HomeMy WebLinkAboutInsurance Certificate: Taylor Site Development
ACORDTM CERTIFICATE OF LIABILITY INSURANCE OP 10 JGI DATE (MM/DDIYYYY)
TAYSI-l 10/21/08
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
W.R. Reed &: Co. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
4380 SW Macadam Ave., #300 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Portland OR 97239-6427
Phone: 503-223-1128 INSURERS AFFORDING COVERAGE NAlC#
INSURED INSURER A: American Fire &: Casualty
INSURER B:
Taylor Site Development Inc INSURER C:
dba Taylor Construction
PO Box 1132 INSURER D:
Medford OR 97501-0084
INSURER E:
COVERAGES
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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
LTR NSR[ TYPE OF INSURANCE POLICY NUMBER ~~~1ri:rJ~~E P8k~~Y(~fl:b~N LIMITS
GENERAL LIABILITY EACH OCCURRENCE $ 1000000
- ~~~~ES (E~~u~~nce)
A X X COMMERCIAL GENERAL LIABILITY BKA53763040 10/08/08 10/08/09 $ 100000
I CLAIMS MADE [!] OCCUR MED EXP (Anyone person) $ 5000
X Ded: $1000 PD PERSONAL & ADV INJURY $ 1000000
-
GENERAL AGGREGATE $ 2000000
-
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2000000
I n PRO- nLOC
POLICY JECT
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT
- (Ea accident) $ 1000000
A X ANY AUTO BAA53763040 10/08/08 10/08/09
-
ALL OWNED AUTOS BODIL Y INJURY
- $
SCHEDULED AUTOS (Per person)
-
HIRED AUTOS BODILY INJURY
- (Per accident) $
NON-OWNED AUTOS
-
- PROPERTY DAMAGE $
(Per accident)
GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $
=1 />NY AUTO OTHER THAN EA ACC $
AUTO ONLY: AGG $
EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $
=:=J OCCUR D CLAIMS MADE AGGREGATE $
$
=1 DEDUCTIBLE $
RETENTION $ $
WORKERS COMPENSATION AND ITB'~/~I~:~s.1 IVIN-
ER
EMPLOYERS' LIABILITY E.L. EACH ACCIDENT $
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYEE $
~~~c8iS~~6SI~16~s below E.L. DISEASE - POLICY LIMIT $
OTHER
Fe ~> .C'\ 'c
DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS , 1 '
RE: North Main Pump Station \
,
City of Ashland and Oregon Dept of Transportation are C ,~) .~ -: 2008
I
additional insured's per form CG8416 attached. - I
-
-_...~,
I i
CERTIFICATE HOLDER
CANCELLATION
l.~.. _
ASH1021
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATIO
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ~ DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
City of Ashland
20 E Main St
Ashland OR 97520
ACORD 25 (2001/08)
COMMERCIAL GENERAL ..'LIABILITY
CGc84161203
'THI$E:ND()RSEMENT~H.o.NGJ=STaep()LleV.;PLSAsE~EAD IT. oAilEFULLY.
