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HomeMy WebLinkAboutInsurance Certificate: DeVore, Reginald DBA DeVore Electric & Construction AC R® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 03/12/2021 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 NAME CT Debbie D Reed Insurance Marketplace, Inc. PHONE (A/C. Ext): (541)779"0177 (a c,Nod:(541)772-8235 1998 Sky Park Dr • E-MAIL debbie@insmarket.com Medford,OR 97501 INSURER(S)AFFORDING COVERAGE NAIC# INSURER A: Allied Insurance Company • .23787 INSURED INSURERS: Allied Insurance Group 23787 Reginald DeVore INSURERC: SAIF Corporation DBA: DeVore Electric&Construction 792 E Dutton Rd INSURER D: Eagle Point,OR 97524-7975 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 00015615-1242815 REVISION NUMBER: 43 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 JNSD�ADDL SUBR WVD POLICY NUMBER JMPOLICY EFF POLICY EXP LIMITS MIDD/YYYY)_(MM/DD/YYYYL A X COMMERCIAL GENERAL LIABILITY Y ACP7575924983 02/17/2021 02/17/2022 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED CLAIMS-MADE X I OCCUR PREMISES(Ea occurrence) $ 100,000 MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GENL AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY JET LOC PRODUCTS-COMP/OPAGG $ 2,000,000 OTHER: • $ B AUTOMOBILE LIABILITY Y ACP7575924983 02/17/2021 02/17/2022 CO BII ED SINGLE LIMIT $ 1,000.000 . ANY AUTO BODILY INJURY(Per person) $ OWNEDSCHEDULED AUTOS ONLY X AUTOS BODILY INJURY(Per accident) $ HIRED NON-OWNED PROPERTY DAMAGE X AUTOS ONLY X AUTOS ONLY (Per accident) A UMBRELLA LIAB X OCCUR ACP7575924983 02/17/2021 02/17/2022 EACH OCCURRENCE $ 2,000,000 X EXCESS LIAB CLAIMS-MADE AGGREGATE $ 2,000,000 DED RETENTION$ `+ WORKERS COMPENSATION 769387 03/01/2021 03/01/2022 X STATUTE OTH- ER AND EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? N/A (Mandatory In NH) E.L.DISEASE-Fly EMPLOYEE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below - E.L.DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) City of Ashland,Oregon,its officers,agents and employees with respect to claims arising out of the provision of work under this agreement-per attached endorsements cg7288 1216&CG 7246 11 15&auto AC 7005 0316 • 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. 20 E Main Street Ashland,OR 97520 AUTHO ZED REPRESEgEG/ TATIVE E (DDR) ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD Printed by DDR on March 12,2021 at 09:27AM • • . . 1‘1044J.okru5 a4 . -0,011 . CofitP05C COMMERCIAL GENERAL LIABILITY CG72461115 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - AUTOMATIC STATUS FOR OTHER PARTIES WHEN REQUIRED IN WRITTEN CONSTRUCTION AGREEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Section II — Who Is An Insured is amended to a. All work, including material, parts or include as an additional insured: equipment furnished in connection with Ongoing Operations such work, on the project (other than 1. Any person or organization for whom you are service, maintenance or repairs) to be performing operations when you and such adadditionalormaby or on behalf of the insured(s) at the location of the person or organization have agreed in writing covered operations has been completed: in a contract or agreement that such person or or organization be added as an additional b. that operation of "your work" out of which insured on your policy;and the injury or damae arises has been put 2. Any other person or organization you are to its intended use by any person or required to add as an additional insured organization other than another under the contract or agreement described in Paragraph 1. above. contractor or subcontractor engaged in performing operations for a principal as a Such person(s) or organization(s) is an additional part of the same project. insured only with respect to liability for "bodily B. Section II.— Who Is An Insured is amended to injury", "property damage" or "personal and advertising injury"caused, in whole or in part, by: include as an additional insured: a. Your acts or omissions;or Products—Completed Operations b. The acts or omissions of those acting on Any person or organization with whom you have your behalf; agreed in writing in a contract or agreement that such person or organization be added as an in the performance of your ongoing operations for additional insured on your policy with respect to the additional insured. liability for "bodily injury" or "property damage" However, the insurance afforded to such caused, in whole or in part, by "your work" additional insured described above: performed for such person or organization and a. Only applies to the extent permitted by included in the "products-completed operations law; and hazard". b. Will not be broader than that which you However, the insurance afforded to such are required by the contract or agreement additional insured described above: to provide for such additional insured. a. Only applies to the extent permitted by A person's or organization's status as an law; and additional insured for ongoing operations ends b. Will not be broader than that which you when your operations for the person or are required by the contract or agreement organization described in Paragraph 1. above are to provide for such additional insured. completed. C. With respect to the insurance afforded to these With respect to insurance afforded to these additional insureds, this insurance does not apply additional insureds for ongoing operations, this to "bodily injury", "property damage" or "personal insurance does not apply to "bodily injury" or