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Insurance Certificate: Pacific Paving, Inc. (2)
DATE(MM/DDIYYYY) ACCPRE) . CERTIFICATE OF LIABILITY INSURANCE. `� _ 9/25/2023 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 . HUB International Northwest, LLC PHONE Mary-Beth Woomer FAX PO Box 10167 (A/c.No.Ext):541-687-1117 (NC,No):541-342-8280 Eugene OR 97440 ADDRESS: marybeth.woomer©hubinternational.com INSURER(S)AFFORDING COVERAGE NAIC# • • INSURER A:Cincinnati Casualty 28665 INSURED - PACIPAV-02 INSURER B Pacific Paving, Inc - PO BOX 2370 INSURER C: Medford OR 97501 INSURERD: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:2142751187 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. . ITR TYPE OF INSURANCE • INSD SUBR wvD POLICY NUMBER POLICY EFF POLICY EXP LIMITS (MMIDDIYYYY) (MMIDD/Yl'YY) • A. X. COMMERCIAL GENERAL LIABILITY Y Y EPP0567282 3/20/2023 3/20/2024 EACH OCCURRENCE $1,000,000 . DAMAGE TO RENTED . CLAIMS-MADE X OCCUR PREMISES(Ea occurrence) $500,000 MED EXP(Any one person) $10,000 PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: ' GENERAL AGGREGATE . _ $2,000,000 POLICY X Of X LOC • • PRODUCTS-COMP/OP AGG $2,000,000 OTHER: $ • A AUTOMOBILE LIABILITY Y Y EPP0567282 3/20/2023 3/20/2024 (Ea COMaccidBINEDent)SINGLE LIMIT $1,000,000 • ANY AUTO• • BODILY INJURY(Per person) $ • OWNED X SCHEDULED •AUTOS ONLY AUTOS BODILY NJURY(Peraccident) $ X HIRED x NON-OWNED PROPERTY DAMAGE $ _ AUTOS ONLY _ AUTOS ONLY (Per accident) A X UMBRELLA LIAB X OCCUR• EPP0567282 3/20/2023 3/20/2024 EACH OCCURRENCE $1,000,000 • EXCESS LIAB CLAIMS-MADE AGGREGATE $1,000,000 DED X RETENTION$tt $ WORKERS COMPENSATION PER OTH- • AND EMPLOYERS'LIABILITY Y/N STATUTE' ER ANYPROPRIETOR/PARTNER/EXECUTIVE N/A E.L.EACH ACCIDENT $ OFFICER/MEMBEREXCLUDED? - (Mandatory,In NH) E.L.DISEASE-EA EMPLOYEE $ ' If yes,describe under . DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ i. DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) ' Certificate holder and all entities required by written contract are included as additional insureds on a primary and non-contributory,basis with waiver of subrogation with respects to the general liability and auto liability as required by written contract per attached endorsements.Umbrella is Excess over General Liability,Auto and Employers Liability.Subject to policy limits,terms,conditions and exclusions. CERTIFICATE HOLDER CANCELLATION • • SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE ' - THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 1 (ACCORDANCE WITH THE POLICY PROVISIONS. City of Ashland • 20 E. Main St • Ashland OR 97520 AUTHORIZED REPRESENTATIVE • 0 ^ - I / , ( • ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD • • • • • • • THIS ENDORSEMENT CHANGES THE POLICY.PLEASE READ IT CAREFULLY. b. Loss Of Earnings$ 500 - 5. Medical Payments CONTRACTORS'COMMERCIAL GENERAL LIABILITY Medical Expense Lunt:$10,000 BROADENED ENDORSEMENT • 9. Property Damage To Borrowed Equipment • . Each Occurrence Limit $10,000 This endorsement modifies insurance provided under the following: Deductitie Amount: $ 250 ' 16. Voluntary Property Damage Coverage(Coverage a.)And Care,Custody Or Control Liability COMMERCIAL GENERAL LIABILITY COVERAGE PART Coverage(Coverage b.) • ' - Limits Of Insurance • A. Endorsement-Table of Contents: - Coverage a. • $1- Coverage: Begins on Page: $5,000 Aggrega000 Each te • 1. Employee Benefit Liability Coverage...._..._..._-.._. Coverage b.$5,000 Each Occurrence unless otherwise stated$ 2. Unintentional Failure To Disclose Hazards........._..._..._..._...__..._............._..._..._....._.......9 Deductible Amount(Each Oenrrrence) 3. Damage To Premises Rented To You...._..._..._........_-..__........_..._..._..._..................._..._.9 Coverage a.$250 • . 4. Supplementary Payments...._..._..._..._....---._....._........_..._..._...__........_........ ..._...__..._10 Coverage b.$250 unless otherwise stated$ 5. Medical Payments...._........_........_..._....._..._........_........_....._..._..._..._..._.........._........_...10 6. 180 Day Coverage For Newly Formed Or Acquired Organizations...._..._........_........__. 10 COVERAGE PREMIUM BASIS RATE ' ADVANCE PREMIUM 7. Waiver Of Subrogation...._..._..._..._..._..._....._.......:_.:._..._.:.__..._........_..._:.._..._....._..._11 (a) Area ( (For Limits in Excess of 8. Automatic Additional Insured-Specified Relationships' • For Limits in Excess of p ps'.............._........_..............._.......11 (b) Payroll • Managers Or Lessors Of Premises; (c) Gross Sales • $5,000) $5,000) • Lessor Of Leased Equipment; (d) Units • Vendors; (e) Other • State Or Governmental Agency Or Subdivision Or Political Subdivision-Permits b. Care, Custody Or • Or Authorizations Relating To Premises;and Control $ • Mortgagee,Assignee Or Receiver TOTAL ANNUAL PREMIUM $ 9. Property Damage To Borrowed Equipment........._..-_.'_..._...__..._..._.:._........_..._....._...14 10. Employees As Insureds-Specified Health Care Services And Good Samaritan . • Services...._..._..._..._..._..._...-._..._..._..._..._...__..._... 15 • 11. Broadened Notice OfOccurence...._..._..._......-._...__..._........_..._..._..._....._..._..............15 • 12. Nonowned Aircraft..:._..._..._:.._........_....._........_..._..._..._....._............._..._.........._..._..._..15 13. Bodily Injury Redefined...._..._..._..._..._..-_..... ..._.-._.,._..._...__..._........_..._..._.-._....._....15 , 14. Expected Or Intended Injury Redefined...._........_..._..:_...__........_........_..._..._................15 15. Former Employees As Insureds...._---_.-......_..._..:_..:.._..._..._..._..._...__........_..._........_..15 • 16. Voluntary Property Damage Coverage And Care,Custody Or Control Liability Coverage...._..._........_..._...__.:._..._..........:...:..:......_... ..._..._.:......_............._....:..._..._...16 . '17. Broadened Contractual.Liability-Work Within 50'Of Railroad Property...._..._...•..._....17 ' 18. Alienated Premises...._..._..._..._........_....._........_..._..._...__..._.._....:..._..._...__..._........_.17 ' • • B. Limits Of Insurance: - • • . The Commercial General Liability Limits of Insurance apply to the insurance provided by this endorse- ment,except as provided below: 1. Employee Benefit Liability Coverage . - Each Employee Limit: $1,000,000 Aggregate Limit: $3,000,000 - Deductible Amount: $ 1,000 • 3. Damage To Premises Rented To You ' The lesser of: • ' a. The Each Occurrence Limit shown in the Declarations;or . ' 0 • b. $500,000 unless otherwise stated$ -.-- 4. Supplementary Payments • • a. Bail Bonds: $2,500 , • Includes copyrighted material of Insurance Includes copyrighted material of Insurance GA 233 0917 Services Office,Inc,with is permission. Page 1 of 17 ,GA 233 0917 Services Office,Inc,with its permission. • Page 2 of 17 • • • . C. Coverages this endorsement pro- (d) Insufficiency Of Funds (i) Taxes,Fines Or Penalties - vided: 1. Employee Benefit Liability Coverage Damages arising out of an Taxes,fines or penalties,In- a) You did not have ' insufficiency of funds to cluding those imposed un- a. The following is added to Section I- • knowledge of a meet any obligations under der the Internal Revenue . Coverages: claim or"suit'on or any plan induded in the Code or any similar state or ' Employee Benefit Liability Cover- before the"first ef- "employee,benefit program". local lay. age endive date" the endorsement. (e) Inadequacy Of Perfor- ) Employment-Related Prac- (1) Insuring Agreement mance Of Invest- tices You will bement/Advice Given With Any liability arising out of' (a) We will pay those sums that deemed to have Respect To Participation • the insured becomes legally knowledge of a any: obligated to pay as damag- claim or "suit' Any daim based upon: es caused by any act,error when any"author (1) Refusaltoemploy; or omission of the insured, • ized re resents 1) Failure of any invest- (2) Termination of employ- ment P ment to perform; P �' or of any other person for 'tire'; menta whose acts the insured is 2) Errors in providing in- legally liable, to which this 0 Reports all,or formation on past per- (3) Coercion, demotion, insurance applies. We will any part,of the • fomiance of investment evaluation, reassign- have the right and duty to act, error or . vehicles;or ment, discipine, defa- defend the insured against omission to us mation, harassment, any "suit' seeking those or any other 3) Advice given to any • humiliation, discrimina- damages However,we will insurer; • person with respect to tion or other employ- have no duty to defend II) Receives a that person's decision to ment-related