GENE'RALLIABILITY
MASTER.PAlt.:P'LtJSf)
f:OiR,C.ON;STRU-CTION
This ~.ndor$em~ntmodifiesinsura nee provided ." under thefollowi ng:
CPMMERCIAL~ENERAL. L1ABILITYCQVERAGEPART
INDEX
SUBJECT
aLA"'~J:T.AP[)ITI()NAI... INSl,JRE[)(()WNI$R~,)"ESSI3ESjC()N"J"RAc:"[()R~ O.RI-E$SORS)
.FIRE,. LlGHTNING,EXPLOSIONAN.D:SPRINKL.ER LEAKAGEDAMAGETOPREMlSES;V:O:U. RENT
NON~WNEDVVATERCRAFT
SUPPLEMENTARV.P:A.VMENTS1BAIL...B()ND$)
PERSONALANoAf]\lERTISINGOINJlJRY ..ELEC"rRONICPUBLlCATION'aTENSION
AGGREGATE LIMITS. (PER-LOCATION)
.A$(.;REGATE.L1MITS(PEERPROJ.ECT)
VOLUNTARYPRQPER:TYOAMAGE COVERAGE
-OFF'PREMISESCARE, CUSTODYORCON'tROL.COVERAGE
NEVVLYFOR.MED 'ORA:<Z,QIJIREOQFtGA6JIZA110NS
DUYIES1NTHEE:\lENT OF OCCURRENCE, OFFENSE, CLAIM OR SUIT
BODILY INJURY (IVIENtAL.ANGUISH)
WAIVEROF= .TRANSFEROFRIGHTS;QF....RECO\lERY.AGAINST.OTHERS
MEDICALPAVMENTS
BROAD NAMED INSURED
SltOADENEb.'.MQBILE:,EQUIPMENT
INCIDENTAL.MALPRACTICEL.IABILITY
NON.eWNEOAIRCAAFT
PROPERTYDAMAGE..ELEVATORS
CG841S 1203
Incl udescopyrightedmaterial.oflS0Propedies, . Jnc. f with its permission.
ISOPropertjes, Inc.. 2003
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Page 10f9
1. BLANKET ADDITIONAL INSURED (OWners, Lessees, Contractors or Lessors)
(Jncludesa Primary/Non-Contributory provision)
Who Is An Insured-Section II isamcndpdto inoludotlsQninSl.Irqq any person or organtzationwhom you arc required
to name as an additional insured onthis policyirta written contractor written agreement. The written contract or written
agreement must be currently ineffectorbecormihgeffectiveduringtheterm ofthis policy and executed prior to the
"bodily injury," "property damage" or "personalandadvertisinginjury."
The insuranoe provided the additional insured is limited as follows:
A. The person or organization is only an additional insured with respect to liability:
1. Arising out of real property, as described in a written oontract or written agreement, that you own, rent,
lease or occupy; or
2. Caused in whole or in part by your ongoing operations performed for that insured.
The insUrance provided the additiOnalihsured in1.A~2.above does not apply to:
a. Coverage A - Bodily Injury and . Property Damage Liability, Coverage B - Personal and
Advertisinglrijury Liabilityordefen$e coverage under the Suppl&mentary Payments arising
out of an architect1s, engineers or surveyor's rendering of or failure to render any professioral
services including:
(1) The preparing, approving, or failing toprepareorapprovemapsrshopdrawings,
opinions, reports, surveys, fieldorders,.change orders or dravvings and specifications;
and
(2) Supervisory, inspection, architectural or engineeringaotivities.
b. "Bodily injury" or "property damage" occurring after:
(1) All work, including materials, parts or equipment furnish~din connection with such work,
on the project (other than service, maintenance or repairs) were performed by or on
behalf of the additional insUred(s)atthesite Where thecovereddperatiOr1s<have been
completed; or
(2) That portionof'y-ourworl('outof wnich the injury or damage arises has been put to its
intended US.8 by~nyperson()rprgani.~ionotherth;ananothe.rpPlitractot()r
subcontractor engaged in performing operatiohs for a principal as . part of the same
project
B. The limits ofinsuranoe applicable to the. additional insured are those speoified . inawrittenoontract or written
agreement or the limits of Insurance as stated in the Declarations of this policy and cJefinedinSectionnl *'
LimitsOfJnsurance of this policy., whichever are less. These limits are inclusive of.and l"IotinaddiUQntotbe
limits of in$urancaavailableunderthis poliCY.
c. The insurance.provided theadcHtional insUred does notapplytotheHaoilityreSultihgff6111the splenegUgence of
the additional insured. .
CG 84 16 12 03
Includes copyrighted material of ISO Properties, Inc., with its permission.
