HomeMy WebLinkAboutInsurance Certificate: Scelzi Enterprises, Inc. --""� SCELENT-01 BLOOSIGIAN
CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDYYYY)
2/2t2o2s
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 License#OE02096 CONTACT Blair Loosigian
NAME:
DiBuduo&DeFendis Insurance Brokers,LLC PHONE FAX
6873 N.West Ave,Ste 101 (A/C,No,Ext): (Al.,No)_
Fresno,CA 93711 AODRIEss:blair.loosigian@dibu.com
INSURERS AFFORDING COVERAGE NAIC#
INSURER A:Fireman's Fund Insurance Co. 21873
INSURED INSURER B:Arch Insurance Company 11150
Scelzi Enterprises,Inc. INSURERC:Znat Insurance Companv 30120
2286 E.Date Ave. INSURER D:
Fresno,CA 93706
INSURER E:
INSURER F:
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY 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 NUMBER POLICY EFF POLICY EXP LIMITS
LTR INSD WVD MMIDD MMIDD1Yl'YY
A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
CLAIMS-MADE o OCCUR X X USCO15795250 5/112025 5/1t2026 DAMAG PREM ses Ea oNcu nce $ 100,000
MED EXP An one erson $ 5,000
PERSONAL&ADV INJURY $ 1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: I GENERAL AGGREGATE $ 2,000,000
X POLICY PEO LOC PRODUCTS-COMP/OP AGG $ 2,000,000
OTHER: $
B AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000
Ea accident $
r
ANY AUTO X X 71CAB5310100 511/2025 51112026 BODILY INJURY Per erson $
OWNED SCHEDULED
AUTOS ONLY AUTOS BODILY INJURY Per accident $
AUTUSOL PROPERTY
ONLY AO N� P cn $
A X UMBRELLA LIAB X OCCUR (. EACH OCCURRENCE $ 10,000,000
EXCESS LIAB CLAIMS-MADE USC01183325U 51112025 511/2026 AGGREGATE $ 10,000,000
DED RETENTION$ $
C WORKERS COMPENSATION PER X STATUTE OH ER
(AND EMPLOYERS'LIABILITY M1225509 31112026 31112027 1,000,000
ANY PROPRIETORfPARTNERIEXECUTIVE Y� N 1 A E.L.EACH ACCIDENT $
EXCLUDED?OFFICERIMEMBER
(Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000
Ifyes,describe under 1,000,000
DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $
B Garagekeepers Liab 71CAB5310100 51112025 5/112026 Direct Primary
B Dealer Physical Damg 71CAS5310100 511/2025 511/2026 Comp/Coll$500 Ded 6,000,000
DESCRIPTION OF OPERATIONS t LOCATIONS 1 VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required)
City,its officers,agents,volunteers and employees are named additional insured with respect to General Liability per attached form CG71930319.A
Liberalization Clause-Equivalent Coverage to Expiring for Auto Liability and named additional insured per attached forms CA0248001224 and CA70181014.
Waiver of subrogation applies to General Liability per attached form CG71930319 and Auto Liability per attached form CA70181014.This insurance is primar
and non-contributory per attached form CG71930319(General Liability)and CA70181014(Auto Liability).Certificate holder is named as loss payee per as
respects Garagekeepers Legal Liability per form CA99370187(Direct Primary/Comp&Collision)with a six million dollar limit.Contractor's insurance covera,,
will be primary insurance with respect to City,its officers,agents,volunteers and employees per attached form CG71930319(General Liability)and
CA71060717(Auto Liability)and any insurance or self-insurance maintained by the City will be in excess of Contractor's insurance and not contributory with
it.Contractor will furnish certificates of insurance and endorsements to City prior to City's execution of this Agreement.
CERTIFICATE HOLDER CANCELLATION
City of Ashland SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
20 E Main St THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
Ashland OR 97520-1814 ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
ACORD 25(2016/03) @ 1988-2015 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
Allianz
MultiCover0 -Without Medical Payments - CG 71 93 03 19
Policy Amendment(s) Commercial General Liability Coverage Form
Your Commercial General Liability Coverage Form in revised aafollows:
1. Broadened Named Insured
A. SECTION || -WHO |S/\N INSURED, item 3.. io deleted and replaced by the following:
3. Any organization that you own at the inception of this policy, or newly acquire or form during the policy
period, and over which you maintain during the policy period majority ownership or majority inUmn+a1'
will qualify asa Named Insured if:
u. There iono other similar insurance available 0o that organization; and
b. The first Named Insured shown in the Declarations has the responsibility of placing insurance for
that organization; and
c. That organization is incorporated or organized under the laws of the United States of America.
However:
(1) Coverage under this provision 3 is afforded only until the next occurring annual anniversary of the
beginning of the policy period shown in the Declarations,or the end of the policy period,whichever
is earlier; and
.
(2) Coverage A does not apply to bodily injury or property damage that occurred before you acquired
ur formed the organization; and
(3) Coverage B does not apply to personal and advertising injury arising out of an offense committed
before you acquired or formed the organization.
B. SECTION || 'VVHO IS AN |NSUREO, the last paragraph, is deleted and nap|uoed by the following:
No person or organization is an insured with respect to the conduct of any current or past partnership,joint
venture, or limited liability company that is not shown as u Named Insured in the Declarations. However,
this does not apply to a limited liability company that meets all of the conditions in Section || -VVho Is An
Insured, item 3.. above.
2. Additional Insured
If an Additional Insured endorsement is attached to this policy that specifically names a person or organization
as an additional insured,then this Section 2. Additional Insured does not apply to such person or organization.
SECTION || WHO |SAN INSURED,subsection 2.e.. im added aufollows:
e. Any person or organization is included as on additional insunad, but only iw the extent such person or
organization is legally obligated to pay for bodily injury, property damage or personal and advertising
injury caused by your acts or omissions.With respect to the insurance afforded to such additional insured,
all of the following additional provisions apply:
(1) You have agreed in awhttmn insured contract that such person or organization be added as an
additional insured under this po|ioy�
.
