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HomeMy WebLinkAboutRANESES, MICHAEL - 2018INSURANCE ON FILE Oe UORK MAY PROCEED do NTIL INSURANCE EXPIRES CLERK OF CO NCIL DATE. N-2018-088 MAY 2 9 2018 AGREEMENT WITH MICHAEL RANESES TO SERVE AS A HEARING OFFICER THIS AGREEMENT is made and entered into this 27th day of February, 2018 by and between Michael Raneses, ("Contractor"), and the City of Santa Ana, a charter city and municipal corporation organized and existing under the Constitution and laws of the State of California ("City"). RECITALS A. The City desires to retain a contractor having special skill and knowledge in the field of arbitration and mediation to provide on-call professional administrative hearing services. B. Contractor represents that Contractor is able and willing to provide such services to the City. C. In undertaking the performance of this Agreement, Contractor represents that it is knowledgeable in its field and that any services performed by Contractor ander this Agreement will be performed in compliance with such standards as may reasonably be expected from a professional consulting firm in the field. NOW THEREFORE, in consideration of the mutual and respective promises, and subject to the terms and conditions hereinafter set forth, the parties agree as follows: 1. SCOPE OF SERVICES Contractor will provide on-call professional administrative hearing services for the City of Santa Ana Planning and Building Services Agency, as set forth in the attached Exhibit A, incorporated by reference into this Agreement. COMPENSATION a. City agrees to pay, and Contractor agrees to accept as total payment for its services for City, the rates and charges identified in Exhibit A. The total sum to be expended during the term of this Agreement shall not exceed $10,000. b. Payment by City shalt be made within 45 days (forty-five) days following receipt of proper invoice evidencing work performed, subject to City accounting procedures. Payment need not be made for work which fails to meet the standards of performance set forth in the Recitals which may reasonably be expected by City. 3. TERM This Agreement shall commence on the date first written above for a two (2) year term with the option for the City to grant up to a one (1) year renewal, exercisable by a writing by the City Manager and the City Attorney, unless terminated earlier in accordance with Section 13, below. Page 1 of 7 4. INDEPENDENT CONTRACTOR Contractor shall, during the entire term of this Agreement, be construed to be an independent contractor and not an employee of the City. This Agreement is not intended nor shall it be construed to create an employer-employee relationship, a joint venture relationship, or to allow the City to exercise discretion or control over the professional manner in which Contractor performs the services which are the subject matter of this Agreement; however, the services to be provided by Contractor shall be provided in a manner consistent with all applicable standards and regulations governing such services. Contractor shall pay all salaries and wages, employer's social security taxes, unemployment insurance and similar taxes relating to employees and shall be responsible for all applicable withholding taxes. 5. INSURANCE Prior to undertaking performance of work under this Agreement, Contractor shall maintain and shall require its subcontractors, if any, to obtain and maintain insurance as described below: a. Commercial General Liability Insurance. Contractor shall maintain commercial general liability insurance naming the City, its officers, employees, agents, volunteers and representatives as additional insured(s) and shall include, but not be limited to protection against claims arising from bodily and personal injury, including death resulting therefrom and damage to property, resulting from any act or occurrence arising out of Contractor's operations in the performance of this Agreement, including, without limitation, acts involving vehicles. The amounts of insurance shall be not less than the following: single limit coverage applying to bodily and personal injury, including death resulting therefrom, and property damage, in the total,amount of $1,000,000 per occurrence, with $2;000,000 in the aggregate. Such insurance shall (a) name the City, its officers, employees, agents, and representatives as additional insured(s); (b) be primary and not contributory with respect to insurance or self-insurance programs maintained by the City; and (c) contain standard separation of insureds provisions. b. Business automobile liability insurance, or equivalent form, with a combined single limit for coverage as stated in the attached certificates of insurance provided as Exhibit B to this Agreement. Such insurance shall include coverage for owned, hired and non -owned automobiles. C. Worker's Compensation Insurance. In accordance with the provisions of Section 3700 of the Labor Code, Contractor, if Contractor has any employees, is required to be insured against liability for worker's compensation or to undertake self- insurance. Prior to commencing the performance of the work under this Agreement, Contractor agrees to obtain and maintain any employer's liability insurance with limits not less than $1,000,000 per accident. d. If Contractor is or employs a licensed professional such as an architect or engineer: Professional liability (errors and omissions) insurance, with a combined single limit of not less than $1,000,000 per claim with $2,000,000 in the aggregate. C. The following requirements apply to the insurance to be provided by Contractor Page 2 of 7 pursuant to this section: i. Contractor shall maintain all insurance required above in full force and effect for the entire period covered by this Agreement. ii. Certificates of insurance shall be furnished to the City upon execution of this Agreement and shall be approved by the City. iii. Certificates and policies shall state that the policies shall not be canceled or reduced in coverage or changed in any other material aspect without thirty (30) days prior written notice to the City. iv. Contractor shall supply City with a fully executed additional insured endorsement. f If Contractor fails or refuses to produce or maintain the insurance required by this section or fails or refuses to furnish the City with required proof that insurance has been procured and is in force and paid for, the City shall have the right, at the City's election, to forthwith terminate this Agreement. Such termination shall not affect Contractor's right to be paid for its time and materials expended prior to notification of termination. Contractor waives the right to receive compensation and agrees to indemnify the City for any work performed prior to approval of insurance by the City. 6. INDEMNIFICATION Contractor agrees to defend, and shall indemnify and hold harmless the City, its officers, agents, employees, contractors, special counsel, and representatives from liability: (1) for personal injury, damages, just compensation, restitution, judicial or equitable relief arising out of claims for personal injury, including death, and claims for property damage, which may arise from the negligent operations of the Contractor, its subcontractors, agents, employees, or other persons acting on its behalf which relates to the services described in section 1 of this Agreement; and (2) from any claim that personal injury, damages, just compensation, restitution, judicial or equitable relief is due by reason of the terms of or effects arising from this Agreement. This indemnity and hold harmless agreement applies to all claims for damages, just compensation, restitution, judicial or equitable relief suffered, or alleged to have been suffered, by reason of the events referred to in this Section or by reason of the terms of, or effects, arising from tliis Agreement. The Contractor further agrees to indemnify, hold harmless, and pay all costs for the defense of the City, including fees and costs for special counsel to be selected by the City, regarding any action by a third party challenging the validity of this Agreement, or asserting that personal injury, damages, just compensation, restitution, judicial or equitable relief due to personal or property rights arises by reason of the terms of, or effects arising from this Agreement. City may make all reasonable decisions with respect to its representation in any legal proceeding. Notwithstanding the foregoing, to the extent Contractor's services are subject to Civil Code Section 2782.8, the above indemnity shall be limited, to the extent required by Civil Code Section 2782.8, to claims that arise out of', pertain to, or relate to the negligence, recklessness, or willful misconduct of the Contractor. RECORDS Contractor shall keep records and invoices in connection with the work to be performed under this Agreement. Contractor shall maintain complete and accurate records with respect to Page 3 of 7 the costs incurred under this Agreement and any services, expenditures, and disbursements charged to the City for a minimum period of three (3) years, or for any longer period required by law, from the date of final payment to Contractor under this Agreement. All such records and invoices shall be clearly identifiable. Contractor shall allow a representative of the City to examine, audit, and make transcripts or copies of such records and any other documents created pursuant to this Agreement during regular business hours. Contractor shall allow inspection of all work, data, documents, proceedings, and activities related to this Agreement for a period of three (3) years from the date of final payment to Contractor under this Agreement. 8. CONFIDENTIALITY If Contractor receives from the City information which due to the nature of such information is reasonably understood to be confidential and/or proprietary, Contractor agrees that it shall not use or disclose such information except in the performance of this Agreement, and further agrees to exercise the same degree of care it uses to protect its own information of like importance, but in no event less than reasonable care. "Confidential Information' shall include all nonpublic information. Confidential information includes not only written information, but also information transferred orally, visually, electronically, or by other means. Confidential information disclosed to either party by any subsidiary and/or agent of the other party is covered by this Agreement. The foregoing obligations of non-use and nondisclosure shall not apply to any information that (a) has been disclosed in publicly available sources; (b) is, through no fault of the Contractor disclosed in a publicly available source; (c) is in rightful possession of the Contractor without an obligation of confidentiality; (d) is required to be disclosed by operation of law; or (e) is independently developed by the Contractor without reference to information disclosed by the City. 9. CONFLICT OF INTEREST CLAUSE Contractor covenants that it presently has no interests and shall not have interests, direct or indirect, which would conflict in any manner with performance of services specified under this Agreement. 