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HomeMy WebLinkAboutInsurance Certificate: Welburn ELectric Inc ,----41 ® DATE(MM/DDIYYYY) A�D CERTIFICATE OF LIABILITY INSURANCE • 9/29/2023 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. Protectors Insurance, LLC PHONE Theresa Watson FAX P.O. Box 4669 INC.No.Ext):541-773-5358 (A/c,No):541-772-1906 • Medford OR 97504 ADDRESS: TheresaW@Protectorslns.com INSURER(S)AFFORDING COVERAGE NAIC# • INSURERA:The Cincinnati Insurance Co 10677 INSURED WELBU-1 INSURERS:SAIF Corporation • 36196 Welburn Electric Inc . PO Box 329 INSURER C: Phoenix OR 97535 INSURERD: • INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:7880081 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 WLIMITS LTR INSD VD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) A X COMMERCIAL GENERAL LIABILITY Y Y EPP0295267 12/23/2022 10/1/2025 EACH OCCURRENCE _51,000,000 DAMAGE CLAIMS-MADE X OCCUR PREM SESO(Ea occurrence) $500,000 MED EXP(Any one person) $10,000 • PERSONAL&ADV INJURY $1,000,000 GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 POLICY X 781, . LOC . PRODUCTS-COMP/OP AGG_ $2,000,000 OTHER: • $ A AUTOMOBILE LIABILITY Y Y EBA0295267. 10/1/2023 10/1/2024 COMBINED SINGLE LIMIT $1,000,000 (Ea accident) X ANY AUTO BODILY INJURY(Per person) $ • OWNED SCHEDULED • BODILY INJURY(Per accident) $ ' AUTOS ONLY AUTOS _ HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY (Per accident) A X UMBRELLA LIAB X OCCUR EPP0295267 12/23/2022 10/1/2025 EACH OCCURRENCE $5,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE _ $ DED RETENTIONS ' $ • B WORKERS COMPENSATION 488390 10/1/2023 10/1/2024 X STATUTE OERH AND EMPLOYERS'LIABILITY Y I N • ' ANYPROPRIETOR/PARTNER/EXECUTIVE Y NIA E.L.EACH ACCIDENT' $1,000,000 OFFICER/MEMBER EXCLUDED? -- --- -- - (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below . . E.L.DISEASE-POLICY LIMIT $1,000,000 A Professional . EPP0295267 12/23/2022 10/1/2025 1,000,000 5,000 deductible A Pollution EPP0295267 12/23/2022 10/1/2025 1,000,000 3,000 deductible A Installation Floater EPP0295267 12/23/2022 10/1/2025 500,000 1,000 deductible DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached.if more space is required) Certificate Holder is Additional Insured when required by written contract per forms GA233 and GA472.For Commercial Auto per form AA288.Forms include Waiver of Subrogation,Primary/Noncontributory language,Ongoing and Completed Operations language. l • CERTIFICATE HOLDER CANCELLATION • SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Ashland 20 E Main St AUTHOR! ESENTATIVE Ashland OR 97520 I . ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) . The ACORD name and logo are registered marks of ACORD • www.saif.com IIIA saift; . Carrier no: 20001. Endorsement no: WC000313 (Ed. 430B) SAIF policy: 488390 Welburn Electric Inc • Waiver of Our Right to Recover from Others Endorsement We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. Schedule Description: ALL OPERATIONS Contractor name: Persons and/or organizations with whom the insured-employer is requiredby written contract to waive subrogation rights. This endorsement does not alter the rights of an injured worker to pursue recovery from another party or SAIF to receive a statutory share of recoveries by an injured worker, even from the party listed in the schedule. The premium charge for this endorsement is based on one (1) percent of your manual premium. Effective date: October 01, 2023 This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. Countersigned September 14, 2023 at Salem, Oregon WC000313 Chip Terhune (Ed. 430B) President and Chief Executive Officer • 400 High Street SE Salem,OR 97312 P:800:285.8525 • F:503.373.8020 Pol PC1 E430a • 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 0 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 "property damage"arising out of the operation D. Employee Hired Auto of a covered "auto" when you have assumed 1. Changes in Liability Coverage liability for such "bodily injury" or "property . damage" under an "insured contract", provid- The following is added to the SECTION II ed the "bodily injury"or"property damage"oc-. - LIABILITY COVERAGE, A. Coverage, curs subsequent to the execution or the "in- 1.Who is an Insured: sured contract". An "employee" of yours is an "insured" B. Noncontributory Insurance while operating an "auto" hired or rented under a contract or agreement in that SECTION IV - BUSINESS AUTO CONDI- "employee's" name,with your permission, TIONS, B. General Conditions, 5. Other In- while performing duties .related to the surance c. is deleted.in its entirety and re- conduct of your business. placed by the following: c. Regardless of the provisions of Par- 2. Changes in General Conditions agraph a. above, this Coverage SECTION IV - BUSINESS AUTO CON- Form's Liability Coverage is primary DITIONS, B. General Conditions, 5. and we will not seek contribution Other Insurance is deleted in its entirety from any otherinsurance for any Iia- and replaced by the following: bility assumed under an "insured contract" that requires liability'to be . b. For Hired Auto Physical Damage assumed on a primary noncontributo- Coverage the following are deemed ry basis. 0 to be covered "autos"you own: C. Additional Insured by Contract (1) Any covered "auto", you lease, • hire, rent or borrow; and SECTION II - LIABILITY COVERAGE, A. Coverage, 1.Who is an Insured is ameded' (2) Any covered "auto" hired or to include as an insured any person or organi- rented by your employee under zation for whom you have agreed in a valid a contract'in that individual "em- written contract to provide insurance as af- ployee's" name, with your per- forded by this policy. mission, while performing duties related to the conduct of your This provision is limited to the 'scope of the business. valid written contract. Includes copyrighted material of ISO AA 288 06 20 . 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 "accident" that occurred before you SECTION III - PHYSICAL DAMAGE COV- • acquired or formed the organization; ERAGE, C. Limit of Insurance is amended 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 and any accessories used with this d. Does not apply to an insured under equipment as a result of any one "acci- any other automobile liability policy or dent"is the lesser of: would be an insured under such a policy but for the termination ofsuch a. The actual cash value of the dam- policy or the exhaustion of such poli- aged or stolen property as of the time cys limits of insurance. of the"accident"; b. The cost of repairing or replacing the 3. Any of your "employees" while using a 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 P g used by the "auto" manufacturer for for bail bonds.with $4,000 in.