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HomeMy WebLinkAboutInsurance Certificate: Carollo Engineers (3) ACORD~ CERTIFICATE OF LIABILITY INSURANCE T DATE (MMIDDfYY) 06/30/10 PRODUCER 0564249 1-800-833-7337 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Heffernan Insurance Brokers/ ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Heffernan Professional Practices HOLDER, THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 1808 Embarcadero Road, Suite A ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, Palo Alto, CA 94303 INSURERS AFFORDING COVERAGE INSURED INSURER A: OneBeacon America Insurance Com....anu Carollo Engineers, A Professional Corporation American Insurance Company INSURER B: ACE 10540 Talbert Avenue, Suite 200 East INSURER C: Fountain Valley, CA 92708 INSURER D: INSURER E: COVERAGES THE POLICIES OF INSURANCE L1STEO BELOW HAVE BEEN ISSUED TO THE INSUREO NAMEO ABOVE FOR THE POLICY PERIOO INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONOITION 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 PAlO CLAIMS. 11!'4!>~ TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE P~~IfJ EXPIRATION LIMITS A ~NERAL LIABILITY 7180103170000 12/31/09 12/31/10 EACH OCCURRENCE $1,000,000 X COMMERCIAL GENERAL LIABILITY FIRE DAMAGE (Anyone fire) $ 500,000 I CLAIMS MADE 0 OCCUR MED EXP (Anyone person) 525,000 PERSONAl & ADV INJURY 51,000,000 GENERAL AGGREGATE 52,000,000 ~'~ AGG:l~lEILlMIT APnSIPER PRODUCTS - COMP/OP AGG 52,000,000 POLICY X ~~,9.; LOC A 0!!-TOMOBILE LIABILITY 7180103170000 12/31/09 12/31110 COMBINED SINGLE LIMIT 51,000,000 ~ ANY AUTO (Eaaccidenl) e- ALL OWNED AUTOS BODILY INJURY $ e- SCHEDULED AUTOS (Per person) e- HIRED AUTOS BODILY INJURY I NON-OWNED AUTOS (Per accident) e- e- PROPERTY DAMAGE I (Peraccidenl) RRAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO OTHER THAN EAACC I AUTO ONLY; AGG $ A 0ESS L.IABILlTY 7180103170000 12/31/09 12/31/10 EACH OCCURRENCE $1,000,000 X OCCUR D CLAIMS MADE AGGREGATE $1,000,000 $ R DEDUCTIBLE I RETENTION I $ A WORKERS COMPENSATION AND 4060316440000 12/31/09 12/31/10 X I T'6~,9nJN" I I OJi!- EMPLOYERS' LIABILITY $1,000,000 E.l. EACH ACCIDENT E.L. DISEASE - EA EMPLOYEF $1,000,000 E.L. DISEASE - POLICY LIMIT 51,000,000 OTHER B Professional Liability G21656495007 07/04/10 07/04/11 Per Claim $1,000,000 Retroactive Date: Unlimited Aggregate $1,000,000 Deductible $400,000 DESCRIPTION OF OPERATIONSfLOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS All operations of the named insured. Professional Liability is written in aggregate limits of liability not less than the amount shown. Re: Water Conservation & Reuse Study (WCRS) and Comprehensive Water Plan (CWMP) . Carollo Project ~: 8406A.OO. The City of Ashland, Oregon, and its elected officials, officers and employees are included as additional insureds with respects to General & Auto Liability. CERTIFICATE HOLDER I I ADDITIONAL INSURED; INSURER LEnER; CANCELLATION *10 DAYS NOTICE FOR NON-PAYMENT OF PREMIUM SHOULD ANY OFTHE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION Ci ty of Ashland DATE THEREOF, THE ISSUING INSURER WILL ~~~MAIL ~ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, ~ 20 East Main Street Ashland, OR 97520 AUTHORIZED REPRESENTATIVE $- , USA ACORD 25-5 (7/97) anne10a 16461093 @ACORDCORPORATION 1988 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. @VANTAGE FOR AUTOMOBILE This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM The following schedule lists the coverage extensions provided by this endorsement. Refer to the individual provi- sions to determine the extent of your coverage. SCHEDULE OF COVERAGE EXTENSIONS 1. Additional Insured By Contract 11, Extra Expense - Broadened Coverage 2. Airbag Discharge 12, Fellow Employee Exclusion 3. Auto Theft Reward 13. Glass Repair - Waiver of Deductible 4, Blanket Waiver of Subrogation 14. Hired Auto Physical Damage Coverage 5. Bodily Injury Redefined - Mental Anguish 15. Hired Auto - Worldwide Coverage Territory 6, Broad Form Named Insured 16. Lease Gap Coverage 7. Communications Equipment 17, Liability Coverage - Supplementary Payments 8. Drive Other Car - Executive Officers 18, Newly Formed or Acquired Organizations 9: Duties In The Event of Accident, Claim, Suit or Loss 19. Physical Damage - Transportation Expenses 10. Emolovees As Insureds 20. Towina - Anv Auto 1, ADDITIONAL INSURED BY CONTRACT The Who Is An Insured provision under SECTION II - LIABILITY COVERAGE is amended to include as Ian additional insured any person or organization with whom you agreed in a written contract, written agreement or permit, to provide insurance such as is afforded under this Coverage Form. Such person or organization is an insured only with respect to liability for "bodily injury" or "property damage" caused, in whole or in part by your maintenance, operation or use of your covered "autos". With respect to the insurance afforded to these additional insureds, this insurance does not apply: a. Unless the written