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HomeMy WebLinkAboutInsurance Certificate: Nexgen Risk Management LLCClient#: 1496150 NEXGETEA ACORDTM CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 1 2/26/2025 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 any rights to the certificate holder in lieu of such endorsement(s). PRODUCER NAME: Bambi Brown, CIC, CRM USI Insurance Services NW CL1 PHONE 503.295.8312 FAX 610.362.8189 A/C, No, Ext : (A/C, No): 825 NE Multnomah, Suite 1500 E-MAIL ADDRESS: bambi.brown@usi.com Portland, OR 97232 INSURER(S) AFFORDING COVERAGE NAIC # 503 224-8390 Crestbrook Insurance Company INSURER A: p y 18961 INSURED INSURER B : AXIS Surplus Insurance Company 26620 Nexgen Risk Management LLC Evanston Insurance Company INSURER C : p y 35378 See Schedule of Named Insureds Below Endurance American Specialty Ins Co INSURER D : p Y 41718 PO Box 309 Gemini Insurance Company INSURER E : P y 10833 Ontario, OR 97914 INSURER F COVERAGES CERTIFICATE NUMBER: 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 CONTRACTOR 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. LTR TYPE OF INSURANCE ADDLSUBR NSR WVD POLICY NUMBER POLICY EFF (MM/DD/YYYY) POLICY EXP (MM/DD/YYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY CPP142504B 03/01/2025 03/01/2026 EACH OCCURRENCE $1,000,000 CLAIMS -MADE [* OCCUR PREMI6ESOEaoNcurrDence $300,000 X MED EXP (Any one person) $ O BI/PD Ded: $250,000 PERSONAL & ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 PRO - POLICY JECT X LOC PRODUCTS - COMP/OPAGG $2,000,000 Stop Gap $1,000,000 OTHER: A AUTOMOBILE LIABILITY CPP142504B 03/01/2025 03/01/202 EeaBc,denSINGLELIMIT $1,000,000 X BODILY INJURY (Per person) $ ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE Pera ccident $ X HIRED NON -OWNED AUTOS ONLY X AUTOS ONLY B UMBRELLA LAB X OCCUR P00100135672702 03/01/2025 03/01/2026 EACH OCCURRENCE $2 OOO 000 X AGGREGATE s2,000,000 EXCESS LAB CLAIMS -MADE OVER GL DED I X RETENTION $0 $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? ❑ N / A PER OTH- STATUTE ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ C Excess 3x2 GL MKLV5EUE103911 03/01/2025 03/01/202 $3,000,000 Limit D Excess OVER AUTO EXT30054142701 03/01/2025 03/01/202 $1,000,000 Limit E Excess 4x1 AUTO GVE100197608 03/01/2025 03/01/202 $4,000,000 Limit DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Named Insured Continued: NEXGEN Logistics, LLC; NEXGEN Team, LLC;Carson Oil Company, Inc; NEXGEN Propane, LLC; Carson Transload, LLC; Carson; Campo & Poole Distributing LLC;************************************ The General Liability and Automobile Liability policies include an automatic Additional Insured endorsement. that provides Additional Insured status to the Certificate Holder, only when there is a written (See Attached Descriptions) CERTIFICATE HOLDER CANCELLATION City of Ashland 90 N Mountain Ave Ashland, OR 97520 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) 1 of 2 #S48254984/M48242504 © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD PDNZP DESCRIPTIONS (Continued from Page 1) contract that requires such status, and only with regard to work performed on behalf of the named insured. The General Liability and Automobile Liability policies contain a special endorsement with Primary and Noncontributory wording, when required by written contract. The General Liability, Automobile Liability and Workers Compensation policies include a Waiver of Subrogation endorsement in favor of the Certificate Holder as referenced above. Additional Insured does not applies to Workers compensation policy. Excess Liability policies follows form to General Liability, Auto Liability, and Employers Liability. RE: Delivery of Fuel. SAGITTA 25.3 (2016/03) 2 of 2 #S48254984/M48242504 CPP142504B COMMERCIAL GENERAL LIABILITY CG20431219 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - AUTOMATIC STATUS WHEN REQUIRED IN WRITTEN CONTRACT OR AGREEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Section II — Who Is An Insured is amended to include as an additional insured any person(s) or organization(s) for whom you have agreed in writing in a contract or agreement that such person(s) or organization(s) be added as an additional insured on your policy. Such person(s) or organization(s) is an additional insured only with respect to liability for: 