and advertising injury"arising out of the rendering "property damage"occurring after: CG 72 46 11 15 Includes copyrighted material of Insurance Services Office, Inc. Page 1 of 2 with its permission. CG 72 46 11 15 of, or the failure to render, any professional 2. Available under the applicable Limits of architectural, engineering or surveying services, Insurance shown in the Declarations; including: whichever is less. 1. The preparing, approving, or failing to prepare This endorsement shall not increase the or approve, maps, shop drawings, opinions, applicable Limits of Insurance shown in the reports, surveys, field orders, change orders Declarations. or drawings and specifications;or E. With respect to the insurance afforded to these 2. Supervisory, inspection, architectural or additional insureds, the following is added to engineering activities. Section IV — Commercial General Liability This exclusion applies even if the claims against Conditions, Condition 4. Other Insurance and any insured allege negligence or other supersedes any provision to the contrary: wrongdoing in the supervision, hiring, Primary And Noncontributory Insurance employment, training or monitoring of others by that insured, if the "occurrence"which caused the This insurance is primary to and will not seek "bodily injury" or "property damage", or the contribution from any other insurance offense which caused the "personal and available to an additional insured under your advertising injury", involved the rendering of, or policy provided that: the failure to render, any professional (1) The additional insured is a Named architectural, engineering or surveying services. Insured under such other insurance;and (2) You have agreed in writing in a contract D. With respect to the insurance afforded to these or agreement that this insurance would additional insureds, the following is added to be primary and would not seek Section III—Limits Of Insurance: contribution from any other insurance The most we will pay on behalf of the additional available to the additional insured. insured is the amount of insurance: 1. Required by the contract or agreement described in Paragraph A.1.or Paragraph B.; or All terms and conditions of this policy apply unless modified by this endorsement. Page 2 of 2 Includes copyrighted material of Insurance Services Office, Inc. . CG 72 46 11 15 with its permission. COMMERCIAL GENERAL LIABILITY CG 72,88 12 16 THIS ENDORSEMENT CHANGES THE POLICY. PLEASEREAD IT CAREFULLY.. CONTRACTORS ENHANCEMENT ENDORSEMENT INCLUDING MEDICAL. PAYMENTS This endorsement modifies insurance.provided Under the following: COMMERCIAL GEisIERAL LIABILITY COVERAGE PART - _ • , • A. Lost Key COverage C. Non-OWned Watercraft 1. Under Section I—Coverages,Coverage A Under Section I — Coverages, Coverage A Bodily Injury And Property Damage Bodily Injury Arid Property Damage Liability, Overage is extended to include 2 EXclUslent Exclusion g. Aircraft, Auto Or the following: Wateteraft:Peregraph(2)(a)is replaced with: If a customers master or grand key; .(a) Less than 51 feet longi and excluding electronic key •card, is foal. 0.„ Expanded Property Damage Coverage damaged •or stolen while in your .care, 1, For the purpoSes of this endorsement Only; custody or control we will pay the cost of replacing the keys,including the master lock Section Coverages, :Coverage A and an keys used in the same lock,thecoM pow Injury And Property Damage . . of adjusting locks to accept the new keys,or Liability, Exclusions, Exclusion, _ tnecost to replace the locks, whichever:is Damage TO Property is -amended as less. follows: 2 kimitoinsurance—For the purpose of this a• Paragraphs (5), and (6)are deleted Overage, the most we will pay is;$16;660 -in-their entirety. per"ocCurrericie:. b.. Paragraph (4) is deleted in its entirety , B. Voluntary Property Damage and replaced with: 1. Under Section Coverages, Coverage A (4) Personal property in the care Bodily Injury And Property Damage Li1ity, custody,or control of the insured: coverage is extended to include theldlowing: (a) For storage or sale at premises At your request, w.e WM pay for "properly you own,rent or occupy;or damage"to property of others caused by you (b) While being transported by.any and while in your possession,arising out Of your aircraft, "auto" or watercraft business operations and 'occurring during the owned or operated by or rented PAW period, to Or loaned to ahif:insured: 2. :Wilt of Insurance For the purpose of this c; The coverage provided by this Coverage the most we will pay is$1,500 per endorsement does not apply to "occurrence, "property damage': C Non-Owned Watercraft .(1) klising out of the disappearance or „ Under Section I Coverages, Coverage A loss.of use of personal property, Bodily Injury And Property Damage'Liability, (2) Included in the "products-completed 2. Exclusions Exclusion g iAircraft, Auto Or operations ha4ard".. Watercraft paragraph.(2)(e)is replaced with! (a) Less than 61 feetIong;•and CG.7288 12 16 Includes copyrighted material of Insurance Services Office,Inc Pager lot5 „ thits permission, AP 01A03058385214 4.520 10344 INSURED COPY 47 00127E9 CO 12 80 12 15. 2. 