contract or agreement has been executed or the permit has been issued prior to the "bodily injury" or "property damage"; b, To any person or organization included as an insured by endorsement or in the Declarations, or c. To any,lessor of "autos" when their contract or agreement with you for such leased "auto" ends, 2. AIR BAG DISCHARGE " you purchased physical damage coverage for a covered "auto" under this policy, we will pay to reset or re- place an airbag that accidentally discharges without the vehicle being involved in an accident. No deductible applies to this additional coverage, However, this coverage only applies if the airbag is not covered under a manufacturer's warranty and you did not intentionally cause the airbag to discharge. 3, AUTO THEFT REWARD We will pay up to a $2,000 reward in the event of a covered loss, for information leading to the arrest and con- viction of anyone stealing a covered "auto", A reward will not be paid to you, a family member, employee or any public official while performing their duty. 4. BLANKET WAIVER OF SUBROGATION The Transfer Of Rights Of Recovery Against Others To Us condition under SECTION IV - LOSS CONDI- TIONS is replaced by the following: We will waive any right of recovery we may have against any person or organization because of payments we make for injury or damage arising out of the operation of a covered "auto" when you have assumed liability for such "bodily injury" or "property damage" under an "insured contract", provided the contract is in writing and executed prior to the "bodily injury" or "property damage". 5. BODILY INJURY REDEFINED - MENTAL ANGUISH The definition of "bodily injury" under SECTION V - DEFINITIONS is replaced by the following: "Bodily injury" means bodily injury, sickness, or disease sustained by a person, including mental anguish or death resulting from any of these at any time. VCA 2010205 Includes copyrighted material of Insurance Services Office, Inc. Copyright 2004, !!!!!!!!!!!!!1! I! II!!!!!!! II I!!! !1!1!!!! II!!!!I !I! @@@@@@@@@@@@@@@@@@@@@ Page 1 of 4 6. BROAD FORM NAMED INSURED a. The Who Is An Insured provision under SECTION II - LIABILITY COVERAGE is amended to include the following: . Any organization which is a legally incorporated entity in which you own a financial interest of more than 50% of the voting stock on the effective date of this Coverage Form will be a Named Insured until the 180th day or the end of the policy period whichever comes first, provided there is no other similar insurance avail- able to that organization. b. Paragraph a. of this provision 6. does not apply to "bodily injury" or "property damage" for which an "insured" is also an insured under any other automobile policy or would be an insured under such a policy, but for i1s termination or the exhaustion of its Ii mil of insurance, 7. COMMUNICATIONS EQUIPMENT a. The exclusion for electronic equipment under Exclusions of SECTION III - PHYSICAL DAMAGE COVERAGE does not apply to loss of any permanently installed, non-removable communications equipment designed for use as a: 1. Citizen's band radio; 2. Two-way mobile radio or telephone; 3. Scanning monilor receiver, or 4. GPS Navigation System including its antenna and other accessories, b. No Deductible applies to this additional coverage. c. The most we will pay for this coverage is $2,000 per occurrence, 8, DRIVE OTHER CAR - EXECUTIVE OFFICERS a. The Who Is An Insured provision under SECTION 11- LIABILITY COVERAGE is amended to include: If you are designated in the Declarations as: 1. An individual; you and your spouse, 2. A partnership; your partners and their spouses, 3. An organization other than an individual or a partnership; you "executive officers" and their spouses, b. SECTION II - LIABILITY COVERAGE and SECTION 11I- PHYSICAL DAMAGE COVERAGE are extended to include "autos' you don't own, hire, lease or borrow while in the care, custody or control of an insured listed in 8.a. This does not include any "auto": 1. Owned by any insured listed in 8.a., or any member of their household, including any such "auto" that is owned but not insured; 2. Used by an insured listed in 8.a. while working in the business of selling servicing, repairing or parking autos; or, 3, Insured under another policy of insurance. If Medical Payments, UninsuredlUnderinsured Motorist, Personal Injury Protection or other compulsory coverages required by the governing jurisdiction are covered on this policy, then insureds listed in 8.a, above and family members residing in the same households are "insureds" while: 1, Occupying as a passenger, or 2. A pedestrian when struck by any auto you do not own, hire, lease or borrow, except any auto owned by that insured listed in 8,a, their family members or an auto insured under any other policy. c. The limits and deductibles applicable to this provision will be the largest applicable to any owned "auto" for the specific insurance, d. The following definition is added to SECTION V - DEFINITIONS of the policy: "Executive officer" means a person holding any of the officer positions created by your charter, constitu- tion, by-laws or any similar governing document. e. The Other Insurance Condilion, under SECTION IV - BUSINESS AUTO CONDITIONS, does not apply to the provisions of this Drive Other Car endorsement. There is no "other insurance" applicable to this en- dorsement. Page 2 of 4 Includes copyrighted material of Insurance Services Office, Inc. Copyright 2004, !1!!!J!! I!!!! il!!!!! I!!!! !l! II!!! !1!!!1! I!!I !!!!!! VCA 201 0205 9, DUTIES IN THE EVENT OF ACCIDENT, CLAIM, SUIT OR LOSS Under SECTION IV - BUSINESS AUTO CONDITIONS - the Duties In The Event Of Accident, Claim, Suit Or Loss Condition is amended as follows: The requirements that you must a. notify us of an "accident" claim, "suit" or "loss" and b, send us documents concerning a claim or "suit" apply only when such "accident" claim, "suit" or "loss" is known to: a. You, if you are an individual; b, A partner, if you are a partnership; c. An executive officer of the corporation or insurance manager, if you are a corporation; or d. A manager, if you are a limited liability company. 10, EMPLOYEES AS INSUREDS The Who Is An Insured provision under SECTION II - LIABILITY COVERAGE is changed by adding the following: Any employee of yours while using a covered "auto" you don't own, hire or borrow in your business or your personal affairs. This coverage is excess over any other collectible insurance, 11. EXTRA EXPENSE - BROADENED COVERAGE Under Paragraph A, of SECTION 11I- PHYSICAL DAMAGE COVERAGE, the following Coverage is added: We will pay for the expense of returning a stolen covered "auto" to you subject to Paragraph C. Limit Of Insurance. 12. FELLOW EMPLOYEE EXCLUSION The Fellow Employee exclusion under SECTION II - LIABILITY COVERAGE does not apply if the "bodily injury" results from the use of a covered "auto" you own or hire. This coverage is excess over any other in- surance, 13, GLASS REPAIR - WAIVER OF DEDUCTIBLE Under Paragraph D. Deductible - of SECTION III - PHYSICAL DAMAGE COVERAGE, the following is added: No deductible applies to glass damage if the glass is repaired rather than replaced. 14. HIRED AUTO - PHYSICAL DAMAGE COVERAGE If hired "autos" are covered "autos" under SECTION II - LIABILITY COVERAGE and if Comprehensive, Specified Causes of Loss, or Collision coverages are provided under this policy for any "auto" you own, then SECTION III - PHYSICAL DAMAGE COVERAGE is extended to "autos" you hire, subject to the fol- lowing limit: The most we will pay for "loss" to any hired "auto" is the lesser of: a. $50,000, b. The actual cash value, or c, The cost of repairing or replacing it with other property of like kind or quality, The deductible will be equal to the largest deductible applicable to any owned "auto" for that coverage. No deductible applies to "loss" caused by fire or lightning, Hired Auto Physical Damage coverage is excess over any other collectible insurance. Subject to the above limit, deductible and excess provisions, we will provide coverage equal to the broadest coverage applicable to any covered "auto" you own. We will also cover loss of use of the hired "auto" if the following conditions are met: a. it results from an accident, b. you are legally liable, and c, the lessor incurs an actual financial loss. The most we will pay for this loss of use coverage is $1,000 per "accident". VCA 201 02 05 Includes copyrighted material of Insurance SelVices Office, Inc. Copyright 2004, ! II!! I!!! I!! I!! I! I! i!]!! I!! I!!!!! fl!!!!! rl!!!!!!!! Page 3 of 4 15. HIRED AUTO - WORLDWIDE COVERAGE TERRITORY The definition of coverage te~ritory in General Conditions- Policy Period, Coverage Territory - of SEC- TION IV - BUSINESS AUTO CONDITIONS is amended to add: Anywhere in the world for autos hired for 30 days or less, provided that any "suit" is brought in the United States of America (including its territories and possessions), Puerto Rico or Canada. 16. LEASE GAP COVERAGE Under Paragraph C, Limit of Insurance - of SECTION III - PHYSICAL DAMAGE COVERAGE, the follow- ing is added: ' We will also pay the difference between the actual cash value of a covered "auto" at the time of "loss" and the remaining balance on your lease if the following conditions are met: .a. The "auto" has a long term lease and is covered on this policy, b. The lessor is added as an Additional Insured in a written lease agreement. c. You are legally obligated for the remaining balance. We will. not pay for any amounts representing excess wear and tear charges; additional mileage charges; taxes; overdue payments; penalties, interest or charges resulting from overdue payments; or lease termina- tion fees, 17. LIABILITY COVERAGE EXTENSIONS - SUPPLEMENTARY PAYMENTS Under SECTION 11- LIABILITY COVERAGE, the Coverage Extension for Supplementary Payments is re- vised as follows: . a. The limit for the cost of bail bonds is amended to $3,500, b, The limit for reasonable expenses incurred by the "insured" is amended to $500 a day, 18, NEWLY FORMED OR ACQUIRED ORGANIZATIONS a. The Who Is An Insured provision under SECTION II - LIABILITY COVERAGE is amended to include as an "insured" any organization that is formed or acquired by you and over which you maintain majority ownership, b. Paragraph a. of this provision 18, does not apply to any organization: 1. That is a joint venture or partnership, 2, That is an "insured" under any other policy, 3. That has exhausted its Umit of Insurance under any other policy, or 4. 