(2) The bodily injury, property damage or personal and advertising injury for which said person or
organization is legally obligated to pay occurs subsequent to the execution of such insured contract;
(3) The mostwe will pay is the lesser of eitherthe amount of insurance available underthe applicable Limits
of Insurance shown in the Declarations or the limits of insurance required by the insured contract;
(4) The insurance afforded to such additional insured only applies to the extent permitted by law;
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(5) Such person or organization ison additional insured only with respect to:
(a) Their ownership, maintenance, or use of that part of the premises, or land, owned by, rented to,
or leased to you, axuu[t such person or organization is not an insured with respect to structural
a|1enntione, new construction or demolition operations performed by or on behalf ofsuch person
or organization;
(b) Your ongoing operations performed for that insured;
(c) Their financial control of you, except such person or organization is not an insured with respect to
structural alterations, new construction or demolition operations performed by or on behalf of such
person ororganization;
(d) The maintenanoe, operation or use by you of equipment leased to you by such person or
organization;
(e) Operations pmdbnnnd by you or on your behalf and for which x state or political subdivision has
issued a permit, provided such operations are not performed for such state or political subdivision,
and are not included within the products-completed operations hazard; or
(� Their liability aaa grantor mfa franchise k>you.
(8) This insurance does not apply to bodily injury, property damage, personal and advertising injury,
occurrence oroffense:
(a) Which takes place at a particular premises after you cease to be a tenant of that premises;
(b) Which takes place after all work, including mmteriu|a, poUo or equipment furnished in connection
with such work to be performed by or on behalf of the additional insured at the site of the covered
operations, has been completed;
(c) Which takes place after that portion of your work out of which the injury or damage arises has
been put to its intended use by any other person or organization other than another contractor or
subcontractor engaged in performing operations for a principal as part of the same project; or
(d) Which takes place after the expiration of any equipment lease to which (4)(d)above applies;
(7) With respect to architects, engineers or surveyors,coverage does not apply to bodily injury, property
damage or personal and advertising injury arising out of the rendering or failure to render any
professional services byor for you, including:
(o) The preparing,approving,or failing to prepare or approve,maps,shop drawings,opinions,reports,
surveys,field orders, change orders, or drawings and specifications; or
(b) Supervisory, inspection, architectural, or engineering services.
These exclusions apply even if the claims against any insured allege negligence or other wrongdoing in the
supervision,hiring,employment,training or monitoring of others by that insured,if the occurrence which caused
the bodily injury or property damage,or the offense which caused the personal or advertising injury,involved
the rendering of or the failure to render any professional services by or for you.
3. Additional Insured -Vendors
If an Additional Insured Vendors endorsement is attached to this policy that mpeoihoo||y names a person or
organization as an additional insured, then this Section 3. Additional Insured Vendors does not apply tp that
person mrorganization.
Un(aoe the pnoducts-oonmp|eted operations hazard is excluded from this pu|ioK SECTION || -VVH0 IS AN
INSURED, item 2iis added oefollows:
[ Any vendor of yours is included as an additional insured, but only with respect to bodily injury or property
damage caused by your products which are distributed or on|d in the regular course of the vendor's
business, subject ho the following additional exclusions:
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(1) The insurance afforded such vendor does not apply to:
(a) Bodily injury m property damage for which the vendor is obligated Vo pay damages by reason of
the assumption of liability ina contract or agreement. This exclusion does not apply ho liability for
damages that the vendor would have in the absence of the contract oragreement;
(b) Any express warranty unauthorized byyou;
(o) Any physical or chemical change in the product made intentionally by the vendor;
(d) Repackaging, unless unpacked solely for the purpose of inspection, demonstration,testing,or the
substitution of parts under instructions from the manufacturer, and then repackaged in the original
container;
(e) Any failure to make such inapacdons, odjue0nents, bests or servicing as the vendor has agreed
to make or normally undertakes to make in the usual course ofbusiness, in connection with the
distribution or sale of the products;
(D Demunatmdon, inotoUatimn, servicing or repair operations, except such operations podbnnud by
the vendor in full compliance with the manufacturer's written instructions at the vendor's premises
in connection with the sale of the product;
(0) Products which, after distribution or sale by you, have been labeled or relabeled or used as a
container, part or ingredient of any other thing or substance by or for the vendor;or
(h) Bodily injury or property damage arising out of the liability of the vendor for its own oda or .
omissions or those of its employees or anyone else acting un its behalf.
(2) This insurance does not applyto any insured person or organization from whom you have acquired such
products or any ingredient, part or container,entering into, accompanying or containing such products;
(3) The most we will pay is the lesser of either the amount of insurance available under the applicable
Limits of Insurance shown in the Declarations or the limits of insurance required by the contract or
agreement; and
(4) The insurance afforded to such vendor only applies to the extent permitted by law.
4. Additional Insured -Limited Primary and Noncontributory Provision
The following is added as a second paragraph to Section IV Conditions, Condition 4.Other Insurance,following
paragraph b.(2):
However, if you have added any person, organization or vendor of yours as an additional insured to this policy
by way of this K4u|tiCovep@ endorsement and have agreed in a written insured contract that this insurance is
primary and non-contributory with other insurance available to that additional insured, this insurance is primary
and we will not seek contribution from such additional insuved'a other insuranoe, provided that the additional
insured imo Named Insured under such other insurance.