(2); and the installation of such equipment; b. Removable from a permanently in- 2. Replacing the $250 Limit of Insurance for reasonable expenses with$500 in(4). stalled housing unit as described in Paragraph 2.a.above; or H. Amended Fellow Employee Exclusion c. An integral part of such equipment. SECTION II-LIABILITY COVERAGE, B. Ex- F. Who is an Insured-Amended 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 Coverage, then Comprehensive and Collision 1. Any subsidiary which is•a legally incorpo- Physical Damage Coverages as provided un- rated entity of which you own a financial der SECTION III - PHYSICAL DAMAGE • interest of more than 50% of the voting COVERAGE of this Coverage Part are ex- stock on the effective date of this cover- tended to "autos" you hire,subject to the fol- age form. 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 "in- ever is the least, minus a deductible. sured" under such policy but for termina- tion 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" 2. Any organization that is newly acquired orfor that coverage, or$1,000,whichever is less. formed by you and over which you main- tain majority ownership. The insurance 3. Hired Auto - Physical Damage coverage provided by this provision: is excess over any other collectible insur- ance. Includes copyrighted material of ISO AA 288 06 20 Properties, Inc.,with its permission. Page 2 of 4 4. Subject to the above limit,deductible,and K. Transportation Expense-Higher Limits excess provisions we will provide cover- , age equal to the broadest coverage appli- SECTION III - PHYSICAL DAMAGE COV- cable to any covered "auto" you own in- ERAGE, A. Coverage, 4. Coverage' Exten- sured under this policy. sions is amended by replacing $20 per day with $50 per' day, and $600 maximum with Coverage includes loss of use of that hired au- $1,500 maximum in Extension a. Transpor- to, provided itresults from an "accident" for tation Expenses. which you are legally liable and as a result of ' which a monetary loss is sustained by the L. Airbag Coverage leasing or rental concern. The most'we will . SECTION III - PHYSICAL DAMAGE COV- pay for any one "accident"is$3,000. ' ERAGE, B. Exclusions, 3.a. is amended by If a limit for Hired Auto - Physical Damage is adding the following: shown in the Schedule, then that limit 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 and the deductibles shown in the apply to the accidental discharge of an airbag. Schedule are applicable. This coverage for airbags is excess over any J. Rental Reimbursement other collectible insurance or warranty. SECTION III - PHYSICAL DAMAGE COV- M. Loan or Lease Gap Coverage ERAGE is amended by adding the following: 1. SECTION III .- PHYSICAL DAMAGE 1. We will pay for rental reimbursement ex- COVERAGE, C. Limit of Insurance is penses incurred by you for the rental of deleted in its entirety and replaced by the 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, otherwise applicable amount of each cov- and only in the event of a "total loss" to . erage you have on a covered "auto". No such a private passenger type "auto": deductible applies to this coverage., a. The most we will pay for"loss"in any 2. We will pay only for those expenses in- one "accident"is the greater of: •'curred during the policy period beginning (1) The amount due under the terms 24 hours after the "loss" and ending, re- of the lease or loan to which gardless of the policy's 'expiration, with your covered private passenger the lesser of the following number of type "auto"is subject, but will not days: include: a. . The number of days reasonably re- (a) Overdue lease or loan pay- quired to repair the covered "auto". If • ments; "loss" is caused by theft,this number of days is added to the number of (b) Financial penalties imposed days it takes'to locate the covered under the lease due to high "auto"and return it to you; or mileage, excessive use or b. 30 days. abnormal wear and tear; 3. Our payment is limited to the lesser of the (c) Security depositsnot re- funded by the lesssor; following amounts: a. Necessary and actual expenses in- (d) Costs for extended warran- ties, Credit Life Insurance, Health, Accident or Disabil- b. $50 per day. .ity Insurance purchased with the loan or lease; and 4. This coverage does not apply while there • are spare or reserve "autos" available to (e) Carry-over balances from you for your operations. previous loans or leases, or 5. We will pay under this coverage only that (2) Actual cash value of the stolen amount of your rental reimbursement ex- or damaged property. penses which is not already provided for b. An adjustment fo)r 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 AA 288 06 20 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- TIONS, of this Loan or Lease Gap Coverage: TIONS; B. General Conditions, 2. Conceal- ment, Misrepresentation 'or Fraud is 'Total loss" means'.a "loss" in which the amended by,adding the following: cost of repairs plus the salvage value ex- ceeds the actual cash value.- However, if you unintentionally fail to disclose • any hazards existing on the effective date of N. Glass Repair-Waiver of Deductible this Coverage-Form, we will not deny cover- SECTION ;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- ratherthan 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 tal anguish and death sustained by the same Event of Accident,Claim,Suit ora.is person that results from such bodily injury, Loss, sickness or disease. "Bodily injury" does not amended by adding the following: include mental anguish or death that does not This condition applies only when the "acci- result from bodily injury, sickness or disease. dent"or"loss"is known to: R. Coverage for Certain Operations in Con- 1. You,if you are an individual; nection with Railroads 2. A partner, if you are a partnership; With respect to the use•of a covered "auto" in operations for or affecting a railroad: 3. An executive officer or insurance manag- er, if you area corporation; or 1. SECTION V DEFINITIONS, H. "Insured contract", 1.c.is deleted in its entirety and 4. A member or manager, if you are a lim- ' replaced by the following: ited liability company. • c. An easement or license agreement; 2. SECTION V - DEFINITIONS, H. "Insured contract",2.a.is deleted. Includes copyrighted material of ISO AA 288 06 20 ' Properties, Inc.,with its permission. Page 4 of 4 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 writtenadditional insured coverage included • agreement.Ongoing operations does , within the "products-completed oper- not apply to "bodily injury"or"proper- ations hazard" fora 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 Ioca- 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 organiza- ucts-completed operations hazard", tion other than another contrac- this Paragraph b. does not apply to tor or subcontractor engaged in that person or organization. • performing operations for a prin- cipal as a part of the same pro- 2. If the written contract or written agree- ject; and ment described in Paragraph 1. above specifically requires you to provide addi- • b. "Bodily injury" or "property damage" tional insured coverage to that person or caused, in whole or in part, by"your organization: work" performed under that written contract or written agreement and.in- • a. Arising out of your ongoing opera- tions or arisingout of'your work"; or Includes copyrighted material of Insurance GA 472 05 20 