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HomeMy WebLinkAboutInsurance Certificate: Mountain View Paving Inc (2) • , • Ac Rd CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDIYYYY) `.----- 9/20/2022 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 HUB International Northwest,LLC PHPHONE: Kim Schnetzky PO Box 10167 ((A//C N .Ext):541-687-1117 FAX No):541-342-8280 Eugene OR 97440 f,DPR EMAIL ADDRESS: kim.schnetzky@hubinternational.com 8 L tJ% INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Cincinnati Casualty 28665 (MouED ntain View Paving Inc• 14229 INSURER B • PO Box 508 INSURER C: Talent OR 97540 INSURER D: INSURER E: . INSURER F: COVERAGES CERTIFICATE NUMBER:716815566 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 DESC: : • EREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PA M INSR TYPE OF INSURANCE ADDLISUBR POLICY EFF •'•LICY EXP LTR INSD WVD POLICY NUMBER (MM/DD MIDDIYYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY Y Y EPP 0404007 9/25/202 9/25/2023 EACH• CURRENCE $1,000,000 CLAIMS-MADE X OCCUR DAM; E 0 RENTED P-- ISES Ea occurrence $500,000 MED EXP(Any one person) $10,000 - PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 POLICY X JECT , LOC �\PR UCTS-COMP/OP AGG $2,000,000 OTHER: $ A AUTOMOBILE LIABILITY Y Y EPP 0404007 9/25/202. 9/25/2023 CEaOM ccideNEDnt)SINGLE LIMIT $1,000,000 X ANY AUTO ;ODILY INJURY(Per person) $ OWNED SCHEDULED BODILYINJURY•(Per $ AUTOS ONLY AUTOS ( accident) X HIRED y NON-OWNED PROPERTY DAMAGE AUTOS ONLY _ AUTOS ONLY (Per accident) $ A X UMBRELLA LIAB X OCCUR EPP 0404007 9/25/2022 9/25/2023 . EACH OCCURRENCE _ $1,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $1,000,000 DED RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y N STATUTE ER / ANYPROPRIETOR/PARTNER/EXECUTIVENIA E.L.EACH ACCIDENT $ OFFICER/M EMBER EXCLUDED? (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS!LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Certificate holder and all entities required by written contract are included as additional insureds on a primary and non-contributory basis with waiver of subrogation as respects to the general liability including completed operations and auto liability,including waiver of subrogation as required by written contract per attached endorsements.Subject to policy limits,terms,conditions and exclusions. • • • CERTIFICATE HOLDER CANCELLATION ' SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE • THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Ashland ACCORDANCE WITH THE POLICY PROVISIONS. . 90 N.Mountain Ashland OR 97520 AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD THIS ENDORSEMENT CHANGES THE POLICY.PLEASE READ IT CAREFULLY. b. By way of an edition of an ISO addi- 2. With respect to the insurance afforded to tional insured endorsement that In- the additional Insureds described in Para- cludes arising out of your ongoing graph B.1.,the following additional exclu- CONTRACTORS ADDITIONAL INSURED -AUTOMATIC STATUS operations or arising out of "your . sions apply:• - work"; AND AUTOMATIC WAIVER OF SUBROGATION This insurance does not apply to: then the phrase caused, in whole or in WHEN REQUIRED IN WRITTEN CONTRACT,AGREEMENT, part,by in Paragraph A.1.a.and/or Para- a. "Bodily injury","property damage"or graph A.1.b.above,whichever applies,is "personal and advertising injury"ads- PERMIT OR AUTHORIZATION replaced by the phrase arising out of. - ing out of operations performed for the federal government,state or mu • - 3. With respect to the insurance afforded to nicipality;or This endorsement modifies insurance provided under the following: the additional insureds described in Para- injury"graph A.1.,the following additional exclu- b. "Bodily 1 ry o r"property damage" sion applies:. included within the "products- COMMERCIAL GENERAL LIABILITY COVERAGE PART completed operations hazard." This insurance does not apply to"bodily injury', "property damage" or "personal C. The insurance afforded to additional insureds A. Additional Insured -Owners, Lessees Or cluded in the "products-completed and advertising injury"arising out of the described in Paragraphs A.and B.: Contractors-Automatic Status For Other operations hazard",•but only if: 1 rendering of,or the failure to render,any 1. Only applies to the extent permitted by Parties When Required In Written Contract professional architectural,engineering or law;and Or Agreement With You (1) The Coverage Part to which this services,including: endorsement is attached pro-. 2. Will not be broader than that which you 1. Section II - Who Is An Insured is vides coverage for"bodily injury" a. The preparing,approving or failing to are required by the written contract,writ- amended to include as an additional in- or "property damage" included prepare or approve, maps, shop ten agreement,written permit or written . sured any person or organization you within the "products-completed drawings,opinions,reports,surveys, authorization to provide for such addition- have agreed in writing in a contract or operations hazard";and field orders,change orders or draw- 'al insured;and agreement to add as an additional in- logs and specifications;or sured on this Coverage Part. Such per- (2) The written contract or written 3. Does nota I to organize- son(s)or organization(s)is an additional agreement requires you to pro- • b. Supervisory,inspection,architectural apply any person, sub- insuredvide additional insured coverage engineering activities. divisionon,oor governmentalsubdivisionagency oriuor en ineerin a orpolitical s specifically only with respect to liability for: P Y included within the "products named as an additional insured for the a. "Bodily injury","property damage"or completed operations hazard" This exclusion applies even if the claims °personal and advertising injury" for that person or organization. - against any insured allege negligence or same project in the schedule of an en- other wrongdoing in the supervision,bin- dorsement added to this Coverage Part caused, in whole or in part, by the If the written contract or written ing,employment,training or monitoring of performance of your ongoing opera- D. With respect to the insurance afforded to the lions by you or on your behalf,under agreement requires you to provide others by that insured,iif the"occurrence" additional insureds described in Paragraphs that written contract or written additional insured coverage included which caused the"bodily injury"or"prop- A.and B.,the following is added to Section III agreement.Ongoing operations does within the"products-completed oper- erty damage", or the offense which -Limits Of Insurance:. not apply to"bodily injury"or"proper- ations hazard"for a specified length caused the"personal and advertising inju • - ry damage"occurring after: of time for that person or organiza- ty",involved the rendering of,or the fail- The most we will pay on behalf of the addi- tion, the "bodily injury"or"property ure to render,any professional architec- ' tional insured is the amount of insurance: (1) All work, including materials, damage"must occur prior to the ex- tura!,engineering or surveying services. parts or equipment furnished in piration of that period of time in order 1. Required by the written contract,written such on for this insurance to apply. 