5. Waiver ofSubrogation
SECTION |V - COMMERCIAL GENERAL LIABILITY CONDITIONS, item 8., is deleted and replaced by the
following: ----
0 Tran��rofRighLeofRoouveryAgaino�D�henioU�and0�nke\VV�ivorofSubnngation
a. If the insured has rights to recover all or part of any payment we have made under this Coverage Part,
those rights are transferred to us.The insured must do nothing after the loss to impair those rights. At
our request,the insured will bring suit or transfer those rights to us and help us enforce them.
b. If required by a written insured contract executed prior to the occurrence or offense, we waive any
right of recovery we may have against any person or organization named in such insured contract,
because of payments we make for injury or damage arising out of your operations or your work for
that person ororganization.
car,93oo`y
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8. Cancellation 'SQDays
Common Policy Conditions endorsement |L0017. A. Cancellation, hum 2.h. is deleted and replaced by the
following:
b. 90 days before the effective date of cancellation if we cancel for any other reason.
7. Liberalization
SECTION UV - COMMERCIAL GENERAL LIABILITY CONDITIONS, the following is added as an additional
Condition:
Liberalization
If we adopt a change in our forms or rules which would broaden the coverage provided by any form that is a part
of this policy without an extra premium charge, the broader coverage will apply to this policy. This extension is
effective upon the approval of such broader coverage\n your state.
O. Fine, Explosion, Sprinkler Leakage, or Lightning Legal Liability Coverage
A. SECTION | - COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE L|A8|L|TY� 2.
Exclusions,the last paragraph, in deleted and replaced by the following:
Exo|uaionuo.through n.dmnot apply to damage by fire,explosion,sprinkler leakage,or lightning to premises
while:
1. Rented toyou;
2. Temporarily occupied by you with the permission cf the owner;or
3. Managed by you under a written agreement with the owner.
A separate limit of insurance applies to this coverage as described in Section III -LIMITS OF INSURANCE.
B. SECTION III -LIMITS OF INSURANCE, item 6., is deleted and replaced by the following:
8. Subject to 5. above. the Damage to Puamioaa Rented To You Limit shown in the Declarations, for
property damage to any one premises while rented to you,or in the case of damage by fire,explosion,
sprinkler leakage, or lightning while rented to you, temporarily occupied by you with the permission of
the owner, or managed by you under a written agreement with the owner, is the greater of:
a. $1'O0U.UOO Any One Premises; or
b. The Damage Th Premises Rented Tb You Limit shown in the Declarations.
C. SECTION |V ' COMMERCIAL GENERAL LIABILITY COND|T0NS, 4. Other |nauxanm*. b. Exooaa
Insurance, (1)(a). items(i)and (iii)' are deleted and replaced by the following:
(i) That is Fine. Exp|omion, Sprinkler Leakage or Lightning insurance for premises while rented to you,
temporarily occupied by you with permission of the owner,or managed byyou undera written agreement
with the owner;
(iii) That is insurance purchased by you to cover your liability as a tenant for property damage to premises
rented to you,temporarily occupied by you with the permission of the owner,or managed by you under
m written agreement with the owner;or
D. SECTION V-DEFINITIONS, 9. Insured Contract, item a., is deleted and replaced by the following:
(o) A contract for a lease ofpremises. However, that portion of the contract for a lease of premises that
indemnifies any person or organization for damage by fire, explosion,sprinkler leakage, or lightning to
premises while rented to you, temporarily occupied by you with permission of the owner, or managed
by you under a written agreement with the owner, im not an insured contract;
S. Damage to Invitees'Automobiles from Failing Trees or Tree Limbs-Limited Coverage
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THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ ITCAREFULU[
LIBERALIZATION CLAUSE— EQUIVALENT COVERAGE TO EXPIRING POLICY
This endorsement modifies insurance provided under the following:
BUSINESS AUTO COVERAGE FORM
|tis agreed that:
1. Regarding any "accident", claim, "sud^ or ^loae occurring during the policy period shown in the
Declarations,this Policy shall provide coverage no less broad than the Expiring Policy provided that
such coverage shall be subjectto any applicable deductible or retention and Limits of Insurance of this
Policy.
2. "Expiring Policy"means:
Title: Commercial Auto
Insurer:American Automobile Insurance Company
Policy Number: SCV00074S'24
Policy Period: Fnom:U5-U1'2O24 To:O5'O1'202S
All other terms and conditions of this Policy remain unchanged.
00CA8248001224 @2O24 Arch Insurance Group Inc. Page 1of1
American Automobile Insurance Company
Policy Number:
Policy Period: From:QG-D1-2Q24-To: D5-Q1-2Q25
FUeetCover@ Endorsement — CA 70 18 10 14
Policy Amendment
This Endorsement modifies insurance provided under the:
Business Auto Coverage Form
Motor Carrier Coverage Form
A. Broadened Named Insured
Section || — Covered Autos Liability Covenoge, A. Coveege, 1. Who Is An Insured, the
following iaadded:
Any organization you own on the inception of this policy, or newly acquire or form during the
policy period, and over which you maintain during the policy period, majority ownership or
majority interest will qualify us a Named Insured if:
(1) There iane other similar insurance available io that organization; and
(2) The first Named Insured shown in the Declarations of this policy has the responsibility of
placing insurance for that organization; and
(3) The organization is incorporated or organized under the laws of the United States of America.
However
(m) Coverage under this provision is afforded only until the next occurring 12 month anniversary of
the beginning of the policy period shown in the Dedamhona, or the end of the policy
period, whichever ia earlier; and
(b) Coverage under this provision does not apply to bodily injury or property damage that
results from on accident that occurred before you acquired or formed the organization; and
(c) No person or organization is an insured with respect to any current or past partnership, or
joint venture that is not shown as a Named Insured in the Declarations; and
(d) Coverage undmrA.(1). (2) ond (3) mbovu does not apply to any organization that is covered
as on insured under any other automobile liability insurance policy whose limits of
insurance have been exhausted or vvhnae insurer has become insolvent.