practices, against any "suit' seeking written or ver- participate or not to par- acts or omissions;or damages to which this in- bal demand or tidpate in any plan in (4 Consequential Iiabili surance does not apply.We claim for dam- luded in the"employee ) as a result of1,(2)or• may, at our discretion, in- ages because benefit program". (3)above. ( ) • vestigate any report of an of the act, er- (f) Workers' Compensation • ad, error or omission and roc or orris And Similar Laws This exclusion applies • settle any daim or"suit'thatsign;and whether the insured may be • may result.But Any daim arising out of your held liable as an employer 1) The amount we will payb) There is no other failure to comply with the or in any other capacity and applicable insur- mandatory provisions of any to any obligation to share for damages is limited ante. • workers' compensation, un- damages with or repay as described in Section employment compensation someone else who must pay ' Ill - Limits Of Insur- (2) Exclusions insurance,sodal security or damages because of the in- . ante;and • This insurance does not apply to: disability benefits law or any jury. 2) Our right and duty to similar law. defend ends when we (a) Bodily Injury, Property (3) Supplementary Payments • . have used up the appli- Damage Or Personal And (g) ERISA Section I - Coverages, Sup- . cable limit of insurance Advertising Injury Damages for which any in- • plementary Payments-Cover- in the payment of judg- 'Bodilyirksured is liable because of Ii- . ages A And B also apply to this ments or settlements, "p "property abilityimposed on a fidud- Coverage. damage" or 'personal and 9 No other obligation or liabil- advertising injury'. ary by the Employee Re- ity to pay sumsortirement Income Security perform b. Who Is An Insured Lia- acts or ss covered (b) Dishonest, Fraudulent, Act of 1974, as now or As respects Employee Benefit Lia- Griminal Or Malicious Act hereafter amended, or by bll' Coverage.Section II-Who Is unless er¢ilidliy provided for anysimilar federal,state or g under Supplementary Damages arising cut of anylocal An Insured is replaced by the folovr Payments. intentional, dishonest, laws. ing: fraudulent, criminal or mall- (h) Available Benefits you are desk rated in the Deo- (b) This insurance applies to mous act,error or omission, (1) If larationsyas: g damages only if the act,er- committed by any insured, Any daim for benefits to the ror or omission,is negligent- induding the willful or reds- • extent that such benefits are (a) An individual,you and your ly committed in the"admin- less violation of any statute. available, with reasonable - spouse are insureds,but on- istration"of your"employee. effort and cooperation of the ly with respect to the con- benefit program";and (c) Failure To Perform A Con- insured,from the applicable duct of a business of which 1 Occurs Burin the di tract funds accrued or other cd- 9 P cY [edible insurance. you are the sole owner. period;or Damages arising out of fail- (b) A partnership or joint ven- ure of performance of con- t Occurred prior to the P tract by any insurer. tore, you are Your members, our part• - d. ' effective date" of Includes copyrighted material of Insurance Includes copyrighted material of Insurance GA 233 0917 Services Office,Inc,with is permission. Page 3 of 17 GA 233 0917 ., Services Office,Inc,with is permission. Page 4 of 17 • • ners,and their spouses are zation.However,coverage under (b) A series of related ads,er- tiflcation of the action taken, also insureds but only with this provision: rors or omissions, regard- you shall promptly reim • - respect to the conduct of less of the amount of time burse us for such part of the your business. (a) Is afforded only until the that lapses between such Deductible Amount as we 180th day after you acquire - ads,errors or omissions; have paid. (c) A limited liability company, or form the organization or you are an insured. Your the end of the policy period, negligently committed in the d. Additional Conditions members are also insureds, whichever is earlier;and "administration"of your"employ- As respects Employee y but only with respect to:the. ee benefit program". pe ee Benefit Lia- conduct of your business. (b) Does not apply to any act, bility Coverage,Section IV-Corn- Your managers are in- error or omission that was However,the amount paid under mercial General Liability Condi- sureds,but only with respect committed before you ac- this endorsement shall not ex- tions is amended as folows: to their duties as your man- • quired or formed the organi- ceed,and will be subject to the ageszation. limits and restrictions_that apply (1) Item 2.Duties In The Event Of C. Limits Of Insurance to the payment of benefits in any Occurrence,Offense,Claim Or (d) An organization other than a plan included in the"employee Suit is replaced by the following: partnership,joint venture or As respects Employee Benefit Lia- benefit program." - 2. Duties In The Event Of An limited liability company,you bility Coverage,Section III-Limits4 Deductible Amount • Act,Error Or Omission,Or • are an insured.Your"execu- Of Insurance is replaced by the fit- O Claim Or Suit the_officers" and directors -lowing: i • (a) Our obligation to pay dam- are insureds, but only with • ages on behalf of the in- a. You must see to it that respect to their duties as (1) The Limits of Insurance shown in sured applies only to the we are notified as soon your officers or directors. Section B.Limits Of Insurance, amount of damages in ex- as practicable of an act, Your stockholders are also 1. Employee Benefit Liability cess of the Deductible error or omission which insureds, but only with re- Coverage and the roles below fix Amount stated in the Deda- may result in a claim. • sped to their liability as the most we will pay regardless rations as applicable to To the extent possible, stoddhdders, of the number of. Each Employee. The limitsnotice should include: • (e) A trust,you are an insured. (a) Insureds; of insurance shall not be re- (1) What the act,error • Your trustees are also in- duped by the amount of this or omission was sureds,but only with respect (b) Claims made or "suits" deductible. and when it oc- • to their duties as trustees. brought; • (b) The Deductible Amount carred;and (2) Each of •the following is also an (c) Persons or organizations stated in the Declarations insured: • making daims or bringing applies to all damages sus- (2) The names and • "sults'; faired by any one"employ- addresses of arty• • • (a) Each of your "employeesf- • • " ee",including such"employ- one who emsysua who is or was authorized to (d) Acts,errors or omissions;or ee's"dependents and bene- res damage as a administer your "employee fidaries,because of all acts, error result f se act, (e) Benefits included in yourerror or omission.' • benefit program', "employee benefit program". errors or omissions to which (b) Any persons, organizationsthis insurance applies. b. 'If a daim is made or (2) The Aggregate Limit shown in "suit'is brought against or"employees'having prop- Section B.Limits Of Insurance, (c) The terms of this insurance, any insured,you must: • er temporary authorization 1. Employee Benefit Liability including those with respect to administer your"employ- Coverage of this endorsement is to: (1) Immediately record ee benefit program" if you the most we will pay for all dam- the specifics of the . die,but only until your legal ages because of ads,errors or 1) Our right and duty to claim or"suit'and representative is appointed; omissions negligently committed defend the insured the date received; • or in the "administration" of your against any "suns and c Your legal re resentative if "employee benefit program". seeking those damag- ( ) 9 p es;and (2) Notify us as soon you die, but only with re- (3) Subject to the limit described in ' as practicable. • sped to duties as such.That (2) above, the Each Employee 2) Your duties,and the du- representative will have all ties of any other in- You must see to it that • Limit shown in Section B.Limits vdved insured, in the we receive written no- • your rights and duties under Of Insurance, 1. Employee event of an act,error or lice of the daim or"suit' this Coverage Part. Benefit LiabilityCoverage g of omission,or claim; as soon as practicable. (3) Any organization you newly ac- this endorsement is the most we quire or form,other than a part- will pay for all damages sus- apply irrespective of the ap- c. You and any other in- nership,joint venture or limited tamed by any one "employee", plication of the Deductible vdved insured must:, liability company,and over which including damages sustained by Amount. you maintain ownership or major- such "employee's' dependents (1) Immediately send ity interest, will qualify as a and beneficiaries,as a result of (d)'We may pay any part or all us copies of any • NNamed Insured if no other similar of the Deductible Amount to demands, notices, amed Inured if o that organi- (a) An act,error or omission;or effect settlement of any summonses or Ie- • daim or"suit'and,upon no- • gal papers re- Includes copyrighted material of Insurance Includes copyrighted material of Insurance _ GA 233 0917 Services Office,Inc.,with its permission. Page 5 of 17 GA 233 0917 Services Office,Inc,with its permission. 