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HomeMy WebLinkAboutInsurance Certificate: Welbrun Electric Inc 710/18/2025 E(MM/DD/YYYY) ACCORD® CERTIFICATE OF LIABILITY INSURANCE 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 NAME: Theresa Watson Protectors Insurance, LLC PHONE FAX P.O. Box 4669 A/C No Ext: 541-773-5358 A/C,No:541-772-1906 Medford OR 97504 ADDE-MRESS: TheresaW@Protectorslns.com INSURER(S)AFFORDING COVERAGE NAIC# wsURERA:The Cincinnati Ins Co 10677 INSURED WELBU-1 INSURERB: SAIF Corporation 36196 Welburn Electric Inc PO Box 329 INsuRERc:Zurich American Insurance Phoenix OR 97535 INSURERD: Columbia Casualty Company INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:203902472 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR INSD WVD POLICYNUMBER MM/DD MM/DD A X COMMERCIAL GENERAL LIABILITY Y Y EPP0295267 10/1/2025 10/1/2028 EACH OCCURRENCE $1,000,000 CLAIMS-MADE OCCUR DAMAGE TO RENTED PREMISES 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 PRO- POLICY� ECT1:1 LOC PRODUCTS-COMP/OP AGG $2,000,000 OTHER: $ A AUTOMOBILE LIABILITY Y Y EBA 0295267 10/1/2025 10/1/2026 COMBINED SINGLE LIMIT $1,000,000 Ea accident X ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS X HIRED X NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident A X UMBRELLALIAB X OCCUR EPP0295267 10/1/2025 10/1/2028 EACH OCCURRENCE $5,000,000 EXCESS LAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ B WORKERS COMPENSATION Y 488390 10/1/2025 10/1/2026 X PER OTH- C AND EMPLOYERS'LIABILITY Y/N WC9707380-01 10/1/2025 10/1/2026 STATUTE ER ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $1,000,000 OFFICER/MEMBER EXCLUDED? FY] N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000 D Contractors Errors&Omissions N N CE0591979699 10/1/2025 10/1/2026 Each Claim Limit 2,000,000 Pollution Liability Y Y Aggregate Limit 2,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Certificate Holder is Additional Insured for General Liability when required by written contract per forms GA233 and GA472. For Commercial Auto per form AA288. Forms include Waiver of Subrogation, Primary/Noncontributory language, Ongoing and Completed Operations language. For Pollution Liability via form CNA88508. Subrogation via form CNA83662. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Ashland 20 E Main St AUTHORI ESENTATIVE Ashland OR 97520 = @ 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD COMMERCIAL GENERAL LIABILITY COVERAGE FORM Various provisions in this Coverage Part restrict SUPPLEMENTARY PAYMENTS - COW this insurance. Read the entire Coverage Part ERAGES A AND B. carefully to determine rights, duties and what is and is not covered. b. This insurance applies to "bodily injury" and "property damage" only if: Throughout this Coverage Part the words "you" and "your" refer to the Named Insured shown in (1) The "bodily injury" or "property dam- the Declarations, and any other person or organi- age" is caused by an 'occurrence" zation qualifying as a Named Insured under this that takes place in the "coverage ter- Coverage Part. The words "we", "us" and 'bur" ritory"; refer to the Company providing this insurance. (2) The "bodily injury" or "property dam- The word "insured" means any person or organi- age" occurs during the policy period; zation qualifying as such under SECTION 11-WHO and IS AN INSURED. (3) Prior to the "coverage term" in which Other words and phrases that appear in quotation "bodily injury" or "property damage" marks have special meaning. Refer to SECTION occurs, you did not know, per Para- V-DEFINITIONS. graph 1.d. below, that the "bodily in- jury" or "property damage" had oc- SECTION 1-COVERAGES curred or had begun to occur, in COVERAGE A. BODILY INJURY AND PROP- whole or in part. ERTY DAMAGE LIABILITY c. "Bodily injury" or "property damage" which: 1. Insuring Agreement (1) Occurs during the "coverage term"; a. We will pay those sums that the insured and becomes legally obligated to pay as damages because of "bodily injury" or (2) Was not, prior to the "coverage "property damage" to which this insur- term", known by you, per Paragraph ance applies. We will have the right and 1.d.below, to have occurred; duty to defend the insured against any includes an continuation change or re- suit seeking those damages. However, y g we will have no duty to defend the in- sumption of that "bodily injury" or "prop- sured against any "suit" seeking dam- erty damage" after the end of the "cover- ages for "bodily injury" or "property dam- age term" in which it first became known age" to which this insurance does not by you. apply. We may, at our discretion, investi- d. You will be deemed to know that "bodily gate any occurrence and settle any injury" or "property damage" has oc- claim or suit that may result. But: curred at the earliest time when any (1) The amount we will pay for damages "authorized representative": is limited as described in SECTION (1) Reports all, or any part, of the "bodily III-LIMITS OF INSURANCE; and injury" or "property damage" to us or (2) Our right and duty to defend ends any other insurer; when we have used up the applica- (2) Receives a written or verbal demand ble limit of insurance in the payment or claim for damages because of the of judgments or settlements under "bodily injury" or "property damage"; SECTION 1 - COVERAGES, COW ERAGE A. BODILY INJURY AND (3) First observes, or reasonably should PROPERTY DAMAGE LIABILITY; have first observed, the "bodily in- SECTION 1 - COVERAGES, COW jury" or "property damage"; ERAGE B. PERSONAL AND AD- VERTISING INJURY LIABILITY; or (4) Becomes aware, or reasonably medical expenses under SECTION 1 should have become aware, by any - COVERAGES COVERAGE C. means other than as described in (3) MEDICAL PAYMENTS. above, that "bodily injury" or "prop- erty damage" had occurred or had No other obligation or liability to pay sums begun to occur; or or perform acts or services is covered unless expressly provided for under (5) Becomes aware, or reasonably should have become aware, of a Includes copyrighted material of Insurance GA 101 12 04 Services Office, Inc., with its permission. Page 1 of 22 condition from which "bodily injury" (3) Any statute, ordinance or regulation or "property damage" is substantially relating to the sale, gift, distribution certain to occur. or use of alcoholic beverages. e. Damages because of "bodily injury" in- This exclusion applies only if you are in clude damages claimed by any person or the business of manufacturing, distribut- organization for care, loss of services or ing, selling, serving or furnishing alcoholic death resulting at any time from the "bod- beverages. ily injury". d. Workers' Compensation and Similar 2. Exclusions Laws This insurance does not apply to: Any obligation of the insured under a workers'compensation, disability benefits a. Expected or Intended Injury or unemployment compensation law or "Bodily injury" or "property damage" any similar law. which may reasonably be expected to re- e. Employer's Liability sult from the intentional or criminal acts of the insured or which is in fact expected or "Bodily injury" to: intended by the insured, even if the injury or damage is of a different degree or type (1) An "employee" the insured sus- than actually expected or intended. This tained in the "workplace"; exclusion does not apply to "bodily injury" (2) An "employee" of the insured arising resulting from the use of reasonable force out of the performance of duties re- to protect persons or property. lated to the conduct of the insured's b. Contractual Liability business; or "Bodily injury" or "property damage" for (3) The spouse, child, parent, brother or which the insured is obligated to pay sister of that "employee" as a conse- damages by reason of the assumption of quence of Paragraphs (1) or (2) liability in a contract or agreement. This above. exclusion does not apply to liability for This exclusion applies: damages: (1) Whether the insured may be liable (1) That the insured would have in the as an employer or in any other ca- absence of the contract or agree- pacity; and ment; or (2) To any obligation to share damages (2) Assumed in a contract or agreement with or repay someone else who that is an "insured contract", pro- p y must pay damages because of the vided the "bodily injury" or "property injury. damage" occurs subsequent to the execution of the contract or agree- This exclusion does not apply to liability ment. When a claim for such "bodily assumed by the insured under an "in- injury" or "property damage" is sured contract". made, we will defend that claim pro- vided the insured has assumed the f. Pollutant obligation to defend such claim in the (1) "Bodily injury" or "property damage" insured contract". Such defense arising out of the actual, alleged or payments will not reduce the limits of threatened discharge, dispersal, insurance. seepage, migration, release, escape c. Liquor Liability or emission of"pollutants": "Bodily injury" or "property damage" for (a) At or from any premises, site or which any insured may be held liable by location which is or was at any reason of: time owned or occupied by, or rented or loaned to, any insured. (1) Causing or contributing to the intoxi- However, Paragraph (a) does cation of any person; not apply to: (2) The furnishing of alcoholic bever- 1) "Bodily injury" to any person ages to a person under the legal injured while on any prem- drinking age or under the influence ises, site or location owned of alcohol; or or occupied by, or rented or loaned to, you provided: Includes copyrighted material of Insurance GA 101 12 04 Services Office, Inc., with its permission. Page 2 of 22 a) The injury is caused by airborne irritants or con- the inadequate ventila- taminants used in a manu- tion of vapors; facturing process or which is the product or by-product b) The person injured is of any manufacturing proc- first exposed to such ess; vapors during the pol- icy period; and 2) "Bodily injury" or "property damage" for which you may c) Within 30 days of such be held liable, if you are a first exposure, the per- contractor, and the owner son injured is clinically or lessee of such premises, diagnosed or treated site or location has been by a physician for the added to this Coverage Part medical condition as an additional insured caused by the expo- with respect to your ongo- sure to such vapors. ing operations or "your However, Paragraph c) work" performed for that does not apply if the additional insured at that "bodily injury" is caused premises, site or location by vapors produced by and such premises, site or or originating from location is not and never equipment that is used was owned or occupied by, to heat, cool or dehu- or rented or loaned to, any midify the building, or insured, other than that ad- equipment that is used ditional insured; or to heat water for per- sonal use, by the 3) "Bodily injury" or "property building's occupants or damage" arising out of heat, their guests. smoke or fumes from a This exception 1) shall ap- "hostile fire"; ply only to Named Insureds; (b) At or from any premises, site or we shall have no duty to location which is or was at any defend or pay damages for time used by or for any insured any person or organization or others for the handling, stor- that is not a Named In- age, disposal, processing or sured. However, this para- treatment of waste; graph does not apply if the (c) Which are or were at any time bodily injury is caused by transported, handled, stored,trans vapors produced by or p originating from equipment treated, disposed of, or proc- that is used to heat, cool or essed as waste by or for: dehumidify the building, or 1) Any insured; or equipment that is used to heat water for personal use, 2) Any person or organization by the building's occupants for whom you may be le- or their guests. gally responsible; For the purpose of the ex- (d) At or from any premises, site or ception granted in Para- location on which any insured or graph 1) only, vapors any contractors or subcontrac- means any gaseous or air- tors working directly or indirectly borne irritant or airborne on any insured's behalf are contaminant, including performing operations if the smoke, fumes, vapor or "pollutants" are brought on or to soot, but excluding asbes- the premises, site or location in tos, which is discharged, connection with such operations dispersed, emitted, re- by such insured, contractor or leased or escapes from subcontractor. However, Para- materials, machinery or graph (d)does not apply to: equipment used in the service or maintenance of 1) "Bodily injury" or "property the premises. Vapors does damage" arising out of the not mean any gaseous or discharge, dispersal, seep- age, migration, release, es- Includes copyrighted material of Insurance GA 101 12 04 Services Office, Inc., with its permission. Page 3 of 22 cape or emission of fuels, erations are to test for, monitor, lubricants or other operating clean up, remove, contain, treat, fluids, or exhaust gases, detoxify or neutralize, or in any which are needed to per- way respond to, or assess the form, or are the result of, effects of, "pollutants". the normal electrical, hy- draulic or mechanical func- (2) Any loss, cost or expense arising out tions necessary for the op- of any: eration of "mobile equip- (a) Request, demand, order or ment or its parts, if such statutory or regulatory require- fuels, lubricants or other ment that any insured or others operating fluids, or exhaust test for, monitor, clean up, re- gases, escape, seep or mi- move, contain, treat, detoxify or grate, or are discharged, neutralize, or in any way re- dispersed, released or spond to, or assess the effects emitted from a vehicle part of, "pollutants"; or designed to hold, store or receive them. This excep- (b) Claim or suit by or on behalf of a tion does not apply if the fu- governmental authority for dam- els, lubricants or other op- ages because of testing for, erating fluids, or exhaust monitoring, cleaning up, remov- gases, escape, seep or mi- ing, containing, treating, detoxi- grate, or are discharged, fying or neutralizing, or in any dispersed, released or way responding to, or assessing emitted with the intent to the effects of, "pollutants". cause "bodily injury" or "property damage" or with However, Paragraphs (2)(a) and (b) the knowledge that "bodily do not apply to liability for damages injury" or "property damage" because of "property damage" that is substantially certain to the insured would have in the ab- occur, or if such fuels, lubri- sence of such request, demand, or- cants or other operating der or statutory or regulatory re- fluids, or exhaust gases, quirement, or such claim or "suit" by are brought on or to the or on behalf of a governmental premises, site or location authority. with such intent to escape, g. Aircraft,Auto or Watercraft seep or migrate, or be dis- charged, dispersed, re- "Bodily injury" or "property damage" aris- leased or emitted as part of ing out of the ownership, maintenance, the operations being per- use or entrustment to others of any air- formed by such insured, craft, "auto" or watercraft owned or oper- contractor or subcontractor; ated by or rented or loaned to any in- sured. Use includes operation and 2) "Bodily injury" or "property "loading or unloading". damage" sustained within a building and caused by the This exclusion applies even if the claims release of gases, fumes or against any insured allege negligence or vapors from materials other wrongdoing in the supervision, hir- brought into that building in ing, employment, training or monitoring of connection with operations others by that insured, if the "occurrence" being performed by you or which caused the "bodily injury" or "prop- on your behalf by a con- erty damage" involved the ownership, tractor or subcontractor; or maintenance, use or entrustment to oth- ers of any aircraft, "auto" or watercraft 3) "Bodily injury" or "property that is owned or operated by or rented or damage" arising out of heat, loaned to any insured. smoke or fumes from a "hostile fire"; or This exclusion does not apply to: (e) At or from any premises, site or (1) A watercraft while ashore on prem- location on which any insured or ises you own or rent; any contractors or subcontrac- tors working directly or indirectly (2) A watercraft you do not own that is: on any insured's behalf are (a) Less than 51 feet long; and performing operations if the op- Includes copyrighted material of Insurance GA 101 12 04 Services Office, Inc., with its permission. Page 4 of 22 (b) Not being used to carry persons governmental authority in hindering or property for a charge; or defending against any of these. (3) Parking an "auto" on, or on the ways j. Damage to Property next to, premises you own or rent, "Property damage" to: provided the "auto" is not owned by or rented or loaned to you or the in- (1) Property you own, rent or occupy, sured; including any costs or expenses in- (4) Liability assumed under any "insured curred by you, or any other person, contract" for the ownership, mainte- organization or entity, for repair, re- nance or use of aircraft or watercraft; placement, enhancement, restora- or tion or maintenance of such property for any reason, including prevention (5) "Bodily injury" or "property damage" of injury to a person or damage to arising out of: another's property; (a) The operation of machinery or (2) Premises you sell, give away or equipment that is on, attached abandon, if the "property damage" to, or part of, a land vehicle that arises out of any part of those prem- would qualify under the defini- ises; tion of "mobile equipment" if it (3) Property loaned to you; were not subject to a compul- sory or financial responsibility (4) Personal property in the care, cus- law or other motor vehicle insur- tody or control of an insured; ance law in the state where it is licensed or principally garaged; (5) That particular part of real property or on which you or any contractors or subcontractors working directly or (b) The operation of any of the ma- indirectly on your behalf are per- chinery or equipment listed in forming operations, if the "property Paragraph f.(2) or f.