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HomeMy WebLinkAboutInsurance Certificate: Professional Credit Holdings Corp. A CERTIFICATE OF LIABILITY INSURANCE " DATE(MM/DD/YYYY) L.----' r 07/08/2022 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 Angie Diethelm NAME: Christensen Group (/ Co.Ext): (952)653-1000 FARC,No): (952)653-1100 9855 West 78th Street,Ste 100 E-MAIL adiethelm@christensengroup.com ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# Eden Prairie MN 55344INsuRERA: Massachusetts Bay Ins Co 22306 INSURED INSURER B: Hanover Insurance Co 22292 Professional Credit Holdings Corporation INSURER C: Hanover American 36064 Ray Klein,Inc INSURER D: Travelers Casualty and Surety Co of America 19038 400 International Way,Ste 250 INSURER E: Evanston Insurance Co. 35378 Springfield OR 97477INSURER F: Arch Specialty Insurance Co. 21199 COVERAGES CERTIFICATE NUMBER: 22-23 Liability 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 ADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MM/DD/YYYY) (MMIDDIYYYY) LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED 100,000 CLAIMS-MADE 7OCCUR PREMISES(Ea occurrence) $ MED EXP(Any one person) $ 10,000 A Y ZDXH672679 06/30/2022 06/30/2023PERSONAL&ADV INJURY $ 1,000,000 GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY JECT PRO X LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 (Ea accident) _ ANY AUTO BODILY INJURY(Per person) $ A OWNED SCHEDULED Y ZDXH672679 06/30/2022 06/30/2023 BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS X HIRED ONLY X AUTOS NON-OWNED ONLY PROPERTY DAMAGE (Per accident) $ AUT _ X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 10,000,000 B EXCESS LIAB CLAIMS-MADE UHXH672696 06/30/2022 06/30/2023 AGGREGATE $ 10,000,000 DED RETENTION$ 0 $ WORKERS COMPENSATION �/ PER OTH- AND EMPLOYERS'LIABILITY /� STATUTE ER C ANY PROPRIETOR/PARTNER/EXECUTIVE Y!N E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? n N/A WZXH639116 06/30/2022 06/30/2023 (Mandatory in NH) EL.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 Professional Liab.Limit $3,000,000 D)Professional Liability D/E E)Cyber Liability 107470356/MKLV5PCY000060 06/30/2022 06/30/2023 Cyber Liab.Limit $3,000,000 , DESCRIPTION OF OPERATIONS I LOCATIONS!VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) The City of Ashland,its elected officials, officers&employees are included as an Additional Insured under the General Liability on a Primary/Non-Contributory basis and Auto Liability when required by written contract. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN City of Ashland ACCORDANCE WITH THE POLICY PROVISIONS. 20 East Main Street AUTHORIZED REPRESENTATIVE Ashland OR 97520 I Z"� , ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: �., LOC#: A 9RO ADDITIONAL REMARKS SCHEDULE Page of AGENCY NAMED INSURED Christensen Group Professional Credit Holdings Corporation POLICY NUMBER CARRIER NAIC CODE EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM ISA SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance:Notes F)Excess Cyber Liability-6/30/22-6/30/23-Policy#C-4LPY-043447-CYBER-2022-Limit:$3,000,000 G)Excess Cyber Liability-6/30/22-6/30/23-Policy#2-CIA-WA-17E-S0112562-00-Limit:$4,000,000 Insurer G:Hudson Excess Insurance Company NAIC:19038 ACORD 101(2008/01) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ZDX H672679 00 2509544 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. COMMERCIAL GENERAL LIABILITY BROADENING ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SUMMARY OF COVERAGES 1. Additional Insured by Contract,Agreement or Permit Included 2. Additional Insured—Primary and Non-Contributory Included 3. Blanket Waiver of Subrogation Included 4. Bodily Injury Redefined Included 5. Broad Form Property Damage—Borrowed Equipment, Customers Goods&Use of Elevators Included 6. Knowledge of Occurrence Included 7. Liberalization Clause Included 8. Medical Payments—Extended Reporting Period Included 9. Newly Acquired or Formed Organizations-Covered until end of policy period Included 10. Non-owned Watercraft 51 ft. 11. Supplementary Payments Increased Limits - Bail Bonds $2,500 - Loss of Earnings $1000 12. Unintentional Failure to Disclose Hazards Included 13. Unintentional Failure to Notify Included This endorsement amends coverages provided under the Commercial General Liability Coverage Part through new coverages, higher limits and broader coverage grants. 1. Additional Insured by Contract, Agreement or (1) "Your work" for the additional insured(s) Permit designated in the contract, agreement or The following is added to SECTION II — WHO IS permit; AN INSURED: (2) Premises you own, rent, lease or occupy; Additional Insured by Contract, Agreement or or Permit (3) Your maintenance, operation or use of a. Any person or organization with whom you equipment leased to you. agreed in a written contract, written agreement b. The insurance afforded to such additional or permit that such person or organization to insured described above: add an additional insured on your policy is an (1) Only applies to the extent permitted by additional insured only with respect to liability law; and for "bodily injury", "property damage", or "personal and advertising injury" caused, in (2) Will not be broader than the insurance yourequiredby are which the contract, whole or in part, by your acts or omissions, or the acts or omissions of those acting on your agreement or permit to provide for such behalf, but only with respect to: additional insured. 