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Representations is any quality in 3) Doors,windows or by fire,explosion,light- amended by the addition of the following: property that caus- other openings. ning, smoke or soot, Based on our dependence upon your rep- es it to damage or (c) 'property damage" caused while rented to you;or resentations as to existing hazards,if un- destroy Pselt by or resulting from water c. In the case of damage intentionally you should fail to disdose all 3) Smog; that leaks or flows from by water, while rented such hazards at the inception date of your - plumbing,heating,air condi- to and ocaipied by you. policy,we will not reject coverage under 4) Mechanical break- Boning, fire protection sys- - this Coverage Part based solely on such down, including • tems, or other equipment, (2) The most we will pay is limited as • failure. rupture or bursting caused by or resulting from described in Section B. Limits • used by centrif- freezing,unless: Of Insurance, 3. Damage To • 3. Damage To Premises Rented To You caused force; Premises Rented To You of this You dd youra. The last Paragraph of 2.Exclusions 5) Settling, cracking, (i) ma maintain heat inn tt a endorsement. under Section I-Coverage A-Bod- shrinking or ex- 'building or structure;or 4. Supplementary Payments ily Injury And Property Damage Li- pension; . Under Section 1-Supplementary Pa ability is replaced by the following: (Ii) You drained the equip- pP rY y- 6) Nesting or infesta- ment and shut off the ments-Coverages A And B: Exdusions c.through q.do not apply lion, or discharge water supply if the heat to"property damage"by fire,explo- or release of waste was not maintained. a. Paragraph 2.is replaced by the fd- sion, lightning, smoke or soot to - products or secre- loving. premises while rented to you or tern- lions, by insects, (d) "Property damage"to: Up to the limit shown in Section B. • porerly occupied by you with permis- birds, rodents or sion of the owner, for which the bi (I) Plumng, heating, air Limits Of Insurance,4.a.Bail Bonds other animals;or of this endorsement for cost of bail amount will pay is limited to the conditioning,fire protec- To Premises Rented To '7) Presence, growth, tion systems, or other bonds required because of accidents You Limit as described in Section III proliferation, equipment or appliano- or traffic law violations arising out of -Limits Of Insurance. spread or any ao- es;or the use of any vehicle to which the Bodily Irjury Liability Coverage ap- thhty of fungus,in- Ii The interior of anylies.We do not have to furnish these b. The insurance provided under Seo- dudng mold or (, buildingor structure, r bonds. tion I-Coverage A-Bodily Injury mildew, and any • _ And Property Damage Liability ap- mycotoxins • tb personal property e, b. Paragraph plies to"property damage"arising out s c' the building or structure, 4.Is replaced by the for- plies to damage topremises that are spares, scents or caused by or resulting lowing: g byproducts pro- from rain,snow,sleet or both rented to and occupied by you. • duced or released ice,whether driven by All reasonable expenses incurred by 1 As respects Water Damage Le- by fungi. wind or not. • the insured at our request to assist us ( ) g in the investigation or defense of the gal Liability,as provided in Para- (b) 'Property damage" caused claim or"suit',including actual loss of graph 3.b.above: . directly or indirectly by any - c. Limit Of Insurance earnings up to the limit shown in Sec- The eo-The exdusions under Section I- of the folowing: With respect to the insurance afford- tion B. Limits Of Insurance, 4.b. • Coverage A-Bodily Injury AndEarthquake, volcanic ed in Paragraphs 3.a.and 3.b.above, Loss Of Earnings of this endorsement Property Damage Liabil' 2. (I) q the Damage To Premises Rented per day because of time off from P cty 9 dY• eruption, landslide or Exclusions, other than I. War To You Limit as shown in the Deda work and the Nuclear Energy Liabil- anyrtieother earth move rations is amended as follows: 5. Medical Payments ity Exclusion(Broad Form),are (1) paragraph 6. of Section III - deleted and the following are - (ii) Water that backs up or Limits Of Insurance is replaced The Medical Expense Limit of Any One added: overflows or is other- • by the following: Person as stated in the Declarations is ' wise discharged from a amended to the limit shown in Section B. This insurance does not apply to: -sewer, drain, sump, 6. Subject to Paragraph 5. Limits Of Insurance, 5. Medical Pay- (a) 'Property damage': sump pump or related above, the Damage To ments of this endorsement equipment Premises Rented To You (i) Assumed in any con- - Limit is the most we will pay 6. 180 Day Coverage For Newly Formed tract or agreement or (Ili)Water under the ground under Coverage A-Bodily Or Acquired Organizations surface pressing on,or • Injury a (II) Caused by or resulting flowing or seeping j ry And Property Dam- Section II - Who Is An Insured is agefor es from any of the follow- through: bcausebolf property dam amended as follows: . ing: 1) Foundations,walls, age"to any one premises: Subparagraph a.of Paragraph 3. is re- 1) Wear and tear, • floors or pavedplaced by the following: surfaces; a. While rented to you,or . temporarily occupied by a. Insurance under this provision is af- forded only unti the 180th day after • • Includes copyrighted material of Insurance Includes copyrighted material of Insurance • GA 233 0917 Services Office,Ina,with is permission. Page 9 of 17 GA 233 0917 • Services Office,Inc.,with its permission. Page 10 of 17 you acquire or form the organization use of that part of the prem- vendor's business, subject or repair opera- - ' or the end of the policy period, ices leased to you, subject to the following additional tions, except such whichever is earlier, to the following additional exclusions: operations per- exdusions formed at the vn- 7. Waiver Of Subrogation (i) The insurance afforded • dors premises in Section IV-Commercial General Llabg- This insurance does not ap- the vendor does not connection with the ity Conditions,9.Transfer Of Rights Of ply to apply to: sale of the product; Recovery Against Others To Us is (i) Any"occurrence which 1) "Bodily injury' or 7) Products which,af- amended by the addition of the following: takes place after you • 'property damage" ter dstribution or We waive anyright of recoverywe maycease to be a tenant in for which the ven- sale by you, have 9 that premises dor is obligated to been labeled or re-. have against any person or organization pay damages by labeled or used as against whom you have agreed to waive (i) Structural alterations, reason of the as- a container,part or such right of recovery in a written contract new construction or sum ion of liability or agreement because of payments we' demolition operations in a contract or ingredient of any thi or sub- o make for injury or damage arising out of performed by or on be- agreement. This other stance by or or forthrthe your ongoing operations or"your work" half of such additional exdusion does not done under a written contract or agree- insured. apply to liability for vendor,or meet with that person or organization and damages that the 8) "Bodily injury' or included in the'products completed oper- (b) Lessor Of Leased Equip- vendor would haveproperty damage" ations hazard".However,our rights may meet in the absence of arising out of the only be waived prior to the"commence" My person or organization the contract or sole negligence of giving rise to the injury or damage for from whom you lease agreement; the vendor for its which we make payment under this Coy- equipment when you and - own acts or omis- erage Part.The insured must do nothingsuch persn(s)or organ'iza2) Any express war- sions or those of after a loss to impair our rights At our re- tion(s)have agreed per Par- rarity unauthorized its employees or quest,the insured will bring"suit'or trans- agraph 8.a.