person or by you or on your behalf for which the Conditions is amended to add the following: caused,in whole or in part,by"your organization: state or governmental agency or subdivi- work" performed under that written sion or political subdivision has issued,in Automatic Additional Insured Provision contract or written agreement and in- a. Arising out of your ongoing opera- writing,a permit or authorization. tions or arising out of"your work";or Includes copyrighted material of Insurance . Includes copyrighted material of Insurance GA 472 OS 20 Services Office,Inc.,with its permission. Page 1 of 3 GA 472 05 20 Services Office,Inc.,with its permission. Page 2 of 3 This insurance applies only if the"bodily inju- scribed in Paragraph A.or B.that this in- ry"or"property damage"occurs,or the"per- surance would be primary to any other in- sonar and advertising injury"offense is corn- surance available to the additional in- mined: sured. 1. During the policy period;and As used in this endorsement,wrap-up insur- ance2. Subsequent to your execution of the writ- means a.centralized insurance program in- ten contractuewritten of t,or the under which one party has secured either a or ren permitagreement, or enwrt,te the surance or self-insurance covering some or all issuancenie of described in Paragraphs au-A- of the contractors or subcontractors perform- and B. ing work on one or more specific project(s). F. Except when G.below applies,the following is Primary And Noncontributory Insurance When Required added to Section IV-Commercial General ,Permit Or Authorization By Written Contract, Liability Conditions, Other Insurance, and Agreement, supersedes any provision to the contrary: Except when wrap-up insurance applies to the Other Additional Insured Coverage claim or"suit"on behalf of the additional in- Wheng sured,this insurance is primary to and will not Applies On An Excess Basis seek contribution from any other insurance This insurance is primary to other insurance available to the additional insured described in available to the additional insured described in Paragraphs A.and B.provided that: Paragraphs A.and B.except: 1. The additional insured is a Named In- 1. As otherwise provided in Section IV- sured under such other insurance;and Commercial General Liability Condi- 2. You have agreed in writing in a contract, tions, Other Insurance, b. Excess In- agreement, permit or authorization de- surance;or scribed in Paragraph A.or B.that this in- 2. For any other valid and collectible insur- surance would be primary and would not ance available to the additional insured as . seek contribution from any other insur- an additional insured on another insur- ance available to the additional insured. ance policy that is written on an excess As used in this endorsement,wrap-up insur- basis.In such case,this insurance is also ance means a centralized insurance program excess. under which one party has secured either in- G. The following is added to Section IV-Com- surance or self-insurance covering some or all mercial General Liability Conditions,Other of the contractors or subcontractors perform- Insurance,and supersedes any provision to ing work on one or more specific project(s). the contrary: H. Section IV-Commercial General Liability Primary Insurance When Required By Writ- Conditions,Transfer Of Rights Of Recov- ten Contract, Agreement, Permit Or Au- ery Against Others To Us is amended by the thorization addition of the following: Except when wrap-up insurance applies to the Waiver of Subrogation claim or"suit"on behalf of the additional in- We waive any right of recovery against any sured,this insurance is primary to any other additional insured under this endorsement. insurance available to the additional insured because of any payment we make under this described in Paragraphs A.and B.provided endorsement, to whom the insured has that: waived its right of recovery in a written con- 1. The additional insured is a Named In- tract,written agreement,written permit or writ- sured under such other insurance;and ten authorization. Such waiver by us applies only to the extent that the insured has waived - 2. You have agreed in writing in a contract, its right of recovery against such additional in- agreement, permit or authorization de- sured prior to loss. Includes copyrighted material of Insurance GA 472 05 20 Services Office,Inc.,with its permission. Page 3 of 3 THIS ENDORSEMENT CHANGES THE POLICY.PLEASE READ IT CAREFULLY. b. Loss Of Earnings:$ 500 5. Medical Payments CONTRACTORS'COMMERCIAL GENERAL LIABILITY Medical Expense Limit:$10,000 BROADENED ENDORSEMENT 9. Property Damage To Borrowed Equipment Each Occurrence Limit: $10,000 This endorsement modifies insurance provided under the following: Deductible Amount: $ 250 16. Voluntary Property Damage Coverage(Coverage a.)And Care,Custody Or Control Liability COMMERCIAL GENERAL LIABILITY COVERAGE PART Coverage(Coverage b.) Limits Of Insurance A. Endorsement-Table of Contents: Coverage a. Coverage: Occurrence Begins on Page: $5,000 Aggregate 1. Employee Benefit Liability Coverage 3 Coverage b.$5,000 Each Occurrence unless otherwise stated$ 2. Unintentional Failure To Disclose Hazards 9 Deductible Amount(Each Occurrence) 3. Damage To Premises Rented To You .9 Coverage a.$250 4. Supplementary Payments 10 Coverage b.$250 unless otherwise stated$ 5. Medical Payments 10 6. 180 Day Coverage For Newly Formed Or Acquired Organizations 10 COVERAGE PREMIUM BASIS RATE ADVANCE PREMIUM 7. Waiver Of Subrogation - 11 (a) Area (For Limits in Excess of (For Limits in Excess of 8. Automatic Additional Insured-Specified Relationships: 11 (b) Payroll $5,000) $5,000) • Managers Or Lessors Of Premises; (c) Gross Sales • Lessor Of Leased Equipment; (d) Units • Vendors; (e) Other • State Or Governmental Agency Or Subdivision Or Political Subdivision-Permits b. Care, Custody Or Or Authorizations Relating To Premises;and Control $ • Mortgagee,Assignee Or Receiver TOTAL ANNUAL PREMIUM $ 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 16. Voluntary Property Damage Coverage And Care,Custody Or Control Liability Coverage 16 17. Broadened Contractual Liability-Work Within 50'Of Railroad Property 17 18. Alienated Premises 17 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. Ball Bonds: $2,500 Includes copyrighted material of Insurance Includes copyrighted material of Insurance GA 233 0917 Services Office,Inc.,with its permission. Page 1 of 17 GA 233 0917 Services Office,Inc.,with its permission. Page 2 of 17 • C. Coverages this endorsement pro- (d) Insufficiency Of Funds (i) Taxes,Fines Or Penalties 1. Employee Benefit Liability Coverage vided: Damages arising out of an Taxes,fines or penalties,In- a. The following is added to Section I- a) You did not have insufficiency of funds to cluding those imposed un- knowledge of a meet any obligations under der the Internal Revenue Coverages: claim or"suit"on or any plan induded in the Code or any similar state or Employee Benefit Liability Cover- before the'first ef- "employee benefit program". local law. age fective date"of this endorsement. (e) Inadequacy Of Perfor- (j) Employment-Related Prac- (1) Insuring Agreement mance Of Invest- tices You will be ment/Advice Given With Any liability arising out of (a) We will pay those sums that deemed to have Respect To Participation the Insured becomes legally knowledge of a any: obligated to pay as damag- claim or "suit" Any claim based upon: es caused by any act,error when any"author- (1) Refusal to employ; or omission of the insured, ized