B. Broadened Who |aanInsured
1. Form CAOOOi (if attached to this policy), Section || — Coverad Autos Liability Coverage, A.
Covenage. 1 Who |sAmInsured, item b.(2) is deleted, and d. is added mafollows:
d. Your employee while using his owned auto, or an auto owned by o member of his or
her houaeho|d, in your business or your personal offoim, provided you do not own, hire
or borrow that auto.
2. Form CA0020 (if attached to this policy), Section || — Covemd Autos Liability Covexage, A.
Coveraqa, 1. Who Is An Insured, item b.(2) in de|*ted, and f. is added aefollows:
f. Your employee or agent while using his owned private passenger type auto, or o
private passenger type auto owned by m member of his or her houaeho|d, in your
business or personal aOaim, provided you do not own, hirm, or borrow that auto.
This form must be attached to Change Endorsement when issued after the policy is written.
One m the mxanz Global Risks ua Companies uo named iv the policy.
cA701810-14 Page 1 ofiO
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C. Additional Insured Coverage and Waiver ofSubrogation
1 Form CA0001 (if attached to this policy), Qmodon U — Covered Autos Liability Covarage, A.
CovmnaQe, 1 Who Is An |naur*d, the following is added as item e ; and form CA0020 (J
attached to this policy), Section || —Covemd Autos Liability Coverage, A. Cuvemge, 1. Who
Is An Insured; the following iaadded as item g.:
Any person or organization with respect Umthe openadon, maintenance, or use, of a covered
auto, provided that you and such person or organization have agreed under an expressed
provision in a written insured contract or written uQreement, or a written permit issued to
you by a governmental or public au1hority, to odd such pemon, organizahon, or governmental
or public authority to this policy as an insured.
However, such person or organization is an insured:
(1) Only with respect to the operation, maintenwnom, or use, of a covered auto; and
(2) Only for bodily injury or property damage caused by an accident which takes place
after:
(a) You executed the insured contract orwritten agreement; or
(b) The permit has been issued to you.
2. Form CA0001 (if attached to this policy), Section |V ' Business Auto Conditions, A. Loss
Conditions. hem 5.; and fnnn CA0020 (if attached to this policy), Section V - Motor Carrier
Conditions,A. Loss Conditions, item G.; the following ioadded:
Waiver ofSubrogation
|f required byo:
a. Written insured contract or written agreement executed prior to the accident; or
b. Written permit issued to you by a governmental or public authority prior to the accident;
we waive any right of recovery we may have against any person or organization named in
such contmci, agreement or permit, because of payments we make for injury ordamage
arising out of the ownmmhip, maintenance oruse of covered auto.
D. Auto Medical Payments ' Increased Limit
For each covered auto described in the Declarations or shown in the Schedule as having
Auto Medical Payments Coverage, the K4�dioa| Payments Limit of for autos is
----
revised io the greater of:
1. $5.000;or
2. The limit shown in the Declarations.
E. Hired Auto Physical Damage Coverage and Loss of Use Expenses
Hired Auto Physical Damage Coverage
cA701810-14 Page 2nf1U
Copyright mmo14mounz Global Risks uu Insurance Company.All rights reserved.
U Physical Damage Coverage is provided by this policy on your owned covered autos, the
following applies:
Any auto that you leaaa, hive' vent or borrow without u driv*r, will be covered under this policy
for Physical Damage Coverage. Howeverunyauoh auto:
1. Will be covered only for the same Physical Damage Coverage that applies to your owned
oovon*U autos;
2. Will be subject to the same applicable deductible shown in the Declarations that applies to
your most similar owned covered audu, except any Comprehensive Coverage deductible
does not apply tu loss caused by fire or lightning; and
3. The most we will pay for any one loss in any one accident is the lesser ofthe following:
u. Actual cash value of the damaged or stolen property as of the time of the loss as
determined by us; ur
b. The 000| of repairing or replacing the damaged or stolen property with other property of
like kind and quality.
In addition, we will pay costs and fees associated with such covered loss only for a maximum
time period of seven days beginning with the date ofloss, subject to a maximum of$5UU.
However:
1. If form CA0001 is attached to this po|iuy, this coverage does not apply to autos you |eaae,
hira, vent or borrow from any of your employees, pudnum (J you are u partnership),
members (if you are m limited liability company) or members of their households; and
2. U [onn CA0020 is attached to this policy, this coverage does not apply to any private
passenger type auto you |aaoe, hina, rent or borrow from any member of your houaehoN,
any of your employees, partners (if you are u partnership), members (J you are a limited
liability company). or agents or members of their households.
Hired Auto Loss ofUse Expenses
FonnCA0UU1 (if attached to this policy), Section III - Physical Damage Coverage, A. Covenage,
4. Coverage Extension, b. Loss of Use Expenses; and form CA0020 (if attached |o this po|ioy).
Section |V Physical Damage Covmnago, A. Covenage, 4. Coverage Extension. b. Loss of Use
Expenses; is deleted and replaced by the following:
b. For Hired Auto Physical Damage, we will pay expenses for which an Insured becomes
legally responsible to pay for loss of use of a vehicle rented or hired without a driver, under
a written rental contract or agreement. We will pay for loss of use expenses if caused by:
(1) Other than collision only if the Declarations indicate that Comprehensive Coverage is
provided for any covered auto;
(2) Specified Causes of Loss only if the Declarations indicate that Specified Causes of Loss
is provided for any covered auto; or
(3) Collision only if the Uao|amhons indicate that Collision Coverage is provided for any
covered auto.
oA701810-14 Page 3of1O
Copyright @uo1*xmaoz Global Risks ou Insurance Company.All rights reserved,
However, the most we will pay for any expenses for loss of use is $100 per day, to u
maximum of$1.00.
F. Coverage Tmrritory- Hired Auto
1. Form C/V001. (if attached to this policy), Section K/ - Business Auto Conditiona, B. General
Conditions, 7. Policy Period, Coverage Territory, b.(5) ia deleted and replaced by the following:
(S) Anywhere in the world if covered auto of the private passenger type is |mased, hirad,
rented or borrowed without o driver for a period of 180 days or |eau.
