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HomeMy WebLinkAboutInsurance Certificate: Peterson Machinery Co. P5260028002 L ga 3 7 A OR� DATE(MM/DDNYYY) [ �+r CERTIFICATE OF LIABILITY INSURANCE 03/29/2022 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. u,' IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. el 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 CA LIC 0B29370 1-925-798-3334 CONTNAMECT Sofia Ocegueda in Edgewood Partners Insurance Center (EPIC) PHONE 800-256-6363 FAX 925-887-6710 g [Concord - Branch ID 15469] (AIC.No.Ext): (AIC.No): E-MAIL P.O. Box 5668 ADDDRRESS:. sofia.ocegueda&epicbrokers.com INSURER(S)AFFORDING COVERAGE NAIC 0 Concord, CA 94524 INSURERA:NATIONAL ONION FIRE INS CO.OF PITTS 19445 INSUREDINSURERS:LEXINGTON /NS CO 19437 Peterson Machinery Co. INSURER C:NEW HAMPSHIRE INS CO 23841 Peterson Holding Company INSURANCE CO OF THE STATE OF PA 19429 P.O. Box 5258 _ INSURERD: INSURERE:WESTCHESTER SURPLUS LINES INS CO 10172 San Leandro, CA 94577 INSURER F: TRAVELERS PROP CAS CO OF AMER 25674 COVERAGES CERTIFICATE NUMBER:64930799 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 TYPEOFINSURANCE ADDLSUBR'. - POLICY EFF POLICY EXP LIMITS INSD,WVD, POLICY NUMBER IMMIDDIYYYY).(MMIDDIYYYY) A X COMMERCIALGENERALLIABILITY X X 0L5268175 04/01/22 04/01/23 EACHOCCURRENCE $ 2,000,000 _ CLAIMS-MADE I X I OCCUR DAMAGETORENTED PREMISES Ea occu ence) $ 600,000 MED EXP(Any oneperson) $ Excluded PERSONAL&ADV INJURY $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE _$ 4,000,000 POLICY X PRO- LOC PRODUCTS-COMP/OPAGG $ 2,000,000 OTHER: $ • A AUTOMOBILELIABILITY X X CA4489668 04/01/22 04/01/23 COMBINEDSINGLE LIMIT $ 5,000,000 (Ea accident) ' $ ANY-AUTO -- - -- - -- - - - - - - - - -- - -- --- --- - , - - - - BODILY INJURY-(Per-person) -$ -- -. OWNED SCHEDULED BODILY INJURY(Per accident) $ _AUTOS ONLY _AUTOS HIRED NON-CANNED PROPERTYDAMAGE $ AUTOS ONLY _'AUTOS ONLY (Per accident) ' $ , B X UMBRELLALIAB X OCCUR 080877677 1 04/01/22 04/01/23 EACHOCCURRENCE $ 4,000,000 EXCESSUAB CLAIMS-MADE AGGREGATE $ 4,000,000 DED RETENTIONS $ C WORKERSCOMPEN8ATION X WC015893698 - CA ONLY 04/01/22 04/01/23 X STATUTE 0TH AND EMPLOYERS'LIABILITY D. ANYPROPRIETOR/PARTNERIEXECUTIVE Yn NIA WC015893697 - Other Stete44/01/22 04/01/23 E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBEREXCLUDED? IT (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ E Excess Liability 671796000003 04/01/22 04/01/23 Occ & Aggregate 10,000,000 F Prop & Equip of Others OT6306N847906TIL22 04/01/22 04/01/23 Blanket Limit 10,000,000 Deductible 100,000 DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more apace Is required) IRE: All Contracts/Written Agreements between the Certificate Holder and the Insured. Additional Insured(s): City of Ashland, Oregon, its officers, agents and employees. where required by written contract per policy form attached. GL and Auto coverage is Primary and Waiver of Subrogation applies per the attached where required by contract per policy form. WC Waiver of Subrogation Applies for California if required by written contract per the attached policy form. Excess Policy is follow-form. CERTIFICATE HOLDER - CANCELLATION. Account #1044350 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Ashland THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 90 N. Mountain Ave. AUTHORIZEDREPRESENTATIVE Ashland, OR 97520 P5,i�� I USA -_, ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD . SofiaOcegueda 64930799 J P5260028002 Im SUPPLEMENT TO CERTIFICATE OF INSURANCE 03/D9/2022 NAME OF INSURED: Peterson Machinery Co. Peterson Holding Company k. 0 N Additional Description of Operations/Remarks from Page 1: This page intentionally left blank. oo • Additional Information: SUPP(05/04) P5260028002 mem POLICY NUMBER: GL 526-81-75 COMMERCIAL GENERAL LIABILITY CG 20 10 04 13 O THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Personls) Or Organizationls) Location(s) Of Covered Operations ANY PERSON OR ORGANIZATION WHOM YOU PER THE CONTRACTOR AGREEMENT. BECOME OBLIGATED TO INCLUDE AS AN ADDITIONAL INSURED AS A RESULT OF ANY CONTRACT OR AGREEMENT YOU HAVE ENTERED INTO. Information required to complete this Schedule;if not shown above;will-be shown in the Declarations: i- - - A. Section II - Who Is An Insured is amended to that which you are required by the contract include as an additional insured the person(s) or or agreement to provide for such additional organization(s) shown in the Schedule, but only insured. with respect to liability for "bodily injury", B. With respect to the insurance afforded to these "property damage" or "personal and advertising additional insureds, the following additional injury" caused, in whole or in part, by: exclusions apply: 1. Your acts or omissions; or This insurance does not apply to "bodily injury" 2. The acts or omissions of those acting on or "property damage" occurring after: your behalf; 1. All work, including materials, parts or in the performance of your ongoing operations equipment furnished in connection with such for the additional insured(s) at the location(s) work, on the project (other than service, designated above. maintenance or repairs) to be performed by or on behalf of the additional insured(s) at However: the location of the covered operations has 1. The insurance afforded to such additional been completed; or insured only applies to the extent permitted 2. That portion of "your work" out of which by law; and the injury or damage arises has been put.to 2. If coverage provided to the additional its intended . use by any person or insured is required by a contract or organization other than another contractor or agreement, the insurance afforded to such subcontractor engaged in performing additional insured will not be broader than operations for a principal as a part of the same project. CG 20 10 04 13 0 Insurance Services Office, Inc., 2012. Page 1 of 2 0 P5260028002 h 01- C. C. With respect to the insurance afforded to these 2. Available under the applicable Limits of additional insureds, the following is added to Insurance shown in the Declarations; Section III - Limits Of Insurance: whichever is less. If coverage provided to the additional insured is required by a contract or agreement, the most This endorsement shall not increase the we will pay on behalf of the additional insured applicable Limits of Insurance shown in the is the amount of insurance: Declarations. oo 1. Required by the contract or agreement; or Page 2 of 2 0 Insurance Services Office, Inc., 2012 . CG 20 10 04 13 0 P5260028002 - - ■ • • POLICY NUMBER: GL 526-51-75 COMMERCIAL GENERAL LIABILITY CG 20 37 04 13 w■ O THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Location And Description Of Completed Operations Or Organization(s) ANY PERSON OR ORGANIZATION PER THE CONTRACT OR AGREEMENT., WHOM YOU BECOME OBLIGATED TO INCLUDE AS AN ADDITIONAL INSURED AS A RESULT OF ANY CONTRACT OR AGREEMENT YOU HAVE ENTERED INTO. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II - Who Is An Insured is amended to which you are required by the contract or include as an additional insured the person(s) or agreement to provide for such additional organization(s) shown in the Schedule, but only insured. with respect to liability for "bodily injury" or B. With respect to the insurance afforded to these "property damage" caused, in whole or in part, additional insureds', the following is added to by "your work" at the location designated and Section III-Limits Of Insurance: described in the Schedule of this endorsement If coverage provided to the additional insured is performed for that additional insured and required by 'a contract or agreement, the most included in the "products-completed operations we will pay on behalf of the additional insured hazard". is the amount of insurance: However: • 1. Required by the contract or agreement; or 1. The insurance afforded to such additional 2. Available under the applicable Limits of Insu- insured only applies to the extent permitted rance shown in the Declarations; by law; and whichever is less. 2. If coverage provided to the 'additional insured is required by a contract or agree- This endorsement shall not increase the appli= meet, the insurance afforded to such addi- cable Limits of Insurance shown in the Decla- tional insured will not be broader than that rations. CG 20 37 04 13 0 Insurance Services Office, Inc., 2012. Page 1 of 1 ' ❑ P5260028002 .3 • ENDORSEMENT# This endorsement, effective 12:01 A.M. 04/01/2022 forms a part of Policy No.GL 526-81-75 issued to PETERSON HOLDING COMPANY By NATIONAL UNIONFIRE INSURANCE COMPANY OF PITTSBURGH, PA THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. LIMITED ADVICE OF CANCELLATION PROVIDED VIA E-MAIL TO ENTITIES OTHER THAN THE FIRST NAMED INSURED This policy is amended as follows: In the event that the Insurer cancels this policy for any reason other than non-payment of premium_, and 1. the cancellation effective date is prior to this policy's expiration date; 2. the First Named Insured is under an existing contractual obligation to notify a certificate holder when this policy is canceled (hereinafter, the "Certificate Holders)") and has provided to the Insurer, either directly or through its broker of record, the email address of a contact at each such entity; and 3. the Insurer received this information after the First Named Insured receives notice of cancellation of this policy and prior to this policy's cancellation effective date, via an electronic spreadsheet that is acceptable to the Insurer, the Insurer will provide advice of cancellation (the "Advice") via e-mail to each such Certificate Holders within 31 days after the First Named Insured provides such information to the Insurer; provided, however, that if a specific number of days is not stated above, then the Advice will be provided to such Certificate Holder(s) as soon as reasonably practicable after the 'First Named Insured provides such information to the Insurer. Proof of the Insurer emailing the Advice, using the information provided by the First Named Insured, will serve as proof that the Insurer has fully satisfied its obligations under this endorsement., This endorsement does not affect, in any way, coverage provided under this policy or the cancellation of this policy or the effective date thereof, nor shall this endorsement invest any rights in any entity not insured under this policy. The following Definitions apply to this endorsement: 1. First Named Insured means the Named Insured shown on the Declarations Page of this policy. 2. Insurer means the insurance company shown in the header on the Declarations page of this. policy. All other terms, conditions and exclusions shall remain the same. Authorized Representative 107414 (03/11) Page 1 P5260028002 ENDORSEMENT This endorsement, effective 12:01 A.M. 04/01/2022 forms a part of policy No.GL 526-81-75 issued to PETERSON HOLDING COMPANY by NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH, PA THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. AMENDMENT OF LIMITS OF INSURANCE (Per Project or Per. Location Aggregate•Limit) This endorsement modifies insurance provided under the following: , COMMERCIAL GENERAL LIABILITY.COVERAGE FORM I. Your policy is amended to include either a Per Project General Aggregate Limit, a Per Location General Aggregate Limit or.a Per Project and Per Location General Aggregate Limit. Please select only one of the following: [ 1 Per Project General Aggregate Limit $ 1.Per Location General Aggregate Limit $ [Xl Per Project and Per Location.General Aggregate Limit , $ 4,000,000 IF NEITHER OF.THESE BOXES ARE CHECKED, THIS ENDORSEMENT IS VOID. IF MORE THAN ONE OF THE THESE BOXES ARE CHECKED, THIS ENDORSEMENT IS VOID, Ii. SECTION III--LIMITS OF INSURANCE , is amended to include the following: 1. The Limits of Insurance and the rules below fix the most we •will, pay regardless of the number of: a. Insureds; b. Claims made or "suits" brought; or. c. Persons or organizations making claims or bringing "suits". 2. The General Aggregate Limit is the most we will pay for the sum of: a. Medical expenses under Coverage C; b. Damages under Coverage A, except damages because of "bodily injury" or "property damage" included in the products-completed operations hazard";and c. Damages under Coverage B. 3. The Products-Completed Operations Aggregate Limit is the most we will pay under. Coverage A for damages because of"bodily injury" and "property damage" included in the "products-completed operations hazard". 4. Subject to 2. above,the Personal and Advertising Injury Limit is the most we will pay under Coverage B for the sum of all damages because of all "personal and advertising injury" sustained by any one person or organization'.. 