1. "Bodily injury" or "property damage" not included in the "products -completed operations hazard"; or 2. "Personal and advertising injury" caused by, in whole or in part, your acts or omissions or the acts or omissions of those acting on your behalf in the performance of your operations. B. The insurance afforded to such additional insured described in Paragraph A. of this endorsement: 1. Only applies to the extent permitted by law; and Will not be broader than that which you are required by the contract or agreement to provide for such additional insured. C. With respect to insurance afforded to these additional insureds, the following additional exclusion applies: This insurance does not apply to "bodily injury", "property damage" or "personal and advertising injury" due to rendering of or failure to render any professional service. This includes but is not limited to: 1. Legal, accounting or advertising services; 2. Preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings or specifications; 3. Inspection, supervision, quality control, architectural or engineering activities done by or for you on a project on which you serve as construction manager; 4. Engineering services, including related supervisory or inspection services; 5. Medical, surgical, dental, X-ray or nursing services treatment, advice or instruction; 6. Any health or therapeutic service treatment, advice or instruction; 7. Any service, treatment, advice or instruction for the purpose of appearance or skin enhancement, hair removal or replacement, or personal grooming or therapy; 8. Any service, treatment, advice or instruction relating to physical fitness, including service, treatment, advice or instruction in connection with diet, cardiovascular fitness, bodybuilding or physical training programs; 9. Optometry or optical or hearing aid services including the prescribing, preparation, fitting, demonstration or distribution of ophthalmic lenses and similar products or hearing aid devices; 10. Body piercing services; 11. Services in the practice of pharmacy; 12. Law enforcement or firefighting services; and 13. Handling, embalming, disposal, burial, cremation or disinterment of dead bodies. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by that insured, if the "occurrence" which caused the "bodily injury" or "property damage", or the offense which caused the "personal and advertising injury", involved the rendering of or failure to render any professional service. CG20431219 © Insurance Services Office, Inc., 2018 Insured Copy Page 1 of 2 D. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance: The most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement described in Paragraph A.; or 2. Available under the applicable limits of insurance; whichever is less. This endorsement shall applicable limits of insurance. not increase the Page 2 of 2 © Insurance Services Office, Inc., 2018 Insured Copy CG 20 43 12 19 CPP142504B COMMERCIAL GENERAL LIABILITY CG 20 01 12 19 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NONCONTRIBUTORY - OTHER INSURANCE CONDITION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to the Other Insurance Condition and supersedes any provision to the contrary: Primary And Noncontributory Insurance This insurance is primary to and will not seek contribution from any other insurance available to an additional insured under your policy provided that: (1) The additional insured is a Named Insured under such other insurance; and (2) You have agreed in writing in a contract or agreement that this insurance would be primary and would not seek contribution from any other insurance available to the additional insured. CG20011219 © Insurance Services Office, Inc., 2018 Insured Copy Page 1 of 1 CPP142504B COMMERCIAL GENERAL LIABILITY CG24531219 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (WAIVER OF SUBROGATION) - AUTOMATIC This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART ELECTRONIC DATA LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAGE PART DESIGNATED SITES POLLUTION LIABILITY LIMITED COVERAGE PART DESIGNATED SITES PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART RAILROAD PROTECTIVE LIABILITY COVERAGE PART UNDERGROUND STORAGE TANK POLICY DESIGNATED TANKS The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV — Conditions: We waive any right