'Unlit of Insurance - The most we will pay E Supplementary Payments for loss arising out of any one "occurrence" Under Section I—Coverages,Supplementary LS5500, Payments ,‘Ctiverages A and B Paragraphs 3. Deductible - Our Obligation to pay for a 1.b. And 14.are replaced witiu covered'loss:applies only to the amount of b., Up to$2;509 for cost of bail bonds required loss in excess of$250: because oi accidents or traffic law violations We will pay the deductible amount to effect arising out of the use of any to which settlement of any clan or "suit" and upon the Bodily injury Liability Coverage applies: notification having been taken you shall We do not have to furnish these bonds. Promptly reimburse us for the deductible as d All reasonable expenses incurred by the has been paid by us.„ insured at our widest tO wok. us in the -, . .., . This insurance is primary to any expanded investigation or defense of the claim or damage coverage provided by a separate "suit', including actual kiss of,earnings up to endorsement attached to this policy, and it ;5K)a day because of time off front wile*. will supplant any deductible in said a Newly Formed And Acquired Organizations enoorSement Under Section II - Who Is. An IntUred E. Damage To Premises Rented To You Paragraph 3.a.is replaced with: 1, Under Section I r-Coveragetl..COverege A a, Coverage under this provision'is afforded Bodily InjuryAnd PrOperty Darrow only until the 180th day after you acquire or Liability, the last paragraph of 2, in the organization or the end of the policy Exclusions is replaced With: period,whichever is earlier; If Damage To Premises.Rented To You is H. Additional Insured- Automatic Status When not otherwise :excluded. Exclusions c. . • : , -• - • Required In An Agreement Of Contract With through 0.•,do not apply to damage by lire, 'You; lightning; exPlosion, smoke,. or sprinkler while rented Section 111,VVho Is An Insured is amended to leakage to premises to'you or inClude: temporarily occupied by you„voittypennission of the owner. A separate limit of insurance 4 Any person(s) or otganization(S),described applies to. this coverage as described in in Paragraphs:a.,d.:below with whom you Section 01-.1iitefte Of:Insurancehave agreed in writing in a :contract or written agreernent that such person or ' 2, Under *OW Ill , Limits:Of insurance,• organization- be added at• an additional PiragraPh:ft,IS replaCed,vvith'; intOred. on your policy during the policy , ,6., Subject 16 5. above, 'the Damage To. petted shown in the Declarations ft•.-,,PreriiiSeRented-To You Limit .IS the . . . . , . Pefeeh et PraartigAtion- add Meat wifoivill pay under Coverage The ed as ari A for insured by this endoripment is an:insured damages because of"property damage" orily1Or ilability due 0: to any one premises, While rented to, you, or in the case of damage by firea Lessors of Leased Equipment with _ , • .. lightning, explosion, smoke or sprinkler reap00101401f liability for"bodily:injury", !deka* while rented to you or "properly damage", Or "personal and temporarily occupied by you with advertising injury', causedln.whitile de in .. .. . , .,„ ... ,. . . , . . - permission of the owner.. The limit is part by your maintenance, operation or . . increased to$1,000,000 use of equipment leased you by such :., . : ...., ,• 3 Under Section IV , conemereet General person(s) or- organization(s) This .; . . . . , insurance does net, apply to any Mobility.Condition% Condition 4. Other " Insurance,0, Excess insurance(1)(a)(ii) occurrence Which Ol(eS place affee the.. ... . . . is replaced with: ,ease eXpires, - (II) That is Fire,. Lightning, Explosion, However, their status as additional SnOkinsured, under this 'peppy, ends when e, or Sprinkler leakage , , their lease, bontract,‘er.egreerriehf with inSurance or premises rerited to you for such'leased equipment eXpires. you or temporarily occupied by you with permission of the owner. Page 2 of 5 Includes copyrighted matedelpfinsuranceSenoces,Office,loc, 01,721812 16 With its,PeOlssieh' ACP;°LAMS:4305214 1:520 18344 INSURED COPY . I. • • 47 01:1i07,00 CG 728812 16 b. Managers or Lessors of Premises d. Owners, Lessees;or Contractors with with respect to liability arising out of the respect to liability; for "bodily injury", Ownership,-Maintenente, or use of that "property damage", or "personal :and - part of the premises you own, rent, leaysetor occupy. advertising injury'caused, in whole or in i*rl,by: This insurance does not apply to (1) Your acts or omissions;or (I) Any "occurrence"which takes place (2)•The acts or emissions of those , ,. : after you rcease to be a tenant in. acting your behalf,. that-premises. mE the perfortnance of your ongOing (2) Structural alterations, new on- operations •performed for .that ., struction or ,dernoillien, operations additional insured,whether the work performed by or on -behalf of the is performed by .you or on your . _ person or organization:. t ... .1._ :,,, behalf. - .4,,, liOWever, their status as .additional The insurance_does not apply to: . , insured 6100rthi0.:0611PY ends when you (1) "Soda!' injury, "property damage", 000010 600 tenant tifeuChpreiniSes. or "personal and, advertising injurr c. State or Political Subdivision - arising out of the rendering Of or the Permits i Reiatiittito Premises. with failure to render any professional . , ' , respect to the following hazards for architectural, engineering, or survey which the state or political subdivision cervices,including:. has issued a peppit or authorization in , (0) The preparing, approving, Or connection with.premises you own, i7011,t, failing to prepare or approve, or control and to WhiCh'MIS insurance maps, shop drawings,opinions, applies: reports, survey, field orders, , (1) The existence; maintenance, repair, OhaPgq,ordOrsi or drawings and cOnstr4ctiOn, erection,Or removal of specifications or advertising ,signs, awnings; (b). Supervisory, inspection, arch"- canopies, cellar