Services Office; Inc., with its permission. Page 1 of 3 b. By way of an edition of an ISO addi- 2. With respect to the insurance afforded to tional insured endorsement that in- the additional insureds described in Para- cludes arising out of your ongoing graph B.1., the following additional exclu- operations or arising out of "your sions apply: wore; This insurance does not apply to: then the phrase caused, in whole or in part, by in Paragraph A.1.a. and/or Para- a. Bodily injury, "property damage" or graph A.1.b. above, whichever applies, is "personal and advertising injury"aris- replaced by the phrase arising out of. ing out of operations performed for thefederal government, state or mu- 3. With respect to the insurance afforded to nicipality; or the additional insureds described in Para- graph A.1., 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. The preparing, approving or failing to 2. Will not be broader than .that which you are required by the written contract, writ- prepare or approve, maps, shop ten agreement, written permit or written drawings, opinions, reports, surveys, . authorization to provide for such addition- field orders, change orders or draw- al insured; and ings and specifications; or 3. Does not apply to any person, organiza- b. Supervisory, inspection, architectural tion, state, governmental agency or sub- or engineering activities. division 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" additional insureds described in Paragraphs which caused the "bodily injury" or "prop- 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 bythe 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. For the purpose of determining the required amount of insurance only,we will Agency Or Subdivision Or Political Subdi- include the minimum amount of any Urn- vision - Automatic Status When Required brella Liability or Excess Liability cover- In Written Permits Or Authorizations age required for that additional insured in 1. Section II - Who Is An Insured is that written contract, written agreement, amended to include as an additional in- written permit or written authorization; or sured any state or governmental agency . 2. Available under the applicable limits of in- or subdivision or political subdivision you surance; have agreed in writing in a permit or au- thorization to add as an additional insured whichever is less. on this Coverage Part. Such state or gov- ernmental agency or subdivision or politi- This endorsement shall not increase the appli- cal subdivision is an additional insured cable limits of insurance. only with respect to operations performed E. Section IV - Commercial General 'Liability by you or on your behalf for which the Conditions is amended to add the following: state or governmental agency or subdivi- sion or political subdivision has issued, in Automatic Additional Insured Provision writing, a permit or authorization. Includes copyrighted material of Insurance GA 472 05 20 Services Office, Inc., with its permission. Page 2 of 3 1' This insurance applies only if the "bodily inju- • scribed in Paragraph A. or B.that this in- ry" or "property damage" occurs, or the "per- surance would be primary to any other in- sonar and advertising injury" offense is corn- surance available to the additional in- mitted: •sured. 1. During the policy period; and As used in this endorsement, wrap-up insur- ance2. Subsequent toyour execution of the writ= means a centralized insurance program q under which one party has secured either in- ten contract or written agreement, or the 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 project(s). and B. • F. Except when G.below applies,the following is Primary. And Noncontributory Insurance When Required added to Section IV - Commercial General Or Authorization PermitBy Written Contract, Liability Conditions, Other Insurance, and Agreement, supersedes any provision to the contrary: Except when wrap-up insurance appliesto the Other Additional Insured Coverage claim or "suit" on behalf of the additional in- Wheng sured, this insurance is primary to and will not Applies On An Excess Basis seek contribution from any other insurance This insurance is primary to other insurance available to the additional insured described in available to the additional insured described in Paragraphs A.and B.provided that: Paragraphs A.and B.except: 1. The additional insured is a Named In- 1.- As otherwise provided in Section IV -/ sured under such other insurance; and Commercial General Liability Condi- 2. You have agreed in writing in a contract, tions, Other Insurance, b. Excess In- agreement, permit or authorization de- surance; or scribed in Paragraph A. or B.that this in- . 2. For any other valid and collectible insur- surance would be primary and would not ance available to the additional insured as seek contribution from any other insur- an additional insured on another insur- ante available to the additional insured. ance policy that is written on an excess As used in this endorsement, wrap-up insur- basis. In such case,this insurance is also ' ance means a centralized insurance program excess. under which one party has secured either in- G. The following is added to Section IV - 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 ing work on one or more specific project(s). the contrary: H. Section IV - Commercial General Liability Primary Insurance When Required By Writ- Conditions, Transfer Of Rights Of Recov- ten Contract, Agreement, Permit Or Au- ery Against Others To Us is amended by the thorization addition of the following: Except when wrap-up insurance applies to the Waiver of Subrogation claim or "suit" on behalf of the additional in- We waive any right of recovery against any sured, this insurance is primary to any other additional insured under this endorsement, insurance available-to the additional insured because of any payment we make under this described in Paragraphs A. and B. provided endorsement, to whom the insured has that: waived its right of recovery in a written con- 1. The additional insured is a Named In- tract,written agreement, written permit or writ- sured under such other insurance; and ten authorization. Such waiver by us applies only to the extent that the insured has waived 2. You have agreed in writing in a contract, its right of recovery against such additional in- agreement, permit or authorization de- sured prior to loss. ' • Includes copyrighted material of Insurance GA 472 05 20 Services Office, Inc., with its permission. Page 3 of 3 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. • • CONTRACTORS' 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 2 9. Property Damage To Borrowed Equipment 14 10. Employees As Insureds- Specified Health Care Services And Good-Samaritan • Services 15 11. Broadened Notice Of Occurrence 15 12. Nonowned Aircraft 15 13. Bodily Injury Redefined 15 14. Expected Or Intended Injury Redefined 15 15. Former Employees As Insureds 15 16. Voluntary Property Damage Coverage And Care, Custody Or Control Liability Coverage 16. 