180 days or more after its acquisition or formation by you, unless you have given us notice of the acquisition or formation, c. Paragraph a. of this provision 18. does not apply to "bodily injury" or "property damage" that results from an "accident" that occurred before you formed or acquired the organization, 19. PHYSICAL DAMAGE - TRANSPORTATION EXPENSES COVERAGE Under SECTION 11I- PHYSICAL DAMAGE Coverage Extensions, the limit for Transportation Expenses is amended to $75 per day and the maximum is amended to $1,800, 20, TOWING - COVERED AUTOS Under SECTION 11I- PHYSICAL DAMAGE COVERAGE, Coverage for Towing is amended as follows: a. This coverage applies to any covered "auto" for which a premium charge for towing and labor is shown in the Schedule or in the Declarations. b. The limit is $100. Page 4 of 4 Includes copyrighted material of Insurance Services Office, Inc. Copyright 2004, !! I!!!!!!!! t!!!! I!!!!!!!!! !l!!! I!! [!I!! [!1!1!1 !I!! VCA 201 02 05 ADDITIONAL INSURED This form modifies insurance provided under the following: GL CONTRACTORS EXTENDER (VCG 206 02 05) WHO IS AN INSURED - (Section II) is deleted and replaced by the following wording: A. Section II - Who Is An Insured is amended to include as an additional insured any person or organization for whom you are performing operations when you and such person or organization have agreed in writing in a contract, agreement or permit that such person or organization be added as an additional insured on your policy. Such person or organization is an additional insured only with respect to liability for "bodily injury," "property damage" or "personal and advertising injury" caused, in whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing and completed operations for the additional insured, The insurance provided to the additional insured is limited as follows: a) This endorsement shall not increase the limits stated in Section 111- LIMITS OF INSURANCE. b) This insurance does not apply to "bodily injury: or "property damage" caused by "your work" included in the "products-completed operations hazard" unless you are required to provide such coverage for the additional insured by a written contract or written agreement in effect during this policy period and signed and executed by you prior to the loss for which coverage is sought. B. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to: 1, "Bodily injury," "property damage" or "personal and advertising injury" arising out of the rendering of, or the failure to render, any professional architectural, engineering or surveying services, including: a, 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, inspections, architectural or engineering activities. Primary & Non-Contributory: Any coverage provided by this endorsement to an additional insured shall be excess over any other valid and collectible insurance available to the additional insured whether primary, excess, contingent or on any other basis unless a written contract or written agreement in effect during this policy period and signed and executed by you prior to the loss for which coverage is sought specifically requires that this insurance apply on a primary or noncontributory basis. Separation of Insureds: Except with respect to the Limits of Insurance, and any rights or duties specifically assigned in this Coverage Part to the first Named Insured, this insurance applies: a. As if each Named Insured were the only Named Insured; and b, Separately to each insured against whom claim is made or "suit" is brought. Per Project Aggregate: Under Section III = Limits of Insurance, the General Aggregate Limit applies separately to each of your projects away from premises owned by or rented to you. Waiver of Subrogation: Section IV - Transfer of Rights of Recovery Against Others to Us Condition is amended to add the following: We will waive any right of recovery we may have against any person or organization because of payments we make for injury or damage arising out of your ongoing operations done under a written contract or agreement with that person or organization and included in "your work" or the "products-completed operations hazard". This waiver applies only to persons or organizations with whom you have a written contract executed prior to the "bodily injury" or "property damage", that requires you to waive your rights of recovery. Narnedlnsured: Carollo Engineers, A Professional