of recovery against any person or organization, because of any payment we make under this Coverage Part, to whom the insured has waived its right of recovery in a written contract or agreement. Such waiver by us applies only to the extent that the insured has waived its right of recovery against such person or organization prior to loss. CG 24 53 12 19 © Insurance Services Office, Inc., 2018 Page 1 of 1 Insured Copy CPP142504B COMMERCIAL AUTO THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. COMMERCIAL AUTO PLUS ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM The BUSINESS AUTO COVERAGE FORM is amended to include the following additions and extensions of coverage: A. NEWLY ACQUIRED OR FORMED ENTITIES B. TEMPORARY SUBSTITUTE AUTOS - PHYSICAL DAMAGE COVERAGE C. BLANKET ADDITIONAL INSURED - REQUIRED BY CONTRACT D. EMPLOYEES AS INSUREDS - NONOWNED AUTOS E. EMPLOYEE HIRED AUTOS F. SUPPLEMENTARY PAYMENTS - BAIL BONDS G. SUPPLEMENTARY PAYMENTS - LOSS OF EARNINGS H. FELLOW EMPLOYEE COVERAGE I. PROPERTY OF OTHERS J. PERSONAL EFFECTS COVERAGE K. AUTO MEDICAL PAYMENTS COVERAGE - INCREASED LIMITS L. EXPANDED TOWING COVERAGE M. AUTO LOAN OR LEASE COVERAGE N. RENTAL REIMBURSEMENT COVERAGE O. EXPANDED TRANSPORTATION EXPENSE P. EXPENSE YOU INCUR TO RECOVER A STOLEN AUTO Q. ACCIDENTAL AIRBAG DISCHARGE COVERAGE R. PHYSICAL DAMAGE - TWO OR MORE DEDUCTIBLES S. BLANKET WAIVER OF SUBROGATION T. AMENDED DUTIES IN THE EVENT OF ACCIDENT, CLAIM, SUIT OR LOSS U. UNINTENTIONAL FAILURE TO DISCLOSE HAZARDS A. NEWLY ACQUIRED OR FORMED ENTITIES The Named Insured shown in the Declarations is amended to include any organization you newly acquire or form, other than a partnership, joint venture, or limited liability company, and over which you maintain ownership or majority (more than 50%) interest; if there is no other similar insurance available to that organization. Coverage under this provision is afforded only until the 901h day after you acquire or form the organization, or the end of the policy period, whichever comes first. B. TEMPORARY SUBSTITUTE AUTOS - PHYSICAL DAMAGE COVERAGE The following is added to Paragraph C. Certain Trailers, Mobile Equipment And Temporary Substitute Autos of SECTION I - COVERED AUTOS: If Physical Damage Coverage is provided on a covered "auto" you own that is out of service because of its breakdown, repair, servicing, "loss", or destruction, then you have coverage for any "auto' you do not own, while used with the permission of its owner as a temporary substitute for the covered out of service "auto'. The deductible for the temporary substitute "auto' will be the same as the applicable deductible for the covered "auto' it replaces. CCAB191 1013 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Insured Copy Page 1 of 6 COMMERCIAL AUTO C. BLANKET ADDITIONAL INSURED — REQUIRED BY CONTRACT The following is added to Paragraph A.1. Who Is An Insured of SECTION II — COVERED AUTOS LIABILITY COVERAGE: Any person(s) or organization(s) is an additional "insured" with whom you have agreed in a valid written contract or agreement, executed prior to any "accident" or "loss", that such person(s) or organization(s) be added as an additional "insured" on your policy. Such persons or organizations are additional "insureds", but only with respect to liability for "bodily injury" or "property damage" caused by an "accident" that is, in whole or in part, caused by your acts or omissions or the acts or omissions of those acting on your behalf and resulting from the ownership, maintenance or use of a covered "auto". D. EMPLOYEES AS INSUREDS — NONOWNED AUTOS The following is added to the SECTION II — COVERED AUTOS LIABILITY COVERAGE, Paragraph A.1. Who Is An Insured provision: Any "employee" of yours is an "insured" while using a covered "auto" you don't own, hire or borrow in your business or your personal affairs. E. EMPLOYEE HIRED AUTOS 1. Changes In Covered Autos Liability Coverage The following is added to the Who Is An Insured Provision: An "employee" of yours is an "insured" while operating an "auto" hired or rented under a contract or agreement in an "employee's" name, with your permission, while performing duties related to the conduct of your business. 