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HomeMy WebLinkAboutInsurance Certificate: Duru GeoSolutions, LLC dba The Galli Group (2) COMMERCIAL GENERAL LIABILITY CG88100413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. COMMERCIAL GENERAL LIABILITY EXTENSION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART INDEX SUBJECT PAGE NON-OWNED AIRCRAFT 2 NON-OWNED WATERCRAFT 2 PROPERTY DAMAGE LIABILITY -ELEVATORS 2 EXTENDED DAMAGE TO PROPERTY RENTED TO YOU (Tenant's Property Damage) 2 MEDICAL PAYMENTS EXTENSION 3 EXTENSION OF SUPPLEMENTARY PAYMENTS -COVERAGES A AND B 3 ADDITIONAL INSUREDS -BY CONTRACT, AGREEMENT OR PERMIT 3 PRIMARY AND NON-CONTRIBUTORY- ADDITIONAL INSURED EXTENSION 5 ADDITIONAL INSUREDS -EXTENDED PROTECTION OF YOUR "LIMITS OF INSURANCE" 6 WHO IS AN INSURED -INCIDENTAL MEDICAL ERRORS/MALPRACTICE AND WHO IS AN INSURED -FELLOW EMPLOYEE EXTENSION -MANAGEMENT EMPLOYEES 6 NEWLY FORMED OR ADDITIONALLY ACQUIRED ENTITIES 7 FAILURE TO DISCLOSE HAZARDS AND PRIOR OCCURRENCES 7 KNOWLEDGE OF OCCURRENCE, OFFENSE, CLAIM OR SUIT 7 LIBERALIZATION CLAUSE 7 BODILY INJURY REDEFINED 7 EXTENDED PROPERTY DAMAGE 8 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US - 8 WHEN REQUIRED IN A CONTRACT OR AGREEMENT WITH YOU © 2013 Liberty Mutual Insurance CG 88 10 04 13 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. Page 1 of 8 With respect to coverage afforded by this endorsement, the provisions of the policy apply unless modified by the endorsement. A. NON-OWNED AIRCRAFT Under Paragraph 2. Exclusions of Section | - Coveroge A - Bodi|y Injury And Property Oornoge Liability, exclusion g. Airuroft, Auto Or Watercraft does not apply to an aircraft provided: 1. |tionot owned by any inouned� 2. |tiohired, chartered or loaned with atnained paid crew; 3. The pilot in command holds auurnendy effective m*rtifivahe, issued by the duly constituted authority of the United States of America or Canada, designating her or him auommeruia| or airline pilot; and 4. It is not being used to carry persons or property for acharge. However, the insurance afforded by this provision dmso not apply if there is available to the insured other valid and collectible inounanue, whether primary. exm*oo (other than insurance written to apply specifically in exm*oo of this po|iuy), contingent or on any other baoio, that would also apply to the |000 covered under this provision. B. NON-OWNED WATERCRAFT � ----- Under Paragraph 2. Exclusions ofSection | -Coverage A-Bodily Injury And Property Oornoge Liability, � ----- nnnmm I Subparagraph (2) of exclusion g. Aircraft, Auto Or Watercraft is replaced by the following: This exclusion does not apply to: (2) Awmterunaft you do not own that is: (o) Less than 52hset long; and � (b) Not being used to carry persons or property for acharge. C. PROPERTY DAMAGE LIABILITY -ELEVATORS 1. Under Paragraph 2. Exclusions of Section | - Coveroge A - Bodi|y Injury And Property Damage Liabil- ity, Subparagraphs (3), (4) and (G) of exclusion j. Oornoge To Property do not apply if such "property damage" results from the use of elevators. For the purpose of this provioion, elevators do not include vehicle lifts. Vehicle lifts are lifts or hoists used in automobile service or repair operations. 2. The following is added to Section |V - Cornrneruio| General Liability Conditions, Condition 4. Other Insurance, Paragraph b. Excess Insurance: The insurance afforded by this provision of this endorsement is exm*oo over any property inounanm*, whether primary, exm*oo, contingent or on any other basis. O. EXTENDED DAMAGE TO PROPERTY RENTED TO YOU (Tenant's Property Damage) � n If Damage To Premises Rented To You is not otherwise excluded from this Coverage Part: 1. Under Paragraph 2. Exclusions ofSection | -Coverage A-Bodily Injury and Property Oornoge Liability: o. The fourth from the last paragraph of exclusion j. Damage To Property is replaced by the follow- ing: Paragraphs (1), (3) and (4) of this exclusion do not apply to "property damage" (other than damage by fine. |ightning, exp|ooion, smoke, or leakage from an uuhumadu fine protection system) to: (i) Premises rented to you for a period of 7or fewer uonoeuudws days; or (ii) Contents that you rent or lease as part ofapremises rental or lease agreement for aperiod of more than 7dayo. Paragraphs (1), (3) and (4) of this exclusion do not apply to "property damage" to contents of premises rented to you for a period of 7or fewer uonoeuudws days. A separate limit of insurance applies to this coverage as described in Section ||| - Limits of Insurance. � 2O13 Liberty Mutual Insurance CG88 10 04 13 Includes copyrighted material of Insurance Services Office,|no..with its permission. Page 2of8 b. The last paragraph of subsection 2. Exclusions is replaced by the following: Exclusions u. through n. do not apply to damage by fire, |ighhning, exp|ooion, smoke or leakage from automatic fine protection systems to premises while rented to you or temporarily occupied by you with permission of the owner. Aoepanahe limit of insurance applies to Damage To Premises Rented To You as described in Section ||| -Lirnito Of Insurance. 2. Paragraph G. under Section |U -Lirnito Of Insurance is replaced by the following: G. Sut�eut to Paragraph 5. above, the Damage To Premises Rented To You Limit is the most we will pay under Coverage Afor damages because of "property damage" to: o. Any one premise: (1) While rented to you; or (3) While rented to you or temporarily occupied by you with permission of the owner for damage by fine. |ightning, exp|ooion, smoke or leakage from automatic protection sys- tems; or b. Contents that you rent or lease as part ofapremises rental or lease agreement. 3. As regards coverage provided by this provision O. EXTENDED DAMAGE TO PROPERTY RENTED TO YOU (Tenant's Property Damage) - Panagnaph 9.o. of Definitions is replaced with the following: 9.o. Auontnaut for a |eaoe of premises. Hmwewsr, that portion of the contract for a |eaoe of premises that indemnifies any person or organization for damage by fine. |ightning, exp|ooion, smoke, or leakage from automatic fine protection systems to premises while rented to you or temporarily occupied by you with the permission of the ownmr, or for damage to contents of such premises that are included in your premises rental or lease agreement, is not an "insured contract". E. MEDICAL PAYMENTS EXTENSION If Coverage CK0mdiuo| Payments is not otherwise excluded, the Medical Payments provided by this policy are amended as follows: Under Paragraph 1. Insuring Agreement of Section | - Covenoge C - Medical Payments, Subparagraph (b) of Paragraph o. is replaced by the following: (b) The expenses are incurred and reported within three years of the date of the accident; and F. EXTENSION OF SUPPLEMENTARY PAYMENTS -COVERAGESA AND B 1. Under Supplementary Payments -CoverogeoAand B. Panagnaph 1.b. is replaced by the following: b. Up to $3,000 for cost of bail bonds required because of accidents or traffic law violations arising out of the use of any vehicle to which the Bodily Injury Liability Coverage applies. We do not have to furnish these bonds. 2 Paragraph 1 d is replaced by the following: � . . . � ^ d. All reasonable expenses incurred by the insured at our request to assist us in the investigation or defense of the claim or ''ouit^, including actual |000 of earnings up to a500 aday because of time off from work. : G. ADDITIONAL INSUREDS -BY CONTRACT, AGREEMENT OR PERMIT 1. Paragraph 2. under Section || -VVho Is An Insured is amended to include as an insured any person or organization whom you have agreed to add as an additional insured in awritten uontnaut, written agreement or permit. Such person or organization is an additional insured but only with respect to liability for "bodily irjury^. "property damage" or "personal and advertising irjury^ caused in whole or in part by: o. Your auto or omiooiono, or the acts or omissions of those acting on your beha|f, in the performance of your on going operations for the additional insured that are the subject of the written contract or written agreement provided that the "bodily injury^ or "property damage" ouuuru, or the "per- sonal and advertising injury^ is uommitted, subsequent to the signing of such written contract or written agreement; or @ 20131-ibonyMutua| Insurance CG88 10 04 13 Includes copyrighted material of Insurance Services Office,|no..with its permission. Page 3of8 b. Premises or facilities rented by you or used by you; or u. The manbsnanm*, operation or use by you of equipment rented or leased to you by such person or organization; or d. Operations performed by