ISO Properties.. Inc'L2003
P~g~2 9f$
O.As respe,cts the,coverage' provided to the additional insured u nderth is endorsement, Section IV -Conditions is
arnendedasfollows:
1. Thcf()lloWingiapdQcdtoC()f1ditioh2.Dutj~\S1111heEve"t:()f'Oq~~rrence,Offen$e,CIUim, 'or Suit:
An additional insured under'thisendbtsernel1t:willassool1'as practicable:
a. Give written notice of an Iloccurrenee"oranoffense, that may resultin aelaimor llsuit"
undertbis insuranoe taus;
b. Ie'noer the defense andtndemnltyOf :anyclaimor "suit" to 'all insurers whomalsQ, have
insurance, aVcHlable 'to · the additjonal" inSlJred;anCl
c.Agreeto makeavailableanyofherinsurance,which 'the,additional' insured, has, fora loss
we.coverunder this Cover<3ge Part.
2. The foJl()\Ningj~arJdBd to Condition 3. Legal Actinn AOfJinst:Us'
We have no duty to ,defend or indemnity-an additionalinsuredunderthis endorsement until 'we receive
writt~n notice'of a crair110rifsuif'frqmtheadditiona'linSLJtsd.
'3. ThefdUoWintJis:,addedto Rcal"q{;Jtaphil., 'Pri~"y Il1sUtane~ofCQ"~jti()n 4. Other Insurance:
Iftne., addiUonarinSureo's polley. hasan' Other Insurance proViSiohma~ins ',its policy excess, ,and,a
Named Insured '.,has,agreed, in'a'writtencontractorwritten, agreemeRtto.providefheadditional, ,insured
oovera,g~ona" prima.rYE3.nd,.nonc0ntributoW.t.Jc1~.iSl,..tlii~,. p()liCY$~U ,peprirnary and we 'will pot .se~k
pQntribl.Jtion' from' thEfadditionalinsured's polioy;'fordal'l'1ag$S"wecQver,
4. The following Js added to Raragra,pHb" 'Exc~slnsu@nCeQfC()n.dition4. :OtherJl'Isuran~:
Except as provided in Paragraph4.a. . Primary Insuranceasamencledabo\le~ any coverage provided
herelJndershall beexceS$'o\leranYother~ali'ljaJldCOUe9tibleJnsur~noe~?1ilabIe lethe' additional
insur:edWhetherprilllary,excesslcontingentoro?,aqVPtherQasis'.,ln tbeeY~ntanpdditionalinsured,has
lJtherCO\lera.~~ aV~IIC\blefQr~n"oqcurren~"bYVittqe()~:calsP~jnganad(jjtlQnat insured QpQther
policies, this insl..lranceisexcess overthose'otherpoJicie$; ,
2. FIRE, LIGHTNING,. EXPLOSIONANI)'SPRINKLERLEAKA.GEDAIVIAGETOPREIVUSESYOURENT
lftlilmageToPrell1is@s Rel1ted.To' You uhderCdverage.A'is. notothetWi$eeXdludedfrornthispolicy,thefOlloWing
applies:
CG841S '12 03
A. Thelastparagraphof2. Exclusions of Section I-Coverage A is replaced bylhefollowing:
If[)amageToPrel11is~sR~ntedT() YOUjsnototh~rwiS~e.)(clL1ded'ExcIUSio"!>>c.thr9l..lgh n .. do not
applytodamagebyfire,. lightning ,"explosion"o[sprinklerleakageio'premiseswhile.' rented to YOllor
temporarily occUpied ,byyou with perrnissior'loflheowner.Aseparafe timitOf 'jrlsura nee applies to this
coverage as described' i nSedionul ..Lil11it50f hlsurance.