2. Changes In General Conditions Paragraph 5.b. of the Other Insurance Condition in the BUSINESS AUTO COVERAGE FORM is replaced by the following: For Hired Auto Physical Damage Coverage, the following are deemed to be covered "autos" you own: a. Any covered "auto" you lease, hire, rent or borrow; and b. Any covered "auto" hired or rented by your "employee" under a contract in an "employee's" name, with your permission, while performing duties related to the conduct of your business. However, any "auto" that is leased, hired, rented or borrowed with a driver is not a covered "auto". F. SUPPLEMENTARY PAYMENTS — BAIL BONDS The following replaces Paragraph A.2.a. (2) of SECTION II — COVERED AUTOS LIABILITY COVERAGE: (2) Up to $5,000 for cost of bail bonds (including bonds for related traffic law violations) required because of an "accident" we cover. We do not have to furnish these bonds. G. SUPPLEMENTARY PAYMENTS — LOSS OF EARNINGS The following replaces Paragraph A.2.a. (4) of SECTION II — COVERED AUTOS LIABILITY COVERAGE: CCAB191 1013 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Insured Copy Page 2 of 6 COMMERCIAL AUTO (4) All reasonable expenses incurred by the "insured" at our request, including actual loss of earnings up to $500 a day because of time off from work. H. FELLOW EMPLOYEE COVERAGE The Fellow Employee Exclusion contained under the COVERED AUTOS LIABILITY COVERAGE does not apply. PROPERTY OF OTHERS The Care, Custody Or Control Exclusion in SECTION II — COVERED AUTOS LIABILITY COVERAGE does not apply to "property damage" to property, other than your property, up to an amount not exceeding $3,000 in any one "accident". This coverage applies as a result of a covered "loss", without applying a deductible. Coverage is excess over any other valid and collectible insurance. J. PERSONAL EFFECTS COVERAGE The following is added to Paragraph A.4. Coverage Extensions of SECTION III — PHYSICAL DAMAGE COVERAGE: We will pay up to $1,000 for the "loss" to personal effects which are: (1) Owned by an "insured"; and (2) In or on your covered "auto'. This coverage applies as a result of a covered "loss", without applying a deductible. Coverage is excess over any other valid and collectible insurance. K. AUTO MEDICAL PAYMENTS COVERAGE — INCREASED LIMITS In the event of a covered "loss" where Auto Medical Payments Coverage applies, we will double the Limit Of Insurance for Medical Payments shown in the Declarations for each "insured" who was wearing a seat belt at the time of the "accident". This limit is the most we will pay for all covered medical expenses regardless of the number of covered "autos", "insureds", premiums paid, claims made or vehicles involved in the "accident". L. EXPANDED TOWING COVERAGE The following replaces Paragraph A.2. of SECTION III — PHYSICAL DAMAGE COVERAGE: We will pay up to: 1. $100 for a covered "auto" you own of the private passenger type; or 2. $500 for a covered "auto" you own that is not of the private passenger type; for towing and labor costs incurred each time the covered "auto" is disabled. However, the labor must be performed at the place of disablement. M. AUTO LOAN OR LEASE COVERAGE Physical Damage Coverage is amended by the addition of the following: 1. In the event of a total "loss" to a covered "auto", we will pay any unpaid amount due on the lease or loan, including up to a maximum of $500 for early termination fees or penalties, for a covered "auto", less: CCAB191 1013 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Insured Copy Page 3 of 6 COMMERCIAL AUTO a. The amount paid under the policy's Physical Damage Coverage; and b. Any: (1) Overdue lease/loan payments at the time of the "loss"; (2) Financial penalties imposed under a lease for excessive use, abnormal wear and tear or high mileage; (3) Security deposits not returned by the lessor; (4) Costs of extended warranties, Credit Life insurance, Health, Accident, or Disability insurance purchased with the loan or lease; and (5) Carry-over balances from previous loans or leases. 2. This coverage only applies to a "loss" which is also covered under this policy for Comprehensive, Specified Causes Of Loss, or Collision Coverage. 3. Coverage does not apply to any unpaid amount due on a loan for which the covered "auto" is not the sole collateral. 