5. Subject to 2. or 3. above, whichever applies,the Each Occurrence Limit is the most we will pay for the sum of: a: 'Damages under Coverage A; and , b. Medical expenses under Coverage C 86681 (9/04) Page 1 of 2 P5260028002 ry because of all"bodily injury" and "property damage" arising out of any one "occurrence". cc 6. Subject to 5. above, the Damage to Premises Rented To You,Limit is the mostwe will pay o under Coverage A because of "property damage"to any one premises,while rented to you, or in the case of damage by fire, while rented to you or temporarily occupied by you with permission of the owner. COCO 7. Subject to 5. above, the Medical Expense Limit is the most we will pay under Coverage C for all medical expense's because of "bodily injury" sustained by any one person. 8. Subject to 2., 4., 5., 6., and/or 7. above, the Per Project Aggregate Limit is the most we will pay under Coverages A, B,and C combined for the sum of: a. Damages under Coverage A; b. Damages under Coverage B; and , c. Medical Expenses under Coverage C arising out of any single Project described above. 9. Subject to 2., 4., 5., 6., and/or 7. above, the Per Location.Aggregate Limit is the most we will pay under Coverages A, B, and C combined for the sum of: a. Damages under Coverage A; b. Damages under Coverage B; and c. Medical expenses under Coverage C arising out of the any single Location described above. The Limits of Insurance of this Coverage Part apply separately to each consecutive annual period and to any remaining period of less than 12 months, starting with the beginning of the policy period shown in the Declarations, unless the policy period is extended after issuance for an additional period of less than 12 months. In that case, the additional period will be deemed part of the last preceding period for purposes of determining the Limits of Insurance. III. The Limits of Insurance shown in.the Declarations are deleted in their entirety and replaced by the Limits of Insurance set forth below. Limits of Insurance General Aggregate Limit $ 10,000,000 Each Occurrence Limit $ 2,000,000 Products-Completed Operations Aggregate Limit $ 4,000,000 Personal &Advertising Injury Limit $ 2,000,000 Damage to Premises Rented to You $ 500,000 Medical Expense Limit $ 25,000 Per Project General Aggregate Limit, Per Location $ 4,000,000 General Aggregate Limit or Per Project and Per Location General Aggregate Limit IV. SECTION V- DEFINITIONS, is amended to include the following: 23."Location" means premises involving the same or connecting lots, or premises whose connection is interrupted only by a street, roadway, waterway, or right-of-way railroad. All other terms and conditions of this policy remain the same. f Auth rized Representative or Countersignature (in States Where Applicable 86681 (9/04) Page 2 of 2 P5260028002 -• POLICY NUMBER: GL 526-81-75 COMMERCIAL GENERAL LIABILITY w■ CG 20 11 04 13 w■ O THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED -. MANAGERS OR LESSORS OF PREMISES This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE •. Designation Of Premises (Part Leased To You): ANY PREMISES OR PART THEREOF LEASED TO YOU. Name Of Person(s) Or Organization(s) (Additional Insured): ANY PERSON OR ORGANIZATION FROM WHOM YOU LEASE PREMISES OR WHO MANAGES PREMISES YOU OWN AND TO WHOM YOU BECOME OBLIGATED TO INCLUDE AS AN ADDITIONAL INSURED UNDER THIS POLICY AS A RESULT OF ANY LEASE OR MANAGEMENT AGREEMENT YOU ENTER INTO WITH SUCH PARTIES. Additional Premium: $ INCLUDED I Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II - Who Is An Insured is amended to Schedule and subject to the following additional include as an additional insured the person(s) or exclusions: organization(s) shown in the Schedule, but only This insurance does not apply to: with respect to liability arising out of the ownership, maintenance or use of that part of 1. Any "occurrence'' which takes place after the premises leased to you and shown in the you cease to be a tenant in that premises. CG 20 11 04 13 0 Insurance Services Office, Inc.,,2012 Page 1 of 2 P5260028002 �a Qa 2. Structural alterations, new construction or B. With respect to the insurance afforded to these u. demolition operations performed by or on additional insureds, the following is added to 1/40 behalf of the person(s) or organization(s) Section III- Limits Of Insurance: shown in the Schedule. If coverage provided to the additional insured is 1/40 However: required by a contract or agreement, the most 00 1. The insurance afforded to such additional in- we will pay on behalf of the additional insured sured only applies to the extent permitted by is the amount of insurance: law; and 1. Required by the contract or agreement; or 2. If coverage provided to the additional in- 2. Available under the applicable Limits of sured is required by a contract or ag- Insurance shown in the Declarations; reement, the insurance afforded to such whichever is less. additional insured will not be broader than that which you are required by the contract This endorsement shall not increase the. or agreement to provide for such additional applicable Limits of Insurance shown in the insured. Declarations. Page 2 of 2 0 Insurance Services Office, Inc., 2012 CG 20 11 04 13 P5260028002 ENDORSEMENT This endorsement, effective 12:01 A.M. 04/01/2022 forms a part of O policy No.GL 526-81-75 issued to PETERSON HOLDING COMPANY 0000 by NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH, PA THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CONTROLLED INSURANCE PROGRAM (CIP) EXCLUSION -WITH LIMITED EXCEPTIONS This endorsement modifies insurance provided under the following: Commercial General Liability Coverage Form I. The following exclusion is added to Paragraph 2, Exclusions of Coverage A- Bodily Injury And Property Damage Liability: This insurance does not apply to "bodily injury"or "property damage"arising out of any project that is or was subject to a Controlled Insurance Program ("CIP") in which you are or were an enrollee. This exclusion applies whether or not the "CIP": (1) Provides coverage identical to that provided by this policy; (2) Has limits adequate to cover all claims; or (3) Remains in effect. This exclusion does not apply: (1) to "bodily injury" or "property damage" which occurs at any location owned by, or rented to, you that is outside the project site for that project, and is not covered by the terms of the "CIP" for that project, or (2) to "bodily injury" which occurs during ongoing operations for work being performed on a project subject to a "CIP" after such program has terminated or is no longer in effect. These exceptions, 1 and 2 above, do not apply to "bodily injury" or "property damage" included in the "products completed operations hazard" even if you are required to provide such coverage for an additional insured by written contract or agreement. II. The following is added to Section V - Definitions: A. A Controlled Insurance Program ("CIP") is also known as an "Owner-Controlled Insurance Program (OCIP), a Contractor-Controlled Insurance Program (CCIP) or a Wrap-Up Insurance Program. "CIP" means an insurance program under which one party procures insurance on behalf of all enrolled contractors performing work on a construction project or on a specific site. All other terms, conditions, and exclusions shall remain the same. 119201 (04/15) Includes copyrighted information.of Insurance Services Office, Page 1 of 1 Inc., with its permission. P5260028002 POLICY NUMBER: GL 526-81-75 COMMERCIAL GENERAL LIABILITY CG 20 01 04 13 O THIS ENDORSEMENT CHANGES THE.POLICY. PLEASE READ IT CAREFULLY. C` PRIMARY AND NONCONTRIBUTORY - OTHER INSURANCE CONDITION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to the Other Insurance policy provided that: Condition and supersedes any provision to the (1)The additional insured is a Named Insured contrary: under such other insurance; and Primary And Noncontributory Insurance . (2)You have agreed in writing in a contract This insurance is primary to and will not or agreement thatthis insurance would seek contribution from any other insurance be primary and would not seek contribu- available to an additional insured under your tion from any other insurance available to the additional insured. CG 20 01 04 13 0 Insurance Services Office, Inc., 2012 Page 1 of 1 P5260028002 g � I IN o ■ POLICY NUMBER: GL 526-81-75 COMMERCIAL GENERAL LIABILITY • r w• CG24040509 win WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Person Or Organization: PURSUANT TO APPLICABLE WRITTEN CONTRACT OR AGREEMENT YOU ENTER INTO. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Sec- tion IV- Conditions: We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing opera- tions or "your work" done under a contract with that person or organization and included in the "products-completed operations hazard". This waiver applies only to the person or organization shown in the Schedule above. • CG 24 04 05 09 0 Insurance Services Office, Inc., 2008 Page 1 of 1 0 P5260028002 • ENDORSEMENT This endorsement, effective 12:01 A.M. 04/01/2022 forms a part of v, Policy No.CA 448-96-68 issued to PETERSON HOLDING COMPANY by NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH, PA THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - WHERE REQUIRED UNDERCONTRACT OR AGREEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM SCHEDULE ADDITIONAL INSURED: Any person or organization for whom you are contractually bound to provide Additional Insured status but only to the extent of such person's or organization's liability arising out of the use of a covered "auto". I. SECTION II - COVERED AUTOS LIABILITY COVERAGE, A. Coverage, 1. - Who Is Insured, is amended to add: d. Any person or organization, shown in the schedule above, to whom you become obligated to include as an additional insured under this policy, as a result of any contract or agreement you enter into which requires you to furnish insurance to that person or organization of the type provided by this policy, but only with respect to liability arising out of use of a covered • "auto". However,the insurance provided will not exceed the lesser of: . (1) The coverage and/or limits of this policy, or (2) The coverage and/or limits required by said contract or agreement. 71 AUTHORIZED REPRESENTATIVE 87950 (9/14) Includes copyrighted information of Insurance Services Office,Inc., Page 1 of 1 with its permission. PS260026002 POLICY NUMBER: CA 448-96-68 COMMERCIAL AUTO CA 20 01 10,13 0 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. LESSOR - ADDITIONAL INSURED AND LOSS PAYEE 0000 This endorsement modifies insurance provided under the following: . w AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Named Insured: PETERSON HOLDING COMPANY Endorsement Effective Date: . 04/01/2022 SCHEDULE Insurance Company: NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH, PA Policy Number: CA 448-96-68 Effective Date: 04/01/2022 Expiration Date: 04/01/2023 Named Insured: PETERSON HOLD I NG COMPANY Address: 955 MARINA BLVD SAN LEANDRO, CA 94577 Additional Insured (Lessor): Address: Designation Or Description Of "Leased Autos": ALL "AUTOS" UNDER A LEASING OR RENTAL AGREMENT BETWEEN THE "INSURED" AND THE LESSOR LISTED ABOVE AS THE ADDITIONAL INSURED THAT REQUIRES DIRECT PRIMARY INSURANCE. Coverages Limit Of Insurance Covered Autos Liability $5 000,000 Each "Accident" Actual Cash Value Or Cost Of Repair,Whichever Is Less, Minus Comprehensive $250 Deductible For Each Covered "Leased Auto" Collision Actual Cash Value Or Cost Of Repair,Whichever Is Less, Minus $500 Deductible For Each Covered "Leased Auto" Actual Cash Value Or Cost Of Repair,Whichever Is Less, Minus Specified Causes Of Loss ' Deductible For Each Covered "Leased Auto" Information required to complete this Schedule,if not shown above,will be shown in the Declarations. CA 20 01 10 13 0 Insurance Services Office, Inc.,2011 Page 1 of 2 0 P5260028002 1111_ A. Coverage 1. We will pay, as interest may appear, you oa 1. Any "leased auto" designated or described and the lessor named in this endorsement in the Schedule will be considered a covered for "loss" to a "leased auto". o "auto" you own and not a covered "auto" 2. The insurance covers the interest of the you hire or borrow. lessor unless the "loss" results from fraud- 2. For a "leased auto" designated or described ulent acts or omissions on your part. in the Schedule, Who Is An Insured pro- 3. If we make any payment to the lessor, we vision under Covered Autos Liability Cover- will obtain his or her rights against any other age is changed to include as an "insured" party. the lessor named in the Schedule. However, C. Cancellation the lessor is an "insured" only for "bodily injury" or "property damage" resulting from 1. If we cancel the policy, we will mail notice the acts or omissions by: to the lessor in accordance with the Can- cellation Common Policy Condition. a. You; b. Any of your "employees" or agents; or 2. If you cancel the policy, we will mail notice to the lessor. c. Any person, except the lessor or any 3. Cancellation ends this agreement. "employee" or agent of the lessor, op p The lessor is not liable for payment of your op- erating a "leased auto" with the per- p Y mission of any of the above. premiums. 