(3) of the damage" arises out of those opera- definition of mobile equipment". tions; or h. Mobile Equipment (6) That particular part of any property "Bodily injury" or "property damage" aris- that must be restored, repaired or ing out of: replaced because "your work" was incorrectly performed on it. (1) The transportation of "mobile equip- Paragraphs (1), (3) and (4) of this exclu- ment by an auto owned or oper- ated by or rented or loaned to any sion do not apply to "property damage" insured; or (other than damage by fire or explosion) to premises, including the contents of (2) The use of "mobile equipment" in, or such premises, rented to you for a period while in practice for, or while being of 7 or fewer consecutive days, for which prepared for, any prearranged rac- the amount we will pay is limited to the ing, speed, demolition, or stunting Damage To Premises Rented To You activity. Limit as described in SECTION III - LIM- ITS OF INSURANCE. i. War Paragraph (2) of this exclusion does not "Bodily injury" or "property damage", apply if the premises are "your work" and however caused, arising, directly or indi- were never occupied, rented or held for rectly, out of: rental by you. (1) War, including undeclared or civil Paragraphs(3), (4), (5) and(6)of this ex- war; clusion do not apply to liability assumed (2) Warlike action by a military force, in- under a sidetrack agreement. cluding action in hindering or de- Paragraph (6) of this exclusion does not fending against an actual or ex- apply to "property damage" included in pected attack, by any government, the "products-completed operations haz- sovereign or other authority using and". military personnel or other agents; or (3) Insurrection, rebellion, revolution, k. Damage to Your Product usurped power, or action taken by "Property damage" to "your product" arising out of it or any part of it. Includes copyrighted material of Insurance GA 101 12 04 Services Office, Inc., with its permission. Page 5 of 22 I. Damage to Your Work q. Employment-Related Practices "Property damage" to "your work" arising "Bodily injury" to: out of it or any part of it and included in the "products-completed operations haz- ard". (a) Refusal to employ that person; This exclusion does not apply if the dam- (b) Termination of that person's aged work or the work out of which the employment; or damage arises was performed on your behalf by a subcontractor. (c) Other employment-related prac- tices, policies, acts or omissions m. Damage to Impaired Property or Prop- including but not limited to coer- erty Not Physically Injured cion, criticism, demotion, "Property damage" to "impaired property" evaluation, failure to promote, or property that has not been physically reassignment, discipline, defa- injured, arising out of: mation, harassment, humiliation or discrimination directed at that (1) A defect, deficiency, inadequacy or person; or dangerous condition in "your prod- uct" or "your work"; or (2) The spouse, child, parent, brother or sister of that person as a conse- (2) A delay or failure by you or anyone quence of "bodily injury" to that per- acting on your behalf to perform a son at whom any of the employment- contract or agreement in accordance related practices described in Para- with its terms. graphs (a), (b) or (c) above is di- rected. This exclusion does not apply to the loss of use of other property arising out of This exclusion applies: sudden and accidental physical injury to (1) Whether the insured may be liable your product or your work after it has been put to its intended use. as an employer or in any other ca- pacity; and n. Recall of Products, Work or Impaired Property (2) To any obligation to share damages with or repay someone else who Any liability or damages claimed for any must pay damages because of the loss, cost or expense incurred by you or injury. others for the loss of use, withdrawal, re- call, inspection, repair, replacement, ad- justment, removal or disposal of: An additional insured added by attach- (1) "Your product"; ment of an endorsement to this verage Part that iss eking coverage foroa claim (2) "Your work"; or or "suit", if that additional insured knew, per the following paragraph, that "bodily (3) "Impaired property"; injury" or "property damage" had oc- if such product, work or property is with- curred or had begun to occur, in whole or drawn or recalled from the market or from in part, prior to the "coverage term" in use by any person or organization be- which such "bodily injury" or "property cause of a known or suspected defect, damage" occurs or begins to occur. deficiency, inadequacy or dangerous An additional insured added by attach- condition in it. ment of an endorsement to this Coverage o. Personal and Advertising Injury Part will be deemed to have known that "bodily injury" or "property damage" has "Bodily injury" arising out of"personal and occurred or has begun to occur at the advertising injury". earliest time when that additional insured, or any one of its owners, members, part- p. Asbestos ners, managers, executive officers, "em- "Bodily injury" or "property damage" aris- ployees" assigned to manage that addi- ing out of, attributable to, or any way re- tional insured's insurance program, or lated to asbestos in any form or trans- "employees" assigned to give or receive miffed in any manner. notice of an "occurrence", "personal and advertising injury" offense, claim or "suit": Includes copyrighted material of Insurance GA 101 12 04 Services Office, Inc., with its permission. Page 6 of 22 (1) Reports all, or any part, of the "bodily a. We will pay those sums that the insured injury" or "property damage" to us or becomes legally obligated to pay as any other insurer; damages because of "personal and ad- vertising injury" to which this insurance (2) Receives a written or verbal demand applies. We will have the right and duty or claim for damages because of the to defend the insured against any "suit" bodily injury or property damage"; seeking those damages. However, we (3) First observes, or reasonably should will have no duty to defend the insured have first observed, the "bodily in- against any "suit" seeking damages for jury" or "property damage"; this insurancertnsurance does not isin applyy whichur " to We may, (4) Becomes aware, or reasonably at our discretion, investigate any offense should have become aware, by any and settle any claim or "suit" that may re- means other than as described in (3) sult. But: above, that "bodily injury" or "prop- erty damage" had occurred or had (1) The amount we will pay for damages begun to occur; or is limited as described in SECTION III-LIMITS OF INSURANCE; and (5) Becomes aware, or reasonably should have become aware, of a (2) Our right and duty to defend ends condition from which "bodily injury" when we have used up the applica- bleor "property damage" is substantially limit of insurance in the payment certain to occur. of judgments or settlements under SECTION I - COVERAGES, COW s. Electronic Data ERAGE A. BODILY INJURY AND PROPERTY DAMAGE LIABILITY; Damages arising out of the loss of, loss SECTION I - COVERAGES, COW of use of, damage to, corruption of, in- ERAGE B. PERSONAL AND AD- ability to access, or inability to manipulate VERTISING INJURY LIABILITY; or "electronic data". medical expenses under SECTION I t. Distribution of Material in Violation of - COVERAGES, COVERAGE C. Statutes MEDICAL PAYMENTS. "Bodily injury" or "property damage" aris- No other obligation or liability to pay sums ing directly or indirectly out of any action or perform acts or services is covered or omission that violates or is alleged to unless expressly provided for under violate: SUPPLEMENTARY PAYMENTS - COV- ERAGES A AND B. a. The Telephone Consumer Protection Act (TCPA), including any amend- b. This insurance applies to "personal and ment of or addition to such law; or advertising injury" only if: b. The CAN-SPAM Act of 2003, includ- (1) The "personal and advertising injury" ing any amendment of or addition to is caused by an offense arising out such law; or of your business; and c. Any statute, ordinance or regulation, (2) The "personal and advertising injury" other than the TCPA or CAN-SPAM offense was committed in the "cov- Act of 2003, that prohibits or limits the erage territory" during the policy pe- sending, transmitting, communicating riod; and or distribution of material or informa- (3) Prior to the "coverage term" in which tion. the "personal and advertising injury" Exclusions c. through q. do not apply to offense is committed, you did not "property damage" by fire or explosion to know, per Paragraph 1.d. below, that premises while rented to you or temporarily the offense had been committed or occupied by you with permission of the owner, had begun to be committed, in whole for which the amount we will pay is limited to or in part. the Damage to Premises Rented To You Limit c. "Personal and advertising injury" caused as described in SECTION III - LIMITS OF IN- by an offense which: SURANCE. COVERAGE B. PERSONAL AND ADVERTISING (1) Was committed during the "coverage INJURY LIABILITY term"; and 1. Insuring Agreement Includes copyrighted material of Insurance GA 101 12 04 Services Office, Inc., with its permission. Page 7 of 22 (2) Was not, prior to the "coverage (1) The inception of this Coverage Part; term", known by you, per Paragraph or 1.d.below, to have been committed; (2) The "coverage term" in which insur- includes any continuation, change or re- ance coverage is sought. sumption of that offense after the end of d. Criminal Acts the coverage term in which it first be- came known by you. "Personal and advertising injury" arising d. You will be deemed to know that a "per- out of a criminal act committed by or at sonal and advertising injury" offense has the direction of the insured. been committed at the earliest time when e. Contractual Liability any"authorized representative": "Personal and advertising injury" for (1) Reports all, or any part, of the "per- which the insured is obligated to pay sonal and advertising injury" to us or damages by reason of the assumption of any other insurer; liability in a contract or agreement. This (2) Receives a written or verbal demand exclusion does not apply to liability for or claim for damages because of the damages: "personal and advertising injury"; (1) That the insured would have in the (3) First observes, or reasonably should absence of the contract or agree- have first observed, the offense that ment; or caused the "personal and advertis- (2) Assumed in a contract or agreement ing injury"; that is an "insured contract", pro- (4) Becomes aware, or reasonably vided the "personal and advertising should have become aware, by any injury" is caused by or arises out of means, other than as described in an offense committed subsequent to (3)above, that the offense had been the execution of the contract or committed or had begun to be com- agreement. When a claim for such miffed; or "personal and advertising injury" is made, we will defend that claim, pro- (5) Becomes aware, or reasonably vided the insured has assumed the should have become aware, of a obligation to defend such claim in the condition from which "personal and "insured contract". Such defense advertising injury" is substantially payments will not reduce the limits of certain to occur. insurance. 2. Exclusions f. Breach of Contract This insurance does not apply to: "Personal and advertising injury" arising out of a breach of contract, except an im- a. Knowing Violation of Rights of Another plied contract to use another's advertising "Personal and advertising injury" caused idea in your "advertisement". by or at the direction of the insured with g. Quality or Performance of Goods - the knowledge that the act would violate Failure to Conform to Statements the rights of another and would inflict "personal and advertising injury". "Personal and advertising injury" arising out of the failure of goods, products or b. Material Published With Knowledge of services to conform with any statement of Falsity quality or performance made in your "ad- "Personal and advertising injury" arising vertisement". out of oral or written publication of mate- h. Wrong Description of Prices rial, if done by or at the direction of the in- sured with knowledge of its falsity. "Personal and advertising injury" arising out of the wrong description of the price c. Material Published Prior to Coverage of goods, products or services stated in Term your "advertisement". "Personal and advertising injury" arising i. Infringement of Copyright, Patent, out of oral or written publication of mate- Trademark or Trade Secret rial whose first publication took place be- fore the later of the following: "Personal and advertising injury" arising out of the infringement of copyright, pat- Includes copyrighted material of Insurance GA 101 12 04 Services Office, Inc., with its permission. Page 8 of 22 ent, trademark, trade secret or other in- or discrimination directed at that tellectual property rights. person; or However, this exclusion does not apply to (2) The spouse, child, parent, brother or infringement, in your "advertisement", of sister of that person as a conse- copyright, trade dress or slogan. quence of "personal and advertising injury" to that person at whom any of j. Insureds in Media and Internet Type the employment-related practices Businesses described in Paragraphs (a), (b) or "Personal and advertising injury" com- (c)above is directed. miffed by an insured whose business is: This exclusion applies: (1) Advertising, broadcasting, publishing (1) Whether the insured may be liable or telecasting; as an employer or in any other ca- (2) Designing or determining content of pacity; and web-sites for others; or (2) To any obligation to share damages (3) An Internet search, access, content with or repay someone else who or service provider. must pay damages because of the injury. However, this exclusion does not apply to n. Pollutant Paragraphs 17. a., b. and c. of personal and advertising injury" under SECTION V "Personal and advertising injury" arising -DEFINITIONS. out of the actual, alleged or threatened For the purposes of this exclusion, the discharge, dispersal, seepage, migration, placing of frames, borders or links, or ad- release, escape or emission of "pollut- vertising, for you or others anywhere on ants" at any time. the Internet is not, by itself, considered o. Pollutant-Related the business of advertising, broadcasting, publishing or telecasting. Any loss, cost or expense arising out of k. Electronic Chatrooms or Bulletin any: Boards (1) Request, demand, order or statutory or regulatory requirement that any "Personal and advertising injury" arising insured or others test for, monitor, out of an electronic chatroom or bulletin clean up, remove, contain, treat, board any insured hosts, owns, or over detoxify or neutralize, or in any way which any insured exercises control. respond to, or assess the effects of, I. Unauthorized Use of Another's Name "pollutants"; or or Product (2) Claim or suit by or on behalf of a Personal and advertising injury arising governmental authority for damages out of the unauthorized use of another's because of testing for, monitoring, name or product in your e-mail address, cleaning up, removing, containing, domain name or metatag, or any other treating, detoxifying or neutralizing, similar tactics to mislead another's poten- or in any way responding to, or as- tial customers. sessing the effects of, "pollutants". m. Employment Related Practices p. Asbestos "Personal and advertising injury" to: Personal and advertising injury arising out of, attributable to, or any way related (1) A person arising out of any: to asbestos in any form or transmitted in (a) Refusal to employ that person; any manner. (b) Termination of that person's q. Additional Insured Prior Knowledge employment; or An additional insured added by attach- ment of an endorsement to this Coverage (c) Other employment-related prac- Part that is seeking coverage for a claim tices, policies, acts or omissions or "suit", if that additional insured knew, including but not limited to coer- per the following paragraph, that a "per- cion, criticism, demotion, sonal and advertising injury" offense had evaluation, failure to promote, been committed or had begun to be reassignment, discipline, defa- committed, in whole or in part, prior to the mation, harassment, humiliation "coverage term" in which such offense Includes copyrighted material of Insurance GA 101 12 04 Services Office, Inc., with its permission. Page 9 of 22 was committed or began to be commit- "Personal and advertising injury" arising ted. directly or indirectly out of any action or omission that violates or is alleged to An additional insured added by attach- violate: ment of an endorsement to this Coverage Part will be deemed to have known that a a. The Telephone Consumer Protection "personal and advertising injury" offense Act (TCPA), including any amend- has been committed or has begun to be ment of or addition to such law; or committed at the earliest time when that additional insured, or any one of its own- b. The CAN-SPAM Act of 2003, includ- ers, members, partners, managers, ex- ing any amendment of or addition to such law; or ecutive officers, "employees" assigned to manage that additional insured's insur- c. Any statute, ordinance or regulation, ance program, or "employees" assigned other than the TCPA or CAN-SPAM to give or receive notice of an "occur- Act of 2003, that prohibits or limits the rence , personal and advertising injury sending, transmitting, communicating offense, claim or "suit": or distribution of material or informa- (1) Reports all, or any part, of the "per- tion. sonal and advertising injury" to us or COVERAGE C.MEDICAL PAYMENTS any other insurer; (2) Receives a written or verbal demand 1. Insuring Agreement or claim for damages because of the a. We will pay medical expenses as de- "personal and advertising injury"; scribed below for "bodily injury" caused (3) First observes, or reasonably should by an accident: have first observed, the offense that (1) On premises you own or rent; caused the "personal and advertis- (2) On ways next to premises you own ing injury"; or rent; or (4) Becomes aware, or reasonably (3) Because of your operations; should have become aware, by any means other than as described in (3) provided that: above, that the "personal and adver- tising injury" offense had been com- (1) The accident takes place in the mitted or had begun to be commit- "coverage territory" and during the ted; or policy period; (5) Becomes aware, or reasonably (2) The expenses are incurred and re- should have become aware, of a ported to us within three years of the condition from which "personal and date of the accident; and advertising injury" is substantially certain to occur. (3) The injured person submits to ex- amination, at our expense, by physi- r. War cians of our choice as often as we Personal and advertising injury", how- reasonably require. ever caused, arising, directly or indirectly, b. We will make these payments regardless out of: of fault. These payments will not exceed the applicable limit of insurance. We will (1) War, including undeclared or civil pay reasonable expenses for: war; (1) First aid administered at the time of (2) Warlike action by a military force, in- an accident; cluding action in hindering or de- fending against an actual or ex- (2) Necessary medical, surgical, x-ray pected attack, by any government, and dental services, including pros- sovereign or other authority using thetic devices; and military personnel or other agents; or (3) Necessary ambulance, hospital, (3) Insurrection, rebellion, revolution, professional nursing and funeral usurped power, or action taken by services. governmental authority in hindering or defending against any of these. 2. Exclusions s. Distribution of Material in Violation of We will not pay expenses for "bodily injury": Statutes Includes copyrighted material of Insurance GA 101 12 04 Services Office, Inc., with its permission. Page 10 of 22 a. Any Insured cluding actual loss of earnings up to $250 a To any insured, except "volunteer work- day because of time off from work. ers". 