2. Form CA0020 (if attached to this policy), Section V Motor Carrier Conditions, B. General
Conditions, 7. Policy Perind, Coverage Territory, b.(S) is deleted and replaced by the following:
(5) Anywhere in the mmdd if covered auto of the private passenger typo is |eaoed, hirad,
rented or borrowed without a driver for a period of 180 days or less,
G. Communication Equipment Coverage
Form CA0001 (if attached to this policy), Section ||| - Physical Damage Cuvmnugm, C. Limits of
|nouxanue. Paragraph 1.b.; and form CA0020 (if attached to this policy), Section |V - Physical
Damage Coverage, C. Limits of |noumnce. Paragraph 1.b.; is deleted and replaced by the
following:
b. All electronic equipment that napnoduumo . receives or bnnamUa audio, visual or data signals in
any one loss ia $1.5UO. if, otthe time of loss, such electronic equipment is:
H. Tapoa, Records, CDs and DVD Coverage
The Physical Damage Coverage Section is amended as follows:
1 The exclusion referring to topms, vmmonde, discs, or other similar audio, visual or data
electronic devices designed for use with audio, visual or data e|ao1noniu equipment does not
apply.
2. Under Comprehensive Coverage ' Form CA0001 (if attached to this policy), Section III-
Physical Damage Coveegm, A. Coverage; and form CA0020 (if attached to this policy),
Section |V- Physical Damage Covemgn, A. Coverage; the following is added:
We will pay for loss to hapea, recorda, discs or other similar devices used with oudio, visual
or data m|aoinonic equipment. We will pay only if the bupea, nyoordm, discs or other similar
audiu, visual or data electronic devices:
u. Are your proporty, or that ofa family member; and ----
b. Are in a covered auto at the time of loss.
The most wo will pay for loss im $250. No deductible applies to this coverage.
| Personal Effects Coverage
Form CA0001 (if attached to this policy), Section III ' Physical Damage Coverage, A. Covamge,
4. Coverage Extensions; and form CA0020 (if attached to this policy), Section |V -
Physical Damage Covenage, A. Covemge, 4. Coverage Extensions; item u. is added as follows:
cx701810-14 Page 4of1O
Copyright mou1*mxnnz Global Risks uS Insurance Company.All rights reserved.
c. Personal Effects Coverage
We will pay up to $500 for loss for clothing items or other personal effects that are owned
by an insured and are in an Owned auto at the time of m covered loss.
Personal Effects do not include audio visual or electronic devices, money, giftoands, securidea,
iewe|ry, or tools.
This coverage is excess over any other oo||uchb|o insurance.
No deductible applies to this coverage.
J. Airbag Coverage
1. Form CA0001 (if attached to this policy), Section ||| Physical Damage Coveosgo, B.
Exclusions, 3,e.; and form CA0020 (if attached to this policy), Section |V - Physical Damage
Cmvanage. 8. Enu|uaiony, 3.a.; the following isadded:
Hmvmswar, mechanical breakdown does not mean the unintended discharge of an airbag.
provided that any loss covered under this provision is anoeua over any other collectable
insurance or warranty designed to cover such unintended discharge.
K Rental Reimbursement
Form CA0001 (if attached to this policy), Section ||| - Physical Damage Cnvomgm. A. Coverage,
4. Coverage Extensions-, and form CA0020 (if attached to this po|icy). Section IV - Physical
Damage Covumge, A. Covermge, 4. Coverage Extensions; item d. is added as follows:
d. Rental Reimbursement or Transportation Expenses
If loss occurs to a covered auto described or designated in the Declarations or Schedule
and covered for Physical Damage Coverage,we will pay for rental expenses for the rental of
u similar replacement auto and additional transportation axpmnmes, incurred by you. This
payment applies in addition to the otherwise applicable amount of each coverage you have on
the covered auto. No deductible applies to this coverage. However:
(1) We will pay only for those expenses incurred by you that begin 24 hours after the
covered loss.
(2) We will cease paying for those expenaes, regardless ofthe policy's expiration doie, at
the earlier ofthe following dates:
(a) The number of days reasonably required to repair or replace the covered auto. If
loss is caused by theft, this number of days is added to the number of days it takes
to locate and return the covered auto to you; or
(b) 45 days from the duk* this coverage begins.
(3) Our payment is limited tu the lesser of the following amounts:
(m) Necessary and actual expenses incurred by you; or
(b) $1.5M
(4) This coverage does not apply while there are spare or reserve autos uvmi|mNe to you for
ox701810-14 Page 5of1O
Copyright @2014mou^z u|oom|Risks uu mavmnco Company.All nomu reserved.
your operations.
(5) If loss nmuke from the total dmft of covered private passenger type auto (ifCAOO2O
is attached to this po|icy), or ocavared private passenger auto (ifCA00O1 is attached
to this po|icy), we will pay under this coverage only that amount of your covered rental
expenses or additional transportation expenses which are not already provided for under
the Physical Damage Coverage Extensions.
L. Extended Towing Coverage
1. Form C&0001 (if attached in this policy), Section ||| - Physical Damage Coverage, A.
Covenago, 2. Towing, is deleted and n*p|moed by the following:
2. Extended Towing
We will pay up to $758 per disablement for towing and labor costs you incur each time
your covered auto is disabled. However:
o. All labor must be performed at the place cfdisablement; and
b. If the covered auto is of the private passenger type, no deductible applies; and
o. If the covered auto is not of the private passenger 1ypm, our obligation to pay will be
reduced by Q250deductib|e per disablement.
d. If the covered auto is not of the private passenger type and the disablement results
from o loss covered under Section ||| - Physical Damage CovemOe, A. Coverage,
Paragraphs 1, a., b., or o., there is no separate deductible for the Extended Towing
Coverage.
