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2023-101 PO 20240060- Bill's Glass & Windshields
Purchase Order /MaCI"' � ,v 4L Fiscal Year 2024 Page: 1 of: 1 B City of Ashland L ATTN:Accounts Payable Purchase L 20 E. Main . Order# 20240060 Ashland, OR 97520 T Phone: 541/552-2010 O Email: payable@ashland.or.us E BILL'S GLASS &WINDSHIELDS H C/O Facilities Maintenance Div N 2407 SISKIYOU BLVD I 90 North Mountain Ave D ASHLAND, OR 97520 P Ashland, OR 97520 OR Email: SHERI@BILLSGLASS.COM Phone: 541/488-5358 O Fax: 541/552-2304 lam 6,.s�.u dZ`IY =_2-3�6 5 �....E;=`_6 53 iT. —..'—.2, �r=11 ,10.15 @ e1.E.a 3 El���� E _1�-12_.. (541)488-2500 David Arnold ar� A. =08/08/2023 114 • FOB ASHLAND OR/NET30 City Accounts Payable On-call Glass Repair 1 On-call Glass Repair& Replacement 1.0 $5,000.00 $5,000.00 Goods and Services Agreement($35,000 or less) Completion date: June 30, 2024 Project Account: *************** GL SUMMARY*************** • • I 088400-602400 $5,000.00 I I 1 i • B y. IL :� � 1. Date: I.�✓ �' Aut orizd Signatu;- ;1407 $5,000.00 • "- FORM33 CITY OF A request for a PurchaseOr,$60 ASHLAND REQUISITION Date of request: 7/26/2023 Required date for delivery: Vendor Name . Bill's Glass Address,City,State,Zip • 2407 Siskivou Blvd..Ashland,OR.975.20 Contact Name&Telephone Number James Reeves.541-488-2500,James Reeves<jamese,bilisglass.com> Email address • SOURCING METHOD ❑ Exempt from Competitive Bidding ❑ Invitation to Bid 0 Emergency ❑ Reason for exemption: Date approved by Council: 0 Form#13,Written findings and Authorization. O AMC 2.50 _(Attach copy of council communication) 0 Written quote or proposal attached ❑ Written quote or proposal attached _(If council approval required,attach copy of CC) ® Small Procurement 0 Request for Proposal Cooperative Procurement Not exceeding$5,000 Date approved by Council: 0 State of Oregon ❑ Direct Award _(Attach copy of council communication) Contract# ® Verbal/Written quote(s)or proposal(s) 0 Request for Qualifications(Public Works) 0 State of Washington Date approved by Council: Contract# (Attach copy of council communication) 0 Other government agency contract Intermediate Procurement ❑ Sole Source Agency GOODS&SERVICES ❑ Applicable Form(#5,6,7 or 8) Contract# Greater than$5,000 and less than$100,000 0 Written quote or proposal attached Intergovernmental Agreement ❑ (3)Written bids and solicitation attached 0 Form#4,Personal Services$5K to$75K Agency PERSONAL SERVICES Date approved by Council: 0 Annual cost to City does not exceed$25,000. Greater than$5,000 and less than$75,000 Valid until: (Date) Agreement approved by Legal and approved/signed by ❑ Less than$35,000,by direct appointment 0 Special Procurement City Administrator.AMC 2.50.070(4) ❑ (3)Written proposals&solicitation attached 0 Form#9,Request for Approval 0 Annual cost to City exceeds$25,000,Council 0 Form#4,Personal Services$5K to$75K 0 Written quote or proposal attached approval required.(Attach copy of council communication) Date approved by Council: Valid until: (Date) ' • Description of SERVICES Total Cost Glass repair and replacement services as needed. .;$5000:00: Item # Quantity Unit Description of MATERIALS Unit Price Total Cost $0 $0.00 $0 $0.00 $0 $0.00 ❑ Per attached quote/proposal :TOTAL • COST Project Number: _ _ Account Number: 088400-602400 ;$5100040 *Expenditure must be charged to the appropriate account numbers for the financials to accurately reflect the actual expenditures. IT Director in collaboration with department to approve . hardware and software purchases: IT Director Date Support-Yes/No By signing this requisition form,I certify that the City's pu•-c c. ratting requirements have been satisfied. • Employee: i Department Head. mob `.2. 2 3 (Equal .or greater than$5,000) Department ManagerlSupervisor: City Manager: �� (Greater $35,000) Funds appropriated for current fiscal yea62)YE /NO �"�/�cl, Finance Director-(Equa greater than$5,000) Comments: Form#3-Requisition • GOODS AND SERVICES AGREEMENT ($35,000 OR LESS) PROVIDER: Bill's Glass CITY OF PROVIDER'S ASH LAN D CONTACT: James Reeves 20 East Main Street Ashland,Oregon 97520 ADDRESS: 2407 Siskiyou Boulevard Telephone: 541/488-5587 Ashland, OR 97520 Fax: 541/488-6006 PHONE: 541-488-2500 This Goods and Services Agreement (hereinafter "Agreement") is entered into by and between the City of Ashland, an Oregon municipal corporation (hereinafter "City") and Bill's Glass, (a domestic/foreign business corporation) ("hereinafter"Provider"), for glass repair and replacement. 1. PROVIDER'S OBLIGATIONS 1.1 Provide glass repair and replacement for FY24 as set forth in the "SUPPORTING DOCUMENTS" attached hereto and, by this reference, incorporated herein. Provider expressly acknowledges that time is of the essence of any completion date set forth in the SUPPORTING DOCUMENTS, and that no waiver or extension of such deadline may be authorized except in the same manner as herein provided for authority to exceed the maximum compensation. The services defined and described in the "SUPPORTING DOCUMENTS"shall hereinafter be collectively referred to as"Work." 1.2 Provider shall obtain and maintain during the term of this Agreement and until City's final acceptance of all Work received hereunder,a policy or policies of liability insurance including commercial general liability insurance with a combined single limit, or the equivalent, of not less than $2,000,000 (two million dollars)per occurrence for Bodily Injury and Property Damage. 1.2.1 The insurance required in this Article shall include the following coverages: • Comprehensive General or Commercial General Liability, including personal injury, contractual liability, and products/completed operations coverage; and • Automobile Liability. 1.2.2 Each policy of such insurance shall be on an "occurrence" and not a "claims made" form, and shall: • Name as additional insured "the City of Ashland, Oregon, its officers, agents and employees" with respect to claims arising out of the provision of Work under this Agreement; • Apply to each named and additional named insured as though a separate policy had been issued to each,provided that the policy limits shall not be increased thereby; • Apply as primary coverage for each additional named insured except to the extent that two or more such policies are intended to "layer" coverage and,`taken together, they provide total coverage from the first dollar of liability; • Provider shall immediately notify the City of any change in insurance coverage • Provider shall supply an endorsement naming the City, its officers, employees and agents as additional insureds by the Effective Date of this Agreement; and • Be evidenced by a certificate or certificates of such insurance approved by the City. Page 1 of 6: Goods and Services Agreement between the City of Ashland and Bill's Glass 1.3 Provider shall,at its own expense,maintain Worker's Compensation Insurance in compliance with ORS 656.017, which requires subject employers to provide workers' compensation coverage for all of its subject workers. 1.4 Provider agrees that no person shall, on the grounds of race, color, religion, creed, sex, marital status, familial status or domestic partnership, national origin, age, mental or physical disability, sexual orientation, gender identity or source of income, suffer discrimination in the performance of this Agreement when employed by Provider. Provider agrees to comply with all applicable requirements of federal and state civil rights and rehabilitation statutes, rules and regulations. Further; Provider agrees not to discriminate against a disadvantaged business enterprise,minority-owned business,woman-owned business, a business that a service-disabled veteran owns or an emerging small business enterprise certified under ORS 200.055, in awarding subcontracts as required by ORS 279A.110. 1.5 In all solicitations either by competitive bidding or negotiation made by Provider for work to be performed under a subcontract, including procurements of materials or leases of equipment, each potential subcontractor or supplier shall be notified by the Providers of the Provider's obligations under this Agreement and Title VI of the Civil Rights Act of 1964 and other federal nondiscrimination laws. 1.6 Living Wage Requirements: If the amount of this Agreement is $25,335.05 or more, Provider is required to comply with Chapter 3.12 of the Ashland Municipal Code by paying a living wage,as defined in that chapter,to all employees performing Work under this Agreement and to any Subcontractor who performs 50% or more of the Work under this Agreement. Provider is also required to post the notice attached hereto as "Exhibit A"predominantly in areas where it will be seen by all employees. 1.7 Assignment: Provider shall not assign this Agreement or subcontract any portion of the Work to be provided hereunder without the prior written consent of the City. Any attempted assignment or subcontract without written consent of the City shall be void. Provider shall be fully responsible for the acts or omissions of any assigns or subcontractors and of all persons employed by them,and the approval by the City of any assignment or subcontract shall not create any contractual relation between the assignee or subcontractor and the City. 2. CITY'S OBLIGATIONS 2.1 City shall pay Provider the hourly rates effective 7/17/23 as specified in the SUPPORTING DOCUMENTS. 2.2 In no event shall Provider's total of all compensation and reimbursement under this Agreement exceed the sum of$5,000 (this is maximum, not to exceed amount of ENTIRE Agreement) without express, written approval from the City official whose signature appears below, or such official's successor in office. Provider expressly acknowledges that no other person has authority to order or authorize additional Work which would cause this maximum sum to be exceeded and that any authorization from the responsible official must be in writing. Provider further acknowledges that any Work delivered or expenses incurred without authorization as provided herein is done at Provider's own risk and as a volunteer without expectation of compensation or reimbursement. 3. GENERAL PROVISIONS 3.1 This is a non-exclusive Agreement. City is not obligated to procure any specific amount of Work from Provider and is free to procure similar types of goods and services from other providers in its sole discretion. • Page 2 of 6: Goods and Services Agreement between the City of Ashland and Bill's Glass 3.2 Provider is an independent contractor and not an employee or agent of the City for any purpose. 3.3 Provider is not entitled to, and expressly waives all claims to City benefits such as health and disability insurance,paid leave, and retirement. • 3.4 This Agreement embodies the full and complete understanding of the parties respecting the subject matter hereof. It supersedes all prior agreements,negotiations, and representations between the parties, whether written or oral. 3.5 This Agreement may be amended only by written instrument executed with the same formalities as this Agreement. 3.6 The following laws of the State of Oregon are hereby incorporated by reference into this Agreement: ORS 279B.220,279B.230 and 279B.235. 3.7 This Agreement shall be governed by the laws of the State of Oregon without regard to conflict of laws principles. Exclusive venue for litigation of any action arising under this Agreement shall be in the Circuit Court of the State of Oregon for Jackson County unless exclusive jurisdiction is in federal court, in which case exclusive venue shall be in the federal district court for the district of Oregon. Each party expressly waives any and all rights to maintain an action under this Agreement in any other venue, and expressly consents that, upon motion of the other party, any case may be dismissed or its venue transferred, as appropriate,so as to effectuate this choice of venue. 