5. All costs taxed against the insured in the "suit". b. Hired Person 6. Prejudgment interest awarded against the To a person hired to do work for or on insured on that part of the judgment we be- behalf of any insured or a tenant of any come obligated to pay and which falls within insured. the applicable limit of insurance. If we make c. Injury on Normally Occupied Premises an offer to pay the applicable limit of insur- ance,we will not pay any prejudgment interest To a person injured on that part of prem- based on that period of time after the offer. ises you own or rent that the person nor- mally occupies. 7. All interest on the full amount of any judgment that accrues after entry of the judgment and d. Workers' Compensation and Similar before we have paid, offered to pay, or de- Laws posited in court the part of the judgment that To a person, whether or not an "em- is within the applicable limit of insurance. ployee" of any insured, if benefits for the These payments will not reduce the limits of insur- "bodily injury" are payable or must be ance. provided under a workers' compensation SECTION 11-WHO IS AN INSURED or disability benefits law or a similar law. e. Athletic Activities 1. If you are designated in the Declarations as: To any person injured while officiating, a. An individual, you and your spouse are coaching, practicing for, instructing or insureds, but only with respect to the participating in any physical exercises or conduct of a business of which you are games, sports, or athletic contests or ex- the sole owner. hibitions of an athletic or sports nature. b. A partnership or joint venture, you are an f. Products-Completed Operations Haz- insured. Your members, your partners, and and their spouses are also insureds, but only with respect to the conduct of your Included within the "products-completed business. operations hazard". c. A limited liability company, you are an in- g. Coverage A Exclusions sured. Your members are also insureds, but only with respect to the conduct of Excluded under COVERAGE A. BODILY your business. Your managers are in- INJURY AND PROPERTY DAMAGE LI- sureds, but only with respect to their du- ABILITY. ties as your managers. SUPPLEMENTARY PAYMENTS - COVERAGES d. An organization other than a partnership, A AND B joint venture or limited liability company, We will pay, with respect to any claim we investi- you are an insured. Your "executive offi- gate or settle, or any "suit" against an insured we cers" and directors are insureds, but only defend: with respect to their duties as your offi- cers or directors. Your stockholders are 1. All expenses we incur. also insureds, but only with respect to 2. Up to $250 for cost of bail bonds required be- their liability as stockholders. cause of accidents or traffic law violations e. A trust, you are an insured. Your trustees arising out of the use of any vehicle to which are also insureds, but only with respect to the Bodily Injury Liability Coverage applies. their duties as trustees. We do not have to furnish these bonds. 2. Each of the following is also an insured: 3. The cost of bonds to release attachments, but only for bond amounts within the applicable a. Your "volunteer workers" only while per- limit of insurance. We do not have to furnish forming duties related to the conduct of your business, or your "employees", these bonds. other than either your "executive officers" 4. All reasonable expenses incurred by the in- (if you are an organization other than a sured at our request to assist us in the inves- partnership, joint venture or limited liability tigation or defense of the claim or "suit", in- company) or your managers (if you are a limited liability company), but only for acts within the scope of their employment by Includes copyrighted material of Insurance GA 101 12 04 Services Office, Inc., with its permission. Page 11 of 22 you or while performing duties related to d. Your legal representative if you die, but the conduct of your business. However, only with respect to duties as such. That none of these "employees" or "volunteer representative will have all your rights workers" are insureds for: and duties under this Coverage Part. (1) "Bodily injury" or "personal and ad- 3. Any organization you newly acquire or form, vertising injury": other than a partnership, joint venture or lim- ited liability company, and over which you (a) To you, to your partners or maintain ownership or majority interest, will members (if you are a partner- qualify as a Named Insured if there is no other ship or joint venture), to your similar insurance available to that organiza- members (if you are a limited li- tion. However: ability company), to a co- "employee" while in the course a. Insurance under this provision is afforded of his or her employment or only until the 90th day after you acquire performing duties related to the or form the organization or the end of the conduct of your business, or to policy period, whichever is earlier; your other "volunteer workers" COVERAGE A. BODILY INJURY AND b. while performing duties related to the conduct of your business; PROPERTY DAMAGE LIABILITY doesnot apply to "bodily injury" or "property (b) To the spouse, child, parent, damage" that occurred before you ac- brother or sister of that co- quired or formed the organization; and "employee" or "volunteer c. COVERAGE B. PERSONAL AND AD- worker as a consequence of VERTISING INJURY LIABILITY does not Paragraph (1)(a)above; apply to "personal and advertising injury" (c) For which there is any obligation arising out of an offense committed be- to share damages with or repay fore you acquired or formed the organi- someone else who must pay zation. damages because of the injury described in Paragraphs (1)(a) No person or organization is an insured with re- or(b)above; or spect to the conduct of any current or past part- nership, joint venture or limited liability company (d) Arising out of his or her provid- that is not shown as a Named Insured in the Dec- ing or failing to provide profes- larations. sional health care services. SECTION III-LIMITS OF INSURANCE (2) "Property damage" to property: 1. The Limits of Insurance shown in the Declara- (a) Owned, occupied or used by; or tions and the rules below fix the most we will (b) Rented to, in the care, custody pay regardless of the number of: or control of, or over which a. Insureds; physical control is being exer- cised for any purpose by, b. Claims made or "suits" brought; or you, any of your "employees", "vol- c. Persons or organizations making claims unteer workers", any partner or or bringing "suits". member (if you are a partnership or 2. a. The General Aggregate Limit is the most joint venture), or any member (if you we will pay for the sum of: are a limited liability company). (1) Medical expenses under COVER- b. Any person (other than your "employee" AGE C. MEDICAL PAYMENTS; or "volunteer worker"), or any organiza- tion while acting as your real estate man- (2) Damages under COVERAGE A. ager. BODILY INJURY AND PROPERTY DAMAGE LIABILITY except dam- c. Any person or organization having proper ages because of "bodily injury" or temporary custody of your property if you "property damage" included in the die, but only: "products-completed operations (1) With respect to liability arising out of hazard"; and the maintenance or use of that prop- (3) Damages under COVERAGE B. erty; and PERSONAL AND ADVERTISING (2) Until your legal representative has INJURY LIABILITY. been appointed. This General Aggregate Limit will not ap- ply if either the Location General Aggre- Includes copyrighted material of Insurance GA 101 12 04 Services Office, Inc., with its permission. Page 12 of 22 gate Limit of Insurance, Paragraph 2.b., your behalf at the same location for or the Construction Project General Ag- the same persons or organizations, gregate Limit of Insurance, Paragraph no matter how often or under how 2.c.applies. many different contracts, will be deemed to be a single construction b. A separate Location General Aggregate project. Limit of Insurance, equal to the amount of the General Aggregate Limit shown in the 3. The Products-Completed Operations Aggre- Declarations, shall apply to each location gate Limit is the most we will pay under COV- owned by, or rented or leased to you and ERAGE A. BODILY INJURY AND PROP- is the most we will pay for the sum of: ERTY DAMAGE LIABILITY for damages be- cause of "bodily injury" and "property dam- (1) Damages under COVERAGE A. age" included in the "products-completed op- BODILY INJURY AND PROPERTY erations hazard". DAMAGE LIABILITY, except dam- ages because of "bodily injury" or 4. Subject to 2.a. above, the Personal and Ad- "property damage" included in the vertising Injury Limit is the most we will pay "products-completed operations under COVERAGE B. PERSONAL AND AD- hazard"; and VERTISING INJURY LIABILITY for the sum of all damages because of all "personal and ad- (2) Medical expenses under COVER- vertising injury" sustained by any one person AGE C. MEDICAL PAYMENTS, or organization. which can be attributed to operations at 5. Subject to 2. or 3. above, whichever applies, only a single location owned by, or rented the Each Occurrence Limit is the most we will or leased to you. pay for the sum of: c. A separate Construction Project General a. Damages under COVERAGE A. BODILY Aggregate Limit of Insurance, equal to INJURY AND PROPERTY DAMAGE LI- the amount of the General Aggregate ABILITY; and Limit shown in the Declarations, shall ap- ply to each construction project and is the b. Medical expenses under COVERAGE C. most we will pay for the sum of: MEDICAL PAYMENTS; (1) Damages under COVERAGE A. because of all "bodily injury" and "property BODILY INJURY AND PROPERTY damage" arising out of any one "occurrence". DAMAGE LIABILITY, except dam- 6. Subject to 5. above, the Dama e to Premises ages because of bodily injury or 1 g "property damage" included in the Rented to You Limit is the most we will pay "products-completed operations under COVERAGE A. BODILY INJURY AND hazard"; and PROPERTY DAMAGE LIABILITY for dam- ages because of "property damage" to any (2) Medical expenses under COVER- one premises, while rented to you, or in the AGE C. MEDICAL PAYMENTS; case of damage by fire or explosion, while rented to you or temporarily occupied by you which can be attributed only to ongoing with permission of the owner. operations and only at a single construc- tion project. 7. Subject to 5. above, the Medical Expense Limit is the most we will pay under COVER- d. Only for the purpose of determining which AGE C. MEDICAL PAYMENTS for all medical General Aggregate Limit of Insurance, expenses because of "bodily injury" sustained 2.a.,2.b.,or 2.c., applies: by any one person. (1) Location means premises involving The Limits of Insurance of this Coverage Part ap- the same or connecting lots, or ply separately to each "coverage term". premises, whose connection is inter- rupted only by a street, roadway, SECTION IV - COMMERCIAL GENERAL LI- waterway or right-of-way of a rail- ABILITY CONDITIONS road. 1. Bankruptcy (2) Construction project means a loca- tion you do not own, rent or lease Bankruptcy or insolvency of the insured or of where ongoing improvements, al- the insured's estate will not relieve us of our terations, installation, demolition or obligations under this Coverage Part. maintenance work is performed by 2. Duties in the Event of Occurrence, Offense, you or on your behalf. All connected Claim or Suit ongoing improvements, alterations, installation, demolition or mainte- a. You must see to it that we are notified as nance work performed by you or on soon as practicable of an "occurrence" or Includes copyrighted material of Insurance GA 101 12 04 Services Office, Inc., with its permission. Page 13 of 22 a "personal and advertising injury" of- under the terms of this Coverage Part or that fense which may result in a claim. To the are in excess of the applicable limit of insur- extent possible, notice should include: ance. An agreed settlement means a settle- ment and release of liability signed by us, the (1) How, when and where the "occur- insured and the claimant or the claimant's le- rence" or offense took place; gal representative. (2) The names and addresses of any 4. Liberalization injured persons and witnesses; and If, within 60 days prior to the beginning of this (3) The nature and location of any injury Coverage Part or during the policy period, we or damage arising out of the "occur- make any changes to any forms or endorse- rence or offense. ments of this Coverage Part for which there is b. If a claim is made or "suit" is brought currently no separate premium charge, and against any insured, you must: that change provides more coverage than this Coverage Part, the change will automatically (1) Immediately record the specifics of apply to this Coverage Part as of the latter of: the claim or "suit" and the date re- ceived; and a. The date we implemented the change in your state; or (2) Notify us as soon as practicable. b. The date this Coverage Part became ef- You must see to it that we receive written fective; and notice of the claim or "suit" as soon as will be considered as included until the end of practicable. the current policy period. We will make no c. You and any other involved insured must: additional premium charge for this additional (1) Immediately send us copies of any coverage during the interim. demands, notices, summonses or 5. Other Insurance legal papers received in connection If other valid and collectible insurance is with the claim or "suit"; available to the insured for a loss we cover (2) Authorize us to obtain records and under COVERAGE A. BODILY INJURY AND other information; PROPERTY DAMAGE LIABILITY or COV- ERAGE B. PERSONAL AND ADVERTISING (3) Cooperate with us in the investiga- INJURY LIABILITY of this Coverage Part, our tion or settlement of the claim or de- obligations are limited as follows: fense against the "suit"; and (4) Assist us, upon our request, in the a. Primary Insurance enforcement of any right against any This insurance is primary except when b. person or organization which may be below applies. If this insurance is pri- liable to the insured because of in- mary, our obligations are not affected jury or damage to which this insur- unless any of the other insurance is also ance may also apply. primary. Then, we will share with all that other insurance by the method described d. No insured will, except at that insured's in c.below. own cost, voluntarily make a payment, assume any obligation, or incur any ex- b. Excess Insurance pense, other than for first aid, without our consent. This insurance is excess over: 3. Legal Action Against Us (1) Any of the other insurance, whether primary, excess, contingent or on No person or organization has a right under any other basis: this Coverage Part: (a) That is Fire, Extended Cover- a. To join us as a party or otherwise bring age, Builder's Risk, Installation us into a "suit" asking for damages from Risk or similar insurance for an insured; or "your work"; b. To sue us on this Coverage Part unless (b) That is Fire or Explosion insur- aII of its terms have been fully complied ance for premises rented to you with. or temporarily occupied by you A person or organization may sue us to re- with permission of the owner; cover on an agreed settlement or on a final (c) That is insurance purchased by judgment against an insured; but we will not you to cover your liability as a be liable for damages that are not payable tenant for "property damage" to Includes copyrighted material of Insurance GA 101 12 04 Services Office, Inc., with its permission. Page 14 of 22 premises rented to you or tem- shown in the Declarations of this Cover- porarily occupied by you with age Part. permission of the owner; or c. Method of Sharing (d) If the loss arises out of the maintenance or use of aircraft, If all of the other insurance permits con- "autos" or watercraft to the ex- tribution by equal shares, we will follow tent not subject to SECTION 1 - this method also. Under this approach COVERAGES, COVERAGE A. each insurer contributes equal amounts BODILY INJURY AND PROP- until it has paid its applicable limit of in- ERTY DAMAGE LIABILITY, 2. surance or none of the loss remains, Exclusions, g.Aircraft,Auto or whichever comes first. Watercraft. If any of the other insurance does not (2) Any other primary insurance avail- permit contribution by equal shares, we able to the insured covering liability will contribute by limits. Under this for damages arising out of the method, each insurer's share is based on premises or operations, or the prod- the ratio of its applicable limit of insurance ucts and completed operations, for to the total applicable limits of insurance which the insured has been added of all insurers. as an additional insured by attach- 6. Premium Audit ment of an endorsement. a. We will compute all premiums for this (3) Any other insurance: Coverage Part in accordance with our (a) Whether primary, excess, con- rules and rates. tingent or on any other basis, b. Premium shown in this Coverage Part as except when such insurance is advance premium is a deposit premium written specifically to be excess only. At the close of each audit period we over this insurance; and will compute the earned premium for that (b) That is a consolidated (wrap-up) period and send notice to the first Named insurance program which has Insured. The due date for audit and ret- been provided by the prime rospective premiums is the date shown contractor/project manager or as the due date on the bill. If: owner of the consolidated proj- (1) The earned premium is less than the ect in which you are involved. deposit premium, we will return the When this insurance is excess, we will excess to the first Named Insured; or have no duty under COVERAGE A. (2) The earned premium is greater than BODILY INJURY AND PROPERTY the deposit premium, the difference DAMAGE LIABILITY or COVERAGE B. will be due and payable to us by the PERSONAL AND ADVERTISING IN- first Named Insured upon notice from JURY LIABILITY to defend the insured us. against any "suit" if any other insurer has a duty to defend the insured against that c. The first Named Insured must keep rec- "suit". If no other insurer defends, we will ords of the information we need for pre- undertake to do so, but we will be entitled mium computation, and send us copies at to the insured's rights against all those such times as we may request. other insurers. 7. Representations When this insurance is excess over other insurance, we will pay only our share of By accepting this Coverage Part, you agree: the amount of the loss, if any, that ex- a. The statements in the Declarations are ceeds the sum of: accurate and complete; (1) The total amount that all such other b. Those statements are based upon repre- insurance would pay for the loss in sentations you made to us; and the absence of this insurance; and (2) The total of all deductible and self- c. We have issued this Coverage Part in re- insured amounts under all that other liance upon your representations. insurance. 