represents- 1) Failure of any invest- Termination of employ- ment; m to or of any other person for five"; ment to perform; (2) ment; p whose acts the insured is 2) Errors in providing in- legally liable, to which this i) Reports all, or formation on past per- (3) Coercion, demotion, insurance applies. We will any part,of the evaluation,formance of investment reassign- have the right and duty to act, error or vehicles;or ment, discipline, defa- defend the insured against omission to us mation, harassment, any "suit" seeking those or any other 3) Advice given to any humiliation, discrimina- damages.However,we will insurer, person with respect to tion or other employ- have no duty to defendij Receives a that person's decision to ment-related practices, against any "suit' seeking ) participate or not to par- acts or omissions;or written or ver- damages to which this in- bat demand or tidpate in any plan in- (4) Consequential liability surance does not apply.Wemor cluded in the"employee cam- as a may, at our discretion, in- ages because benefit program". (3)abovelt of(1),(2)or vestigate any report of an of the act, er- (f) Workers' Compensation ror or omis-error or omission and This exclusion applies settle any claim or"suit'that s- And Similar Laws whether the insured may be may result.But: sion;and Any claim arising out of your held liable as an employer 1) The amount we will payb) There is no other failure to comply with the or in any other capacity and applicable insur- mandatory provisions of any to any obligation to share ' for damages is limited ance. workers' compensation, un- damages with or repay as described in Section employment compensation someone else who must pay 111 - Limits Of Insur- (2) Exclusions insurance,social security or damages because of the fin- ance;and • This insurance does not apply to: disability benefits law or any jury. 2) Our right and duty to similar law. Supplementary defend ends when we (a) Bodily Injury, Property (3) Payments ERISA Damage Or Personal And (g) have used up the appli- 9 Section I - Coverages, Sup- cable limit of insurance Advertising Injury Damages for which any in- plementary Payments-Cover- In the payment of judg- "Bodily injury", "property sured is liable because of li- ages A And B also apply to this ments or settlements. damage" or "personal and ability Imposed on a fidud- Coverage. No other obligation or liabil- advertising injury". ary by the Employee Re- b. Who Is An Insured • it topay sums orperform Re- tirement Income Security y (b) Dishonest, Fraudulent, Act of 1974, as now or As respects Employee Benefit Lia- acts or services is covered Criminal Or Malicious Act hereafter amended, or by unless explicitly provided for dl, bility Coverage,Section II-Who Is under Supplementary Damages arising out of any any similar feerastate or An Insured is replaced by the follow- Payments. intentional, dishonest, local laws. ing: fraudulent,criminal or mall- (h) Available Benefits (b) This insurance applies to cious act,error or omission, (1) If you are designated In the Dec- damages only If the act,er- committed by any insured, Any claim for benefits to the laratlons as: ror or omission,Is negligent- including the willful or reds- extent that such benefits are (a) An individual,you and your ly committed In the"admin- less violation of any statute. available, with reasonable spouse are insureds,but on- istration"of your"employee effort and cooperation of the ly with respect to the con- benefit program";and (c) Failure To Perforin A Con- insured,from the applicable duct of a business of which 1 Occurs duringthepolicytract funds accrued or other col- ) lectible insurance. you are the sole owner. period;or Damages arising out of failA- ure of performance of con- (b) turearyousareoarnoiInsured. 2) Occurred prior to the tract by any insurer. Your effective date" of members, your part- Includes copyrighted material of Insurance • Includes copyrighted material of Insurance GA 233 0917 Services Office,Inc.,with its permission. Page 3 of 17 GA 233 0917 Services Office,Inc.,with its permission. Page 4 of 17 ners,and their spouses are zafion.However,coverage under (b) A series of related acts,er- tification of the action taken, also insureds but only with this provision: rors or omissions, regard- you shall promptly reim- respect to the conduct of less of the amount of time burse us for such part of the your business. (a) Is afforded only until the that lapses between such Deductible Amount as we 180th day after you acquire acts,errors or omissions; have paid. (c) A limited liability company, or form the organization or you are an insured. Your the end of the policy period, negligently committed in the d. Additional Conditions members are also insureds, whichever is earlier;and "administration"of your"employ. but only with respect to the ee benefit program". As respects Employee Benefit Lia- conduct of your business. (b) Does not apply to any act, bility Coverage,Section IV-Corn- Your managers are in- error or omission that was However,the amount paid under mercial General Liability Condi- sureds,but only with respect committed before you ac- this endorsement shall not ex- tions is amended as follows: to their duties as your man- quired or formed the organi- ceed,and will be subject to the agers. zation. limits and restrictions that apply (1) Item 2.Duties In The Event Of to the payment of benefits in any Occurrence,Offense,Claim Or (d) An organization other than a c. Limits Of Insurance plan included in the "employee Suit is replaced by the following: partnership,joint venture orAs respects Employee Benefit Lia- benefit program." 2. Duties In The Event Of An limited liability company,you bility Coverage,Section III-Limits ActError Or Omission,Or are an insured.Your"execu- (4) Deductible Amount , five officers" and directors Of Insurance is replaced by the fol- Claim Or Suit are Insureds, but only with lowing: (a) Our obligation to pay dam- a. You must see to it that respect to their duties as (1) The Limitsof Insuranceshownin ages on behalf of the in- we are notified as soon sured applies only to the your officers or directors. Section B.Limits Of Insurance, amount of damages in ex- as practicable of an act, Your stockholders are also 1. Employee Benefit Liability cess of the Deductible error or omission which insureds, but only with re- Coverage and the rules below fix Amount stated in the Dada- may result in a daim. sped to their liability as the most we will pay regardless rations as applicable to To the extent possible, stockholders. of the number of. Each Employee. The limits notice should include: (e) A trust,you are an insured. (a) Insureds; of insurance shall not be re- (1) What the act,error Your trustees are also in- duced by the amount of this sureds,but onlywith respect (b) Claims made or "suits" deductible. oromission was brought; and when it oc- to their duties as trustees. 