421-2915 06 15 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. Page 1 of 4 ZDX H672679 00 2509544 (3) Applies on a primary basis if that is advertising injury" involved the rendering required by the written contract, written of or failure to render any professional agreement or permit. services by or for you. (4) Will not be broader than coverage d. With respect to the insurance afforded to provided to any other insured. these additional insureds, the following is (5) Does not apply if the "bodily injury", added to SECTION III — LIMITS OF "property damage" or "personal and INSURANCE: advertising injury" is otherwise excluded The most we will pay on behalf of the from coverage under this Coverage Part, additional insured for a covered claim is the including any endorsements thereto. lesser of the amount of insurance: c. This provision does not apply: 1. Required by the contract, agreement or (1) Unless the written contract or written permit described in Paragraph a.; or agreement was executed or permit was 2. Available under the applicable Limits of issued prior to the"bodily injury", "property Insurance shown in the Declarations. damage", or "personal injury and This endorsement shall not increase the advertising injury". applicable Limits of Insurance shown in the (2) To any person or organization included as Declarations. an insured by another endorsement 2. Additional Insured — Primary and Non- issued by us and made part of this Contributory Coverage Part. The following is added to SECTION IV — (3) To any lessor of equipment: COMMERCIAL GENERAL LIABILITY (a) After the equipment lease expires; or CONDITIONS, Paragraph 4. Other insurance: (b) If the "bodily injury", "property Additional Insured — Primary and Non- damage", "personal and advertising Contributory injury" arises out of sole negligence of If you agree in a written contract, written the lessor agreement or permit that the insurance provided to (4) To any: any person or organization included as an (a) Owners or other interests from. whom Additional Insured under SECTION II — WHO IS land has been leased which takes AN INSURED, is primary and non-contributory, place after the lease for the land ex- the following applies: pires; or If other valid and collectible insurance is available (b) Managers or lessors of premises if: to the Additional Insured for a loss covered under Coverages A or B of this Coverage Part, our (i) The occurrence takes place after obligations are limited as follows: you cease to be a tenant in that premises; or a. Primary Insurance (ii) The "bodily injury", "property This insurance is primary to other insurance damage", "personal injury" or that is available to the Additional Insured "advertising injury" arises out of which covers the structural alterations, new con- Additional Insured as a Named Insured. We struction or demolition operations will not seek contribution from any other performed by or on behalf of the insurance available to the Additional Insured manager or lessor. except: (5) To "bodily injury", "property damage" or (1) For the sole negligence of the Additional "personal and advertising injury" arising Insured; out of the rendering of or the failure to (2) When the Additional Insured is an render any professional services. Additional Insured under another primary This exclusion applies even if the claims liability policy; or against any insured allege negligence or (3) when b. below applies. other wrongdoing in the supervision, hiring, employment, training or monitoring If this insurance is primary, our obligations are of others by that insured, if the not affected unless any of the other insurance "occurrence" which caused the "bodily is also primary. Then, we will share with all injury"or"property damage"or the offense that other insurance by the method described which caused the "personal and in c. below. 