4. This endorsement does not apply to any covered "auto" for which broader coverage is provided by any other endorsement form on this policy. N. RENTAL REIMBURSEMENT COVERAGE 1. We will pay for rental reimbursement expenses incurred by you for the rental of an "auto" because of "loss" to a covered "auto". Payment applies in addition to the otherwise applicable amount of each coverage you have on a covered "auto". No deductibles apply to this coverage. 2. This coverage applies only to a covered "auto" for which Physical Damage Coverage is provided on this policy. 3. We will pay only for those expenses incurred during the policy period beginning 24 hours after the "loss" and ending, regardless of the policy's expiration, with the lesser of the following number of days: a. The number of days reasonably required to repair or replace the covered "auto". If "loss" is caused by theft, this number of days is added to the number of days it takes to locate the covered "auto" and return it to you. b. 30 days. 4. Our payment is limited to the lesser of the following amounts: a. Necessary and actual expenses incurred. b. $75 for any one day or for a maximum of 30 days. 5. This coverage does not apply while there are spare or reserve "autos" available to you for your operations. 6. If "loss" results from the total theft of a covered "auto" of the private passenger type, we will pay under this coverage only that amount of your rental reimbursement expenses which is not already provided for under the Expanded Transportation Expense Coverage Extension in this form. 7. This endorsement does not apply to any covered "auto" for which broader coverage is provided by any other endorsement form on this policy. O. EXPANDED TRANSPORTATION EXPENSE Paragraph A.4.a. of SECTION III - PHYSICAL DAMAGE is replaced by the following: CCAB191 1013 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Insured Copy Page 4 of 6 COMMERCIAL AUTO We will pay up to $50 per day to a maximum of $1,500 for temporary transportation expense incurred by you because of the total theft of a covered "auto" of the private passenger type. We will pay only for those covered "autos" for which you carry either Comprehensive or Specified Causes Of Loss Coverage. We will pay for temporary transportation expenses incurred during the period beginning 48 hours after the theft and ending, regardless of the policy's expiration, when the covered "auto" is returned to use or we pay for its "loss". P. EXPENSE YOU INCUR TO RECOVER A STOLEN AUTO The following is added to Paragraph A.4. of SECTION III — PHYSICAL DAMAGE COVERAGE: We will pay up to $5,000 for the expense of recovering a stolen covered "auto" to you. We will pay only for those covered "autos" for which you carry Comprehensive or Specified Causes Of Loss Coverage. Q. ACCIDENTAL AIRBAG DISCHARGE COVERAGE The following is added to Paragraph B.3.a. of SECTION III — PHYSICAL DAMAGE COVERAGE: Mechanical breakdown does not include the accidental discharge of an airbag. R. PHYSICAL DAMAGE — TWO OR MORE DEDUCTIBLES The following is added to Paragraph D. Deductible of SECTION III — PHYSICAL DAMAGE COVERAGE: When two or more covered "autos" sustain "loss" in the same collision, the "loss" will be reduced by the largest single deductible that applies. For purposes of this coverage, an "auto" and its attached "trailer" are two separate "autos". S. BLANKET WAIVER OF SUBROGATION The Transfer Of Rights Of Recovery Against Others To Us Condition does not apply, but only when the Named Insured agrees that subrogation is waived prior to the "accident" or the "loss" under the terms of a written contract entered into between the Named Insured and an entity that is part of that contract. T. AMENDED DUTIES IN THE EVENT OF ACCIDENT, CLAIM, SUIT OR LOSS The following replaces Paragraph A.2.a. Duties In The Event Of Accident, Claim, Suit Or Loss of SECTION IV — BUSINESS AUTO CONDITIONS: We have no duty to provide coverage under this policy unless there has been full compliance with the following duties: a. In the event of "accident", claim, "suit", or "loss", your insurance manager or any other person you designate as responsible for insurance -related matters must notify us promptly of an "accident" or a "loss", regardless of the amount, which may result in a claim. Include: (1) How, when and where the "accident" or "loss" occurred; (2) The "insured's" name and address; and (3) To the extent possible, the names and addresses of any injured persons and witnesses. Paragraph A.2.b.