17. Broadened Contractual Liability-Work Within 50' Of Railroad Property 17 18. Alienated Premises • 17 B. Limits Of Insurance: The Commercial General Liability Limits of Insurance apply to the insurance provided by this endorse- ment, except as provided below: 1. Employee Benefit Liability-Coverage • Each Employee Limit: $1,000,000 Aggregate Limit: $3,000,000 Deductible Amount: $ 1,000 3. Damage To Premises Rented To You The lesser of: • a. The Each Occurrence Limit shown in the Declarations;or b. $500,006 unless otherwise stated$ 4. Supplementary Payments • a. Bail Bonds: $2;500 • .) Includes copyrighted material of Insurance GA 233 09 17 - ServicesOffice, Inc.,with its permission. Page.1 of 17 b. Loss Of Earnings:$ 500 5. Medical Payments Medical Expense Limit:$ 10,000 9. Property Damage To Borrowed Equipment Each Occurrence Limit: $10,000 Deductible Amount: $ 250 • 16. Voluntary Property Damage Coverage (Coverage a.) And Care, Custody Or Control Liability Coverage(Coverage b.) Limits Of Insurance • Coverage a. $1,000 Each Occurrence $5,000 Aggregate Coverage b.$5,000 Each Occurrence unless otherwise stated$ Deductible Amount(Each Occurrence) • Coverage a.$250 Coverage b.$250 unless otherwise stated$ COVERAGE PREMIUM BASIS RATE ADVANCE PREMIUM (a) Area (For Limits in Excess of (For Limits in Excess of (b) Payroll $5,000) $5,000) (c) Gross Sales (d) Units (e) Other b. Care, Custody Or Control TOTAL ANNUAL PREMIUM ( Includes copyrighted material of Insurance GA 233 09 17 Services Office, Inc.,with its permission. Page 2 of 17 • C. Coverages this endorsement pro- 1. Employee Benefit Liability Coverage vided: a) You did not have a. The following is added to Section I - knowledge of a Coverages: ' claim or"suit"on or Employee Benefit Liability Cover- . before the "first ef- age fective date" of this endorsement. (1) Insuring Agreement •You will be (a) We will pay those sums that deemed to have the insured becomes legally knowledge of a obligated to pay as damag- claim or "suit" es caused by any act, error when any "author- or omission of the insured, , ized representa- • or of any other person for tive"; whose acts the insured is legally liable, to which this i) Reports all, or insurance applies. We will any part,of the have the right and duty to act, error or defend the insured against omission to us any "suit" seeking those or any other damages. However, we will insurer; have no duty to defend ii) Receives • a against any "suit" seeking written or ver- damages to which this in- bal demand or surance does not apply. We claim for dam- may, at our discretion, in- ages because vestigate any report of an of the act, er- act, error or omission and ror or omis- . settle any claim or"suit'that sion; and may result. But: 1) The amount we will pay . . b) There is no other for damages is limited. applicable insur- ance. as described in Section Ill - Limits Of• Insur- (2) Exclusions ance; and This insurance does not apply to: 2) Our right and duty to • defend ends when we (a) Bodily Injury, Property have used up the appli- Damage Or Personal And • cable limit of insurance Advertising Injury . in the payment of judg- "Bodily injury", "property ments or settlements. damage" or "personal and , Noother obligation or liabil- - advertising injury". ity to pay sums or perform (b) Dishonest, Fraudulent, acts or services is covered Criminal Or Malicious Act unless explicitly provided for under Supplementary Damages arising out of any ' Payments. intentional, dishonest, (b) This insurance applies to fraudulent, criminal or mali- damages only if the act, er- cious act, error or omission, committed by any insured, ror or omission, is negligent- including the willful or reck- ly committed in the "admin- less violation of any statute. istration" of your,"employee benefit program"; and (c) Failure To Perform A Con- tract1) Occurs during the policy ' - period; or Damages arising out of fail- 2) Occurred prior to the ure of performance of con- tract by any insurer."first effective date" of Includes copyrighted material of Insurance GA 233 0917 Services Office, Inc.,with its permission. Page 3 of 17 • • (d) Insufficiency Of Funds (i) .Taxes, Fines Or Penalties Damages arising out of an Taxes, fines or penalties, in- insufficiency of funds to cluding those imposed un- meet any obligations under der the Internal Revenue • any plan induded .in the ' Code or any similar state or "employee benefit program". . local law. (e) Inadequacy Of Perfor- a) Employment-Related Prac- mance Of Invest- tices ment/Advice Given. With Respect To Participation Any liability arising out of any: Any daim based upon: (1) Refusal to employ; 1) Failure of any invest- ment to perform; (2) Termination of employ- ment; 2) Errors in. providing in- formation on past per- (3) Coercion, demotion, • fomiance of investment evaluation, reassign- vehicles; or ment, discipline, defa- mation, harassment, 3) Advice given to any humiliation, discrimina- person with respect to tion or other employ- that person's decision to ment- related practices, participate or not to par- acts or omissions;or ticipate in any plan in- cluded in the "employee (4) C.Consequential ti l liabilit benefit program . as a (1), (2) or (3)above. (f) Workers' Compensation And Similar Laws This exclusion applies whether the insured may be Any claim arising out of your held liable as an employer failure to comply with the or in any other capacity and mandatory provisions of any .to any obligation to share workers' compensation, un- damages with or repay employment compensation someone else who must pay insurance, social security or damages because of the in- disability benefits law or any jury.• . similar law. (3) Supplementary Payments (g) ERISA Section I - Coverages, Sup- Damages for which any in- plementary Payments - Cover • - sured is liable because of li- ages A And B also apply to this ability imposed on a fiduci- Coverage. ary by the Employee Re- ' tirement ' Income Security b. Who Is An Insured Act of 1974, as now or . As respects Employee Benefit Lia- hereafter amended, or by bility Coverage, Section II-Who Is any similar federal, state or , An Insured is replaced by the follow- local laws. ing: • (h) Available Benefits (1) If you are designated in the Dec- . 