10. DISCRIMINATION Contractor shall not discriminate because of race, color, creed, religion, sex, marital status, sexual orientation, age, national origin, ancestry, or disability, as defined and prohibited by applicable law, in the recruitment, selection, training, utilization, promotion, termination or other employment related activities. Contractor affirms that it is an equal opportunity employer and shall comply with all applicable federal, state and local laws and regulations. 11. EXCLUSIVITY AND AMENDMENT This Agreement represents the complete and exclusive statement between the City and Contractor, and supersedes any and all other agreements, oral or written, between the parties. In the event of a conflict between the terms of this Agreement and any attachments hereto, the terms of this Agreement shall prevail. This Agreement may not be modified except by written instrument Page 4 of 7 signed by the City and by an authorized representative of Contractor. The parties agree that any terms or conditions of any purchase order or other instrument that are inconsistent with, or in addition to, the terms and conditions hereof, shall not bind or obligate Contractor or the City. Each party to this Agreement acknowledges that no representations, inducements, promises or agreements, orally or otherwise, have been made by any party, or anyone acting on behalf of any party, which is not embodied herein. 12. ASSIGNMENT Inasmuch as this Agreement is intended to secure the specialized services of Contractor, Contractor may not assign, transfer, delegate, or subcontract any interest herein without the prior written consent of the City and any such assignment, transfer, delegation or subcontract without the City's prior written consent shall be considered null and void. Nothing in this Agreement shall be construed to limit the City's ability to have any of the services which are the subject to this Agreement performed by City personnel or by other contractors retained by City. 13. TERMINATION This Agreement may be terminated by the City upon thirty (30) days written notice of termination. In such event, Contractor shall be entitled to receive and the City shall pay Contractor compensation for all services performed by Contractor prior to receipt of such notice of termination, subject to the following conditions: a. As a condition of such payment, the Executive Director may require Contractor to deliver to the City all work product(s) completed as of such date, and in such case such work product shall be the property of the City unless prohibited by law, and Contractor consents to the City's use thereof for such purposes as the City deems appropriate. b. Payment need not be made for work which fails to meet the standard of performance specified in the Recitals of this Agreement. 14. WAIVER No waiver of breach, failure of any condition, or any right or remedy contained in or granted by the provisions of this Agreement shall be effective unless it is in writing and signed by the party waiving the breach, failure, right or remedy. No waiver of any breach, failure or right, or remedy shall be deemed a waiver of any other breach, failure, right or remedy, whether or not similar, nor shall any waiver constitute a continuing waiver unless the writing so specifies. 15. JURISDICTION - VENUE This Agreement has been executed and delivered in the State of Cal ifornia and the validity, interpretation, performance, and enforcement of any of the clauses of this Agreement shall be determined and governed by the laws of the State of California. Both parties further agree that Orange County, California, shall be the venue for any action or proceeding that may be brought or arise out of, in connection with or by reason ofthis Agreement. Page 5 of 7 16. PROFESSIONAL LICENSES Contractor shall, throughout the term of this Agreement, maintain all necessary licenses, permits, approvals, waivers, and exemptions necessary for the provision of the services hereunder and required by the laws and regulations of the United States, the State of California, the City of Santa Ana and all other govemrpental agencies. Contractor shall notify the City immediately and in writing of its inability to obtain or maintain such permits, licenses, approvals, waivers, and exemptions. Said inability shall be cause for termination of this Agreement. 17. MISCELLANEOUS PROVISIONS a. Each undersigned represents and warrants that its signature herein below has the power, authority and right to bind their respective parties to each of the terms of this Agreement, and shall indemnify City fully, including reasonable costs and attorney's fees, for any injuries or damages to City in the event that such authority or power is not, in fact, held by the signatory or is withdrawn. b. All Exhibits referenced herein and attached hereto shall be incorporated as if fully set forth in the body of this Agreement. 18. NOTICE Any notice, tender, demand, delivery, or other communication pursuant to this Agreement shall be in writing and shall be deemed to be properly given if delivered in person or mailed by first class or certified mail, postage prepaid, or sent by fax or other telegraphic communication in the manner provided in this Section, to the following persons: To City: Cleric of the City Council City of Santa Ana 20 Civic Center Plaza (M-30) P.O. Box 1988 Santa Ana, CA 92702-1988 Fax: 714- 647-6956 With courtesy copies to: Executive Director, Planning and Building Sonia R. Carvalho Agency City Attorney City of Santa Ana City of Santa Ana 20 Civic Center Plaza (M-19) 20 Civic Center Plaza (M-29) P.O. Box 1988 P.O. Box 1988 Santa Ana, California 92702 Santa Ana, California 92702 Fax: 714-647-5897 Fax: 714- 647-6515 Page 6 of 7 N-2018-088 To Contractor: Michael Raneses 2409 Miramome Court Tustin, CA 92782 A party may change its address by giving notice in writing to the other party. Thereafter, any commmiication shall be addressed and transmitted to the new address. If sent by mail, communication shall be effective or deemed to have been given three (3) days after it has been deposited in the United States mail, duly registered or certified, with postage prepaid, and, addressed as set forth above. If sent by fax, communication shall be effective or deemed to have been given twenty-four (24) hours after the time set forth on the transmission report issued by the transmitting facsimile machine, addressed as set forth above. For purposes of calculating these time frames, weekends, federal, state, County or City holidays shall be excluded. IN WPfNESS WHEREOF, the parties hereto have executed this Agreement the date and year first above written. ATTEST: &�c4'1clzaa Ue' Maria D. Huizar Clerk of the Council APPROVED AS TO FORM: SONIA R. CARVALHO City Attorney Lisa Storck Assistant City Attorney RECOMMENDED FOR APPROVAL: Candida Neal Acting Executive Director Planning and Building Services Agency CITY OF SANTA ANA �M r S§Ciodmez 11 City Manager CONTRACTOR: Michael neses Page 7 of 7 EXHIBIT A SCOPE OF SERVICES Exhibit A Michael Raneses 2409 Miramonte Court, Tustin, CA 92782 1 714.287.4999 1 mikeraneses@gmail.com December 15, 2017 Estella Rodarte Code Enforcement Supervisor City of Santa Ana Planning & Building Agency 20 Civic Center Plaza Santa Ana, CA 92701 Dear Ms Rodarte, At your request, I am submitting the following information for your consideration of my selection as a Hearing Officer for your agency. Experience Please see enclosed resume Scope of Work Provision of a full range of Administrative Hearing services in accordance with the Santa Ana Municipal Code Availability I am available to serve as a Hearing Officer M ,,, on an on-call basis for the City. Fee Schedule I request a fee of $100 per hour for any time spent in case preparation and research, conducting hearings, and for preparation of reports following hearings. Term of Contract I will commit to serve as a Hearing Officer for a term of one year, rererovfe q�aHp. Ms Rodarte, I appreciate your considering my application. I look forward to talking with you, and serving as a Hearing officer for the City of Santa Ana. Sincerely, Mike Raneses UNITED SERVICES AUTOMOBILE ASSOCIATION IA RECIPROCAL INTERINSURANCE EXCHANGE) USAW 9800 Fredericksburg Road - San Antonio, Texas 76288 CALIFORNIA AUTO POLICY AMENDED DECLARATIONS of ACH TO PREVIOUS POLI) lamed Insured aCY nd Address MICHAEL EUGENE RANESES LTC USA RET N-2018-088 2409 M1 INA MON TE CT TUSTIN CA 92782-9000 EH IYEARI TRADE NAME I MODEL BODY TYPE ?91171 TOYOTA (HIGHLANDER 14 DOOR ADDL INFO ON NEXT PAGE MAIL MGH -M -i State 108 ,09 , , , ven POLICY NUMBER fCta IiT13RQt331�—IAK, 00186 66 18U 7101 0 01 MICHAEL EUGENE RANESES 03 RUTH L RANESES IDENTIFICATION NUMBER 120001 5TDKZRFH9HS524448 SYM is vemCietsl aescrmea nerein is pnncipauy garages at the aeove aoaress uniess otnenvise statoa.I«arc-re+arson+m: a=a+:Ieesx f-f+r+eP=Pleeagte IEH 08 TUSTIN CA 92782-9000 IEH 09 TUSTIN CA 92782-9000 This no icy Frovides ONLY those coverages w ers a orein um is shown below. The limits shown_____ may re reouceg by Poiicy PloVisions Vehicles r which a rami Isted unless ano may nor tae c moineg rag raises or me s eclfloc's a t ria elsewhere in this D r}umber or 10V. VEH VEH VEH VEH COVERAGES LIMITS OF LIABILITY 08 6 -MONTH 09 6 -MONTH ("ACV" MEANS ACTUAL CASH VALUE) 0=DED PREMIUM D=DED PREMIUM D@DED PREMIUM D=DED PREMIUM AM UN $ WOUNTI 6AMOUNT[ WOUNTIa BODILY INJURY EA PER $ 100;00 EA ACC $ 300,00C 89.82 268.5 PROPERTY DAMAGE EA ACC $ 100,OOC 86.92 245.87 4RT B - MEDICAL PAYMENTS EA PER $ 2,qOC 6.55 13.76 4RT C - UNINSURED MOTORISTS BODILY INJURY EA PER $ 100,0.0 EA ACC $ 300,OOC 35.26 81.31 kRT D - PHYSICAL DAMAGE COVERAGE COMPREHENSIVE LOSS ACV LESS D 50 24.02 50 87.07 COLLISION LOSS ACV LESS D 5C 144.27 50 782.11 TOWING AND LABOR 5.88 7.36 k*COVERAGES EXCLUDED WHEN ANY VEHICLE PERATED BY JOY MARIE RA ESES TOTAL PRE IUM SEE F LOWING PAG (S) :H 09 ADDNL INTEREST - PERSONAL CORP CITY OF SANTA ANA OFFICERS AND, SANTA ANA, CA ENDT A074 APPLIES )DITIONAL INTEREST - EMPLOYER iE CITY OF SANTA ANA, OFFICER, SANTA ANA, CA 40ORSEMENTS, ADDED 03-20-18 - NONE :MAIN IN EFFECT(REFER TO PREVIOUS POLICY)- A073(05) A074( ) RS PC EXCLUSION OF NAMED DRIVER 5100CA(02) 1 WI Nta`y VVHtKt:Ur, me buosrru; heir Attorney -in -Fact on this date 100 U 07-11 FEBRUARY 26, 2018 Laura BisPresident, USAA Reciprocal (01)V-4 k'2- L Inc. UNITED SERVICES AUTOMOBILE ASSOCIATION (A RECIPROCAL INTERINSURANCE EXCHANGE) us�1' 9890 Fredericksburg Road - San Antonio, Texas 78288 CALIFORNIA AUTO POLICY AMENDED DECLARATIONS (ATTACH TO PREVIOUS POLICY) smed Insured and Address MICHAEL EUGENE RANESES LTC USA RET 2409 MIRA MONTE CT TUSTIN CA 92782-9000 :H IYEARI TRADE NAME I MODEL I BODY TYPE a Stete ven POLICY NUMBER �`�1FdE 00186 66 18U 7101 0 This policy ,prove es those. coverages where a premium_ Is shown Oelow. Tfie limits shown mny un raaucaa vy PUnaymium Plvveasv s vehloles for which a reIs lista unless ano may nor oe cvmolnea regaraless oT Ina specifloaliv authorized elsewhere In this Dlay. numner or COVERAGES LIMITS OF LIABILITY VEK VEH V: CACV" MEANS ACTUAL CASH VALUE) D=DED PREMIUM D=PED PREMIUM [0v=t:DtEED PREMIUM D=DED PREMIUM MQUN a MDUN $ MDUN a MDUN a :HICLE TOTAL PREMIUM 392.72 1486.04 . -----------------------------ADJUSTMENT REASO --------------------------__---- 1RT A - BI LIAR LIMIT CHANGED VEH 08 09 PART C - JM BI LIMIT CHANGEC REVISED 6 MONTH PREMIU ...