9 (b) The Deductible Amount curved;and (2) Each of the followingis also an (c) Persons or organizations stated in the Declarations makingclaims or bringing applies to all damages sus- (2) Thed names and insured: 9 9 PW 9 addresses of any- "suits"; tained by any one"employ- one who may suf- (a) Each of your "employees" ee",including such"employ- fer damages who is or was authorized to (d) Acts,errors or omissions;or ee's"dependents and bene- thas a result of administer your "employee (e) Benefits included fidaries,because of all acts, error or omission. se act, your benefit program"; errors or omissions to which "employee benefit program". (b) Any persons, organizations this insurance applies. b. If a daim is made or or"employees" (2) The Aggregate Limit shown in "suit"is brought against , having prop- Section B.Limits Of Insurance, (c) The terms of this Insurance, any insured,you must: er temporary authorization 1. Employee Benefit Liability including those with respect to administer your"employ- to: (1) Immediately record ee benefit program" if you Coverage of this endorsement is p g y the most we will pay for all dam- the specifics of the die,but only until your legal 1) Our right and duty to ages because of acts,errors or claim or"suit"and representative is appointed; omissions negligently committed defend the insured the date received; or in the "administration" of your against any "suits" and Your legal representative if "employee benefit program". seeking those damag- (c) nd (2) Notify us as soon you die, but only with re- (3) Subject to the limit described in as practicable. sped to duties as such.That (2) above, the Each Employee 2) Your duties,and the du- representative will have all ties of any other in- You must see to It that Limit shown in Section B.Limits volved insured, in the we receive written no- your rights and duties under Of Insurance, 1. Employee event of an act,error or Lice of the daim or"suit" this Coverage Part. Benefit LiabilityCoverage 9 of omission,or claim; as soon as practicable. (3) Any organization you newly ac- this endorsement is the most we quire or form,other than a part- will pay for all damages sus- apply irrespective of the ap- c. You and any other In- nership,joint venture or limited tained by any one "employee", plication of the Deductible volved insured must: liability company,and over which including damages sustained by Amount. you maintain ownership or major- such "employee's" dependents (1) Immediately send ity interest, will qualify as a and benefidaries,as a result of: (d) We may pay any part or all us copies of any NamedInsured if no other similar of the Deductible Amount to demands, notices, imilae applies to that organi- (a) An act,error or omission;or effect settlement of any summonses or le- claim or"suit"and,upon no- gal papers re- Includes copyrighted material of Insurance Includes copyrighted material of Insurance GA 233 0917 Services Office,Inc.,with its permission. Page 5 of 17 GA 233 0917 Services Office,Inc.,with its permission. Page 6 of 17 0 a N W W O C0 V N N - • m _ 8.0.3 Q O1 OCg J8"' O G -6-28.22p. c' S'''-' 3 mmF,zgc=ym J v vmms ' -g J���<$to 7. ((� m R,J,.,. Ngo v'2>• -01....-_8 N,_.'6JQ o v8i m- !S' Q g S-1C my N'0 D.m N 3 m S_g N gm y m c-fi'g � _ _ -O-°w & a-=m JNm3N 2 c 9NNNC @ Q' muF 8Oj4-C my3J0.m=m SOatroll dm N.yOJ° Sd.0 -08 IAA 9� Q3' 2.�. d 7 *al H. ID�mJJn' �NN,m aVJJ^3N" ,q0.--11 N.3^mm mJg w. 9 C H m COw y 8 S 8 N m O)a f 0 N O SI m m:'C N-. i J _ NO S C30 m OOmm C 'm@Nd m g �j ia '<CJ Qm 318 N O Jm a°0 -'�•S, 3.� S m m9.^TFNw"-,ip d -fpF Vg 0 OAC m. <dw m omw�• J 9mm O wggg g'. S.' o'-v� oc�v n 3_ryp.mmm_� m F.Qm3mm Jg°og�s°JN.Qgo ..m^gf• aco,n. °$ �i� S0 1C735N�=03 m o.��OS m C??N OCKi 031=OO J d 0= •C- g5 SO C 8 0 dm gJ c$ m 'mdP,d9,8*° m. mm �<N � Ss <7c :3mJm as 3Y '5g: F,3 Bim N N mo .= Li P C _ 08 J .J ?-tux. Q a 8 • o.m mc)N m D 9-6 9 m 3,A m n 6O 9mm meom 'nog vNNQgeT o PIT S;, 6vo'9>•m-i Z mSo=dCO3Fm°N- Fgov30oOF o g 'm oro 'mow mpp•pmS F mm3 • mm o>• _ mm gm_-.3 o m K m 3 J J .<(� =4123.1.a � -1,782.,507 (a�' m<_. o y m�3 � y J�y m J l°• J ((pp .p• y'O �. N fp'O »m 16 S f0 m; .3 N<O 9 J N L-1 N o o fD Q N o.J J N 6 C 8.m m F y.�.1J _..°<,aJ -.N� OO.°J .m. Nm� O pC�6Gmy C J-g_O-n`GNO' `G m C•,14 N r .f0 •fG V °01 9 2 O 2 O m874:".--22v8-2• N• .C.g 2 <- N w .O O a J d O-.� CO g J T 3 d M 91.2-8 N N.. O 'O fOO �J 8° �p-gro m. 9 O -;r205� oZ m mn FOO yJm NmC-m f R J N N J Ol _Q y 6. O 3 = F<Oo Q O C y H n (C O g'N a fm/i J N F J N 9 s 5 8 g'O. 2.8. -9 m E°' JFm 2,5 3'o m .g m w q‹. 9gamNm m 9Jm C_vJ 3 o Smm ' v' i 5';.1. c:o 'm n EJ3 m o ' m n m�o�n CO-gig-•J-<oo m �" g- o; E. ,-�yo•a `z':ina- J J ^i gi5. yy (n} N'mJ -. M O -0 N - ..O O C a N N m w ( A*.- -.6 ' SJn 3.Ow CC_2�=m m i -,N m^m N N 3 m 535meg' 33 �pom�3J» °' 2. ig ; ko�ng2�Qa`'3.� °'yo3.d0c,,CDN Y m s m g 6(O O m S 9 m m K O S w m m m N N N 0 N W W O V W N Q P O T'O o2,m)r QO^O"'O o-S2%'Rw2a.<No0m37 Cgmmoa6Om�my82 Cg6.amo �'mf_m� mmol°Jo°3- o= Nf ,§ 0C 8"'m N Of m_a N 8 6 1 J N N 0 m m 2-N O y 2&5 S N_9 m N v 3 m *...6 -e m ➢t W•"'.5.2-E. O:N d 5 !. ma 'm ,§,i...p• N S m m-&.-174:u=...m C.,-6,--.5 -Y,;m 0 m O S m°m S°N O ,,....-0 m 3 Co 8 3 E °° a - 3 3 0 m� v_o-3R.'J6N.Oamm 3 ctmam^o,3"Bm'06am m�a� �mFFm JFOOQ Gm8 .o m •-v.R, (a(�g gr -F,(Gpp f0 N8K(Npd,4MC g'vg N m'OwmR X$3�y act.-3z5' 5 O mJ B0 N� O m 3= O o N d N m N 9 N 0 m fl1 2 0^ J r g E y'°p 6 v_m 3 aa N w '3 N m - N C 0011 S N O O°O'O N ((DD C a d 4 O'd as (0055 8 2 1 590°2 6'o P. m a m v -m C o'of 7 k3.-(6-2m mj-,m m�.pm, g O 2'2 3.g y 9- a o. g. 9 $. 33, $ O 3 3 .1, g go o ri gs 4m 4 =� 52 2NN -oomam oS'nJ�_. B ' m9 5 ? 2�8_ g� S "� Sm P a g.m N 01 • V m O� '3,a Th.= g m N O J pg . a 1 A O F m NNOyJy mamrtltemm a_. mJNm�.� d O •C-�•mOQ , `28m3Jo A3 Q,- ms4,mm-. oD 3N36m ay fmFmSD =J3 J Fmm9gomv_ `< H d^ S4^'^-NIO- O-vo-m m8 =Ca3mN8 .Scif°J ;gN�$3 0760o' O 5 N ddm mmC•m,0s@a- 38980 59 mao85- a3gmSa. .-6=•c3y R^.omgnmm 6 a '-' =Cc gv= g3Qg m'�`°'p3 Co m m C o F. 6.0 0-0 J -J; -N 3 - _ 7'p 2. o "°o v m ••C N S OSm N_.-. (CO. o O•O3 m» 8.c.:to5 C6(ml'm^V '<o 0. Nm 9 N OvF mm 8 9°_nm y 3m C- Q mm F_.�. CJ Jm O.c.N,Jm m O'< (o o '32.3 0 2no01•0-� m*>>O. m :58. g opo 0 ri-.4 na:5d<ad a9ga. m m m�'m Em j,mmiOC.o m�m�0 p3a-.0 CO qm '13-0= ' v Amm N JQ.3m3 N 6g ^ 0 a gmmSB0 ^ 68.3,7 �dp_�p^.a CC -Vm� °•O 7m NO.(S� _ a g-m_ O2-• yC, '.33 Q38aB pt- �3p�°cN•1'003 6m g6-.gm y dm9nw n QO2J si o cTagom 3•»oqa !,1 -09- m?Q'.�s 'mm ?mo'C? aymeZaQoa ,s' 2. Unintentional Failure To Disclose Haz- 2) Rust or other cor- 2) Basements, you with permission of ards rosion, decay, de- whether paved or the owner, terioration, hidden not;or Section IV-Commercial General Liabil- or latent defect or b. In the case of damage ity Conditions, 7. Representations is any quality in 3) Doors,windows or by fire,explosion,light- amended by the addition of the following: property that caus- other openings. ning, smoke or soot, Based on our dependence upon your rep- es it to damage or (c) Property damage" caused while rented to you;or resentations as to existing hazards,if un- destroy tiself, by or resulting from water c. In the case of damage intentionally you should fail to disdose all 3) Smog; that leaks or flows from by water, while rented such hazards at the inception date of your plumbing,heating,air condi- to and occupied by you. policy,we will not reject coverage under 4) Mechanical break- tioning, fire protection sys- this Coverage Part based solely on such down, including tems, or other equipment, (2) The most we will pay Is limited as failure. rupture or bursting caused by or resulting from described in Section B. Limits caused by centrif- freezing,unless: Of Insurance, 3. Damage To 3. Damage To Premises Rented To You ugal force; Premises Rented To You of this a. The last Paragraph of 2.Exclusions (i) You did your best to endorsement. under SectionI-Covera Coverage 5) Settling,shrinkingor cracking, maintaindinheat in the 4. Supplementary Payments il9 ensioor ex- building or structure;or PP ry Y y Injury And Property Damage Li- pension; Under Section I-Supplementary ability is replaced by the following: (ii) You drained the equip- PP rYPay- 6)Exduslons c.through q.do not apply Nesting