3.8 Provider shall defend,save,hold harmless and indemnify the City and its officers,employees and agents from and against any and all claims, suits, actions, losses, damages, liabilities, costs, and expenses of any nature resulting from, arising out of, or relating to the activities of Provider or its officers, employees, contractors, or agents under this Agreement. 3.9 Neither party to this Agreement shall hold the other responsible for damages or delay in performance caused by acts of God,strikes, lockouts, accidents, or other events beyond the control of the other or the other's officers, employees or agents. 3.10 If any provision of this Agreement is found by a court of competent jurisdiction to be unenforceable, such provision shall not affect the other provisions, but such unenforceable provision shall be deemed modified to the extent necessary to render it enforceable, preserving to the fullest extent permitted the intent of Provider and the City set forth in this Agreement. 3.11 Deliveries will be F.O.B destination. Provider shall pay all transportation and handling charges for the • Goods.Provider is responsible and liable for loss or damage until final inspection and acceptance of the Goods by the City. Provider remains liable for latent defects,fraud, and warranties. 3.12 The City may inspect and test the Goods. The City may reject non-conforming Goods and require Provider to correct them without charge or deliver them at a reduced price, as negotiated. If Provider does not cure any defects within a reasonable time, the City may reject the Goods and cancel this Agreement in whole or in part. This paragraph does not affect or limit the City's rights, including its rights under the Uniform Commercial Code, ORS Chapter 72 (UCC). 3.13 Provider represents and warrants that the Goods are new, current, and fully warranted by the manufacturer. Delivered Goods will comply with SUPPORTING DOCUMENTS and be free from defects in labor, material and manufacture. Provider shall transfer all warranties to the City. Page 3 of 6: Goods and Services Agreement between the City of Ashland and Bill's Glass . 4. SUPPORTING DOCUMENTS 4.1 The following documents are, by this reference, expressly incorporated in this Agreement, and are collectively referred to in this Agreement as the "SUPPORTING DOCUMENTS:" • The Provider's complete written Rate Sheet dated July 17,2023. 4.2 This Agreement and the SUPPORTING DOCUMENTS shall be construed to be mutually complimentary and supplementary wherever possible. In the event of a conflict which cannot be so resolved, the provisions of this Agreement itself shall control over any conflicting provisions in any of the SUPPORTING DOCUMENTS. In the event of conflict between provisions of two of the SUPPORTING DOCUMENTS,the several supporting documents shall be given precedence in the order listed in Article 4.1. 5. REMEDIES 5.1 In the event Provider is in default of this Agreement, City may, at its option, pursue any or all of the remedies available to it under this Agreement and at law or in equity, including,but not limited to: 5.1.1 Termination of this Agreement; 5.1.2 Withholding all monies due for the Work that Provider has failed to deliver within any scheduled completion dates or any Work that have been delivered inadequately or defectively; 5.1.3 Initiation of an action or proceeding for damages, specific performance, or declaratory or injunctive relief; 5.1.4 These remedies are cumulative to the extent the remedies are not inconsistent,and City may pursue any remedy or remedies singly, collectively, successively or in any order whatsoever. 5.2 In no event shall City be liable to Provider for any expenses related to termination of this Agreement or • for anticipated profits. If previous amounts paid to Provider exceed the amount due, Provider shall pay immediately any excess to City upon written demand provided. 6. TERM AND TERMINATION 6.1 Term This Agreement shall be effective from the date of execution on behalf of the City as set forth below (the "Effective Date"), and shall continue in full force and effect until June 30, 2024, unless sooner terminated as provided in Subsection 6.2. 6.2 Termination 6.2.1 The City and Provider may terminate this Agreement by mutual agreement at any time. 6.2.2 The City may, upon not less than thirty (30) days' prior written notice, terminate this Agreement for any reason deemed appropriate in its sole discretion. 6.2.3 Either party may terminate this Agreement,with cause, by not less than fourteen (14) days'prior written notice if the cause is not cured within that fourteen (14) day period after written notice. Such termination is in addition to and not in lieu of any other remedy at law or equity. 7. NOTICE • Whenever notice is required or permitted to be given under this Agreement, such notice shall be given in writing to the other party by personal delivery, by sending via a reputable commercial overnight courier, or by mailing using registered or certified United States mail, return receipt requested, postage prepaid, to the address set forth below: If to the City: Page 4 of 6: Goods and Services Agreement between the City of Ashland and Bill's Glass • City of Ashland—Facilities Maintenance Department • Attn: David Arnold 20 E. Main Street Ashland, Oregon 97520 Phone: (541) 552-2292 With a copy to: City of Ashland—Legal Department 20 E. Main Street Ashland, OR 97520 Phone: (541)488-5350 If to Provider: Bill's Glass Attn: James Reeves 2407 Siskiyou Blvd Ashland, OR 97520 541-488-2500 8. WAIVER OF BREACH One or more waivers or failures to object by either party to the other's breach of any provision,term,condition, or covenant contained in this Agreement shall not be construed as a waiver of any subsequent breach,whether or not of the same nature. 9. PROVIDER'S COMPLIANCE WITH TAX LAWS 9.1 Provider represents and warrants to the City that: 9.1.1 Provider shall, throughout the term of this Agreement, including any extensions hereof, comply with: (i) All tax laws of the State of Oregon, including but not limited to ORS 305.620 and ORS chapters 316,317, and 318; (ii) Any tax provisions imposed by a political subdivision of the State of Oregon applicable to Provider; and (iii) Any rules, regulations, charter provisions, or ordinances that implement or enforce any of the foregoing tax laws or provisions. 9.1.2 Provider,for a period of no fewer than six(6) calendar years preceding the Effective Date of this Agreement, has faithfully complied with: (i) All tax laws of the State of Oregon, including but not limited to ORS 305.620 and ORS chapters 3.16, 317, and 318; (ii) Any tax provisions imposed by a political subdivision of the State of Oregon applicable to Provider; and (iii) Any rules, regulations, charter provisions, or ordinances that implement or enforce any of the foregoing tax laws or provisions. 9.2 Provider's failure to comply with the tax laws of the State of Oregon and all applicable tax laws of any political subdivision of the State of Oregon shall constitute a material breach of this Agreement. Further, any violation of Provider's warranty, as set forth in this Article 9, shall constitute a material breach of this Agreement. Any material breach of this Agreement shall entitle the City to terminate this Agreement and to seek damages and any other relief available under this Agreement,at law,or in equity. Page 5 of 6: Goods and Services Agreement between the City of Ashland and Bill's Glass IN WITNESS WHEREOF the parties have caused this Agreement to be signed in their respective names by their duly authorized representatives as of the dates set forth below. • CITY OF ASHLAND: Bill's Glass(PROVIDER): By: =Li By: ►'s- .re ignature Scoter" IZ1Qej/LS Printed Name Printed Name 6 Title Title .z. 2 3 7/2-I l2? Date !l Date r (W-9 is to be submitted with this signed Agreement) • Purchase Order No. • • Page 6 of 6: Goods and Services Agreement between the City of Ashland and Bill's Glass tr AC o® CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) 02/22/2023 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Hart Insurance Agency PHONE Kriati R Dolmage FAX PO Box 1240 IAIC.No,ExtI: (541) 779-4232 (A/C.No1:(541) 772-3963 ADDRESS: kdolmage@hartinsurance.com Grants Pass OR 97528 • INSURER(S)AFFORDING COVERAGE NAIL I/ INSURER A:Cincinnati Insurance Company 10677 INSURED INSURER B: Butlers Glass Service Inc Bills Glass & Windshields INSURERC: 319 E McAndrews Road INSURERD: Medford OR 97501 INSURERS: (541) 773-5881 INSURERF: COVERAGES KD CERTIFICATE NUMBER:Cert ID 25201 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LTR INSO WVO POLICY NUMBER (MMIDD/YYYY) IMM/DD/YYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY. EACH OCCURRENCE $ 1,000,000 RENTED CLAIMS-MADE X OCCUR Y Y EPP 0374731 02/19/2023 02/19/2024 PREMSESAMAGEO(Ea occurrence) $ 500,000 MED EXP(Any one person) $ 10,000 PERSONAL 8 ADVINJURY _ $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 ){ PRO- POLICY JECT LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 A X ANY AUTO Y Y ESA 0374731 02/19/2023 02/19/2024 BODILYINJURY(Perperson) $ • OWNED SCHEDULED BODILYINJURY(Peraccident $ • AUTOS ONLY AUTOS ) HIRED NON-OWNED PROPERTY DAMAGE • AUTOS ONLY AUTOS ONLY (Per accident) $ A X UMBRELLALIAB X OCCUR EPP 0374731 02/19/2023 02/19/2024 EACH OCCURRENCE $ 1,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE _ $ 1,000,000 DED RETENTIONS 5 WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y I N STATUTE ER ANYPROPRIETOR/PARTNER/EXECUTIVE EL EACH ACCIDENT S OFFICER/MEMBEREXCLUDED? N/A (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ S S DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) certificate holder is listed as additional insured per attached forms GA472 09/18, GA210 09/17 and AA288 01/16 CERTIFICATE HOLDER CANCELLATION cathy.crocker@ashland.or.us 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 East Main Street AUTHORIZED REPRESENTATIVE Ashland OR 97520 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD Page 1 of 1 H , d � � ,. . GLASS co mail, 'WINDSHIEL_DS'i` � EMEROENCY ww.B -QI.ss.com BOARD( ti E IinIEDF®RD ASHLAND GRANTS PASS BILL'S GLASS AND WINDSHIEL IS (yen ASHLAND) 2407 SISKIYOU BLV ASHLAND OR. 97620 PHONE: 541-488-2500 FAX: 541-488-3270 Date:07/17/2023 Re:2023-2024 Contract City of Ashland Schedule of Labor Rates July1 , 2023-June 30, 2024 Butler's Glass Service Inc. DBA Bill's Glass & Windshields. Cost per hour will be $95.00 *per man for work scheduled within the hours of 8:OOam-5:00 pm Monday through Friday. Cost per hour will be $190.00 *per man for work that is performed outside of the above hours or days. *Additional men may be needed on some repairs due to size or safety restrictions. This is the labor rate only, materials and equipment rental if needed are additional. After-hours Boardups $350.00 minimum for labor and materials-labor to include travel times from Medford. New commercial construction projects are exempt from this pricing and will be bid on a per job basis. Sincerely, General Manager / . 