'Any claim for benefits to the larations as: extent that such benefits are (a) An individual, you and your available, .with reasonable spouse are insureds, but on- effort and cooperation of the ly with respect to the con- insured, from the applicable duct of a business of which funds accrued or other col- you are the sole owner. lectible insurance. (b) A partnership or joint ven- ture, you are an insured. Your members, your part- Includes copyrighted material of Insurance GA 233 0917 Services Office, Inc.,with its permission. Page 4 of 17 ners, and their spouses are zation. However, coverage under also insureds but only with this provision: respect to the conduct of your business. (a) Is afforded only until the 180th day after you acquire (c) A limited liability company, or form the organization or you are an insured. Your the end of the policy period, members are also insureds, whichever is earlier; and but only with respect to the conduct of your business. (b) Does not apply to any act, Your managers are in- error or omission that was sureds, but only with respect committed before you ac- to their duties as your man- quired or formed the organi- agers. zation. (d) An organization other than a c. Limits Of Insurance - 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 respect to their duties as (1) The Limits of Insurance shown in your officers or directors. Section B. Limits Of Insurance, Your stockholders are also 1. Employee Benefit Liability insureds, but only with re- Coverage and the rules below fix spect to their liability as the most we will pay regardless stockholders. of the number of: (e) A trust, you are an insured. (a) Insureds; Your trustees are also in- sureds, but only with respect (b) Claims made or "suits" to their duties as trustees. brought; (2) Each of the following is also an• (c) Persons or organizations insured: making claims or bringing "suits"; (a) Each of your "employees" - who is or was authorized to (d)• Acts,errors or omissions; or administer your "employee (e) Benefits induded 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 (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- nership, joint• venture or limited tained by any one "employee", liability company,and over which including damages sustained by you maintain ownership or major- such "employee's" dependents ity interest, will qualify as a . and beneficiaries, as a result of: Named Insured if no other similar (a) An act, error or omission; or insurance applies to that organi- Includes copyrighted material of Insurance GA 233 0917 Services Office, Inc.,with its permission. Page 5 of 17 (b) A series of related acts, er- tification of the action taken, l'ors 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- ee employee benefit program". As respects Employee Benefit Lia- bility Coverage, Section IV - Corn- However, the amount paid under mercial General Liability Condi- this endorsement shall not ex- tions is amended as follows: Geed, and will be sutiject to the limits and restrictions that apply (1) Item 2. Duties In The Event Of to the payment of benefitsin any • Occurrence, Offense, Claim Or plan included in the "employee Suit is replaced by the following: benefit program." 2. Duties In The Event Of An (4) Deductible Amount Act, Error Or Omission,Or Claim Or Suit (a). Our obligation to pay dam- ages on behalf of the in- a. You must see to it that sured applies only to the we are notified as soon amount of damages in ex- as practicable of an act, cess of the Deductible • error or omission which Amount stated in the Decla- may result in a claim. • rations as applicable to To the extent possible, Each Employee. The limits notice should include: of insurance shall not be re- (1) What the act, error duced by theamount 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 tained 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, ficiaries, 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, ny 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 2) Your duties,and the du-, as practicable. 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. (1) Immediately send (d) We may pay any part or all us copies of any of the Deductible Amount to demands, notices, effect 'settlement of any summonses or le- claim or "suit" and, upon no- gal papers re- Includes copyrighted material of Insurance GA 233 0917 Services Office, Inc.,with its permission. Page 6 of 17 ceived in connec- tion by equal shares, tion with the claim we will followthis meth- • or"suit"; od also. Under this ap- (2) Authorize us to ob- proach each insurer contributes equal tain records and amounts until it has other information; paid its applicable limit (3) Cooperate with us of insurance or none of in the investigation the loss remains, or settlement of the whichever comes first. claim or defense ' If any of the other in- against the "suit"; surance does not permit and . contribution by equal • (4) Assist us, upon our shares, we will contrib- request, in the en- ute, by limits. Under this forcement of any method, each insurer's right against any . share is based on the person or organi- ratio of its applicable zation which may limit of insurance to the be liable to the in- total applicable limits of sured because of insurance of all insur- an act, error or ers. omission to which c. No Coverage this insurance may also apply. This insurance shall not d. No insured will, except cover any loss for which the insured is entitled to at that insured's own recovery under any cost, voluntarily make a other insurance in force payment, assume any previous to the effective obligation, or incur any date of this Coverage expense without our Part. consent. (2) Item 5. Other Insurance is e. Additional Definitions re- placed by the following: As respects Employee Benefit Lia- s. Other Insurance bility Coverage, Section V - Defini- tions is amended as follows: If other valid and collectible (1) The following definitions are insurance is available to the added: insured for a loss we cover under this Coverage, Part, 1. "Administration"means: our obligations are limited as • follows: a. Providing information to "employees", including a. Primary Insurance theirdependents and • beneficiaries, with re- This insurance is prima- spect to eligibility for or ry except when c.below scope of "employee applies. If this insurance benefit programs"; is primary, our .obliga- tions arenot affected b. Interpreting the "em- • unless any of the other ployee benefit pro- insurance is also prima- . grams"; ry. Then, we will share with all that other insur- , c. Handling . records in ance by the method de- connection with the scribed in b.below. ' "employee benefit pro- grams';or b. Method Of Sharing d. Effecting, continuing or If all of the other insur- terminating any "em- ance permits contribu- ployee's" participation in Includes copyrighted material of Insurance GA 233 0917 Services Office, Inc.,with its permission. Page 7 of 17 any benefit included inc. Unemployment insur- the "employee benefit ance, .social security program". benefits, workers' corn However, "administration" pensation and disability benefits; and does not indude: a. Handlingpayroll deduc- d. Vacation plans, includ- ing buy and sell pro- ' tions; or • grams; leave of ab- b. The failure to effect or 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 4. "First effective date" means benefits, workers'.corn- the date upon which cover- pensation and disability ' ' age was first effected in a benefits. ' series of•uninterrupted. re- 2. "Cafeteria plans" means newals of insurance cover- plans authorized by.applica- ' age. ble law to allow"employees" (2) The following definitions are de- to elect to pay for certain leted in their entirety and .re- . benefits with pre-tax dollars. placed by the following: 3. "Employee benefit pro- 8. "Employee" means a person' grams" means a program actively employed, formerly providing some of all of the employed, on leave of ab- following following benefits to "em- sence or disabled, or