3. The coverages provided under this endorse- E. Additional Definition ment apply to any "leased auto" described in As usedin this endorsement: the Schedule until the expiration date shown "Leased auto" means an "auto" leased or in the Schedule, or when the lessor or his or rented to you, including any substitute, re- her agent takes possession of the "leased placement or extra "auto" needed to meet auto", whichever occurs first, seasonal or other needs, under a leasing or B. Loss Payable Clause rental agreement that requires you to provide direct primary insurance for the lessor. CA 20 01 10 13 0 Insurance Services Office, Inc.,2011 Page 2 of 2 0 P5260028002 ■ 2 MEN ■ ENDORSEMENT w■ This endorsement,effective 12:01A.M. 04/01/2022 forms a part of w■ 0 policy No. CA 448-96-68 issued to PETERSON HOLDING COMPANY by NATIONAL UNION Fl RE INSURANCE COMPANY OF PITTSBURGH, PA THIS ENDORSEMENT,CHANGES THE POLICY. PLEASE READ IT CAREFULLY. INSURANCE PRIMARY AS TO CERTAIN ADDITIONAL INSUREDS This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM Section IV - Business Auto Conditions, B., General Conditions, 5., Other Insurance, c., is amended by the addition of the following sentence: The insurance afforded under this policy to an additional insured will apply as primary insurance for such additional insured where so required under an,agreement executed prior to the date of accident. We will not ask any insurer that has issued other insurance to such additional insured to contribute to the settlement of loss arising out of such accident. All other terms and conditions remain unchanged. • Auth rued Representative or Countersignature(in States Where Applicable) 74445 110/99) P5260028002 ENDORSEMENT O This endorsement, effective 12;01 A.M. 04/01/2022 forms a part of policy No. CA 448-96-68 issued to PETERSON HOLDING COMPANY by NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH, PA THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM Section IV - Business Auto Conditions, A. - Loss Conditions, 5. - Transfer of Rights of Recovery Against Others to Us, is amended to add: However, we will waive any right of recover we have against any person or organization with whom you have entered into a contract or agreement because of payments we make under this Coverage Form arising out of • an "accident" or"loss" if: (1) The "accident" or "loss" is due to operations undertaken in accordance with the contract existing between you and such person or organization; and (2) The contract or agreement was.entered into prior to any "accident" or"loss". No waiver of the right of recovery will directly or indirectly apply to your employees or employees of the person or organization, and we reserve our rights or lien to be reimbursed from any recovery funds obtained by any injured employee. AUT ORIZED REPRESENTATIVE 62897 (6/95) P5260028002 d IIIIIIIIIIII, ENDORSEMENT# This endorsement, effective 12:01 A.M. '04/01/2022 forms a part of Policy No.CA 448-96-68 issued to PETERSON HOLDING COMPANY by NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH, PA THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EARLY NOTICE OF CANCELLATION PROVIDED BY US This endorsement modifies insurance provided underthe following: AUTO DEALERS COVERAGE FORM COMMERCIAL GENERAL LIABILITY COVERAGE FORM BUSINESS AUTO COVERAGE FORM - MOTOR CARRIER COVERAGE FORM COMMON POLICY CONDITIONS, A. -Cancellation, 2. is amended to read: 2. We may cancel this policy by mailing or delivering to the first Named Insured written notice of cancellation at least: - a. TEN ( 10)* days before the effective date of cancellation if we cancel for nonpayment of premium; or b. SIXTY ( 60)* days before the effective .date of cancellation if we cancel for any other reason. * The notice period provided shall not be less than that required by applicable state law(s). AUT ORIZED REPRESENTATIVE 99307 (9/14) Includes copyrighted information of Insurance Services Office,Inc., Page 1 of 1 with its permission. P5260028002 NAMED INSURED:Peterson Holding Company(per policy) POLICY NUMBER: QT6307387B447 TIL 22 ISSUE DATE:04/01/2022 oa THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. 0 DELUXE PROPERTY COVERAGE PART AMENDATORY ENDORSEMENT LOSS PAYABLE PROVISIONS This endorsement modifies insurance provided under the following: DELUXE PROPERTY COVERAGE FORM Nothing in this endorsement increases the applicable ply with terms of this Coverage Part, the Limit of Insurance. We will not pay any Loss Payee Loss Payee will still have the right to re- more than their financial interest in the Covered Prop- ceive loss payment if the Loss Payee: erty, and we will not pay more than the applicable (1) Pays any premium due under this Limit of Insurance on the Covered Property. Coverage Part at our request if you Each of the following Clauses, A, B, C and D, is have failed to do so:. added to the Loss Payment Loss Condition as indi- (2) Submits a signed, sworn proof of loss cated in the Schedule below. within 60 days after receiving notice A. LOSS PAYABLE CLAUSE from us of your failure to do so;and For Covered Property in which both you and a (3) Has notified us of any change in Loss Payee shown in the Schedule below have ownership, occupancy or substantial an insurable interest,we will: change in risk known to the Loss 1. Adjust losses with you;and Payee. 