4. This Paragraph A.does not apply to addi- agreement,written permit or written au- connectiontect withthesr thanchwork,on tional insureds described in Paragraph B. thorization described In Paragraphs A. the maintenance or repairs) to be service, If the written contract or written B. Additional Insured-State Or and B.For the purpose of determining the performed by or on behalf of the agreement requires you to provide Agency Or Subdivision Or Political GovernmentalSubdi- required amount of insurance only,we will additional insured coverage for a include the minimum amount of any Um- additionaltiocovered at the Iota- . vision-Automatic Status When Required brella Liability tion of the covered operations person or organization per only ISO In Written Permits Or Authorizations or Excess Liability coyer- has been completed;or additional insured endorsement form age required for that additional insured In number CG 20 10,without specifying 1. Section II • Who Is An Insured is that written contract, written agreement, (2) That portion of"your work"out of _ an edition date,and without specifi- amended to include as an additional in- written permit or written authorization;or • which the Injury or damage aris- cally requiring additional insured sured any state or governmental agency 2. Available under the applicable limits of In- es has been put to its intended coverage included within the"prod- or subdivision or political subdivision you surance; use by any person or organiza- ucts-completed operations hazard", have agreed In writing in a permit or au- tion other than another contrac- this Paragraph b.does not apply to thorization to add as an additional insured whichever is less. tor or subcontractor engaged in that person or organization. on this Coverage ParL Such state or gov- This endorsement shall not inc• rease the Ir performing operations for a prin- 2. If the written contract or written agree- emmental agency or subdivision or politi- PP- cipal as a part of the same pro- g cal subdivision is an additional insured cable limits of insurance. ject;and ment described in Paragraph 1. above only with respect to operations performed specifically requires you to provide addi- by you or on your behalf for which the E. Section IV-Commercial General Liability ' b, "Bodily injury"or"property damage" tional insured coverage to that person or Conditions is amended to add the following: caused,in whole or in part,by"your organization: state or governmental agency or subdivi- work" performed under that written sion or political subdivision has issued,In Automatic Additional Insured Provision • contract or written agreement and in- a. Arising out of your ongoing opera- writing,a permit or authorization. • tions or arising out of'Your work";or Includes copyrighted material of Insurance . Includes copyrighted material of Insurance GA 472 05 20 Services Office,Inc.,with its permission. Page 1 of 3 GA 472 05 20 Services Office,Inc.,with its permission. Page 2 of 3 This insurance applies only If the"bodily inju- scribed in Paragraph A.or B.that this in- ry"or"property damage"occurs,or the"per- surance would be primary to any other In- sonal and advertising injury'offense is corn- surance available to the additional in- mitted: sured. 1. During the policy period;and As used in this endorsement,wrap-up insur- • execution of the writ- ance means a-centralized insurance program 2. Subsequent toyour q under which one party has secured either in- ten contract or written agreement,or the surance or self-insurance covering some or all issuance of a written permit or written au- of the contractors or subcontractors perform- thorization, described in Paragraphs A. ing work on one or more specific project(s). and B. F. Except when G.below applies,the following is Primary And Noncontributory Insurance When Re added to Section IV-Commercial GeneralBy Written Contract, Liability Conditions, Other Insurance, and Agreement,Permit red it Or Authorization supersedes any provision to the contrary: Except when wrap-up insurance applies to the claim or"suit"on behalf of the additional in- When Other Additional Insured Coverage sured,this insurance is primary to and will not Applies On An Excess Basis seek contribution from any other insurance This insurance is primary to other insurance available to the additional insured described in available to the additional insured described in Paragraphs A.and B.provided that: • Paragraphs A.and B.except 1. The additional insured is a Named In- 1. As otherwise provided in Section IV- sured under such other insurance;and Commercial General Liability Condi- 2. You have agreed in writing in a contract, tions, Other Insurance, b. Excess In- agreement, permit or authorization de- surance;or scribed in Paragraph A.or B.that this in- 2. For any other valid and collectible insur- surance would be primary and would not ance available to the additional insured as seek contribution from any other insur- an additional insured on another insur- ance available to the additional insured. ance policy that is written on an excess As used in this endorsement,wrap-up insur- basis.In such case,this Insurance is also ance means a centralized insurance program excess. under which one party has secured either in- G. The following is added to Section IV-Com- surance or self-insurance covering some or all mercial General Liability Conditions,Other of the contractors or subcontractors perform- Insurance,and supersedes any provision to ing work on one or more specific project(s). the contrary: H. Section IV-Commercial General Liability Primary Insurance When Required By Writ- Conditions,Transfer Of Rights Of Recov- ten Contract, Agreement, Permit Or Au- ery Against Others To Us is amended by the thorization addition of the following: Except when wrap-up Insurance applies to the Waiver of Subrogation claim or"suit"on behalf of the additional in- We waive any right of recovery against any sured,this insurance is primary to any other additional insured under this endorsement, insurance available to the additional insured because of any payment we make under this described in Paragraphs A.and B.provided endorsement, to whom the insured has that: waived its right of recovery in a written con- 1. The additional insured is a Named In- tract,written agreement,written permit or writ- sured under such other insurance;and ten authorization.Such waiver by us applies only to the extent that the insured has waived 2. You have agreed In writing In a contract, its right of recovery against such additional in • - agreement, permit or authorization de- sured prior to loss. Includes copyrighted material of Insurance GA 472 05 20 ' . Services Office,Inc.,with its permission. Page 3 of 3 THIS ENDORSEMENT CHANGES THE POLICY.PLEASE READ IT CAREFULLY. b. Loss Of Earnings:$ 500 5. Medical Payments CONTRACTORS'COMMERCIAL GENERAL LIABILITY Medical Expense Limit:$10,000 BROADENED ENDORSEMENT 9._ Property Damage To Borrowed Equipment Each Occurrence Limit $10,000 This endorsement modifies insurance provided under the following: Deductible Amount: $ 250 16. Voluntary Property Damage Coverage(Coverage a.)And Care,Custody Or Control Liability COMMERCIAL GENERAL LIABILITY COVERAGE PART Coverage(Coverage b.) Limits Of Insurance A. Endorsement-Table of Contents: Coverage a. $1,000 Each Occurrence Coverage: Begins on Page: $5,000 Aggregate 1. Employee Benefit Liability Coverage...._......... ...... 3 Coverage b.$5,000 Each Occurrence unless otherwise stated$ ......_..._........................................_...... 2. Unintentional Failure To Disclose Hazards 9 Deductible Amount(Each Occurrence) 3. Damage To Premises Rented To You 9 Coverage a.$250 4. Supplementary Payments........................................_..._..._.......__________..........._.....10 Coverage b.$250 unless otherwise stated$ 5. Medical Payments.............._..._........_....................._______........._........................._..._...10 PREMIUM BASIS RATE ADVANCE PREMIUM 6. 180 Day Coverage For Newly Formed Or Acquired Organizations 10 COVERAGE 7. Waiver Of Subrogation.............._...................._................................._..._..._......... 11 a) Area (For Limits in Excess of (For Limits In Excess of 8. Automatic Additional Insured.Specified Relationships:...._..._...................._..._..._ 11 b) Payroll $5,000) $5,000) • Managers Or Lessors Of Premises; c) Gross Sales • Lessor Of Leased Equipment; d) Units • Vendors; e) Other • State Or Governmental Agency Or Subdivision Or Political Subdivision-Permits b. Care, Custody Or Or Authorizations Relating To Premises;and Control $ • .Mortgagee,Assignee Or Receiver TOTAL ANNUAL PREMIUM 9. Property Damage To Borrowed Equipment........._..................__..._..._..................__. 14 10. Employees As Insureds-Specified Health Care Services And Good Samaritan Services 15 11. Broadened Notice Of Occurrence 15 12. Nonowned Aircraft........._.. ......._..............._..._..............................................._..._..._..._ 15 13. Bodily injury Redefined......................................_..._............._....._..._........................._ 15 14. Expected Or intended Injury Redefined 15 15. Former Employees As Insureds 15 16. Voluntary Property Damage Coverage And Care,Custody Or Control Liability Coverage.............._..............._........_...................._..._........_........................._...................._.16 • 17. Broadened Contractual Liability-Work Within 50'Of Railroad Property...._............._ 17 18. Alienated Premises...._........................._........_.................._....._..._............._...__.... 