1 • AC�® DATE(MMIDDIYYYY) CERTIFICATE OF LIABILITY INSURANCE 02/16/2023 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(les)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Kris ti Dolmage Hart Insurance Agency PHONE FAX PO Box 1240 4AIC.No.Extl: (541) .779-4232 (AIC,No):(541) 772-3963 _ A MAIL kdolma e Grants Pass OR 97528 • ADDRESS: g Ohartinsurance.com INSURER(S)AFFORDING COVERAGE NAIC# INSURERA:Cincinnati Specialty Underwriter 13037 INSURED INSURER B: Butlers Glass Service Inc Bills Glass & Windshields INSURER C: 319 E McAndrews Road INSURERD: Medford OR 97501 INSURERE: (541) 773-5881 INSURERF: COVERAGES MB CERTIFICATE NUMBER:Cert ID 25156 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADM SUER POLICY EFF POLICY EXP INSD WVD POLICY NUMBER (MM/DD/YYYYI (MM/DD/YYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED CLAIMS-MADE X OCCUR Y Y CSU0079916 02/19/2023 02/19/2024 PREMISES(Ea occurrence) $ MED EXP(Any one person) $ X Products & Completed PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE _ $ POLICY X Tei LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO y BODILY INJURY(Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Per accident) $ HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY _AUTOS ONLY (Per accident) _ $ A X UMBRELLALIAB X OCCUR CSU0086650 02/19/2023 02/19/2024 EACH OCCURRENCE $ 1,000,000 EXCESSLIAB CLAIMS-MADE AGGREGATE $ 1,000,000 DED RETENTION$ - $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY YIN STATUTE ER ANYPROPRIETORIPARTNER/EXECUTIVE N/A E.L.EACH ACCIDENT S OFFICER/MEMBEREXCLUDED7 (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ • If yes,describe under • DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ S S DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) Certificate holder is listed as additional insured including waiver of subrogation where required by written contract per attached forms CSIA405 08/09 and CSGA4087 12/12 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City Of Ashland ACCORDANCE WITH THE POLICY PROVISIONS. 20 East Main Street AUTHORIZED REPRESEENNT2ATIVE apfizy Ashland OR 97520 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD Page 1 of 1 ,. THiS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CONTRACTORS ADDITIONAL INSURED - AUTOMATIC STATUS AND AUTOMATIC WAIVER OF SUBROGATION WHEN REQUIRED iN WRITTEN CONTRACT, AGREEMENT, PERMIT OR AUTHORIZATION . This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART • A. Additional Insured - Owners, Lessees Or cluded in the "products-completed Contractors - Automatic Status For Other operations hazard", but only if: Parties When Required In Written Contract Or Agreement With You (1) The Coverage Part to which this endorsement is attached pro- 1. Section II - Who Is An insured is vides coverage for"bodily injury" amended to include as an additional in- or "property damage" included sured any person or organization you - within the "products-completed have agreed in writing in a contract or operations hazard";and agreement to add as an additional in- sured on this Coverage Part. Such per- (2) The written contract or written son(s) or organization(s) is an additional agreement requires you to pro- insured only with respect to liability for: vide additional insured coverage included within the "products- a. "Bodily injury", "property damage" or completed operations hazard" "personal and advertising injury" for that person or organization. caused, in whole or In part, by the performance of your ongoing opera- If the written contract or written . tions by you or on your behalf, under agreement requires you to provide that written contract or written additional insured coverage included . agreement. Ongoing operations does within the "products-completed oper- ; not apply to"bodily injury"or"proper- ations hazard" for a specified length • ! ty damage"occurring after: of time for that person or organiza- tion, the "bodily injury" or "property (1) All work, including materials, damage" must occur prior to the ex- parts or equipment furnished in piration of that period of time in order • connection with such work, on for this insurance to apply. • the project (other than service, maintenance or repairs) to be If the written contract or written • performed by or on behalf of the agreement requires you to provide additional insured(s) at the loca- additional insured coverage for a tion of the covered operations person or organization per only iSO has been completed;or additional insured endorsement form number CG 2010,without specifying (2) That portion of"your work"out of an edition date, and without specifi- which the injury or damage aris- cally requiring additional insured es has been put to Its intended coverage included within the "prod- use by any person or organize- ucts-completed operations hazard", tion other than another contrac- this Paragraph b, does not apply to tor or subcontractor engaged in that person or organization. performing operations for a prin- cipal 2. If the written contract or written a ree- jet and as a part of the same pro- ment described in Paragraph 1. above specifically requires you to provide adds- b. "Bodily injury" or "property damage" tional insured coverage to that person or • caused, in whole or in part, by "your organization: work" performed under that written a. Arisingout ofyour ongoing contract or written agreement and in g g opera- tions or arising out of"your work";or • Includes copyrighted material of insurance GA 472 0918 Services Office, Inc.,with its permission. Page 1 on I. • 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- ciudes arising out of your ongoing graph B.1„ the following additional exclu- operations or arising out of "your sions apply: . work"; This insurance does not apply to: then the phrase caused, in whole or in part, by in Paragraph A,1.a.and/or Para- a. "Bodily injury", "property damage" or graph A1.b. above,whichever applies, is "personal and advertising injury" aris- replaced by the phrase arising out of. ing out of operations performed for the federal government, state or mu- 3. With respect to the insurance afforded to nicipality;or the additional insureds described in Para- graph Al.,the following additional exclu- b. "Bodily injury" or "property damage" sion applies: included within the "products- completed operations hazard." This insurance does not apply to "bodily injury", "property damage" or "personal C. The insurance afforded to additional insureds and advertising injury" arising out of the described in Paragraphs A.and B.: rendering of, or the failure to render, any 1. Only applies to the extent permitted by professional architectural, engineering or law;and surveying services, including: a, 2. WiII not be broader than that which you The preparing, approving or failing to writ- prepare shop are required by the written contract, writ- prepares,or opinions,approve,remaps,a, surveys, ten agreement, written permit or written field orders, change orders or draw- al isud;thorization to provide for such addition• ings and specifications;or al nsured;and b. Supervisory, inspection, architectural 3. Does not apply to any person, organiza- engineering aption. tion, state, governmental agency or sub- ordivision or political subdivision specifically This exclusion applies even if the claims named as an additional insured for the against any insured allege negligence or same project in the schedule of an en- other wrongdoing in the supervision, hir- dorsement added to this Coverage Part, ing, employment,training or monitoring of D. With respect to the insurance afforded to the others by that insured, if the "occurrence" which caused the"bodilyinjury"or"prop- additional insureds described in Paragraphs in'� ry A,and B.,the following is added to Section III erty damage", or the offense which -Limits Of Insurance: caused the"personal and advertising Inju • - ry", involved the rendering of, or the fail- The most we will pay on behalf of the addi- ure to render, any professional architec- tional insured is the amount of insurance: tural,engineering or surveying services. 1. Required by the written contract, written 4. This Paragraph A. does not apply to addi- agreement, written permit or written au- tional insureds described in Paragraph B. thorization described in Paragraphs A. B. Additional Insured-State Or Governmental and B.;or Agency Or Subdivision Or Political Subdi- 2. Available under the applicable Limits of ' vision - Automatic Status When Required Insurance shown in the Declarations; In Written Permits Or Authorizations whichever is less. 1. Section H - Who Is An Insured is This endorsement shall not increase thea appli- sured to Includeteoras an governmental additional i y cable Limits of Insurance shown in the Decla- orsured any state or agency subdivision or political subdivision you rations. have agreed in writing In a contract, E. Section IV - Commercial General Liability agreement, permit or authorization to add. Conditions is amended to add the following: • as an additional insured on this Coverage Part. Such state or governmental agency Automatic Additional Insured Provision or subdivision or political subdivision is an additional insured only with respect to op- This insurance applies only if the "bodily inju- erations performed by you or on your be- ry" or"property damage" occurs, or the "per- half for which the state or governmental sonal and advertising injury" offense is com- agency or subdivision or political subdivi- miffed: sion issued, in writing, a contract, agree- 1. During the policy period;and ; ment,permit or authorization. I Includes copyrighted material of Insurance GA 472 0918 Services Office, Inc.,with Its permission. Page 2 of 3 2. Subsequent to your execution of the writ- As used in this,endorsement, wrap-up insur- ten contract or written agreement, or the ance means any insurance provided by a con- issuance of a written permit or written au- solidated(wrap-up)insurance program. thorization, described in Paragraphs A. and B. Primary And Noncontributory Insurance When Required By Written Contract, F. Except when G.below applies,the following is Agreement,Permit Or Authorization added to Section IV - Commercial General Liability Conditions, 5. Other Insurance, Except when wrap-up insurance applies to the and supersedes any provision to the contrary: claim or suit on behalf of the additional in- sured, this insurance is primary to and will not When Other Additional Insured Coverage seek contribution from any other insurance Applies On An Excess Basis available to the additional insured described In This insurance is primary to other insurance Paragraphs A.and B.provided that: available to the additional insured described in 1. The additional insured is a Named in- Paragraphs A.and B.except: sured under such other insurance; and 1. As otherwise provided in Section IV - 2. You have agreed in writing in a contract, Commercial General Liability Condi- agreement, permit or authorization de- tions,S.Other Insurance, b. Excess In. scribed in Paragraph A. or B.that this in- surance; or surance would be primary and would not 2. For any other valid and collectible insur- seek contribution from any other insur- ance available to the additional insured as ance available to the additional Insured. an additional insured by attachment of an As used in this endorsement, wrap-up insur• endorsement to another insurance policy ance means any insurance provided by a con- that is written on an excess basis. In such solidated(wrap-up)insurance program. case,this insurance is also excess. H. Section IV - Commercial General Liability G. The following is added to Section IV - Corn- Conditions, 9. Transfer Of Rights Of Re- mercial General Liability Conditions, 5. covery Against Others To Us is amended by Other Insurance, and supersedes any provi- the addition of the following: sion to the contrary: • We waive any right of recovery we may have Primary Insurance When Required By Writ- against any additional insured under this en- ten Contract, Agreement, Permit Or Au- dorsement against whom you have agreed to thorization waive such right of recovery in a written con- Except when wrap-up insurance applies to the tract,written agreement,written permit or writ- • claim or "suit" on behalf of the additional In- ten authorization because of payments we sured, this insurance is primary to any other make for injury or damage arising out of your insurance available to the additional insured ongoing operations or your work done under a written contract, written agreement, written described in Paragraphs A. and B. provided that: permit or written authorization. However, our rights may only be waived prior to the `occur- 1. The additional insured is a Named In- rence" giving rise to the injury or damage for sured under such other insurance;and which we make payment under this Coverage Part. The insured must do nothing after a loss 2. You have agreed in writing in a contract, to impair our rights.At our request,the insured agreement, permit or authorization de- will bring "suit" or transfer those rights to us scribed in Paragraph A. or B.that this in- and help us enforce those rights. surance would be primary to any other In- surance available to the additional In- sured. • Includes copyrighted material of Insurance GA 472 0918 Services Office,Inc.,with its permission. Page 3 of 3 E 1 _ t THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. COMMERCIAL GENERAL LIABILITY BROADENED ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Endorsement-Table of Contents: Coverage: Begins on Page: 1. Employee Benefit Liability Coverage 3 2. Unintentional Failure To Disclose Hazards 9 3. Damage To Premises Rented To You 9 4. Supplementary Payments 10 5. Medical Payments 10 6. 