(2) Duties In The Event Of Accident, Claim, Suit Or Loss of SECTION IV — BUSINESS AUTO CONDITIONS is amended as follows: b. Additionally, you and any other involved "insured" must: CCAB191 1013 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Insured Copy Page 5 of 6 COMMERCIAL AUTO (2) Notify us and send us copies of any request, demand, order, notice, summons or legal papers received concerning the claim or "suit" as soon as practicable. For the purposes of this coverage provided, you are presumed to have knowledge of the "accident" or "loss" when it has been reported to the insurance manager or any other person you designate as responsible for insurance -related matters. U. UNINTENTIONAL FAILURE TO DISCLOSE HAZARDS The following Condition is added to SECTION IV — BUSINESS AUTO CONDITIONS: Unintentional Failure To Disclose Hazards Failure by you to disclose to us all hazards existing as of the inception date of this policy shall not prejudice us with respect to the coverage afforded by this policy, provided such error or omission is not intentional. ALL OTHER CONDITIONS AND PROVISIONS OF THE POLICY REMAIN UNCHANGED BY THIS ENDORSEMENT. Includes copyrighted material of Insurance Services Office, Inc., with its permission. CCAB191 1013 Page 6 of 6 Insured Copy 1492115AM79L1:3 COMMERCIAL AUTO CA99481013 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. POLLUTION LIABILITY - BROADENED COVERAGE FOR COVERED AUTOS - BUSINESS AUTO AND MOTOR CARRIER COVERAGE FORMS This endorsement modifies insurance provided under the following: 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. A. Covered Autos Liability Coverage is changed as "Covered pollution cost or expense" does not follows: include any cost or expense arising out of the 1. Paragraph a. of the Pollution Exclusion actual, alleged or threatened discharge, applies only to liability assumed under a dispersal, seepage, migration, release or contract or agreement. escape of "pollutants": With respect to the coverage afforded by Paragraph A.1. above, Exclusion 13.6. Care, Custody Or Control does not apply. B. Changes In Definitions For the purposes of this endorsement, Paragraph D. of the Definitions Section is replaced by the following: D. "Covered pollution cost or expense" means any cost or expense arising out of: 1. Any request, demand, order or statutory or regulatory requirement that any "insured" or others test for, monitor, clean up, remove, contain, treat, detoxify or neutralize, or in any way respond to, or assess the effects of "pollutants"; or 2. Any claim or "suit' by or on behalf of a governmental authority for damages because of testing for, monitoring, cleaning up, removing, containing, treating, detoxifying or neutralizing, or in any way responding to or assessing the effects of "pollutants". a. Before the "pollutants" or any property in which the "pollutants" are contained are moved from the place where they are accepted by the "insured" for movement into or onto the covered "auto"; or b. After the "pollutants" or any property in which the "pollutants" are contained are moved from the covered "auto" to the place where they are finally delivered, disposed of or abandoned by the "insured". Paragraphs a. and b. above do not apply to "accidents" that occur away from premises owned by or rented to an "insured" with respect to "pollutants" not in or upon a covered "auto" if: (1) The "pollutants" or any property in which the "pollutants" are contained are upset, overturned or damaged as a result of the maintenance or use of a covered "auto"; and (2) The discharge, dispersal, seepage, migration, release or escape of the "pollutants" is caused directly by such upset, overturn or damage. CA99481013 © Insurance Services Office, Inc., 2011 Insured Copy Page 1 of 1 FORM MCS-90 OMB No.: 2126-0008 USDOT Number: Date Received: Please note, the expiration date as stated on this form relates to the process for renewing the Information Collection Request for this form with the Office of Management and Budget. This requirement to collect information as requested on this form does not expire. For questions, please contact the Office of Registration and Safety Information, Registration, Licensing, and Insurance Division. A Federal Agency may not conduct or sponsor, and a person is not required to respond to, nor shall a person be subject to a penalty for failure to comply with a collection of information subject to the requirements of the Paperwork Reduction Act unless that collection of information displays a current valid OMB Control Number. The OMB Control Number for this information collection is 2126-0008. Public reporting for this collection of information is estimated to be approximately 2 minutes per response, including the time for reviewing instructions, gathering the data needed, and completing and reviewing the collection of information. All responses to this collection of information arc mandatory. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to: Information Collection Clearance Officer, Federal Motor Carrier Safety Administration, MC-RRA, Washington, D.C. 20590. United States Department of Transportation Federal Motor Carrier Safety Administration ............ Endorsement for Motor Carrier Policies of Insurance for Public Liability under Sections 29 and 30 of the Motor Carrier Act of 1980 FORM MCS-90 Issued to NEXGEN LOGISTICS, LLC (Motor Carrier name) Of PO BOX 10948 (Motor Carrier state or province) 3125 NW 35TH AVE PORTLAND, OR USA 97296 Dated at Des Moines, IA on this Ol day of March, 2025 Amending Policy Number: C P P 14 2 5 0 4 B Effective Date: 0 3/ 01 / 2 0 2 5 Name of Insurance Company: CRESTBROOK INSURANCE COMPANY Countersigned by: /° 4Ak (authorized company representative) The policy to which this endorsement is attached provides primary or excess insurance, as indicated for the limits shown (check only one): X This insurance is primary and the company shall not be liable for amounts in excess of $ 1 , 0 0 0 , 0 0 0 for each accident. This insurance is excess and the company shall not he liable fbr amounts in excess of $ for each accident in excess of the underlvin; limit of $ for each accident. Whenever required by the Federal Motor Carrier Safety Administration (FMCSA), the company agrees to furnish the FMCSA a duplicate of said policy and all its endorsements. The company also agrees, upon telephone request by an authorized representative of the FMCSA , to verify that the policy is in force as of a particular date. The telephone number to call is: (800) 228-6700. Cancellation of this endorsement may be effected by the company or the insured by giving (1) thirty-five (35) days notice in writing to the other party (said 35 days notice to commence from the date the notice is mailed, proof of mailing shall be sufficient proof of notice), and (2) if the insured is subject to the FMCSA's registration requirements under49 U.S.C. 13901, by providing thirty (30) days notice to the FMCSA (said 30 days notice to commence from the date the notice is received by the FMCSA at its office in Washington, DC). =Filingsust be transmitted online via the Internet at,, http:/ANww.fmcsa.dot.gov/urs FORM MCS-90 Page 1 of 3 (continued on neat page) Rev 61311011 Insured Copy FORM MCS-90 OMB No.: 2126-0008 DEFINITIONS AS USED IN THIS ENDORSEMENT Accident includes continuous or repeated exposure to conditions or which results in bodily injury, property damage, or environmental damage which the insured neither expected nor intended. Motor Vehicle means a land vehicle, machine, truck, tractor, trailer, or semitrailer propelled or drawn by mechanical power and used on a highway for transporting property, or any combination thereof. Bodily Injury means injury to the body, sickness, or disease to any person, including death resulting from any of these. Property Damage means damage to or loss of use of tangible property. The insurance policy to which this endorsement is attached provides automobile liability insurance and is amended to assure compliance by the insured, within the limits stated herein, as a motor carrier of property, with Sections 29 and 30 of the Motor Carrier Act of 1980 and the rules and regulations of the Federal Motor Carrier Safety Administration (FMCSA). In consideration of the premium stated in the policy to which this endorsement is attached, the insurer (the company) agrees to pay, within the limits of liability described herein, any final judgment recovered against the insured for public liability resulting from negligence in the operation, maintenance or use of motor vehicles subject to the financial responsibility requirements of Sections 29 and 30 of the Motor