$ 1878,76 6 NTH DECREASE ... $ 183.10 PREMIUM DUE AT INCEPTION. THIS I NOT A BILL, STATEMENT TO FOLLOW. iE FOLLOWING COVERAGE(S) DEFINED IN THIS POLICY ARE NOT PROVIDED FOR; VEH 08 - EXTENDED BENEFITS COVER GE, RENTAL REIMBURSEMENT VEH 09 - EXTENDED BENEFITS COVER GE, RENTAL REIMBURSEMENT n WITNESS WHEREUF, the Subscril heir Attomey-in-Fact on this date 2/2 Laura HIS President USAA Reciprocal )00 U 07-11 1,0468ZP.000717.ODDD.0002.O.ODOOOO.7 1461-07-11 WORKERS' COMPENSATION DECLARATION 1 1/741!.4-L,�i'��✓CSC� Hereby affirm under penalty of perjury, the (Nme/Title) following declaration I certify on behalf of 41c.1/1A&' �j' tt/cx5 that during the term of my (Consultant/Company Name) contract for /74,79,4i.</G 0/r -L services with the City of Santa Ana, I will not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions and provide proof of workers' compensation coverage. DATE: 02- - /- 20 / r Name:/��i/•4C—'G q Jz S Title: %f�/✓.C?�eV' C�FFICC/� Telephone: 7/5/ • t?r 7. 4177 q WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. .acORO® CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIVYYY) F 04/26/2018 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Hiscox Inc. d/b/a/ Hiscox Insurance Agency in CA qHIC NNu E . (888 202-3007 AAic Not; 520 Madison Avenue EMAIL ADDRESS: Contact@hiscox.COm INSURER$ AFFORDING COVERAGE NAICN 32nd Floor INSURERA: HIBCOX Insurance Company Inc 10200 New York, NY 10022 N-201$_088 INSURED INSURER B GEN'L X INSURER C PERSONAL &ADV INJURY $ 1,000,000 MICHAEL RANESES INSURER D: PRODUCTS. COMPIOPAGG $ SIT Gen. Agg. 2409 MIRA MONTE CT INSURER E: AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS NOWO HIREDAUTOS AUTOS NEO AUTOS 1 INSURERF; TUSTIN CA 92782 COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDLSUBR VD POLICYNUMBER POLICY EFF MMIDDIYYYY POLICY EXP MMIDDYYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE XX OCCUR UDC -2163525 -CGL -18 02/01/2018 02/01/2019 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES Ea occurrence $ 100,000 MED EXP (Any one person) $ 5,000 GEN'L X PERSONAL &ADV INJURY $ 1,000,000 AGGREGATE LIMIT APPLIES PER: POLICY D PRO- LOC OTHER: GENERAL AGGREGATE $ 2,000,000 PRODUCTS. COMPIOPAGG $ SIT Gen. Agg. $ AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS NOWO HIREDAUTOS AUTOS NEO AUTOS COMBINED SINGLE LIMIT $ Ea accident BODILY INJURY (Per person) $ BODILY INJURY Per accident ( ) $ PROPERTVDAMAGE $ Per accident $ UMBRELLALIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOWPARTNERIEXECUTIVE ❑ OFF CERIMEMBEREXCLUDED4 I (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA PER OTH- STATUTE ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE -POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if mare space Is required) CERTIFICATE HOLDER CANCELLATION - SHOULD ANY OF THE AB VE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DA THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH TH POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD xS 40 H I SCOX A Guide To Your General Liability Policy The following is a guide to your General Liability policy. We have identified several key coverage items along with the limits and deductibles you have selected. To make it easier, we have also added a brief explanation of those items. We want you to feel confident about your new policy. If any of the information below is incorrect or if you have any questions, please contact one of our advisors at 888-202-3007 (Mon -Fri, 8am-10pm EST) or send us an e-mail at contact@hiscox.com. Policy number: UDC -2163525 -CGL -18 Policy effective dates: From: February 01, 2018 This determines the time period during which your coverage applies. To: February 01, 2019 __ _ N . _ __ _W-- --------- Form �Form of business: This identifies the legal structure of your business and determines who is Individual/Sole Proprietor insured under your policy. Business Property and Equipment Coverage: Rejected Optional terrorism coverage: Total cost of policy: © Hiscox Inc. 2010 Included $ 350.00 Page 1 Each occurrence limit $ 1,000,000 The most we will pay for all damages due to bodily injury and property damage, and medical expenses that arise out of any one occurrence. Defense costs we incur, in the defense of a lawsuit filed against you, will not reduce this limit. General aggregate limit $ 2,000,000 The most we will pay for all damages and medical expenses for the entire policy. Defense costs we incur, in the defense of a lawsuit filed against you, will not reduce this limit. Damage to premises rented to you $ 100,000 any one premises The most we will pay for damages, for which you are liable, to any one premises that is rented to you. This may include office space, conference rooms or training facilities, but does not include your primary residence if you are a home-based business. Medical expenses $ 5,000 any one person The most we will pay for all medical expenses sustained by any one person. Personal and advertising injury limit $ 1,000,000 any one person The most we will pay for all personal and advertising injury or organization (e.g., libel, slander) sustained by any one person or organization. Deductible for General Liability Coverage No deductible No deductible applies to the general liability portion of your policy so you are not required to make any payments in the events of such claims. 14 day full refund Be confident that you have made the right choice. We give you 14 days to review your policy. If you are not satisf and have not had any claims or losses, you can cancel your policy back to its start date and receive a full refund. Notice of claim If you have a claim, please call us at 866-424-8508. You may also e-mail us at reportaclaim@hiscox.com What does my General Liability Policy cover? For a summary showing examples of what you are and are not covered for, please read the Coverage Summary document. This guide does not modify the terms and conditions of your policy, which are contained in your policy documents, nor does it imply any claim is covered or not covered. We recommend that you read your policy documents to learn the details of your coverage. @ Hiscox Inc. 2010 Page 2 AM HISC®X Reinventing Small Business Insurance® General Liability Coverage Summary We want you to understand the Hiscox General Liability coverage. This summary explains the main areas of coverage and exclusions. If you have any questions about your coverage, please contact one of our advisors at 888-202-3007 (Mon -Fri, 8am-10pm EST) or via email at contact@hiscox.com. Bodily injury or property damage To the extent you are legally liable, we cover damages or claims expenses if you injure a third -party or damage someone else's property. However, damage to premises you rent is only covered if caused by fire or if the premises is rented to you for a period of 7 or fewer consecutive days. Medical payments We will make medical payments as a result of bodily injury that occurs in the course of your business operations regardless of fault. Defense costs' If you're sued, even if you're not at fault, we will appoint an attorney to defend you, even if the lawsuit is groundless. We will pay these defense costs on your behalf. Personal and advertising injury We cover claims of libel and slander that are not part of your professional services. We also protect you if your advertisement unintentionally uses a third party's advertising idea or infringes upon another's copyright. We do not provide this coverage to marketing or PR professionals, research consultants, graphic designers, lawyers, recruiters, real estate agents/brokers or property managers: Electronic data liability Specifically added for consultants and technology service providers, Hiscox covers your liability for damage to someone's electronic data resulting from the physical damage of property. We provide up to $25,000 of coverage. Worldwide insurance coverage We cover damage that occurs in the United States, its territories and Canada. We also offer some coverage for instances outside these areas while you're away on short periods of travel. Employees or temporary staff Hiscox will cover claims arising from your employees' or temporary staff's actions if they were performed on behalf of your business. Supplemental payments Your Hiscox policy covers the following expenses, should they be incurred, without reducing your limit of liability: • All expenses we incur, including the defense of lawsuits • Up to $250 a day for reasonable expenses (including loss of earnings) you incur as a result of assisting us in the defense of a claim or lawsuit • Interest on damage awards Intent to injure We won't cover you for any act that occurs with the intent to injure. This includes personal and advertising injuries if you knew your actions were false or violated the rights of others. Outside the policy period We won't cover claims for bodily injury, property damage, or personal and advertising injury that do not occur during the policy period. Known claims and circumstances We won't cover your business for any claim or circumstance that could result in a claim you knew about prior to the start of your first Hiscox policy. Personally identifiable information We won't cover your failure to protect any personally identifiable information that is in your care. Professional services We won't cover any professional services performed by you. These types of risks may be covered as part of our Professional Liability Policy. Vehicles and boats We won't cover any claims arising out of the ownership or use of an automobile or a watercraft. Workers' compensation We won't cover any obligation you may have under a workers' compensation claim or similar law. Your property We won't cover claims for damage to property you own or have in your care. However, protection for your own business equipment can be purchased as part of our Business Owners Policy. Personal and advertising injury We don't provide this coverage to marketing or PR professionals, research consultants, graphic designers, lawyers, recruiters, real estate agents/brokers or property managers. However, this coverage is available as part of our Professional Liability Policy. Bodily injury — A client falls over your bag and you are legally liable for the injury. We will cover the subsequent claim and related medical expenses up to your limits of liability. Property damage and data loss - You spill coffee on a client's server causing damage and loss of data. We will cover the subsequent claim up to your limits of liability. Personal injury — One of your employees is at lunch. He talks to the owner of the shop about one of your clients in a false and unflattering way. The client learns of this discussion and sues for slander. We will cover the subsequent claim, up to your limits of liability, and pay for an attorney to defend you if necessary. Coverage summaries, descriptions, and claims examples are provided for illustrative purposes only and are subject to the applicable policy limits, deductibles, exclusions, terms, and conditions. Not all insurance products and services are available in all states. Hiscox recommends you read the policy documents to learn the full details of coverage. Underwritten by Hiscox Insurance Company Inc., 104 South Michigan Avenue, Suite 600, Chicago, IL 60603, as administered by Hiscox Inc., a licensed insurance provider in all states and DC. Aes HISCOX GET THE RIGHT INSURANCE, RIGHT NOW Your Insurance documents Enclosed you will find the policy documents that make up your insurance contract with us, Hiscox Insurance Company Inc. Please read through all of these documents. If you have any questions or need to update any of your information please call us at 888-202-3007 (Mon -Fri, 8am-10pm EST). Declarations Page This contains specific policy information, such as the limits and deductibles you have selected. Policy Wording This details the terms and conditions of your coverage, subject to policy endorsements. These documents modify the Policy Wording or Declarations Page. conditions as required by your state and are part of your policy. These documents provide information that may affect your coverage such as optional terrorism coverage (if purchased) and other important items required by your state. Application Summary This is a summary of the information that you provided to us as part of your application. Please review this document and let us know if any of the information is incorrect. Please inform us immediately if you have a claim or loss to report. Please have your policy number available so we can handle your call quickly. Email: reportaclaim@hiscox.com Phone: 866-424-8508 Mail: Attn: Direct Claims Hiscox 520 Madison Avenue - 32nd Floor New York, NY, 10022 Jo H l SCOX GET THE RIGHT INSURANCE, RIGHT NOW Declarations Page HISCOX INSURANCE COMPANY INC. (A Stock Company) 104 South Michigan Avenue, Suite 600 Chicago Illinois 60603 Commercial General Liability Declarations In return for the payment of the premium, and subject to all the terms of this Policy, we agree with you to provide the insurance as stated in this Policy. Policy No.: I UDC -2163525 -CGL -18 Named Insured: Address: Policy period: Form of Business: Each Occurrence Limit: MICHAEL RANESES 12409 MIRA MONTE CT TUSTIN, CA 92782 From: I February 01, 2018 I To: I February 01, 2019 At 12:01 A.M. (Standard Time) at the address shown above. Damage to Premises Rented to You Limit: Medical Expense Limit: Personal &Advertising Injury Limit: General Aggregate Limit: Products/Completed Operations Aggregate Limit: Supplemental Business Personal Property Floater Coverage Limit: Supplemental Business Personal Property Floater Coverage Deductible: Individual/Sole Proprietor Is 1,000,000 $ 100,000 Any one premises $ 5,000 Any one person $ 1,000,000 Any one person or organization $ 2,000,000 Products -completed operations are subject to the General Aggregate Limit $0 Not Applicable All Premises You Own, Rent or Occupy Premises Number: Address: Total Premium: Attachments: 2409 MIRA MONTE CT TUSTIN, CA 92782 $ 350.00 See attached Forms and Endorsements Schedule. CGL D001 01 10 Includes copyrighted material of Insurance Services Office, Inc., with Page 1 its permission. 0 ISO Properties, Inc., 2000 Vitt+ HISCOX INSURANCE COMPANY INC. (A Stock Company) H I SC®X 104 South Michigan Avenue, Suite 600 Chicago Illinois 60603 IN WITNESS WHEREOF, the Insurer indicated above has caused this Policy to be signed by its President and Secretary, but this Policy shall not be effective unless also signed by the Insurer's duly authorized representative. President Secretary Authorized Representative CGL D001 01 10 Includes copyrighted material of Insurance Services Office, Inc., with Page 2 its permission. © ISO Properties, Inc., 2000 40 HISCOX HISCOX INSURANCE COMPANY INC. (A Stock Company) 104 South Michigan Avenue, Suite 600, Chicago, Illinois 60603 Forms and Endorsements Schedule Forms and Endorsements made part of this policy at time of issue: CGL D001 01 10 - Commercial General Liability Declarations CG 00 01 12 07 - General Liability Coverage Form CGL E5421 CW (02/14) - Additional Insured - Automatic Status CGL E5409 CW (03/10) - Right and Duty to Select Defense Counsel CGL E5404 CW (03/10) - Exclusion - Personal Information CGL E5408 CW (03/10) - Cancellation Provision (14 Day Full Refund) CGL E5403 CW (03/10) - Notice Information CGL E5401 CW (03/10) - Definition of Employee CGL E5407 CW (03/10) - Exclusion - Professional Services IL 00 21 09 08 - Nuclear Energy Liability Exclusion Endorsement (Broad Form) IL 02 70 09 08 - California Changes - Cancellation and Nonrenewal CG 32 34 01 05 - California Changes IL 00 17 1198 - Common Policy Conditions CG 04 37 12 04 - Electronic Data Liability CG 21 41 11 85 - Exclusion - Intercompany Products Suits CG 00 68 05 09 - Recording and Distribution of Material or Information in Violation of Law Exclusion CG 21 70 01 15 - Cap On Losses From Certified Acts Of Terrorism IL 09 85 01 15 - Disclosure Pursuant To Terrorism Risk Insurance Act INT N001 CW (01/09) - Economic And Trade Sanctions Policyholder Notice INT D001 01 10 Page 1 of 1 AM HISCOX GET THE RIGHT INSURANCE, RIGHT NOW Policy Wording AM HiSCOX COMMERCIAL GENERAL LIABILITY CG 00 01 12 07 COMMERCIAL GENERAL LIABILITY COVERAGE FORM Various provisions in this policy restrict coverage. Read the entire policy carefully to determine rights, duties and what is and is not covered. Throughout this policy the words "you" and "your" refer to the Named Insured shown in the Declarations, and any other person or organization qualifying as a Named Insured under this policy. The words "we", '.us" and "our" refer to the company providing this insurance. The word "insured" means any person or organization qualifying as such under Section II — Who Is An In- sured. Other words and phrases that appear in quotation marks have special meaning. Refer to Section V — Definitions. SECTION I — COVERAGES COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY 1. Insuring Agreement a. We will pay those sums that the insured be- comes legally obligated to pay as damages because of "bodily injury" or "property damage" to which this insurance applies. We will have the right and duty to defend the insured against any "suit" seeking those damages. However, we will have no duty to defend the insured against any "suit" seeking damages for "bodily injury" or "property damage" to which this in- surance does not apply. We may, at our discre- tion, investigate any "occurrence" and settle any claim or "suit" that may result. But: (1) The amount we will pay for damages is limited as described in Section III — Limits Of Insurance; and (2) Our right and duty to defend ends when we have used up the applicable limit of insur- ance in the payment of judgments or set- tlements under Coverages A or B or medi- cal expenses under Coverage C. No other obligation or liability to pay sums or perform acts or services is covered unless ex- plicitly provided for under Supplementary Pay- ments — Coverages A and B. b. This insurance applies to "bodily injury" and "property damage" only if: (1) The "bodily injury" or "property damage" is caused by an "occurrence" that takes place in the "coverage territory"; (2) The "bodily injury" or "property damage" occurs during the policy period; and (3) Prior to the policy period, no insured listed under Paragraph 1. of Section II — Who Is An Insured and no "employee" authorized by you to give or receive notice of an "oc- currence" or claim, knew that the "bodily in- jury" or "property damage" had occurred, in whole or in part. If such a listed insured or authorized "employee" knew, prior to the policy period, that the "bodily injury" or "property damage" occurred, then any con- tinuation, change or resumption of such "bodily injury" or "property damage" during or after the policy period will be deemed to have been known prior to the policy period. c. "Bodily injury" or "property damage" which occurs during the policy period and was not, prior to the policy period, known to have oc- curred by any insured listed under Paragraph 1. of Section II — Who Is An Insured or any "employee" authorized by you to give or re- ceive notice of an "occurrence" or claim, in- cludes any continuation, change or resumption of that "bodily injury" or "property damage" af- ter the end of the policy period. d. "Bodily injury" or "property damage" will be deemed to have been known to have occurred at the earliest time when any insured listed un- der Paragraph 1. of Section II — Who Is An In- sured or any "employee" authorized by you to give or receive notice of an "occurrence" or claim: (1) Reports all, or any part, of the "bodily injury" or "property damage" to us or any other in- surer; (2) Receives a written or verbal demand or claim for damages because of the "bodily injury" or "property damage"; or (3) Becomes aware by any other means that "bodily injury" or "property damage" has oc- curred or has begun to occur. CG 00 01 12 07 © ISO Properties, Inc., 2006 Page 1 of 16 e. Damages because of "bodily injury" include damages claimed by any person or organiza- tion for care, loss of services or death resulting at any time from the "bodily injury". 2. Exclusions This insurance does not apply to: a. 