you or on your behalf for which the obsbs or political subdivision has issued apennit subject to the following additional provisions: (1) This insurance does not apply to "bodily injury". "property damage", or "personal and ad- vertising injury^ arising out of the operations performed for the state or political subdivision; ----- (3) This insurance does not apply to "bodily injury" or "property damage" included within the . ~~~~~ uomp|ehed operations hazard". (3) Insurance applies to premises you mwn, nent, or control but only with respect to the following hazards: (o) The exiohenm*, mainhenanm*, nepair, uonotruution, eneudon, or removal of advertising oigno, mwningo, uanopieo, m*||ar entnanueo, uoo| ho|eo, dhwswmyo, manho|eo, marquees, hoist away openingo, sidewalk vau|to, street bannero, or decorations and similar expo- sures; or (b) The uonotruudon, eneudon, or removal of elevators; or (u) The mwnerohip, mainhenanm*, or use ofany elevators covered by this insurance. However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agneement, the insur- ance afforded to such additional insured will not be broader than that which you are required by � the contract or agreement to provide for such additional insured. With respect to Paragraph 1.o. above, a peroon'o or organizadon'o status as an additional insured under this endorsement ends when: (1) All wmrk, including maheria|o, parts or equipment furnished in connection with such wmrk, on the project (other than oemiue, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or (2) That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as part of the same project. With respect to Paragraph 1.b. above, a peruon'o or organizadon'o status as an additional insured under this endorsement ends when their written contract or written agreement with you for such premises or facilities ends. � n With respects to Paragraph 1.u. above. this insurance does not apply hu any ^ouuurnenue^ which takes place after the equipment rental or lease agreement has expired or you have returned such equipment to the lessor. : The insurance provided by this endorsement applies only if the written contract or written agreement is signed prior to the "bodily injury^ or "property damage". We have no duty to defend an additional insured under this endorsement until we nem*iws written notice ofa ^ouit^ by the additional insured as required in Paragraph b. of Condition 2. Oudmo In the Event Of Occurrence, Offense, C|oirn Or Suit under Section |V - Cornrneruio| General Liability Condi- tions. � 2O13 Liberty Mutual Insurance CG88 10 04 13 Includes copyrighted material of Insurance Services Office,|no..with its permission. Page 4of8 2. With respect to the insurance provided by this endorsement, the following are added to Paragraph 2. Exclusions under Section | -Coveroge A-Bodi|y Injury And Property Oornoge Liability: This insurance does not apply to: o. "Bodily irjury^ or "property damage" arising from the sole negligence of the additional insured. b. "Bodily injury^ or "property damage" that occurs prior to you commencing operations at the location where such "bodily irjury^ or "property damage" occurs. u. "Bodily injury^. "property damage" or "personal and advertising injury^ arising out of the render- ing of, or the failure to nender, any professional aruhiheotuna|, engineering or surveying oemiueo. including: (1) The pnepahng, approving, or failing to prepare or approve, mapo, shop drawingo, opiniono, neporto, ourveyo, field orderu, change orders or drawings and specifications; or (3) Supemioory, inopeution, architectural or engineering activities. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the oupemioion, hiring, emp|oyment, training or monitoring of others by that inoured, if the "occur- rence" which caused the "bodily injury" or "property damage^, or the offense which caused the "personal and advertising injury^, involved the rendering of, or the failure to nender, any professional aruhiheutuna|, engineering or surveying services. d. "Bodily irjury^ or "property damage" occurring after: (1) All wmrk, including maheha|o, parts or equipment furnished in connection with such wmrk, on the project (other than msmims, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or (2) That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as part of the same project. e. Any person or organization specifically designated as an additional insured for ongoing operations by a separate ADDITIONAL INSURED -OWNERS, LESSEES OR CONTRACTORS endorsement is- sued by us and made apart of this policy. 