180 Day Coverage For Newly Formed Or Acquired Organizations 10 7. Waiver Of Subrogation 11 8. Automatic Additional Insured-Specified Relationships: 11 • Managers Or Lessors Of Premises; • Lessor Of Leased Equipment; • Vendors; • State Or Governmental Agency Or Subdivision Or Political Subdivision-Permits Or Authorizations Relating To Premises;and • Mortgagee,Assignee Or Receiver 9. Property Damage To Borrowed Equipment 14 10. Employees As Insureds -Specified Health Care Services And Good Samaritan Services 15 11. Broadened Notice Of Occurrence 15 12. Nonowned Aircraft 15 13. Bodily Injury Redefined 15 14. Expected Or intended Injury Redefined 15 15. Former Employees As Insureds 15 B. Limits Of Insurance: The Commercial General Liability Limits of Insurance apply to the insurance provided by this endorse- ment, except as provided below: 1. Employee Benefit Liability Coverage Each Employee Limit: $1,000,000 Aggregate Limit: $3,000,000 Deductible Amount: $ 1,000 3. Damage To Premises Rented To You The lesser of: a. The Each Occurrence Limit shown in the Declarations;or b. $500,000 unless otherwise stated$ 4. Supplementary Payments . a. Bail Bonds: $2,500 b. Loss Of Earnings:$ 500 Includes copyrighted material of Insurance GA 210 0917 Services Office, Inc.,with Its permission. Page 1 of 15 • 5. Medical Payments Medical Expense Limit:$10,000 9. Property Damage To Borrowed Equipment Each Occurrence Limit: $10,000 Deductible Amount: $ 250 • • Includes copyrighted material of Insurance GA 210 0917 Services Office, Inc.,with its permission. Page 2 0115 • C. Coverages 2) Occurred prior to the 1. Employee Benefit Liability Coverage "first effective date" of a. The following is added to Section 1- this endorsement pro- Coverages: vided: Employee Benefit Liability Cover- a) You did not have knowledge of a age claim or"suit'on or (1) Insuring Agreement before the "first ef- fective date"of this (a) We will pay those sums that endorsement. the insured becomes legally will be obligated to pay as damag- You Youdeeto have es caused by any act, error a claim now knowledge of or omission of the insured, or "suit"fa or of any other person for whose acts the Insured is when any "author- legally liable, to which this ized representa- insurance applies. We will tive"; have the right and duty to I) Reports all, or defend the insured against • any part,of the any "suit" seeking those act, error or damages. However, we will omission to us have no duty to defend or any other against any "suit" seeking insurer, damages to which this in- surance does not apply. We ii) Receives a may, at our discretion, in- written or ver- vestigate any report of an bal demand or act, error or omission and claim for dam- settle any claim or"suit"that ages because may result. But: of the act, er- ror or orris- 1) The amount we will pay sion;and for damages is limited as described in Section b) There is no other Ill - Limits Of Insur- applicable insur- ance; and ance. 2) Our right and duty to (2) Exclusions defend ends when we have used up the appli- This insurance does not apply to; cable limit of insurance • (a) Bodily Injury, Property in the payment of judg- Damage Or Personal And ments or settlements. Advertising Injury No other obligation or liabil- "Bodily injury', "property ity to pay sums or perform damage" or "personal and acts or services is covered advertising injury". unless explidfiy provided for under Supplementary (b) Dishonest, Fraudulent, Payments. Criminal Or Malicious Act (b) This insurance applies to Damages arising out of any damages only If the act, er- intentional, dishonest, ror or omission, is negligent- fraudulent, criminal or mali- ly committed in the "admin- pious act, error or omission, • istration" of your "employee committed by any insured, benefit program"; and including the willful or reck- 1) Occurs during the policy less violation of any statute. period; or Includes copyrighted material of Insurance GA 210 0917 Services Office,Inc.,with its permission. Page 3 of 15 { • (c) Failure To Perform A Con- effort and cooperation of the tract Insured, from the applicable funds accrued or other col- Damages arising out of fail- lectibie insurance. ure of performance of con- tract by any usurer. (i) Taxes,Fines Or Penalties (d) Insufficiency Of Funds Taxes,fines or penalties, in- cluding those Imposed un- Damages arising out of an der the internal Revenue • insufficiency of funds to Code or any similar state or meet any obligations under local law. any plan included in the "employee benefit program". (j) Employment-Related Prac- (e) Inadequacy Of Perfor- tices mance Of Invest- Any liability arising out of ment/Advice Given With any: • Respect To Participation (1) Refusal to employ; Any claim based upon: (2) Termination of employ- 1) Failure of any invest- ment; ment to perform; (3) Coercion, demotion, 2) Errors in providing in- evaluation, reassign- formation on past per- ment, discipline, defa- formance of investment rnation, harassment, vehicles;or humiliation, employ- 3) discrimina- Advice given to any tion or other ment-related practices, personwithrespect to that person's decision to acts or omissions;or participate or not to par- (4) Consequential liability tfdpate in any plan In- as a result of(1), (2)or eluded in the"employee (3)above. benefit program". This exclusion applies (f) Workers' Compensation whether the insured may be And Similar Laws held liable as an employer or in any other capacity and Any claim arising out of your to any obligation to share failure to comply with the mandatory provisions of any damagessowith or repay workers' compensation, un- amaegoes becausee who must pay d In- employment compensation damages of the ln- insurance, social security or fury' disability benefits law or any (3) Supplementary Payments ` • similar law. (g) ERISA Section I - Coverages, Sup- plementary Payments -Cover • - Damages for which any in- ages A And B also apply to this sured is liable because of li- Coverage. 1 ability imposed on a fiduci- b. Who Is An Insured ary by the Employee Re • - tirement income Security As respects Employee Benefit Lia- Act of 1974, as now or bility Coverage, Section II-Who Is . hereafter amended, or by An Insured Is replaced by the follow- • any similar federal, state or ing: ; local laws. (1) If you are designated in the Dec- (h) eo-(h) Available Benefits larations as: Any claim for benefits to the (a) An individual, you and your extent that such benefits are spouse are insureds, but on- available, with reasonable iy with respect to the con- includes copyrighted material of Insurance GA 210 0917 Services Office, Inc.,with its permission. Page 4 of 15 duct of a business of which liability company,and over which you are the sole owner. you maintain ownership or major- ity interest, will qualify as a (b) Apartnership or joint yen- Named Insured if no other similar ture, you are an insured. insurance applies to that organi- Your members, your part- zation. However,coverage under ners, and their spouses are this provision: also insureds but only with respect to the conduct of (a) Is afforded only until the your business. 180th day after you acquire or form the organization or (c) A limited liability company, the end of the policy period, you are an insured. Your whichever is earlier;and members are also insureds, but only with respect to the (b) Does not apply to any act, conduct of your business, error or omission that was Your managers are in- committed before you ac- sureds,but only with respect quired or formed the organi- • to their duties as your man- zation. agers. c. Limits Of Insurance (d) An organization other than a partnership,Joint venture or As respects Employee Benefit Lia- limited liability company,you bility Coverage, Section III -Limits are an insured.Your"execu- Of Insurance is replaced by the fol- tive officers" and directors lowing: are insureds, but only with (1) The Limits of Insurance shown in respect to their duties as Section B.Limits Of Insurance, your officers or directors. 1. Employee Benefit Liability Your stockholders are also Coverage and the rules below fix Insureds, but only with re- the most we will pay regardless spect to their liability as of the number of: stockholders. (e) A trust, you are an insured. (a) Insureds; Your trustees are also in- (b) Claims made or "suits" sureds,but only with respect brought; • to their duties as trustees. (c) Persons or organizations (2) Each of the following is also an making claims or bringing insured: "suits"; (a) Each of your "employees" (d).Acts,errors or omissions;or who is or was authorized to administer your "employee (e) Benefits Included In your benefit program"; "employee benefit program". (b) Any persons, organizations (2) The Aggregate Limit shown in or"employees" having prop- Section B.Limits Of insurance, er temporary authorization 1. Employee Benefit Liability to administer your „employ- Coverage of this endorsement Is ee benefit program” if you the most we will pay for all dam- die, but only until your legal ages because of acts, errors or representative is appointed; omissions negligently committed or in the "administration" of your (c) Your legal representative if "employee benefit program"_ you die, but only with re- (3) Subject to the limit described in spect to duties as such.That (2) above, the Each Employee representative will have all Limit shown in Section B. Limits your rights and duties under Of Insurance, 1. Employee this Coverage Part. Benefit Liability Coverage of this endorsement is the most we • (3) Any organization you newly ac- will pay for all damages sus- quire or form, other than a part- tained by any one "employee", nership, joint venture or limited including damages sustained by Includes copyrighted material of Insurance GA 210 0817 Services Office, Inc.,with its permission. Page 5 of 15 3 • such "employee's" dependents (d) We may pay any part or all and beneficiaries,as a result of: of the Deductible Amount to effect settlement of any (a) An act,error or omission;or claim or"suit'and, upon no- (b) A series of related acts, er- tification of the action taken, rors or omissions, regard- you shall promptly reim- less of the amount of time burse us for such part of the that lapses between such Deductible Amount as we acts, errors or omissions; have paid. negligently committed in the d. Additional Conditions "administration"of your"employ- As respects Employee Benefit Lia.. ee benefit program". bility Coverage, Section IV -Corn- However, the amount paid under Inercial General Liability Condi- this endorsement shall not ex- tions is amended as follows: ceed, and will be subject to the (1) Item 2. Duties In The Event Of limits and restrictions that apply Occurrence, Offense,Claim Or to the payment of benefits in any Suit is replaced by the following: plan included In the "employee benefit program." 