Corporation Additional Insured: Policy No,: 71B0103170000 Any person or organization with whom you have agreed in written contract, executed prior to loss, to name as additional insured. ACORDm CERTIFICATE OF LIABILITY INSURANCE I DATE (MMfDDIYY) 06/30/10 PRODUCER 0564249 1-800-833-7337 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Heffernan Insurance Brokers/ ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Heffernan Professional Practices HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 1808 Embarcadero Road, Suite A ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, Palo Alto, CA 94303 INSURERS AFFORDING COVERAGE INSURED INSURER A:. OneBeacon America Insurance Comnanv Carollo Engineers, A Professional Corporation INSURER B: ACE American Insurance Company 10540 Talbert Avenue, Suite 200 East INSURER c: Fountain Valley, CA 92708 INSURER 0: I INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INOICATED. NOTWITHSTANOING 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. I J.N1i~ TYPE OF INSURANCE POLlCY NUMBER PEH~Y EFFECTIVE POLlCY EXPIRATION A ~NERAL LIABILITY X COMMERCIAL GENERAL LIABILITY -1 CLAIMS MADE 0 OCCUR 7180103170000 12/31/09 12/31/10 LIMITS $1,000,000 $500,000 $25,000 $1,000,000 $ 2,000,000 PRODUCTS - COMP/OP AGG $ 2, 000, 000 FIRE DAMAGE (Anyone fire) MED EXP (Anyone person) PERSONAL & ADV INJURY EACH OCCURRENCE e- e- ~'L AGGR~E LIMIT AP~S PER I J POLICY I X I ~~R.,: I I LOC A ~TOMOBILE LIABILITY ~ ANY AUTO ~ ALL OWNED AUTOS ~ SCHEDULED AUTOS ~ HIRED AUTOS f--- NON-OWNED AUTOS - GENERAl AGGREGATE 7180103170000 12/31/09 nRAGE L.IABIL.ITY H ANY AUTO A ~ESS LIABILITY ~ OCCUR D CLAIMS MADE h DEDUCTIBL.E H ~ETENTION $ A WORKERS COMPENSATION AND EMPL.OYERS' LIABILITY 7180103170000 12/31/09 4060316440000 12/31/09 OTHER B Professional Liability G21656495007 Retroactive Date: Unlimited 07/04/10 07/04/11 Per Claim Aggregate Deductible Sl,OOO,OOO Sl,OOO,OOO s400,000 DESCRIPTION OF OPERATIONS/L.OCATlONSNEHICL.ES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS All operations of the named insured. Professional Liability is written in aggregate limits of liability not less than the amount shown. Re: Complete all engineering fora Categorical Exclusion (CE) for the installation of 1040 ZeeWeed embrane filter module at the Ashland Wastewater Treatment Plant, Carollo project #: Not yet assigned The City of Ashland, Oregon, and its elected officials, officers and employees are included as additional insureds with respects to General and Auto Liability. CERTIFICATE HOLDER I I ADDITIONAL. INSURED; INSURER L.ETTER; CANCELLATION *10 DAYS NOTICE FOR NON-PAYMENT OF PREMIUM SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELL.ED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ~~'~MAlL ~ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, ~ City of Ashland 20 E. Main Street Ashland, OR 97520 , ACORD 25-5 (7/97) anne1.. 16461087 USA ~iIl"'--l~XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX AUTHORIZED REPRESENTATIVE $- @ACORDCORPORATION 1988 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. @VANTAGE FOR AUTOMOBILE This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM The following schedule lists the coverage extensions provided by this endorsement. Refer to the individual provi- sions to determine the extent of your coverage. SCHEDULE OF COVERAGE EXTENSIONS 1, Additional Insured By Contract 11, Extra Expense - Broadened Coverage 2. Airbag Discharge 12, Fellow Employee Exclusion 3. Auto Theft Reward 13, Glass Repair - Waiver of Deductible 4, Blanket Waiver of Subrogation 14. Hired Auto Physical Damage Coverage 5. Bodily Injury Redefined - Mental Anguish 15. Hired Auto - Worldwide Coverage Territory 6. Broad Form Named Insured 16, Lease Gap Coverage 7, Communications Equipment 17. Liability Coverage - Supplementary Payments 8. Drive Other Car - Executive Officers 18, Newly Formed or Acquired Organizations 9. Duties In The Event of Accident, Claim, Suit or Loss 19. Physical Damage - Transportation Expenses 10. Emolovees As Insureds 20. Towina - Anv Auto 1. ADDITIONAL INSURED BY CONTRACT The Who Is An Insured provision under SECTION II - LIABILITY COVERAGE is amended to include as Ian additional insured any person or organization with whom you agreed in a written contract, written agreement or permit, to provide insurance such as is afforded under this Coverage Form, Such person or organization is an insured only with respect to liability for "bodily injury" or "property damage" caused, in whole or in part by your maintenance, operation or use of your covered "autos". With respect to the insurance afforded to these additional insureds, this insurance does not apply: a, Unless the written contract or agreement has been executed or the permit has been issued prior to the "bodily injury" or "property damage"; b. To any person or organization included as an insured by endorsement or in the Declarations, or c. To any, lessor of "autos" when their contract or agreement with you for such leased "auto" ends, 2, AIRBAG DISCHARGE If you purchased physical damage coverage for a covered "auto" under this policy, we will pay to reset or re- place an airbag that accidentally discharges without the vehicle being involved in an accident. No deductible applies to this additional coverage, However, this coverage only applies if the airbag is not covered under a manufacturer's warranty and you did not intentionally cause the airbag to discharge. 