421-2915 06 15 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. Page 2 of 4 ZDX H672679 00 2509544 b. Excess Insurance insurer contributes equal amounts until it has (1) This insurance is excess over any of the paid its applicable limit of insurance or none of the loss remains, whichever comes first. If any other insurance, whether primary, excess, contingent or on any other basis: of the other insurance does not permit contribution by equal shares,we will contribute (a) That is Fire, Extended Coverage, by limits. Under this method, each insurer's Builder's Risk, Installation Risk or share is based on the ratio of its applicable similar coverage for"your work"; limit of insurance to the total applicable limits (b) That is Fire insurance for premises of insurance of all insurers rented to the Additional Insured or 3. Blanket Waiver of Subrogation temporarily occupied by the Additional Insured with permission of the owner; The following is added to SECTION IV — COMMERCIAL GENERAL LIABILITY (c) That is insurance purchased by the CONDITIONS, Paragraph 8. Transfer Of Rights Additional Insured to cover the Of Recovery Against Others To Us: Additional Insured's liability as a tenant for "property damage" to We waive any right of recovery we may have premises rented to the Additional against any person or organization with whom you Insured or temporarily occupied by the have a written contract that requires such waiver Additional with permission of the because of payments we make for damage under owner; or this coverage form. The damage must arise out of your activities under a written contract with that (d) If the loss arises out of the person or organization. This waiver applies only to maintenance or use of aircraft, "autos" the extent that subrogation is waived under a or watercraft to the extent not subject written contract executed prior to the "occurrence" to Exclusion g. of SECTION I — or offense giving rise to such payments. COVERAGE A — BODILY INURY AND PROPERTY DAMAGE 4. Bodily Injury Redefined LIABILITY. SECTION V— DEFINITIONS, Definition 3. "bodily (2) When this insurance is excess, we will injury"is replaced by the following: have no duty under Coverages A or B to 3. "Bodily injury" means bodily injury, sickness or defend the insured against any"suit"if any disease sustained by a person including death other insurer has a duty to defend the resulting from any of these at any time. "Bodily insured against that "suit". If no other injury" includes mental anguish or other insurer defends, we will undertake to do mental injury resulting from "bodily injury". so, but we will be entitled to the insured's 5. Broad Form Property Damage — Borrowed rights against all those other insurers. Equipment, Customers Goods, Use of (3) When this insurance is excess over other Elevators Insurance, we will pay only our share of a. SECTION I—COVERAGES, COVERAGE A— the amount of the loss, if any, that BODILIY INJURY AND PROPERTY exceeds the sum of: DAMAGE LIABILITY, Paragraph 2. (a) The total amount that all such other Exclusions subparagraph j. is amended as insurance would pay for the loss in the follows: absence of this insurance; and Paragraph (4) does not apply to "property (b) The total of all deductible and self damage" to borrowed equipment while at a insured amounts under all that other jobsite and not being used to perform insurance. operations. We will share the remaining loss, if any, Paragraphs (3), (4) and (6) do not apply to with any other insurance that is not "property damage"to "customers goods"while described in this Excess Insurance on your premises nor do they apply to the use provision and was not bought specifically of elevators at premises you own, rent, lease to apply in excess of the Limits of or occupy. Insurance shown in the Declarations of b. The following is added to SECTION V — this Coverage Part. DEFINTIONS: c. Method Of Sharing 24. "Customers goods" means property of If all of the other insurance permits your customer on your premises for the contribution by equal shares,we will follow this purpose of being: method also. Under this approach each 421-2915 06 15 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. Page 3 of 4 ZDX H672679 00 2509544 a. worked on; or 10. Non-Owned Watercraft b. used in your manufacturing process. SECTION I — COVERAGES, COVERAGE A c. The insurance afforded under this provision is BODILY INJURY AND PROPERTY DAMAGE excess over any other valid and collectible LIABILITY, Paragraph 2. Exclusions, property insurance (including deductible) subparagraph g.(2) is replaced by the following: available to the insured whether primary, g. Aircraft,Auto Or Watercraft excess, contingent (2) A watercraft you do not own that is: 6. Knowledge of Occurrence (a) Less than 51 feet long; and The following is added to SECTION IV — COMMERCIAL GENERAL LIABILITY (b) Not being used to carry persons or CONDITIONS, Paragraph 2. Duties in the Event property for a charge; of Occurrence, Offense, Claim or Suit: This provision applies to any person who, with your consent, either uses or is e. Notice of an "occurrence", offense, claim or responsible for the use of a watercraft. "suit" will be considered knowledge of the insured if reported to an individual named 11. Supplementary Payments Increased Limits insured, partner, executive officer or an SECTION I — SUPPLEMENTARY PAYMENTS "employee" designated by you to give us such COVERAGES A AND B, Paragraphs 1.b. and a notice. 