or infesta- ment and shut off the ments-Coverages A And B: tion, or discharge water supply if the heat lowing:to"property damage"by fire,explo- or release of waste was not maintained. a. Paragraphw2.is replaced by the fol- sion, lightning, smoke or soot to wing: while rented to you or tern- tions,products o insects,secre- premises (d) 'Property damage"to: oraril occupied bytions, rodentsby P rtY 9 Limits to the limit Insurance,4.a.Section B. porarily p' you with permis- birds, or (i) Plumbing, heating, Of Bail Bonds sion of the owner, for which the other animals;or air of this endorsement for cost of bail amount we will pay is limited to the conditioning,fire protec- Damage To Premises Rented To 7) Presence, growth, tion systems, or other bonds required because of acddents You Limit as described in Section III proliferation, equipment or applianc- or traffic law violations arising out of -Limits Of Insurance. spread or any ac- es;or the use of any vehicle to which the of fungus,in- Bodily Injury Liability Coverage ap- tivityb. The Insurance provided under Sec- (ii) The interior of any plies.We do not have to furnish these tion I-Coverage A-Bodily Injury eluding mold or building or structure,or bonds. mildew, and any topersonal property in And Property Damage Liability ap- mycotoxins, P P y plies to"property damage"arising out the building or structure, b. lowing: 4.Is replaced by the fol- plies to damage to spores, scents or caused by or resulting lowing: bothfwater rented to and occupiedpremisesby that yoare byproducts pro- from rain,snow,sleet or All reasonable expenses incurred b duced or released our request s (1) As res eds Water Dama a Le- by fungi. win wr not. driven by inn i e invd ti tioreto assist use p g wind or not. gal Liability,as provided in Para- (b) "Property damage" caused inclaim the or"utigancl n actuale ofthe graph 3.b.above: c. Limit Of Insurance ars "suit',including loss c- directty or indirectly by any earnings up to the limit shown In Sec- The exclusions under Section I- of the following: With respect to the insurance afford- tion B. Limits Of Insurance, 4.b. Coverage A-Bodily Injury AndEarthquake, volcanic ed in Paragraphs 3.a.and 3.b.above, Loss Of Earnings of this endorsement Property Damage Liability, 2. (I) q the Damage To Premises Rented per day because of time off from P Y 9 eruption, landslide or To You Limit as shown in the Deda- work. Exclusions, other than i. War any other earth move- rations is amended as follows: and the Nuclear Energy Liabil- ment; 5. Medical Payments Ity Exclusion(Broad Form),are (1) Paragraph 6. of Section III - deleted and the following are (ii) Water that backs up or Limits Of Insurance is replaced The Medical Expense Limit of Any One added: overflows or is other- byPerson as stated in the Declarations is wise discharged from a the following: amended to the limit shown In Section B. This insurance does not apply to: sewer, drain, sump, 6. Subject to Paragraph 5. Limits Of Insurance, 5. Medical Pay- (a) "Property damage": sump pump or related above, the Damage To ments of this endorsement. equipment; Premises Rented To You 6. 180 DayCoverage For NewlyFormed(i) Assumed in any con- Limit is the most we will pay 9 tract or agreement;or (ii)Water under the ground under Coverage A-Bodily Or Acquired Organizations surface pressing on,or Injury Dam- (ii) Caused by or resulting flowing or seeping j ry And Property Y Section fWho Is An Insured is a from any of the follow- through: age Liability for damages amended as follows: because of"property clam- ing: 1) Foundations,walls, age"to any one premises: Subparagraph a.of Paragraph 3. is re- 1) Wear and tear; floors or paved a. Whileplaced by the following: surfaces; temporaarilyrily occupied you,or by a. Insurance under this provision is af- forded only until the 180th day after Includes copyrighted material of Insurance Includes copyrighted material of Insurance GA 233 0917 Services Office,Inc.,with is permission. Page 9 of 17 GA 233 0917 Services Office,Inc.,with its permission. Page 10 of 17 you acquire or form the organization use of that part of the prem- vendor's business, subject or repair opera- or the end of the policy period, ises leased to you, subject to the following additional tions, except such whichever is earlier; to the following additional exclusions: operations per- ation exclusions: The insurance afforded formed atre the ven- 7. Waiver Of Subrogation () dot's premises In This insurance does not ap- the vendor does not connection with the Section IV-Commercial General Liabil- ply to: apply to: sale of the roduct; ity Conditions,9.Transfer Of Rights Of P Recovery Against Others To Us is (i) Any"occurrence"which 1) "Bodily injury' or 7) Products which,af- amended by the addition of the following: takes place after you "property damage" ter distribution or We waive any right of recovery we may cease to be a tenant in for which the ven- by have against anythat premises; dor is obligated to sale you,have g person or organization g been labeled usedor as against whom you have agreed to waive (ii) Structural alterations, pay damages the as-by labeled ne as reason of the i container, aror my such right of recovery in a written contract new construction or sumption of liability ingredient of an or agreement because of payments we demolition operationsor g Y make for injuryor damage arisingout of agreement a contract This otherc y or forsub- the g performed by or on be- stance byor the your ongoing operations or"your work" half of such additional exdusion does not done under a written contract or agree- insured. vendor,or pent with that person or organization and applymto thathty for included In the"products-completed oper- (b) Lessor Of Leased Equip- vendor the 8) "Bodily injury" or pent vendor would have "property damage" ations hazard".However,our rights may in the absence of arising out of the only be waived prior to the"occurrence" Any person or organization the contract or sole negligence of giving rise to the injury or damage for from whom you lease agreement; the vendor for its which we make payment under this Cov- equipment when you and own acts or omis- erage Part The insured must do nothing such person(s)or organizes- 2) Any express war- sions or those of after a loss to impair our rights.At our re- tion(srant unauthorized quest,the insured will bring"suit"or trans- agraph have agreed per Par- Y its employees or fer those rights to us and help us enforce dorsement 8.a.(1)oof this insur-n- Anyy you; anyone else acting to provide on its behalf.How- those rights. ance.Such person(s)or or- 3) physical or ever,this exclusion anization s are insureds chemical change in does not I to: 8. Automatic Additional Insured -Sped- 9 () the product made apply fled Relationships only with respect to liability intentionally by the for"bodily injury', "property a) The eained a. The following added to Section II- damage" or vendor; lions contained is "personal and Who Is An Insured: advertising injury"caused,in 4) Repackaging, ex- In Paragraphs (1) Any person(s)or organization(s) whole or in part, by your kept when un- of)c)(ith s)or n) maintenance, operation or packed solely for described in Paragraph 8.a.