8. Separation of Insureds We will share the remaining loss, if any, Except with respect to the Limits of Insurance, with any other insurance that is not de- and any rights or duties specifically assigned scribed in this Excess Insurance provi- in this Coverage Part to the first Named In- sion and was not bought specifically to sured, this insurance applies: apply in excess of the Limits of Insurance Includes copyrighted material of Insurance GA 101 12 04 Services Office, Inc., with its permission. Page 15 of 22 a. As if each Named Insured were the only (1) An individual, you and your spouse Named Insured; and are "authorized representatives". b. Separately to each insured against whom (2) A partnership or joint venture, your claim is made or "suit" is brought. members, your partners, and their spouses are "authorized representa- 9. Transfer of Rights of Recovery Against tives". Others to Us (3) A limited liability company, your If the insured has rights to recover all or part members and your managers are of any payment we have made under this "authorized representatives". Coverage Part, those rights are transferred to us. The insured must do nothing after loss to (4) An organization other than a part- impair them. At our request, the insured will nership, joint venture or limited liabil- bring "suit" or transfer those rights to us and ity company, your "executive offi- help us enforce them. cers" and directors are "authorized a Forms or Policies representatives". Provided you are 10. Two or More Coverage not a publicly traded organization, Issued by Us your stockholders are also "author- If this Coverage Part and any other Coverage ized representatives". Form, Coverage Part or policy issued to you (5) A trust, your trustees are "authorized by us or any company affiliated with us apply representatives". to the same 'occurrence" or "personal and p advertising injury" offense, the aggregate b. Your "employees": maximum limit of insurance under all the Cov- erage Forms, Coverage Parts or policies shall (1) Assigned to manage your insurance not exceed the highest applicable limit of in- program; or surance under any one Coverage Form, Cov- (2) Responsible for giving or receiving erage Part or policy. This condition does not notice of an 'occurrence", "personal apply to any Coverage Form, Coverage Part and advertising injury" offense, claim or policy issued by us or an affiliated company specifically to apply as excess insurance over or "suit"; this Coverage Part. are also "authorized representatives". 11. When We Do Not Renew 3. "Auto" means: If we decide not to renew this Coverage Part, a. A land motor vehicle, trailer or semitrailer we will mail or deliver to the first Named In- designed for travel on public roads, in- sured shown in the Declarations written notice cluding any attached machinery or of the nonrenewal not less than 30 days be- equipment; or fore the expiration date. b. Any other land vehicle that is subject to a If notice is mailed, proof of mailing will be suf- compulsory or financial responsibility law ficient proof of notice. or other motor vehicle insurance law in SECTION V-DEFINITIONS the state where it is licensed or principally garaged. 1. Advertisement means a notice that is broad- However, "auto" does not include "mobile cast, telecast or published to the general pub- equipment". lic or specific market segments about your goods, products or services for the purpose of 4. "Bodily injury" means bodily injury, sickness or attracting customers or supporters. "Adver- disease sustained by a person, including tisement" includes a publicity article. For pur- death resulting from any of these at any time. poses of this definition: 5. "Coverage term" means the following individ- a. Notices that are published include mate- ual increment, or if a multi-year policy period, rial placed on the Internet or on similar increments, of time, which comprise the policy electronic means of communication; and period of this Coverage Part: b. Regarding web-sites, only that part of a a. The year commencing on the Effective web-site that is about your goods, prod- Date of this Coverage Part at 12:01 AM ucts or services for the purposes of at- standard time at your mailing address tracting customers or supporters is con- shown in the Declarations, and if a multi- sidered an "advertisement". year policy period, each consecutive an- 2. "Authorized representative" means: nual period thereafter, or portion thereof if any period is for a period of less than 12 a. If you are designated in the Declarations months, constitute individual "coverage as: terms". The last "coverage term" ends at Includes copyrighted material of Insurance GA 101 12 04 Services Office, Inc., with its permission. Page 16 of 22 12:00 AM standard time at your mailing 10. "Hostile fire" means one which becomes un- address shown in the Declarations on the controllable or breaks out from where it was earlier of: intended to be. (1) The day the policy period shown in 11. "Impaired property" means tangible property, the Declarations ends; or other than "your product" or "your work", that cannot be used or is less useful because: (2) The day the policy to which this Cov- erage Part is attached is terminated a. It incorporates "your product" or "your or cancelled. work" that is known or thought to be de- fective, deficient, inadequate or danger- b. However, if after the issuance of this ous; or Coverage Part, any "coverage term" is extended for an additional period of less b. You have failed to fulfill the terms of a than 12 months, that additional period of contract or agreement; time will be deemed to be part of the last if such property can be restored to use b preceding coverage term". p p y y: 6. "Coverage territory" means: a. The repair, replacement, adjustment or removal of "your product" or "your work"; a. The United States of America (including or its territories and possessions), Puerto Rico and Canada; b. Your fulfilling the terms of the contract or agreement. b. International waters or airspace, but only if the injury or damage occurs in the 12. "Insured contract" means: course of travel or transportation between a. A contract for a lease of premises. How- any places included in a.above; or ever, that portion of the contract for a c. All other parts of the world if the injury or lease of premises that indemnifies any damage arises out of: person or organization for "property damage" by fire or explosion to premises (1) Goods or products made or sold by while rented to you or temporarily occu- you in the territory described in a. pied by you with permission of the owner above; is not an "insured contract"; (2) The activities of a person whose b. A sidetrack agreement; home is in the territory described in a.above, but is away for a short time c. Any easement or license agreement, ex- on your business; or cept in connection with construction or demolition operations on or within 50 feet (3) "Personal and advertising injury" of- of a railroad; fenses that take place through the Internet or similar electronic means d. An obligation, as required by ordinance, of communication, to indemnify a municipality, except in connection with work for a municipality; provided the insured's responsibility to pay damages is determined in a "suit" on e. An elevator maintenance agreement; the merits, in the territory described in a. f. That part of any other contract or agree- above or in a settlement to which we ment pertaining to your business (includ- agree. ing an indemnification of a municipality in 7. "Electronic data" means information, facts or connection with work performed for a programs stored as or on, created or used on, municipality) under which you assume or transmitted to or from computer software, the tort liability of another party to pay for including systems and applications software, "bodily injury", "property damage" or hard or floppy disks, CD-ROMs, tapes, drives, "personal and advertising injury" to a third cells, data processing devices or any other person or organization. Tort liability media which are used with electronically con- means a liability that would be imposed trolled equipment. by law in the absence of any contract or agreement. 8. "Employee" includes a "leased worker". "Em- ployee" does not include a "temporary Paragraph f. does not include that part of worker". any contract or agreement: 9. "Executive officer" means a person holding (1) That indemnifies a railroad for "bodily any of the officer positions created by your injury", "property damage" or "per- charter, constitution, by-laws or any other sonal and advertising injury" arising similar governing document. out of construction or demolition op- erations, within 50 feet of any rail- Includes copyrighted material of Insurance GA 101 12 04 Services Office, Inc., with its permission. Page 17 of 22 road property and affecting any rail- engines; marketing analysis; and road bridge or trestle, tracks, road- providing access to the Internet or beds, tunnel, underpass or crossing; other similar networks; or (2) That indemnifies an architect, engi- (7) Under which the insured, if a web- neer or surveyor for injury or damage site designer or content provider, or arising out of: Internet search, access, content or service provider, assumes liability for (a) Preparing, approving, or failing injury or damage arising out of the to prepare or approve, maps, insured's rendering or failure to ren- shop drawings, opinions, re- der Internet services, including those ports, surveys, field orders, listed in Paragraph (6), above. change orders or drawings and specifications; or 13. "Leased worker" means a person leased to you by a labor leasing firm under an agree- (b) Giving directions or instructions, ment between you and the labor leasing firm, or failing to give them, if that is to perform duties related to the conduct of the primary cause of the injury your business. "Leased worker" includes su- or damage; pervisors furnished to you by the labor leasing (3) Under which the insured, if an archi- firm. "Leased worker" does not include a tect, engineer or surveyor, assumes "temporary worker". liability for an injury or damage aris- 14. "Loading or unloading" means the handling of ing out of the insured's rendering or property: failure to render professional serv- ices, including those listed in Para- a. After it is moved from the place where it is graph (2) above and supervisory, in- accepted for movement into or onto an spection, architectural or engineering aircraft,watercraft or "auto"; activities; b. While it is in or on an aircraft, watercraft (4) That indemnifies an advertising, pub- or "auto"; or lic relations or media consulting firm for "personal and advertising injury" c. While it is being moved from an aircraft, arising out of the planning, execution watercraft or "auto" to the place where it or failure to execute marketing com- is finally delivered; munications programs. Marketing but "loading or unloading" does not include communications programs include the movement of property by means of a me- but are not limited to comprehensive chanical device, other than a hand truck, that marketing campaigns; consumer, is not attached to the aircraft, watercraft or trade and corporate advertising for "auto". all media; media planning, buying, monitoring and analysis; direct mail; 15. "Mobile equipment" means any of the follow- promotion; sales materials; design; ing types of land vehicles, including any at- presentations; point-of-sale materi- tached machinery or equipment: als; market research; public relations and new product development; a. Bulldozers, farm machinery, forklifts and other vehicles designed for use princi- (5) Under which the insured, if an adver- pally off public roads; tising, public relations or media con- sulting firm, assumes liability for b. Vehicles maintained for use solely on or "personal and advertising injury" next to premises you own or rent; arising out of the insured's rendering c. Vehicles that travel on crawler treads; or failure to render professional services, including those services d. Vehicles, whether self-propelled or not, listed in Paragraph (4), above; maintained primarily to provide mobility to (6) That indemnifies a web-site designer permanently mounted: or content provider, or Internet (1) Power cranes, shovels, loaders, dig- search, access, content or service gers or drills; or provider for injury or damage arising out of the planning, execution or fail- (2) Road construction or resurfacing ure to execute Internet services. equipment such as graders, scrap- Internet services include but are not ers or rollers; limited to design, production, distri- e. Vehicles not described in a., b., c. or d. bution, maintenance and administra- above that are not self-propelled and are tion of web-sites and web-banners; maintained primarily to provide mobility to hosting web-sites; registering do- main names; registering with search Includes copyrighted material of Insurance GA 101 12 04 Services Office, Inc., with its permission. Page 18 of 22 permanently attached equipment of the d. Oral or written publication, in any manner, following types: of material that slanders or libels a per- son or organization or disparages a per- (1) Air compressors, pumps and gen- son's or organization's goods, products or erators, including spraying, welding, services; building cleaning, geophysical explo- ration, lighting and well servicing e. Oral or written publication, in any manner, equipment; or of material that violates a person's right of (2) Cherry pickers and similar devices privacy; used to raise or lower workers; f. The use of another's advertising idea in f. Vehicles not described in a., b., c. or d. your "advertisement"; or above maintained primarily for purposes g. Infringing upon another's copyright, trade other than the transportation of persons dress or slogan in your "advertisement". or cargo. 18. "Pollutant" means any solid, liquid, gaseous or However, self-propelled vehicles with the thermal irritant or contaminant, including following types of permanently attached smoke, vapor, soot, fumes, acids, alkalis, equipment are not "mobile equipment" chemicals, petroleum, petroleum products but will be considered "autos": and petroleum by-products, and waste. Waste includes materials to be recycled, re- (1) Equipment designed primarily for: conditioned or reclaimed. "Pollutants" include (a) Snow removal; but are not limited to substances which are generally recognized in industry or govern- (b) Road maintenance, but not con- ment to be harmful or toxic to persons, prop- struction or resurfacing; or erty or the environment regardless of whether the injury or damage is caused directly or indi- (c) Street cleaning; rectly by the "pollutants" and whether: (2) Cherry pickers and similar devices a. The insured is regularly or otherwise en- mounted on automobile or truck gaged in activities which taint or degrade chassis and used to raise or lower the environment; or workers; and b. The insured uses, generates or produces (3) Air compressors, pumps and gen- the "pollutant". erators, including spraying, welding, building cleaning, geophysical explo- 19. "Products-completed operations hazard": ration, lighting and well servicing equipment. a. Includes all "bodily injury" and "property damage" occurring away from premises However, "mobile equipment" does not in- you own or rent and arising out of "your clude any land vehicles that are subject to a product" or "your work" except: compulsory or financial responsibility law or other motor vehicle insurance law in the state (1) Products that are still in your physical where it is licensed or principally garaged. possession; or Land vehicles subject to a compulsory or fi- (2) Work that has not yet been com- nancial responsibility law or other motor vehi- pleted or abandoned. However, cle insurance law are considered "autos". "your work" will be deemed com- 16. "Occurrence" means an accident, including pleted at the earliest of the following continuous or repeated exposure to substan- times: tially the same general harmful conditions. (a) When all of the work called for in 17. "Personal and advertising injury" means in- your contract has been com- jury, including consequential "bodily injury", pleted; or arising out of one or more of the following of- (b) When all of the work to be done fenses: at the job site has been com- a. False arrest, detention or imprisonment; pleted if your contract calls for work at more than one job site; b. Malicious prosecution; or c. The wrongful eviction from, wrongful entry (c) When that part of the work done into, or invasion of the right of private oc- at a job site has been put to its cupancy of a room, dwelling or premises intended use by any person or that a person occupies, committed by or organization other than another on behalf of its owner, landlord or lessor; contractor or subcontractor working on the same project. Includes copyrighted material of Insurance GA 101 12 04 Services Office, Inc., with its permission. Page 19 of 22 Work that may need service, main- her work and acts at the direction of and tenance, correction, repair or re- within the scope of duties determined by you, placement, but which is otherwise and is not paid a fee, salary or other compen- complete, will be treated as com- sation by you or anyone else for their work pleted. performed for you. b. Does not include "bodily injury" or "prop- 24. "Workplace" means that place and during erty damage" arising out of: such hours to which the "employee" sustain- ing "bodily injury" was assigned by you, or (1) The transportation of property, un- any other person or entity acting on your be- less the injury or damage arises out half, to work on the date of"occurrence". of a condition in or on a vehicle not owned or operated by you, and that 25. "Your product": condition was created by the "load- ing or unloading of that vehicle by any insured; (1) Any goods or products, other than (2) The existence of tools, uninstalled real property, manufactured, sold, equipment or abandoned or unused handled, distributed or disposed of materials; or by: (3) Products or operations for which the (a) You; classification, listed in the Declara- (b) Others trading under your name; tions or in a schedule, states that or products-completed operations are included. (c) A person or organization whose 20. "Property damage" means: business or assets you have acquired; and a. Physical injury to tangible property, in- (2) Containers (other than vehicles), cluding all resulting loss of use of that materials, parts or equipment fur- property. All such loss of use shall be nished in connection with such deemed to occur at the time of the physi- goods or products. cal injury that caused it; or b. Loss of use of tangible property that is b. Includes: not physically injured. All such loss of (1) Warranties or representations made use shall be deemed to occur at the time at any time with respect to the fit- of the "occurrence" that caused it. ness, quality, durability, performance For the purposes of this insurance, "electronic or use of"your product"; and data" is not tangible property. (2) The providing of or failure to provide 21. "Suit" means a civil proceeding in which warnings or instructions. money damages