2. Pay any claim for loss or damage jointly to All of the terms of this Coverage Part will a you and the Loss Payee, as interests may then apply directly to the Loss Payee. appear. d. If we pay the Loss Payee for any loss or B. LENDER'S LOSS PAYABLE CLAUSE damage and deny payment to you be- cause of your acts or because you have 1. The Loss Payee shown in the Schedule be- failed to comply with the terms of this low is a creditor, including a mortgageholder Coverage Part: or trustee, whose interest in Covered Prop- erty is established by such written instru- (1) The Loss Payee's rights will be trans- ments as: ferred to us to the extent of the a. Warehouse receipts: amount we pay;and b. A contract for deed: (2) The Loss Payee's rights to recover the full amount of the Loss Payee's c. Bills of lading: claim will not be impaired. d. Financing statements;or At our option, we may pay to the Loss e. Mortgages, deeds of trust, or security Payee the whole principal on the debt agreements. plus any accrued interest. In this event, you will pay.your remaining 2. For Covered Property in which both you and debt to us. a Loss Payee have an insurable interest: a. We will payfor covered loss or damage to At our option, we may pay to the Loss 9 Payee the whole principal on the debt each Loss Payee in their order or prece- plus any accrued interest. In this event, dence,as interest may appear. you will pay your remaining debt to us. b. The Loss Payee has the right to receive 3. If we cancel this policy, we will give written loss payment even if the Loss Payee has notice to the Loss Payee at least: started foreclosure or similar action on the Covered Property. cellation if we cancel for your a. 10 days before the effective date of non- c. can- If we deny your claim because of your . acts or because you have failed to corn- DX payment of premium;or T3 79 11 12 ©2011 The Travelers Indemnity Company.All rights reserved. Page 1 of 2 Includes copyrighted material of Insurance Services Office,Inc.with its permission. P5260028002 �- 'NT b. 30 days before the effective date of can- 3: The following is added to the Other Insurance cellation if we cancel for any other rea- Condition: 01 son. For Covered Property that is the subject of a 4. If we elect not to renew this policy, we will contract of sale, the word "you" includes the give written notice to the Loss Payee at least Loss Payee. 10 days before the expiration date of this pol- D. BUILDING OWNER LOSS PAYABLE CLAUSE 00 icy. C. CONTRACT OF SALE CLAUSE 1. The Loss Payee shown in the.Schedule be- low is the owner of the described building, in 1. The Loss Payee shown in the Schedule be- which you are a tenant. low is a person or organization you have en • - tered into a contract with for the sale of Coy- 2. We will adjust losses to the described building ered Property. with the Loss Payee. Any loss payment made 2. For Covered Property in which both.you and to the Loss Payee will satisfy your claims the Loss Payee havean insurable interest, against us for the owner's prop erty. we will: 3. We will adjust losses to tenants' improve- a. Adjust losses with you;and ments and,betterments with.you, unless the lease provides otherwis e. b. Pay any claim for,loss or damage jointly to you and the Loss Payee, as interest may appear. SCHEDULE Premises Location Number: Building Number: Applicable Clause (Indicate A,B,C or D): • Description of Property: ALL LEASED LOCATIONS ALL FINANCED REAL AND/OR PERSONAL PROPERTY ALL OWNED LOCATIONS Loss Payee Name: ANY ENTITY WITH AN OWNERSHIP OR FINANCIAL INTEREST IN REAL AND/OR PERSONAL PROPERTY COVERED UNDER THIS POLICY Loss Payee Address: • Page 2 of 2 to 2011 The Travelers Indemnity Company.All rights reserved. DX T3 79 11 12 ' Includes copyrighted material of Insurance Services Office,Inc.with its permission. P5260028002 1 1� NAMED INSURED:Peterson Holding Company(per policy) COMMERCIAL INLAND MARINE POLICY NUMBER: QT6307387B447 TIL 22 m THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. 0 BLANKET LOSS PAYEES This endorsement modifies insurance provided under the IM PAK COVERAGE FORM. The following is added to Section E — ADDITIONAL b. Pay any claim for loss or damage jointly to you COVERAGE CONDITIONS: and the Loss Payee as your interests may ap- Loss Payable Provision pear. In the event of a Covered Cause of Loss to Covered This endorsement applies to all Covered Property for Property in which both you and a Loss Payee share which a Loss Payee is on file with us or your insur- an insurable interest, we will: ance agent or insurance broker. a. Adjust the loss or damage with you; and CM T5 60 01 10 O 2009 The Travelers Indemnity Company Page 1 of 1 Includes copyrighted material of Insurance Services Office,Inc.with its permission. PS260028002 S - BLANKET WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT This endorsement changes the policy to which it is attached effective on the inception date of the policy unless a different date is indicated below. M (The following "attaching clause' need be completed only when this endorsement is issued subsequent to preparation of the policy). This endorsement, effective 12:01 AM 04/01/2022 forms a part of Policy No.WC 015-89-3698 Issued to PETERSON HOLDI NG COMPANY w By NEW HAMPSHIRE INSURANCE COMPANY We have a right to recover our.payments from anyone liable for an injury covered by this policy. We will not enforce our right against any person or organization with whom you have a written contract that requires you to obtain this agreement from us, as regards any work you perform for such person or organization. The additional premium for this endorsement shall be 2.00 % of the total estimated workers compensation premium for this policy. . • • WC 04 03 61 Countersigned by (Ed. 11190) Authorized Representative P5260028002 - WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT This endorsement changes the policy to which it is attached effective on inception date of the policy unless a different date is indicated below. This endorsement, effective 12:01 AM 04/01/2022 forms.a part of Policy No. WC 015-89-3697 1/40 Issued to PETERSON HOLDING COMPANY By THE INSURANCE COMPANY OF THE STATE OF PENNSYLVANIA 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 any one not named in the Schedule. Schedule ANY PERSON OR ORGANIZATION TO WHOM YOU BECOME OBLIGATED TO WAIVE YOUR RIGHTS OF RECOVERY AGAINST, UNDER ANY CONTRACT OR AGREEMENT YOU ENTER INTO PRIOR TO THE OCCURRENCE OF LOSS. This form is not applicable in Kansas for private construction contracts as defined in K.S.A. 16-1801 through K.S.A 16-1807 or public construction