Carrier Act of 1980 regardless of whether or not each motor vehicle is specifically described in the policy and whether or not such negligence occurs on any route or in any territory authorized to be served by the insured or elsewhere. Such insurance as is afforded, for public liability, does not apply to injury to or death of the insured's employees while engaged in the course of their employment, or property transported by the insured, designated as cargo. It is understood and agreed that no condition, provision, stipulation, or limitation contained in the policy, this endorsement, or any other endorsement thereon, Environmental Restoration means restitution for the loss, damage, or destruction of natural resources arising out of the accidental discharge, dispersal, release or escape into or upon the land, atmosphere, watercourse, or body of water, of any commodity transported by a motor carrier. This shall include the cost of removal and the cost of necessary measures taken to minimize or mitigate damage to human health, the natural environment, fish, shellfish, and wildlife. Public Liability means liability for bodily injury, property damage, and environmental restoration. or violation thereof, shall relieve the company from liability or from the payment of any final judgment, within the limits of liability herein described, irrespective of the financial condition, insolvency or bankruptcy of the insured. However, all terms, conditions, and limitations in the policy to which the endorsement is attached shall remain in full force and effect as binding between the insured and the company. The insured agrees to reimburse the company for any payment made by the company on account of any accident, claim, or suit involving a breach of the terms of the policy, and for any payment that the company would not have been obligated to make under the provisions of the policy except for the agreement contained in this endorsement. It is further understood and agreed that, upon failure of the company to pay any final judgment recovered against the insured as provided herein, the judgment creditor may maintain an action in any court of competent jurisdiction against the company to compel such payment. The limits of the company's liability for the amounts prescribed in this endorsement apply separately to each accident and any payment under the policy because of anyone accident shall not operate to reduce the liability of the company for the payment of final judgments resulting from any other accident. (continued on next page) FORM MCS-90 Page 2 of 3 Insured Copy FORM MCS-90 OMB No.: 2126-0008 SCHEDULE OF LIMITS - PUBLIC LIABILITY Type of carriage Commodity transported January 1, 1985 (1) For -hire (in interstate or foreign commerce, with a Property (nonhazardous) $750,000 gross vehicle weight rating of 10,001 or more pounds). (2) For -hire and Private (in interstate, foreign, or intrastate commerce, with a gross vehicle weight rating of 10,001 or more pounds). (3) For -hire and Private (in interstate or foreign commerce, in any quantity; or in intrastate commerce, in bulk only; with a gross vehicle weight rating of 10,001 or more pounds). (4) For -hire and Private (In interstate or foreign commerce, with a gross vehicle weight rating of less than 10,001 pounds). Hazardous substances, as defined in 49 CFR 171.8,, transported in cargo tanks, portable tanks, or hopper - type vehicles with capacities in excess of 3,500 water gallons; or in bulk Division 1.1, 1.2, and 1.3 materials, Division 2.3, Hazard Zone A, or Division 6.1, Packing Group I, Hazard Zone A material; in bulk Division 2.1 or 2.2; or highway route controlled quantities of a Class 7 material, as defined in 49 CFR 173.403. Oil listed in 49 CFR 172.101, hazardous waste, hazardous materials, and hazardous substances defined in 49 CFR 171.8 and listed in 49 CFR 172.101, but not mentioned in (2) above or (4) below. Any quantity of Division 1.1, 1.2, or 1.3 material; any quantity of a Division 2.3, Hazard Zone A, or Division 6.1, Packing Group I, Hazard Zone A material; or highway route controlled quantities of a Class 7 material as defined in 49 CFR 173.403 * The schedule of limits shown does not provide coverage. The limits shown in the schedule are for information purposes only. $5,000,000 $1,000,000 $5,000,000 FORM MG&Wftge 3 of 3