3. With respect to the insurance afforded to these additional inounedo, the following is added to Section ||| -LirnitoOf |nouronum: If coverage provided to the additional insured is required by a contract or agneement, the most we will pay on behalf of the additional insured io the amount of insurance: o. Required by the contract or agreement; or b. Available under the applicable Limits of Insurance shown in the Declarations; whichever ioless. n This endorsement shall not increase the applicable Limits of Insurance shown in the Deu|andio no. H. PRIMARY AND NON-CONTRIBUTORY ADDITIONAL INSURED EXTENSION This provision applies to any person or organization who qualifies as an additional insured under any form � or endorsement under this policy. Condition 4. Other Insurance of SECTION [V - COMMERCIAL GENERAL LIABILITY CONDITIONS io amend- ed aofollows: o. The following is added to Paragraph o. Primary Insurance: If an additional inoured'o policy has an Other Insurance provision making its policy exueoo, and you have agreed in awhtten contract or written agreement to provide the additional insured coverage on a primary and noncontributory baoio, this policy shall be primary and we will not seek contribution from the additional inouned'o policy for damages we cover. @ 2O13 Liberty Mutual Insurance CG88 10 04 13 Includes copyrighted material of Insurance Services Office,|no..with its permission. Page 5of8 b. The following is added to Paragraph b. Excess Insurance: When awhtten contract or written agreement, other than apnemioeo |eaoe, facilities nenbs| contract or agneement, an equipment rental or lease contract or agneemmnt, or permit issued by aobshe or political subdivision between you and an additional insured does not require this insurance to be primary or primary and non-uontributory, this insurance is exm*oo over any other insurance for which the addi- tional insured is designated ooaNamed Insured. Regardless of the written agreement between you and an additional inouned, this insurance is excess over any other insurance whether primary, exm*oo, contingent or on any other basis for which the ----- additional insured has been added as an additional insured on other policies. i ADDITIONAL INSUREDS -EXTENOEO PROTECTION OF YOUR ^L|K0|TS OF INSURANCE" This provision applies to any person or organization who qualifies as an additional insured under any form or endorsement under this policy. 1. The following is added to Condition 2. Oudmo In The Event Of Occurrence, Offense, Claim or Suit: An additional insured under this endorsement will as soon as practicable: o. Give written notice of an ^ouuurnenm*^ or an offense that may result in au|aim or "suit" under � ----- this insurance to us; . b. Tender the defense and indemnity of any claim or "suit" to all insurers whom also have insurance available hu the additional insured; and u. Agree to make available any other insurance which the additional insured has for a |000 we cover under this Coverage Part. d. We have no duty to defend or indemnify an additional insured under this endorsement until � we nem*iws written notice ofa^ouit^ by the additional insured. 2. The limits of insurance applicable to the additional insured are those specified in awritten contract or written agreement or the limits of insurance as stated in the Declarations of this policy and defined in Section ||| - Limits of Insurance of this po|iuy, whichever are less. These limits are inclusive of and not in addition to the limits of insurance available under this policy. J. WHO |SANINSURED -INCIDENTAL MEDICAL ERRORS/ MALPRACTICE WHO IS AN INSURED -FELLOW EMPLOYEE EXTENSION -K0ANAGEK0ENT EMPLOYEES Paragraph 2.o.