entrances, oda' . .. ,. techwat or engineering act*, holes, driveways, Manholes, marquees, hoist away openingS, Side** vaUltai Street batinett, Or (2) "Bodily injury"or "property'damage" aft decorations and ',anvil*-exposures; 0PCOrdriter: or (a) All WP1*, 1114t_dilti materials, parts,or equipment furnished in (2) The construction, erection, or . COnnection--With-Stich Work, on re:movatef eievators;.Or - -: • ' - the project (other than service, ... . The ownerahig maintenance, or-use of maintenance or repairs) to be any elevators covered by this insurance performed br or on behalf of the This insurance does not apply to additional insured(s) at the • (1)--"Bodily iniOti!" Or "0009 daTege". lodetied df file- Covered . .., operations has been.completed,erdd or "personal or. advertising injury" bt . . „„ .. arising out of operations performed for the state municipality,or (b):That portion of "your work"'out .., ..: of which the jury or damage - . (2) "Bodily injury" or "property : included within the "products- anteintended has been put lo •its -... , , . . ed 00e,by any person Or coptpleied operations haOrpr: organization other than another ..'-. However; such' state or political contractor or subcontractor subdivision's status as additional engaged in performing . • insured under this policy,ends when the operations for',a principal as a permit ends. part of the same project. CG 72 80 12 16. indudeatoPAthtad Mate*,of•lasuratiaa SaiviOas Office,Inc., Palie 1 0'0 vial fti-petkim ACP CAA:1365630214 1.520 13344 INSUREiatOPY, 47 0019761 CG 7250 12 16 However,a person or organizations This coverage does not apply 'Up:overage C — status as.additional. insured under Medical Payments le excluded either by The this policy ends when your provisions of any beverage tonna attached to the operations for'that additional insured policy or by eridersement. ai•OCcirtipleteil K. Knowledge Of An'Occurrence With respect to the insurance afforded to Under section- Pi — Commercial General such additional insureds a -, O. doOril3ed Liability Conditions, the following is added to above the following is added to the Section Condition 2. Duties in The Event Of III—Lianfte.01 Insurance: Occurrence,,Offense,Claim Or Suit: If coverage provided to the additionalde. Knowle ge91 an occurrence,.offense, claim insured is required by a contract or . Or suit by an agent or employee of, any agreeMent,the most we Will pay on behalf of , insured shall not in itself constitute the additional insured is the amount of knowledge of the insured. unless you, a insurance; partner, if you are a partnership; or an 1. Required by the contract or agreement: executive officer, or insurance manager, if or you are a porporatien receives, such notice 2. Available under the.applicable tLimits of of an occurrence i.offense, claim; or suit from insurance shown in the Declarations, the agent Or employee whichever is less: f The requirements in Paragraph b. will not be considered breached unless there is This endorsement shall not increase the , knowledge of occurrence as outlined in applicable-Limits of Insurance shown in the Paragraph e,abOie. Declarations. . L. Unintentional Failure To Disclose Hazard However, Ihe insurance :afforded to such additional`insureds a,—d.described above Under Section IV - Commercial General _ Liability Conditions, Condition 6, 1. Only applies to the extent permitted by Representations the following paragraph is law,and added: 2. Will not be broader than that which you d. Your failure 10.diCloSe all hazards or prior are- required by. the centred or teeuttenCes" or Offenses,existing ea Of the agreement to provide such additional inception date of the policy shall not intutedprejudice the. coverage by this Limit I. Aggregate Per Project policy provided such failure to disclose all hazards Of prier"occurrences"or Oftellaet.10 Under Section III ,-. Limits Of Insurance The . . . , . . .. following paragraph is added to Paragraph 2 not intentieriel. This provision does not . , The General Aggregate Limit under Section IIIaffeCt our right to;collect Odditional preihiurn , ; _ , Llinitiof Insurance applies separately to each or exercise our right of canoellatiOn or non- ... ., . : - , . . of your construction projects away from senewat. premises owned by or rented to you. M" Waiver Of Subrogation J Medical.Payments Under Section IV — Commercial General . Wider Section III '.7 Limits Of Insurance, Liability'Conditions,5.Transfer Of.Rights* Paragraph 7.is replaced with: -RecOvery:Against Others.To Us the following . , paragraph it added: T. Subjectio 5,above,the higher of: , It required by a written contract executed prior to a. $1 0,500;Or loss, we waive any right of subrogation we may b. The amount shown in the Declarations have against the contracting person or for Medical Expense Limit is the most organization because of payments we make for we will pay under Coverage C for all ipjoryor tlemage, ending out of your ongoing medical expenses because of "bodily operations or"your work"done under,a contract, injury sustained by one person, with that person or organization and Included in the"Produote7comoieted.operatiOns hazard". Page 4 of 5 Includes copyrighted materiel of insorance SerVices:pfrice,Inc., :-CO./288.12.i6 vilth:fts permission. ACP titA030563115214 L520 18344' 111SURED COPY . 