17 B. Limits Of Insurance: The Commercial General Liability Limits of Insurance apply to the Insurance provided by this endorse- ment,except as provided below: 1. Employee Benefit Liability Coverage • Each Employee Limit: $1,000,000 Aggregate Limit: $3,000,000 Deductible Amount: $ 1,000 3. Damage To Premises Rented To You The lesser of: a. The Each Occurrence Limit shown in the Declarations;or b. $500,000 unless otherwise stated$ • 4. supplementary Payments ' a. Ball Bonds: $2,500 Includes copyrighted material of Insurance Includes copyrighted material of Insurance GA 233 0917 Services Office,Inc,with its permission. Page 1 of 17 GA 233 0917 Services Office,Inc.,with its permission. Page 2 of 17 • • • • C. Coverages . this endorsement pro- (d) Insufficiency Of Funds • (i) Taxes,Fines Or Penalties vided: Damages arising out of an Taxes,fines or penalties,In- a)t. Employee Benefit Liability Coverage �9 a. The following is added to Section I- You did not have eetinsufficiencyny of funds to eluding those Imposed un- knowledge of a meet any obligations under der the Internal Revenue Coverages: claim or"suit"on or any plan included in the Code or any similar state or Employee Benefit Liability Cover- before the"first ef- "employee benefit program". local law. age fectivedate"of this endorsement. (e) inadequacy Of Perfor- ) Employment-Related Prac- (1) Insuring Agreement mance Of Invest- tires You will be me ice Given With Any liability arising out of ' (a) We will pay those sums that - deemed to have Respectpest To Participation the Insured becomes legally knowledge of a any: obligated to pay as damag- claim or "suit' Any dalm based upon: (1) Refusal to employ; es caused by any act,error when any"author- 1) Failure of any invest- or omission of the insured, ized represents- ment to perform;, (2) Termination of employ. ' or of any other person for _ tive"; ment; whose ads the insured is ( 2) Errors in providing in • - legally liable, to which this i) Reports all, or formation on past per- (3) Coercion, demotion, insurance applies. We will any part,of the formance of investment evaluation, reassign have the right and duty to act, error or vehicles;or ment, discipline, defa- defend the Insured against omission to us mation, harassment, any "suit" seeking those or any other 3) Advice given to any humiliation, discrimina- damages. However,we will insurer, person with respect to tion or other employ- have no duty to defend11 Receives a that person's decision to ment-related practices, against any "suit" seeking written or ver- participate or not to par- acts or omissions;or damages to which this In- bal demand orticipate In any plan In- ,(2)Consequential liability saran does not apply.We claim for dam- eluded in the"employee (4) as a Cons e sult of 1 o becauser may, at our discretion, In- benefit program". above. ( ) vests to any report of an ages (3) of the act, er- (f) Workers' Compensation ad, error or omission and This exclusion applies settle any claim or"suit'that slon;and orris- And Similar Laws whether the Insured may be may result.But: Any claim arising out of your held liable as an employer b) There is no other failure to comply with the, • or in any other capacity and ' 1) The amount we will pay applicable insur- mandatory provisions of any to any obligation to share for damages is limited • ance. workers' compensation, un- damages with or repay ' as described in Section employment compensation someone else who must pay III - Limits Of Incur- (2) Exclusions insurance,social security or damages because of the fin- ance;and disability benefits law or any Jury. This insurance does not apply to: 2) Our right and duty to similar law. • defend ends when we (a) )uryp BodilyIn Property (3) Supplementary Payments Damage Or Personal And (9) ERISA Section I - Coverages, Su have used up the appli- Advertisingu 9 p- cable limit of Insurance Injury ry Damages for which any in- elementary Payments-Cover- • in the payment of Judg- 'Bodily Injury', "property sured is liable because of ii- ages A And B also apply to this ments or settlements, damage" or "personal and ability imposed on a fidud- Coverage. advertising injury'. ary by the Employee Re- b. Who Is An Insured N• o other obligation orliabil- tirement Income Security • ity to pay sums or perform (b) Dishonest, Fraudulent, Act of 1974, as now or As respects Employee Benefit 13a- ads or services Is covered Criminal Or Malicious Act • hereafter amended, or by bility Coverage,Section II-Who Is , unless explicitly provided for • any similar federalstate or under Supplementary Damages arising out of any local laws. An Insured is replaced by the follow- . Payments. Intentional, dishonest, Irv. fraudulent,criminal or mali- (h) Available Benefits (1) If you are designated in the Dec- (b) eo-(b) This Insurance applies to cious act,error or omission, damages onlyIf the ad,er- Any claim for benefits to the locations as: 9committed by any insured, benefits are roc or omission',Is negligent- including the willful or reds- extent that such (a) An individual,you and your ly committed in the"admin- less violation of any statute. available, with reasonableeffort and cooperation of the spouse are Insureds,but on- bene t of your"employee P ly with respect to the con- duct of and (c) Failure To Perform A Con- insured,from the applicable dud of a business of which 1) Occurs during the policy tract funds accrued or other col- you are the sole owner. period;or Damages arisingout of fail- lectible insurance. 9 (b) A partnership or Joint ven- t Occurred riot to the ure of performance of coil- . on- tura, you are an Insured. P tract by any usurer. Your members, your part- "first effective date" of Includes copyrighted material of Insurance Includes copyrighted material of Insurance GA 233 0917 Services Office,Inc.,with its permission. Page 3 of 17 GA 233 0917 Services Office,Inc,with its permission. Page 4 of 17 • ners,and their spouses are nation.However,coverage under (b) A series of related ads,er- tification of the action taken, also insureds but only with this provision: rors or omissions, regard- you shall promptly reim- respect to the conduct of less of the amount of time - burse us for such part of the your business. (a) Is afforded only until the that lapses between such Deductible Amount as we 180th day after you acquire acts,errors or omissions; have paid. (c) A limited liability company, or form the organization or you are an insured. Your the end of the policy period, negligently committed in the d. Additional Conditions members are also insureds, whichever is earlier,and "administration"of your"employ- but respects Employee Benefit Lia- con uct withorespect to the Does nota i to anyact, ee benefit program". bility Coverage,Setion IV-Com- Your geur business. (b) error or omissionsthawas. However,the amount paid under merclal Genral LiabilityCondi- Your managers are In- committed before Condi- sureds,but only with respect you Sc-ao- this endorsement shall not ex- tions Is amended as follows: to their duties asY our man- quired or formed the organi- ceed,and will be subject to the agers. nation. limits and restrictionsthat apply (1) Item 2.Duties In The Event Of Occurrence,Offense,Claim Or • to the payment of benefits in any (d) An organization other than a. c. Limits Of Insurance plan Included In the "employee Suit is replaced by the following: . partnership,joint venture or As respects Employee Benefit Lia- benefit program." 2. Duties In The Event Of An limited liability company,you bility Coverage,Section III-Limits Deductible Amount Act,Error Or Omission,Or are an insured.Your"execu- Of Insurance is replaced by the fol- - (4) Claim Or Suit tive officers" and directors lowing: (a) Our obligation to pay dam- are insureds, but only withages on behalf of the In- a. You must see to it that respect to their duties as - (1) The Limitts of Insurance shown insured applies only to the we are notified as soon your officers or directors. Section B.Limits Of Insurance, amount of damages In ex- as practicable of an act, Your stockholders are also 1. Employee Benefit Liability cess of the Deductble error or omission which insureds, but only with re- Coverage and the rules below fix Amount stated in the Deda- may result in a daim. sped to their liability as the most we will pay regardless rations as applicable to To the extent possible, stockholders. of the number of: Each Employee. The limits notice should Include: (e) A trust,you are an Insured. (a) Insureds; of insurance shall not be re- (1) What the act,error Your trustees are also in- duced by the amount of this or omission was sureds,but only with respect (b) Claims made or "suits" deductible. and when It oc- to their duties as trustees. brought; (b) The Deductible Amount carred;and •(2) Each of the