retired. ployees", whether provided "Employee" includes ' a through a "cafeteria plan" or "leased worker". "Employee". otherwise: does not include a "tempo- a. Group life insurance; rary worker". group accident or health •21. "Suit"means-a civil proceed- insurance;-dental,vision ing in which money damag- and hearing plans; and es because of an act, error flexible spending ac- or omission to which this in- counts; provided that no - surance applies are alleged. one other than an "em- "Suit"includes: ployee" may subscribe to such benefits and a. An arbitration proceed- • such benefits are made , ing in which such darn- generally available to ages are claimed and to those "employees" who • which the insured must • ) satisfy the plan's eligibil- , , submit or does submit ity requirements; . with our consent; b. Profit .sharing plans, b. Any other alternative employee savings dispute resolution pro- plans, employee' stockseeding in which such ownership plans, pen- damages are claimed sion plans and stock and to which the in- subscription plans, pro- sured submits with our vided that no one other consent;or than an "employee" may subscribe, to such 'I c. An appeal of a civil pro- ' • benefits and such bene- seeding. • . fits are made generally •• available to all "employ- ees" who are eligible under the plan for such • - benefits; Includes copyrighted material of Insurance GA 233 0917 ! . •Services Office, Inc.;with its permission. ' • Page 8 of 17 _, 2. Unintentional Failure To Disclose Haz- • 2) Rust or other cor- ards • rosion, decay, de- - terioration, hidden Section IV-Commercial General Liabil- or latent defect or ity Conditions;. 7. Representations, is 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 disdose all 3) Smog; such hazards at the inception date,of your . policy, we will not reject coverage under 4) Mechanical break- . this,Coverage Part based solely on such down, including . failure. f rupture or bursting caused by centrif- 3. Damage To Premises Rented To You ugal force; a. The last Paragraph of 2. Exclusions under Section I-Coverage A-Bod- 5) 'Settling, cex, g � shrinking g or or ex- • ily Injury And Property Damage.Li- ability is replaced by the following: ( pansion; Exclusions c.through q, do not apply 6) Nesting or infest a- , tion, or discharge to "property damage" by fire, explo- or release of waste sign, lightning, smoke or soot to - products or secre- premises while rented to you or tern- tions, by insects, porarily occupied by you with permis- birds, rodents or sion of the owner, for which the • other animals; or amount we will pay is limited to the Damage To Premises Rented To 7) Presence, growth, You Limit as described in Section III , proliferation, -Limits Of Insurance. spread or any ac- ' tivity of fungus, in- b. The insurance provided under Sec- cluding mold or tion I - Coverage A - Bodily Injury mildew, and any And Property Damage Liability ap- mycotoxins, plies to "property damage"arising out • spores, scents or of water damage to premises that are . 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 3.13.above: directlyor indirectly by any . The exclusions under Section I- of the following: i 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- wise discharged from a This insurance does not apply to: sewer, drain, sump, • (a) "Property damage": sump pump or related equipment; (I) Assumed in any con- tract or agreement; or (iii) Water under the ground 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 233 0917 Services Office, Inc.,with its permission. Page 9 of 17 • 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. - ning, 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. tioning, fire protection sys- tems, or other equipment, .- (2) The most we will pay is limited as caused by or resulting from described in Section B. Limits freezing, unless: Of Insurance, 3. Damage To 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 fol- 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 protec- of this endorsement for cost of bail tion systems, or other bonds.required because of accidents or traffic law violations arising or applianc- 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 Day g 6. 180 Coverage For Newly is the most we will pay 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 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- • or the end of the policy period, ises leased to you, subject whichever is earlier; to the following additional 7. Waiver Of Subrogation exclusions: This insurance does not ap- Section IV-Commercial General Liabil- • ply to: ity Conditions, 9.Transfer Of Rights Of Recovery Against Others To Us is (i) Any "occurrence" which amended by the addition of the following: takes place after you cease to be a tenant in We waive any right of recovery we may that premises; have against any person or organization against whom you have agreed to waive (ii) Structural alterations, such right of recovery in a written contract new construction or or agreement because of payments we demolition operations make for injury or damage arising out of performed by or on be- your ongoing operations or "your work" half of such additional done under a written contract or agree- insured. mentwith that person or.organization and included in the "products-completed oper- (b) Lessor Of Leased Equip- ations hazard". However, our rights may ment only be waived prior to the "occurrence". giving rise to the injury or damage for Any person or organization from whom you lease which we make payment under this Coy- equipment when you and erage Part. The insured must do nothing such person(s) or organiza- 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 those rights. dorsement to provide insur- those Such person(s) or or- 8. Automatic Additional Insured - Sped- ganization(s) are insureds fied Relationships only with respect to liability for "bodily injury", "property a. The following is added to Section II- damage" or "personal and Who Is An Insured: advertising injury"caused, in (1) Any person(s) or organization(s) mhole or in. part, by your maintenance, operation or described in Paragraph 8.a.(2)of use of equipment leased to this endorsement (hereinafter re- you by such person(s) or or- ferred to as additional insured) ganization(s). A person's or whom you are required to add as organization's status as an an additional insured under this additional insured under this Coverage Part by reason of a endorsement ends when written contract, written agree- - their contract or agreement merit, written permit or written with you for such leased authorization. equipment ends. However, (2) Only the following persons or or- this insurance does not ap- ganizations are additional in- ply to any "occurrence" sureds under this endorsement, which takes place after the and insurance coverage provided equipment lease expires. to such additional insureds is lira- (c) Vendors ited as provided herein: • Any person or organization (a) Managers g Or Lessors Of (referred to below as ven- Premises 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.i.