contracts as defined in K.S.A. 16-1901 through 16-1908, except where permitted by statute or other applicable law, such as for use in wrap-up insurance programs. Any person or organization for which the employer has agreed by written contract, executed prior to loss, may execute a waiver of subrogation. However, for purposes of work performed by the employer in Missouri, this waiver of subrogation does--not apply to any construction group of classifications as designated by the waiver of right to recover from others (subrogation) rule in our manual. This form is not applicable in California, Kentucky, New Hampshire, New Jersey, Texas, or Utah. INCVA'0% 00 03 13 Countersigned 9 by (Ed. 04/84) Authorized Representative P5260028002 L ry ' CALIFORNIA ADVANCE NOTICE OF CANCELLATION OR NON-RENEWAL BY US EXTENDEDMI ' This endorsement changes the policy to which it is attached effective on the inception date of the policy unless a different date is indicated below. t (The following"attaching clause" need be completed only when this endorsement Is Issued subsequent to preparation of the policy). This endorsement, effective 12:01 AM 04/01/2022 forms a part of Policy No. WC 015-89-3698 Issued to PETERSON HOLDING COMPANY By NEW HAMPSHIRE INSURANCE COMPANY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY PART SIX- CONDITIONS, D. -Cancellation,2. is deleted in its entirety and replaced with: We may cancel or non-renew this policy. We will mail or deliver to,you not less than 10 days advance written notice of cancellation for reasons (a) through (g) and 30 days advance written notice of cancellation for reasons (h) through (m) of California Cancellation Endorsement WC990017. We will mail`or deliver to you not less than 30 days and not more than 120 days advance written notice of non-renewal. Except for non-payment of premium and non-payment of loss reimbursement or non-delivery of satisfactory security or .collateral when due, for which we will provide advance written notice in accordance with the provisions of any-applicable statute or regulation, we shall not provide less than the number of days set forth below. Mailing that notice to you, at your mailing address shown in Item 1 of the Information Page will be sufficient to prove notice. Cancellation: 60 Days Non-Renewal: 60 ,Days WC 99 04 11 Countersigned by (Ed. 08103) Authorized Representative J P5260028002 1$ Excerptfrom Policy Number.080877677 'ry Named Insured:Peterson Holding Company etal Effedtive:4/1/2022-471/2023 2. You have failed to fulfill the terms of a contract or agreement; if such property can be restored to use by: ca 1. The repair, replacement, adjustment or removal of"your product" or "your work"; or 2. Your fulfilling the terms of the contract or agreement. J. "Insured" means: 1. The "Named Insured"; 2. Except for liability arising our of the ownership, maintenance,or use of"covered autos"; a. If you are designated in the Declarations as: (1) An individual,you and your spouse are "Insureds", but only with respect to the conduct of a business of which you are the sole owner; (2) A partnership or joint venture,you are an "Insured". Your members and your partners, and their spouses are also "Insureds", but only with respect to the conduct of your business; (3) A limited liability company, you are an "Insured". Your members are also "Insureds", but only with respect to the conduct of your business. Your managers are "Insureds", but only with respect to their duties as your managers; (4) An organization other than a partnership, joint venture or limited liability company, you are an "Insured". Your "executive officers" and directors are "Insureds", but only with respect to their duties as your officers or directors. Your stockholders are also "Insureds", but only with respect to their liability as stockholders; (5) A trust, you are an "Insured". Your trustees are also "Insureds", but only with respect to their duties as trustees; b. Your "volunteer workers" only while performing duties related to the conduct of your business.Your "employees" other than your "executive officers" (if you are an organization other than a partnership, joint venture or limited liability company) or your managers (if you are a limited liability company), but only for acts within the scope of their employment by you or while performing duties related to the conduct of your business. However, none of these "employees" or'volunteer workers" are insureds for: (1) "Bodily injury" or "personal and advertising injury": (a) To you, to your partners or members (if you are a partnership or joint venture), to your members (if you are a limited liability company), to a co-"employee" in the course of his or her employment or performing duties related to the conduct of your business or to your other "volunteer workers" while performing duties related to the conduct of your business; or any claim or "suit" brought by or on behalf of the spouse, child, parent, brother or sister of that co-"employee" or "volunteer worker" as a consequence of such "bodily injury" or "personal and advertising injury", or; (b) For which there is any obligation to share damages with or repay someone else who must pay damages because of the injury described in Paragraphs (1)(i) above. (2) "Property damage" to property: (a) Owned,occupied or used by, (b) Rented to, in the care,custody or control of, or over which physical control is being exercised for any purpose by you, any of your "employees", "volunteer workers", any partner or member (if you are a partnership or joint venture), or any member (if you are a limited liability company). c. Any person (other than your "employee" or"volunteer worker") or organization while acting as your real estate manager; d• Your legal representative if you die, but only with respect to duties as such. That representative will have all your rights and duties under this policy; OC-UMBR SPEC/MEN LX9799(10/05) Page 14 of 24 P5260028002 a Excerpt from Policy Number:080877677 _ Named Insured: Peterson Holding Company etal Effective :4/1/2022-4/1/2023 e. Any person or organization, other than the "Named Insured", included as an additional "Insured" under "scheduled underlying insurance", but not.for broader coverage than would be afforded by such "scheduled underlying insurance". i 11 3. Only with respect to liability