following is also an (c) Persons or organizations stated in the Declarations (2) The names and insured: making claims or bringing applies to all damages sus- addresses of any- "suits"; tamed by any one"employ- one who may suf- (a) Each of your "employees" ee",including such"employ- far damages as a who Is or was authorized to (d) Acts,errors or omissions;or ee's"dependents and bene- result of the ad, administer your "employee (e) Benefits Included in your ficiaries,because of all acts, error or omission. benefit program"; "employee benefit program". errors or omissions to which this insurance applies. b. If a daim is made or (b) Any persons, organizations (2) The Aggregate Limit shown in "suit"Is brought against or"employees"having prop- Section B.Limits Of Insurance, (c) The terms of this insurance, any insured,you must: er temporary authorization1. Employee Benefit Liability including those with respect to administer your"employ- Coverage of this endorsement is to: (1) Immediately record ee benefit program': if you the most we will pay for all dam- the specifics of the die,but only until your legal ages because of acts,errors or 1) Our right and duty to claim or"suit"and 9defend the insured representative is appointed; omissions negligentlycommitted the date received; or against any "suits" and in the "administration" of your seeking those damag- (c) Your legal representative if "employee benefit program". es;and (2) Notify us as soon you die, but only with re- (3) Subject to the limit described in as practicable. • spect to duties as such.That (2) bove, the Each Employee 2) Your oan,and tee In- representative will have all vas of any other the You must see to n tno- P Limit shown In Section B.Limits no- your rights and duties under Of Insurance, 1. Employee eventevinsured,error weiof thehivc written • this Coverage Part. miof,o act,claim; or asse of claim or e.t" Benefit Liability Coverage of omission,or soon as practicable. • (3) Any organization you newly ac- this endorsement is the most we quire or form,other than a part- will pay for all damages sus- apply Irrespective of the ap- c. You and any other In- nership,joint venture or limited tained by any one "employee", plication of the Deductible volved insured must: liabilitycompany,and over which including damages sustained by Amount. such "employee's" dependents (1) Immediately send you maintain ownership or major- ity interest, will qualify as a and beneficiaries,as a result of (d) of the We may a aeductible Asarmount to uscopiss notices, Named Insured if no other similar (a) An act,error or omission;or effect settlement of any summonses or le- Insurance applies to that organa- — claim or"suit'and,upon no- gel papers re- Incudes copyrighted material of Insurance includes copyrighted material of insurance GA 233 0917 Services Office,Inc.,with its permission. • Page 5 of 17 GA 233 0917 Services Office,Inc.,with its permission. Page 6 of 17 • • • • m m 03 d o c E 33=, o atn o. 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' • 2. Unintentional Failure To Disclose Haz- 2) Rust or other cor- 2) Basements, you with permission of ards rosion, decay, de- whether paved or the owner; • terioration, hidden not;or Section IV-Commercial General Liabil- or latent defect or b. In the case of damage ity Conditions, 7. Representations is any quality In 3) Doors,windows or by fire,explosion,light- amended by the addition of the following: property that caus- other openings. ning, smoke or soot, es it to damage or while rented to you;or Based on our dependence upon your rep- (c) "Property damage" caused resentations as to existing hazards,if un- destroy tselr • by or resulting from water c. In the case of damage intentionally you should fail to disclose all 3) Smog; that leaks or flows from by water, while rented such hazards at the inception date of your plumbing,heating,air condi- to and occupied by you. policy,we will not reject coverage under 4) Mechanical break- tioning, fire protection sys- this Coverage Part based solely on such down. Including tems, or other equipment, (2) The most we will pay Is limited as failure. rupture or bursting caused by or resulting from described in Section B. Limits causedby centrif- freezing,unless: Of Insurance, 3. Damage To 3. Damage To Premises Rented To You ugal force; Premises Rented To You of this (i) You did your best to endorsement. a. The last Paragraph of 2.Exclusions 5) Settling, cracking, • maintain heat in the under Section I-Coverage A-Bod- shrinking or ex- building or structure;or 4. Supplementary Payments ily Injury And Property Damage Li- pension; Under Section I-Supplementary ability is replaced by the following: (ii) You drained the equip- pP rY Pay- 6) Nesting or infesta- ment and shut off the ments-Coverages A And B: Exclusions c.through q.do not apply tion, or discharge water supply if the heat a. Paragraph 2.is replaced by the fol- to"property damage"by fire,explo- or release of waste was not maintained, sion, lightning, smoke or soot to lowing: remises while rented toyou or tem- products o I sacra, (d) 'Property damage"to: P tions, by insects, • P � g �� Up to the limit shown In Section B. porarily occupied by you with permis- birds, rodents or (i) Plumbing, heating, air Limits Of Insurance,4.a.Bail Bonds sion of the owner, for which the other animals;orconditioning,fire proton- Damage of this endorsement for cost of bail amount we will pay is limited to the bonds re cared because of accidents Damage To Premises Rented To 7) Presence, growth, • tion systems, or other or traffic law violations arising out of You Limit as described In Section III proliferation, equipment or appliancto- -Limits Of Insurance. spread or any ac- es;or B ariluse of anyl vehicle i icleCoverei a ach ha tivity of fungus,in- - ry Liability h ap- tivity The Insurance provided under Sec- eluding mold or (ii) The g Interior of ,or plies.oWe do not have to furnish these tlon I-Coverage A-Bodily Injury mildew, and any building or structure,or bonds. And Property Damage Liabilityap- to personal property In P rtY mycotoxins, the building or structure, b. Paragraph 4.Is replaced by the fol- plies to"property damage"arising out spores, scents orcaused by or resulting lowing: of water damage to premises that are byproducts pro- from rain,snow,sleet or both rented to and occupied by you. duced or releasedAll reasonable expenses Incurred by by fungi. Ice,whether driven by the insured at our request to assist us (1) 'As respects Water Damage Le- wind or not. In the investigation or defense of the gal Liability,as provided in Para- (b) "Property damage" causedc. Limit Of Ins• urance claim or"suit",including actual loss of graph 3.b.above: directly or Indirectly by any earnings up to the limit shown In Sec- . The exduslons under Section 1- of the following: With respect to the Insurance afford- tion B. Limits Of Insurance, 4.b. . Coverage A-Bodily Injury And Earthquake, volcanic ed In Paragraphs 3.a.and 3.b.above, Loss Of Earnings of this endorsement Property Damage Liability, 2. () q the Damage To Premises Rented per day because of time off from P t'tY 9 ttY. eruption, landslide or To You Limit as shown in the Deda- work Exclusions, other than I. War any other earth move- rations is amended as follows: - and the Nuclear Energy Liabil- meet; 5. Medical Payments Ity Exclusion(Broad Form),are (1) Paragraph 6. of Section III - deleted and the following are (ii) Water that backs up or Limits Of Insurance is replaced The Medical Expense Umit of Any One added: overflows or is other- by the following: Person as stated In the Declarations Is • wise discharged from a amended to the limit shown In Section B. This insurance does not apply to: sewer, drain, sump, 6. Sulijed to Paragraph 5. Limits Of Insurance, 5. Medical Pay- (a) "Property damage": sump pump or related above, the Damage To ments of this endorsement equipment; Premises Rented To You (i)\ Assumed In any con- Limit is the most we will pay 6. 