1.d.are replaced by the following: 7. Liberalization Clause 1.b.Up to $2,500 for cost of bail bonds required The following is added to SECTION IV — because of accidents or traffic law violations COMMERCIAL GENERAL LIABILITY arising out of the use of any vehicle to which CONDITIONS: the Bodily Injury Liability Coverage applies. We do not have to furnish these bonds. Liberalization Clause If we adopt any revision that would broaden the 1.d.All reasonable expenses incurred by the insured at our request to assist us in the coverage under this Coverage Form without investigation or defense of the claim or "suit", additional premium, within 45 days prior to or including actual loss of earnings up to$1000 a during the policy period, the broadened coverage day because of time off from work. will immediately apply to this Coverage Part. 8. Medical Payments — Extended Reporting 12. Unintentional Failure to Disclose Hazards Period The following is added to SECTION IV — COMMERCIAL GENERAL LIABILITY a. SECTION I—COVERAGES, COVERAGE C— CONDITIONS, Paragraph 6. Representations: MEDICAL PAYMENTS, Paragraph 1. Insuring Agreement, subparagraph a.(3)(b) We will not disclaim coverage under this Coverage is replaced by the following: Part if you fail to disclose all hazards existing as of the inception date of the policy provided such (b) The expenses are incurred and reported failure is not intentional. to us within three years of the date of the accident; and 13. Unintentional Failure to Notify b. This coverage does not apply if COVERAGE The following is added to SECTION IV — C — MEDICAL PAYMENTS is excluded either COMMERCIAL GENERAL LIABILITY by the provisions of the Coverage Part or by CONDITIONS, Paragraph 2. Duties in the Event endorsement. of Occurrence,Offense, Claim or Suit: 9. Newly Acquired Or Formed Organizations Your rights afforded under this policy shall not be prejudiced if you fail to give us notice of an SECTION II —WHO IS AN INSURED, Paragraph "occurrence", offense, claim or"suit", solely due to 3.a. is replaced by the following: your reasonable and documented belief that the a. Coverage under this provision is afforded until "bodily injury" or"property damage" is not covered the end of the policy period. under this policy. ALL OTHER TERMS, CONDITIONS,AND EXCLUSIONS REMAIN UNCHANGED. 421-2915 06 15 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. Page 4 of 4 ZDX H672679 00 2509544 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. COMMERCIAL GENERAL LIABILITY ENHANCEMENT ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SUMMARY OF COVERAGES 1. Additional Insured—Broad Form Vendors Included 2. Aggregate Limit per Location Included 3. Alienated Premises Included 4. Broad Form Named Insured Included 5. Extended Property Damage Included 6. Incidental Malpractice(Employed nurses, EMT's&paramedics) Included 7. Mobile Equipment Redefined Included 8. Personal Injury—Broad Form Included 9. Product Recall Expense - Product Recall Expense Each Occurrence Limit $25,000 - Product Recall Expense Aggregate Limit $50,000 - Product Recall Deductible $500 10. Property Damage Legal Liability—Broad Form - Fire, Lightning, Explosion, Smoke and Leakage from Fire Protective Systems $1,000,000 Damage Limit This endorsement amends coverages provided under the Commercial General Liability Coverage Part through new coverages, higher limits and broader coverage grants. 1. Additional Insured—Broad Form Vendors (4) Does not apply if the "bodily injury", The following is added to SECTION II —WHO IS "property damage" or "personal and AN INSURED: advertising injury" is otherwise excluded from coverage under this Coverage Part, Additional Insured—Broad Form Vendors including any endorsements thereto a. Any person or organization that is a vendor c. With respect to insurance afforded to such with whom you agreed in a written contract or vendors, the following additional exclusions written agreement to include as an additional apply: insured under this Coverage Part is an insured, but only with respect to liability for The insurance afforded to the vendor does "bodily injury" or "property damage" arising not apply to: out of"your products"which are distributed or (1) "Bodily injury" or "property damage" for sold in the regular course of the vendor's which the vendor is obligated to pay business. damages by reasons of the assumption b. The insurance afforded to such vendor of liability in a contract or agreement. described above: This exclusion does not apply to liability for damages that the insured would have (1) Only applies to the extent permitted by in the absence of the contract or law; agreement; (2) Will not be broader than the insurance (2) Any express warranty unauthorized by which you are required by the contract or you; agreement to provide for such vendor; (3) Any physical or chemical change in the (3) Will not be broader than coverage product made intentionally by the vendor; provided to any other insured; and (4) Repackaging, unless unpacked solely for the purpose of inspection, demonstration, 421-2916 06 15 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. Page 1 of 6 ZDX H672679 00 2509544 testing, or the substitution of parts under 2. Available under the applicable Limits of instruction from the manufacturer, and Insurance shown in the Declarations; then repackaged in the original container; This