(1) of this'en- — by you; anyone else acting fer those rights to us and help us enforce dorsement to provide insur- sical or on its behalf.How- those rights. ante.Such person(s)or or- 3) My PhY ever,this exdusion • chemical change in aniiatin s insureds ' does not apply to: 8. Automatic Additional Insured-SSped- g () arethe product made only with respect to liability fled Relationships ) intentionally by the a) The excep- -- 'bod ly injury', "property vendor, • a. The following is added to Section II- damage"'or "personal and . • tions contained Who Is An Insured: advertising injury'caused,in 4) Repackaging, ex- in Paragraphs whole or in part, by your kept when un- (c)(I)4)or 6) (1) Any person(s)or organization(s) maintenance, operation or packed solely for of this en- described in Paragraph 8.a.(2)ofuse of equipment leased to the purpose of in- dorsement;or this endorsement(hereinafter re- you by such person(s)or or- spection, demon- • b) Such inspec- ferred to as additional insured) ganizatin(s).A person's or • station,testing,or do whom you are required to add as organization's status as an the substitution of ns ess r an additional'insured under this g mevicits,tests or Coverage Part byreason of a enditional insured under this parts under in- servicing as 9 endorsement ends when strukYions from the written contract, written agree- their contract or agreement manufacturer, and • - a eve dor has to • mart, written permit or written with you for such leased then repackaged in make or nor- authorization. equipment ends. However, the original con- malty under- (2) Only the following persons or or- this insurance does not ap- tamer; . takes to make anizatins are additional in- ply to any "occurrence" • in the usual g which takesplace after the My failure to make sureds under this endorsement, 5) such course of and insurance coverage provided . equipment leasee hires. arijustm n inspections, business, in to such additional insureds is firm- (c) Vendors • . or servicing as the• • connection ited as provided herein: vendor has agreed with the distri- Or Lessors Of Any person or organization to make or normal- • bution or sale (a) Managers 9 (referred to below as wen- ly undertakes to of the prod- Premises dor) with whom you have make in the usual uds. The manager or lessor of a agreed per Paragraph course of bush- • (i) This insurance does not • premises leased to you with 8.a.(1)of this endorsement • ness,in connection apply to any insured whom you have agreed per to provide insurance,but on- with the distribution , person.or organization: Paragraph 8.a.(1)of this en- ly with respect to'bodily in- or sale of the dorsement to provide insur- • jury" or'property damage" . products; • 1) From whom you anoe, but only with respect arising out of'your products" have acquired to liability arising out of the which are distributed or sold ' 6) Demonstration, in- such products, or ownership, maintenance or in the regular course of the stallation,servicing any ingredient,part Includes copyrighted material of Insurance Includes copyrighted material of Insurance GA 233 0917 Services Office,Inc.,with its permission. Page 11 of 17 GA 233 0917 Services Office,Inc,with its permission. Page 42 of 17 • or container,enter- (e) Mortgagee, Assignee Or in Paragraph 8.a.(1)of this en- tion I-Coverage A-Bodiy Injury ing into,aocompa- Receiver dorsement;or And Property Damage Liability: vying or containing such products;or Any person or organization (2) Available under the applicable Paragraphs(3)and(4)of this exdu- with whom you have agreed Limits of Insurance shown in the sion do not apply to tools or equip- 2) When liability in- per Paragraph 8.a.(1)of this Declarations; ment loaned to you,provided they are duded within the endorsement to provide in- not being used to perform operations "products- whichever is less. surance, but only with re- at the time of loss completed opera- spect to their liability as This endorsement shall not increase • tions hazard" has mortgagee,assignee,or re- thea applicable Limits of Insurance b. With • byrthis to the inft theeee o endorse- beene- exduded un- ceiver and arisingout of the PP ed this section of shown in the Declarations. ment,the follow in additional ovi- der this Coverage ownership,maintenance, org - Partwith respect to use of the premises by you. c. Section IV - Commercial General cions apply: . such products. However, this' insurance Liability Conditions is amended to (1) The Limits of Insurance shown in State Or Governmental does not apply to structural include the following: the Declarations are replaced by (d) alterations,new construction the limits designated in Section Agency Or Subdivision Or and demolition operations Automatic Additional Insured Pro- B. Limits Of Insurance, 9. • Political Subdivision - vision performed by or for that per- Property Damage To Borrowed Permits Or Authorizations son or organization. This insurance applies only if the Equipment of this endorsement Relating To Premises 'bodilyin' or"propertydamage"(3) The insurance afforded to addi- jury' 9 " with respect to coverage provid- Any state or governmental tional insureds described in Par- occurs,or the"personal and advertis- ed by this endorsement.These agency or subdivision or Po- agraph 8.a.(1) of this endorse- ing injury'offense is committed: limits are indusive of and not in litical subdivision with which • menu (1) Duringthe aaddition to the limits being re- you have agreed per Para- P lid period;and • placed.The Limits of Insurance graph 8.a.(1) of this en- (a) Only applies to'the extent (2) Subsequent to your execution of shown in Section B. Limits Of dorsement to provide insur- permitted by law;and the written contract or written Insurance,9.Property Damage ance, subject to the follow agreement,or the issuance of a To Borrowed Equipment of this (b) Will not be broader than that • ing additional provision: written permit or written authori endorsement fix the most we will which you are required by This insurance applies only the written contract,written zation, described in Paragraph pay in any one"occurrence"re-with respect to the following agreement,written permit or 8.a.(1). gardless of the number of: hazards for which the state written authorization to pro- d. Section IV-Commercial General (a) Insureds; or governmental agency or vide for such additional in- Liability Cond@ions is amended as subdivision or political sub- sized;and followr (b) Claims made or "suits" • division has issued a permit brought;or • or authorization in conneo- (c) Does not apply to any per- Condition 5. Other Insurance is . tion with premises you own, son, organization, vendor, amended to include:. (c) Persons or organizations rent or control and to which state, governmental agency making claims or bringing or subdivision orpolitical . And NoncontributoryIn- subdivision, Suits. this insurance applies: Primary specifically surance (2) Deductible Clause (i) The existence, mainte- named as an additional in- nance, ,wnstruc- sired under repair, otherThis insurance is primary to and will P any provi- not seek contribution from any other (a) Our obligation paydam- • tion,erection or removal sion of, or endorsement ages on your behalf applies . of advertising signs, added to, this Coverage insurance available to an additional • only to the amount of dam- awnings,canopies,cel- Part, provided such other insured per Paragraph 8.a.(1)of this ages for each"occurrence" lar entrances, coal provision or endorsement endorsement provided that which are in excess of the . holes, driveways, man- covers the injury or damage (1) The additional insured is a' Deductible Amount stated in holes, marquees, hoist for which this insurance ap- Named Insured under such other Section B.Limits Of Insur- away openings, side- plies: - insurance;and ance,9.Property Damage walk vaults,street ban- b. With respect to the insurance afford- To Borrowed Equipment of ners or decorations and (2) You have agreed in writing in a this endorsement The limits similarexpostres;or ed to the additional insureds de- . onansurescontract, agreement, permit or of insurance will not be re- sorbed in Paragraph 8.a.(1)of this authorization described in 8.a.