47 00197112. CG 72'88 12 16 N. Liberalization O. Broadened Bodily Injury Definition (Mental Under, Section IV — Commercial General Anguish) Liability Conditions, the following condition is Under Section V — Definitions Definition 3 added: 'Bodily Injury'is replaced with: 10. Liberalization 3, '1304 injury meanS physical injury, If we revise this Overage • sickness, or disease to a person ancl if forrn to provide wising out of the foregoing, menial anguish, more coverage without Additional premiumwising or hum charge,your policy will automatically provide mental injiliation• the additional coverage as of the day the including death at any time g therem. revision is effective in your state. All terms and conditions of this policy apply unless modified by this endorsement. CG 72 88 12 16 Includes smpyrighted material of Insurance Services Office,Inc., Page 5 of 5 with its.PPrOPPiPP• ACP 01.A03056385214 1.520 18344 INSURED COPY 47 00197113 COMMERCIAL AUTO AC 70 05 03 16 THIS ENDORSEMENT CHANGES THE POLICY.PLEASE READ IT CAREFULLY. f:VSINESS AUTO PROTECTION - GOLD This endorsementmodiffes insurance provided under the blowing: BUSINESS AUTO COVERAGE FORM SUMMARY OF coremags A. Merit Of This Endorsement B. Newly Acquiped or Formed Entitles C. Employees as insureds—.Ronowned Autos D. Additional:insured by:Contract,Nadler Agreement SupplarnentaryPayntents-,Bell Bonds F. SUpplementarYPayMenti—LOst.of Earnings G. Personal Effects and Property of Others Extension H. PrOldlltlerit:htterest Coverage I. Fellow Employee—OffictriMenagers and Supervisors Hired Auto Physical Damage K Temporary Substitute Autos—Physical Damage Coverage L Expanded Towing Coverage M. .Acb Loan orLeitiisCoversge N. Original Equipment Manufacturer Parts—Leased Prkale Passenger Types 0. Deductible Amendtrienis P. RatilaillelmbineemadCOVetage 0, Expanded TneilipedetIon Expense FL Extra Exp.ortta•-Stolen kilos s. Physical Damage Unit of insurance T. New Vehicle ctepteorritant Cost U.: Physical Damage Coverage Extension • TranSfer Of Rights of RecevoryAgainstOlvers To Us W. Section!V.-easiness Auto Cortditions—Notics of andKnOWledge of Occurrence X. Hired.Car Coverage Territory Y. Emergency Lockout Z. Cancellation COncRion • • AC TO 05. VG InOludes copyrighted wrabwiatof insurence,BerVIces Office.Inc. Paige I of? with ntpOIMINSION. ACP NAPOIP4541$81163 MIN MN 'WNW*coev scam cam as Man COIRMERCiAl.AUTO AC 70 05.0116' A.' EFFECT OF THIS ENDORSEMENT If'specifgallyrequired.by the written contract or agreement referenced lin Vie partial.*above, Coverage provided under this poloyis modified any cOverage prOVided by thit.endorsement to by the provisions of this endorsement If there an additional ineUred shall be primary and is any conga betWeen this plOvieldne of this any other veld and Colima:6 Insurance ova . endorsement and tha provialanm at any state, 410 to Vie addition& Insured *hat be non. specific endorsementalso attached to this poi. contrioutoly with thlt Ineurance, If the *Witten oh then the provislOn(c)of tiw stake)** contract does 00,tPiellike this coverage to be endorsement shia apply Instead of the provi, primary end Vie additional insured**000000 to tiOns of this endoreernent that are in conflict, be norkOnthbutoty,du)rt ifili Insurance val be but only,tO Vie Clete:4ot*confliet,antionlYto excess.over any other valid and colleatibki Inter, the extent necessery to bring tuch proilebris awe avallabletoe Lia &inred., ,7-. Into conformarice with the state requirement(s) .-- tgtionsg • ..::-1 , - , contained In the provision(s)of the tiateepicific endorsement E. SUPPIMAENTARY PAYMENTS - SAIL B. NEWLY ACQUIRED OR FORMED ENTITIES BONDS The Named Insured shown in the Declarations is aiipplernentaly Payments Of SECTION 11 - amended to include Any organization you newly COVERED AUTOS LIABILITY COVERAGE is acquire or form, other than a pennons*,joint revised as follows . - v.entes, or limited Ilibilty company, and over (?) llp tO UAW fat cOtt Of bajl:bonds(including which you Inaba&ownership or majority(more bonds for related traffic law Violations) than 50%)interest If there Is no other similar in, required because of an"accidenr we Cover. . . liwigme available:to that organizeliOn.Coverage WO tkollOtileVet0 furnish these bonds: under this provision Is afforded. until the IS& F. SUPPLEMENTARY' PAYMENTS .,..LOSS OF 'day after you acquire or form theorgatikatiOn or EARNINGS ' the encl of tie pcilky period,whiolieVor is later. SupplementaryPayments of the SECTION II- C. EMPLOYEES As INSUREDS - NONOWNED COVERED AUTOS LIABILITY COVERAGE Is AUTOS ' revised as f011oWs: The renewing k added to prognaph A.I.Who Is (4) N1 reaporudge:experwes incumedby the In- . An.insured Of SECTION II-COVEFIED AUTOS PPS'44 0.4r ructilauLlOOludieg Actual lose LIABILITY COVERAGE: of earnings up to $500 a day because of d. Any "ampbyee" of yours Is an `Insured" thneeffltont Wort while using a owe*'IttutO•you don't own, .G. PERSONAL .LIFFEcTS Mc PRoPERTY CIF hie or beim In your birelnees or your per- OTHERtibrittisioN .; .sOrisiialklia • ._,_._, - 1_„,..1101 .9.100„posto.dyori,..09001 Exclusion of liLz,AINNIIONALTIANINIREO ',1Y": CONTMOT, = ' -• SECTION 11 . .;t--- COVERED- '.ALITOS PERMIT OR AGREEMENT LIABILITY COVERAGE, does. not apply to The following Is added to Ai. Who Is An In, - • ..'i . -:- -i. ' In- 'property*maw to property,-other than cured of SECTION 0 - COVERED AUTOS Your.property,up to on etoountnot exceed- LIABILITY COVERAGE: lug:$250in any ene 606Oldiair. Comm. My person or organization that you are re, Is excess over any Other Valid and Oollectble putted to name as an additional Insured In a insurance. Written COM**or agreement that IS executed 2. The following.paragraph Is ildtked..to A.4- or signed by you prior to a 100ditt teleff or Coverage Ektonslone.of SECTION mu - vropoity damage occurrence Is an Insured' I PHYSICAL DAMAGE'COVERAGE: , kr COViirsid AUto Liability Overage. How. o.