because of "bodily injury", c. Does not include vending machines or "property damage" or "personal and advertis- other property rented to or located for the ing injury" to which this insurance applies are use of others but not sold. alleged. "Suit" includes: 26. "Your work": a. An arbitration proceeding in which such damages are claimed and to which the a. Means: insured must submit or does submit with (1) Work or operations performed by our consent; you or on your behalf; and b. Any other alternative dispute resolution (2) Materials, parts or equipment fur- proceeding in which such damages are nished in connection with such work claimed and to which the insured submits or operations. with our consent; or c. An appeal of a civil proceeding. b. Includes: 22. "Temporary worker" means a person who is (1) Warranties or representations made furnished to you to substitute for a permanent at any time with respect to the fit- "employee" on leave or to meet seasonal or ness, quality, durability, performance short-term workload conditions. or use of your work"; and 23. "Volunteer worker" means a person who is (2) The providing of or failure to provide not your "employee", and who donates his or warnings or instructions. Includes copyrighted material of Insurance GA 101 12 04 Services Office, Inc., with its permission. Page 20 of 22 NUCLEAR ENERGY LIABILITY EXCLUSION (Broad Form) 1. The insurance does not apply: an insured of services, materials, A. Under an Liability Coverage, to "bodily parts or equipment in connection y y g y with the planning, construction, injury" or "property damage": maintenance, operation or use of (1) With respect to which an insured un- any "nuclear facility", but if such fa- der this Coverage Part is also an in- cility is located within the United sured under a nuclear energy liability States of America, its territories or policy issued by Nuclear Energy Li- possessions or Canada, this Exclu- ability Insurance Association, Mutual sion (3) applies only to "property Atomic Energy Liability Underwriters, damage" to such "nuclear facility" Nuclear Insurance Association of and any property thereat. Canada, or any of their successors, 2. As used in this exclusion: or would be an insured under any such policy but for its termination "Hazardous properties" includes radioactive, upon exhaustion of its limit of liability; toxic or explosive properties. or "Nuclear material" means "source material", (2) Resulting from the "hazardous prop- "special nuclear material" or "by-product ma- erties" of "nuclear material" and with terial". respect to which (a) any person or organization is required to maintain "Source material", "special nuclear material", financial protection pursuant to the and "by-product material" have the meanings Atomic Energy Act of 1954, or any given them in the Atomic Energy Act of 1954 law amendatory thereof, or (b) the or in any law amendatory thereof. insured is, or had this Coverage Part "Spent fuel" means any fuel element or fuel not been issued would be, entitled to component, solid or liquid, which has been indemnity from the United States of used or exposed to radiation in a "nuclear re- America, or any agency thereof, un- actor". der any agreement entered into by the United States of America, or any "Waste" means any waste material (a) con- agency thereof, with any person or taining "by-product material" other than the organization. tailings or wastes produced by the extraction or concentration of uranium or thorium from B. Under any Medical Payments coverage, any ore processed primarily for its "source to expenses incurred with respect to material" content and (b) resulting from the "bodily injury" resulting from the "hazard- operation b an person or organization of ous properties" of nuclear material and p y y p g p p �� �� �� any "nuclear facility" included under the first arising out of the operation of a "nuclear two paragraphs of the definition of "nuclear facility" by any person or organization. facility". C. Under any Liability Coverage, to "bodily "Nuclear facility" means: injury" or "property damage" resulting from the "hazardous properties" of "nu- A. Any "nuclear reactor"; clear material", if: B. Any equipment or device designed or (1) The "nuclear material" (a) is at any used for (1) separating the isotopes of "nuclear facility" owned by, or oper- uranium or plutonium, (2) processing or ated by or on behalf of, an insured, utilizing "spent fuel", or (3) handling, or (b) has been discharged or dis- processing or packaging "waste"; persed therefrom; C. Any equipment or device used for the (2) The "nuclear material" is contained in processing, fabricating or alloying of "spent fuel" or "waste" at any time "special nuclear material" if at any time possessed, handled, used, proc- the total amount of such material in the essed, stored, transported or dis- custody of the insured at the premises posed of, by or on behalf of an in- where such equipment or device is lo- sured; or cated consists of or contains more than 25 grams of plutonium or uranium 233 or (3) The bodily injury or property dam- any combination thereof, or more than age arises out of the furnishing by 250 grams of uranium 235; Includes copyrighted material of Insurance GA 101 12 04 Services Office, Inc., with its permission. Page 21 of 22 D. Any structure, basin, excavation, prem- "Nuclear reactor" means any apparatus de- ises or place prepared or used for the signed or used to sustain nuclear fission in a storage or disposal of"waste"; self-supporting chain reaction or to contain a critical mass of fissionable material. and includes the site on which any of the foregoing is located, all operations conducted "Property damage" includes all forms of ra- on such site and all premises used for such dioactive contamination of property. operations. Includes copyrighted material of Insurance GA 101 12 04 Services Office, Inc., with its permission. Page 22 of 22 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CONTRACTORS ADDITIONAL INSURED - AUTOMATIC STATUS AND AUTOMATIC WAIVER OF SUBROGATION WHEN REQUIRED IN WRITTEN CONTRACT, AGREEMENT, PERMIT OR AUTHORIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Additional Insured - Owners, Lessees Or cluded in the "products-completed Contractors - Automatic Status For Other operations hazard", but only if: Parties When Required In Written Contract Or Agreement With You (1) The Coverage Part to which this endorsement is attached pro- 1. Section II - Who Is An Insured is vides coverage for "bodily injury" amended to include as an additional in- or "property damage" included sured any person or organization you within the "products-completed have agreed in writing in a contract or operations hazard'; and agreement to add as an additional in- sured on this Coverage Part. Such per- (2) The written contract or written son(s) or organization(s) is an additional agreement requires you to pro- insured only with respect to liability for: vide additional insured coverage included within the "products- a. "Bodily injury', "property damage" or completed operations hazard" "personal and advertising injury" for that person or organization. caused, in whole or in part, by the performance of your ongoing opera- If the written contract or written tions by you or on your behalf, under agreement requires you to provide that written contract or written additional insured coverage included agreement. Ongoing operations does within the "products-completed oper- not apply to "bodily injury" or "proper- ations hazard" for a specified length ty damage"occurring after: of time for that person or organiza- tion, the "bodily injury" or "property (1) All work, including materials, damage" must occur prior to the ex- parts or equipment furnished in piration of that period of time in order connection with such work, on for this insurance to apply. the project (other than service, maintenance or repairs) to be If the written contract or written performed by or on behalf of the agreement requires you to provide additional insured(s) at the loca- additional insured coverage for a tion of the covered operations person or organization per only ISO has been completed; or additional insured endorsement form number CG 20 10, without specifying (2) That portion of "your work"out of an edition date, and without specifi- which the injury or damage aris- cally requiring additional insured es has been put to its intended coverage included within the "prod- use by any person or organiza- ucts-completed operations hazard", tion other than another contrac- this Paragraph b. does not apply to for or subcontractor engaged in that person or organization. performing operations for a prin- cipal as a part of the same pro- 2. If the written contract or written agree- ject; and ment described in Paragraph 1. above specifically requires you to provide addi- b. "Bodily injury' or "property damage" tional insured coverage to that person or caused, in whole or in part, by "your organization: work" performed under that written contract or written agreement and in- a. Arising out of your ongoing opera- tions or arising out of'your work'; or Includes copyrighted material of Insurance GA 472 05 20 Services Office, Inc., with its permission. Page 1 of 3 b. By way of an edition of an ISO addi- 2. With respect to the insurance afforded to tional insured endorsement that in- the additional insureds described in Para- cludes arising out of your ongoing graph 13.1., the following additional exclu- operations or arising out of "your sions apply: work"; This insurance does not apply to: then the phrase caused, in whole or in part, by in Paragraph A.1.a. and/or Para- a. "Bodily injury', "property damage" or graph A.1.b. above, whichever applies, is "personal and advertising injury" aris- replaced by the phrase arising out of ing out of operations performed for the federal government, state or mu- 3. With respect to the insurance afforded to nicipality; or the additional insureds described in Para- graph A.1., the following additional exclu- b. "Bodily injury' or "property damage" sion applies: included within the "products- completed operations hazard." This insurance does not apply to "bodily injury', "property damage" or "personal C. The insurance afforded to additional insureds and advertising injury" arising out of the described in Paragraphs A. and B.: rendering of, or the failure to render, any 1. Only applies to the extent permitted by professional architectural, engineering or law; and surveying services, including: a 2. Will not be broader than that which you . The preparing, approving or failing to are required by the written contract, writ- prepare or approve, maps, shop ten agreement, written permit or written drawings, opinions, reports, surveys, authorization to provide for such addition- field orders, change orders or draw- al insured; and ings and specifications; or b 3. Does not apply to any person, organiza- . Supervisory, inspection, architectural tion, state, governmental agency or sub- or engineering activities. division or political subdivision specifically This exclusion applies even if the claims named as an additional insured for the against any insured allege negligence or same project in the schedule of an en- other wrongdoing in the supervision, hir- dorsement added to this Coverage Part. ing, employment,training or monitoring of D. With respect to the insurance afforded to the others by that insured, if the "occurrence" additional insureds described in Paragraphs which caused the "bodily injury" or "prop- A. and B.,the following is added to Section III erty damage", or the offense which -Limits Of Insurance: caused the "personal and advertising inju- ry", involved the rendering of, or the fail- The most we will pay on behalf of the addi- ure to render, any professional architec- tional insured is the amount of insurance: tural, engineering or surveying services. 1. Required by the written contract, written 4. This Paragraph A. does not apply to addi- agreement, written permit or written au- tional insureds described in Paragraph B. thorization described in Paragraphs A. and B. For the purpose of determining the B. Additional Insured -State Or Governmental required amount of insurance only,we will Agency Or Subdivision Or Political Subdi- include the minimum amount of any Um- vision - Automatic Status When Required brella Liability or Excess Liability cover- In Written Permits Or Authorizations age required for that additional insured in 1. Section II - Who Is An Insured is that written contract, written agreement, amended to include as an additional in- written permit or written authorization; or sured any state or governmental agency 2. Available under the applicable limits of in- or subdivision or political subdivision you surance; have agreed in writing in a permit or au- thorization to add as an additional insured whichever is less. on this Coverage Part. Such state or gov- ernmental agency or subdivision or politi- This endorsement shall not increase the appli- cal subdivision is an additional insured cable limits of insurance. only with respect to operations performed E. Section IV - Commercial General Liability by you or on your behalf for which the Conditions is amended to add the following: state or governmental agency or subdivi- sion or political subdivision has issued, in Automatic Additional Insured Provision writing, a permit or authorization. Includes copyrighted material of Insurance GA 472 05 20 Services Office, Inc., with its permission. Page 2 of 3 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 com- surance available to the additional in- mitted: sured. 1. During the policy period; and As used in this endorsement, wrap-up insur- ance means a centralized insurance program 2. Subsequent to your execution of the writ- 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 added to Section IV - Commercial General When Required By Written Contract, Liability Conditions, Other Insurance, and Agreement, Permit Or Authorization supersedes any provision to the contrary: Except when wrap-up insurance applies to the When Other Additional Insured Coverage claim or "suit" on behalf of the additional in- g 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 anoe available to the additional insured as seek contribution from any other insur- an additional insured on another insur- anoe available to the additional insured. anoe 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. CONTRACTORS' COMMERCIAL GENERAL LIABILITY BROADENED ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Endorsement-Table of Contents: Coverage: Begins on Page: 1. Employee Benefit Liability Coverage......................................................................................3 2. Unintentional Failure To Disclose Hazards.............................................................................9 3. Damage To Premises Rented To You......................................................................................9 4. Supplementary Payments...................................................................................................... 10 5. Medical Payments...................................................................................................................10 6. 180 Day Coverage For Newly Formed Or Acquired Organizations ...................................10 7. Waiver Of Subrogation........................................................................................................... 11 8. Automatic Additional Insured-Specified Relationships: ..................................................11 • Managers Or Lessors Of Premises; • Lessor Of Leased Equipment; • Vendors; • State Or Governmental Agency Or Subdivision Or Political Subdivision - Permits Or Authorizations Relating To Premises; and • Mortgagee,Assignee Or Receiver 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. Bail Bonds: $2,500 Includes copyrighted material of Insurance GA 233 0917 Services Office, Inc., with its permission. Page 1 of 17 b. Loss Of Earnings:$ 500 5. Medical Payments Medical Expense Limit: $10,000 9. Property Damage To Borrowed Equipment Each Occurrence Limit: $10,000 Deductible Amount: $ 250 16. Voluntary Property Damage Coverage (Coverage a.) And Care, Custody Or Control Liability Coverage(Coverage b.) Limits Of Insurance Coverage a. $1,000 Each Occurrence $5,000 Aggregate Coverage b.$5,000 Each Occurrence unless otherwise stated $ Deductible Amount(Each Occurrence) Coverage a.$250 Coverage b.