InclUdesebpyrightedmaterialdfl$O ..Pr()pettj~$I. IPO'1Wif.hits' perrniS~ioh.
l$O Prqperties" Inc., 2003
Pag~3 of9
B. Paragraph 6. of.Section III ..Limits Of Insurance is replaced by the fOllowing:
6. Subject to 5. above, the higher of $300,000. or the Damage To Premises Rented To You Limit
shown in the Summary of Limits apdChargcssection ofthispo.licy is the most we will pay under
Coverage A for damages because ofuproperty damage lito premises rented to you or
temporartlYocCLlpied by you with the petmission of the owner arising out of anyone fire,
lightning, "explosion" or sprinkler leakage incident.
C. Paragraph b.(1)(b) of Condition 4. Other Insurance (Section IV - Conditions) is replaced by the
following:
(1) That is Fire, Lightning, Explosion-or Sprinkler Leakage insurance for premises rented to you or
temporarily occupied by you with the permission of the owner;
D. Para.graph 9.a. of the definition of "insured contract" in Section V.. Definitions is replaced by the
following:
9. "lnstiredcbntract" means:
a. Acontractfortheleaseofpremises. However. that portion .ofthe contract for a lease of
premises that indemnifies any person or organization for damages by fire, lightning,
"explosion" or sprinkler leakage to premises while rented toyou or temporarily occupied
by you with the permission of the owner is not an "insured contract";
E. The following definition is added to Section V .. Definitions:
"Expl osion" means a sudden release of expanding press.ureaccompanied t?y.a noise, a bursting forth of
material and eVidence of the scattering of debris to locations further than would have resulted by gravity
alone.
"Explosion" does not include any of the following:
1. Artificially generated electrical current including electrical arcing that disturbs electrical
deVices,.appliances or wires;
2. Rupture or bursting of water pipes;
3; Explosion of steamboilers,steam pipes, steam engines or steam turbines owned or
I~asedbyyou,or operatedlJnderyour contrQI;.or
4. Ruptur-eorburstingcaused. by centrifugal. force.
3. NON..oWNED WATERCRAFT
$l;.lbparagr~ph;_g~(21,()fParGlgraph._,2~,E~cllJ$ion,ofSe<::ti()n.1 .. Cqv~rag~A. is r~pl~Cedby the following:
{2) AWclt~tbt~ftyou-d6J1otown th~ti$:
(;:J) Lessthan.5tfeeftong; and
(6) Not being usedto cBrry persons or property for a charge;
4. SUPPLEMENTARY PAYMENTS
In the Supplementary Payments ..Coverages A and B provision:
The limltforthe cost of bail bonds in paragraph 1.b. is changed from $250 to $1000.
CG84 16.12 03
IncIUde~popyrightedn}aterjSllof 1$0 . Propertie~J Inc., with its perrnls~ion.
l$O Propgrties..Jhg.,2Po.3
P~g.Q, 4 6f$
5. PERSONAL AND ADVERTISING INJURY-ELECTRONICPUBLlCATION EXTENSION
ParagtapH$14~b.,d.ahde.of $ection V - Definitions<ar~replaced by the following:
b. Malicious prosecutionor.abuseof process;
d. Oral, written. televised, videotaped or electronic pUblication of m ateria I thatslanders or libels a person or
organizationordisparagesaperson'sqrorgani?8tion'sgoods, .pr()qy~. Qr services:;
e. Oral, written, televised, videotaped orelectronio.publioation of material th~tViolatesa person's right of
privacy;
The followingJsadded to ParagrapH 14. 'Personal:andAdvertisll"lglnjury' of section V.. Definitions:
h. Dlscriminationor humiliation tHat results in injurytothefeelingsorrepL.Jtationofa natural person, but
ohlyif such discriminati.on'or.humiliation is:
(1.) Not done -intentionallY by.orafthe-dire.ctibhbf:
(~) An insured; or
(ll) Arry I 'executive dfficer 'di rector ,stookholder, partner or member. of the .insured; . and
(2). Not (jire.ct1y()rJn.qirectly rslatsoto theemplqymentpr()spectiYe.ernploYrn~nt()rtermination of
~rhploYmeritofatIY.P'f:r$QrI orperson:;sby aliy.. i n$urerc:J.