• WO WO PaY OP to$500 for your properly . . . ever, With respect to covered fauteir, eucti thatk 100 or-damaged ti,$a tesuit-of a parson Or organization is an Insured only to coveted %eV, vdtheut epplYing a do- the extent that person or organization qualifies 0010. Doventgels moose over any as an Insured*under Al.Who Is an Insured of other Valid and collecikle ineurance. SECTION II - COVERED AUTOS LIABILITY COVERAGE: • PORO 2 of/ !riptides cOpyrighted mated&ofincurance Services Office,Inc. ACIO OE(41 le i With its perodislon • i { sus CAPD7844104153 51111 MP. MOUND COPY :AC70060111C0 WI 4/ 0$2671144 I 4,• . I • COMMERCIAL AUTO AC760E1316 IL PREJUDGMENT INTEREST COVERAGE tuba*for*covered'auto"you own that The following paragraph is added to SECTION II Is out of service because of its: — COVERED AUTOS LIABILITY COVERAGE, a. Breakdown; 2. Coverage Extensions, a. 'Supplementary b. Rep* Payments; c. Sontking;: (7) Prejudgment Interest awarded against the " Insured"on that part of the judgment.we d. Lose%Or pay. If we.make an offer to pay the appN. e. Obstruction cable limit of Insurance, we will not pay The 00,440 that opplitio Is the same as any prejudgment Interest based on that . , the coverage provided for the vehicle being pettodOf tireioaftOr$10-ofter. ' 1 ,%.replaced. 1. FELLInkr“- EMPLOYEE - OPPICERS, •, ) MANAGERS,AND sUPERVIIMRS L. EXPANDED TOWING COVERAGE The Fellow Employee Exclusion In SECTION II t We Wilpay -,-COVERED AUTOS LIABILITY COVERAGE Is replaced as follovis;, a. $10Q for a covered "auto"-you own of _ A. IBotRy injury' to any fellow `employee" of theprIvatO oatsOngertype,or MO Insured"arising out of and In the course b. $500 for a covered"auto"you own that of•the fallow "employees" employment or Is not of the passengertype, WhIlo performing duties related to the con- for towing end labor costs Incurred each duct of your buelnoSa This exclusion does time the bowed'nuke Is disabled.flOwev• . .. . . . .. , . . . not,apply ID an lirretrred, Who occupies a er.the labor must; be performed'et the place . , . position as an officer. manager, or sunervi- of disablement. SC.r. 2. NS coverage 00110 only for en "auto" J. HIRED AUTO PHYSICAL DAMAGE covered this policy COinpeehertehro or , .. . If covered'aide designation symbols I or Sap- SPOOltioad Causes of tote Coverage and . - ply to Liability Coverage and If at toast one'su- •tollifon 00voragOo to' you Oh Is-60!.red bifihts Po4Y for cOul' 3. PaymOntappiteo•in additionto the otherwise prohOriiivei.SpOcitted'CatirMS of LOIS,or Conf. appOcable amount of each coverage you don coverages, then the Phial* Damage . have anted**"auto". - oclicAllos provided we extended to"autos"you ht AUTO LOANOR LEASE oOVERAtit, 1000,hire,:rent or bOnOW*1111044 driver;and and ...O 1. In fro event of:0 total ltre't a covered • provisions In the.Busineos Auto Corm . _ . . . , .. . "srote,..Vi0 Will_06Y.any'unpaid amount OW, applicable.to filtedAritio Paysiort Damageappfy on ihaIOan',.rir let*,k ,-ft,:rip4airt:mair--.;_,:. 140 61ti KgrItOt.$100000.,Thededdc4bla at he ' ' '- -t'inaila-outsso0 An'aarly lannbailliA boo or -04I0110 fliall#60atclad00100 a0011.00-11i la ally «' -- « .• ' priindliail.-for your covered.tuto.less: owned !ante•10r that beverage: Any COMpre- henSIVO deductible does .not apply to fire or a. Ihonunt paid.ander SECTIO — . ...„ .,. .. _ .. .. , .... , e PHYSICAL DN III AMAGE COVERAGE of thle-polloy;and K. TEMPORARYuSUBSTITUTE.., . AUTOS -, PHYSICAL DAMAGE COVERAGE b. Any; The klloWille 10 addfid Act,Par4OPIgi C.POOliki . 1) Overdueleasefitteri payments at the time of*lorttr; Trafere, MobileRfilprnent And Temporary Substitute-Mtge of SECTION-I - COVERED :- 2) Fiturnoletpenahlas!Mose400ga AUTOS: • • lease for excessive use,.abnormal . ,.... 111;110olit Damage Coverage,. is- provided by wake and•UrarOr high miloogo: this Coverage Form, the fallowing,types of 3) Security deposits not refunded by.a Vehicles are also covered`Milos'lot Physi, . lisioot; cal Damage Coverage: - 4): Costs of extended warranties,Credit Any 700.01 you do not own Ole used with Lift* insurance,Health, ACCident;or the pOrMleidOrt of Its owner as a temporary Disability*thence purchased with the Witte;and AC 7603 6610 Includes copyrightod material of Insurance Services 0fhoe,inc„ Peso 3 at 7 with no permission Sais-00$417444P408S attic IVO • streurttir cost, sercessereer 420$ 4P Wit • COMMERCIAL AUTO AC70,05431e 5) Carry-over balances from previous NO deductible applies to glass if the.plass Is re- leases. paired,In a manner acceptable torus,rather than 2. This coverage only applies to.a'loss'which replaced. is also covered under this policy for Com- P. RENTAL AEIStBURSEMENT COVERAGE prehensive, Specified Causes of Loss, or 1: This Coverage applies only to a Ovoid"au- Collision°overage. to'for which Physical Damage Coverage.Is 3. Coverage does not apply to any unpaid • provided on this policy: amount due on a loan for which the covered 2. We will pay for rental reimbursement ex, "auto'Is not the sole collateral ,parses incurred by you for the rental.of an N. ORIGINAL EQUIPMENT IINANUFACTUftER '."auto"because of'yeas' a_covered`cute' PARTS -`LEASED -RRIVATE•OMEN— GER •`"Pa ent . . --'" - ym appNes M eddrtion to the otherwise TYPES applicable amount of each coverage you Under Paragraph C. Limit of insurance of have On a covered "auto No deductibles SECTION ill -- PHYSICAL DAMAGE applyto