$250 unless otherwise stated $ COVERAGE PREMIUM BASIS RATE ADVANCE PREMIUM (a) Area (For Limits in Excess of (For Limits in Excess of (b) Payroll $5,000) $5,000) (c) Gross Sales (d) Units e Other b. Care, Custody Or Control TOTAL ANNUAL PREMIUM Includes copyrighted material of Insurance GA 233 0917 Services Office, Inc., with its permission. Page 2 of 17 C. Coverages this endorsement pro- 1. Employee Benefit Liability Coverage vided: Youa. The following is added to Section I - a) know iddge he e Coverages: claim or "suit"on or Employee Benefit Liability Cover- before the "first ef- age fective date" of this endorsement. (1) Insuring Agreement You will be (a) We will pay those sums that deemed to have the insured becomes legally knowledge of a obligated to pay as damag- claim or "suit" es caused by any act, error when any "author- or omission of the insured, ized representa- or of any other person for tive'; whose acts the insured is legally liable, to which this i) Reports all, or insurance applies. We will any part, of the have the right and duty to act, error or defend the insured against omission to us any "suit" seeking those or any other damages. However, we will insurer; have no duty to defend against any "suit" seeking ii) Receives a written or ver- damages to which this in- surance does not apply. W demand or pp y- e claim for dam- may, at our discretion, in- ages because vestigate any report of an of the act, Br- act, error or omission and ror or omis- settle any claim or "suit' that sion; and may result. But: 1) The amount we will pay b) There is no other for damages is limited applicable insur- ance. as described in Section III - Limits Of Insur- (2) Exclusions ance; and This insurance does not apply to: 2) Our right and duty to defend ends when we (a) Bodily Injury, Property have used up the appli- Damage Or Personal And cable limit of insurance Advertising Injury in the payment of judg- "Bodily injury", "property ments or settlements. damage" or "personal and No other obligation or liabil- advertising injury". ity to pay sums or perform (b) Dishonest, Fraudulent, acts or services is covered Criminal Or Malicious Act unless explicitly provided for under Supplementary Damages arising out of any Payments. intentional, dishonest, fraudulent, criminal or mali- (b) This insurance applies to cious act, error or omission, damages only if the act, er- committed by any insured, ror or omission, is negligent- including the willful or reck- ly committed in the "admin- less violation of any statute. istration" of your "employee benefit program'; and (c) Failure To Perform A Con- 1) Occurs during the policy tract period; or Damages arising out of fail- ureprior of performance of con- 2) p tract by any insurer. "first effective date" of Includes copyrighted material of Insurance GA 233 0917 Services Office, Inc., with its permission. Page 3 of 17 (d) Insufficiency Of Funds (i) Taxes, Fines Or Penalties Damages arising out of an Taxes, fines or penalties, in- insufficiency of funds to cluding those imposed un- meet any obligations under der the Internal Revenue any plan included in the Code or any similar state or "employee benefit program". local law. (e) Inadequacy Of Perfor- (j) Employment-Related Prac- mance Of Invest- tices ment/Advice Given With Respect To Participation Any liability arising out of any: Any daim based upon: (1) Refusal to employ; 1) Failure of any invest- ment to perform; (2) Termination of employ,- ment; 2) Errors in providing in- formation on past per- (3) Coercion, demotion, formance of investment evaluation, reassign- vehicles; or ment, discipline, defa- mation, harassment, 3) Advice given to any humiliation, discrimina- person with respect to tion or other employ- that person's decision to ment- related practioes, participate or not to par- acts or omissions; or ticipate in any plan in- cluded in the "employee (4) Consequential liability benefit program". as a result of (1), (2) or (3)above. (f) Workers' Compensation And Similar Laws This exclusion applies whether the insured may be Any claim arising out of your held liable as an employer failure to comply with the or in any other capacity and mandatory provisions of any to any obligation to share workers' compensation, un- damages with or repay employment compensation someone else who must pay insurance, social security or damages because of the in- disability benefits law or any jury. similar law. (3) Supplementary Payments (g) ERISA Section I - Coverages, Sup- Damages for which any in- plementary Payments - Cover- sured is liable because of li- ages A And B also apply to this ability imposed on a fiduci- Coverage. ary by the Employee Re- tirement Income Security b. Who Is An Insured Act of 1974, as now or As respects Employee Benefit Lia- hereafter amended, or by bility Coverage, Section II - Who Is any similar federal, state or An Insured is replaced by the follow- local laws. ing: (h) Available Benefits (1) If you are designated in the Dec- Any claim for benefits to the larations as: extent that such benefits are (a) An individual, you and your available, with reasonable spouse are insureds, but on- effort and cooperation of the ly with respect to the con- insured, from the applicable duct of a business of which funds accrued or other col- you are the sole owner. lectible insurance. (b) A partnership or joint ven- ture, you are an insured. Your members, your part- Includes copyrighted material of Insurance GA 233 0917 Services Office, Inc., with its permission. Page 4 of 17 ners, and their spouses are zation. However, coverage under also insureds but only with this provision: respect to the conduct of your business. (a) Is afforded only until the 180th day after you acquire (c) A limited liability company, or form the organization or you are an insured. Your the end of the policy period, members are also insureds, whichever is earlier; and but only with respect to the conduct of your business. (b) Does not apply to any act, Your managers are in- error or omission that was sureds, but only with respect committed before you ac- to their duties as your man- quired or formed the organi- agers. zation. (d) An organization other than a c. Limits Of Insurance partnership, joint venture or As respects Employee Benefit Lia- limited liability company, you bility Coverage, Section III - Limits are an insured.Your "execu- Of Insurance is replaced by the fol- tive officers" and directors lowing: are insureds, but only with respect to their duties as (1) The Limits of Insurance shown in your officers or directors. Section B. Limits Of Insurance, Your stockholders are also 1. Employee Benefit Liability insureds, but only with re- Coverage and the rules below fix spect to their liability as the most we will pay regardless stockholders. of the number of: (e) A trust, you are an insured. (a) Insureds; Your trustees are also in- sureds, but only with respect (b) Claims made or "suits" to their duties as trustees. brought; (2) Each of the following is also an (c) Persons or organizations insured: making claims or bringing "suits"; (a) Each of your "employees" who is or was authorized to (d) Acts, errors or omissions; or administer your "employee (e) Benefits included in your benefit program''; "employee benefit program". (b) Any persons, organizations (2) The Aggregate Limit shown in or "employees" having prop- Section B. Limits Of Insurance, er temporary authorization 1. Employee Benefit Liability to administer your "employ- Coverage of this endorsement is ee benefit program" if you the most we will pay for all dam- die, but only until your legal ages because of acts, errors or representative is appointed; omissions negligently committed or in the "administration" of your (c) Your legal representative if "employee benefit program". you die, but only with re- (3) Subject to the limit described in spect to duties as such.That (2) above, the Each Employee representative will have all Limit shown in Section B. Limits your rights and duties under Of Insurance, 1. Employee this Coverage Part. Benefit Liability Coverage of (3) Any organization you newly ac- this endorsement is the most we quire or form, other than a part- will pay for all damages sus- nership, joint venture or limited tained by any one "employee", liability company, and over which including damages sustained by you maintain ownership or major- such "employee's" dependents ity interest, will qualify as a and beneficiaries, as a result of: Named Insured if no other similar i (a) An act, error or omission; or insurance applies to that organi- Includes copyrighted material of Insurance GA 233 0917 Services Office, Inc., with its permission. Page 5 of 17 (b) A series of related acts, er- tification of the action taken, rors or omissions, regard- you shall promptly reim- less of the amount of time burse us for such part of the that lapses between such Deductible Amount as we acts, errors or omissions; have paid. negligently committed in the d. Additional Conditions "administration" of your "employ As respects Employee Benefit Lia- ee benefit program". bility Coverage, Section IV - Com- However, the amount paid under mercial General Liability Condi- this endorsement shall not ex- tions is amended as follows: ceed, and will be subject to the limits and restrictions that apply (1) Item 2. Duties In The Event Of to the payment of benefits in any Occurrence, Offense, Claim Or plan included in the "employee Suit is replaced by the following: benefit program." 2. Duties In The Event Of An (4) Deductible Amount Act, Error Or Omission, Or Claim Or Suit (a) Our obligation to pay dam- ages on behalf of the in- a. You must see to it that sured applies only to the we are notified as soon amount of damages in ex- as practicable of an act, cess of the Deductible error or omission which Amount stated in the Decla- may result in a claim. rations as applicable to To the extent possible, Each Employee. The limits notice should include: of insurance shall not be re- (1) What the act, error duced by the amount of this or omission was deductible. and when it oc- (b) The Deductible Amount curred; and stated in the Declarations (2) The names and applies to all damages sus- addresses of any tained by any one "employ- one who may suf- ee", including such "employ- fer damages as a ee's" dependents and bene- result of the act, ficiaries, because of all acts, error or omission. errors or omissions to which this insurance applies. b. If a claim is made or "suit" is brought against (c) The terms of this insurance, any insured, you must: including those with respect to: (1) Immediately record 1) Our right and duty to the specifics of the claim or "suit" and defend the insured the date received; against any "suits" and seeking those damag- es; and (2) Notify us as soon 2) Your duties, and the du- as practicable. ties of any other in- You must see to it that volved insured, in the we receive written no- event of an act, error or tice of the claim or"suit" omission,or claim; as soon as practicable. apply irrespective of the ap- c. You and any other in- plication of the Deductible volved insured must: Amount. (1) Immediately send (d) We may pay any part or all us copies of any of the Deductible Amount to demands, notices, effect settlement of any summonses or le- claim or "suit" and, upon no- gal papers re- Includes copyrighted material of Insurance GA 233 0917 Services Office, Inc., with its permission. Page 6 of 17 ceived in connec- tion by equal shares, tion with the claim we will follow this meth- or "suit'; od also. Under this ap- proach each insurer (t) Authorizecontributes equal tain records and amounts until it has other information; paid its applicable limit (3) Cooperate with us of insurance or none of in the investigation the loss remains, or settlement of the whichever comes first. claim or defense If any of the other in- against the "suit''; surance does not permit and contribution by equal (4) Assist us, upon our shares, we will contrib- request, in the en- ute by limits. Under this forcement of any method, each insurer's right against any share is based on the person or organi- ratio of its applicable zation which may limit of insurance to the be liable to the in- total applicable limits of sured because of insurance of all insur- an act, error or ers. omission to which c. No Coverage this insurance may also apply. This insurance shall not cover any loss for which d. No insured will, except the insured is entitled to at that insured's own recovery under any cost, voluntarily make a other insurance in force payment, assume any previous to the effective obligation, or incur any date of this Coverage expense without our Part. consent. (2) Item 5. Other Insurance is re- e. Additional Definitions placed by the following: As respects Employee Benefit Lia- bility Coverage, Section V - Defini- tions is amended as follows: If other valid and collectible (1) The following definitions are insurance is available to the added: insured for a loss we cover under this Coverage Part, 1. "Administration"means: our obligations are limited as follows: a. Providing information to "employees", including a. Primary Insurance their dependents and This insurance is prima- beneficiaries, with re- ry except when c. below sped to eligibility for or scope of "employee applies. If this insurance is primary, our obliga- tions are not affected b. Interpreting the "em- unless any of the other ployee benefit pro- insurance is also prima- grams'; ry. Then, we will share with all that other insur- c. Handling records in ance by the method de- connection with the scribed in b.below. "employee benefit pro- grams'; or b. Method Of Sharing d. Effecting, continuing or If all of the other insur- terminating any "em- ance permits contribu- ployee's" participation in Includes copyrighted material of Insurance GA 233 0917 Services Office, Inc., with its permission. Page 7 of 17 any benefit included in c. Unemployment insur- the "employee benefit ance, social security program". benefits, workers' com- However, "administration" pensation and disability benefits; and does not include: a. Handling payroll deduc- d. Vacation plans, includ- ing buy and sell pro- tions; or grams; leave of ab- b. The failure to effect or senoe programs, includ- maintain any insurance ing military, maternity, or adequate limits of family, and civil leave; coverage of insurance, tuition assistance plans; including but not limited transportation and to unemployment insur- health club subsidies. ance, social security 4. "First effective date" means benefits, workers' com- the date upon which cover- pensation and disability age was first effected in a benefits. series of uninterrupted re- 2. "Cafeteria plans" means newals of insurance cover- plans authorized by applica- age. ble law to allow "employees" (2) The following definitions are de- to elect to pay for certain leted in their entirety and re- benefits with pre-tax dollars. placed by the following: 3. "Employee benefit pro- 8. "Employee" means a person grams" means a program actively employed, formerly providing some of all of the employed, on leave of ab- following benefits to "em- sence or disabled, or retired. ployees", whether provided "Employee" includes a through a "cafeteria plan" or "leased worker". "Employee" otherwise: does not include a "tempo- a. Group life insurance; rary worker". group accident or health 21. 'Suit"means a civil proceed- insurance; dental, vision ing in which money damag- and hearing plans; and es because of an act, error flexible spending ac- or omission to which this in- counts; provided that no surance applies are alleged. one other than an "em- 'Suit"includes: ployee" may subscribe to such benefits and a. An arbitration proceed- such benefits are made ing in which such dam- generally available to ages are claimed and to those "employees" who which the insured must satisfy the plan's eligibil- submit or does submit ity requirements; with our oonsent; b. Profit sharing plans, b. Any other alternative employee savings dispute resolution pro- plans, employee stock ceeding in which such ownership plans, pen- damages are claimed sion plans and stock and to which the in- subscription plans, pro- sured submits with our vided that no one other consent; or than an "employee" may subscribe to such c. An appeal of a civil pro- benefits and such bene- ceeding. fits are made generally available to all "employ- ees" who are eligible under the plan for such benefits; Includes copyrighted material of Insurance GA 233 0917 Services Office, Inc., with its permission. Page 8 of 17 2. Unintentional Failure To Disclose Haz- 2) Rust or other cor- ards rosion, decay, de- Section IV-Commercial General Liabil- or laation, hidden it Conditions 7. Representations is a latent defect n Y � p any quality in amended by the addition of the following: property that caus- Based on our dependenoe upon your rep- es it to damage or resentations as to existing hazards, if un- destroy itself; intentionally you should fail to disclose all 3) Smog; such hazards at the inception date of your policy, we will not reject coverage under 4) Mechanical break- this Coverage Part based solely on such down, including failure. rupture or bursting a To Premises Rented To You caused e; centrif- 3. Damage ugal force; a. The last Paragraph of 2. Exclusions 5) Settling, cracking, under Section I -Coverage A- Bod- shrinking or ex- ily Injury And Property Damage Li- pansion; ability is replaced by the following: Exclusions c.through q. do not apply 6) Nesting or char e to 'property damage" by fire, explo- or r a discharge sion, lightning, smoke or soot to or release of waste products or secre- premises while rented to you or tem- tions, by insects, porarily occupied by you with permis- birds, rodents or sion of the owner, for which the other animals; or amount we will pay is limited to the Damage To Premises Rented To 7) Presence, growth, You Limit as described in Section III proliferation, - Limits Of Insurance. spread or any ac- tivityb. The insurance provided under Sec- cui g fungus, in- b. I - Coverage A - Bodily Injury mildew, mold or g Y 1 rY mildew, and any And Property Damage Liability ap- mycotoxins, plies to 'property damage" arising out spores, scents or of water damage to premises that are byproducts pro- both rented to and occupied by you. duced or released (1) As respects Water Damage Le- by fungi. gal Liability, as provided in Para- (b) "Property damage" caused graph 3.b.above: directly or indirectly by any The exclusions under Section I - of the following: Coverage A- Bodily Injury And (i) Earthquake, volcanic Property Damage Liability, 2. eruption, landslide or Exclusions, other than L War any other earth move- and the Nuclear Energy Liabil- ment; ity Exclusion (Broad Form), are deleted and the following are (i i) Water that backs up or added: overflows or is other- This insurance does not apply to: wise discharged from a sewer, drain, sump, (a) "Property damage": sump pump or related equipment; (i) Assumed in any con- tract or agreement; or (iii) Water under the ground surface pressing on, or (ii) Caused by or resulting flowing or seeping from any of the follow- through: ing: 1) Foundations, walls, 1) Wear and tear; floors or paved surfaces; Includes copyrighted material of Insurance GA 233 0917 Services Office, Inc., with its permission. Page 9 of 17 2) Basements, you with permission of whether paved or the owner; not; or b. In the case of damage 3) Doors, windows or by fire, explosion, light- other openings. ning, smoke or soot, (c) "Property damage" caused while rented to you; or by or resulting from water c. In the case of damage that leaks or flows from by water, while rented plumbing, heating, air condi- to and occupied by you. tioning, fire protection sys- tems, or other equipment, (2) The most we will pay is limited as caused by or resulting from described in Section B. Limits freezing, unless: Of Insurance, 3. Damage To Premises Rented To You of this (i) You did your best to endorsement. maintain heat in the building or structure; or 4. Supplementary Payments (ii) You drained the equip- Under Section I - Supplementary Pay- ment and shut off the ments-Coverages A And B: water supply if the heat a. Paragraph 2. is replaced by the fol- was not maintained. lowing: (d) "Property damage"to: Up to the limit shown in Section B. (i) Plumbing, heating, air Limits Of Insurance, 4.a. Bail Bonds conditioning, fire protec- of this endorsement for cost of bail tion systems, or other bonds required because of accidents equipment or applianc- or traffic law violations arising out of es; or the use of any vehicle to which the Bodily Injury Liability Coverage ap- (ii) The interior of any plies.We do not have to furnish these building or structure, or bonds. to personal property in the building or structure, b. Paragraph 4. is replaced by the fol- caused by or resulting lowing: from rain, snow, sleet or All reasonable expenses incurred by ice, whether driven by the insured at our request to assist us wind or not. in the investigation or defense of the c. Limit Of Insurance claim or "suit", including actual loss of earnings up to the limit shown in Sec- With respect to the insurance afford- tion B. Limits Of Insurance, 4.b. ed in Paragraphs 3.a. and 3.b.above, Loss Of Earnings of this endorsement the Damage To Premises Rented per day because of time off from To You Limit as shown in the Decla- work. rations is amended as follows: 5. Medical Payments (1) Paragraph 6. of Section III - Limits Of Insurance is replaced The Medical Expense Limit of Any One by the following: Person as stated in the Declarations is amended to the limit shown in Section B. 6. Subject to Paragraph 5. Limits Of Insurance, 5. Medical Pay- above, the Damage To ments of this endorsement. Premises Rented To You Y g 6. 