(2) duced by the application of (ii) The construction,erec- endorsement,the following is added of this endorsement that this in- such deductible amount tion or removal of eleva- to Section III-Limits Of Insurance: surance would be primary and tors;orb Section IV - Commercial • The most we will pay on behalf of the would not seek contribution from or (b) (ill)The ownership,mainte- additional insured is the amount of in- any other insurance available to General Liability Condi- the additional insured, tions, 2. Duties In The mance or use of any el- surance: Event Of Occurrence,Of- evators covered by the 9. Property Damage To Borrowed Equip- tense, Claim Or Suit, a • insurance. (1) Required by the written contract, P ftY 9 q P- P written agreement,written permit meat plies to each daim or"suit" or written authorization describedirrespective of the amount. a. The following is added to Exclusion . 2.j.Damage To Property under Seo- Includes copyrighted material of Insurance Includes copyrighted material of Insurance GA 233 0917 Services Office,Inc.,with Is permission. Page 13 of 17 GA 233 0917 Services Office,Inc,with its permission. Page 14 of 17 • • (c) We may pay any part or all 12. Nonowned Aircraft 16. Voluntary Property Damage Coverage (2) Exclusions of the deductible amount to The followingis added to Exclusion 2.g. a. Coverage D -VoluntaryProperty This insurance does not I to effect settlement of any 9 P rtY apply ' claim or"suit'and,upon no- Aircraft,Auto Or Watercraft under Seo- Damage Coverage "property damage"that would be tfication of the action taken, tion I-Coverage A-Bodily Injury And Section I-Covera es is amended to excluded by Coverage A-Bodl- you shall promptly rein Property Damage Liability: g ly Injury And Property Damage burse us for such part of the This exdusion does not apply an air-to indude the following: Liability,2.Exclusions,except deductiblepaid amount as has craft you do not own,provided that: (1) Insuring Agreement agraphs(3),(4),(5)and(6), Icfor J.Damage To Property,par- . been paid by us. (a) We willthe cost to re- Damage To Your Product,and a.• The pilot in command holds a current pay g 10. Employees As Insureds - Specified effective certificate,issued by a duly pair or replace "property I.Damage To Your Work. Health Cam Services And Good Samar- damage"to property of oth- constituted authority of the United 3 Definitions !tan Services States of America or Canada,desig- era arising out of operations (3) business Paragraph 2a.(1)(d) under Section II- noting that person as a canmerdal or when:incidental to your For purposes of Voluntary Who Is An Insured does not apply to: airline transport pilot Property Damage Coverage only,the following definitions un- a. Your"employee 'who provide pro- b. The aircraft is rented with a trained, 1) you;Damage is caused der Section V-Definitions are fessional health care services on your paid crew;and replaced by the following: • behalf as a duly licensed nurse, C. The aircraft does not transport per- 2) Damage occurs while in emergency medical technician or sons or cargo for a your possession. 16. "Occurrence"means an in- paramedic in the jurisdiction where an charge. cident, including continuous "occurrence"or offense to which this 13. Bodily Injury Redefined At your wrilten request,we or repeated exposure to insurance applies takes place;or will make this payment re- substantially the same gen- Section V-Definitions,4."Bodily injury' gardless of whether you are eral harmful conditions that b. Your"employees"or"vdunteer work- is replaced by the following: at fault for the "property result in"property damage". ers",other than an employed or vol- - damage". unteer doctor, providing first aid or ' 4. "Bodily injury'means bodily harm or 20. 'Property damage" means good samaritan services during their injury, sickness, disease, disability, If you, at our request, re- physical injury to tangible work hours for you will be deemed to humiliation,shock,'fright,mental an- place, or make any repairs property."Electronic data"is be acting within the scope of their guish or mental injury,induding care, to, damaged property of not tangible property, and employment by you or performing du- loss of services or death resulting others, the amount we will 'property damage"does not • ties related to the conduct of your from any of these at any time. pay under Voluntary Prop- indude disappearance, ab- • business. 14. Expected Or Intended Injury Redefined erty Damage Coverage will slradion or theft. P J ry. be determined by your actu- 11. Broadened Notice Of Occurrence The last sentence of Exclusion 22.Ex- al cost to replace or repair b. Care,Custody Or Control Liability •Paragraph a. of Condition 2. Duties In pected Or Intended Injury under Sec- the damaged propery, ex- Coverage. P tion I-Coverage A-BodilyInjury And eluding any profit or over- For purposes of the coverage provid- The Event Of Occurrence, Offense, g j ry head. Claim Or Suit under Section IV-Com Property Damage Liability is replaced by ed by Care,Custody Or Control LI- mercial General Liability Conditions is the following: Any payment we make un- ability Coverage in this endorsement replaced by the following: This exclusion does not apply to'bodily der Voluntary Property only: • a. You must see to it that we are notified. injury'or'property damage"resulting from Damage Coverage shall not (1) Section I-Coverage A-Bodily as soon as practicable of an"occur- the use of reasonable force to protect per- be interpreted as an admis- Injury And Property Damage rence"or an offense which may result sons or property. s n of liability by you or by us Liablliry, 2. Exclusions, J. in aa include:daim.To the edent possible,no- 15. Former Employees As Insureds Damage To Property,Subpara- tice should include: It shall be your duty,not our graphs(3),(4)and(5)do not ap- • • The following is added to Paragraph 2. duty,to defend any daim or ply to'property damage"to the (1) How,when and where the"co- under Section Il-Who Is An Insured: "suit'to which this insurance property of others described urrence"or offense took place; applies. therein. 2. Each of the following is also an in- (2) The names and addresses of sured: • No other obligation or liabt- (2).It shall be your duty,not our duty, any injured persons and wit- • ity to pay sums or perform to defend any daim or"suiY'to , messes;and Any of your former"employees',di- tads or services is covered. which this insurance applies. • rectors, managers, members, part- (3) The nature and location of any ners or"executive officers",including (b) This insurance applies to No other obligation or liability to , injury or damage arising out of but not limited to retired,disabled or 'property damage"only it pay sums or perform acts or ser- • the"occurrence"or offense. those on leave of absence,but only vices is covered. • • This requirement applies only when for acts within the scope of their em- 1) The"property damage" the"oewrence"or offense is known ployment by you or for duties related takes place in the"coy- This Paragraph (2) supersedes • to an"authorized representative" to.the conduct of your business erage teritory';andParany provisiono the contrary. inthe Coverage 2) The"property damage" occurs during the policy (3) "Property damage" for which period. Care,Custody Or Control Lla- bllity Coverage provides cover- Includes copyrighted material of Insurance Includes copyrighted material of Insurance GA 233 0917 Services Office,Inc,with is permission. Page 15 of 17 GA 233 0917 Services Office,Inc.,with its permission. Page 16 of 17 age shall be deemed to be (3) The Voluntary Property Dam- caused by an "ooairrence"but age Coverage,Aggregate Limit shall not serve to limit or restrict Of Insurance is the most we will • the applicability of any exclusion pay for the sum of all damages for"property damage"under this under Voluntary Property Coverage Part. Damage Coverage. This limit . c. Limits Of insurance And Deducti- applieseparately to each"cow t bles erage term'. For purposes of the coverage provid (4) Deductible Clause .ed by Voluntary Property Damage (a) Our obligation to pay dam- Coverage and Care, Custody Or ages on your behalf applies • Control Liability Coverage,Section only to the amount of dam- III-Limits Of Insurance is amended ages for each"occurrence" to include the following: which are in excess of the • (1) The Limits of Insurance shown in Dedudide Amount stated • for the applicable coverage • the Dedarations are replaced by in the Schedule.The limits the limits designated in Section. of insurance will not be re- B. Limits'Of Insurance, 16. duced by the application of Voluntary Property Damage such Deductible Amount. Coverage And Care,Custody Or Control Liability Coverage, (b) Section, IV'- Commercial in this endorsement These limits - General Liability Condi- are indusive of,and not in addi- tions, 2. Duties In The tion to,the limits being replaced. Event Of Occurrence,Of- The Limits of Insurance shown in fense, Claim Or Suit, ap- ' the Schedule for the most we will plies to cad)claim or"suit' pay regardless of the number of: irrespective of the amount. (a) Insureds; (c) We may pay any part or all (b) Claims made or 'Suits' of the Deductible Amount to effect settlement of any brought;or claim or"suit'and,upon no- (c) Persons or organizations tilcation of the action taken, • making daims or bringing you shall promptly reim- •"suite'. burse us for such part of the Deductible Amount as has • (2) (a) Subject to (3) below, the been paid by us. Voluntary Property Dam- age age Coverage,Each Occur- 17. Broadened Contractual Liability-Work ' rence Limit Of'Insurance is ' Within 50'Of Railroad Property . the most we will pay for the Section V-Definitions,12.'Insured con- sum of damages under Vol- tract'is amended as follows: untary Property Damage Coverage; a. Paragraph c.is replaced by the fol- ' (b) The Care,Custody Or Con- lowing: trol Liability Coverage, c. My easement or license agree- • Each Oowrrence Limit Of ment; • Insurance is the most wewill pay for the sum of damages 'b. Paragraph f.