(2)of use of equipment leased to the purpose of in- dorsement;or this endorsement(hereinafter re- you by such person(s)or or- spection, demon- b) Such inspec- ferred to as additional insured) b) Such iac ust- whom ganization(s).A person's or stration,testing,or tions, a ust- you are required to add as organization's status as an the substitution of q ments, or an additional Insured under this additional insured under this parts under in- servicing as Coverage Part by reason of a endorsement ends when structions from the g written contract, written agree- the vendor has g their contract or agreement manufacturer, and agreed to pent, written permit or written with you for such leased then repackaged in authorization. equipment ends. However, the original con- make or der- this insurance does nottaint, takes under- (2) Only the following persons or or- ap-ganizations are additional in- ply to any "occurrence" in takes to make sureds under this endorsement, which takes place after the 5) Any failure to make course usual and insurance coverage provided equipment lease expires. such inspections,tests business, in adjustments, tests to such additional insureds is lim- connection ited as provided herein: (c) Vendors or servicing as the with the distd- Any person or organization tovendor has agreed bution or sale (a) Managers Or Lessors Of (referred to below as ven- ly make or normal-sto of the prod- Premises dor) with whom you have ly undertakes to ucts. agreedper Paragraph make in the usual The manager or lessor of a rag P course of busi- premises leased to you with 8.a.(1)of this endorsement ness,in connection (II) This Insuranceapply to any Insured does not to provide insurance,but on- whom you have agreed per with the distribution Paragraph 8.a.(1)of this en- ly with respect to'bodily in- or sale of the person or organization: dorsement torovide insur- jury" or 'property damage" p products; 1) From whom you ance,but onlywith respect arising out of'your products" pe have acquired to liability arising out of the which are distributed or sold 6) Demonstration, in- such products, or ownership, maintenance or in the regular course of the stallation,servicing any ingredient,part Includes copyrighted material of Insurance Includes copyrighted material of Insurance GA 233 0917 Services Office,Inc.,with its permission. Page 11 of 17 GA 233 0917 Services Office,Inc.,with its permission. Page 12 of 17 or container,enter- (e) Mortgagee, Assignee Or in Paragraph 8.a.(1)of this en- tion I-Coverage A-Bodily Injury ing into,accompa- Receiver dorsement;or And Property Damage Liability: vying or containing such products;or Any person or organization (2) Available under the applicable Paragraphs(3)and(4)of this exclu- with whom you have agreed Limits of Insurance shown in the sion do not apply to tools or equip- 2) When liability in- per Paragraph 8.a.(1)of this Declarations; ment loaned to you,provided they are eluded within the endorsement to provide in- not being used to perform operations "products- surance, but only with re- whichever is less. at the time of loss. completed opera- spect to their liability as This endorsement shall not increase b. With respect to the insurance rovid- tions hazard" has mortgagee,assignee,or re- the applicable Limits of Insurance ed bytis section of the endorse- been excluded un- ceiver and arising out of the shown in the Declarations. ment, the following additional der this Coverage ownership, maintenance, or provi- Part with respect to use of the premises by you. c. Section IV -Commercial General sions apply: such products. However, this insurance Liability Conditions is amended to (1) The Limits of Insurance shown in does not apply to structural include the following: the Declarations are replaced (d) State Or Governmental alterations,new construction p by Agency Or Subdivision Or and demolition operations Automatic Additional Insured Pro- the limits designated in Section Political Subdivision - vision B. Limits Of Insurance, 9. performed by or for that per- Property Damage To Borrowed Permits Or Authorizations P rtY 9 son or organization. This insurance applies onlyif the Equipment of this endorsement Relating To Premises PP (3) The Insurance afforded to addi- "bodily injury'or"property damage" with respect to coverage provid- Any state or governmental tional insureds described in Par- occurs,or the"personal and advertis- ed by this endorsement.These agency or subdivision or po- agraph 8.a.(1) of this endorse- ing injury"offense is committed: limits are inclusive of and not in litical subdivision with which maul: addition to the limits being re- you have agreed per Para- (1) During the policy period;and placed.The Limits of Insurance graph 8.a.(1) of this en- (a) Only applies to the extent (2) Subsequent to your execution of shown in Section B. Limits Of dorsement to provide insur- permitted by law;and the written contract or written Insurance,9.Property Damage anoe,subject to the follow- agreement,or the issuance of a To Borrowed Equipment of this ing additional provision: (b) Will not be broader than thatendorsement fix the most we will which you are required by written permit or written authorl- This Insurance applies only the written contract,written zation, described in Paragraph pay in any one"occurrence"re- with respect to the following agreement,written permit or 8.a.(1). gardless of the number of: hazards for which the state written authorization to pro- d. Section IV-Commercial General (a) Insureds; or governmental agency or vide for such additional in- Liability Conditions Is amended as (b) Claims made or "suits" subdivision or political sub- cured;and follows: brou ht;or division has issued a permit 9 or authorization in connec- (c) Does not apply to any per- Condition 5. Other Insurance is tion with premises you own, son, organization, vendor, amended to include: (c) Persons or organizations state,governmental agency making claims or bringing rentisor control and to which g �' "suits". - this Insurance applies: or subdivision or political Primary And Noncontributory In- subdivision, specifically surance (2) Deductible Clause (I) The existence, mainte- named as an additional in- This Insurance is primaryto and will nance,repair,construe- cured under any other provi- (a) Our obligation to pay dam- tion,erection or removal sion of, or endorsement not seek contribution from any other ages on your behalf applies of advertising signs, added to, this Coverage insurance available to an additional only to the amount of dam- awnings,canopies,cel- Part, provided such other insured per Paragraph 8.a.(1)of this ages for each"occurrence" lar entrances, coal provision or endorsement endorsement provided that: which are in excess of the holes, driveways, man- covers the injury or damage (1) The additional insured Is a Deductible Amount stated in holes, marquees, hoist for which this insurance ap- Named Insured under such other Section B.Limits Of Insur- away openings, side- plies. insurance;and ance,9.Property Damage walk vaults,street ban- To Borrowed Equipment of ners or decorations and b. With respect to the insurance afford- (2) You have agreed in writing in a this endorsement.The limits similar exposures;or ed to the additional insureds de- contract, agreement, permit or of Insurance will not be re- scribed in Paragraph 8.a.(1)of this authorization described in 8.a.(2) duced by the application of (Ii) The construction,erec- endorsement,the following is added of this endorsement that this in- such deductible amount. tion or removal of eteva- to Section III-Limits Of Insurance: surance would be primary and tors;orb Section IV - Commercial The most we will pay on behalf of the would not seek contribution from General LiabilityCondi- nonce The ownership,mainte- additional insured is the amount of in- any other insurance available to the additional insured. tions, 2. Duties In The nance or use of any el- surance: Event Of Occurrence,Of- evators covered by this 9. Property Damage To Borrowed Equip- fence, Claim Or Suit, insurance. (1) Required by the written contract, P rtY 9 q P ap- written agreement,written permit ment plies to each claim or"suit" or written authorization described a. The following is added to Exclusion Irrespective of the amount. 