(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 233 0917 Services Office, Inc.,with its permission. Page 11 of 17 vendor's business, subject ' or repair opera- , to the following additional tions, except such exclusions: • operations per- - formed at the ven- (i) The insurance afforded dor's premises in the vendor does not . connection with the apply to: • sale of the product; 1) "Bodily injury" or 7) Products which, af- "property damage" ter distribution or for which the ven- • sale by you, have dor is obligated to been labeled or re- pay damages by labeled 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 • own acts or omis- 2) . Any express war- ranty unauthorized signs those of its employees or by you; ( anyone else acting ' 3) Any physical or on its behalf. How- chemical change in ever,this exclusion the product made does not apply to: intentionally by the a) The excep- vendor; tions contained k 4) Repackaging, ex- in Paragraphs cept when • un- (a) (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, accust- the substitution of ments, tests or parts under in- servicing as structions from the the vendor has manufacturer, and agreed to . then repackaged in make or nor- the original con- . mally under- tainer; • takes to make 5) Any failure to make in the usual such inspections, - course of adjustments, tests business, in or servicing as the connection til- vendor has agreed with the dsal to make or normal- bution or sale ly undertakes to S 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 i have 6) Demonstration, in- 'acquired such ,products, or stallation, servicing . any ingredient, part ' ' S Includes copyrighted material of Insurance GA 233 09 17 Services Office, Inc.,with its permission. Page'12 of 17 • or container, enter- (e) Mortgagee, Assignee Or ing into, accompa- ' _ 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 cluded within the ' ' endorsement to provide in- • "products- surance, but only with re- completed opera- sped 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 does not apply to structural (d) State Or Governmental alterations, new construction Agency Or Subdivision Or and demolition operations Political Subdivision - performed by or for that per- Permits Or Authorizations son.or organization. Relating To Premises 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 insur- permitted by law; and ance, subject to the follow- ing additional provision: (b) Will not be broader than'that which you are required by This insurance applies only • the written contract, written - with respect to the following agreement, written permit or hazards for which the state written authorization to pro- or governmental agency or vide for such additional in- subdivision or political sub- sured; and division has issued a permit , or authorization in connec- (c) Does 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- nance, repair, construc- sured under any other provi- . tion, erection or removal sion of, or endorsement of advertising signs, added to, this Coverage awnings, canopies, cel- ' Part, provided such other lar entrances, coal . provision or endorsement holes, driveways, man- 'covers the injury or damage holes, marquees, hoist for which this insurance ap- away openings, side- plies. . walk vaults, street ban- ners or decorations and b. With respect to the insurance afford- similar exposures; or ed to the additional insureds de- scribed in Paragraph 8.a.(1) of this (ii) The construction; erec- endorsement, the following is added tion or removal of eleva- to Section III-Limits Of Insurance: tors;or The most we will pay on behalf of the (iii) 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, writtenagreement, written permit or written authorization described Includes copyrighted material,of Insurance . GA 233 0917 Services Office, Inc.,with its permission. Page 13 of 17 _ in Paragraph 8.a.(1) of this en- tion I - 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 whichever is less. - . not being used to perform operations • at the time of loss. This endorsement shall not increase b. With respect to the insurance provid- the applicable Limits of Insurance ed by this section of the endorse- shown in the Declarations. • ment, the following additional provi- , c: Section IV - Commercial General sions apply: Liability Conditions is amended to (1) The Limits of Insurance shown in _ include the following: the Declarations are replaced by Automatic Additional Insured Pro- the limits designated in Section vision B. 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 indusive 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 I To Borrowed Equipment of this written permit or written authori- endorsement fix the most we will zation, described in Paragraph pay in any one "occurrence" re- 8.a.(1). gardless of the number of: d. Section IV - Commercial General . (a) Insureds; Liability Conditions is amended as (b) Claims made or "suits" follows: brought;or Condition 5. Other Insurance is. , (c) Persons or organizations amended to include: making claims or bringing Primary And Noncontributory In- "suits". surance (2) Deductible Clause This insurance is primary to and will, (a) Our obligation to pay dam- • not,seek contribution from any other ages on your behalf applies insurance available to an additional only to the amount of dam- insured per Paragraph 8.a.(1) of this ages for each."occurrence" endorsement provided that:. - which are in excess of the (1) The additional insured is a Deductible Amount stated in Named Insured under such other Section B. Limits Of Insur- insurance; and ante; 9. Property Damage To Borrowed Equipment of (2) You have agreed in writing in a this endorsement. The limits contract, agreement, permit or of insurance will not be re- authorization described in 8.a.(2) • duced by the application of of this endorsement that this in- . such deductible amount. surance would be primary and would not seek contribution from (b) Section IV Commercial any other insurance available to General Liability Condi- the additional insured. tions, 2. Duties In The • Event Of Occurrence, Of- . 9. Property Damage To Borrowed Equip- fense, Claim Or Suit, ap- • ment plies to each claim or "suit" a. The following is added to Exclusion irrespective of the amount.' 2.j.Damage To Property under Sec- Includes copyrighted material of Insurance GA 233 09.17 Services Office, Inc.,with its permission. Page 14 of 17 (c) We may pay any part or all 12: Nonowned Aircraft of the deductible amount to effect settlement of any The following is added to Exclusion 2.g. claim or"suit" and, upon no- Aircraft, Auto Or Watercraft under Sec- tification of the action taken, tion I - Coverage A- Bodily Injury And • you shall promptly reim- Property Damage Liability: burse us for such part of the This exdusion does not apply to an air- deductible amount as has craft you do not own, provided that: been paid by us. a. The pilot in command holds a current 10. Employees As Insureds - Specified effective certificate, issued by a duly Health Care Services And Good Samar- constituted authority of the United itan Services States of America or Canada, desig- Paragraph 2.a.