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" resulting from the use of reasonable force to protect persons or property. b. Contractual Liability "Bodily injury" or "property damage" for which the insured is obligated to pay damages by reason of the assumption of liability in a con- tract or agreement. This exclusion does not apply to liability for damages: (1) That the insured would have in the absence of the contract or agreement; or (2) Assumed in a contract or agreement that is an "insured contract", provided the "bodily injury" or "property damage" occurs subse- quent to the execution of the contract or agreement. Solely for the purposes of liabil- ity assumed in an "insured contract", rea- sonable attorney fees and necessary litiga- tion expenses incurred by or for a party other than an insured are deemed to be damages because of "bodily injury" or "property damage", provided: (a) Liability to such party for, or for the cost of, that party's defense has also been assumed in the same "insured contract"; and (b) Such attorney fees and litigation ex- penses are for defense of that party against a civil or alternative dispute resolution proceeding in which damages to which this insurance applies are al- leged. c. Liquor Liability "Bodily injury" or "property damage" for which any insured may be held liable by reason of: (1) Causing or contributing to the intoxication of any person; (2) The furnishing of alcoholic beverages to a person under the legal drinking age or un- der the influence of alcohol; or (3) Any statute, ordinance or regulation relating to the sale, gift, distribution or use of alco- holic beverages. This exclusion applies only if you are in the business of manufacturing, distributing, selling, serving or furnishing alcoholic beverages. d. Workers' Compensation And Similar Laws Any obligation of the insured under a workers' compensation, disability benefits or unem- ployment compensation law or any similar law. a. Employer's Liability "Bodily injury" to: (1) An "employee" of the insured arising out of and in the course of: (a) Employment by the insured; or (b) Performing duties related to the conduct of the insured's business; or (2) The spouse, child, parent, brother or sister of that "employee" as a consequence of Paragraph (1) above. This exclusion applies whether the insured may be liable as an employer or in any other capacity and to any obligation to share dam- ages with or repay someone else who must pay damages because of the injury. This exclusion does not apply to liability as- sumed by the insured under an "insured con- tract". Page 2 of 16 © ISO Properties, Inc., 2006 CG 00 01 12 07 f. Pollution (1) "Bodily injury" or "property damage" arising out of the actual, alleged or threatened dis- charge, dispersal, seepage, migration, re- lease or escape of "pollutants": (a) At or from any premises, site or location which is or was at any time owned or occupied by, or rented or loaned to, any insured. However, this subparagraph does not apply to: (1) "Bodily injury" if sustained within a building and caused by smoke, fumes, vapor or soot produced by or originating from equipment that is used to heat, cool or dehumidify the building, or equipment that is used to heat water for personal use, by the building's occupants or their guests; (tt) "Bodily injury" or "property damage" for which you may be held liable, if you are a contractor and the owner or lessee of such premises, site or location has been added to your pol- icy as an additional insured with re- spect to your ongoing operations performed for that additional insured at that premises, site or location and such premises, site or location is not and never was owned or occupied by, or rented or loaned to, any in- sured, other than that additional in- sured: or (iii) "Bodily injury" or "property damage" arising out of heat, smoke or fumes from a "hostile fire"; (b) At or from any premises, site or location which is or was at any time used by or for any insured or others for the han- dling, storage, disposal, processing or treatment of waste; (c) Which are or were at any time trans- ported, handled, stored, treated, dis- posed of, or processed as waste by or for: (t) Any insured; or (ii) Any person or organization for whom you may be legally responsible; or (d) At or from any premises, site or location on which any insured or any contractors or subcontractors working directly or in- directly on any insured's behalf are per- forming operations if the "pollutants" are brought on or to the premises, site or lo- cation in connection with such opera- tions by such insured, contractor or sub- contractor. However, this subparagraph does not apply to: (t) "Bodily injury" or "property damage" arising out of the escape of fuels, lu- bricants or other operating fluids which are needed to perform the normal electrical, hydraulic or me- chanical functions necessary for the operation of "mobile equipment" or its parts, if such fuels, lubricants or other operating fluids escape from a vehicle part designed to hold, store or receive them. This exception does not apply if the "bodily injury" or "property damage" arises out of the intentional discharge, dispersal or re- lease of the fuels, lubricants or other operating fluids, or if such fuels, lu- bricants or other operating fluids are brought on or to the premises, site or location with the intent that they be discharged, dispersed or released as part of the operations being per- formed by such insured, contractor or subcontractor; (ti) "Bodily injury" or "property damage" sustained within a building and caused by the release of gases, fumes or vapors from materials brought into that building in connec- tion with operations being performed by you or on your behalf by a con- tractor or subcontractor; or (iii) "Bodily injury" or "property damage" arising out of heat, smoke or fumes from a "hostile fire". (e) At or from any premises, site or location on which any insured or any contractors or subcontractors working directly or in- directly on any insured's behalf are per- forming operations if the operations are to test for, monitor, clean up, remove, contain, treat, detoxify or neutralize, or in any way respond to, or assess the ef- fects of, "pollutants". CG 00 01 12 07 © ISO Properties, Inc., 2006 Page 3 of 16 (2) Any loss, cost or expense arising out of any: (a) Request, demand, order or statutory or regulatory requirement that any insured or others test for, monitor, clean up, re- move, contain, treat, detoxify or neutral- ize, or in any way respond to, or assess the effects of, "pollutants"; or (b) Claim or "suit" by or on behalf of a gov- ernmental authority for damages be- cause of testing for, monitoring, cleaning up, removing, containing, treating, de- toxifying or neutralizing, or in any way responding to, or assessing the effects of, "pollutants". However, this paragraph does not apply to liability for damages because of "property damage" that the insured would have in the absence of such request, demand, order or statutory or regulatory requirement, or such claim or "suit" by or on behalf of a govern- mental authority. g. Aircraft, Auto Or Watercraft "Bodily injury" or "property damage" arising out of the ownership, maintenance, use or en- trustment to others of any aircraft, "auto" or wa- tercraft owned or operated by or rented or loaned to any insured. Use includes operation and "loading or unloading". This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision, hiring, employ- ment, training or monitoring of others by that insured, if the "occurrence" which caused the "bodily injury" or "property damage" involved the ownership, maintenance, use or entrust- ment to others of any aircraft, "auto" or water- craft that is owned or operated by or rented or loaned to any insured. This exclusion does not apply to: (1) A watercraft while ashore on premises you own or rent; (2) A watercraft you do not own that is: (a) Less than 26 feet long; and (b) Not being used to carry persons or property for a charge; (3) Parking an "auto" on, or on the ways next to, premises you own or rent, provided the "auto" is not owned by or rented or loaned to you or the insured; (5) "Bodily injury" or "property damage" arising out of: (a) The operation of machinery or equip- ment that is attached to, or part of, a land vehicle that would qualify under the definition of "mobile equipment" if it were not subject to a compulsory or financial responsibility law or other motor vehicle insurance law in the state where it is li- censed or principally garaged; or (b) the operation of any of the machinery or equipment listed in Paragraph f.(2) or f.(3) of the definition of "mobile equip- ment". h. Mobile Equipment "Bodily injury" or "property damage" arising out of: (1) The transportation of "mobile equipment" by an "auto" owned or operated by or rented or loaned to any insured; or (2) The use of "mobile equipment" in, or while in practice for, or while being prepared for, any prearranged racing, speed, demolition, or stunting activity. i. War "Bodily injury" or "property damage", however caused, arising, directly or indirectly, out of: (1) War, including undeclared or civil war; (2) Warlike action by a military force, including action in hindering or defending against an actual or expected attack, by any govern- ment, sovereign or other authority using military personnel or other agents; or (3) Insurrection, rebellion, revolution, usurped power, or action taken by governmental au- thority in hindering or defending against any of these. j. Damage To Property "Property damage" to: (1) Property you own, rent, or occupy, including any costs or expenses incurred by you, or any other person, organization or entity, for repair, replacement, enhancement, restora- tion or maintenance of such property for any reason, including prevention of injury to a person or damage to another's property; (2) Premises you sell, give away or abandon, if the "property damage" arises out of any part of those premises; (4) Liability assumed under any "insured con- (3) Property loaned to you; tract" for the ownership, maintenance or (4) Personal property in the care, custody or use of aircraft or watercraft; or control of the insured; Page 4 of 16 © ISO Properties, Inc., 2006 CG 00 01 12 07 (5) That particular part of real property on which you or any contractors or subcontrac- tors working directly or indirectly on your behalf are performing operations, if the "property damage" arises out of those op- erations; or (6) That particular part of any property that must be restored, repaired or replaced be- cause "your work" was incorrectly per- formed on it. Paragraphs (1), (3) and (4) of this exclusion do not apply to "property damage" (other than damage by fire) to premises, including the con- tents of such premises, rented to you for a pe- riod of 7 or fewer consecutive days. A separate limit of insurance applies to Damage To Prem- ises Rented To You as described in Section III — Limits Of Insurance. Paragraph (2) of this exclusion does not apply if the premises are "your work" and were never occupied, rented or held for rental by you. Paragraphs (3), (4), (5) and (6) of this exclu- sion do not apply to liability assumed under a sidetrack agreement. Paragraph (6) of this exclusion does not apply to "property damage" included in the "products - completed operations hazard". k. Damage To Your Product "Property damage" to 'your product' arising out of it or any part of it. I. Damage To Your Work "Property damage" to "your work" arising out of it or any part of it and included in the "products - completed operations hazard". This exclusion does not apply if the damaged work or the work out of which the damage arises was performed on your behalf by a sub- contractor. m. Damage To Impaired Property Or Property Not Physically Injured "Property damage" to "impaired property' or property that has not been physically injured, arising out of: (1) A defect, deficiency, inadequacy or danger- ous condition in "your product' or "your work"; or (2) A delay or failure by you or anyone acting on your behalf to