2.j.Damage To Property under Sec- Includes copyrighted material of Insurance Includes copyrighted material of Insurance GA 233 0917 Services Office,Inc.,with its permission. Page 13 of 17 GA 233 0917 Services Office,Inc.,with its permission. Page 14 of 17 (c) We may pay any part or all 12. Nonowned Aircraft 16. Voluntary Property Damage Coverage (2) Exclusions of the deductible amount to The followingis added to Exclusion 2. a. Coverage D -VoluntaryProperty This insurance does not I to effect settlement of any 9• 9 P rtY apply claim or'Suit"and,upon no- Aircraft,Auto Or Watercraft under Sec- Damage Coverage "property damage"that would be tification of the action taken, tion I-Coverage A-Bodily Injury And excluded by Coverage A-Bodi- you shall promptly ream- Property Damage Liability: Section I-Coverages is amended to Include the following: ly Injury ryAnd PropertyDama e burse us for such part of theThis exclusion does not apply to an air- Liability,2.Exclusions,except craft you do not own,providedpthat: (1) Insuring deductible amount as hasAgreement for).Damage To Property,par- been been paid by us. agraphs(3),(4),(5)and(6), k. a. The pilot in command holds a current (a) We will pay the cost to re- Damage To Your Product,and 10. Employees As Insureds - Specified effective certificate,Issued by a duly pair or replace "property I.Damage To Your Work. Health Care Services And Good Samar- constituted authority of the United damage"to property of Wh- iten Services States of America or Canada,desig- ern arising out of operations (3) Definitions natio that as a commerdal or incidental to your business For Paragraph 2.a.(1)(d) under Section II - g person when: purposes of Voluntary Who Is An Insured does not apply to: airline transport pilot Property Damage Coverage a. Your"employees"who provide pro- b. The aircraft is rented with a trained, 1) Damage is caused by only,the following definitions un- der Section V-Definitions are fessional health care services on your paid crew;and you;or replaced by the following: behalf as a duly licensed nurse, c. The aircraft does not transport per- 2) Damage occurs while In emergency medical technician or sons or cargo for a charge. yourpossession. 16. "Occurrence"means an in- paramedic in the jurisdiction where an cadent,Inducting continuous "occurrence"or offense to which this 13. Bodily Injury Redefined At your written request,we or repeated exposure to insurance applies takes place;or will make this payment re- substantially the same gen- Section V-Definitions,4."Bodily injury" gardless of whether you are eral harmful conditions that b. Your"employees"or"volunteer work- is replaced by the following: at fault for the "property result in"property damage". era",other than an employed or vol- damage". unteer doctor, providing first aid or 4. "Bodily injury"means bodily harm or 20. 'Property damage" means good samaritan services during their injury, sickness, disease, disability, If you, at our request, re- physical Injury to tangible work hours for you will be deemed to humiliation,shock,fright,mental an- place, or make any repairs property."Electronic data"Is be acting within the scope of their guish or mental Injury,including care, to, damaged property of not tangible property, and employment by you or performing du- loss of services or death resulting others, the amount we will "property damage"does not ties related to the conduct of your from any of these at arty tine. pay under Voluntary Prop- include disappearance, ab- business. erty Damage Coverage will straction or theft. 14. Expected Or Intended Injury Redefined be determined by your actu- 11. Broadened Notice Of Occurrence The last sentence of Exclusion 2.a.Ex- al cost to replace or repair b. Care,Custody Or Control Liability acted Or Intended Injury under Sec- the damaged property, ex- Coverage Paragraph a.of Conditionccua2. Duties e,In P j ry cludin anyprofit or over-The Event Of Occurrence, Offense, tion I-Coverage A-Bodily Injury And g For purposes of the coverage provid- Claim Or Suit under Section IV-Com- Property Damage Liability Is replaced by head. ed by Care,Custody Or Control Li- merclal General Liability Conditions is the following: Any payment we make un- ability Coverage In this endorsement replaced by the following: only: This exclusion does not apply to"bodily der Voluntary Property a. You must see to It that we are notified irgury"or"property damage"resulting from Damage Coverage shall not (1) Section I-Coverage A-Bodily as soon as practicable of an"occur- the use of reasonable force to protect per- be interpreted as an admin- Injury And Property Damage sons or property. • son of liability by you or by rence"or an offense which may result Liability, 2. Exclusions, j. In a claim.To the extent possible,no- 15. Former Employees As Insureds us Damage To Property,Subpara- tie tice should include: It shall be your duty,not our graphs(3),(4)and(5)do not ap- The following Is added to Paragraph 2. duty,to defend any claim or ply to"property damage"to the (1) How,when and where the"oc- under Section II-Who Is An Insured: "suit"to which this insurance property of others described currence"or offense took place; therein. 2. Each of the following is also an in- applies. (2) The names and addresses of sured: No other obligation or liabil- (2) It shall be your duty,not our duty, any injured persons and wit- ity to pay sums or perform to defend any claim or"suit"to nesses;and Any of your former"employees",di- acts or services is covered. which this insurance applies. rectors, managers, members, part- (3) The nature and location of any ners or"executive officers",including (b) This insurance applies to No other obligation or liability to irjury or damage arising out of but not limited to retired,disabled or "property damage"only it pay sums or perform acts or ser- the"occurrence"or offense. those on leave of absence,but only vices is covered. This requirement applies only when for acts within the scope of their em- 1) The"property damage" the"occurrence"or offense Is known ployment by you or for duties related takes place in the"coy- This Paragraph (2) supersedes any to an"authorized representative". to the conduct of your business. erage territory';and Part to the scontrary. theion In Coverage 2) The"property damage" occurs during the potty (3) "Property damage" for which period. Care,Custody Or Control Lia- bility Coverage provides cover- Includes copyrighted material of Insurance Incudes copyrighted material of Insurance GA 233 0917 Services Office,Inc.,with its permission. Page 15 of 17 GA 233 0917 Services Office,Inc.,with its permission. Page 16 of 17 age shall be deemed to be (3) The Voluntary Property Dam- caused by an "occurrence" but age Coverage,Aggregate Limit shall not serve to limit or restrict Of Insurance is the most we will the applicability of any exclusion pay for the sum of all damages for"property damage"under this under Voluntary Property Coverage Part. Damage Coverage. This limit c. Limits Of Insurance And Deducti- applies separately to each"cov- erage term'. bles For purposes of the coverage provid- (4) Deductible Clause ed by Voluntary Property