(1Xd) under Section II - nating that person as a commercial or Who Is An Insured does not apply to: airline transport pilot; a. Your. "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 for a charge. paramedic in the jurisdiction where an "occurrence" or offense to which this 13. Bodily Injury Redefined insurance applies takes place; or Section V-Definitions, 4. "Bodily injury'. b. Your "employees" or "volunteer work- isreplaced 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 lime. 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 - Com- Property Damage Liability is replaced by mercial General Liability Conditions is the following: replaced by the following: This exclusion does not apply to "bodily a. You must see to it that we are notified 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. Former Employees As Insureds tice should include: The following is added to Paragraph 2. (1) How, when and where the "oc- under Section II-Who Is An Insured: currence"or offense took place; • • 2. Each of the following is also an in- (2) The names and addresses of sured: any injured persons and wit- nesses; and Any of your former "employees", di- rectors, :managers, members, part- (3) The nature and location of any ners or "executive officers", including injury or damage arising out of but not limited to retired, disabled or the "occurrence"or offense. those onleave of absence, but only This requirement applies only when for acts within the scope of their em- the "occurrence" or offense is known ployment by you or for duties related town"authorized representative". to the conduct of your business. Includes copyrighted material of Insurance GA 233 0917 Services Office, Inc.,with its permission. Page 15 of 17 16. Voluntary Property Damage Coverage (2) Exclusions a. Coverage D - Voluntary Property This insurance does not apply to Damage Coverage "property damage".that would be excluded by Coverage A-Bodi- Section I-Coverages is amended to ly Injury And Property Damage include the following: • Liability, 2. Exclusions; except (1) Insuring Agreement for j, Damage To Property, par- " , agraphs (3), (4), (5) and (6), k. (a) We will pay the cost to re- Damage To Your Product, and pair or replace "property I. Damage To Your Work. damage" to property of oth- ers arising out of operations (3) Definitions - incidental to your business For purposes of Voluntary when: Property •Damage Coverage 1) Damage is caused by only,the following definitions un- you; or der Section V - Definitions are replaced by the following: 2) Damage occurs while in your possession. 16. "Occurrence" means an in- cident, including continuous At your written request, we or repeated exposure to .will make this payment re- substantially the same gen- gardless of whether you are eral.harmful conditions that at fault for the "property result in "property damage". damage". - 20. "Property damage" means If you, at our request, re- physical injury to tangible place, or make any.repairs property. "Electronic data" is to, damaged property of not tangible property, and others, the amount we will "property damage" does not pay under Voluntary Prop- include disappearance, ab- erty Damage Coverage will straction or theft. be determined by your actu- al cost to replace or repair . b. Care, Custody Or Control Liability the damaged property, ex- Coverage cluding any profit or over- For purposes of the coverage provid- head. . ed by Care, Custody Or Control Li- Any payment we make un- ability Coverage in this endorsement der Voluntary Property. only: Damage Coverage shall not (1) Section I-Coverage A-Bodily be interpreted as an admis- Injury And Property Damage sion of liability by,you or by Liability, 2. Exclusions, j. us. Damage To Property, Subpara- It shall be your duty, not our graphs(3),(4)and (5)do not ap- duty, to defend any claim or ply to "property damage" to the "suit'to which this insurance property of others described applies. therein. No other obligation or liabil- (2) It shall be your duty, not our duty, ity to pay sums or perform to defend any claim or "suit" to acts or services is covered. • which this insurance applies. (b) This insurance applies to No other obligation or liability to • "property damage"only if: pay sums or perform acts or ser- . vices is covered. 1) The "property damage" . takes place in the "cov- . This Paragraph (2) supersedes erage territory'; and any provision in the Coverage Part to the contrary. , 2) The "property damage" occurs during the policy (3) "Property damage" for which period. Care, Custody Or Control Lia- bility Coverage provides cover- Includes copyrighted material of Insurance GA 233 0917 . . Services Office, Inc.,with its permission. Page 16 of 17 • age shall be deemed to be (3) The Voluntary Property Dam- caused by an "occurrence" but age Coverage, Aggregate Limit shall not serve to limit or restrict Of Insurance is the most we will the applicability'of any exclusion pay for the sum of all damages for "property damage" under this under Voluntary Property Coverage Part. Damage Coverage. This limit c. Limits Of Insurance And Deducti- applies separately to each "cov- erage term". • bles For purposes of the coverage provid- ed (4) Deductible Clause 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- • Ill-Limits Of Insurance is amended ages for each "occurrence" to include the following: which are in excess of the The in Deductible Amount stated (1) Limitsof Insuranceshownfor the applicable coverage the Declarations are replaced by in the Schedule. The limits the limits designated in Section of insurance will not be re- B. Limits Of Insurance, 16. duced by the application of Voluntary And Damage' such Deductible Amount. Coverage And Care, Custody. Or Control Liability Coverage, (b) Section IV Commercial in this endorsement.These limits , General Liability Condi- are inclusive of, and not in addi- tions, 2. Duties In The tion to, the limits being replaced. Event Of Occurrence, Of- The Limits of Insurance shown in fense, Claim Or Suit, ap- the Schedule fix the most we will plies to each claim or "suit' • pay regardless of the number of: irrespective of the amount. (a) Insureds; . (c) We may pay any part or all Claims made or "suits" of the Deductible Amount to (b) effect settlement of any brought;or claim or "suit" and, upon no- (c) Persons or` organizations tification of the action taken, making claims or bringing you. shall promptly reim- "suits". burse us for such part of the Deductible Amount as has (2) (a) Subject to (3) below, the been paid by us. Voluntary_ Property Dam- 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- lowing: (b) The Care,Custody Or Con- trol Liability, Coverage, , ' c. Any easement or license agree- Each Occurrence Limit Of ment; Insurance is the most we will pay for the sum of damages b. Paragraph f.(1)is deleted in its entire- under Care, Custody Or ' ty. Control Liability Coverage; ' 18. Alienated Premises because of all "property damage" Exclusion 2.j. 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 its permission. Page 17 of 17