180 Day Coverage For Newly Formed tract or agreement;or (iii)Water under the ground under Coverage A-Bodily Or Acquired Organizations surface pressing on,or Injury And Property Dam- •' (ii) Caused by or resulting flowing or seeping age Liabilityfor damages aSmendend asII - Who Is An Insured is from any of the follow- through: because of roperty dam- amended follows: . Ing. 1) Foundations,walls, age"to any one premises: Subparagraph a.of Paragraph 3. is re- 1) Wear and tear, floors or paved a. While rented to you,or placed by the following: surfaces; -• temporadly.occupied by a. Insurance under this provision Is af- - forded only until the 180th day after Includes copyrighted material of Insurance Includes copyrighted material of Insurance GA 233 0917 Services Office,Inc.,with its permission. Page 9 of 17 GA 233 0917 Services Office,Inc.,with its permission. Page 10 of 17 / you acquire or form the organization use of that part of the prem- vendor's business, subject ' or repair opera- or the end of the policy period, ises leased to you, subject to the following additional tions, except such whichever Is earlier; to the following additional exclusions: operations per- exclusions: formed at the yen- 7. Waiver Of Subrogation (i) The insurance afforded dor's premises In Section IV-Commercial General Liabil- • This insurance does not ap- the vendor does not connection with the ity Conditions,9.Transfer Of Rights Of ply to: apply to: sale of the product; Recovery Against Others To Us is () Any"occurrence"which 1) "Bodily Injury' or 7) Products which,af- amended by the addition of the following: takes place after you "property damage" ter distribution or We waive any right of recovery we may cease to be a tenant in • for whidi the den- sate by you,have have against anyperson or organization that premises; dor is obligated to been labeled or re- pay 9 pay •damages by labeled or used as against whom you have agreed to waive (ii) Structural alterations, reason of the as- such right of recovery in a written contract new construction or sum tion of liability . a container,part or or agreement because ofpayments we demolition operations P ingredient of any 9 Pe In a contract or other thing or sub make for injury or damage arising out of performed by or on be- agreement This your ongoing operations or"your work" half of such additionalexclusion does not stance by or for the done under a written contract or agree- • insured. apply to liability for vendor,or ment with that person or organization and damages that the 8) "Bodily injury' or included In the"products-completed oper- (b) Lessor Of Leased Equip- vendor would have "property damage" ations hazard".However,our rights may ment in the absence of arising out of the only be waived prior to the"occurrence" '- Any person or organization the contract or sole negligence of giving rise to the injury or damage for from whom you lease agreement; • the vendor for its which we make payment under this Cov- equipment when you and own acts or omis- erage Part.The Insured must do nothing such person(s)or organize- 2) Any express war- stuns or those of after a loss to Impair our rights.At our re- tion(s)have agreed per Par- ranty unauthorized its employees or quest,the insured will bring"suit"or trans- agraph 8.a.(1) of this en- by you; anyone else acting fer those rights to us and help us enforce dorsement to provide insur- on its behalf.How- - ' those rights. , once.Such person(s)or or- 3) Any physical or ever,this exclusion P () chemical change in _ 8. Automatic Additional Insured-Speci- ganization(s) are insureds the product made does not apply to: tied Relationships only with respect to liability Intentionally by the - a) The exceP for'bodily injury',"property vendor. a. The following is added to Section II- damage" or "personal and lions contained Who Is An Insured: advertising injury"caused,in 4) Repackaging, ex- In Paragraphs Any or whole or in part, by your cept when un- '(c)(I)4)'or 6) (1) person(s) organization(s) maintenance, operation or packed solely for of this en- described in Paragraph 8.a.(2)of use of equipment leased to the purpose of In- dorsement;or this endorsement(hereinafter re- you by such person(s)or or- spection, demon- ferred to as additional insured) ganization s.Aperson's or stration,testing,or b) Such inspec- whom you are required to add as () tions, ac(ust- q organization's status as an the substitution of merits,tests or an additional Insured under this additional insured under this parts under in- Coverage Part by reason of a endorsement ends when strudlons from the servicing as written contract, written agree- their contract or agreement manufacturer, and tagreed her dndor has ment, written permit or written with you for such leased then repackaged In •� make or nor • - authorization. equipment ends. However, the original con- malty under- (2) Only the following persons or or- this insurance does not ap- tainer, takes to make ganizations are additional in- ply to any "occurrence" in the usual which takes place after the 5) Any failure to make sureds under this endorsement, such Inspections, course of and insurance coverage provided equipment lease e�ghires. adjustments, tests business, in to such additional insureds is Ilm- (c) Vendors or servicing as the connection Ited as provided herein: • vendor has agreed with the distri- Any person or organization to make or normal- button or sale (a) Managers 9 Or Lessors Of (referred to below as yen- of the prod- Premises dor) with whom you have ly undertakes al ucts. make in the usual The manager or lessor of a agreed per Paragraph course of bust- 9 (ii) This Insurance does not premises leased toyou with t provide this endorsementce,but nets,in connection apply to any Insured whom you have agreed per to Insurance,but on- with the distribution person or organization: Paragraph 8.a.(1)of this en- ly with respect to'bodily in- or sale of the dorsement to provide Insur- jury" or "property damage" products; . 1) From whom you ance,but only with respect arising out of'your products" have acquired to liability arising out of the which are distributed or sold 6) Demonstration, in- such products, or ownership, maintenance or . • in the regular course of the stallation,servicing any Ingredient,part includes copyrighted material of Insurance Includes copyrighted material of Insurance GA 233 0917 Services Office,Ina,with its permission. Page 11 of 17 GA 233 0917 Services Office,Ina,with its permission. Page 12 of 17 • or container,enter- (e) Mortgagee, Assignee Or in Paragraph 8.a.(1)of this en- tion I-Coverage A-Bodily Injury Ing into,accompa- Receiver dorsement or And Property Damage Liability: • nying or containing Any person or organization (2) Available under the applicable Paragraphs(3)and(4)of this exclu- withsuch products;w whom you•have agreed Limits of Insurance shown in the sion do not apply to tools or equip- ' 2) When liability in- per Paragraph 8.a.(1)of this Declarations; ment loaned to you,provided they are cluded within the endorsement to provide in- whichever Is less. not being used to perform operations "products- surance, but only with re- at the time of loss. completed opera- spect to their liability as This endorsement shall not increase Sons hazard" has mortgagee,assignee,or re- the applicable Limits of Insurance b. Withrespectto the insuranceofthe endorse- beenproe- excluded un- celver and arising out of the pI ed by this section of shown in the Declarations. ment,the following additional provi- der this Coverage ownership,maintenance, or sionsapply: Part with respect to use of the premises by you. c. Section IV -Commercial General . such products. However, this insurance • Liability Conditions Is amended to (1) The Limits of Insurance shown in State Or Governmental does not apply to structural include the following: the Declarations are replaced by (d) alterations,new construction the limits designated In Section Agency Or Subdivision Or and demolition operations Automatic Additional Insured Pro- Political Subdivision - p vision B. Limits Of Insurance, 9. performed by or for that per- Property Damage To Borrowed Permits •Or Authorizations son or organization. This Insurance applies only if the Equipment of this endorsement Relating To Premises • "bodily Injury"or"property damage" with respect to coverage provid- Any (3) The lIinsureds be o addi-ar state or governmental linnet insureds described in Par- occurs,or the"personal and advertis- ed by this endorsement.These agency or subdivision or po- agraph 8.a.(1) of this endorse- ing injury'offense is committed: limits are inclusive of and not in Iitical subdivision with which ment addition to the limits being re- . - you have agreed per Para- (1) During the policy period;and placed.The Limits of Insurance graph 8.a.(1) of this en- (a) Only applies to the extent (2) Subsequent to your execution of shown In Section B. Limits Of dorsement to provide Insur- permitted by law;and the written contract or written Insurance.9.Property Damage ance,subject to the follow agreement,or the issuance of a To Borrowed Equipment of this (b) Will not be broader than that Ing additional provision: written permit or written authori- endorsement fix the most we will which you are required by in anyone"occurrence"This insurance applies only the written contract,written nation, described In Paragraph payarin s e r re- with respect to the following agreement,written permit or _ 8.a.