(1) of Section || -Who Is An Insured is replaced with the following: (1) "Bodily injury^ or "personal and advertising irjury^: (o) To you, to your partners or members (if you are a partnership or joint wsntune), to your members (if you are a limited liability uompany), to a co-"employee" while in the course of his or her employ- ment or performing duties related to the conduct of your buoineoo, or to your other "volunteer n workers" while performing duties related to the conduct of your business; (b) To the opouoe, uhi|d, panent, brother or sister of that co-"employee" or "volunteer worker" as consequence of Paragraph (1) (o) above; : (u) For which there is any obligation to share damages with or repay someone else who must pay damages because of the injury described in Paragraphs (1) (o) or (b) above; or (d) Arising out of his or her providing or failing to provide professional health care oemim*o. However, if you are not in the business of providing professional health care oemim*o or providing profes- sional health care personnel to othero, or if coverage for providing professional health care ser- vices is not otherwise excluded by separate endoruement, this provision (Paragraph (d)) does not apply. Paragraphs (o) and (b) above do not apply to "bodily injury^ or "personal and advertising injury^ caused by an "employee" who is acting in aoupervioory capacity for you. Supervisory capacity as used herein means the "employee's" job responsibilities assigned by you. includes the direct supervision of other "employ- ees" of yours. However, none of these "employees" are insureds for "bodily injury^ or "personal and @ 20131-ibonyMutua| Insurance CG88 10 04 13 Includes copyrighted material of Insurance Services Office,|no..with its permission. Page Gof8 advertising injury" arising out of their willful uonduut, which is defined as the purposeful or willful intent to cause "bodily injury" or "personal and advertising injury', or caused in whole or in part by their intoxica- tion by liquor or controlled substances. The coverage provided by provision J. is excess over any other valid and collectable insurance available to your "employee". K. NEWLY FORMED ORAOO|UONAL[f ACQUIRED ENTITIES Paragraph 3. of Section || -Who Is An Insured is replaced by the following: 3. Any organization you newly acquire or form and over which you maintain ownership or majority inteneot, will qualify as a Named Insured if there is no other similar insurance available to that organization. However: o. Coverage under this provision is afforded only until the expiration of the policy period in which the entity was acquired or formed by you; b. Coverage Adoeo not apply to "bodily injury^ or "property damage" that occurred before you acquired or formed the organization; and u. Coverage B does not apply to "personal and advertising irjury^ arising out of an offense committed before you acquired or formed the organization. d. Records and descriptions of operations must be maintained by the first Named Insured. 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 aoaNamed Insured in the Declarations or qualifies aoaninsured under this provision. L. FAILURE TO DISCLOSE HAZARDS AND PRIOR OCCURRENCES Under Section |V - Cornrneruio| General Liability Conditions, the following is added to Condition G. Repre- sentations: Your failure to disclose all hazards or prior ^ouuurnenm*o^ existing aoof the inception date of the policy shall not prejudice the coverage afforded by this policy provided such failure to disclose all hazards or prior "occurrences" is not intentional. M. KNOWLEDGE OF OCCURRENCE, OFFENSE, CLAIM OR SUIT Under Section P# - Cornrneruio| General Liability Conditions, the following is added to Condition 2. Oudmo In The Event ofOccurrence, Offense, Claim OrSuit: Knowledge of an ^ouuurnenum^, offenoe, claim or "suit" by an agent, servant or "employee" of any insured shall not in itself constitute knowledge of the insured unless an insured listed under Paragraph 1. of Section || -VVho Is An Insured or a person who has been designated by them to nem*iws reports of ^ouuurnenm*o^, offenoeo, claims or "suits" shall have nem*iwsd such notice from the agent, servant or "employee". n N. LIBERALIZATION CLAUSE If we revise this Commercial General Liability Extension Endorsement to provide more uowsnsge without additional premium uharge, your policy will automatically provide the coverage as of the day the revision is m effective in your state. 