Subparagraphsb.andc. of2.,..Exclusions of Sectionl.-CoverageS..PersonaLAndAdvertising.llljuryLiabilityare
replaced by the following:
b. l\IIaterhlIPubli$hed. With ~noWledgf!OfFaISiity
'PersoMal-andadvertising inj urY'" ati.Si hgoutdf aral,written,televised,\lideofaped 0 relectronic
publication of -materialj.ifdone .byoratthedirectionoftheinsured with, ,I<nowledge of. its falsity;
c. lVIirterlal.pJ.lb.ll$I'l~PtlorT() P()ll~y.PerIOct
uPersonal:(inda.dy~rti$ingi~j urY'ari~jn~ 'outoforal,~ritten.lt~eViSed,.Videota~d. or electronic
publioationolmateria:lwhose first publi.oationtookplaoebefore the beginni ngof thepolioy period;
6. AGGREGATELlMITS:()FINSURANOEfPER'LOCATtON)
The...Oe1ieral.~ggregate. u.rr1it..uhder:sectionnl:1.1111i'fsOflnSllran(;e'~ppnes<.separatelytoeachOfcyoUr. illocationsll
ownedbyorrentectto youorfernporqrHyoQoupied by youwith.theperrnissionof the owner.
"Location"means .premises involving the same or oonnectinglots, orpremises whose..connection.isinterrupted only by a
street,. roadwaY1 waterway-or right..of,;,wayofa railroad.
7. AGGREGAT'ELIMIT'SOF IN~URANCE(PERPROJECT)
The General..Aggr~~ate Urnitul1oefSeC1:io...mLimitsQf ]nsurancQ,appnesseparatelyfoeachofyour'.projectsaway
from prem.isesowned by or rentedtoyou.
CG84 1612 03
IncludescopyrightedmaterialofJSOPropeJties, Jnc., with itS permission.
180 Properties, hie. I 2003 .
PageS of9
8. VOLUNTARY PROPERTY DAMAGE COVERAGE
At your request, we will pay for "loss" to property of others 0(3 used py your business operations. The most we will pay for
this coverage is $500 each "oocurrenoe.1I The 11106S" mustoocur during the policy period. The lIooourrence" must take
place in the "coverage territory".
"Loss" means unintended damage or destruction" !'Loss"does not mean disappearance, abstraction or theft.
This coverage does not apply to:
1. Damage arising out of the use of any "auto";
2. Property you own, occupy, rent or lease from others; or
3. Property on your premises for sale, service, repair or storage.
None of the other policy exclusions apply to this coverage.
If the policy to which this endorsement is attached is written with a property damage liability deductible, the deductible
shall apply to Voluntar)'Property Damage. Thelit'riitofcoveragesfutedabove shall not be reduced by the amount of this
deductible.
9. OFF PREMISES CARE, CUSTODY OR CONTROL COVERAGE
A. We will. pay those sums that you become legally obligated to pay as damages because of "property damage" to
personal property of others while in your or your "employees" care, custody or control or real property of others
over which you or your "employees" are exercising physical control if the "property damage" arises out of your
business operations. This Coverage> is subj.ect to sections B., C., D. and E. below.
B. Exclusions
This insurance shall not apply to:
1. · 'Property damagell of property atpremises owned, rented, leased, operated or used by you;
2. "Property damage" of property while in transit;
3. The cost of repairing or replacing:
(a) Any of your work defectively or incorrectly done by you or by others on your behalf; or
(b) Arry product manufactured, sOld.orsupplieclbyyou, unless the "propertydamage" is caused
dircotJybyyouaftordcHvcry ofthoproduot or completion of the workand.re6ulting from a
subsequent undertaking; or
4. "Property damage" of property caused by or arj~ing pQt ofthelJpro,cluots"GOmpleted9~rati(ms hazard".