this,coverage. COVERAGE,Seddon 4 is added as follows: 3. We will pay only for those expenses Incurred 4. We Will use new original equipment vehide during the polity period beginning 24 hoots manufacturer parts for any private passer- alter the"loss'and ending,regardless of the ger type covered 'auto"where required by POWs.expiation, with the Ismer of the the lease agreement Which has atter of at full a ing number of days: least six months. If a new original equip= •a The number of days reasonably merit vehicle manufacturer part;is not In pro- required to repair or replace the covered duction or Gstdbutloo we May use a like, "auto'. If loss' is caused by theft, this hind.and quality replacement part,. number of days'is added to the number C. DEDu�B1.E AMENDMENTS of day; ft takes to locate the covered Tho following are added to the Deducible prowl- 'auto'and return 5 to: you. ::loo of SECTitaN III -- PHYSICAL DAMAGE b Tare number of days shown in the COVERAGE: Schedule. If another'policy or ooverags One that`Is not an 4. Out payment Is limited to the lesser of the automobile policy or coverage fern issued by following amounts: this company applies to the same'ebcldenr,the a Necessary and actual expenses following apple:; incurred 1. If the deductible under this cover ge is the b. $lS for any one day or for a msuamum smaller (or smallest) deductible, It wAl be - of 30 days: ' ; waived:. r 5. This coverage does reel-appily'whle there 2. If the deductible under this coverage;is not are spare or remove'autos*ave uabie to you the smaller(or smallest)deduclible,Itwill be for your operations, reduced by the amount of the s mater(or 6. 0"loss`results from the total theft of a cov- smdlest)tteducdble. • eyed 'auto'of theprivate passenger Type, If a Comprehensive or Specitied Causes of Lore we will pay under this coverage only that Coverage 'toss` from one 'accident" Involves amount of your rental reimbursement ex- two or More covered.'autos', only the highest . penssswhlch Is not already provided for un- dedu tible.appicabte to those coverages all be . . _ der SECTION Ill ——PHYSICAL DAMAGE applied to the'"accident,°if the.cause of the 10s0 COVERAGE Coverage Extension. fe covered for those Vehicles This provision only Q. WARDED ThANSPORTA11ON EXPENSE applies If you.carry Comprehensive or Specified Paragraph A.4e. of SECTION III. PHYSICAL. CaUte s of Loss Covertige far those dehldes, and does not extend IN: DAMAGE.COVERAGE is replaced by the loll w� oovriraga to any covered "autos" for Which you do. riot -cony Such coverage. We will pay up to$50 per day b:a maximum of St500 for temporary transportation exQense In- carred by you because of the total theft of a Page 4 of 1 lndudes copyrighted matsrdal.of:Insurance Services Office,inc AC 70 0$03 id with its petmlatIon. ace eApo764s 5,1111 110303 , SISUREIS Mod Ac7ooroateso vim 47 COW. . • ' COMERCIAL AUTO AC 70 05031e covered "auto' of the private passenger type: mord manufacturer or other sources in- We will only pay tOr those covered.'autos for clung non-original equipment Manu- Which you .tarry Comprehensive or Specified factUnws and Causes of Loss Coverage.We will pay for bob- b. If a repair or replacement result's in bet# .potary transportation expenses Incurred during ter than filti3. kind or quality,we will net the patiodbegkining14 hours after the theftiand . pay for 1h®amount of the net Improve.. ending, regardless of the policy's expiration, Mont. when the Covered'auto'is returned to use or we 6. If we offer to pay the actual cash value of pay Ur or,,, "lost°. the damaged or stolen property, we will R. EXTRA EXPENSE•••STOLEN AUTOS 0000 auto advertising wraps,paint Oslo* The fOlowing.paragraph Is added.to Coverage • . fi ;zetion,and Anger hUSIneskreltited adverbs- 410016147ot...SECTION ill —7. 'INVOICAL . , )ibs rrnettileetiOns„-10-,addition to the ;OW DAMAGE COVERAGE: cash value of the iprePerlY,Mb'advertising , C. We will pay for Op to$6,000for the expense wraps, paint customization, and similar of returning a stolen covered saute to you. by0000 related advertising m411001006 Werivdit pay only for those covered 'autos' will-be.Valued at the coat to replace thorn for which You 00trY tectOptoherisive-or Spec- - with an atattnient.made for depreciation Med Causes of Loss Coverage and physical condition. S. PHYSICAL.DAMAGE LICIT OF BIBUBANCE T. HEW'YEW=REPLACEMENT COST Under SECTION III .- PHYSICAL DAMAGE The folloWing is added to the Limit of insurance . ., COVERAGE, Paragraph C.,limit of Insurance PIO** Of SECTION 111 —. PHYSICAL It replaced by the following: DAMAGE COVERAGE! C.limit Of in0100000 5. The provisions of paragraph'1. and 0. do nOt ennitve covered logo°ot the private 1: The most.we willpay for IOW in any one passenger**.Or A VehiCle with.a gross laccideriels the 10400: • Velithlt.welitht rating400000 pounds or a. The actual cash value of the damaged 100 Ukiah lie.?new vehicle.' or stolen property as of the time of In the event of a total'lose-to youroew ve- late%or hide to*Mehl*oOverigotOptes.we will b. The cost of repairing or replacing the pay id VOW OP** ciaMODadOr*WM fropetly• . a: Roo .veriflable ''new vehicle' porches* 2. $1500 I"the most we will pay for lose In MC! you:paid for your dwriagad Ohl. any.one ittcCidenr to all electronic*Op- de,not inOlOttte.any insurance or war- merit thafreptedge00.receives or transmits rahlles.pon*O"ed; audio, visual or data signals which;at the • b. .If ft Is aiailable;the purchase price,as - time ollotteilt::,li. . ,.. . . negotiated by us, of a'hew Vehicle of a: Permanently Installed In or upon the the same make;model,and equipment covered"auto'In ahousing,opening or or the similar rnOdelevatietite.not other location that it not normally Used Including, , .:., 'any furnishings, Pei,th. or by the "auto"-manufacturer for-the- In, equipment.not installed Witt,'0010* Othilation of such equipment furor or manufamisrer0 dealership;or. b. •Removable from 4perntenenttyinstafied c. The market value,of your damaged mi- nimising unit as described In Paragraph , *leo not intilittfurnishings, any Inps. 2.a. above or Is an Integral part of that .... „. ..,,.. ... . — parts,or eqUIpMent,not tallied.by the equipment or Mambo:doter or manufacturers dealer- c. Are hoorah pail of such otpdp.mont. thine 3. An•adjustment for depreciation and physloat We wig not,pay for initiation or,402 up costs „., ,. ......