0. BODILY INJURY REDEFINED Under Section V -Oefinidono, Definition 3. is replaced by the following: 3. "Bodily Injury" means physical irjury, sickness or disease sustained by a person. This includes mental anguioh, mental injury, ohouk, fright or death that results from such physical injury. sick- ness ordisease. � 2O13 Liberty Mutual Insurance CG88 10 04 13 Includes copyrighted material of Insurance Services Office,|no..with its permission. Page 7of8 P. EXTENDED PROPERTY DAMAGE Exclusion o. of COVERAGE A. BOO|[f INJURY AND PROPERTY DAMAGE LIABILITY is replaced by the following: o. Expected Or Intended Injury "Bodily injury^ or "property damage" expected or intended from the standpoint of the insured. This exclusion does not apply to "bodily injury^ or "property damage" resulting from the use of reasonable force to protect persons or property. Q. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US - WHEN REQUIRED IN A CONTRACT ORAGREEK0ENT WITH YOU Under Section |V - Cornrneruio| General Liability Conditions, the following is added to Condition 8. Trans- fer �f �i Rights Against� �th � U r g Recovery gono Others o o: We waive any right of recovery we may have against aperuon or organization because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the "products-completed operations hazard" provided: 1. You and that person or organization have agreed in writing in auontnaut or agreement that you waive such rights against that person or organization; and 2. The injury or damage occurs subsequent to the execution of the written contract or written agree- ment. � � n � � 20131-ibonyMutua| Insurance CG88 10 04 13 Includes copyrighted material of Insurance Services Office,|no..with its permission. Page 8of8 POLICY NUMBER: COMMERCIAL AUTO AC 00 33 03 20 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BUSINESS AUTO POLICY BASE EXTENSION This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM With respect to coverage afforded by this endorsement, the provisions of the policy apply unless modified by endorsement. SECTION II—COVERED AUTOS LIABILITY COVERAGE is amended as follows: 1. Newly Formed Or Acquired Subsidiaries The following is added to SECTION II—COVERED AUTOS LIABILITY COVERAGE, Paragraph A.1.Who Is An Insured: d. Any legally incorporated subsidiary of which you own more than 50 percent interest during the policy period shown on the Declarations. Coverage shall apply for the first ninety (90) days after your acquisition or the formation of such subsidiary, including the date of acquisition or formation. If you wish to add or continue coverage you must ask us to insure the subsidiary within ninety (90) days after you acquire or form the subsidiary. However, "insured" does not include any subsidiary that: (1) Is a partnership or joint venture; or (2) Is an "insured" under any other automobile policy except a policy written specifically to apply in excess of any coverage provided by this policy; or (3) Has exhausted its Limit of Insurance for any policy with effective dates overlapping the date of acquisition or formation; or (4) Following the entity's acquisition or formation by you, has had any other automobile policy cancelled or non-renewed. Coverage under this provision d. does not apply to "bodily injury" or "property damage" caused by an accident that occurred before you acquired or formed the subsidiary. 2. Employee Hired Auto The following is added to SECTION II—COVERED AUTOS LIABILITY COVERAGE, Paragraph A.1.Who Is An Insured: e. An "employee" of yours is an "insured" while operating an "auto" hired or rented under a contract or agreement in an "employee's" name, with your permission, while performing duties related to the conduct of your business. Paragraph 5.b.of the Other Insurance Condition in the Business Auto and Auto Dealers Coverage Forms and Paragraph 5.f. of the Other Insurance - Primary And Excess Insurance Provisions Condition in the Motor Carrier Coverage Form are replaced by the following: For Hired Auto Physical Damage Coverage, the following are deemed to be covered "autos"you own: 1. Any covered "auto"you lease, hire, rent or borrow; and AC 00 33 03 20 ©2020 Liberty Mutual Insurance Page 1 of 4 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 07/03/2024 66015260 candidateProcess HC Insured Copy 2. Any covered"auto" hired or rented by your"employee" under a contract in an "employee's"name,with your permission, while performing duties related to the conduct of your business. However, any"auto"that is leased, hired, rented or borrowed with a driver is not a covered "auto". 