C. Limit$'Of..ln$lJra.n~- Thef11()st.weWillp~Yfor.'lpropertYdarnag~'1 underthis$ectiQn ~~....is.$25,000 for each
"occurrenoe", The.mostwewlUpayforthe:sumof all ,damages covered under thtS section 8. because of
"property damage" iscanannual.aggreg.ate timit of$25, 000.
The Limits ()flnsUfanC$provided .under this SectiQn 9. .are inQllJ$iv~ Of and not in addition t()any9tt)~r limits. provided
in the polJcyoreridor$emelits atfaChedtoit.
D. Deductible ,-We wiHnot pay for "pr()pertydarnage"inahyone"OCclJrr.ence~1 UhtillhearnountofHproperty
damage"'exceeds $250. .If theJDolicy to-whictlthis. endorsement is.attachedcon~insat'propertydamagel'
deduqtible, that deductible shall apply if it is greater than $250,
E. In the event of "property damage" covered by this endorsement, you shall, if requested by us) replaoe the
property or furnish the laoor and materials necessary for repairs thereto at your actual cost, excluding profit or
overhead charges.
CG 84 16 12 03
Includescopyrightedmateriet1of ISO Properties,lnc" with its permission.
1$0 Properties, Inc., 2003
PageS ()f 9
10. NEWLY FORMED OR ACQUIRED ORGANIZATIONS
A. Paragtaph4,pfSection II-Who Is .A.olnsuredisdeletedandreplaoedbythefollowiOg:
4. AnY bLJsinessernityacquited by you 'or incorporated or organized byyoU.underthe laws. of any individual
state of the United Statesbf ,Amerioaover which yOumairitainmsjorityownersnipi nterest excee ding fifty
percent. SuchacquiredorneVJlyform~d organizabonwill.qualifyas a Named Jnsured.if there is no
simIlarinsuranceavaHabletofha,t ~ntity.. ~!owev~r:
a. '~overageJ.ln,d~rth.:is.pr()\fl$ton'applieSdnlYuntllthee)(piration. Of the. policy period inwhichthe
entity was acquired or incorporated or organized byyou.
b. Coverage A does not app~y to Jlbodily inj.ury"or .llproperty damagel' thatoccurredbeforetheentity
wasacqlJiredor jnGorporat~d or organi~!?dbyYQI..L
c. CoverageS dpes hot apply to llpe rsona I and advertising injury"arising.out of an 'offense
comrriittedbefore.the ehfitywas . acqlJiredorJncorporatedor organized by "YOIJ.
d. Records and descriptions of operations must be majntained by the fj rst Named .Insured.
B. This$~ction10.doesnot.taPply to neWly formed QraqqIJit(:)d organizatipns ifcQveragejs excludedeithe rby
provisipns of the Coverage ., Ptilrt or byotherendorsemeht(s)attGiPhedto it
11. PUTIES1NTHEEVENTOF OOCUR.R.ENCE, OFFENSE,CLAIM,ORSUIT
A. The requirements in Section IV -Conditions, Pi3ragraph2.a. ,that you mustsee to itthatwearenotifiedofan
"popurrencellappliE3s. pn1ywhenthe · ',occurrence" is known to:
1. You, ifYQuarearl.jpClividUal;
2. A ,partner, ifVoLiaJe'apal1hershfp;
.-3. A memberormanager,ifYDu are a Jimited liability company;
4. Anexecutiveoffieerordesignee, if you are-aeorporation;
5. Atru~tee,ifyou are atrqst;.Qr
6. A.de$igne~, .lfYQU,Elreany:other1Ype otorganlzation.
B. The....requiremerits jnSection IV-Conditions Paragraph2.b. that you must see to if that We reoeivewritten
n0tiocofaolaim,or"suit"will not bcoonsidcrcdbrcaohcd unlcssthcbrcaoh oooursaftcrsuoholaimorllsuit".is
knownto:
1. You. ifyoua.re anindhlidual:
2.Apa'~ner, ifyouare.apa~nership;
3. A member ormanagerifyou are a' limited . liability oompany;
A. An executive officer or. designee, if you are a corporation;
5. A trustee, if you are a trust; or
6. A designee, if you are any other type oforganization:
Knowledge ofan"occurrence! II clairnorllsuitll bylhe agent,servantor"ertlployeellofanyinsured shaUnot ill itself
constitute.knowledgeofthe insuredLJnless an Officer or designee Shall have received ribtfcefrom.itsagent, servantor
"employee'l.