perform a contract or agreement in accordance with its terms. This exclusion does not apply to the loss of use of other property arising out of sudden and ac- cidental physical injury to "your product' or "your work" after it has been put to its intended use. n. Recall Of Products, Work Or Impaired Property Damages claimed for any loss, cost or ex- pense incurred by you or others for the loss of use, withdrawal, recall, inspection, repair, re- placement, adjustment, removal or disposal of: (1) "Your product; (2) "Your work"; or (3) 'Impaired property"; if such product, work, or property is withdrawn or recalled from the market or from use by any person or organization because of a known or suspected defect, deficiency, inadequacy or dangerous condition in it. o. Personal And Advertising Injury 'Bodily injury' arising out of "personal and ad- vertising injury'. p. Electronic Data Damages arising out of the loss of, loss of use of, damage to, corruption of, inability to access, or inability to manipulate electronic data. As used in this exclusion, electronic data means information, facts or programs stored as or on, created or used on, or transmitted to or from computer software, including systems and applications software, hard or floppy disks, CD- ROMS, tapes, drives, cells, data processing devices or any other media which are used with electronically controlled equipment. q. Distribution Of Material In Violation Of Statutes 'Bodily injury' or "property damage" arising di- rectly or indirectly out of any action or omission that violates or is alleged to violate: (1) The Telephone Consumer Protection Act (TCPA), including any amendment of or addition to such law; or (2) The CAN -SPAM Act of 2003, including any amendment of or addition to such law; or (3) Any statute, ordinance or regulation, other than the TCPA or CAN -SPAM Act of 2003, that prohibits or limits the sending, transmit- ting, communicating or distribution of mate- rial or information. CG 00 01 12 07 © ISO Properties, Inc., 2006 Page 5 of 16 Exclusions c. through in. do not apply to damage by fire to premises while rented to you or tempo- rarily occupied by you with permission of the owner. A separate limit of insurance applies to this coverage as described in Section III — Limits Of Insurance. COVERAGE B PERSONAL AND ADVERTISING INJURY LIABILITY 1. Insuring Agreement a. We will pay those sums that the insured be- comes legally obligated to pay as damages because of "personal and advertising injury'. to which this insurance applies. We will have the right and duty to defend the insured against any "suit" seeking those damages. However, we will have no duty to defend the insured against any "suit" seeking damages for "per- sonal and advertising injury" to which this in- surance does not apply. We may, at our discre- tion, investigate any offense and settle any claim or "suit" that may result. But: (1) The amount we will pay for damages is limited as described in Section III — Limits Of Insurance; and (2) Our right and duty to defend end when we have used up the applicable limit of insur- ance in the payment of judgments or set- tlements under Coverages A or B or medi- cal expenses under Coverage C. No other obligation or liability to pay sums or perform acts or services is covered unless ex- plicitly provided for under Supplementary Pay- ments — Coverages A and B. b. This insurance applies to "personal and adver- tising injury" caused by an offense arising out of your business but only if the offense was committed in the "coverage territory" during the policy period. 2. Exclusions This insurance does not apply to: a. Knowing Violation Of Rights Of Another "Personal and advertising injury" caused by or at the direction of the insured with the knowl- edge that the act would violate the rights of an- other and would inflict "personal and advertis- ing injury". b. Material Published With Knowledge Of Falsity c. Material Published Prior To Policy Period "Personal and advertising injury" arising out of oral or written publication of material whose first publication took place before the beginning of the policy period. d. Criminal Acts "Personal and advertising injury" arising out of a criminal act committed by or at the direction of the insured. e. Contractual Liability "Personal and advertising injury" for which the insured has assumed liability in a contract or agreement. This exclusion does not apply to li- ability for damages that the insured would have in the absence of the contract or agreement. f. Breach Of Contract "Personal and advertising injury" arising out of a breach of contract, except an implied con- tract to use another's advertising idea in your "advertisement". g. Quality Or Performance Of Goods — Failure To Conform To Statements "Personal and advertising injury" arising out of the failure of goods, products or services to conform with any statement of quality or per- formance made in your "advertisement". h. Wrong Description Of Prices "Personal and advertising injury" arising out of the wrong description of the price of goods, products or services stated in your "advertise- ment". i. Infringement Of Copyright, Patent, Trademark Or Trade Secret "Personal and advertising injury" arising out of the infringement of copyright, patent, trade- mark, trade secret or other intellectual property rights. Under this exclusion, such other intellec- tual property rights do not include the use of another's advertising idea in your "advertise- ment". However, this exclusion does not apply to in- fringement, in your "advertisement", of copy- right, trade dress or slogan. j. Insureds In Media And Internet Type Businesses "Personal and advertising injury" committed by an insured whose business is: "Personal and advertising injury" arising out of 1 Advertising, broadcasting, oral or written publication of material, if done by () g, g, publishing or or at the direction of the insured with knowl- telecasting; edge of its falsity. (2) Designing or determining content of web- sites for others; or Page 6 of 16 © ISO Properties, Inc., 2006 CG 00 01 12 07 (3) An Internet search, access, content or service provider. However, this exclusion does not apply to Paragraphs 14.a., b. and c. of "personal and advertising injury" under the Definitions Sec- tion. For the purposes of this exclusion, the placing of frames, borders or links, or advertising, for you or others anywhere on the Internet, is not by itself, considered the business of advertis- ing, broadcasting, publishing or telecasting. k. Electronic Chatrooms Or Bulletin Boards "Personal and advertising injury" arising out of an electronic chatroom or bulletin board the in- sured hosts, owns, or over which the insured exercises control. I. Unauthorized Use Of Another's Name Or Product "Personal and advertising injury" arising out of the unauthorized use of another's name or product in your e-mail address, domain name or metatag, or any other similar tactics to mis- lead another's potential customers. m. Pollution "Personal and advertising injury" arising out of the actual, alleged or threatened discharge, dispersal, seepage, migration, release or es- cape of "pollutants" at any time. n. Pollution -Related Any loss, cost or expense arising out of any: (1) Request, demand, order or statutory or regulatory requirement that any insured or others test for, monitor, clean up, remove, contain, treat, detoxify or neutralize, or in any way respond to, or assess the effects of, "pollutants"; or (2) Claim or suit by or on behalf of a govern- mental authority for damages because of testing for, monitoring, cleaning up, remov- ing, containing, treating, detoxifying or neu- tralizing, or in any way responding to, or assessing the effects of, "pollutants". o. War "Personal and advertising injury", however caused, arising, directly or indirectly, out of: (1) War, including undeclared or civil war; (2) Warlike action by a military force, including action in hindering or defending against an actual or expected attack, by any govern- ment, sovereign or other authority using military personnel or other agents; or (3) Insurrection, rebellion, revolution, usurped power, or action taken by governmental au- thority in hindering or defending against any of these. p. Distribution Of Material In Violation Of Statutes "Personal and advertising injury" arising di- rectly or indirectly out of any action or omission that violates or is alleged to violate: (1) The Telephone Consumer Protection Act (TCPA), including any amendment of or addition to such law; or (2) The CAN -SPAM Act of 2003, including any amendment of or addition to such law; or (3) Any statute, ordinance or regulation, other than the TCPA or CAN -SPAM Act of 2003, that prohibits or limits the sending, transmit- ting, communicating or distribution of mate- rial or information. COVERAGE C MEDICAL PAYMENTS 1. Insuring Agreement a. We will pay medical expenses as described below for "bodily injury" caused by an accident: (1) On premises you own or rent; (2) On ways next to premises you own or rent; or (3) Because of your operations; provided that: (a) The accident takes place in the "cover- age territory" and during the policy pe- riod; (b) The expenses are incurred and reported to us within one year of the date of the accident; and (c) The injured person submits to examina- tion, at our expense, by physicians of our choice as often as we reasonably require. b. We will make these payments regardless of fault. These payments will not exceed the ap- plicable limit of insurance. We will pay reason- able expenses for: (1) First aid administered at the time of an accident; (2) Necessary medical, surgical, x-ray and dental services, including prosthetic de- vices; and (3) Necessary ambulance, hospital, profes- sional nursing and funeral services. CG 00 01 12 07 © ISO Properties, Inc., 2006 Page 7 of 16 0 2. Exclusions We will not pay expenses for "bodily injury": a. Any Insured To any insured, except "volunteer workers" b. Hired Person To a person hired to do work for or on behalf of any insured or a tenant of any insured. c. Injury On Normally Occupied Premises To a person injured on that part of premises you own or rent that the person normally occu- pies. d. Workers Compensation And Similar Laws To a person, whether or not an "employee" of any insured, if benefits for the "bodily injury" are payable or must be provided under a work- ers' compensation or disability benefits law or a similar law. e. Athletics Activities To a person injured while practicing, instructing or participating in any physical exercises or games, sports, or athletic contests. I. Products -Completed Operations Hazard Included within the "products -completed opera- tions hazard". g. Coverage A Exclusions Excluded under Coverage A. SUPPLEMENTARY PAYMENTS — COVERAGES A AND B 1. We will pay, with respect to any claim we investi- gate or settle, or any "suit" against an insured we defend: a. All expenses we incur. b. Up to $250 