endorsement shall not increase the (5) Any failure to make such inspection, applicable Limits of Insurance shown in the adjustments, tests or servicing as the Declarations. vendor has agreed to make or normally 2. Aggregate Limit Per Location undertakes to make in the usual course of business in connection with the sale of a. SECTION III — LIMITS OF INSURANCE, the the product; General Aggregate Limit applies separately (6) Demonstration, installation, servicing or to each of your "locations" owned by or repair operations, except such operations rented to you. performed at the vendor's premises in b. For purpose of this coverage only, the connection with the sale of the product; following is added to SECTION V — DEFINITIONS: (7) Products which, after distribution or sale by you, have been labeled or relabeled "Location" means premises involving the or used as a container, part or ingredient same or connecting lots, or premises whose of any other thing or substance by or for connection is interrupted only by a street, the vendor; roadway, waterway or right-of-way of a rail- road. (8) "Bodily injury" or "property damage" arising out of the sole negligence of the 3. Alienated Premises vendor for its own acts or omissions or SECTION I — COVERAGES, COVERAGE A — those of its employees or anyone else BODILY INJURY AND PROPERTY DAMAGE acting on its behalf. However, this LIABILITY, Paragraph 2. Exclusions, exclusion does not apply to: subparagraph j.(2) is replaced by the following: (a) The exceptions contained within the (2) Premises you sell, give away or abandon, if exclusion in subparagraphs (4) or(6) the "property damage" arises out of any part above; or of those premises and occurred from hazards (b) Such inspections, adjustments, tests that were known by you, or should have or servicing as the vendor has reasonably been known by you, at the time agreed to make or normally the property was transferred or abandoned. undertakes to make in the usual 4. Broad Form Named Insured course of business, in connection If you are designated in the Declarations as with the distribution or sale of the anything other than an individual, then any products. organization: (9) "Bodily injury" or "property damage" a. Over which you maintained a combined arising out of an "occurrence" that took ownership interest of more than 50% on the place before you have signed the effective date of this policy; contract or agreement with the vendor. (10)To any person or organization included b. That is not a partnership, joint venture or limited liability company; and as an insured by another endorsement issued by us and made part of this c. That is not excluded by any endorsement to Coverage Part. this policy, will qualify as a Named Insured if (11)Any insured person or organization, from there is no other similar insurance available whom you have acquired such products, to that organization, or that would be a available but for exhaustion of its limits. any ingredient, part or container, entering into, accompanying or Any such organization will cease to qualify as a containing such products. Named Insured as of the date during the policy d. With respect to the insurance afforded to period when the combined ownership interest of these vendors, the following is added to the Named Insureds in the organization equals or SECTION III—LIMITS OF INSURANCE: falls below 50/o. The most we will pay on behalf of the vendor 5. Extended Property Damage for a covered claim is the lesser of the SECTION I — COVERAGES, COVERAGE A — amount of insurance: BODILY INJURY AND PROPERTY DAMAGE LIABILITY, Paragraph 2. Exclusions, 1. Required by the contract or agreement subparagraph a. is replaced by the following: described in Paragraph a.; or 421-2916 06 15 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. Page 2 of 6 ZDX H672679 00 2509544 ' a. Expected Or Intended Injury include the unlawful treatment of individuals Bodily injury" or"property damage" expected based upon developmental, physical, or intended from the standpoint of the cognitive, mental, sensory or emotional insured. This exclusion does not apply to impairment or any combination of these. "bodily injury" or "property damage" resulting e. This coverage does not apply if COVERAGE from the use of reasonable force to protect B — PERSONAL AND ADVERTISING persons or property. INJURY LIABILITY is excluded either by the 6. Incidental Malpractice — Employed Nurses, provisions of the Coverage Form or by EMT's and Paramedics endorsement. SECTION 11—WHO IS AN INSURED, paragraph 9. Product Recall Expense 2.a.(1)(d) does not apply to a nurse, emergency a. SECTION I — COVERAGES, COVERAGE A medical technician or paramedic employed by — BODILY INJURY AND PROPERTY you if you are not engaged in the business or DAMAGE LIABILITY, Paragraph 2. occupation of providing medical, paramedical, Exclusions, subparagraph n. is replaced by surgical, dental,x-ray or nursing services. the following: 7. Mobile Equipment Redefined n. Recall of Products, Work or Impaired SECTION V — DEFINITIONS, Definition 12. Property "Mobile Equipment", paragraph f.