(1). of: hazards for which the state written authorization to pro- - d. Section IV-Commercial General (a) Insureds; or governmental agency or vide for such additional in- Liability Conditions Is amended as • (b) Claims made or sults" subdivision or political sub- cured;and follows: division has issued a permit brought;or • or authorization in connec- (c) Does not apply to any per- Condition 5. Other Insurance is (c) Persons or organizations son, organization, vendor, amended to include: tion with premises you own, state,governmental agency making claims.or bringing rent or control and to which or subdivision or political Primary And Noncontributory In- "suits". this insurance applies: subdivision, specifically surance (2).Deductible Clause (I) The existence, mainte- named as an additional In- This Insurance Is primary to and will • nonce,repair,construc- cured under any other provi- (a) Our obligation to pay dam- lion, not seek contribution from any other ages erection or removal clan of, or endorsement on your behalf applies of advertising signs, added to, this Coverage insurance available to an additional only to the amount of dam- awnings,canopies,cal- Part, provided such other insured per Paragraph 8.a.(1)of this ages for each"occurrence" lar entrances, coal provision or endorsement endorsement provided that: which are in excess of the holes, driveways, man- covers the Injury or damage (1) The additional Insured is a Deductible Amount stated in holes, marquees, hoist for which this insurance ap- Named Insured under such other Section B.Limits Of Insur- . away openings, side- plies. insurance;and ance,9.Property Damage walk vaults,street ban- To Borrowed Equipment of b. With respect to the insurance afford- ners or decorations and (2) You have agreed In writing In a this endorsement.The limits ed to the additional insureds de- contract, agreement, ebe similar exposures;or scribed in Paragraph 8.a.(1) of this permit or d Insuranceedby will not io re- scribed () authorization described in 8.a.(2) duced by the application of (1) The construction,erec- endorsement,the following is added of this endorsement that this in- - such deductible amount. lion or removal of eleva= to Section III-Limits Of Insurance: surance would be primary and tom;or - would not seek contribution from (b) Section IV - Commercial The most we will pay on behalf of the General LiabilityCondi- (II)The ownership,mainte- additional insured is the amount of in- any other Insurance available to the additional Insured. tions, 2. Duties In The nonce or use of any el- surance: Event Of Occurrence,Of- Insuran covered by this (1) Required bythe written contract, 9. Property Damage To Borrowed Equip- Tense, Claim Or Suit, ap- writtenInsurance. q ment plies to each claim or"suit" agreement,written permit • or written authorization described a. The following Is added to Exclusion irrespective of the amount. 2.j.Damage To Property under Sec- Includes copyrighted material of Insurance Includes copyrighted material of Insurance GA 233 0917 Services Office,Inc.,with its permission. Page 13 of 17 GA 233 0917 Services Office,Inc.,with its permission. Page 14 of 17 • • • • (c) We may pay any part or all 12. Nonowned Aircraft 16. Voluntary Property Damage Coverage (2) Exclusions of thedeductible amountto The following Is added to Exclusion 2.g. a. Coverage D -Voluntary Property This Insurance does not apply to effectsettlementofany ua claimmor"suit"and,upon no- Aircraft,Auto Or Watercraft under Sec- Damage Coverage "property damage"that would be • tffication of the action taken, tion I-Coverage A-Bodily Injury And excluded by Coverage A-Bodi- you Damage Liability: Section I-Coverages Is amended to you shall promptly reim- Property 9 tY Include the following: ly Injury And Property Damage burse us for such part of the This exduslon does not apply to an air- Liability,2.Exclusions,except deductible amount as has you do not own,provided that: (1) Insuring Agreement for J.Damage To Property,par- been paid by us. agraphs(3),(4),(5)and(6), k. • • a. The pilot in command holds a current (a) We will pay the cost to re- Damage To Your Product,and 10. Employees As Insureds - Specified effective certificate,issued by a duly pair or replace "property I.Damage To Your Work. . Health Care Services And Good Samar- constituted authority of the United damage"to property of oth- itan Services States of America or Canada,desig- ers arising out of operations (3) Definitions . Paragraph 2a.1 d under Section II- nating that person as a commerdal or incidental to your business For purposes of Voluntary ()d airline transport to when: Who Is An Insured does not apply to: sP pilot Property Damage Coverage 1)• Damage is caused byonly,the following definitions un- a. Your"employees"who provide pro b. The aircraft is rented with a trained, g der Section V-Definitions are or you; crew;and • fessional health care services on your paidreplaced by the following: behalf as a duly licensed nurse, c. The aircraft does not transport per- • 2) Damage occurs while In emergency medical technician orsons or cargo for a charge. your possession. 16. "Occurrence"means an in- . paramedic in the jurisdiction where an cident,including continuous . occurrence"or offense to which this 13. Bodily Injury Redefined At your written request,we or repeated exposure to Insurance applies takes place;or . will make this payment re- ' substantially the same gen- Section V-Definitions,4."Bodily injury' gardless of whether you are eral harmful conditions that - b. Your"employees"or"volunteer work Is replaced by the following: at fault for the "property result In'property damage". 1 ers",other than an employed or vol- damage". unteer doctor, providing first aid or 4'. "Bodily injury'means bodily harm or 20. "Property damage" means good samaritan services during their Injury,-sickness, disease, disability, If you, at our request, re- physical Injury to tangible • work hours for you will be deemed to humiliation,shock,fright,mental an- place,or make any repairs property."Electronic data"Is be acting within the scope of their guish or mental Injury,Including care, to, damaged property of • not tangible property, and employment by you or performing du- loss of services or death resulting others, the amount we will 'property damage"does not ties related to the conduct of your from any of these at any time. pay under Voluntary Prop- include disappearance, ab- business. 14. Expected Or Intended Injury Redefined erty Damage Coverage will straction or theft. P J ry be determined by your actu- 11. Broadened Notice Of Occurrence The last sentence of Exclusion 2.a.Ex- al cost to replace or repair b. Care,Custody Or Control Liability pected• Or Intended Injury underSec- the damaged property, ex- Coverage Paragraph a.of Condition 2. Duties In ry eluding any profit or over- The Event Of Occurrence, Offense, tion I-Coverage A-Bodily Injury And For purposes of the coverage provid- Pro Property Damage LiabilityIs replaced byhead. Claim Or Suit under Section IV-Com- P Y 9P ed by Care,Custody Or Control Li • - mercial General Liability Conditions is the following: Any payment we make un- ability Coverage in this endorsement . replaced by the following: This exclusion does not apply to"bodily der Voluntary Property only: injury"or"property damage"resulting from Damage Coverage shall not (1) Section I-Covera e A-Bodily ' asa. You must see acto ti that ofe are"noccurd- the use of reasonable force to protect per- be Interpreted as an admis- Injury And Property Damag re soon as practicable an"occur- • sion of liability rence"or an offense which may result sons or property. us by you or by Liability, 2. Exclusions, j. -In a claim.To the extent possible,no- 15. Former Employees As Insureds Damage To Property,Subpara- tics should include: It shall be your duty,not our graphs(3),(4)and(5)do not ap- The following Is added to Paragraph 2. duty,to defend any claim or ply to"property damage"to the (1) How,when and where the"oc- under Section II-Who Is An Insured: "suit"to which this insurance property of others described currence"or offense took place; applies. therein. The names and addresses of 2. Each of the following Is also an in- It shall beyour (2) sured: No other obligation or liabil- (2) duty,not our duty, any Injured persons and wit- Ity to pay sums