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. c. The cost of bonds to release attachments, but only for bond amounts within the applicable limit of insurance. We do not have to furnish these bonds. d. All reasonable expenses incurred by the in- sured at our request to assist us in the investi- gation or defense of the claim or "suit", includ- ing actual loss of earnings up to $250 a day because of time off from work. e. All court costs taxed against the insured in the "suit". However, these payments do not include attorneys' fees or attorneys' expenses taxed against the insured. I. Prejudgment interest awarded against the insured on that part of the judgment we pay. If we make an offer to pay the applicable limit of insurance, we will not pay any prejudgment in- terest based on that period of time after the of- fer. g. All interest on the full amount of any judgment that accrues after entry of the judgment and before we have paid, offered to pay, or depos- ited in court the part of the judgment that is within the applicable limit of insurance. These payments will not reduce the limits of insur- ance. 2. If we defend an insured against a "suit" and an indemnitee of the insured is also named as a party to the "suit", we will defend that indemnitee if all of the following conditions are met: a. The "suit" against the indemnitee seeks dam- ages for which the insured has assumed the li- ability of the indemnitee in a contract or agree- ment that is an "insured contract"; b. This insurance applies to such liability as- sumed by the insured; c. The obligation to defend, or the cost of the defense of, that indemnitee, has also been as- sumed by the insured in the same "insured contract'; d. The allegations in the "suit" and the information we know about the "occurrence" are such that no conflict appears to exist between the inter- ests of the insured and the interests of the in- demnitee; e. The indemnitee and the insured ask us to conduct and control the defense of that indem- nitee against such "suit" and agree that we can assign the same counsel to defend the insured and the indemnitee; and f. The indemnitee: (1) Agrees in writing to: (a) Cooperate with us in the investigation, settlement or defense of the "suit"; (b) Immediately send us copies of any demands, notices, summonses or legal papers received in connection with the "suit"; (c) Notify any other insurer whose coverage is available to the indemnitee; and (d) Cooperate with us with respect to coor- dinating other applicable insurance available to the indemnitee; and (2) Provides us with written authorization to: (a) Obtain records and other information related to the "suit"; and Page 8 of 16 © ISO Properties, Inc., 2006 CG 00 01 12 07 (b) Conduct and control the defense of the indemnitee in such "suit". So long as the above conditions are met, attor- neys' fees incurred by us in the defense of that in- demnitee, necessary litigation expenses incurred by us and necessary litigation expenses incurred by the indemnitee at our request will be paid as Supplementary Payments. Notwithstanding the provisions of Paragraph 2.b.(2) of Section I — Cov- erage A — Bodily Injury And Property Damage Li- ability, such payments will not be deemed to be damages for "bodily injury" and "property damage" and will not reduce the limits of insurance. Our obligation to defend an insured's indemnitee and to pay for attorneys' fees and necessary litiga- tion expenses as Supplementary Payments ends when we have used up the applicable limit of in- surance in the payment of judgments or settle- ments or the conditions set forth above, or the terms of the agreement described in Paragraph f. above, are no longer met. SECTION II — WHO IS AN INSURED 1. If you are designated in the Declarations as: a. An individual, you and your spouse are insur- eds, but only with respect to the conduct of a business of which you are the sole owner. b. A partnership or joint venture, you are an in- sured. Your members, your partners, and their spouses are also insureds, but only with re- spect to the conduct of your business. c. A limited liability company, you are an insured. Your members are also insureds, but only with respect to the conduct of your business. Your managers are insureds, but only with respect to their duties as your managers. d. An organization other than a partnership, joint venture or limited liability company, you are an insured. Your "executive officers" and directors are insureds, but only with respect to their du- ties as your officers or directors. Your stock- holders are also insureds, but only with respect to their liability as stockholders. e. A trust, you are an insured. Your trustees are also insureds, but only with respect to their du- ties as trustees. 2. Each of the following is also an insured: a. Your "volunteer workers" only while performing duties related to the conduct of your business, or your "employees", other than either your "executive officers" (if you are an organization other than a partnership, joint venture or limited liability company) or your managers (if you are a limited liability company), but only for acts within the scope of their employment by you or while performing duties related to the conduct of your business. However, none of these "em- ployees" or "volunteer workers" are insureds for: (1) "Bodily injury" or "personal and advertising injury": (a) To you, to your partners or members (if you are a partnership or joint venture), to your members (if you are a limited li- ability company), to a co -"employee" while in the course of his or her em- ployment or performing duties related to the conduct of your business, or to your other "volunteer workers" while perform- ing duties related to the conduct of your business; (b) To the spouse, child, parent, brother or sister of that co -"employee" or "volun- teer worker" as a consequence of Para- graph (1)(a) above; (c) 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)(a) or (b) above; or (d) Arising out of his or her providing or failing to provide professional health care services. (2) "Property damage" to property: (a) Owned, occupied or used by, (b) Rented to, in the care, custody or con- trol of, or over which physical control is being exercised for any purpose by you, any of your "employees", "volunteer workers", any partner or member (if you are a partnership or joint venture), or any mem- ber (if you are a limited liability company). CG 00 01 12 07 © ISO Properties, Inc., 2006 Page 9 of 16 b. Any person (other than your "employee" or "volunteer worker"), or any organization while acting as your real estate manager. c. Any person or organization having proper temporary custody of your property if you die, but only: (1) With respect to liability arising out of the maintenance or use of that property; and (2) Until your legal representative has been appointed. d. Your legal representative if you die, but only with respect to duties as such. That represen- tative will have all your rights and duties under this Coverage Part. 3. Any organization you newly acquire or form, other than a partnership, joint venture or limited liability company, and over which you maintain ownership or majority interest, will qualify as a Named In- sured if there is no other similar insurance avail- able to that organization. However: a. Coverage under this provision is afforded only until the 90th day after you acquire or form the organization or the end of the policy period, whichever is earlier; b. Coverage A does not apply to "bodily injury" or "property damage" that occurred before you acquired or formed the organization; and c. Coverage B does not apply to "personal and advertising injury" arising out of an offense committed before you acquired or formed the organization. No person or organization is an insured with respect to the conduct of any current or past partnership, joint venture or limited liability company that is not shown as a Named Insured in the Declarations. SECTION III — LIMITS OF INSURANCE 1. The Limits of Insurance shown in the Declarations and the rules below fix the most we will pay re- gardless of the number of: a. Insureds; b. Claims made or "suits" brought; or c. Persons or organizations making claims or bringing "suits". 2. The General Aggregate Limit is the most we will pay for the sum of: a. Medical expenses under Coverage C; b. Damages under Coverage A, except damages because of "bodily injury" or "property damage" included in the "products -completed operations hazard"; and c. Damages under Coverage B. 3. The Products -Completed Operations Aggregate Limit is the most we will pay under Coverage A for damages because of "bodily injury" and "property damage" included in the "products -completed op- erations hazard". 4. Subject to Paragraph 2. above, the Personal and Advertising Injury Limit is the most we will pay un- der Coverage 6 for the sum of all damages be- cause of all "personal and advertising injury" sus- tained by any one person or organization. 5. Subject to Paragraph 2. or 3. above, whichever applies, the Each Occurrence Limit is the most we will pay for the sum of: a. Damages under Coverage A; and b. Medical expenses under Coverage C because of all "bodily injury" and "property dam- age" arising out of any one "occurrence". 6. Subject to Paragraph 5. above, the Damage To Premises Rented To You Limit is the most we will pay under Coverage A for damages because of "property damage" to any one premises, while rented to you, or in the case of damage by fire, while rented to you or temporarily occupied by you with permission of the owner. 7. Subject to Paragraph 5. above, the Medical Ex- pense Limit is the most we will pay under Cover- age C for all medical expenses because of "bodily injury" sustained by any one person. The Limits of Insurance of this Coverage Part apply separately to each consecutive annual period and to any remaining period of less than 12 months, starting with the beginning of the policy period shown in the Declarations, unless the policy period is extended after issuance for an additional period of less than 12 months. In that case, the additional period will be deemed part of the last preceding period for purposes of determining the Limits of Insurance. SECTION IV—COMMERCIAL GENERAL LIABILITY CONDITIONS 1. Bankruptcy Bankruptcy or insolvency of the insured or of the insured's estate will not relieve us of our obliga- tions under this Coverage Part. 2. Duties In The Event Of Occurrence, Offense, Claim Or Suit a. You must see to it that we are notified as soon as practicable of an "occurrence" or an offense which may result in a claim. To the extent pos- sible, notice should include: (1) How, when and where the "occurrence" or offense took place; (2) The names and addresses of any injured persons and witnesses; and Page 10 of 16 © ISO Properties, Inc., 2006 CG 00 01 12 07 0 (3) The nature and location of any injury or damage arising out of the "occurrence" or offense. b. If a claim is made or "suit" is brought against any insured, you must: (1) Immediately record the specifics of the claim or "suit" and the date received; and (2) Notify us as soon as practicable. You must see to it that we receive written no- tice of the claim or "suit" as soon as practica- ble. c. You and any other involved insured must: (1) Immediately send us copies of any de- mands, notices, summonses or legal pa- pers received in connection with the claim or "suit"; (2) Authorize us to obtain records and other information; (3) Cooperate with us in the investigation or settlement of the claim or defense against the "suit'; and (4) Assist us, upon our request, in the en- forcement of any right against any person or organization which may be liable to the insured because of injury or damage to which this insurance may also apply. d. No insured will, except at that insured's own cost, voluntarily make a payment, assume any obligation, or incur any expense, other than for first aid, without our consent. 