3, AUTO THEFT REWARD We will pay up to a $2,000 reward in the event of a covered loss, for information leading to the arrest and con- viction of anyone stealing a covered "auto". A reward will not be paid to you, a family member, employee or any public official while performing their duty. 4. BLANKET WAIVER OF SUBROGATION The Transfer Of Rights Of Recovery Against Others To Us condition under SECTION IV - LOSS CONDI- TIONS is replaced by the following: We will waive any right of recovery we may have against any person or organization because of payments we make for injury or damage arising out of the operation of a covered "auto" when you have assumed liability for such "bodily injury" or "property damage" under an "insured contract", provided the contract is in writing and executed prior to the "bodily injury" or "property damage", 5. BODILY INJURY REDEFINED - MENTAL ANGUISH The definition of "bodily injury" under SECTION V - DEFINITIONS is replaced by the following: "Bodily injury" means bodily injury, sickness, or disease sustained by a person, including mental anguish or death resulting from any of these at any time. veA 201 02 05 Includes copyrighted material of Insurance Services Office, Inc. Copyright 2004, !!1 !!!!!!! !!l!!!! ill!! I!!!!!!!!! !!!!!!! I!l!! 11!1!! @@@@@@@@@@@@@@@@@@@@@ Page 1 of 4 6. BROAD FORM NAMED INSURED a. The Who Is An Insured provision under SECTION II - LIABILITY COVERAGE is amended to include the following: . Any organization which is a legally incorporated entity in which you own a financial interest of more than 50% of the voting stock on the effective date of this Coverage Form will be a Named Insured until the 180th day or the end of the policy period whichever comes first, provided there is no other similar insurance avail- able to that organization. . b. Paragraph a. of this provision 6. does not apply to "bodily injury" or "property damage" for which an "insured" is also an insured under any other automobile policy or would be an insured under such a policy, but for ITS termination or the exhaustion of its limIT of insurance, 7. COMMUNICATIONS EQUIPMENT a. The exclusion for electronic equipment under Exclusions of SECTION III - PHYSICAL DAMAGE COVERAGE does not apply to loss of any permanently installed, non-removable communications equipment designed for use as a: 1. Citizen's band radio; 2. Two-way mobile radio or telephone; 3. Scanning monITor receiver, or 4. GPS Navigation System including its antenna and other accessories, b. No Deductible applies to this additional coverage, c. The most we will pay for this coverage is $2,000 per occurrence. 8, ORNE OTHER CAR - EXECUTIVE OFFICERS a. The Who Is An Insured provision under SECTION 11- LIABILITY COVERAGE is amended to include: If you are designated in the Declarations as: 1, An individual; you and your spouse, 2, A partnership; your partners and their spouses, 3. An organization other than an individual or a partnership; you "executive officers" and their spouses. b. SECTION II - LIABILITY COVERAGE and SECTION III - PHYSICAL DAMAGE COVERAGE are extended to include "autos" you don't own, hire, lease or borrow while in the care, custody or control of an insured listed in 8.a. This does not include any "auto": 1. Owned by any insured listed in 8.a., or any member of their household, including any such "auto. that is owned but not insured; 2. Used by an insured listed in 8,8. while working in the business of selling servicing, repairing or parking autos; or, 3, Insured under another policy of insurance. If Medical Payments, Uninsured/Underinsured Motorist, Personal Injury Protection or other compuisory coverages required by the governing jurisdiction are covered on this policy, then insureds listed in 8.a. above and family members residing in the same households are "insureds. while: 1, Occupying as a passenger, or 2. A pedestrian when struck by any auto you do not own, hire, lease or borrow, except any auto owned by that insured listed in 8,a, their family members or an auto insured under any other policy. c, The limits and deductibles applicable to this provision will be the largest applicable to any owned "auto. for the specific insurance, d. The following definition is added to SECTION V - DEFINITIONS of the policy: "Executive officer" means a person holding any of the officer positions created by your charter, constitu- tion, by-laws or any similar governing document. e, The Other Insurance Condition, under SECTION IV - BUSINESS AUTO CONDITIONS, does not apply to