_ condition will. be made'h ethtiethilniiiii actual associated with loans or leases. cash*EOM the event ofethtsi'IOW, As. used in this endorsement, a "new 4. Ihe&stet repsdrtng or replacing rnay: vehicle'MOW* an 'auto'of which you aro . a. Be based on an ettknale which includes the Original owner that has not been weal, part; furnished by the Opel egOlp, it,c 7005 0,116 Includes copyrighted materiel of Insurance Services Office,Inc., Page Sot 7 ; with he permission ace SAP37$a4pall7. NH 1153 •.•NISUXBD;WY . P4041040211= 'MI ' 47 4024717' COMMERCIAL AUTO AC 70 050316 ously Med and which you purchased less a. Your ohligaliOnin the Duties in the Event than 365 days before the date of the loss". of-AcCklent,Claim,Suit or Wet Perdi- tion relative to notification requirements U. PHYSICAL DAMAGE COVERAGE applies on& •When the "aCCIdene or -lEXTENSIONS lees"Is knoimt to; Under SECTION III — PHYSICAL DAMAGE (1) YOu„-If you are an individual; COVERAGE. A. Coverage, Coverage Eden- (2) A partner;If you are a partiteretilg: sions,,b. Loss of Use Expenses Is replaced by (2) A Inernber II you lee a Molted frability the blowing: company;or b, Loss of Use Expanses (4) An executive officer or Insurance For Hired Auto Physical Damage, we will manager,If-you area corporation. pay expenses for which an Insured* be. b. Your obligation In the Duties hi the Event *Mee legally responsible to pay for kiss of of Accident,Claim,Suit ar Lose COndlion use of a vehicle rented or hired without a tehttlife to providing us with documents driver, under a written rental contract or Oncoming a claim Or 'tor will not be agreement We will pay for loss of use ox- considered breached unities the breach prinset If caused by: occurs after WO claim or meOlt!Is known (1) Other than collision II the Declarations to:: Indicate.that Comprehensive Coverage (1) You,if you are an individual; is provided for any covered audo", (2) A partner,If you are a partnership, (2) Specified Causes of Less Only II the (3) A me r, If you are a limited Declarations indicate that Specified liability company;or Causes Of Lose Coverage it provided for (4) An executive officer or Insurance any cOltenglaeoto";or - Mangera ,if yoU am a*Oration. :(2) Collision only it the Declarations Indicate that Collision Coverage Is provided for any cOvered lauto.I. X. HIRED CAR—COVERAGE TERRITORY However, the most we will pay for any item (5)of the Policy Period,Coverage Territory expenses for loss of use it$50 par tO a GertaraPOnditiatiris replacedby the foloWing: maximum 01.$1.0Q&The Insurance proVided (5)Anywhersin thetvgirldif a•.Coveradeauto°Is by this provision Is excess over any other leased,.hlred,rented or.borrowed Without a coliettlble btu** ' ddaatkra-POIladOttO'daYstritte;end. V. TRANSFER OF RIGHTS OF RECOVERY Y. EMERGENCY*ACK- OUT AGAINST-0010S YOU . We will reimburse you up to$100 for reasonable The following Is added to the liens*Of Rights expense incurred for the pericioes of a locksmith Of Recovery AgainstOthers To Us Condition; to to lintl,Into your covered'auto!aublect to Wo waive any right of recovery we may these provitioost have against any person or organization to 1. Your doer keyelectronic key or key entry the indent required of you by a written con. pad has I:seen 104 stolen or locked In your tract executed prior to any -00ookrOor be- covered*orb"and you are unable to enter cause of payments'we c-make for damages such.0.U1011,or Under this coverage fent). 2. Your keyless entry device battery dies end W wow OF AND KNOWLEDGE OF you are unable to enter;will%tube as a re- OCCURRENCE . SECTIONIV—BUSINESS AUTO 3 Your key, 01000100 key or key entry pad PON— DITIONS,Paragraph Moramoododoc has been Itert. or stolen rind yeti have follows: changed the lock to prevent an 6. NOTIOEOF ANentry:end D KNOWLEDGEOF OCCURRENCE . - IDaga 6 col7 IncludesociOyrighted material of InsUrahoe Sehrbes Office,Inc AC 70050316 with it**Mato% $00 aporafacteet$3 war taXe Osman)van noietacateco caot --- a open T.—,17.•Ns.: • COMMERCIAL Juno AC 70 05 0.1 16 4. Original copies of receipts for services of a It we cancel for any reason other than non- locksmith must be provided before Wm- payment of premium,we will mail or deliver bursernent is payable. to the First Named Insured written notice of ZCANCELLATION cancellation at least 60 days before the el- . CONDITTON festive date of cancellation. This provision Paragraph A.2. of the COMMON POLICY does not apply in those states that require CONDITION — CANCELLATION applies more than 60 days prior notice of cancans- except as follows: tion. AC 70 08 03 16 Includes copyrighted material of Insurance Services Office,Inc., page Tot? with its permission acs 11011PD/64404.1162 611111 IMISS BONED CCOV AC708921M17 aux 47 Melt