(1) does not Damages claimed for any loss, cost or apply to self-propelled vehicles of less than 1,000 expense incurred by you or others for the pounds gross vehicle weight. loss of use, withdrawal, recall, 8. Personal Injury—Broad Form inspection, repair, replacement, a. SECTION I — COVERAGES, COVERAGE B adjustment, removal or disposal of: — PERSONAL AND ADVERTISING INJURY (1) "Your product"; LIABILITY, Paragraph 2. Exclusions, (2) "Your work"; or subparagraph e. is deleted. (3) "Impaired property"; b. SECTION V — DEFINITIONS, Definition 14, if such product, work, or property is "Personal and advertising injury" withdrawn or recalled from the market or subparagraph b. is replaced by the following: from use by any person or organization b. Malicious prosecution or abuse of because of a known or suspected defect, process. deficiency, inadequacy or dangerous c. The following is added to SECTION V — condition in it, but this exclusion does not DEFINITIONS, Definition 14. "Personal and apply to "product recall expenses" that advertising injury : you incur for the "covered recall" of"your product". "Discrimination" (unless insurance thereof is prohibited by law) that results in injury to the However, this exception to the exclusion feelings or reputation of a natural person, but does not apply to "product recall only if such"discrimination"is: expenses"resulting solely from: (1) Not done intentionally by or at the (4) Failure of any products to accomplish direction of: their intended purpose; (a) The insured; (5) Breach of warranties of fitness, (b) Any officer of the corporation, quality, durability or performance; director, stockholder, partner or (6) Loss of customer approval, or any member of the insured;and cost incurred to regain customer (2) Not directly or indirectly related to an approval; "employee", not to the employment, (7) Redistribution or replacement of prospective employment or termination of "your product" which has been any person or persons by an insured. recalled by like products or d. The following is added to SECTION V — substitutes; DEFINITIONS: (8) Caprice or whim of the insured; "Discrimination" means the unlawful (9) A condition likely to cause loss of treatment of individuals based upon race, which any insured knew or had color, ethnic origin, gender, religion, age, or reason to know at the inception of sexual preference. "Discrimination" does not this insurance; 421-2916 06 15 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. Page 3 of 6 ZDX H672679 00 2509544 (10)Asbestos, including loss, damage or expenses"to an amount that is less than clean up resulting from asbestos or the Product Recall Expense Each asbestos containing materials; Occurrence Limit, the remaining Product (11)Recall of "your products" that have Recall Expense Aggregate Limit is the no known or suspected defect solely most that will be available for because a known or suspected reimbursement of "product recall defect in another of "your products" expenses" in connection with any other has been found. defect or deficiency. b. The following is added to SECTION II — g. Product Recall Deductible WHO IS AN INSURED, Paragraph 3. We will only pay for the amount of COVERAGE A does not apply to "product "product recall expenses" which are in recall expense" arising out of any withdrawal excess of the $500 Product Recall or recall that occurred before you acquired or Deductible. The Product Recall formed the organization. Deductible applies separately to each "covered recall". The limits of insurance c. For the purposes of this endorsement only, will not be reduced by the amount of this the following is added to SECTION 111 — deductible. LIMITS OF INSURANCE: We may, or will if required by law, pay all Product Recall Expense Limits of or any part of any deductible amount, if Insurance applicable. Upon notice of our payment a. The Limits of Insurance shown in the of a deductible amount, you shall SUMMARY OF COVERAGES of this promptly reimburse us for the part of the endorsement and rules stated below fix deductible amount we paid. the most we will pay under this Product The Product Recall Expense Limits of Recall Expense Coverage regardless of Insurance apply separately to each the number of: consecutive annual period and to any (1) Insureds: remaining period of less than 12 months, (2) "Covered Recalls" initiated: or starting with the beginning of the policy Number of period shown in the Declarations, unless the (3) "your products" policy period is extended after issuance for withdrawn. an additional period of less than 12 months. b. The Product Recall Expense Aggregate In that case, the additional period will be Limit is the most we will reimburse you deemed part of the last preceding period for for the sum of all "product recall the purposes of determining the Limits of expenses" incurred for all "covered Insurance. recalls" initiated during the policy period. d. The following is added to SECTION IV — c. The Product Recall Expense Each