(1)is deleted in its entire- under Care, Custody Ort'• Control Liability Coverage; 18. Alienated Premises • ' • because of all"property damage" Exclusion 2j. Damage to Property, • arising out of any one "occur- Paragraph(2)under Section I-Cover • - rence age A - Bodily Injury And Property Damage Liability does not apply if the , premises are'your work". • • • Includes copyrighted material of Insurance GA 233 0917 Services Office,Inc,with as permission. Page 17 of 17 • • • • • • THIS ENDORSEMENT CHANGES THE POLICY.PLEASE READ IT CAREFULLY. b. By way of an edition of an ISO addi. 2. With respect to the insurance afforded to • • tional Insured endorsement that in. the additional insureds described in Para- cludes arising out of your ongoing graph B.1.,the following additional exclu- CONTRACTORS ADDITIONAL INSURED-.AUTOMATIC STATUS operations or arising out of your sionsapply: work"; This insurance does not apply to: AND AUTOMATIC WAIVER OF SUBROGATION Then the phrase caused,in whole or in WHEN REQUIRED IN WRITTEN CONTRACT,AGREEMENT, part,by in Paragraph A.1.a.and/or Para- a. 'Bodily injury','property damage'or . graph A,1.b,above,whichever applies,is "personal and advertising injury'ads- PERMIT OR AUTHORIZATION replaced by the phrase arising out of, ing out of operations performed for the federal government,slate or mu- . • 3. With respect to the insurance afforded to nicipality:or This endorsement modifies insurance provided under the following: the additional Insureds described in Para- °Bodii u graph A,1.,the following additional excl. b. y nJ ry"or"property damage" Sion applies: included within the 'products- COMMERCIAL GENERAL LIABILITY COVERAGE PART completed operations hazard.' • This insurance does not apply to"bodily injury','property damage"or'personal C. The Insurance afforded to additional insureds A. Additional Insured-Owners.Lessees Or cluded in the 'products-completed and advertising injury'arising out of the described in Paragraphs A.and B.: , Contractors-Automatic Status For Other operations hazard',but only if: rendering of,or the failure to render,any 1. Only applies to the extent permitted by Parties When Required In Written Contract professional architectural,engineering or law,and Or Agreement With You (1) The Coverage Part to which this • surveying services,including: endorsement is attached pro- 2. Will not be broader than that which you 1. Section II - Who Is An Insured is vides coverage for'bodily injury - a. The preparing.approving or failing to are required by the written contract.writ- ., amended to include as an additional in- or"property damage"included prepare or approve, maps, shop ten agreement,written permit or written sured any person or organization you within the products-completed drawings.opinions,reports,surveys, authorization to provide for such addition- have agreed in writing in a contract or operations hazard°;and ' field orders,change orders or draw- • al insured:and • agreement to add as an additional in- • ings and specifications:or sured on this Coverage Part.Such per- (2) The written contract or written 3. Does not apply to any person,organize- son(s)or organization(s)is an additional agreement requires you to pro- b..Supervisory,.inspection,architectural tion,state,governmental agency or sub- insured only with respect to liability for: vide additional insured coverage or engineering activities. division or political subdivision specifically included within the °products- named as an additional insured for the • a. 'Bodily injury','properly dame e°or completed operations hazard' This exclusion applies even if the claims P rlY g p p against any insured allege negligence or same project in the schedule of an en- °personal and advertising injury" for that person or organization. 'other wrongdoing in the supervision.hir- dorsement added to this Coverage Part. caused,in whole or in part,by the performance of your ongoing opera- . If the written contract or written' ing,employment,training or monitoring of D. With respect to the insurance afforded to the lions by you or on your behalf,under agreement requires you to provide others by that insured,if the'occurrence additional insureds described in Paragraphs that written contract or written additional insured coverage included which caused the°bodily injury'or'prop- A.and B.,the following is added to Section III agreement.Ongoing operations does • within the"products-completed oper-, erty damage, or the offense which •Limits Of Insurance: not apply to'bodily injury'or'proper- ations hazard°for a specified length caused the"personal and advertising inju- ry damage'occurring after • of time for that person or organize- ry,involved the rendering of.or the fail- The most we will pay on behalf of the addi- • , tion,the'bodily injury"or"property ure to render,any professional architec- tional insured is the amount of insurance: (1) All work. including materials, damage'must occur prior to the ex- Lural,engineering or surveying services. • parts or equipment furnished in piration of that period of time in order 1. Required by the written contract,written connection with such work,on for this insurance to apply. 4. This Paragraph A.does not apply Inaddi• agreement.written permit or written au- the project(other than service, tional insureds described in Paragraph B. thorization described in Paragraphs A. maintenance or repairs)to be If the written contract or written and B.For the purpose of determining the P agreement I re requires you to provide B. Additional Insured-State Or Governmental required amount of insurance only,we will performed by or on behalf of theq y p Agency Or Subdivision Or Political Subdi• q y' Um- additional insured(s)al the loco- additional insured coverage for a g ry include the minimum amount of any Um- erson or organization per only ISO vision-Automatic Status When Required brella Liability or Excess Liabili cover • - tion of the covered operations additional insured endorsement form M Written Permits Or Authorizations age required for that additional insured in • has been completed;or number CG 2010.without specifying that written contract,written agreement. That portion of our work'out of an edition date,and without s ec i- 1. Section 1t - Who Is An Insured is written permit or written authoro:alion;or (2) P yP amended to include as an'additional in- which the injury or damage aril- catty requiring additional insured sured any state or governmental agency 2. Available under the applicable limits of in- • es has been put to its intended coverage included within the'prod- or subdivision or political subdivision you suronce; use by any person or organa- ucts-completed operations hazard', have agreed in writing in a permit or au- lion other than another contrac- . this Paragraph b.does not apply to • thorization to add as an additional insured whichever is less. for or subcontractor engaged in- that person or organization. on this Coverage Part.Such state or gov- performing operations for a prin- ernmental agency or subdivision or polio- This endorsement shall not increase the appli- cipal as a part of the same pro- 2. If the written contract or written agree- cal subdivision is an additional Insured cable limits o(insurance. merit described in Para graph 1.above b jecl;and p only with respect to operations performed specifically requires you t le provide addi- E. Section IV-Commercial General Liability b. 