Damage (a) Our obligation to pay dam- Coverage and Care, Custody Or ages on your behalf applies Control Liability Coverage,Section only to the amount of dam- III-Limits Of Insurance Is amended ages for each"occurrence" to include the following: which are In excess of the Deductible Amount stated (1) The Limits of Insurance shown in for the applicable coverage the Declarations are replaced by in the Schedule.The limits the limits designated In Section of insurance will not be re- B. Limits Of Insurance, 16. duced by the application of Voluntary Property Damage such Deductible Amount. Coverage And Care, Custody Or Control Liability Coverage, (b) Section IV - Commercial in this endorsement.These limits General Liability Condi- are inclusive of,and not In addi- tions, 2. Duties In The tion to,the limits being replaced. Event Of Occurrence, Of- The Limits of Insurance shown In fense, Claim Or Suit, ap- the Schedule fix the most we will plies to each claim or"suit" pay regardless of the number of: irrespective of the amount. (a) Insureds; (c) We may pay any part or all of the Deductible Amount to (b) Claims made or "suits" effect settlement of any brought;or claim or"suit"and,upon no- (c) Persons or organizations no- tification of the action taken, making claims or bringing you shall promptly reim- "suits". burse us for such part of the Deductible Amount as has (2) (a) Subject to (3) below, the been paid by us. Volutary Property Dam- 17. Broadened Contractual Liabili Work age Coverage,Each OccurWithin 50'Of Railroad Property rence Limit Of Insurance iss the most we will pay for the Section V-Definitions,12."Insured con- sum of damages under Vol- tract"is amended as follows: untary Property Damage Coverage; a. Paragraph c.is replaced by the fol- lowing: (b) The Care,Custody Or Con- trol Liability Coverage, c. Any easement or license agree- Each Occurrence Limit Of ment; Insurance is the most we will pay for the sum of damages b. Paragraph f.(1)is deleted in its entire- under Care, Custody Or ty. Control Liability Coverage; 18. Alienated Premises because of all"property damage" Exclusion 2,I. Damage to Property, arising out of any one ocad- Paragraph(2)under Section I-Cover- rence". age A - Bodily Injury And Property Damage Liability does not apply if the premises are"your work". Includes copyrighted material of Insurance GA 233 0917 Services Office,Ina,with its permission. Page 17 of 17 THIS ENDORSEMENT CHANGES THE POLICY.PLEASE READ IT CAREFULLY. However, any "auto" that is leased, a. Is effective on the date of acquisition hired,rented or borrowed with a driver or formation,and is afforded for 180 • is not a covered"auto". days after such date; CinciPlus® E. Audio, Visual and Data Electronic Equip- b. Does not apply to "bodily injury"or BUSINESS AUTO XC+® ment "property damage"resulting from an (EXPANDED COVERAGE PLUS) SECTION III - PHYSICAL DAMAGE COV- "accident"that formedoctheorurredg organeforeization;you COV- ERAGE,C. Limit of Insurance is amended acquired or or anization; ENDORSEMENT 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 This endorsement modifies insurance provided by the following: and any accessories used with this d. Does not apply to an insured under equipment as a result of any one"acci- any other automobile liability policy or BUSINESS AUTO COVERAGE FORM dent"is the lesser of: would be an insured under such a a. The actual cash value of the dam- policy but for the termination of such policy or aged or stolen property as of the time theexhaustion of such poli- insurance. With respect to the coverage provided by this endorsement,the provisions of the Coverage Form apply unless of the"accident"; cys limits of modified by this endorsement. b. The cost of repairing or replacing the 3, Any of your"employees" while using a damaged or stolen property with oth- covered"auto"in your business or your A. Blanket Waiver of Subrogation This provision does not apply unless the valid personal affairs,provided you do not own, written contract has been: er property of like kind and quality;or hire or borrow that"auto". SECTION IV - BUSINESS AUTO CONDI- c. $2,500. TIONS,A.Loss Conditions,5.Transfer of 1. Executed prior to the accident causing G. Liability Coverage Extensions - Supple- Rights of Recovery Against Others to Us is "bodily injury"or"property damage";and Provided the equipment,at the time of the mentary Payments-Higher Limits amended by the addition of the following: "loss"is: • 2. Is still in force at the time of the"accident" SECTION II - LIABILITY COVERAGE, A. We waive any right of recovery we may have causing"bodily injury"or"property dam- a. Permanently installed in or upon the Coverage,2.Coverage Extensions,a.Sup- against any person or organization because of age". covered"auto"in a housing,opening plementary Payments is amended by: payments we make for "bodily injury" or or other location that is not normally "property damn e"arisingout of the operation D. Employee Hired Auto 1. for bail Replacing the with$$2,000 Limit of Insurance 9 P used by the"auto"manufacturer for for bail bonds $4,000 in(2);and of a covered"auto"when you have assumed 1. Changes in Liability Coverage the installation of such equipment; liability for such "bodily injury" or "property 2. Replacing the$250 Limit of Insurance for damage"under an"insured contract",provid- The following is added to the SECTION II b. Removable from a permanently in- reasonable expenses with$500 in(4). ed the"bodily injury"or"property damage"oc- -LIABILITY COVERAGE,A.Coverage, stalled housing unit as described in curs subsequent to the execution or the"in- 1.Who is an Insured: Paragraph 2.a.above;or H. Amended Fellow Employee Exclusion sured contrail". An "employee"of yours is an "insured" c. An integral part of such equipment. SECTION II-LIABILITY COVERAGE,B.Ex- B. Noncontributory Insurance while operating an"auto"hired or rented F. Who Is an Insured-Amended clusions,5.Fellow Employee is modified as SECTION IV - BUSINESS AUTO CONDI- under a contract or agreement in that follows: "employee's"name,with your permission, SECTION II - LIABILITY COVERAGE, A. Exclusion 5.Fellow Employee TIONS,B.General Conditions,5.Other In- while performing duties related to the Coverage,1.Who is an Insured is amended is deleted. surance c. is deleted in its entirety and re- conduct of your business. by adding the following: I. Hired Auto-Physical Damage placed by the following: c. Regardless of the provisions of Par- Coverage, Changes in General Conditions The following are"insureds": If hired"autos"are covered"autos"for Liability agraph a. above, this Coverage SECTION IV-BUSINESS AUTO CON- 1. Any subsidiary which is a legally incorpo- PhysicalPhythen e CCooverages and prCovided un- Form's Liability Coverage is primary DITIONS, B. General Conditions, 5. rated entityof whichyou own a financial der Damage Coverages as DAM GE O SECTION IIIt - PHYSICAL DAMAGE and we will not seek contribution Other Insurance is deleted in its entirety interest of more than 50%of the voting COVERAGE of this Coverage Part are ex- from any other insurance for any Iia- and replaced by the following: stock on the effective date of this cover- tended to"autos"you hire,subject to the fol- bility assumed under an "insured age contract"that requires liability to be b. For Hired Auto Physical Damage 0 lowing: assumed on a primary noncontributo- Coverage the following are deemed However,the insurance afforded by this 1. The most we will pay for"loss" to any ry basis. to be covered"autos"you own: provision does not apply