CG841S12 03
I nel UdescbpyrightedrnateriexldftSO iProperties,. Ine.,Withltspermissioh.
ISO. Properties, Ihc., 2003
Page 7 6f9
12. BODILY INJURY
."";,iIi'"
Paragraph 3. of the definition of "bodily injury" in the Section V -Definitions is replaced by the following:
3. "Bodily injury"meansbodilyinjury,~ickn~$ordiseasesustain~d bya person, including mental anguish
or death resultingfrorrfany' o.fth.aseatanytirne.
13. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAIN5T OTHE:RS
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 any person or organization for whom you perform work under a written contract that requires you to
obtain this agreement from us.
This agreement shall not operate directly or indirectly to benefit anyone not named in the agreement.
14. MEDICAL PAYMENTS
If CoverageCMedical Payments isnototherwise excluded, the Medical Expense Limit provided by this policy shall be
the greater of:
A. $10,000; or
B. The amount shown in the Declarations.
15. BROAD NAMEO INSUREO
Paragraph 2.a.(1 )(d) of Section II - Who Is An Insured isreplaced by the following:
(d) Arising out of his or her providing or failing to provide professional health care services. However, this
exclusion does not apply to nurses, emergency medical technicians or paramedics who are employed by
you to provide medical or paramedical services to your employees.
16. BROADENED MOBILE EQUIPMENT
Paragraph 12.f.(1) of Section V - Definitions is replaced by the following:
(1) Equipment designed primarily for:
(a) Snow removal;
(b) Road maintenance, but not construction or resurfacing;. or
(e) Street cleaning provided that vehicles have a Gross Vehicle Weightof1.000 pounds or greater;
17. INCIDENTAL MALPRACTICELIABILI1Y
Paragraph 3. of Section V- Definitions is replaced by the following:
3. ''Bodily injury" meansbodUy injury, sickness, disease or "inCidental medical malpractice" sustained by a
person1 including mental anguish or death resulting frornany of these at any time.
The foUowingisaddedto Section V - Definitions:
23. IIlncidental medical malpractice" means injury arisingolJtof the negligent rend~ring or failure to render
medical or paramedical servic.e~tQper~nsbyanyphysicia,n, dehtlst,nurse,~mergencymedical
technician or paramedic who is ernployedbyyoutoprovide such services toyour.employees, provided
you are not engaged in the business or ocbupationof providing any services referred to inthis definition.
CG 8416.1203
I ncludescQpyrigtrtedrnateri~I'orl~O Propetties, 1119., with its. perin is~ion.
t$() Prqp~rtie~,ln9_,QQ03
P~g~8()f$
18. NON..QWNED AIRCRAFT
Thefo!lowing Is added to$ubparagraph g. .of 2., Excl usionsof Section I ..Coverage AB()dily InjufYAnd Property
DomQg~.Ljobjlit:y:
(G) An aircraft with a paid crew, that is hired, chartered.or loaned but is not owned byaqyinsured.
19. PROPERTV.DAMAGE...ELEVATORS
The following is added toSubparagraPhj. .of2..,.ExclusionsofSectiQn I ..iCoverage A Bodily.lJljuryAndi..Property
Dan1ageLiabllit,y:
Parc;graphs(3) and. (41 of this exclusion do not apply to damages that result from the use of elevators.
All ptherterms and oonditions of your polioy remain unchanged.
CG84 1612 03
Includes copyrightedrnaterial of ISO Properties, Inc" with its permission.
ISO Properties, Inc., 2003
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