the provisions of this Drive Other Car endorsement. There is no "other insurance" applicable to this en- dorsement. Page 2 of 4 Includes copyrighted material of Insurance Services Office, Inc. Copyright 2004, II!!! l!!!!!!!!!! !l! II!!! Ill!I!!!!!! r!!!!!!! !!!!!!! VCA 201 02 05 9, DUTIES IN THE EVENT OF ACCIDENT, CLAIM, SUIT OR LOSS Under SECTION IV - BUSINESS AUTO CONDITIONS - the Dilties In The Event Of Accident, Claim, Suit Or Loss Condition is amended as follows: The requirements that you must a, notify us of an "accident" claim, "suit" or "loss" and b. send us documents concerning a claim or "suit" apply only when such "accident" claim, "suit" or "loss" is known to: a. You, if you are an individual; b, A partner, if you are a partnership; c. An executive officer of the corporation or insurance manager, if you are a corporation; or d. A manager, if you are a limited liability company. 10, EMPLOYEES AS INSUREDS. The Who Is An Insured provision under SECTION II - LIABILITY COVERAGE is changed by adding the following: Any employee of yours while using a covered "auto" you don't own, hire or borrow in your business or your personal affairs. This coverage is excess over any other collectible insurance, 11, EXTRA EXPENSE - BROADENED COVERAGE Under Paragraph A, of SECTION 11I- PHYSICAL DAMAGE COVERAGE, the following Coverage is added: We will pay for the expense of returning a stolen covered "auto" to you subject to Paragraph C. Limit Of Insurance. 12. FELLOW EMPLOYEE EXCLUSION The Fellow Employee exclusion under SECTION II - LIABILITY COVERAGE does not apply if the "bodily injury" results from the use of a covered "auto" you own or hire, This coverage is excess over any other in- surance, 13, GLASS REPAIR - WAIVER OF DEDUCTIBLE Under Paragraph D, Deductible - of SECTION III - PHYSICAL DAMAGE COVERAGE, the following is added: No deductible applies to glass damage if the glass is repaired rather than replaced. 14, HIRED AUTO - PHYSICAL DAMAGE COVERAGE If hired "autos" are covered "autos" under SECTION II - LIABILITY COVERAGE and if Comprehensive, Specified Causes of Loss, or Collision coverages are provided under this policy for any "auto" you own, then SECTION III - PHYSICAL DAMAGE COVERAGE is extended to "autos" you hire, subject to the fol- lowing limit: The most we will pay for "loss" to any hired "auto" is the lesser of: a. $50,000, b. The actual cash value, or c, The cost of repairing or replacing it with other property of like kind or quality, The deductible will be equal to the largest deductible applicable to any owned "auto" for that coverage, No deductible applies to "loss" caused by fire or lightning. Hired Auto Physical Damage coverage is excess over any other collectible insurance. Subject to the above limit, deductible and excess provisions, we will provide coverage equal to the broadest coverage applicable to any covered "auto" you own. We will also cover loss of use of the hired "auto" if the following conditions are met: a. it results from an accident, b, you are legally liable, and c, the lessor incurs an actual financial loss, The most we will pay for this loss of use coverage is $1,000 per "accident", VCA 201 02 05 Includes copyrighted material of Insurance Services Office, Inc. Copyright 2004, 1!1!!1 !!!!!!!!!1 I!!! !l! I!!] I!!!!! !!!!!!l!1 1!!!1 II! Page 3 of 4 15. HIRED AUTO - WORLDWIDE COVERAGE TERRITORY The definition of coverage territory in General Conditions- Policy Period, Coverage Territory - of SEC- TION IV - BUSINESS AUTO CONDITIONS is amended to add: Anywhere in the world for autos hired for 30 days or less, provided that any "suit" is brought in the United States of America (including its territories and possessions), Puerto Rico or Canada, 16. LEASE GAP COVERAGE Under Paragraph C, Limit of Insurance - of SECTION III - PHYSICAL DAMAGE COVERAGE, the follow- ing is added: ' We will also pay the difference between the actual cash value of a covered "auto" at the time of "loss" and the remaining balance on your lease if the following conditions are met: a. The "auto" has a long term lease and is covered on this policy, b. The lessor is added as an Additional Insured in a written lease agreement. c. You are legally obligated for the remaining balance. We will. not pay for any amounts representing excess wear and tear charges; additional mileage charges; taxes; overdue payments; penalties, interest or charges resulting from overdue payments; or lease termina- tion fees, 17. LIABILITY COVERAGE EXTENSIONS - SUPPLEMENTARY PAYMENTS Under SECTION 11- LIABILITY COVERAGE, the Coverage Extension for Supplementary Payments is re- vised as follows:. . a. The limit for the cost of bail bonds is amended to $3,500. b, The limit for reasonable expenses incurred by the "insured" is amended to $500 a day, 18. NEWLY FORMED OR ACQUIRED ORGANIZATIONS a. The Who Is An Insured provision under SECTION II - LIABILITY COVERAGE is amended to include as an "insured" any organization that is formed or acquired by you and over which you maintain majority ownership, b, .Paragraph a. of this provision 18. does not apply to any organization: 1. That is a joint venture or partnership, 2. That is an "insured" under any other policy, 3. That has exhausted its Limit of Insurance under any other policy, or 4. 