For purposes of this covmrugm, disablement means a breakdown of the covered auto
including mechanical breakdmmn, engine bai|una, or dna b|owmut, where re- pairs cannot be
made roadside and o tow io required to remove the auto from the roadway and to seek
additional services and repair.
2. Form CA0020 (if attached to this policy), Section |V - Physical Damage Coverage, A.
CmveraQe, 2. Towing Private Passenger Autos, is deleted and replaced by the following:
2 Extended Towing
We will pay up to $750 per disablement for towing and labor costs you incur each time
your covered auto iodisabled. However:
u. All labor must be performed at the place ofdisablement; and
b. If the covered auto is of the private passenger type no deductible applies; and
o. If the covered auto is not of the private passenger type our obligation to pay will be
reduced by a $250dodudib|o per disablement.
d. K the covered auto is not of the private passenger type and the disablement
results from a loss covered under Section ||| - Physical Damage Covormgu, A.
Coverage, Paragraphs 1, m., b., or o., there is no separate deductible for the
Extended Towing Coverage.
For purposes of this covenage, disablement means a breakdown of the covered auto
cA/01e10'14 Page Sof1O
Copyright @mo14mnanz Global Risks oo Insurance Company.All rights reserved.
including mechanical breakdown, engine fai|une, or tire blowout, where repairs cannot
be made roadside and u tow is required to remove the auto from the roadway and
to seek additional services and repair.
M. Cancellation - 120Days Notice
K we uanm*| this policy for any reason other than nonpayment of premium, we will mail or
deliver to the first Named Insured at the last mailing address known to us, vvh0en notice of
cancellation at least 120 days prior to the efecfivedate of cancellation.
N. Supplementary Payments - Increased Limits
Section || Liability Coverage, 2. Coverage Extensions, a. Supplementary Paymenta, items (2)
and (4) are deleted and replaced by the following:
(2) Up to $2.500 for the cost of bail bonds (including bonds for nm|abad LmfDr law violations)
required because of an accident we cover.We do not have to furnish these bonds.
(4) All reasonable expenses incurred by the insured at our requeat, including substantiated loss
of earnings up to $500m day, because of time off from work.
O. Duties in the Event of Accident, Claim, Suit or Loss - Amended
Form CA0001 (if attached to this policy) Section |V - Business Auto CondiUnna, A. Loss
Conditions, item 2. a.; and form CA0020 (if attached to this policy) Section V - Motor Carrier
Conditions, A. Loss Conditions, item 2. a.; ia deleted and replaced by the following:
u. |n the event of accident, daim, suit orloss, you must promptly notify us or our authorized
representative when it becomes known to:
(1) You, if you are an individual;
(2) Your partner or member, J you are mpartnership or joint venture;
(3) Your mmmbur, if you area limited liability company;
(4) Your executive officer if you are an organization other than a padnermhip, joint venture or
limited liability company; or
(5) Your authorized representative or insurance manager.
Knowledge of an auoidmnt, claim, suit or loss by other persons does not imply that the
persons listed above have such knowledge.
Notice should include:
(1) How, when and where the accident or loss occurred; and
(2) The insuned'mname and address; and
(3) To the extent possible, the names and address of any injured persons and witnesses.
P. Unintentional Failure LoDisclose Hazards
Form CA0001 (if attached to this policy), Section |V - Business Auto Condiiiona, B. General
uA701810'14 Page 7of1O
Copyright @mo14mnarmGlobal mmxn ua Insurance Company.All xemu vmewou.
Conditions, item 2.; and form CA0020 (J attached to this policy), Section V ' Motor Carrier
Cunditions, 0. General Conditions, item 2.; the following is added:
However, if you unintentionally fail to disclose any hazards existing at the inception date of this
po|ioy, we will not deny coverage under this Coverage Form because of such failure. This
provision does not affect our right to collect additional premium or exercise our right of
cancellation or non-renewal.
C\� Fellow Employee Coverage
Section || Liability Coverage, B. Exclusions, 5. Fellow Employee, the following iaadded:
However, this exclusion does not apply if the bodily injury results from the use of covered auto
you own or hire, and provided that any coverage under this provision only applies in excess over
any other collectible insurance.
R. Limited Mexico Coverage
WARNING
AUTO ACCIDENTS IN MEX|CU ARE SUBJECT TO THE LAWS OF MEX|CO ONLY ' NOT THE
LAWS OF THE UNITED STATES OF AMER|CA. THE REPUBLIC OF K4EX|CU CONSIDERS
ANY AUTO ACCIDENT A CRIMINAL OFFENSE AS WELL ASA CIVIL MATTER.
IN SOME CASES THE COVERAGE PROVIDED HERE MAY NOT BE RECOGNIZED BY
THEMEX|CAN AUTHORITIES AND WE MAY NOT BE ALLOWED TO IMPLEMENT
THIS COVERAGE AT ALL|NK4EX|CO. YOU SHOULD CONSIDER PURCHASING AUTO
COVERAGE FROM AL|CENSED MEX|CAN INSURANCE COMPANY BEFORE DRIVING IN
MEX|CO.
THIS ENDORSEMENT DOES NOT APPLY TO ACCIDENTS OR LOSSES WHICH OCCUR
OUTSIDE OF 25 MILES FROM THE BORDER OF THE UNITED STATES UFAMER|CA.
Form CA8001 (if attached to this policy), Section |V Business Auto Condidons, B. General
Conditions, item 7.; and humo CA0020 (if attached to this policy), Section V - Motor Carrier
Cmndidonn, B. General Conditions, item 7,; the following is added:
The coverage territory is extended to include Mexico, but only:
o. For accidents or losses occurring within 25 miles ofthe United States border-, and
b. For 1hpa into Mexico of 10 days or less;and
o. If the covered auto is principally garaged and principally used in the United States; and
d. If the insured is a resident of the United States.