2. Duties In The Event Of An (4) Deductible Amount Act,Error Or Omission,Or Claim Or Suit (a) Our obligation to pay dam- a. You must see to it that ages on behalf of the In- we are notified as soon sured applies only to the as practicable of an act, amount of damages in ex- error or omission which cess of the Deductible may result In a claim. Amount stated in the Deda- To the extent possible, rations as applicable to notice should include: Each Employee. The limits of insurance shall not be re- (1) What the act, error duced by the amount of this - or omission was deductible. and when it oc- (b) The Deductible Amount curred;and stated in the Declarations (2) The names and applies to all damages sus- addresses of any- . tamed by any, one "employ- one who may suf- ee", including such"employ- fer damages as a ee's"dependents and bene- ) result of the act, fidaries, because of all acts, error or omission. errors or omissions to which this Insurance applies. b. If a claim is made or • "suit'is brought against . (c) The terms of this insurance, any insured,you must: • including those with respect to: (1) Immediately record the specifics of the . 1) Our right and duty to claim or "suit" and defend the insured the date received; against any "suits" and seeking those damag- es;and (2) Notify us as soon - as practicable. 2) Your duties,and the du- . ties of any other In- You must see to it that . volved insured, in the we receive written no- - event of an act,error or tice of the claim or"suit' omission,or claim; as soon as practicable. • apply irrespective of the ap- c. You and any other in- plication of the Deductible volved insured must: • Amount. Includes copyrighted material of Insurance GA 210 0917 Services Office, Inc.,with its permission. Page 6 of 15 (1) Immediately send b. Method Of Sharing us copies of any If all of the other insur- demands, notices, summonses or le- anoe permits contribu- gal papers re- tion by equal shares, ceived in connec- we will follow this meth- tion with the claim od also. Under this ap- or"suit"; proach each insurer contributes equal (2) Authorize us to ob- amounts until It has tam records and paid its applicable limit other information; of Insurance or none of (3) Cooperate with us the loss remains, in the investigation whichever comes first. or settlement of the If any of the other in- claim or defense surance does not permit against the "suit"; contribution by equal and shares, we will contrib- (4) Assist us, upon our ute by limits. Under this in en-r method, each insurer's request, I the share is based on the rea right againstany of any ratio of its applicable person or organlimit of insurance to the parson which may total applicable limits of be liable to the in- insurance of all incur- sured because of ers. an act, error or c. No Coverage omission to which this insurance may This insurance shall not also apply. cover any loss for which the insured is entitled to d. No insured will, except recovery under any at that insured's own other insurance In force cost, voluntarily make a previous to the effective payment, assume any date of this. Coverage obligation, or incur any Part. expense without our consent. e. Additional Definitions • (2) Item 5. Other Insurance is re- As respects Employee Benefit Lia- placed by the following: bility Coverage, Section V-Defini- tions is amended as follows: 5. Other Insurance (1) The following definitions are If other valid and collectible added: insurance is available to the, insured for a loss we cover 1. "Administration"means: under this Coverage Part, a, Providing information to our obligations are limited as "employees", including follows: their dependents and a. Primary Insurance beneficiaries, with re • - spect to eligibility for or This insurance is prima- scope of "employee Ty except when c.below benefit programs', applies.If this Insurance is primary, our oblige- b. Interpreting the "em- tions are not affected ployee benefit pro- unless any of the other grams'; insurance is also prima- c, Handling records in ry. Then, we will share connection with the with all that other insur- "employee benefit pro- ance by the method de- grams"; or scribed in b.below. Includes copyrighted material of Insurance GA 210 0917 Services Office, Inc.,with its permission. Page 7 of 15 • { • d. Effecting, continuing or ees" who are eligible terminating any "em- under the plan for such ployee's"participation in benefits; any benefit included in the "employee benefit c. Unemployment insur- program". ance, social security benefits, workers' corn- However, "administration" pensation and disability does not include: benefits;and • a, Handling payroll deduc- d. Vacation plans, includ- tions; or ing buy andsell pro- b. The failure to effect or grams; leave of ab- sence programs,includ- maintain any insurance ing military, maternity, or adequate limits of family, and civil leave; coverage of insurance, tuition assistance plans; including but not limited transportation and to unemployment insur- health club subsidies. ance, social security benefits, workers' corn- 4. "First effective date" means pensation and disability the date upon which cover- benefits. age was first effected in a series of uninterrupted re- 2. "Cafeteria, plans" means newels of insurance cover- plans authorized by applica- age. ble law to allow"employees" age' to elect to pay for certain (2) The following definitions are de- benefits with pre-tax dollars. feted in their entirety and re- 3. "Employee benefit pro- placed by the following: grams" means a program 8. "Employee"means a person providing some of all of the actively employed, formerly following benefits to "em- employed, on leave of ab- ployees", whether provided sence or disabled,or retired, through a "cafeteria plan"or "Employee" Includes a otherwise: leased worker"."Employed' does not include a "tempo- a. Group life insurance; rary worker". group accident or health insurance;dental,vision 21. "Suit"means a civil proceed- and hearing plans; and ing In which money damag- flexible spending ac- es because of an act, error counts;provided that no or omission to which this in- one other than an "em- surance applies are alleged. ployee" may subscribe "Suit"includes: to such benefits and such benefits are made a. An arbitration proceed- generally available to ing in which such dam- those "employees" who ages are claimed and to satisfy the plan's eiigibil- which the insured must • ity requirements; submit or does submit with our consent; b. Profit sharing plans, employee savings b. Any other alternative plans, employee stook dispute resolution pro- ownership plans, pen- ceeding in whichsuch sion plans and stock damages are claimed subscription plans, pro- and to which the in- vided that no one other sured submits with our than an "employee" consent;or may subscribe to such c. An appeal of a civil pro- benefits and such bene- ceeding. fits are made generally • available to all "employ- Includes copyrighted material of Insurance GA 210 091 r Services Office, Inc.,with its permission. Page 8 01 15 2. Unintentional Failure To Disclose Haz- 2) Rust or other cor- aids rosion, decay, de- en Section IV-Commercial General Liabil- or latent n, c o ity Conditions, 7. Representations is • an latent defector any quality in amended by the addition of the following: property that caus- Based on our dependence upon your rep- es it to damage or resentations as to existing hazards, if un- destroy itself; intentionally you should fail to disclose all such hazards at the inception date of your 3) Smog; policy, we will not reject coverage under 4) Mechanical break- this reakthis Coverage Part based solely on such down, including failure_ rupture or bursting 3. Damage To Premises Rented To You caused by centrif- ugal force; a, The last Paragraph of 2. Exclusions 5) Settling, cracking, under Section 1-Coverage A-Bod- shrinking or ex- ily Injury And Property Damage Li- pension; ability is replaced by the following: infesta- Exclusions c.through q,do not apply tion6) Nesting or to "property damage" by fire, explo- release or discharge sion, lightning, smoke or soot to or or waste secre- premises while rented to you or tern- productsons, by , porarily occupied by you with permis- birds,os, o insects, rodents or sion of the owner, for which the • other animals;or amount we will pay is limited to the Damage To Premises Rented To 7) Presence, growth, You Limit as described in Section IiI proliferation, -Limits Of Insurance. spread or any ac- tivity of fungus, in- b. The insurance provided under Sec- eluding mold or • tion I -Coverage A - Bodily injury mildew, and any And Property Damage Liability ap- ' plies to"property damage"arising out mycotoxins,scents o- of water damage to premises that are spores, s byproducts pro- both rented to and occupied by you. duced or released (1) As respects Water Damage Le- by fungi. gal Liability, as provided in Para- (b) "Property damage" caused graph 3.b.above: directly or Indirectly by any The exclusions under Section 1- of the following: Coverage A-Bodily Injury And (i) Earthquake, volcanic Property Damage Liability, 2. eruption, landslide or Exclusions, other than i. War any other earth move- and the Nuclear Energy Liabil- ment; ity Exclusion(Broad Form),are • deleted and the following. are (ii) Water that backs up or added: overflows or is other- This insurance does not apply to: wise discharged from a sewer, drain, sump, (a) Property damage": sump pump or related equipment; (i) Assumed in any con- tract or agreement;or (iii) Water under the ground surface pressing on, or (ii) Caused by or resulting flowing or seeping from any of the follow- through: Ing: 1) Foundations,walls, 1) Wear and tear; floors or paved surfaces; • Includes copyrighted material of Insurance GA 210 0917 Services Office,Inc.,with its permission. Page 9 of 15 2) Basements, you with permission of whether paved or • the owner; not; or b. In the case of damage 3) Doors, windows or by fire, explosion, light - other openings. Hing, smoke or soot, (c) "Property damage" caused while rented to you;or by or resulting from water c. In the case of damage that leaks or flows from by water, while rented plumbing, heating, air condi- to and occupied by you. tinning, fire otherproequipment,n (2) The most we will pay is limited as sys- tems, orb described in Section B. Limits caused by leor resulting from Of Insurance, 3. Damage To freezing, unless: g • Premises Rented To You of this (i) You did your best to endorsement. maintain heat in the building or structure;or 4. Supplementary Payments (ii) You drained the equip- Under Section I - Supplementary Pay- ment and shut off the ments-Coverages A And B: water supply if the heat a. Paragraph 2, is replaced by the foi- was not maintained. lowing: (d) "Property damage"to: Up to the limit shown in Section B. (i) Plumbing, heating, air Limits Of Insurance,4.a.Bail Bonds conditioning,fire protea of this endorsement for cost of bail tion systems, or other bonds required because of accidents equipment or applianc- or traffic law violations arising out of es; or the use of any vehicle to which the Bodily Injury Liability Coverage ap- (ii) The interior of any plies.We do not have to furnish these building or structure, or bonds. to personal property in the building or structure, b. Paragraph 4. is replaced by the fol- ' caused by or resulting lowing: from rain,snow,sleet or All reasonable expenses Incurred by ice, whether driven by the insured at our request to assist us wind or not. In the investigation or defense of the c. Limit Of insurance claim or"suit',including actual loss of earnings up to the limit shown in Sec- With respect to the insurance afford- tion B. Limits Of Insurance, 4.b. ed in Paragraphs 3.a,and 3.b.above, Loss Of Earnings of this endorsement the Damage To Premises Rented per day because of time off from To You Limit as shown in the Decla- work. rations is amended as follows: 5. Medical Payments (1) Paragraph 6. of Section III - Limits Of Insurance is replaced The Medical Expense Limit of Any One by the following: Person as stated in the Declarations is . amended to the limit shown in Section B. 6. Subject to Paragraph 5. Limits Of Insurance, 5. Medical Pay- above, the Damage To - ments of this endorsement. Premises Rented To You Limit is the most we will pay 6. 