or perform to defend any dalm or"suit"to messes;and Any of your former"employees",d- acts or services Is covered. which this Insurance applies. rectors, managers, members, part- (3) The nature and location of any vers or"executive officers",including (b) This Insurance applies to No other obligation or liability to irjury or damage arising out of but not limited to retired,disabled or 'property damage"only if: pay sums or perform acts or ser- the"occurrence"or offense. those on leave of absence,but only vices is covered. for acts within the scope of their em- 1) The"property damage" This requirement applies only when Thls Paragraph supersedes the"occurrence"or offense Is known ployment by you or for duties related takes place in the"cov. (2) any provision In the Coverage to an"authorized representative". to the conduct of your business. • erage territory';and Partto the contrary. • 2) The"property damage" • occurs during the policy (3) "Property damage" for which. ' period. Care,Custody Or Control Lie- . bility Coverage provides cover- Includes copyrighted material of Insurance Includes copyrighted material of Insurance - GA 233 0917 - Services Office,Inc.,with Its permission. Page 15 of 17 GA 233 0917 Services Office,Inc.,with Its permission. Page 16 of 17 • • • age shall be deemed to be (3) The Voluntary Property Dam- caused by an "occurrence"but age Coverage;Aggregate Limit shall not serve to limit or restrict Of Insurance Is the most we will the applicability of any exclusion pay for the sum of all damages for"property damage"under this under Voluntary Property Coverage Part. Damage Coverage. This limit • c. Limits Of Insurance And Deducti- applies separately to each"cov- bies erage term". For purposes of the coverage provid- (4) Deductible Clause ed by Voluntary Property Damage (a) Our obligation to pay dam- Coverage and Care, Custody Or ages on your behalf applies Control Liability Coverage,Section only to the amount of dam- III-Limits Of Insurance is amended ages for each"occurrence" to include the following: which are In excess of the 1 The Limits of Insurance shown In Deductible Amount stated ( ) for the applicable coverage the Declarations are replaced.by in the Schedule.The limits the limits designated in Section of insurance will not be re- B. Limits Of Insurance, 16. duced by the application of Voluntary Property Damage such Deductible Amount. Coverage And Care, Custody Or Control Liability Coverage, (b) Section IV - Commercial in this endorsement.These limits General Liability Condi- are Inclusive of,and not in addi- tions, 2. Duties In The lion to,the limits being replaced. Event Of Occurrence,Of- The Limits of Insurance shown in Tense, Claim Or Suit, ap- the Schedule fix the most we will plies to each claim or"suit" pay regardless of the number of: irrespective of the amount. - (a) Insureds; (c) We may pay any part or all Claims made or "suits" of the Deductible Amount to (b) effect settlement of any brought;or claim or"suit"and,upon no- . (c) Persons or organizations tification of the action taken, making claims or bringing you shall promptly !elm- "suits". burse us for such part of the • Deductible Amount as has (2) (a) Subject to (3) below, the been paid by us. • Volutary Property Dam • - 17. Broadened Contractual Liability-Work age Coverage,Each OccurWithin 50'Of Railroad Property rence Limit Of Insurance iss • the most we will pay for the Section V-Definitions,12."Insured con- sum of damages under Vol- tract"is amended as follows: • untary Property Damage Coverage; a. Paragraph c.Is replaced by the fol- (b) The Care,Custody Or Con- lowing: trol Liability Coverage, c. Any easement or license agree- • , Each Occurrence Limit Of ment; • Insurance is the most we will pay for the sum of damages b. Paragraph f.(1)is deleted in its entire- ' under Care, Custody Or ty. Control Liability Coverage; 18. Alienated Premises • because of all"property damage" Exclusion 2J. Damage to Property, arising out of any one "occur- -Paragraph(2)under Section I-Cover- rence". age A - Bodily Injury And Property Damage Liability does not apply if the premises are'your work". • • Includes copyrighted material of Insurance GA 233 0917 Services Office,Inc.,with its permission. Page 17 of 17 • • • THIS ENDORSEMENT CHANGES THE POLICY.PLEASE READ IT CAREFULLY. However, any °auto" that is leased, a. Is effective on the date of acquisition hired,rented or borrowed with a driver or formation,and is afforded for 180 • is not a covered"auto". days after such date; • CinciPlus® E. Audio, Visual and Data Electronic Equip- b. Does not apply to"bodily injury"or BUSINESS AUTO XC+® ment "property damage"resulting from an SECTION III - PHYSICAL DAMAGE COV- "accident° that occurred before you (EXPANDED COVERAGE PLUS) ERAGE,C.Limit of Insurance is amended acquired or formed the organization; ENDORSEMENT by adding the following: c. Does not apply to any newly acquired 4. The most we will payfor all"loss"to au- or formed organization that is a Joint venture or partnership;and dio,visual or data electronic equipment This endorsement modifies insurance provided by the following: and any accessories used with this d. Does not apply to an insured under equipment as a result of any one"acci- any other automobile liability policy or • dent"is the lesser of: would be an Insured under such a BUSINESS AUTO COVERAGE FORM a. The actual cash value of the dam- policy but for xhhe termination ofsuch aged or stolen property as of the time policy or the exhaustion of such poli- With respect to the coverage provided by this endorsement,the provisions of the Coverage Form apply unless of the"accident"; cy's limits of insurance. modified by this endorsement. b. The cost of repairing or replacing the 3. Any of your"employees" while using a damaged or stolen with the covered"auto"in your business or your A. Blanket Waiver of Subrogation This provision does not apply unless the valid g propertypersonal affairs,provided you do not own, written contract has been: er property of like kind and quality;or hire or borrow that"auto". SECTION IV - BUSINESS AUTO CONDI- C. $2,500. • TIONS,A.Loss Conditions,5.Transfer of 1. Executed prior to the accident causing G. Liability Coverage Extensions - Supple- Rights of Recovery Against Others to Us is "bodily injury"or"property damage";and Provided the equipment,at the time of the mentary Payments-Higher Limits . amended by the addition of the following: 2. Is still in force at the time of the"accident" "loss"is: SECTION II - LIABILITY COVERAGE, A. We waive any right of recovery we may have causing"bodily injury"or"property dam- a. Permanently installed in or upon the Coverage,2.Coverage Extensions,a.Sup- against any person or organization because of age". covered"auto"in a housing,opening plementary Payments is amended by: payments we make for "bodily injury" or or other location that is not normally 1. Replacing "property dama e"arisingout of the operation D. Employee Hired Auto p g the$2,000 Limit of Insurance • g p used by the"auto"manufacturer for for bail bonds with$4,000 in(2);and of a covered"auto°when you have assumed 1. Changes In Liability Coverage the installation of such equipment; liability for such "bodily injury" or "property 2. Replacing the$250 Limit of Insurance for damage"under an"insured contract",provid- The following is added to the SECTION II b. Removable from a permanently in- reasonable expenses with$500 in(4). ed the"bodily injury"or"property damage"oc- -LIABILITY COVERAGE,A.Coverage, stalled housing unit as described in curs subsequent to the execution or the"in- 1.Who is an Insured: Paragraph 2.a.above;or H. Amended Fellow Employee Exclusion sured contract". An "employee"of yours is an "insured" c. An integral part of such equipment. SECTION II-LIABILITY COVERAGE,B.Ex- ' B. Noncontributory Insurance while operating an"auto"hired or rented F. Who is an Insured-Amended follows: ns,5.Fellow Employee is modified as under a contract or agreement in that follow SECTION IV - BUSINESS AUTO CONDI- "employee's"name,with your permission, SECTION II - LIABILITY COVERAGE, A. Exclusion 5.Fellow Employee is deleted. TIONS,B.General Conditions,5.Other In- while performing duties related to the Coverage,1.Who is an Insured is amended Pto y • surance c.is deleted in its entirety and re- conduct of your business. by adding the following: I. Hired Auto-Physical Damage placed by the following: c. Regardless of the provisions of Par- 2. Changes in General Conditions The following are"insureds": If hired"autos"are covered'autos"for Liability n a ra h a. above, this Coverage