3. Employees As Insureds The following is added to the SECTION II—COVERED AUTOS LIABILITY COVERAGE, Paragraph A.1.Who Is An Insured: f. Any"employee" of yours is an "insured"while using a covered "auto"you don't own, hire or borrow in your business or your personal affairs. 4. Additional Insured By Contract, Agreement Or Permit The following is added to SECTION II—COVERED AUTOS LIABILITY COVERAGE, Paragraph A.I.Who Is An Insured: g. Any person, organization or governmental or public authority with respect to the operation, maintenance or use of a covered "auto", provided that you and such person, organization, or governmental or public authority have agreed in a written contract, written agreement, or permit, to add such person, or organization, or governmental or public authority to this policy as an "insured". However, such person, organization or governmental or public authority is an "insured": (1) Only with respect to the operation, maintenance or use of a covered "auto"; (2) Only for "bodily injury" or "property damage" caused by an "accident" which takes place after you exhausted the written contract or written agreement, or the permit has been issued to you; and (3) Only for the duration of that contract, agreement or permit. The "insured" is required to submit a claim to any other insurer to which coverage could apply for defense and indemnity. Unless the "insured" has agreed in writing to be primary and noncontributory per provision 13. of this endorsement, this policy is excess over any other collectible insurance. 5. Supplementary Payments SECTION II — COVERED AUTOS LIABILITY COVERAGE, 2. Coverage Extensions, a. Supplementary Payments, Paragraph (4) is replaced by the following: (4) All reasonable expenses incurred by the "insured" at our request, including actual loss of earnings up to $500 per day because of time off from work. SECTION III—PHYSICAL DAMAGE COVERAGE is amended as follows: 6. Physical Damage—Additional Transportation Expense Coverage Paragraph AA.a. Coverage, Coverage Extensions,Transportation Expenses of SECTION III—PHYSICAL DAMAGE COVERAGE, is amended to provide a limit of$50 per day and a maximum limit of$1,500 per day. 7. Extra Expense—Broadened Coverage The following is added to SECTION III — PHYSICAL DAMAGE COVERAGE, A. Coverage, 4. Coverage Extensions: c. We will pay up to$1,000 for costs incurred to return a stolen auto to you. Page 2 of 4 ©2020 Liberty Mutual Insurance AC 00 33 03 20 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 07/03/2024 66015260 candidateProcess HC Insured Copy 8. Accidental Airbag Deployment SECTION III—PHYSICAL DAMAGE COVERAGE, B. Exclusions Paragraph 3.a.is replaced by the following: a. Wear and tear, freezing, mechanical or electrical breakdown. However, this exclusion does not apply to the accidental discharge of an airbag if Comprehensive or Collision Coverage is shown in the Declarations. Any insurance we provide shall be excess over any other collectible insurance or reimbursement by manufacturer's warranty. However, we agree to pay any deductible applicable to the other insurance or warranty. 9. Glass Repair—Waiver Of Deductible (Coverage Not Applicable In FL) SECTION III—PHYSICAL DAMAGE COVERAGE, D. Deductible is amended by the addition of the following: No deductible will apply to covered glass damage if the glass is repaired rather than replaced. SECTION IV—BUSINESS AUTO CONDITIONS is amended as follows: 10. Amended Duties In The Event Of Accident, Claim, Suit, Or Loss SECTION IV—BUSINESS AUTO CONDITIONS, Paragraph A.2.a. is replaced in its entirety by the following: a. In the event of"accident", claim, "suit" or"loss", you must promptly notify us when it is known to: (1) You, if you are an individual; (2) A partner, if you are a partnership; (3) Member, if you are a limited liability company; (4) An executive officer or the"employee"designated by the Named Insured to give such notice, if you are a corporation. To the extent possible, notice to us should include: (a) How, when and where the "accident"or"loss"took place; (b) The "insured's" name and address; and (c) The names and addresses of any injured persons and witnesses. 