arising out of the ownership, maintenance, or use of "covered autos": a. You are an "Insured"; b. Anyone else while using with your permission a "covered auto" you own, hire, or borrow is also an "Insured" except: (1) The owner or anyone else from whom you hire or borrow a "covered auto". This u.4 exception does not apply if the "covered auto" is a trailer or semi-trailer connected to a "covered auto" you own; (2) Your "employee" if the "covered auto" is owned by that "employee" or a member of his or her household; (3) Someone using a "covered auto" while he or she is working in a business of selling, servicing, repairing, parking or storing "autos" unless that business is yours; (4) Anyone other than your "employees", partners (if you are a partnership), members (if you are a limited liability company), or a lessee or borrower or any of their "employees",while moving property to or from a "covered auto"; (5) A partner (if you are a partnership), or a member (if you are a limited liability company) for a "covered auto" owned by him or her or a member of his or her household; (6) "Employees" with respect to "bodily injury" to any fellow"employee" of the "Insured" arising out of and in the course of the fellow "employee's" employment or while performing duties related to the conduct of your business; c. Anyone liable for the conduct of an "Insured" described above is also an "Insured", but only to the extent of that liability. 4.—Notwithstanding any of the dhove" _—_ - - -- - --- -- - -- a. No person or organization is an "Insured" with respect to the conduct of any current, past or newly formed partnership,joint venture or limited liability company that is not designated as a "Named Insured" in Item 1 of the.Declarations; and b. No person or organization is an "Insured" under this policy who is not an "Insured" under "scheduled underlying insurance". K. "Insured contract" means that part of any contract or agreement pertaining to your business under which any "Insured" assumes the tort liability of another party to pay for "bodily injury" or "property damage" to a third person or organization. Tort liability means a liability that would be imposed by law in the absence of any contract or agreement. "Insured contract" does not include that part of.any contractor agreement: 1. That indemnifies a railroad for "bodily injury" or"property damage" arising out of construction or demolition operations, within 50 feet of any railroad property and affecting any railroad bridge or trestle,tracks, road-beds,tunnel,underpass or crossing;. 2. That indemnifies an architect,engineer or surveyor for injury or damage arising out of: a. Preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports,surveys,field orders,change orders or.drawings and specifications;or b. Giving directions or instructions, or failing to give them, if that is the primary cause of the injury or damage;or 3. Under which the "Insured", if an architect, engineer or surveyor, assumes liability for an injury or damage arising out of the "Insured's" rendering or failure to render professional services, including those shown in subparagraph 2 above and supervisory, inspection, architectural or engineering activities. OC•UMBR SPECIMEN LX9799(10/05) Page 15 of 24 P5260028002 o lllllllllll. ENDORSEMENT This endorsement,effective 12:01 AM 04/01/2022 Forms a part of policy no.: 080g77677 Issued to: PETERSON HOLDING COMPANY By:LEXINGTON INSURANCE COMPANY 00 PRIMARY AND NON-CONTRIBUTORY IF REQUIRED BY WRITTEN CONTRACT ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL UMBRELLA LIABILITY POLICY Provided that,all of the following conditions are met: 1. The written contract or written agreement requiring that the additional insured be added to this insurance also requires that this insurance be primary and non-contributory with respect to any other insurance carried by the additional insured; 2. Such written contract or written agreement is in effect during this "policy period" and executed prior to the "occurrence" of the "bodily injury" or "property damage"; and 3. Coverage required by such written contract or written agreement is provided in the applicable and collectible "scheduled underlying insurance" or would have been provided but for the exhaustion of the underlying limits of insurance; then notwithstanding any other provisions of this policy to the contrary, including, Paragraph K., Other Insurance of SECTION VI - CONDITIONS, with respect to those additional insureds added through written contract or written agreement for which coverage is provided pursuant to Subparagraph J.2.e. of SECTION V - DEFINITIONS, insurance provided under this policy shall be primary and non-contributory with respect to any other insurance providing coverage to such additional insureds, other than "scheduled underlying insurance". Notwithstanding the foregoing under no circumstances will coverage provided to such additional insureds under this policy be broader than the coverage provided under the "scheduled underlying insurance". This endorsement shall not reinstate or increase the limits of insurance shown on the Declarations. All other terms and conditions of the policy remain the same. Authorized Representative LX4305(06/14) Page 1 of 1 P3260028002 • Edgewood Partners Insurance Center(EPIC) P.O.Box 5668 Concord,CA 94524 • • 202204013915 Electronic Service Requested E B I X//� B p 0 C r 0 MIXED AADC 975 ' 8465 2.7440 MB 0.482 nuh�lu�uIulllliII'IIW"hl111Pufd11I'lll'II'I1'I11II11u1 v City of Ashland 217 00 90 N MOUNTAIN AVE ASHLAND, OR 97520-2014 • This document was brought to you by CertificatesNow. - If you have questions regarding the content of this document, - please contact Sofia Oceguedaat '(800)234-6363.- , • • • For new certificate requests or if you need changes made to at: - • existing certificate, please forward the current certificate - • issued with requested changes via E-Mail: . sofia.ocegueda@epicbrokers.com or diana.novicio@epicbrokers.com Please Note: All requests for new certificates or changes to - existing certificates must be requested by the Named Insured.- • Cc: • • • • The data included in this notice and in the attached document is confidential to Ebix BPO and the party responsible for bringing you this information. • • Certificate Delivery by CertificatesNow-www.ConfirmNet.com-877.669.8600