180 Day Coverage For Newly Formed under Coverage A-Bodily Or Acquired Organizations Injury And Property Dam- Section II - Who Is An Insured is • age Liability for damages amended as follows: because of "property dam- age"to any one premises: Subparagraph a. of Paragraph 3. is re- • placed by the following: a. While rented to you, or • temporarily occupied by a. Insurance under this provision Is af- forded only until the 180th day after Includes copyrighted material of Insurance GA 210 0917 Services Office, Inc.,with its permission. Page 10 of 15 • . i' you acquire or form the organization use of that part of the prem- or the end of the policy period, ises leased to you, subject whichever is earlier; to the following additional 7. Waiver Of Subrogation exclusions: Section IV-Commercial General Liabil- This insurance does not ap- plyity Conditions,9.Transfer Of Rights Of to: Recovery Against Others To Us is (i) Any"occurrence"which amended by the addition of the following: takes place after you We waive any right of recovery p that pwe may ceaseto be a tenant in have against any person or organization to against whom you have agreed to waive (ii) Structural alterations, such right of recovery in a written contract new construction or or agreementbecause of payments we demolition operations make for injury or damage arising out of performed by or on be- your ongoing operations or "your work" half of such additional done under a written contract or agree- insured. ment with that person or organization and included in the"products-completed oper- . (bj Lessor Of Leased Equip- ations hazard". However, our rights may ment only be waived prior to the "occurrence" Any person or organization giving rise to the injury or damage for from whom ynu lease which we make payment under this Coy- equipment when you and erage Part. The insured must do nothing such person(s) or organize- after a loss to impair our rights. At our re- tion(s) have agreed per Par- quest,the insured will bring"suit'or trans- agraph 8,a.(1) of this en- fer those rights to us and help us enforce dorsement to provide insur- those rights. ance. Such person(s) or or- 8. Automatic Additional Insured - Speci- ganization(s) are Insureds fled Relationships only with respect to liability for "boa. The following Is added to Section Ii- damage"lyor "per "nal and Who Is An Insured: advertising injury"caused,in (1) Any person(s) or organizations) whole or in part, by your described In Paragraph 8.a.(2)of maintenance, operation or this endorsement(hereinafter re- use of equipment leased to you by such s or- ferred to as additional insured) person(s) ganization(s).. AA person's or whom you are required to add as organization's status as an an additional insured under this additional insured under this Coverage Part by reason of a endorsement ends when written contract, written agree- their contract or agreement ment, written permit or written with you for such leased authorization. equipment ends. However, (2) Only the following persons or or- this insurance does not ap- ganizations are additional in- ply to any "occurrence" sureds under this endorsement, which takes place after the and insurance coverage provided equipment lease expires. to such additional Insureds is Urn- (c) Vendors ited as provided herein: Any person or organization (a) Managers Or Lessors Of Premises (referred to below as von- dor) with whom you have The manager or lessor of a agreed per Paragraph premises leased to you with 8.a.(1) of this endorsement • whom you have agreed per to provide Insurance,but on- Paragraph 8.a.(1)of this en- ly with respect to 'bodily in- dorsement to provide Insur- jury" or "property damage" ance, but only with respect arising out of"your products" to liability arising out of the which are distributed or sold ownership, maintenance or In the regular course of the Includes copyrighted material of Insurance GA 210 0917 Services Office, Inc.,with Its permission. Page 11 of 15 vendor's business, subject or repair opera- to the following additional tions, except such exclusions: operations per- {i} Ensurance afforded formed at the yen- Thethe vendor does not conn premisesoIn connection with the apply to: sale of the product; 1) "Bodily injury" or 7) Products which,af- "property damage" ter distributioor for which the ven- dor is obligated to sale byyou, have damages by been labeied or re- paylabeled or used as reason of the as- a container, part or sumption of liability ingredient of any In a contract or other thing or sub- agreement, This stance by or for the exclusion does not vendor,or apply to liability for damages that the 8) "Bodily injury" or vendor would have "property damage" in the absence of arising out of the the contract or sole negligence of agreement; the vendor for its 2) Any express war- own acts or omis- ranty unauthorized stone p those of its employees or by you; anyone else acting 3) Any physical or on its behalf. How- chemical owchemical change in ever,this exclusion • the product made does not apply to: intentionally by the a) The excep- ' vendor; tions contained . 4) Repackaging, ex- in Paragraphs cept when un- • (c) (I) 4) or 6) packed solely for of this en- the purpose of in- dorsement;or spection, demon- b) Such Inspec- stration, testing, or tions, aciust the substitution of ments,tests or • parts under in- - servicing as structions from the the vendor has manufacturer, and agreed to • then repackaged in the original con- make or nor- tatner; malty under- takes to make 5) Any failure to make in the usual such Inspections, course of . adjustments, tests business, In or servicing as the connection vendor has agreed with the distri- to make or normal- button or sale iy undertakes to• of the prod- make in the usual ucts. course of busi- (ii) This insurance does not • ness, in connection apply to any insured with the distribution person or organization: or sale of the products; 1) From whom you have acquired 6) Demonstration, in- such products, or stallation, servicing any ingredient, part Includes copyrighted material of Insurance GA 210 0917 Services Office, Inc.,with its permission. Page 12 of 15 or container, enter- (e) Mortgagee, Assignee Or Ing into, =crape- Receiver . nying or containing • such products; or Any person or organization with whom you have agreed 2) When liability in- per Paragraph 8,a.(1) of this eluded within the endorsement to provide in- "products- surance, but only with re- completed opera- spect to their liability as tions hazard" has mortgagee, assignee, or re- been excluded un- ceiver and arising out of the der this Coverage ownership, maintenance, or Part with respect to use of the premises by you. such products. However, this insurance (d) State Or Governmental does not apply to structural Agency Or Subdivision Or alterations, new construction Political Subdivision - and demolition operations r Pemlits Or Authorizations performed or for that per- Relating To Premises son oor organization. Any state or governmental (3) The insurance afforded to addi- tional insureds described in Par- agency or subdivision or po- agraph 8.a.(1) of this endorse- litical subdivision with which ment: you have agreed per Para- graph 8.a.(1) of this en- (a) Only applies to the extent dorsement to provide incur- permitted by law;and anoe, subject to the follow- ing additional provision: (b) Will not be broader than thatwhich you are required by This insurance applies only the written contract, written with respect to the following agreement, written permit or hazards for which the state written authorization to pro- or governmental agency or vide for such additional In- subdivision or political sub- sured; and division has issued a permit or authorization In connec- (c) Does not apply to any per- tion with premises you own, son, organization, vendor, rent or control and to which state, governmental agency this insurance applies: or subdivision or political subdivision, specifically (I) The existence, mainte- named as an additional in- nanoe, repair, construe- sured under any other provi- tion,erection or removal • sion of, or endorsement of advertising signs, added to, this Coverage awnings, canopies, cel- Part, provided such other lar entrances, coal provision or endorsement • holes, driveways, man- covers the Injury or damage holes, marquees, hoist for which this insurance ap- away openings, side- plies. walk vaults, street ban- ners or decorations and b. With respect to the insurance afford- similar exposures;or ed to the additional Insureds de- scribed in Paragraph 8.a,(1) of this (ii) The construction, erec- endorsement, the following is added . tion or removal of eleva- to Section 111-Limits Of Insurance: tors;or . The most we will pay on behalf of the (Hi) The ownership, mainte- additional insured is the amount of.in- nance or use of any el- surance: evators covered by this Insurance. (1) Required by the written contract, written agreement,written permit • or written authorization described Includes copyrighted material of Insurance • GA 210 0917 Services Office, Inc.,with its permission. Page 13 of 15 ; i in Paragraph 8.a.(1) of this en- tion 1 -Coverage A -Bodily Injury dorsement;or And Property Damage Liability: (2) Available under the applicable Paragraphs (3) and (4) of this exclu- Limits of Insurance shown in the sion do not apply to tools or equip- _ Declarations; ment loaned to you,provided they are not being used to perform operations whichever is less. at the time of loss. This endorsement shall not increase b. With respect to the insurance provid- the applicable Limits of Insurance ed by this section of the endorse- shown in the Declarations. ment, the following additional provi- c. Section IV - Commercial General Bions apply: Liability Conditions is amended to (1) The Limits of Insurance shown In include the following: •the Declarations are replaced by Automatic Additional Insured Pro- the limits designated in Section vision B. Limits Of insurance, 9. Property Damage To Borrowed This insurance applies only if the Equipment of this endorsement "bodily injury' or "property damage" with respect to coverage provid- occurs,or the "personal and advertis- ed by this endorsement. These Ing injury"offense Is committed: limits are Inclusive of and not In (1) During the policy period;and addition to the limits being re- placed. The Limits of Insurance • (2) Subsequent to your execution of shown in Section B. Limits Of the written contract or written Insurance,9.Property Damage agreement, or the Issuance of a To Borrowed Equipment of this written permit or written authori- endorsement fix the most we will zatlon, described in Paragraph pay in any one "occurrence" re- 8.a.