180 days or more after its acquisition or formation by you, unless you have given us notice of the acquisition or formation, c. Paragraph a. of this provision 18. does not apply to "bodily injury" or "property damage" that results from an "accident" that occurred before you formed or acquired the organization, 19, PHYSICAL DAMAGE - TRANSPORTATION EXPENSES COVERAGE Under SECTION 11I- PHYSICAL DAMAGE Coverage Extensions, the limit for Transportation Expenses is amended to $75 per day and the maximum is amended to $1,800, 20. TOWING - COVERED AUTOS Under SECTION 11I- PHYSICAL DAMAGE COVERAGE, Coverage for Towing is amended as follows: a. This coverage applies to any covered "auto" for which a premium charge for towing and labor is shown in the Schedule or in the Declarations. b. The limit is $100, Page 4 of 4 Includes copyrighted material of Insurance Services Office, Inc. Copyright 2004, !!!!!!!1!!! !!!!1 !!!!!!!! 11 III II II!!! I!! I!!!!!! !I!! VCA 201 02 05 ADDITIONAL INSURED This form modifies insurance provided under the following: GL CONTRACTORS EXTENDER (VCG 206 02 05) WHO IS AN INSURED - (Section II) is deleted and replaced by the following wording: A. Section II - Who Is An Insured is amended to include as an additional insured any person or organization for whom you are performing operations when you and such person or organization have agreed in writing in a contract, agreement or permit that such person or organization be added as an additional insured on your policy. Such person or organization is an additional insured only with respect to liability for "bodily injury," "property damage" or "personal and advertising injury" caused, in whole or in part, by: 1, Your acts or omissions; or 2, The acts or omissions of those acting on your behalf; in the performance of your ongoing and completed operations for the additional insured. The insurance provided to the additional insured is limited as follows: a) This endorsement shall not increase the limits stated in Section 111- LIMITS OF INSURANCE, b) This insurance does not apply to "bodily injury: or "property damage" caused by "your work" included in the "products-completed operations hazard" unless you are required to provide such coverage for the additional insured by a written contract or written agreement in effect during this policy period and signed and executed by you prior to the loss for which coverage is sought. B, With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to: 1, "Bodily injury," "property damage" or "personal and advertising injury" arising out of the rendering of, or the failure to render, any professional architectural, engineering or surveying services, including: a. 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, inspections, architectural or engineering activities. Primary & Non-Contributory: Any coverage provided by this endorsement to an additional insured shall be excess over any other valid and collectible insurance available to the additional insured whether primary, excess, contingent or on any other basis unless a written contract or written agreement in effect during this policy period and signed and executed by you prior to the loss for which coverage is sought specifically requires that this insurance apply on a primary or noncontributory basis. Separation of Insureds: Except with respect to the Limits of Insurance, and any rights or duties speCifically assigned in this Coverage Part to the first Named Insured, this insurance applies: a. As if each Named Insured were the only Named Insured; and b. Separately to each insured against whom claim is made or "suit" is brought. . Per Project Aggregate: Under Section III = Limits of Insurance, the General Aggregate Limit applies separately to each of your projects away from premises owned by or rented to you, Waiver of Subrogation: Section IV - Transfer of Rights of Recovery Against Others to Us Condition is amended to add the following: We will waive any right of recovery we may have against any person or organization because of payments we make for injury or damage arising out of your ongoing operations done under a written contract or agreement with that person or organization and included in "your work" or the "products-completed operations hazard". This waiver applies only to persons or organizations with whom you have a written contract executed prior to the "bodily injury" or "property damage", that requires you to waive your rights of recovery. Named Insured: Carollo Engineers, A Professional Corporation Additional Insured: Policy No,: 7180103170000 Any person or organization with whom you have agreed in written contract, executed prior to loss, to name as additional insured.