180 Da Coverage For Newly Limit is the most we will pay Y Formed under Coverage A - Bodily Or Acquired Organizations Injury And Property Dam- Section II - Who Is An Insured is age Liability for damages amended as follows: because of 'property dam- age"to any one premises: Subparagraph a. of Paragraph 3. is re- a. While rented to you, or placed by the following: temporarily occupied by a. Insurance under this provision is af- forded only until the 180th day after Includes copyrighted material of Insurance GA 233 0917 Services Office, Inc., with its permission. Pagel 0 of 17 you acquire or form the organization use of that part of the prem- or the end of the policy period, ises leased to you, subject whichever is earlier; to the following additional 7. Waiver Of Subrogation exclusions: This insurance does not ap- Section IV-Commercial General Liabil- ply to. ity Conditions, 9.Transfer Of Rights Of Recovery Against Others To Us is (i) Any "occurrence" which amended by the addition of the following: takes place after you cease to be a tenant in We waive any right of recovery we may that premises; have against any person or organization against whom you have agreed to waive (ii) Structural alterations, such right of recovery in a written contract new construction or or agreement because of payments we demolition operations make for injury or damage arising out of performed by or on be- your ongoing operations or "your work" half of such additional done under a written contract or agree- insured. ment with that person or organization and included in the "products-completed oper- (b) Lessor Of Leased Equip- ations hazard". However, our rights may ment only be waived prior to the "occurrence" Any person or organization giving rise to the injury or damage for from whom you lease which we make payment under this Cov- equipment when you and erage Part. The insured must do nothing such person(s) or organiza- after a loss to impair our rights. At our re- tion(s) have agreed per Par- quest, the insured will bring "suit"or trans- agraph 8.a.(1) of this en- fer those rights to us and help us enforce dorsement to provide insur- those rights. anoe. Such person(s) or or- 8. Automatic Additional Insured - Speci- ganization(s) are insureds fied Relationships only with respect to liability for "bodily injury'', "property a. The following is added to Section II - damage" or "personal and Who Is An Insured: advertising injury'caused, in (1) Any person(s) or organization(s) whole or in part, ti your maintenance, operation or described in Paragraph 8.a.(2) of use of equipment leased to this endorsement (hereinafter re- you by such person(s) or or- ferred to as additional insured) ganization(s). A person's or whom you are required to add as organization's status as an an additional insured under this additional insured under this Coverage Part by reason of a endorsement ends when written contract, written agree- their contract or agreement ment, written permit or written with you for such leased authorization. equipment ends. However, (2) Only the following persons or or- this insurance does not ap- ganizations are additional in- ply to any "occurrence" sureds under this endorsement, which takes place after the and insurance coverage provided equipment lease expires. to such additional insureds is lim- (c) Vendors ited as provided herein: Any person or organization (a) Managers g Or Lessors Of (referred to below as ven- Premises dor) with whom you have The manager or lessor of a agreed per Paragraph premises leased to you with 8.a.(1) of this endorsement whom you have agreed per to provide insurance, but on- Paragraph 8.a.(1) of this en- ly with respect to "bodily in- dorsement to provide insur- jury" or "property damage" ance, but only with respect arising out of 'your products" to liability arising out of the which are distributed or sold ownership, maintenance or in the regular course of the Includes copyrighted material of Insurance GA 233 0917 Services Office, Inc., with its permission. Pagel 1 of 17 vendor's business, subject or repair opera- to the following additional tions, except such exclusions: operations per- formed at the ven- (t) Thei dor's premises in the vendor does not connection with the apply to: sale of the product; 1) "Bodily injury' or 7) Products which, af- "property damage" ter distribution or for which the ven- sale by you, have dor is obligated to been labeled or re- pay damages by labeled or used as reason of the as- a container, part or sumption of liability ingredient of any in a contract or other thing or sub- agreement. This stance by or for the exclusion does not vendor; or apply to liability for damages that the 8) "Bodily injury' or vendor would have "property damage" in the absence of arising out of the the contract or sole negligence of agreement; the vendor for its own acts or omis- 2) Any express war- sions or those of ranty unauthorized its employees or by you; anyone else acting 3) Any physical or on its behalf. How- chemical change in ever, this exclusion the product made does not apply to: intentionally by the a) The excep- vendor; tions contained 4) Repackaging, ex- in Paragraphs cept when un- (c) (i) 4) or 6) packed solely for of this en- the purpose of in- dorsement; or spection, demon- b) Such inspec- stration, testing, or tions, adjust- the substitution of ments, tests or parts under in- servicing as structions from the the vendor has manufacturer, and agreed to then repackaged in make or nor- the original con- mally under- tainer; takes to make 5) Any failure to make in the usual such inspections, course of adjustments, tests business, in or servicing as the connection vendor has agreed with the distri- to make or normal- bution or sale ly undertakes to of the prod- make in the usual ucts. course of busi- (i) This insurance does not ness, in connection apply to any insured with the distribution person or organization: or sale of the products; 1) From whom you 6) Demonstration, in- have acquired such products, or stallation, servicing any ingredient, part Includes copyrighted material of Insurance GA 233 0917 Services Office, Inc., with its permission. Page 12 of 17 or container, enter- (e) Mortgagee, Assignee Or ing into, accompa- Receiver nying or containing such products; or Any person or organization with whom you have agreed 2) When liability in- per Paragraph 8.a.(1) of this cluded within the endorsement to provide in- "products- surance, but only with re- completed opera- spect to their liability as tions hazard" has mortgagee, assignee, or re- been excluded un- ceiver and arising out of the der this Coverage ownership, maintenance, or Part with respect to use of the premises by you. such products. However, this insurance does not apply to structural (d) State Or Governmental alterations, new construction Agency Or Subdivision Or and demolition operations Political Subdivision - performed by or for that per- Permits Or Authorizations son or organization. Relating To Premises Any state or governmental (3) The insurance afforded to addi- tional insureds described in Par- agency or subdivision or po- agraph 8.a.(1) of this endorse- litical subdivision with which ment: you have agreed per Para- graph 8.a.(1) of this en- (a) Only applies to the extent dorsement to provide insur- permitted by law; and ance, subject to the follow- ing additional provision: (b) Will not be broader than that which you are required by This insurance applies only the written contract, written with respect to the following agreement, written permit or hazards for which the state written authorization to pro- or governmental agency or vide for such additional in- subdivision or political sub- sured; and division has issued a permit or authorization in connec- (c) Does not apply to any per- tion with premises you own, son, organization, vendor, rent or control and to which state, governmental agency this insurance applies: or subdivision or political subdivision, specifically (i) The existence, mainte- named as an additional in- nance, repair, construc- sured under any other provi- tion, erection or removal sion of, or endorsement of advertising signs, added to, this Coverage awnings, canopies, cel- Part, provided such other lar entrances, coal provision or endorsement holes, driveways, man- covers the injury or damage holes, marquees, hoist for which this insurance ap- away openings, side- plies. walk vaults, street ban- ners or decorations and b. With respect to the insurance afford- similar exposures; or ed to the additional insureds de- scribed in Paragraph 8.a.(1) of this (ii) The construction, erec- endorsement, the following is added tion or removal of eleva- to Section III-Limits Of Insurance: tors; or The most we will pay on behalf of the (iii) The ownership, mainte- additional insured is the amount of in- nance or use of any el- surance: evators covered by this insurance. (1) Required by the written contract, written agreement, written permit or written authorization described Includes copyrighted material of Insurance GA 233 0917 Services Office, Inc., with its permission. Page 13 of 17 in Paragraph 8.a.(1) of this en- tion I - Coverage A - Bodily Injury dorsement; or And Property Damage Liability: (2) Available under the applicable Paragraphs (3) and (4) of this exclu- Limits of Insurance shown in the sion do not apply to tools or equip- Declarations; ment loaned to you, provided they are whichever is less. not being used to perform operations at the time of loss. This endorsement shall not increase b. With respect to the insurance provid- the applicable Limits of Insurance ed by this section of the endorse- shown in the Declarations. ment, the following additional provi- c. Section IV - Commercial General sions apply: Liability Conditions is amended to (1) The Limits of Insurance shown in include the following: the Declarations are replaced by Automatic Additional Insured Pro- the limits designated in Section vision B. Limits Of Insurance, 9. Property Damage To Borrowed This insurance applies only if the Equipment of this endorsement "bodily injury" or 'property damage" with respect to coverage provid- occurs, or the 'personal and advertis- ed by this endorsement. These ing injury'offense is committed: limits are inclusive of and not in (1) During the policy period; and addition to the limits being re- placed. The Limits of Insurance (2) Subsequent to your execution of shown in Section B. Limits Of the written contract or written Insurance, 9. Property Damage agreement, or the issuance of a To Borrowed Equipment of this written permit or written authori- endorsement fix the most we will zation, described in Paragraph pay in any one 'occurrence" re- 8.a.(1). gardless of the number of: d. Section IV - Commercial General (a) Insureds; Liability Conditions is amended as (b) Claims made or "suits" follows: brought; or Condition 5. Other Insurance is amended to include: (c) Persons or organizations making claims or bringing Primary And Noncontributory In- "suits". surance (2) Deductible Clause This insurance is primary to and will (a) Our obligation to pay dam- not seek contribution from any other ages on your behalf applies insurance available to an additional only to the amount of dam- insured per Paragraph 8.a.(1) of this ages for each 'occurrence" endorsement provided that: which are in excess of the (1) The additional insured is a Deductible Amount stated in Named Insured under such other Section B. Limits Of Insur- insurance; and ance, 9. Property Damage To Borrowed Equipment of (2) You have agreed in writing in a this endorsement. The limits contract, agreement, permit or of insurance will not be re- authorization described in 8.a.(2) duped by the application of of this endorsement that this in- such deductible amount. surance would be primary and would not seek contribution from (b) Section IV - Commercial any other insurance available to General Liability Condi- the additional insured. tions, 2. Duties In The Event Of Occurrence, Of- 9. Property Damage To Borrowed Equip- fense, Claim Or Suit, ap- ment plies to each claim or "suit" a. The following is added to Exclusion irrespective of the amount. 2.j. Damage To Property under Sec- Includes copyrighted material of Insurance GA 233 0917 Services Office, Inc., with its permission. Page 14 of 17 (c) We may pay any part or all 12. Nonowned Aircraft of the deductible amount to effect settlement of any The following is added to Exclusion 2.g. claim or "suit" and, upon no- Aircraft, Auto Or Watercraft under Sec- tification of the action taken, tion I - Coverage A - Bodily Injury And you shall promptly reim- Property Damage Liability: burse us for such part of the This exclusion does not apply to an air- deductible amount as has craft you do not own, provided that: been paid by us. 10. Employees As Insureds - Specified a. The pilot in command holds a current p effective certificate, issued by a duly Health Care Services And Good Samar- constituted authority of the United itan Services States of America or Canada, desig- Paragraph 2.a.(1xd) under Section II - nating that person as a commercial or Who Is An Insured does not apply to: airline transport pilot; a. Your "employees" who provide pro- b. The aircraft is rented with a trained, fessional health care services on your paid crew; and behalf as a duly licensed nurse, c. The aircraft does not transport per- emergency medical technician or sons or cargo for a charge. paramedic in the jurisdiction where an "occurrence" or offense to which this 13. Bodily Injury Redefined insurance applies takes place; or Section V - Definitions, 4. "Bodily injury' b. Your "employees" or "volunteer work is replaced by the following: ers", other than an employed or vol- unteer doctor, providing first aid or 4. "Bodily injury' means bodily harm or good samaritan services during their injury, sickness, disease, disability, work hours for you will be deemed to humiliation, shock, fright, mental an- be acting within the scope of their guish or mental injury, including care, employment by you or performing du- loss of services or death resulting ties related to the conduct of your from any of these at any time. business. 14. Expected Or Intended Injury Redefined 11. Broadened Notice Of Occurrence The last sentence of Exclusion 2.a. Ex- Paragraph a. of Condition 2. Duties In pected Or Intended Injury under Sec- The Event Of Occurrence, Offense, tion I - Coverage A - Bodily Injury And Claim Or Suit under Section IV - Com- Property Damage Liability is replaced by mercial General Liability Conditions is the following: replaced by the following: This exclusion does not apply to "bodily a. You must see to it that we are notified injury" or"property damage" resulting from as soon as practicable of an "occur- the use of reasonable force to protect per- rence" or an offense which may result sons or property. in a daim. To the extent possible, no- 15. Former Employees As Insureds tice should include: 1 How, when and where the "oc- The following is added to Paragraph 2. ( ) under Section II-Who Is An Insured: currence"or offense took place; 2. Each of the following is also an in- (2) The names and addresses of sured: any injured persons and wit- nesses; and Any of your former "employees", di- 3 e nature and location o an rectors, managers, members, part- ( ) The l i f y ners or "executive officers", including injury or damage arising out of but not limited to retired, disabled or the "occurrence" or offense. those on leave of absence, but only This requirement applies only when for acts within the scope of their em- the "occurrence" or offense is known ployment by you or for duties related to an "authorized representative". to the conduct of your business. Includes copyrighted material of Insurance GA 233 0917 Services Office, Inc., with its permission. Page 15 of 17 16. Voluntary Property Damage Coverage (2) Exclusions a. Coverage D - Voluntary Property This insurance does not apply to Damage Coverage "property damage" that would be Section I -Coverages is amended to excluded by Coverage A- Bodi- include the following: ly Injury And Property Damage Liability, 2. Exclusions, except (1) Insuring Agreement for j. Damage To Property, par- agraphs (3), (4), (5) and (6), k. (a) We will pay the cost to re- Damage To Your Product, and pair or replace "property I. Damage To Your Work. damage" to property of oth- ers arising out of operations (3) Definitions incidental to your business For purposes of Voluntary when: Property Damage Coverage 1) Damage is caused by only, the following definitions un- you; or der Section V - Definitions are replaced by the following: 2) Damage occurs while in your possession. 16. "Occurrence" means an in- cident, including continuous At your written request, we or repeated exposure to will make this payment re- substantially the same gen- gardless of whether you are eral harmful conditions that at fault for the "property result in "property damage". damage". 20. "Property damage" means If you, at our request, re- physical injury to tangible place, or make any repairs property. "Electronic data" is to, damaged property of not tangible property, and others, the amount we will "property damage" does not pay under Voluntary Prop- include disappearance, ab- erty Damage Coverage will straction or theft. be determined by your actu- al cost to replace or repair b. Care, Custody Or Control Liability the damaged property, ex- Coverage cluding any profit or over- For purposes of the coverage provid- head. ed by Care, Custody Or Control Li- Any payment we make un- ability Coverage in this endorsement der Voluntary Property only: Damage Coverage shall not (1) Section I -Coverage A- Bodily be interpreted as an admis- Injury And Property Damage sion of liability by you or by Liability, 2. Exclusions, j. us. Damage To Property, Subpara- It shall be your duty, not our graphs(3), (4) and (5)do not ap- duty, to defend any claim or ply to "property damage" to the "suit"to which this insurance property of others described applies. therein. No other obligation or liabil- (2) It shall be your duty, not our duty, ity to pay sums or perform to defend any claim or "suit" to acts or services is covered. which this insurance applies. (b) This insurance applies to No other obligation or liability to "property damage"only if: pay sums or perform acts or ser- vices is covered. 1) The "property damage" takes place in the "cov- This Paragraph (2) supersedes erage territory'; and any provision in the Coverage Part to the contrary. 