(1). gardless of the number of: d. Section IV - Commercial General (a) Insureds; Liability Conditions is amended as (b) Claims made or "suits" follows: brought;or Condition 5. Other Insurance is (c) Persons or organizations amended to include: making daims or bringing Primary And Noncontributory In- "suits". surance (2) Deductible Clause This insurance is primary to and will (a) Our obligation to pay dam- not seek contribution from any other ages on your behalf applies • insurance available to an additional only to the amount of dam- insured per Paragraph 8.a.(1) of this ages for each "occurrence" endorsement provided that: which are in excess of the (1) They additional insured is a Deductible Amount stated In Named Insured under such other Section B. Limits Of Insur- insurance;and ance, 9. Property Damage To Borrowed Equipment of (2) You have agreed in writing in a this endorsement. The limits contract, agreement, permit or of insurance will not be re- authorization described in 8.a.(2) duced by the application of of this endorsement that this in- such Deductible Amount, surance would be primary and would not seek contribution from (b) Section IV - Commercial • any other insurance available to General Liability Condi- the additional insured. tions, .2. Duties In The Event Of Occurrence, Of- 9. Property Damage To Borrowed Equip- fense, Claim Or Suit, ap- meat plies to each daim or "suit" a. The following, is added to Exclusion irrespectNe of the amount. • 2,j.Damage To Property under Sec- Includes copyrighted material of Insurance GA 210 0917 Services Office, Inc.,with its permission. Page 14 of 15 (c) We may pay any part or all 12. Nonowned Aircraft of the deductible amount to effect settlement of any The following is added to Exclusion 2.g. claim or"suit'and, upon no- Aircraft, Auto Or Watercraft under Sec- tification of the action taken, tion I -Coverage A -Bodily Injury And you shall promptly relm- Property Damage Liability: burse us for such part of the This exclusion does not apply to an air- deductible amount as has craft you do not own, provided that: • been paid by us. 10. Employees As Insureds - Specified a. The pilot In command holds a current Health Cam Services And Good Samar- effective certificate, issued by a duly Ilan Services constituted authority of the United States of America or Canada, desig- Paragraph 2,a.(1Xd) under Section n - noting that person as a commercial or Who Is An Insured does not apply to: airline transport pilot; a. Your "employees" who provide pro- b. The aircraft is rented with a trained, fessional health care services on your paid crew;and behalf as a duly licensed nurse, c. The aircraft does not transport per- emergency medical technician or sons or cargo fora charge. paramedic in the jurisdiction where an "occurrence" or offense to which this 13. Bodily Injury Redefined insurance applies takes place;or Section V-Definitions,4."Bodily injury" • b. Your"employees"or"volunteer work- is replaced by the following: ers", other than an employed or vol- unteer doctor, providing first aid or 4. "Bodily injury" means bodily harm or good samaritan services during their injury, sickness, disease, disability, work hours for you will be deemed to humiliation, shock, fright, mental an- be acting within the scope of their guish or mental injury, including care, employment by you or performing du- loss of services or death resulting ties related to the conduct of your from any of these at any time. business. 14. Expected Or intended Injury Redefined • 11. Broadened Notice Of Occurrence The last sentence of Exclusion 2.a. Ex- Paragraph a. of Condition.2. Duties In pected Or Intended Injury under Sec- The Event Of Occurrence, Offense, tion I -Coverage A-Bodily Injury And Claim Or Suit under Section IV- Corn- Property Damage Liability is replaced by mercial General Liability Conditions is the following: replaced by the following: This exclusion does not apply to "bodily a. You must see to it that we are notified injury"or"property damage"resulting from as soon as practicable of an "occur- the use of reasonable force to protect per- rence"or an offense which may result sons or property. in a claim.To the extent possible, no- 15. Fortner Employees As Insureds tice should include: (1) How, when and where the "cc- The following is added to Paragraph 2. currence"or offense took place; cinder Section 11-Who Is An Insured: (2) The names and addresses of 2. Each of the following is also an In- any Injured persons and wit- cured: nesses;and Any of your former "employees", di- rectors, managers, members, part- (3) The nature and location of any ners or"executive officers", including iriury or damage arising outl of but not limited to retired, disabled or • the"occurrence"or offense. those on leave of absence, but only • This requirement applies only when for acts within the scope of their em- the "occurrence" or offense is Imown ployment by you or for duties related to an"authorized representative". to the conduct of your business. • Includes copyrighted material of Insurance GA 210 0917 Services Office, Inc.,with Its permission. Page 15 of 15 • THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CinciPlus® BUSINESS AUTO XC+® (EXPANDED COVERAGE PLUS) ENDORSEMENT • This endorsement modifies insurance provided by the following: BUSINESS AUTO COVERAGE FORM With respect to the coverage provided by this endorsement,the provisions of the Coverage Form apply unless modified by this endorsement. • A. Blanket Waiver of Subrogation This provision does not apply unless the valid SECTION iV - BUSINESS AUTO CONDI- written contract has been: TIONS, A. Loss Conditions, 5. Transfer of 1. Executed prior to the accident causing Rights of Recovery Against Others to Us is "bodily injury"or"property damage";and amended by the addition of the following: 2. Is still in force at the time of the"accident' We waive any right of recovery we may have causing "bodily injury" or "property dam- against any person or organization because of age". payments we make for "bodily injury" or D. Employee Hired Auto "property damage"arising out of the operation of a covered "auto"when you have assumed 1. Changes in Liability Coverage liability for such "bodily injury" or "property damage" under an "insured contract", provid- The following is added to the Section II - ed the"bodily injury"or"property damage"oc- Liability Coverage, A. Coverage, 1. curs subsequent to the execution or the "In- Who is an Insured: sured contract", An "employee" of yours is an "insured" B. Noncontributory Insurance while operating an "auto" hired or rented SECTION IV - BUSINESS AUTO CONDI- under a contract or agreement in that TIONS, B. General Conditions, 5. Other In- "employee's"poname,gwith your t permission,oe surance c,is replaced by the following: conductwhle offyour business.duties related to the your business. c. Regardless of the provisions of Par- 2. Changes in General Conditions agraph a. above, this Coverage Form's Liability Coverage is primary SECTION IV - BUSINESS AUTO CON- and we will not seek contribution DITIONS, B. General Conditions, 5. from any other insurance for.any Iia- Other Insurance is amended by repiac- biiity assumed under an "insured ing Paragraph 5.b.with the following: contract" that requires liability to be assumed on a primary noncontributo- b. For Hired Auto Physical Damage ry basis. Coverage the following are deemed to be covered"autos"you own: C. Additional Insured by Contract (1) Any covered "auto" you lease, SECTION iI - LIABILITY COVERAGE, A. hire,rent or borrow;and • Coverage, I.Who is an Insured is amended to include as an insured any person or organi- (2) Any covered "auto" hired or zation with which you have agreed in a valid rented by your"employee"under written contract to provide insurance as is af- a contract in that individual "em- forded by this policy. per- mission,plo ,1while performiname, with ng dutiesour This provision is limited to the scope of the related to the conduct of your valid written contract. business. Includes copyrighted material of iSO AA 288 01 16 Properties, Inc.,with its permission. Page 1 of 4 } • However, any "auto" that is leased, a. Is effective on the date of acquisition hired, rented or borrowed with a driver or formation, and is afforded for 180 is not a covered"auto". days after such date; E. Audio, Visual and Data Electronic Equip- b. Does not apply to "bodily injury" or ment "property damage" resulting from an SECTION III - PHYSICAL DAMAGE COV- "accident" that occurred before you acquired or formed the organization; ERAGE, C. Limit of Insurance is amended by adding the following: c. Does riot apply to any newly acquired 4. The most we will pay for all "loss" to au- or formed organization that is a joint venture or partnership;and dio, visual or data electronic equipment and any accessories used with this d. Does not apply to an insured under equipment as a result of any one "acci- any other automobile liability policy, dent"is the lesser of: or would be an insured under such a a. The actual cash value of the dam- policy but for the termination of such poli- aged or stolen property as of the time policy limitsr theoexhaustion of such of the"accident"; cy's of Insurance. 3. Any of your "employees" while using a b. The cost of repairing or replacing the covered "auto" in your business or your damaged or stolen property with oth- personal affairs,provided you do not own, er property of like kind and quality;or hire or borrow that"auto". c. $2,500. G. Liability Coverage Extensions - Supple- Provided the equipment,at the time of the mentary Payments-Higher Limits "loss"Is: SECTION II - LIABILITY COVERAGE, A. a. Permanently installed in or upon the Coverage,2. Coverage Extensions,a.Sup- covered "auto" in a housing, opening plementary Payments Is amended by: or other location that is not normally 1. Replacing the $2,000 Limit of Insurance used by the "auto" manufacturer for for bail bonds with$4,000 in(2); and the installation of such equipment; 2. Replacing the $250 Limit of insurance for b. Removable from a permanently In- stalled housing unit as described in reasonable expenses with$500 in(4). Paragraph 2.a.above; or H. Amended Fellow Employee Exclusion c. An integral part of such equipment. SECTION II=LIABILITY COVERAGE, B.F. Who is an Insured-Amended Ex- clusions, 5. Fellow Employee is modified as follows: SECTION II - LIABILITY COVERAGE, A. Exclusion 5.Fellow Employee is deleted. Coverage, 1,Who is an Insured is amended by adding the following: L Hired Auto-Physical Damage The following are"insureds": If hired"autos"are covered"autos"for Liability • 1. Any subsidiary which is a legally incorpo- Coverage, then Comprehensive and Collision • rated entity of which you own a financial Physical Damage Coverages as provided un- rted of more hn ou f ta voting der SECTION III - PHYSICAL DAMAGE interest k tothe ethan 50%date of thise coter- COVERAGE of this Coverage Part are ex- i stoage form. • tended to "autos"you hire, subject to the fol- ! lowing: . However, the insurance afforded by this 1. The most we will pay for "loss" to any provision does not apply to any subsidiary hired"auto"is $50,000 or the actual cash • • that is an "insured" under any other au- value or cost to repair or replace, which- • tomobile liability policy, or would be an ever is the least,minus a deductible. •• Insured under such policy but for termi- nation of such policy or the exhaustion of 2. The deductible will be equal to the largest such policy's limits of insurance. deductible applicable to any owned"auto" • for 2. Any organization that is newly acquired or less. that coverage, or$1,000,whichever is formed by you and over which you main- tainles majority ownership. The Insurance 3. Hired Auto - Physical Damage coverage provided by this provision: is excess over any other collectible insur • - ance. Includes copyrighted material of ISO AA 288 01 16 Properties,Inc.,with its permission. Page 2 of 4 i 1 4. Subject to the above limit,deductible,and K. Transportation Expense•Higher Limits excess provisions we will provide cover- SECTION lil - PHYSICAL DAMAGE COV- cgequal thebroadest coverage appli- ERAGE, A. Coverage,cable to , 4. Coverage any covered "auto" you own in- . 