If a loss toa covered auto occurs in k4mxioo. wm pay for such loss in the United States. If the ====
covered auto must be repaired in Mexico in order to be driven we pay than the
.
actual cash value of such loss an determined by us at the nearest United States point where the
n*pa|m can be made.
Any insurance provided under this provision will be excess over any other collectible insurance.
cx701e10'14 Page 8of1O
Copyright @mo1*mnanz Global Risks uu Insurance Company.All rights reserved.
S. Extended Glass Coverage
Form C&0001 (if attached to this policy), Section ||| Physical Damage Coverage, A. CoveraQe,
item 3.u.; and form CA0020 (if attached to this policy), Section |V ' Physical Damage
Coverage,A. Coverage, item 3u.; is deleted and replaced by the following:
o. 0mmm breakage. If glass must be nap|moed, the deductible will be $100 or the deductible
shown in the Deo|mmdionu, whichever is less. |f glass can be repaired and is actually repaired
rather than rep|aoed, the deductible will be waived. You have the option of having the glass
n*pminad rather than replaced.
T. Broadened Definition of Bodily Injury '
Form CA0001 (if attached to this policy), Section V ' DmUniduna^ item C.; and Form CA0020 (if
attached to this policy), SECTION V| - DEFINITIONS, item C; is deleted and replaced by the
following:
C. Bodily Injury means bodily injury, sickness or disease sustained by a person including
death or manio| anguish resulting from any of these at any time. Mental anguish means any
type of mental or emotional illness or disease.
U Customer Loouo or Loan Physical Damage Coverage Extension
Form CA8001 (if attached to this policy), Section ||| - Physical Damage Covexoge, C. Limit Of
Insurance; and form CA0020 (if attached to this policy), Section |V - Physical Damage
Coverage, C. Limits Of Insurance; item 4. is added as follows:
4. U your covered owned auto is:
(1) Shown in the Schedule and designated as covered for Physical Damage Coverage; and
(2) Shown in this policy as having a loss payee or additional-insured-lessor; and
(3) Incurs a covered total loss;
we will pay the greater of:
(a) The actual cash vo|uo, as determined by us, of the damaged or stolen property as of
the time of the total loss; or
(b) The outstanding indebtedness under the initial finance agreement for the covered
auto and its equipment.
As used hmre, outstanding indebtedness means the amount you owe on the finance
agreement at the time of total loss:
(i) Less any amounts representing taxes' overdue poyments, pmno|ties, intenest, or charges
resulting from overdue payments, additional mi|ma0e, exouau wear and tear, or lease
h*nninaUun fees;and
(ii) Leos any administrative costs or overhead fees meomaoed by the finance company who
has leased the covered auto to you; and
(iii) Less security deposits not returned by the lessor; and
(iv) Lmou omute for extended warranties, Credit Life Insurance, Health, Accident or Disability
Insurance purchased with the loan or lease;and
o^/01807-17 Page 0of18
Copyright @oo17mnanz Global Risks ue Insurance Company.All rights reserved.
(v) Less carry-over balances from previous loans or leases.
V. Two or More Deductibles
1. Section ||| - Physical Damage Covmnage, D. Deductible, of form CA0001 (if attached to this
poUoy), the following is added:
If another Allianz Global Risks US Insurance Company policy or coverage form that is not an
automobile policy or coverage form applies to the same accident or loss, the following
applies:
(1) If the deductible under this Business Auto Coverage Form is the lesser of (or least)
deductib|e, ii will be waived.
(2) If the deductible under this Business Auto Coverage Form is not the lesser, (or least)
deductible, it will be reduced by the amount of the lesser(or least) deductible.
2. Section |V - Physical Damage CuvaroAa, D. Deductible, of form CA0020 (if attached to this
policy), the following is added:
If another Allianz Global Risks US Insurance Company policy or coverage form that is not an
automobile policy or coverage fnnn applies to the aemm accident or loss, the following
applies:
(1) If the deductible under this Business Auto Coverage Form is the lesser of (or least)
deductible, ii will bewaived.
(2) If the deductible under this Business Auto Coverage Form is not the lesser, (or |uavA
deductib|e, it will be reduced by the amount of the lesser(or least) deductible.
All other terms and conditions of the policy remain unchanged.
===
c*701807-17 Page 10of 10
Copyright m2n17mnanz Global Risks ua Insurance Company.All rights reserved.
POLICY NUMBER: 71CAB5310100 COMMERCIAL AUTO
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
GARAGEKEEPERS COVERAGE
This endorsement modifies insurance provided under the following:
BUSINESS AUTO COVERAGE FORM
TRUCKERS COVERAGE FORM
This endorsement changes the policy effective on the inception date of the policy unless another date is indicated
below.
Endorsement Effective
Named Insured Countersigned By
(Authorized Representative)
SCHEDULE
Lo-
cation
No. Coverages Limit of Insurance For Each Location
Comprehensive $ 6000000 MINUS$ 500 DEDUCTIBLE FOR EACH
"CUSTOMER'S AUTO"FOR"LOSS"CAUSED BY THEFT OR MISCHIEF OR VANDALISM
Specified SUBJECT TO$ 2500 MAXIMUM DEDUCTIBLE FOR ALL SUCH "LOSS"IN ANY
1 Causes of Loss ONE EVENT.
Collision $ 6000000 MINUS$ 500 DEDUCTIBLE FOR EACH "CUSTOMERS AUTO"
Comprehensive $ MINUS $ DEDUCTIBLE FOR EACH
"CUSTOMERS AUTO"FOR"LOSS"CAUSED BY THEFT OR MISCHIEF OR VANDALISM
Specified SUBJECT TO$ MAXIMUM DEDUCTIBLE FOR ALL SUCH "LOSS"IN ANY
2 Causes of Loss ONE EVENT.
Collision $ MINUS$ DEDUCTIBLE FOR EACH "CUSTOMERS AUTO"
Comprehensive $ MINUS$ DEDUCTIBLE FOR EACH
"CUSTOMER'S AUTO"FOR"LOSS"CAUSED BY THEFT OR MISCHIEF OR VANDALISM
Specified SUBJECT TO$ MAXIMUM DEDUCTIBLE FOR ALL SUCH "LOSS"IN ANY
3 Causes of Loss ONE EVENT.
Collision $ MINUS$ DEDUCTIBLE FOR EACH "CUSTOMERS AUTO"
LOCATIONS WHERE YOU CONDUCT"GARAGE OPERATIONS."