2) The "property damage" occurs during the policy (3) "Property damage" for which period. Care, Custody Or Control Lia- bility Coverage provides cover- Includes copyrighted material of Insurance GA 233 0917 Services Office, Inc., with its permission. Page 16 of 17 age shall be deemed to be (3) The Voluntary Property Dam- caused by an "occurrence" but age Coverage, Aggregate Limit shall not serve to limit or restrict Of Insurance is the most we will the applicability of any exclusion pay for the sum of all damages for "property damage" under this under Voluntary Property Coverage Part. Damage Coverage. This limit C. Limits Of Insurance And Deducti- applies separately to each "cov- bles 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 Limits of sown n Deductible Amount stated (1) TheLii f I h i 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. duoed 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 tion to, the limits being replaced. Event Of Occurrence, Of- The Limits of Insurance shown in fense, Claim Or Suit, ap- the Schedule fix the most we will plies to each claim or "suit" pay regardless of the number of: irrespective of the amount. (a) Insureds; (c) We may pay any part or all ( of the Deductible Amount to b) Claims made or "suits" brought;or effect settlement of any claim or "suit" and, upon no- (c) Persons or organizations tification of the action taken, making claims or bringing you shall promptly reim- "suits". burse us for such part of the Deductible Amount as has (2) (a) Subject to (3) below, the been paid by us. Voluntary Property Dam- age Coverage, Each Occur- 17. Broadened Contractual Liability - Work rence Limit Of Insurance is Within 50 Of Railroad Property the most we will pay for the Section V-Definitions, 12. "Insured con- sum of damages under Vol- tract" is amended as follows: untary Property Damage Coverage; a. Paragraph c. is replaced by the fol- (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 CNA Policy No: CE0591979699 Endorsement No: 7 Effective Date: 10/01/2025 Ilill iiiil IIi i IIIIIl rl rllll III II lllllrlll Illrl rllll IIIIIIIII IIII IIIIIIII rl rl rl IIIII Illlllllllli IIIIIIIIIIIIII IIIIIIIIIIIIIIIIIIIIIIII IIIIIIIIIIII IIIII (IIII II IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII IIIII III IIIIIIIIII�IIIII IIIIIIIIIIIIII IIIIIIIIIIII IIII IIII It is understood and agreed that, solely with respect to coverage provided under the section entitled COVERAGES the subsection entitled Pollution Incident, the Policy is amended as follows: The Section of the Policy entitled DEFENSE is amended by the addition of the following: Additional Insured with Primary/Non-Contributory Provision A. We also have the right and duty to defend a claim against any person or organization whom you are required to add as an additional insured under this Policy under a written contract or written agreement, provided such contract or agreement: 1. is currently in effect or becomes effective during the term of this policy; 2. was executed prior to the bodily injury or property damage for which such additional insured seeks coverage; and 3. expressly requires making the person or organization an additional insured for pollution coverage such as is provided by this policy. B. The insurance provided to the additional insured is limited as follows: 1. The person or organization is an additional insured only with respect to liability for bodily injury or property damage: a. caused entirely by your negligent acts or omissions or those of others working on your behalf; and b. for which you would be covered under this policy, if the claim had been brought against you. 2. If defense of such a claim results in the additional insured's legal obligation to pay compensatory damages for bodily injury or property damage described in paragraph 2.a. above, then subject to all of the terms and conditions of this policy, we will pay such damages in excess of the self-insured retention up to the applicable Limit of Liability. 3. This insurance is excess of all other insurance available to the additional insured, whether on a primary, excess, contingent or any other basis. But if required by written contract or agreement to be primary and non-contributory, this insurance will be primary and non-contributory relative to insurance on which the additional insured is a Named Insured. 4. Any coverage granted by this provision shall apply only to the extent permissible by law. Countersigned by Authorized Representative CNA88508XX (01/18) Policy No: CE0591979699 Page 1 of 2 Endorsement No: 7 Effective Date: 10/01/2025 Insured Name:Welburn Electric, Inc. ©CNA All Rights Reserved. CNA Policy No: CEO591979699 Endorsement No: 7 Effective Date: 10/01/2025 All other terms and conditions of the policy remain unchanged. This endorsement, which forms a part of and is for attachment to the policy issued by the designated Insurers, takes effect on the Policy Effective date of said policy at the hour stated in said policy, unless another effective date (the Endorsement Effective Date) is shown below, and expires concurrently with said policy. Countersigned by Authorized Representative CNA88508XX (01-2018) Policy No: CEO591979699 Page 2 of 2 Endorsement No: 7 Effective Date: 10/01/2025 Insured Name:Welburn Electric, Inc. ©CNA All Rights Reserved. CNA Policy No: CE0591979699 Endorsement No: 5 Effective Date: 10/01/2025 SUBROGATION AMENDMENT ENDORSEMENT It is understood and agreed that the Section of the Policy entitled CONDITIONS, the Condition entitled Subrogation, is deleted in its entirety and replaced by the following: Subrogation If any of you have rights to recover amounts from another, those rights are transferred to us to the extent of our payment. You must do everything necessary to secure these rights and must do nothing after a claim is made to jeopardize them. We hereby waive subrogation rights against any person or organization with whom the Named Insured has made a written agreement, prior to a claim or circumstance, to waive such rights, to the extent provided in such agreement. All other terms and conditions of the Policy remain unchanged. This endorsement, which forms a part of and is for attachment to the policy issued by the designated Insurers, takes effect on the Policy Effective date of said policy at the hour stated in said policy, unless another effective date (the Endorsement Effective Date) is shown below, and expires concurrently with said policy. Countersigned by Authorized Representative CNA83662XX (10/15) Policy No: CE0591979699 Page 1 of 1 Endorsement No: 5 Effective Date: 10/01/2025 Insured Name:Welburn Electric, Inc. ©CNA All Rights Reserved. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CinciPlus® BUSINESS AUTO XC+® (EXPANDED COVERAGE PLUS) ENDORSEMENT This endorsement modifies insurance provided by the following: BUSINESS AUTO COVERAGE FORM With respect to the coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by this endorsement. A. Blanket Waiver of Subrogation This provision does not apply unless the valid SECTION IV - BUSINESS AUTO CONDI- written contract has been: TIONS, A. Loss Conditions, 5. Transfer of 1. Executed prior to the accident causing Rights of Recovery Against Others to Us is "bodily injury"or "property damage'; and amended by the addition of the following: 2. Is still in force at the time of the "accident" We waive any right of recovery we may have causing "bodily injury" or "property dam- against any person or organization because of age". payments we make for 'bodily injury" or "property damage" arising out of the operation D. Employee Hired Auto of a covered "auto" when you have assumed 1. Changes in Liability Coverage liability for such "bodily injury" or "property damage" under an "insured contract", provid- The following is added to the SECTION II ed the "bodily injury" or "property damage" oc- - LIABILITY COVERAGE, A. Coverage, curs subsequent to the execution or the "in- 1.Who is an Insured: sured contract". An "employee" of yours is an "insured" B. Noncontributory Insurance while operating an "auto" hired or rented SECTION IV - BUSINESS AUTO CONDI- under a contract or agreement in that "employee's" name, with your permission, TIONS, B. General Conditions, 5. Other In- while performing duties related to the surance c. is deleted in its entirety and re- conduct of your business. placed by the following: c. Regardless of the provisions of Par- 2. Changes in General Conditions agraph a. above, this Coverage SECTION IV - BUSINESS AUTO CON- Form's Liability Coverage is primary DITIONS, B. General Conditions, 5. and we will not seek contribution Other Insurance is deleted in its entirety from any other insurance for any lia- and replaced by the following: bility assumed under an "insured contract" that requires liability to be b. For Hired Auto Physical Damage assumed on a primary noncontributo- Coverage the following are deemed ry basis. to be covered "autos"you own: C. Additional Insured by Contract (1) Any covered "auto" you lease, hire, rent or borrow; and SECTION II - LIABILITY COVERAGE, A. Coverage, 1. Who is an Insured is amended (2) Any covered "auto" hired or to include as an insured any person or organi- rented by your "employee" under zation for whom you have agreed in a valid a contract in that individual "em- written contract to provide insurance as af- ployee's" name, with your per- forded by this policy. mission, while performing duties related to the conduct of your This provision is limited to the scope of the business. valid written contract. Includes copyrighted material of ISO AA 288 06 20 Properties, Inc., with its permission. Page 1 of 4 However, any "auto" that is leased, a. Is effective on the date of acquisition hired, rented or borrowed with a driver or formation, and is afforded for 180 is not a covered "auto". days after such date; E. Audio, Visual and Data Electronic Equip- b. Does not apply to "bodily injury' or ment "property damage" resulting from an SECTION III - PHYSICAL DAMAGE COV- "accident" that occurred before you ERAGE, C. Limit of Insurance is amended acquired or formed the organization; by adding the following: c. Does not apply to any newly acquired 4. The most we will pay for all "loss" to au- or formed organization that is a joint dio, visual or data electronic equipment venture or partnership; and 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 a. The actual cash value of the dam- policy but for the termination of such aged or stolen property as of the time policy or the exhaustion of such poli- of the "accident'; cys limits of insurance. 3. Any of your "employees" while using a b. The cost of repairing or replacing the damaged or stolen property with oth- covered "auto" in your business or your er property of like kind and quality; or personal affairs, provided you do not own, hire or borrow that "auto". c. $2,500. G. Liability Coverage Extensions - Supple- Provided the equipment, at the time of the mentary Payments-Higher Limits "loss" is: SECTION II - LIABILITY COVERAGE, A. a. Permanently installed in or upon the Coverage, 2. Coverage Extensions, a. Sup- covered "auto" in a housing, opening plementary Payments is amended by: or other location that is not normally 1. Replacing the $2,000 Limit of Insurance used by the "auto" manufacturer for for bail bonds with $4,000 in (2); and the installation of such equipment; 2. Replacing the $250 Limit of Insurance for b. Removable from a permanently in-stalled housing unit as described in reasonable expenses with$500 in (4). Paragraph 2.a.above; or H. Amended Fellow Employee Exclusion c. An integral part of such equipment. SECTION II - LIABILITY COVERAGE, B. Ex- clusions, 5. Fellow Employee is modified as follows: SECTION II - LIABILITY COVERAGE, A. Exclusion 5. Fellow Employee is deleted. Coverage, 1. Who is an Insured is amended by adding the following: 1. Hired Auto -Physical Damage The following are "insureds": If hired "autos" are covered "autos"for Liability Coverage, then Comprehensive and Collision 1. Any subsidiary which is a legally incorpo- Physical Damage Coverages as provided un- rated entity of which you own a financial der SECTION III - PHYSICAL DAMAGE interest of more than 50% of the voting COVERAGE of this Coverage Part are ex- stock on the effective date of this cover- tended to "autos" you hire, subject to the fol- age form. lowing: However, the insurance afforded by this 1. The most we will pay for "loss" to any provision does not apply to any subsidiary hired "auto" is $50,000 or the actual cash that is an "insured" under any other au- value or cost to repair or replace, which- tomobile liability policy or would be an "in- ever is the least, minus a deductible. sured" under such policy but for termina- tion of such policy or the exhaustion of 2. The deductible will be equal to the largest such policys limits of insurance. deductible applicable to any owned "auto" 2. Any organization that is newly acquired or for that coverage, or$1,000, whichever is less. formed by you and over which you main- tain majority ownership. The insurance 3. Hired Auto - Physical Damage coverage provided by this provision: is excess over any other collectible insur- ance. Includes copyrighted material of ISO AA 288 06 20 Properties, Inc., with its permission. Page 2 of 4 4. Subject to the above limit, deductible, and K. Transportation Expense- Higher Limits excess provisions we will provide cover- age equal to the broadest coverage appli- SECTION III - PHYSICAL DAMAGE COV- cable to any covered "auto" you own in- ERAGE, A. Coverage, 4. Coverage Exten- sured under this policy. sions is amended by replacing $20 per day with $50 per day, and $600 maximum with Coverage includes loss of use of that hired au- $1,500 maximum in Extension a. Transpor- to, provided it results from an "accident" for tation Expenses. which you are legally liable and as a result of which a monetary loss is sustained by the L. Airbag Coverage leasing or rental concern. The most we will SECTION III - PHYSICAL DAMAGE COV- pay for any one "accident"is$3,000. ERAGE, B. Exclusions, 3.a. is amended by If a limit for Hired Auto - Physical Damage is adding the following: shown in the Schedule, then that limit replac- However, the mechanical and electrical es, and is not added to, the $50,000 limit indi- breakdown portion of this exclusion does not cated above and the deductibles shown in the apply to the accidental discharge of an airbag. Schedule are applicable. This coverage for airbags is excess over any J. Rental Reimbursement other collectible insurance or warranty. SECTION III - PHYSICAL DAMAGE COV- M. Loan or Lease Gap Coverage ERAGE is amended by adding the following: 1. SECTION III - PHYSICAL DAMAGE 1. We will pay for rental reimbursement ex- COVERAGE, C. Limit of Insurance is penses incurred by you for the rental of deleted in its entirety and replaced by the an "auto" because of a "loss"to a covered following, but only for private passenger "auto". Payment applies in addition to the type "autos"with an original loan or lease, otherwise applicable amount of each cov- and only in the event of a "total loss" to erage you have on a covered "auto". No such a private passenger type "auto": deductible applies to this coverage. a. The most we will pay for "loss" in any 2. We will pay only for those expenses in- one "accident"is the greater of: curred during the policy period beginning (1) The amount due under the terms 24 hours after the "loss" and ending, re- of the lease or loan to which gardless of the policy's expiration, with your covered private passenger the lesser of the following number of type "auto"is subject, but will not days: include: a. The number of days reasonably re- (a) Overdue lease or loan pay- quired to repair the covered "auto". If ments; "loss" is caused by theft,this number of days is added to the number of (b) Financial penalties imposed days it takes to locate the covered under the lease due to high "auto"and return it to you; or mileage, excessive use or b. 30 days. abnormal wear and tear; 3. Our payment is limited to the lesser of the (c) Security deposits not re- funded by the lessor; following amounts: (d) Costs for extended warran- a. Necessary and actual expenses in- 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 are spare or reserve "autos" available to (e) Carryover balances from you for your operations. previous loans or leases, or 5. We will pay under this coverage only that (2) Actual cash value of the stolen amount of your rental reimbursement ex- or damaged property. penses which is not already provided for b. An adjustment 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 AA 288 06 20 Properties, Inc., with its permission. Page 3 of 4 2. SECTION V - DEFINITIONS is amended P. Unintentional Failure to Disclose Hazards by adding the following, but only for the SECTION IV - BUSINESS AUTO CONDI- purposes of this Loan or Lease Gap Coverage: TIONS, B. General Conditions, 2. Conceal- ment, Misrepresentation or Fraud is "Total loss" means a "loss" in which the amended by adding the following: cost of repairs plus the salvage value ex- ceeds the actual cash value. However, if you unintentionally fail to disclose any hazards existing on the effective date of N. Glass Repair-Waiver of Deductible this Coverage Form, we will not deny cover- SECTION III - PHYSICAL DAMAGE COV- age under this Coverage Form because of ERAGE, D. Deductible is amended by adding such failure. the following: Q. Mental Anguish Resulting from Bodily Inju- No deductible applies to glass damage if the rY glass is repaired in a manner acceptable to us SECTION V - DEFINITIONS, C. "Bodily inju- rather than replaced. ry" is deleted in its entirety and replaced by O. Duties in the Event of an Accident, Claim, the following: Suit or Loss-Amended 'Bodily injury" means bodily injury,sickness or SECTION IV - BUSINESS AUTO CONDI- disease sustained by a person, including men- tal anguish and death sustained by the same TIONS, A. Loss Conditions, 2. Duties in the person that results from such bodily injury, Event of Accident, Claim, Suit or Loss,a. is sickness or disease. 'Bodily injury" does not amended by adding the following: include mental anguish or death that does not This condition applies only when the "acci- result from bodily injury, sickness or disease. dent"or "loss" is known to: R. Coverage for Certain Operations in Con- t. You, if you are an individual; nection with Railroads 2. A partner, if you are a partnership; With respect to the use of a covered "auto" in operations for or affecting a railroad: 3. An executive officer or insurance manag- er, if you are a corporation; or 1. SECTION V - DEFINITIONS, H. "Insured contract", 1.c. is deleted in its entirety and 4. A member or manager, if you are a lim- replaced by the following: ited liability company. c. An easement or license agreement; 2. SECTION V - DEFINITIONS, H. "Insured contract",2.a. is deleted. Includes copyrighted material of ISO AA 288 06 20 Properties, Inc., with its permission. Page 4 of 4 www.saif.com ■ saif Work. Life. Oregon. Carrier no: 20001 Endorsement no: WC000313 (Ed. 04-2025) SAIF policy: 488390 Welburn Electric Inc Waiver of Our Right to Recover from Others Endorsement We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. Schedule Description: ALL OPERATIONS Contractor name: Persons and/or organizations with whom the insured-employer is required by written contract to waive subrogation rights. This endorsement does not alter the rights of an injured worker to pursue recovery from another party or SAIF to receive a statutory share of recoveries by an injured worker, even from the party listed in the schedule. The premium charge for this endorsement is based on one (1) percent of your manual premium. Effective date: October 01, 2025 This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. Countersigned September 11, 2025 at Salem, Oregon 7 WC000313 Chip Terhune (Ed. 04-2025) President and Chief Executive Officer 400 High Street SE Salem,OR 97312 P:800.285.8525 F:503.373.8020 Pol_PC1_E430B