SECTION IV-BUSINESS AUTO CON- 1. Any subsidiarywhich is a legally Inco o- Coverage,Physical then e CCooverages and prCovided p g g Y der Damage Coverages as DAMAGE E un- Form's Liability Coverage is primary DITIONS, B. General Conditions, 5. rated entity of.which you own a financial der SECTION IiI - PHYSICAL DAMAGE and we will not seek contribution Other Insurance is deleted in its entirety interest of more than 50%of the voting COVERAGE of this Coverage Part are ex • - from any other insurance for any Iia- and replaced by the following: stock on the effective date of this cover- tended to"autos"you hire,subject to the fol- bility assumed under an "insured age form. lowing: - contract"that requires liability to be b. For Hired Auto Physical Damage g: Coverage the following are deemed However,the insurance afforded by this assumed on a primary noncontributo- to be covered"autos"you own: 1. The most we will pay for"loss"to any ry basis. provision does not apply to any subsidiary hired"auto"is$50,000 or the actual cash • that is,an"insured"under any other au- value or cost to repair or replace,which- C. Additional Insured by Contract (1) Any covered "auto"you lease, tomobiie liability policy or would be an"in- ever is the least,minus a deductible. hire,rent or borrow;and sured"under such policy but for termina- SECTION II - LIABILITY COVERAGE, A. tion of such policy Coverage,1.Who Is an Insured is amended (2) Any covered "auto" hired or or the exhaustion of 2. The deductible will be equal to the largest • to include as an insured any person or organi- rented by your"employee"under such policy's limits of insurance, deductible applicable to any owned"auto' a contract zation for whom you have agreed in a valid in that individual"em- 2. Any organization that is newly acquired or for that coverage,or$1,000,whichever is less. written contract to provide insurance as af- ployee's" name, with your per- formed by you and over which you main- • forded by this policy. mission,while performing duties talo majority ownership. The insurance 3. Hired Auto-Physical Damage coverage related to the conduct of your provided by this provision: is excess over any other collectible insur- This provision is limited to the scope of the _ business. ance. valid written contract. • Includes copyrighted material of ISO Includes copyrighted material of ISO AA 288 06 20 Properties,Inc.,with its permission. Page 1 of 4 AA 288 06 20 Properties,Inc.,with its permission. Page 2 of 4 4, Subject to the above limit,deductible,and K. Transportation Expense-Higher Limits 2. SECTION V-DEFINITIONS is amended P. Unintentional Failure to Disclose Hazards excess provisions we will provide cover- SECTION III= PHYSICAL DAMAGE COV- by adding the following,but only for the SECTION IV - BUSINESS AUTO CONDI- age equal to the broadest coverage appli- purposes of this Loan or Lease Gap cable to any covered"auto"you own in- ERAGE,A.Coverage,4.Coverage Exten- Coverage: TIONS,B.General Conditions,2.Conceal- sured under this policy. sions is amended by replacing$20 per day ment, Misrepresentation or Fraud is with $50 per day, and $600 maximum with "Total loss"means a"loss"in which the amended by adding the following: Coverage Includes loss of use of that hired au- $1,500 maximum in Extension a.Transpor- cost of repairs plus the salvage value ex- to,provided it results from an"accident"for tation Expenses. ceeds the actual cash value. However,if you unintentionally fail to disclose . which you are legally liable and as a result of any hazards existing on the effective date of which a monetary loss is sustained by the L. Airbag Coverage N. Glass Repair-Waiver of Deductible this Coverage Form,we will not deny cover- leasing or rental concern. The most we will SECTION III - PHYSICAL DAMAGE COV- SECTION III- PHYSICAL DAMAGE COV- age under this Coverage Form because of pay for any one"accident"is$3,000. ERAGE,B.Exclusions,3.a.is amended by ERAGE,D.Deductible is amended by adding such failure. If a limit for Hired Auto-Physical Damage is adding the following: the following: Q. Mental Anguish Resulting from Bodily Inju- shown in the Schedule,then that limit replac- However, the mechanical and electrical No deductible applies to glass damage if the ry es,and is not added to,the$50,000 limit indi- breakdown portion of this exclusion does not glass is repaired in a manner acceptable to us SECTION V-DEFINITIONS,C."Bodily InJu- cated above and the deductibles shown in the apply to the accidental discharge of an airbag. rather than replaced. ry"is deleted in its entirety and replaced by Schedule are applicable. This coverage for airbags is excess over any the following: other collectible insurance or warranty. O. Duties in the Event of an Accident,Claim, J. Rental Reimbursement Suit or Loss-Amended "Bodily injury"means bodily Injury,sickness or SECTION III - PHYSICAL DAMAGE COV- M. Loan or Lease Gap Coverage SECTION IV - BUSINESS AUTO CONDI- disease sustained by a person,including men- talERAGE is amended by adding the following: 1. SECTION III - PHYSICAL DAMAGE TIONS,A.Loss Conditions,2.Duties in the anguisha and results death sustained such bodily y isame COVERAGE, C. Limit of Insurance is Event of Accident,Claim,Suit or Loss,a.is person that from sucn isjuryt 1. We will pay for rental reimbursement ex- deleted in its entiretyand replaced bythe amended byaddingthe following: sickness or disease."Bodily injury"does not penses incurred by you for the rental of P include mental anguish or death that does not an"auto"because of a"loss"to a covered following,but only for private passenger result from bodilyinjury, type"autos"with an original loan or lease, This condition applies only when the result 1 ry,sickness or disease. "auto".Payment applies in addition to the dent"or"loss"is known to: - otherwise applicable amount of each coy- and only in the event of a"total loss"to R. Coverage for Certain Operations in Con- erage you have on a covered"auto".No such a private passenger type'"auto": 1. You,if you are an individual; nection with Railroads deductible applies to this coverage. • a• . The most we will pay for"loss"in any 2. A partner,if you are a partnership; With respect to the use of a covered"auto"In 2. We will pay only for those expenses in- one"accident"is the greater of: operations for or affecting a railroad: curred during the policy period beginning (1) 3. An executive officer or insurance manag- 24 hours after the"loss"and ending, The amount due under the terms er,if you are a corporation:or 1. SECTION V-DEFINITIONS,H."Insured re- of the lease or loan to which contract",1.c.is deleted in its entirety and gardless of the policy's expiration, with your covered private passenger 4. A member or manager,if you are a lira- replaced by the following: the lesser of the following number of type"auto"is subject,but will not ited liability company. days: include: c. An easement or license agreement; a. The number of days reasonably re- (a) Overdue lease or loan pay- 2. SECTION V-DEFINITIONS,H."Insured quired to repair the covered"auto".If ments; contract",2.a.is deleted. "loss"is caused by theft,this number . of days is added to the number of (b) Financial penalties imposed days it takes to locate the covered under the lease due to high "auto"and return it to you;or mileage, excessive use or b. 30 days. abnormal wear and tear; • re- 3. Our payment is limited to the lesser of the (c) fundedSecury tdhe ts not P Yrn by the lessor; •• following amounts: ' a. Necessaryand actual expenses in- (d) Costs for extended warran- P ties, Credit Life Insurance, curred;or Health,Accident or Disabil- b. $50 per day. • . ity Insurance purchased - with the loan or lease;and 4. This coverage does not apply while there (e) Carry-over balances from are spare or reserve"autos"available to previous loans or leases,or you for your operations. 5. We will pay under this coverage only that (2) Actual cash value of the stolen . amount of your rental reimbursement ex- or damaged property. penses which is not already provided for b. An adjustment for depreciation and under SECTION III- PHYSICAL DAM- physical condition will be made in de- AGE COVERAGE, A. Coverage, 4. termining actual cash value at the Coverage Extensions. time of"loss". Includes copyrighted material of ISO Includes copyrighted material of ISO AA 288 06 20 Properties,Inc.,with its permission. Page 3 of 4 AA 288 06 20 Properties,Inc.,with its permission. Page 4 of 4 • �1 4 HUB INTRNATIONAL NORTHWEST LLC • PO BOX 10167 11.3EUGENE OR 97440-2167 • CITY OF ASHLAND. 90 N MOUNTAIN AVE ASHLAND OR 97520-2014