9 9 Exten- sured under this policy. sions is amended by replacing $20 per day with $50 per day, and $600 maximum with Coverage includes loss of use of that hired au- $1,500 maximum in Extension a. Transpor- to, provided it results from an "accident" for tatlon Expenses. which you are legally liable and as a result of L. AirbagCoverage a monetary loss is sustained by the leasing or rental concern. The most we will COV- pay for any one"accident"is$3,000. SECTION III - PHYSICAL DAMAGE COV- ERAGE, B. Exclusions, 3.a. is amended by If a limit for Hired Auto - Physical Damage is adding the following: shown in the Schedule, then that limit replac- However, the mechanical and electrical es,and is not added to,the $50,000 limit indi- breakdown portion of this exclusion does not cated above. apply to the accidental discharge of an airbag. J. Rental Reimbursement This coverage for airbags is excess over any other collectible insurance or warranty. SECTION III - PHYSICAL DAMAGE is • amended by adding the following: M. Loan or Lease Gap Coverage 1. We will pay for rental reimbursement ex- 1. SECTION iII - PHYSICAL DAMAGE penses incurred by you for the rental of COVERAGE, C. Limit of Insurance is an"auto"because of a"loss"to a covered deleted in its entirety and replaced by the "auto". Payment applies in addition to the following, but only for private passenger otherwise applicable amount of each cov- type"autos"with an original loan or lease, erage you have on a covered"auto". No and only in the event of a "total loss" to deductible applies to this coverage, such a private passenger type"auto": 2. We will pay only for those expenses in- • a. The most we will pay for"loss"in any curred during the policy period beginning one"accident"is the greater of: 24 hours after the "loss" and ending, re- (1) The amount due under the terms gardless of the policy's expiration, with of the lease or loan to which the lesser of the following number of your covered private passenger days: type"auto"is subject,but will not a. The number of days reasonably re- include: • quired to repair the covered "auto". If (a) Overdue lease or loan pay- "loss" is caused by theft,this number ments; of days is added to the number of • days it takes to locate the covered (b) Financial penalties imposed • "auto"and return it to you;or under the lease due to high i b. 30 days. mileage, excessive use or abnormal wear and tear; 3. Our payment is limited to the lesser of the amounts: (c) Security deposits not re- followingfunded by the lessor; a. Necessary and actual expenses in- curred;or (d) Costs for extended warran- ties, Credit Life insurance, b. $50 per day. Health, Accident or Disabil- ity Insurance purchased 4. This coverage does not apply while there with the loan or lease; and are spare or reserve "autos" available to you for your operations. (e) Carry-over balances from . previous loans or leases,or 5. We will pay under this coverage only that amount of your rental reimbursement ex- (2) Actual cash value of the stolen penses which is not already provided for or damaged property. • under SECTION III PHYSICAL DAM- b. An adjustment for depreciation and AGE COVERAGE, A. Coverage, 4, physical condition will be made in de- Coverage Extensions. termining actual cash value at the time of"loss". . i Includes copyrighted material of ISO AA 288 01 16 Properties, Inc.,with its permission. Page 3 of 4 • 2. SECTION V- DEFINITIONS is amended P. Unintentional Failure to Disclose Hazards by adding the following, but only for the SECTION IV - BUSINESS AUTO CONDI- purposes of this Loannoor Lease Gap Coverage: TIONS, B. General Conditions, 2. Conceal- ment, Misrepresentation or Fraud is "Total loss" means a "loss" In which the amended by adding the following: cost of repairs plus the salvage value ex- ceeds the actual cash value. However, if you unintentionally fail to disclose any hazards existing on the effective date of N. Glass Repair-Waiver of Deductible this Coverage Form, we will not deny cover- SECTION III - PHYSICAL DAMAGE COV- age under this Coverage Form because of ERAGE,D. Deductible is amended by adding such failure. the following: Q. Mental Anguish Resulting from Bodily inju- No deductible applies to glass damage if the ry glass is repaired in a manner acceptable to us SECTION V-DEFINITIONS, C. "Bodily inju- rather than replaced. ry" is deleted in its entirety and replaced by O. Duties in the Event of an Accident, Claim, the following: Suit or Loss-Amended "Bodily injury" means bodily injury,sickness or SECTION IV - BUSINESS AUTO CONDI- disease sustained by a person,including men- TIONS,A. Loss Conditions,2. Duties in the tai anguishand death sustained by the same Event of Accident,Claim,Suit or Loss,a.is personntshaat resultsfrom such bodily injury, amended by adding the following: sickness orr disease. "Bodily injury" does not include mental anguish or death that does not This condition applies only when the "acci- result from bodily injury,sickness or disease. dent"or"loss"is known to: R.. Coverage for Certain Operations in Con- 1. You,if you are an individual; nectlon with Railroads 2. A partner,if you are a partnership; With respect to the use of a covered"auto"in operations for or affecting a railroad: 3. An executive officer or insurance manag- er,if you are a corporation;or 1. Section V-Definitions, H. "Insured con- tract", 1.c, is amended to read: 4. A member or manager, if you are a lim- ited liability company. c. An easement or license agreement; 2. Section V-Definitions, H. "Insured con- tract",2.a,is deleted. • • Includes copyrighted material of ISO AA 288 01 16 Properties, Inc.,with its permission. Page 4 of 4 ' i COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED OWNERS, LESSEES OR CONTRACTORS - AUTOMATIC STATUS WHEN REQUIRED IN CONSTRUCTION AGREEMENT WITH YOU - COMPLETED OPERATIONS ONLY This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART • • A. SECTION II - WHO iS AN INSURED is This insurance does not apply to: amended to include as an additional insured any person or organization when you and such 1. "Bodily injury","property damage"or"per- person or organization have agreed In writing sorrel and advertising Injury"arising out of In a contract or agreement that such person or the rendering of, or the failure to render, organization be added as an additional insured any professional architectural, engineer- on your policy, but only with respect to "bodily Ing or surveying services,Including: Injury", "property damage" or "personal and a. The preparing,approving,or failing to advertising Injury"caused, In whole or In part, prepare or approve, maps, shop by your work performed for the additional in- drawings, opinions, reports, surveys, sured and included in the"products-completed hazard". field orders, change orders or draw- operationsIngs and specifications;or If not specified otherwise in the written con- b. Supervisory, inspection, architectural tract or agreement, a person's or organize- or engineering activities. tions status as an additional insured under this endorsement ends one year after your opera- 2. 'Bodily injury"or "property damage" arcs- tions for that additional Insured are completed. Ing out of'your work"for which a consoll • - The written contract or agreement must be dated (wrap-up) insurance program has currently In effect or become effective during been provided by the prime contrac- the term of this Coverage Part The contract for/project manager or owner of the con- or agreement must be executed prior to the struction project in which you are Involved. "bodily Injury" "property damage"or"personal and advertising injury"to which this endorse- 3. 'Bodily injury","property damage"or"per- ment pertains. sonal and advertising injury" to any em- ployee of you or to any obligation of the However. additional Insured to indemnify another because of damages arising out of such 1. The insurance afforded to such additional Injury. Insured only applies to the extent permit- ted by law;and 4. 'Bodily injury","property damage"or"per- 2. If coverage provided to the additional in- sonal and advertising injury for which the sured is required by a contract or agree- andNamedthisipolicy!s nsu afforanded no coverage ment, the insurance afforded to such ad- ditional under of Insurance. insured will not be broader than C. With respect to the insurance afforded to that which you are required by the con- these additional Insureds, SECTION 111-LIM- tract or agreement to provide for such ad- ITS OF INSURANCE Is amended to include: ditional insured. The limits applicable to the additional Insured B. With respect to the insurance afforded to are those specified In the written contract or these additional Insureds, the following addi- agreement or in the Declarations of this Coy- linnet exclusions apply: erage Part whichever is less. if no limits are Includes copyrighted material of ISO • Properties,Inc.,with its permission. CSIA405(08109)-A- Page 1 of 2 4 r specified In the written contract or agreement, Any coverage provided herein will be excess the limits applicable to the additional Insured over any other valid and collectible insurance are those specified in the Declarations of this available to the addlfonal Insured whether Coverage Part.The limits of insurance are In- primary, excess, contingent or on any other elusive of and not In addition to the limits of In- basis unless you have agreed In a written con- surance shown in the Declarations. tract or written agreement executed prior to any loss that this insurance will be primary. D. With respect to the Insurance afforded to This Insurance will be noncontributory only if these additional Insureds, SECTION IV you have so agreed In a written contract or COMMERCIAL. GENERAL LIABILITY CON- written agreement executed prior to any loss DITIONS, 4. Other Insurance Is amended to and this coverage is determined to be primary. Include: • Includes copyrighted material of ISO CSIA405(08/09)-A- Properties,Inc.,with Its permission. Page 2 of 2 4 • COMMERCIAL GENERAL LIABILITY CSGA 4087 12 12 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. • WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US - PER CONTRACT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to Paragraph 8.Transfer of Rights of Recovery Against Others to Us of SECTION IV-CONDITIONS: If you have agreed,in a written contract or agreement,to provide a waiver of any right of recovery against a person or organization,we will waive any right of recovery we may have against that person or organization because of payments we make for injury or damage arising out of your ongoing operations or"your work"done under a contract with that person or organization and included In the"products-completed operations hazard". This waiver applies only to that person or organization for which you have agreed to in a written contract to provide said waiver. • • Includes copyrighted material of Insurance CSGA 4087 12 12 Services Office, Inc„with its permission. Page 1 of 1