'Bodily injury°or'property damage" tional insured coverage to that person or by you or on your behalf for which the Conditions is amended to add the following: . • caused,in whole or in part,by your. organization: •stale or governmental agency or subdivi- • work'performed under that written Sion or political subdivision has issued,in 'Automatic Additional Insured Provision contract or written agreement and in- a. Arising out al your ongoing opera- writing,a permit or authorization. tions or arising out of your work';or Includes copyrighted material of Insurance . Includes copyrighted material of Insurance GA 472 05 20 Services Office.Inc.,with its permission. Page 1 of 3 GA 472 05 20 Services Office,Inc.,with its permission. Page 2 of 3 • • • • • • This insurance applies only if the"bodily inju- scribed in Paragraph A.or B.that this in- ry"or°property damage"occurs,or the"per- surance would be primary to any other in- sonal and advertising injury"offense is corn- surance available to the additional in- milted: sated. 1. During the policy period;and As used in this endorsement,wrap-up insur- • 2. Subsequent to your execution of the writ- ante means a central¢ed insurance program ten contract or written agreement.or the under which one party has secured either in- 9 surance or self-insurance covering some or all issuance of a written permit or written au- of the contractors or subcontractors perform- thorization,described in Paragraphs A. ing work on one or more specific projectfs). , and B. F. Except when G.below applies,the following is Primary And Noncontributory Insurance When Required By Written Contract, added to Section IV-Commercial General Liability Conditions,Other Insurance,and Agreement,Permit Or Authorization supersedes any provision to the contrary: Except when wrap-up insurance applies to the claim or"suit"on behalf of the additional in- When Other Additional Insured Coverage sured,this insurance is primary to and will not Applies On An Excess Basis seek contribution from any other insurance ' This Insurance is primary to other insurance . available to the additional insured described in available to the additional insured described in Paragraphs A.and B.provided that: Paragraphs A.and B.except: 1. The additional insured is a Named In- 1. As otherwise provided in Section Iv- sured under such other insurance;and • Commercial General Liability Condi- 2. You have agreed in writing in a contract, tions,Other Insurance,b.Excess In. agreement, permit or authorization de- surance;or scribed in Paragraph A.or B.that this in- • 2. For any other valid and collectible insur• surance would be primary and would not ance available to the additional insured as seek contribution from any other incur- an additional insured on another insur- ante available to the additional insured. ante policy that is written on an excess As used in this endorsement,wrap-up insur- basis.In such case,this insurance is also ante means a centralized insurance program excess. • under which one party has secured either in- G. The following•is added to Section IV-Corn- surance or self-insurance covering some or all • mercial General Liability Conditions,Other of the contractors or subcontractors perform- Insurance,and supersedes any provision to leg work on one or more specific project(s). the contrary: H. Section IV-Commercial'General Liability Primary Insurance When Required By Writ- Conditions,Transfer Of Rights Of Rem, • ten Contract,Agreement,Permit Or Au- ery Against Others To Us is amended by the • thorization addition of the following: Except when wrap-up insurance applies to the Waiver of Subrogation claim or"suit"on behalf,of the additional in- We waive any right of recovery against any sured,this insurance is primary to any other additional insured under this endorsement, insurance available to the additional insured because of any payment we make under this • • described in Paragraphs A.and B.provided endorsement, to whom the insured has that: waived its right of recovery ry in a written con- 1. The additional insured is a Named In- tract.written agreement,written permit or writ- sured under such other insurance;and ten authorization.Such waiver by us applies . only to the extent that the insured has waived 2. You have agreed in writing in a contract, its right of recovery against such additional in- agreement.permit or authorization de- sured prior to loss. Includes copyrighted material of Insurance GA 472 05 20 Services Office.Inc..with its permission. Page 3 of 3 • • . • j. THIS ENDORSEMENT CHANGES THE POLICY.PLEASE READ IT CAREFULLY. However,any°auto"that is leased, a. Is effective on the date of acquisition . hired,rented or borrowed with a driver or formation,and is afforded for 180 ' is not a covered'auto'. days after such date: • CIIICIPIUS® E. Audio,Visual and Data Electronic Equip- b. Does not apply to"bodily injury'or BUSINESS AUTO XC+® ment' 'property damage"resulting from an 'accident'that occurred before you • SECTION III-PHYSICAL DAMAGE COV- . ,acquired or formed the o ani2ation; (EXPANDED COVERAGE PLUS) ERAGE,C.Limit of Insurance is amended rg • ENDORSEMENT by adding the following: c. Does not apply to any newly acquired • or formed organization that is a joint 4. The most we will pay for all loss°to au- venture or partnership;and dio,visual or data electronic equipment' This endorsement modifies insurance provided by the following: and any accessories usedwith this d. Does not apply to an insured under _ . equipment as a result of any one"acci- any other automobile liability policy or r BUSINESS AUTO COVERAGE FORM • dent"is the lesser of: would be an insured under such a a. The actu •al cash value of the dam• policy but for the termination of such aged or stolen property as of the time policy or the exhaustion of such poli- With respect to the coverage provided by this endorsement,the provisions of the Coverage Form apply unless g P P ry , .cys limits of insurance. . •modified by this endorsement. of the"accident; • • b. The cost of repairing or replacing the 3. Any of your'employees'while using a P 9 P 9 covered'auto'in your business or•your A. Blanket Waiver of Subrogation This provision does Conot apply unless the valid damaged or stolen property with olh- personal affairs,provided you do not own, . written ntract has been: aproperly of like kind and quality;or hire or borrow that'auto". SECTION IV- BUSINESS AUTO CONDI- c. $2,500. TIONS,A.Loss Conditions,5.Transfer of 1. Executed prior to the accident causing G. Liability Coverage Extensions • Supple• Rights of Recovery Against Others to Us Is "bodily injury or"property damage";and • Provided the equipment,at the time of the mentary Payments-Higher Limits amended by the addition of the following: 2. Is still in force at the time of the"accident" 'loss'is: SECTION II- LIABILITY COVERAGE,A. We waive any right of recovery we may have causing'bodily injury"or°property dam- a. Permanently installed In-or upon the Coverage,2.Coverage Extensions;a.Sup- against any person or organization because of ' age". covered'auto"in a housing,opening elementary Payments is amended by: . payments we make for 'bodily injury" or or other location that is not normally 1. Replacing the$2,000 Limit of Insurance property damage°arising out of the operation D. Employee Hired Auto used by the'auto"manufacturer for for bail bonds with$4,000 in(2);and of a covered'auto'when you have assumed 1, Changes In Liability Cbverage the. installation of.such equipment; ' liability for such°bodily injury"01°property 2. Replacing the$250 Limit of Insurance for damage"under an"insured contract°.provid- The following is added to the SECTION II b. Removable from a permanently in- reasonable expenses with$500 in(4). ed the"bodily injury"or"property damage"oc- • • -LIABILITY COVERAGE,A.Coverage, stalled housing unit as described in curs subsequent to the execution or the°In- • 1.Who Is an Insured: . . Paragraph 2.a.above;or • H. Amended Fellow Employee Exclusion sured contract'. An"employee"of yours is an"insured° c. An integral part of such equipment. SECTION II-LIABILITY COVERAGE,B.Ex- • B. Noncontributory Insurance white operating an"auto"hired or rented F. Who is an Insured-Amended clusions,5.Fellow Employee is modified as , under a contract or agreement in that follows: SECTION IV-:BUSINESS AUTO CONDI- "employee's"name,with your permission, - SECTION II- LIABILITY COVERAGE, A. Exclusion 5.Fellow Employee is deleted. TIONS,B.General.Condifons,5.Other In- while performing duties related to the • Coverage,1.Who is an Insured is amended p oyee surance c,is deleted in its entirety and re- conduct of your business. by adding the following: I. Hired Auto-Physical Damage placed by the following: 2. Changes in General Conditions• The following