Location Address
No. state your main business location as Location No. I
1 LOCATIONS: BLANKET
2 RATING BASIS: DIRECT PRIMARY
3
CA 99 37 0187 Copyright, Insurance Services Office, Inc., 1985, 1991 Page 1 of 3
Premium for all locations
Comprehensive $ 5652
Specified Causes of Loss $
Collision $ 8130
(if no entry appears above information required to complete this endorsement will be shown in the Oodarudona
aa applicable tmthis endorsement.)
A. This endorsement provides only those coverages 4. COVERAGE EXTENSIONS
where u Limit of Insurance and o premium are Supplementary Payments In addition to the
shown for that coverage in the Schedule. Limit of Insurance, we will pay the"insured:"
B. COVERAGE
a. All expenses weincur.
1. We will pay all sums the "insured" legally must b. The costs of bonds to release attachmentspay as damages for '1mes'' to a covered "auto" in any "suit" we defend, but only for bond
or "auto"equipment left in the 'inaurod'a^ care amounts within our Limit of|nauranco
while the "insured"^ is attending, servicing,. �
rapairng, parking or storing it in your "garage c All reasonable expenses incurred by the
operations"under: "insured" at our raqued, including actual
loss of earnings up io �10Om day because
o. Comprehensive Coverage. From any cause of time off from work�
except:
d. All costs taxed against the "insured" in any
(1) The covered '�uto'o^ collision with
another object; o/ .buit"wmdefend.
e. All inkanaet on the full amount of any
(�� Thocowarud 'bu�o'a"ovm�urn� judgment that accrues after entry ofthe
b. Specified Causes of Loss Coverage. judgment in any "suit" we defend; but our
Caused by: duty to pay interest ends when we have
(i) Fire, lightning orexplosion; paid, offered to poy, or deposited in court
the part of the judgment that is within our
(2) Theft; or Limit ofInsurance.
(3) Mischief urvandalism. C. EXCLUS|C>NS
u. Collision Coverage. Caused by: 1. This insurance does not apply to any of the
(1) The covered 'buto's" collision with following:
another object; or e. Contractual Obligations.
(2) The covered 'bu1o'u"overturn. Liability resulting from any agreement by
2. VVb have the right and duty to defend any'buh" which the "insured" 000ep1a responsibility
asking for these damages. However, we have for"loss."
no duty to defend "suits"for "loss"not covered b. Theft.
by this insurance. We may investigate and .
settle any claim or 'huif' as we consider
�ooe"du*hothe� or conversion caused in
appropriate. Our duty io defend or settle ends any way by you,your employees orbyyour
for a coverage when the Limit ofInsurance for shareholders.
that coverage has been exhausted by payment c Defective Parts.
of judgments orsettlements. Defective parts urmaterials.
3 VVH0 |��� |NSUF��D' d. Faulty Work.
The following ..ana "insureds" for "loss" to FauKy`work you par��rnxsd�^
�covered "autos."
----
a
�� V&* will not pay for "loss" to any of the
' You. following:
k Your pmrtn*rs, amp|oyeeo, directors or s. Tape decks or other sound reproducing
shareholders while acting within the scope equipment unless permanently installed in
of\heirduhosaasuoh ~�=='
covered 'auto.'' ����
b. Tapes, records orother sound reproducing Zi Sometimes to settle o claim or "suit," we may
devices designed for use with sound pay all or any part of the deductible. If this
reproducing equipment. happens you must reimburse us for the
c. Sound receiving equipment designed for deductible or that portion of the deductible that
use as u citizens' bond nadio, two-way we paid.
mobile radio or telephone or scanning E. ADDITIONAL DEFINITIONS
monitor receiver, including its antennas and 1. The definitions of 'auio" and loas" in the
other accessories, unless permanently DEFINITIONS Section are replaced by the
installed in the dash or console opening following:
normally used by the "auto" manufacturer
for the installation oferadio. a. 'y\uto^means a land motor vehicle, trailer or
semitrailer.
D. LIMIT OF INSURANCE AND DEDUCTIBLE
b. '"Loss" means dinaoi and accidental loss or
1- Regardless of the number of covered 'autos.'. damage and includes any resulting loss of
"insureds," premiums paid, claims made or use.
"suits" bnouQht, the most we will pay for each
'1oaa^ at each location is the Gwnagmkeepurx 2. The following are added to the DEFINITIONS
�
CoverageLimit mit of Insurance shown in the
Schedule for that location minus the applicable a. "Garage operations" means the ownmrship,
deductibles for '1oss'' caused by ou||ision, theft maintenance or use of locations for the
or mischief urvandalism. purpose of business ofselling, servicing,
2. The maximum deductible stated in the repairing or parking 'butoa^and that portion
Schedule for Gerxgekeepurm Coverage of the roads or other accesses that adjoin
Comprehensive or Specified Causes of Loma .
Coverage iuthe most that will be deducted for b. 'Work you perfornmd" includes work that
all 'lmao" in any one event caused by theft or someone performed for you.
mischief orvandalism.
CA8S37D18T Copyright, Insurance Services Office, |no.. 1985. 1801 Page%mf3 0