11. Waiver Of Transfer Of Rights Of Recovery Against Others To Us SECTION IV — BUSINESS AUTO CONDITIONS, Paragraph A.5., Transfer of Rights of Recovery Against Others to Us, is amended by the addition of the following: If the person or organization has in a written agreement waived those rights before an "accident" or"loss", our rights are waived also. 12. Hired Auto Coverage Territory SECTION IV—BUSINESS AUTO CONDITIONS, Paragraph B.General Conditions, Item 7.b.(5), Policy Period, Coverage Territory, is replaced with the following: Anywhere in the world, for covered "autos" hired for thirty(30)days or less. This extension of coverage does not apply to an "auto" hired, leased, rented or borrowed with a driver. AC 00 33 03 20 ©2020 Liberty Mutual Insurance Page 3 of 4 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 07/03/2024 66015260 candidateProcess HC Insured Copy 13. Primary And Non-Contributory If Required By Written Contract Or Written Agreement The following is added to SECTION IV— BUSINESS AUTO CONDITIONS, B. GENERAL CONDITIONS, 5. Other Insurance and supersedes any provision to the contrary: e. Subject to the applicable limits of liability,this Coverage Form's Covered Autos Liability Coverage is primary to and will not seek contribution from any other insurance available to an "insured" under your policy provided that: (1) Such "insured" is a Named Insured under such other insurance; and (2) You have agreed in a written contract or written agreement that this insurance would be primary and would not seek contribution from any other insurance collectible to such "insured". SECTION V—DEFINITIONS is amended as follows: 14. Bodily Injury Redefined Under SECTION V—DEFINITIONS, Paragraph C. is replaced by the following: "Bodily injury" means physical injury, sickness or disease sustained by a person, including mental anguish, mental injury, shock, fright or death resulting from any of these at any time. Page 4 of 4 ©2020 Liberty Mutual Insurance AC 00 33 03 20 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 07/03/2024 66015260 candidateProcess HC Insured Copy A�® CERTIFICATE OF LIABILITY INSURANCE 707/22/2026 (MMIDD/YYYY) 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: Misty Whorley Hart Insurance Agency PHONE FAX PO Box 1240 A/C No Ext: (541) 479-5521 A/C No: (541) 474-1890 E-MAIL Grants Pass OR 97528 ADDRESS: mwhorley@hartinsurance.com INSURER(S)AFFORDING COVERAGE NAIC# INSURERA: SAIF Corporation 36196 INSURED INSURER B: Ohio Security Insurance Co 24082 Duru Geosolutions LLC Dba: The Galli Group INSURERC: Ohio Casualty Insurance Co 24074 612 NW 3rd Street INSURER D: General Insurance Co of America 24732 Grants Pass OR 97526 INSURER E7 (541) 955-1611 INSURERF: COVERAGES MW CERTIFICATE NUMBER:Cert ID 35136 (60) 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 POLICY NUMBER MM/DD/YYYY MM/DD/YYYY B X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE IX I OCCUR Y BKS67992207 07/10/2026 07/10/2027 IREMSESOEaoccurrDence $ 1,000,000 MED EXP(Any one person) $ 15,000 PERSONAL&ADV INJURY $ 11000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY❑ PRO ❑ JECT LOC PRODUCTS-COMP/OPAGG $ 2,000,000 OTHER I ICyber $ 50,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident 1,000,000 D X ANY AUTO Y AZG67992207 07/10/2026 07/10/2027 BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident C X UMBRELLA LIAB X OCCUR US067992207 07/10/2026 07/10/2027 EACH OCCURRENCE $ 2,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $ 2,000,000 DED X RETENTION$ 10,000 Compl/Ops $ 2,000,000 WORKERA AND EMPLOYERS' TION Y/N 100069507 11/01/2025 11/01/2026 X STATUTE EER PER H AND EMPLOYERS'LIABILITY ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? � N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 11000,000 If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,maybe attached if more space is required) RE: special inspection of structural upgrades to the City of Ashland ice rink parking structure. With respect to City of Ashland, Oregon, and its elected officials, officers and employees - Policy includes automatic additional insured where required by written contract per attached CG8810 for General Liability and AC0033 for Auto Liability. Primary/non-contributory is included. 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 East Main Street AUTHORIZED REPRESENTATIVE Ashland OR 97520 C) ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD Page 1 of 1