COMMERCIAL GENERAL LIABILITY Occurrence Limit is the most we will pay CONDITIONS, Paragraph 2. Duties in the in connection with any one defect or Event of Occurrence, Offense, Claim or deficiency. Suit: d. All "product recall expenses" in You must take the following actions in the connection with substantially the same event of an actual or anticipated "covered general harmful condition will be deemed recall" that may result in "product recall to arise out of the same defect or expense": deficiency and considered one (1) Give us prompt notice of any discovery "occurrence". or notification that"your product" must be e. Any amount reimbursed for "product withdrawn or recalled, including a recall expenses" in connection with any description of "your product" and the one "occurrence" will reduce the amount reason for the withdrawal or recall; and of the Product Recall Expense Aggregate (2) Cease any further release, shipment, Limit available for reimbursement of consignment or any other method of "product recall expenses" in connection distribution of like or similar products until with any other defect or deficiency. it has been determined that all such f. If the Product Recall Expense Aggregate products are free from defects that could Limit has been reduced by be a cause of loss under this insurance. reimbursement of "product recall 421-2916 06 15 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. Page 4 of 6 ZDX H672679 00 2509544 e. The following definitions are added to a. SECTION I — COVERAGES, COVERAGE A SECTION V—DEFINITIONS: — BODILY INJURY AND PROPERTY "Covered recall," means a recall made DAMAGE LIABILITY, the last paragraph necessary because you or a government (after the exclusions) is replaced by the body has determined that a known or following: suspected defect, deficiency, inadequacy, or Exclusions c. through n. do not apply to dangerous condition in "your product" has damage by fire, lightning, explosion, smoke resulted or will result in "bodily injury" or or leakage from fire protective systems to "property damage". premises while rented to you or temporarily "Product recall expense"means: occupied by you with the permission of the owner. A separate limit of insurance applies a. Necessary and reasonable expenses for: to this coverage as described in SECTION III (1) Communications, including radio or —LIMITS OF INSURANCE. television announcements or printed b. SECTION III — LIMITS OF INSURANCE, advertisements including stationery, Paragraph 6. is replaced by the following: envelopes and postage; (2) Shipping the recalled 6. Subject to Paragraph 5. above, The pp' g products from Damage to Premises Rented to You any purchaser, distributor or user to Limit is the most we will pay under the place or places designated by COVERAGE A for damages because of you; "property damage" to any one premises (3) Remuneration paid to your regular from fire, lightning, explosion, smoke and "employees"for necessary overtime; leakage from fire protective systems to (4) Hiring additional persons, other than premises, while rented to you or your regular"employees"; temporarily occupied by you with permission of the owner. (5) Expenses incurred by "employees" including transportation and ac- The Damage to Premises Rented to You commodations; Limit is the higher of: (6) Expenses to rent additional ware- a. $1,000,000; or house or storage space; b. The Damage to Premises Rented to (7) Disposal of "your product", but only You Limit shown in the Declarations. to the extent that specific methods of This limit will apply to all damage caused destruction other than those by the same event, whether such employed for trash discarding or damage results from fire, lightning, disposal are required to avoid "bodily explosion, smoke, leakage from fire injury" or "property damage" as a protective systems or any combination of result of such disposal; any of these. You incur exclusively for the purpose of c. SECTION IV — COMMERCIAL GENERAL recalling "your product"; and LIABILITY CONDITIONS, Paragraph 4. b. Your lost profit resulting from such Other Insurance, subparagraph b. Excess "covered recall". Insurance, item (a)(ii) is replaced by the following: f. This Product Recall Expense Coverage does (ii) That is fire, lightning, explosion, smoke not apply: 9 9, p or leakage from fire protective systems (1) If the "products — completed operations insurance for premises rented to you or hazard" is excluded from coverage under temporarily occupied by you with this Coverage Part including any permission of the owner;or endorsement thereto; or d. SECTION V — DEFINITIONS, Definition 9. (2) To"product recall expense" arising out of "Insured contract", Paragraph a. is replaced any of"your products" that are otherwise by the following: excluded from coverage under this Coverage Part including endorsements a. A contract for a lease of premises. thereto. However, that portion of the contract for a lease of premises that indemnifies any 10. Property Damage Legal Liability — Broad person or organization for damage by Form fire, lightning, explosion, smoke or leakage from fire protective systems to 421-2916 06 15 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. Page 5 of 6 ZDX H672679 00 2509544 premises while rented to you or e. This coverage does not apply if Damage to temporarily occupied by you with Premises Rented to You is excluded either permission of the owner is not an by the provisions of the Coverage Part or by "insured contract". endorsement. ALL OTHER TERMS, CONDITIONS,AND EXCLUSIONS REMAIN UNCHANGED. 