to any subsidiary that is an"insured"under any other au- hiredlu "auto"oiso 50000 or the actual cash C. Additional Insured by Contract (1) Any covered "auto" you lease, tomobile liability policy or would be an"in value or cost to repair or replace,which- hire,rent or borrow;and ever is the least,minus a deductible. SECTION II - LIABILITY COVERAGE, A sured"under such policy but for termina- Coverage,1.Who Is an Insured is amended (2) Any covered "auto" hired or tion of such policy or the exhaustion of 2. The deductible will be equal to the largest to include as an insured any person or organi- rented by your"employee"under such policy's limits of insurance. deductible applicable to any owned"auto" zation for whom you have agreed in a valid a contract in that individual"em- for that coverage,or$1,000,whichever is 92. Any organization that is newly acquired or written contract to provide insurance as af- ployee's" name, with your per- less. formed by you and over which you main- forded by this policy. mission,while performing duties tain majority ownership. The insurance 3. Hired Auto-Physical Damage coverage related to the conduct of your provided by this provision: is excess over any other collectible insur- This provision is limited to the scope of the business. ance. valid written contract. Includes copyrighted material of ISO Includes copyrighted material of ISO AA 288 06 20 Properties.Inc.,with its permission. Page 1 of 4 AA 288 06 20 Properties,Inc.,with its permission. Page 2 of 4 4. Subject to the above limit,deductible,and K. Transportation Expense-Higher Limits 2. SECTION V-DEFINITIONS is amended P. Unintentional Failure to Disclose Hazards excess provisions we will provide cover- SECTION III - PHYSICAL DAMAGE COV- by adding the following,but only for the SECTION IV - BUSINESS AUTO age equal to the broadest coverage appli- purposes of this Loan or Lease Gap CONDI- cable to any covered"auto"you own in- ERAGE,A.Coverage,4.Coverage Exten- Coverage: TIONS,B.General Conditions,2.Conceal- sured under this policy. sions is amended by replacing$20 per day ment, Misrepresentation or Fraud is with $50 per day, and $600 maximum with "Total loss"means a"loss"in which the amended by adding the following: Coverage includes loss of use of that hired au- $1,500 maximum in Extension a.Transpor- cost of repairs plus the salvage value ex- However,ifyou unintentionally provided it results from an"accident"for tation Expenses. ceeds the actual cash value. fail to disclose which you are legally liable and as a result of any hazards existing on the effective date of which a monetary loss is sustained by the L. Airbag Coverage N. Glass Repair-Waiver of Deductible this Coverage Form,we will not deny cover- leasing or rental concern.The most we will age under this Coverage Form because of pay for any one SECTION III - PHYSICAL DAMAGE COV- SECTION III - PHYSICAL DAMAGE COV- such failure. accident"is$3,000. ERAGE,B.Exclusions,3.a.is amended by ERAGE,D.Deductible is amended by adding If a limit for Hired Auto-Physical Damage is adding the following: the following: Q. Mental Anguish Resulting from Bodily Inju- shown in the Schedule,then that limit replac- However, the mechanical and electrical No deductible applies to glass damage if the ry es,and is not added to,the$50,000 limit indi- breakdown portion of this exclusion does not glass is repaired in a manner acceptable to us SECTION V-DEFINITIONS,C."Bodily Inju- cated above and the deductibles shown in the apply to the accidental discharge of an airbag. rather than replaced. Ty"is deleted in its entirety and replaced by Schedule are applicable. This coverage for airbags is excess over any the following: J. Rental Reimbursement other collectible insurance or warranty. O. Duties in the Event of an Accident,Claim, Suit or Loss-Amended "Bodily injury"means bodily injury,sickness or SECTION III - PHYSICAL DAMAGE COV- M. Loan or Lease Gap Coverage disease sustained by a person,including men- ERAGE is amended by adding the following: SECTION IV - BUSINESS AUTO CONDI- tal anguish and death sustained by the same 1. SECTION III - PHYSICAL DAMAGE TIONS,A.Loss Conditions,2.Duties In the person that results from such bodily injury, 1. We will pay for rental reimbursement ex- COVERAGE, C. Limit of Insurance is Event of Accident,Claim,Suit or Loss,a.is sickness or disease."Bodily injury"does not penses incurred by you for the rental of deleted in its entirety and replaced by the amended by adding the following: an"auto"because of a"loss"to a covered following,but only for private passenger include mental anguish or death that does not "auto".Payment applies In addition to the type"autos"with an original loan or lease, This condition applies only when the "acci- result from bodily injury,sickness or disease. and onlyin the event of a"total loss"to dent"or"loss"is known to: otherwise applicable amount of each coy- R. Coverage for Certain Operations In Con- erage you have on a covered"auto".No such a private passenger type"auto": 1. You,if you are an individual; nection with Railroads deductible applies to this coverage. a. The most we will pay for"loss"in any With respect to the use of a covered"auto"in one"accident"is thegreater of: 2. A partner,if you are a partnership; 2. We will pay only for those expenses in- operations for or affecting a railroad: curred during the policy period beginning (1) The amount due under the terms 3. An executive officer or insurance manag- 24 hours after the"loss"and ending,re- Cr,if you are a corporation;or 1. SECTION V-DEFINITIONS,H."Insured gardless of the "lossexpiration," with of the lease or loan to which contract".1.c.is deleted in its entirety and the lesser of the pfolicy's ing number of your covered private passenger 4. A member or manager,if you are a lim- replaced by the following: type"auto"is subject,but will not ted liability company. days: include: c. An easement or license agreement; a. The number of days reasonably re- (a) Overdue lease or loan pay- 2. SECTION V-DEFINITIONS,H."Insured quired to repair the covered"auto".If ments: contract",2.a.is deleted. loss"is caused by theft,this number of days is added to the number of (b) Financial penalties imposed days it takes to locate the covered under the lease due to high "auto"and return it to you;or mileage, excessive use or b. 30 days. abnormal wear and tear; 3. Our payment is limited to the lesser of the (c) Security deposits not re- following amounts: funded by the lessor; a. Necessary and actual expenses in- (d) Costs for extended warran- ties, Credit Life Insurance, Health,Accident or Disabil- b. $50 per day. ity Insurance purchased with the loan or lease;and 4. This coverage does not apply while there are spare or reserve"autos"available to (e) Carry-over balances from you for your operations. previous loans or leases,or 5. We will pay under this coverage only that (2) Actual cash value of the stolen amount of your rental reimbursement ex- or damaged property. penses which is not already provided for b. An adjustment for depreciation and under SECTION III- PHYSICAL DAM- physical condition will be made in de- AGE COVERAGE, A. Coverage, 4. termining actual cash value at the Coverage Extensions. time of"loss". Includes copyrighted material of ISO Includes copyrighted material of ISO AA 288 06 20 Properties,Inc.,with its permission. Page 3 of 4 AA 288 06 20 Properties,Inc.,with its permission. Page 4 of 4 HUB INTERNATIONAL NORTHWEST LLC PO BOX 10167 LaA EUGENE OR 97440-2167 CITY OF ASHLAND 90 N MOUNTAIN AVE ASHLAND OR 97520-2014