are"insureds": If hired'autos'ate covered'autos"for Liability c. Regardless of the provisions of Par- 'Coverage,-then Comprehensive and Collision agraph a. above, this Coverage SECTION IV-BUSINESS AUTO CON- 1. Any subsidiary which is a legally incorpo- Physical Damage Coverages as provided on- . Form's Liability Coverage is primary DITIONS, B. General Conditions, 5. rated entity of which you own a financial der SECTION 1I1 - PHYSICAL DAMAGE and we will not seek contribution Other Insurance is deleted in its entirety interest of more than 50%of the voting COVERAGE of this Coverage Pad are ex- from any other insurance for any Iia- and replaced by the following: stock on the effective date of this cover- tended to'autos°you hire,subject to the fob bility assumed under an 'insured age form. b. For Hired Auto Physical Damage lowing: assumed that liability to beg assumed on a primarynoncontrihulo- Coverage the following are deemed' However,the insurance afforded by this , to-be covered°autos'you own: apply to anysubsidiary1. The most we will0 pay for theons'to any ry basis. provision does not hired'auto-is o repair or actual cash that is an Insured"under any other an- value or cost to repair or replace,which- C. Additional Insured by Contract • (1) Any covered'auto°you lease, tomobile lability policy or would be an'in• ever is the least,minus a deductible. hire:rent or borrow;and • sured'under such policy but for terming- . - SECTION II- LIABILITY COVERAGE,A. • 2 An covered "auto" hired or • lion of such policy or the exhaustion of 2. The deductible will be equal to the largest Coverage,1.Who is an Insured is amended () ysuch ofi s limits include as an insured any person or organi- rented by your"employee"under p h of insurance. deductible applicable to any owned'auto' cation for whom you have agreed in a valid a contract in that individual"ern- , for that coverage,or$1,000,whichever is to ee's°name,with your . Any organization that is newly acquired or less: written by this pt to provide insurance as,al- P.Y Y r Per• formednmajority by you and over whichhyou ranch • forded this policy. mission,while performing duties lain ownership. The insurance 3. Hired Auto-Physical Damage coverage related to the conduct of your provided by this provision: is excess over any other collectible Insur• • . This provision is limited to the scope of the business. ante. ' valid written contract. Includes copyrighted material of ISO Includes copyrighted material of ISO ' AA 288 06 20 Properties;Inc.,with its permission. Page 1 of 4 AA 288 06 20 Properties.Inc..with Its permission. Page 2 of 4 • • • • • • • 4. Subject to the above limit,deductible.and K. Transportation Expense-Higher Limits 2. SECTION V-DEFINITIONS is amended P. Unintentional Failure to Disclose Hazards excess provisions we will provide cover- by adding the following,but only for the - age equal to the broadest coverage a I'F SECTION III-PHYSICAL DAMAGE COV- SECTION IV-BUSINESS AUTO CONDI- g pppurposes of Loan or Lease Gap cable any coveredpofic'auto'you own in- ERAGE,is Coverage,4.pl Coverage dh- "Coverage: TIONS,MisrepresentationB. epsl atioor 2.Cois • sured under this policy. with$is amended ay replacing xi per day meet reprothe i g: Fraud is with$50 per day,and$600 maximum with "Total loss'means a°loss'in which the amended by adding the following: Coverage includes loss of use of that hired au- $1,500 maximum in Extension a.Transpor- cost of repairs plus the salvage value ex- However.if you unintentionallyfail to disclose to.provided it results from an°accident°for tation Expenses. ceeds the actual cash value. anyeveexistingthe ffail to date of which you are legally liable and as a result of on which a monetary loss is sustained by the L. Airbag Coverage .. N. Glass Repair-Waiver of Deductible this Coverage Form,we will not deny cover- leasing or rental concern.The•most we will age under this Coverage Form because of a for an one accident is$3,O00. SECTION III-.PHYSICAL DAMAGE COV- SECTION III-PHYSICAL DAMAGE COV- such failure. pay y ERAGE,B.Exclusions,3.a.is amended by ERAGE,D.Deductible is amended by adding If a limit for Hired Auto-Physical Damage'is adding the following: the following: Q. Mental Anguish Resulting from Bodily Inju- shown in the Schedule,then that limit replac- However, the mechanical and electrical No deductible applies to glass damage if the ry es,and is not added to,the$50,000 limit indi. .,breakdown portion of this exclusion does not • glass is repaired in a manner acceptable to us SECTION V-DEFINITIONS,C."Bodily Inju- cated above and the deductibles shown in the apply to the accidental discharge of an airbag. rather than replaced. • ry'•is deleted in its entirety and replaced by Schedule are applicable. • This coverage for airbags is excessover any • the following: . J. Rental Reimbursement other collectible insurance or warranty. 0. Duff es in the Event of an Accident,Claim, Suitor Loss-Amended "Bodily injury"means bodily injury,sickness or •SECTION III-PHYSICAL DAMAGE COV- M. Loan or Lease Gap Coverage disease sustained by a person,including men- ERAGE is amended by adding the following: SECTION -BUSINESS AUTO CONDI- tat anguish and death sustained by the same 1. SECTION III - PHYSICAL DAMAGE TIONS,A.Loss Conditions,2.Duties In the .. person that results from such bodily injury, .1 •We will pay for rental reimbursement ex- COVERAGE,C..Limit•of Insurance is Event of Accident,Claim,Suitor Loss,a-is sickness or disease."Bodily injdry"does not penes incurred by you for the rental of deleted in its entirety and replaced by the amended by adding the following: include mental anguish or death that does not an'auto'because of a loss"to a covered. following,but only for private passenger 'auto'.Payment applies in addition to the' type'autos'with an original loan or lease. This condition apples only when the"acci- result from bodily injury,sickness or disease. and onlyin the event of a"total loss"to dent'or loss'is known to: R. Coveragefor Certain Operations in Con- otherwise applicable amount of eacho.No P erage you have on a covered auto'.No such a private passenger type"auto": 1. You,if you are an individual; .Section with Railroads deductible applies to this coverage. a. The most we will pay for loss"in any 2. A partner,if you are a partnership; With respect to the use of a covered'auto"in • 2. We will pay only for those expenses in- one'accident°is the greater of: operations for or affecting a railroad: oared during the policy period beginning (1).The amount due under the terms 3. An executive officer or insurance manag- 1. SECTION V-DEFINITIONS,H.'Insured 24 hours after the°loss°and ending,re- , of er,if you area corporation;or gardless of the policy$expiration,with of the lease or loan to which contract",1.c,is deleted in its entirety and the lesser of the following number of your covered private passenger 4. A member or manager,if you area lira- replaced by the foiloviing: 0 • include: days: type deuto°is subject,but will not • Toed liability company. c. An easement or license agreement; y a. The number of days reasonably re- 2. SECTION V V.DEFINITIONS,H."Insured . ' quired to repair the covered"auto".If (a)�Oveidue •lease or loan pay- contract",2.a.is deleted. "loss"is caused by(heft.this number mems; I • of days is added to the number of (b) Financial penalties imposed . days it takes to locale the covered under the lease due to high • ' . •"auto"and return it to you;or mileage,excessive use or ' b. 30 days. abnormal wear and tear, ' 3, Our payment is limited to the lesser of the (c) funded by the lessor,of re • - following amounts: (d) Costs for extended woman- a. Necessary and actual expenses in- ties,.Credit Life Insurance, curred;or ` Health,Accident or DisabiF • • b. $50 per day. ity Insurance purchased - with the loan or lease;and - , 4. This coverage does not apply while there are spare or reserve'autos'available to (e) Carry-over balances from . . you for your operations. previous loans or leases.or 5. We will pay under this coverage only that (2) Actual cash value of the stolen • • amount of your rental reimbursement ex. or damaged property. penses which is not already provided for b. An adjustment for depreciation and under SECTION III-PHYSICAL DAM- physical condition will be made in de- AGE COVERAGE, A. Coverage, 4. termining actual cash value at the, • . Coverage Extensions. 'time of loss". . • • ' Includes copyrighted material of ISO Includes copyrighted material of ISO AA 288 06 20 Properties,Inc.,with its permission. - Page 3 of 4 AA 288 06 20 Properties,Inc.,with its permission. Page 4 of 4 • . • -LV • .