421-2916 06 15 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. Page 6 of 6 ZDX H672679 00 2509544 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. NOTICE OF CANCELLATION to designated ENTITy(s) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART HANOVER COMMERCIAL FOLLOW FORM EXCESS AND UMBRELLA POLICY COMMERCIAL PROPERTY COVERAGE PART BUSINESS AUTO COVERAGE FORM BUSINESSOWNERS COVERAGE FORM SCHEDULE Name of Designated Entity Mailing Address or Email Address Number Days Notice FREEPORT FINANCIAL 200 S WACKER SUITE 925 CHICAGO, 30 PARTNERS LLC AS AGENT AND IL 60606 ITS SUCCESSORS AND ASSIGNS FREEPORT FINANCIAL 200 S WACKER SUITE 925 CHICAGO, 10 PARTNERS LLC AS AGENT AND IL 60606 ITS SUCCESSORS AND ASSIGNS State on Montana 125 North Roberts 30 Mitchell Building Room 165 PO Box 200135 Helena MT 59620 City of Corona c/o EXIGIS Insurance Compliance 30 Services P.O. Box 947 Murrieta CA 92564 City of Anaheim 201 S.Anaheim Blvd., Suite 107, 30 Anaheim CA 92805 City of Beverly Hills 455 N. Rexford Dr. 30 Beverly Hills CA 90210 City of Burbank 301 E. Olive Ave., Suite 305 30 Burbank CA 91502 City of Costa Mesa 77 Fair Dr, 30 Costa Mesa CA 92626 City of Modesto 1010 Tenth Street Suite 5200 30 Modesto CA 95353 City of Newport Beach 100 Civic Center Dr. 30 Newport Beach CA 92660 City of Portland 1120 SW 5th Ave., Room 1250 30 Portland OR 97204 City of Savannah, GA PO Box 31402 30 Savannah GA 31402 City of Tucson PO Box 27210 30 Tucson AZ 85726-7210 401-1235 1214 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. Page 1 of 2 ZDX H672679 00 2509544 Name of Designated Entity Mailing Address or Email Address Number Days Notice City of Victorville 14343 Civic Drive 30 Victorville CA 92392-2399 Merced county, CA 2222 M Street 30 Merced CA 95340 Solarity Credit Union 110 N 5th Ave 30 Yakima WA 98902 City of Glendale 141 North Glendale Ave 30 Glendale CA 91206 City of Ontario 303 East B Street 30 Ontario CA 91764-4196 (Information required to complete this Schedule, if not shown above, will be shown in the Declarations.) If we cancel this policy for any reason other than nonpayment of premium, we will give written notice of such cancellation to the Designated Entity(s) shown in the Schedule. Such notice may be delivered or sent by any means of our choosing.The notice to the Designated Entity(s)will state the effective date of cancellation. Unless otherwise noted in the Schedule above, such notice will be provided to the Designated Entity(s) no more than the number of days in advance of the effective date of cancellation that we are required to provide to the Named Insured for such cancellation. Such notice of cancellation is solely for the purpose of informing the Designated Entity(s)of the effective date of cancellation and does not grant, alter, or extend any rights or obligations under this policy. ALL OTHER TERMS AND CONDITIONS OF THIS POLICY REMAIN UNCHANGED. 401-1235 12 14 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. Page 2 of 2 Hanover Insurance Group- WZXH639116 2509544 WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT-CALIFORNIA 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 applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. The additional premium for this endorsement shall be 2 % of the California workers'compensation premium otherwise due on such remuneration. Schedule Person or Organization Job Description APPLIES AS BLANKET WAIVER FOR THOSE HAVING A WRITTEN CONTRACT WITH THE POLICY- HOLDER REQUIRING WOS FOR WC POLICYHOLDER EMPLOYEES This endorsement changes the policy to which It is attached and is effective on the date Issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective Policy No. WZX-H639116-00 Endorsement No. Insured Insurance Company THE HANOVER AMERICAN INSURANCE COMPANY Countersigned By WC 04 03 06(Ed 04-84) 000531 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 applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. Schedule CO, ID, OR THIS ENDORSEMENT APPLIES AS A BLANKET WAIVER OF SUBROGATION FOR THOSE PARTIES HAVING A WRITTEN CONTRACT WITH THE POLICY HOLDER REQUIRING A WAIVER OF SUBROGATION FOR WORKERS COMPENSATION COVERAGE OF THE POLICYHOLDERS EMPLOYEES This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective Policy No. Endorsement No. Insured Premium Insurance Company Countersigned by WC 00 03 13 (Ed.4-84) Copyright 1983 National Council on Compensation Insurance. CHRISTENSEN GROUP INSURANCE 9855 WEST 78TH STREET STE 100 EDEN PRAIRIE MN 55344-8004 CITY OF ASHLAND 20 E MAIN ST ASHLAND OR 97520-1849