3. Legal Action Against Us No person or organization has a right under this Coverage Part: a. To join us as a party or otherwise bring us into a "suit" asking for damages from an insured; or b. To sue us on this Coverage Part unless all of its terms have been fully complied with. A person or organization may sue us to recover on an agreed settlement or on a final judgment against an insured; but we will not be liable for damages that are not payable under the terms of this Coverage Part or that are in excess of the ap- plicable limit of insurance. An agreed settlement means a settlement and release of liability signed by us, the insured and the claimant or the claim- ant's legal representative. 4. Otherinsurance If other valid and collectible insurance is available to the insured for a loss we cover under Cover- ages A or B of this Coverage Part, our obligations are limited as follows: a. Primary Insurance This insurance is primary except when Para- graph b. below applies. If this insurance is pri- mary, our obligations are not affected unless any of the other insurance is also primary. Then, we will share with all that other insur- ance by the method described in Paragraph c. below. b. Excess Insurance (1) This insurance is excess over: (a) Any of the other insurance, whether primary, excess, contingent or on any other basis: (t) That is Fire, Extended Coverage, Builder's Risk, Installation Risk or similar coverage for "your work'; (ii) That is Fire insurance for premises rented to you or temporarily occu- pied by you with permission of the owner; (iii) That is insurance purchased by you to cover your liability as a tenant for .'property damage" to premises rented to you or temporarily occu- pied by you with permission of the owner; or (tv) If the loss arises out of the mainte- nance or use of aircraft, "autos" or watercraft to the extent not subject to Exclusion g. of Section I — Coverage A — Bodily Injury And Property Dam- age Liability. (b) Any other primary insurance available to you covering liability for damages aris- ing out of the premises or operations, or the products and completed operations, for which you have been added as an additional insured by attachment of an endorsement. (2) When this insurance is excess, we will have no duty under Coverages A or B to defend the insured against any "suit" if any other insurer has a duty to defend the insured against that "suit". If no other insurer de- fends, we will undertake to do so, but we will be entitled to the insured's rights against all those other insurers. CG 00 01 12 07 © ISO Properties, Inc., 2006 Pagel 1 of 16 0 (3) When this insurance is excess over other insurance, we will pay only our share of the amount of the loss, if any, that exceeds the sum of: (a) The total amount that all such other insurance would pay for the loss in the absence of this insurance; and (b) The total of all deductible and self- insured amounts under all that other in- surance. (4) We will share the remaining loss, if any, with any other insurance that is not de- scribed in this Excess Insurance provision and was not bought specifically to apply in excess of the Limits of Insurance shown in the Declarations of this Coverage Part. c. Method Of Sharing If all of the other insurance permits contribution by equal shares, we will follow this method also. Under this approach each insurer con- tributes equal amounts until it has paid its ap- plicable limit of insurance or none of the loss remains, whichever comes first. If any of the other insurance does not permit contribution by equal shares, we will contribute by limits. Under this method, each insurer's share is based on the ratio of its applicable limit of insurance to the total applicable limits of insurance of all insurers. 5. Premium Audit a. We will compute all premiums for this Cover- age Part in accordance with our rules and rates. b. Premium shown in this Coverage Part as ad- vance premium is a deposit premium only. At the close of each audit period we will compute the earned premium for that period and send notice to the first Named Insured. The due date for audit and retrospective premiums is the date shown as the due date on the bill. If the sum of the advance and audit premiums paid for the policy period is greater than the earned premium, we will return the excess to the first Named Insured. c. The first Named Insured must keep records of the information we need for premium computa- tion, and send us copies at such times as we may request. 6. Representations By accepting this policy, you agree: a. The statements in the Declarations are accu- rate and complete; b. Those statements are based upon representa- tions you made to us; and c. We have issued this policy in reliance upon your representations. 7. 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 in- surance 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. 8. Transfer Of Rights Of Recovery Against Others To Us If the insured has rights to recover all or part of any payment we have made under this Coverage Part, those rights are transferred to us. The in- sured must do nothing after loss to impair them. At our request, the insured will bring "suit" or transfer those rights to us and help us enforce them. 9. When We Do Not Renew If we decide not to renew this Coverage Part, we will mail or deliver to the first Named Insured shown in the Declarations written notice of the nonrenewal not less than 30 days before the expi- ration date. If notice is mailed, proof of mailing will be sufficient proof of notice. SECTION V — DEFINITIONS 1. "Advertisement" means a notice that is broadcast or published to the general public or specific mar- ket segments about your goods, products or ser- vices for the purpose of attracting customers or supporters. For the purposes of this definition: a. Notices that are published include material placed on the Internet or on similar electronic means of communication; and b. Regarding web -sites, only that part of a web- site that is about your goods, products or ser- vices for the purposes of attracting customers or supporters is considered an advertisement. 2. "Auto" means: a. A land motor vehicle, trailer or semitrailer de- signed for travel on public roads, including any attached machinery or equipment; or b. Any other land vehicle that is subject to a com- pulsory or financial responsibility law or other motor vehicle insurance law in the state where it is licensed or principally garaged. However, "auto" does not include "mobile equip- ment". Page 12 of 16 © ISO Properties, Inc., 2006 CG 00 01 12 07 0 3. "Bodily injury" means bodily injury, sickness or disease sustained by a person, including death re- sulting from any of these at any time. A. "Coverage territory" means: a. The United States of America (including its territories and possessions), Puerto Rico and Canada; b. International waters or airspace, but only if the injury or damage occurs in the course of travel or transportation between any places included in Paragraph a. above; or c. All other parts of the world if the injury or dam- age arises out of: (1) Goods or products made or sold by you in the territory described in Paragraph a. above; (2) The activities of a person whose home is in the territory described in Paragraph a. above, but is away for a short time on your business; or (3) "Personal and advertising injury" offenses that take place through the Internet or simi- lar electronic means of communication provided the insured's responsibility to pay dam- ages is determined in a "suit" on the merits, in the territory described in Paragraph a. above or in a settlement we agree to. 5. "Employee" includes a "leased worker". "Em- ployee" does not include a "temporary worker'. 6. "Executive officer" means a person holding any of the officer positions created by your charter, con- stitution, by-laws or any other similar governing document. 7. "Hostile fire" means one which becomes uncon- trollable or breaks out from where it was intended to be. 8. "Impaired property" means tangible property, other than "your product" or "your work", that cannot be used or is less useful because: a. It incorporates "your product" or "your work" that is known or thought to be defective, defi- cient, inadequate or dangerous; or b. You have failed to fulfill the terms of a contract or agreement; if such property can be restored to use by the re- pair, replacement, adjustment or removal of "your product" or "your work" or your fulfilling the terms of the contract or agreement. 9. "Insured contract" means: a. A contract for a lease of premises. However, that portion of the contract for a lease of prem- ises that indemnifies any person or organiza- tion for damage by fire to premises while rented to you or temporarily occupied by you with permission of the owner is not an "insured contract"; b. A sidetrack agreement; c. Any easement or license agreement, except in connection with construction or demolition op- erations on or within 50 feet of a railroad; d. An obligation, as required by ordinance, to indemnify a municipality, except in connection with work for a municipality; e. An elevator maintenance agreement; f. That part of any other contract or agreement pertaining to your business (including an in- demnification of a municipality in connection with work performed for a municipality) under which you assume the tort liability of another party to pay for "bodily injury" or "property dam- age" to a third person or organization. Tort li- ability means a liability that would be imposed by law in the absence of any contract or agreement. Paragraph f. does not include that part of any contract or agreement: (1) That indemnifies a railroad for "bodily injury" or "property damage" arising out of con- struction or demolition operations, within 50 feet of any railroad property and affecting any railroad bridge or trestle, tracks, road- beds, tunnel, underpass or crossing; (2) That indemnifies an architect, engineer or surveyor for injury or damage arising out of: (a) Preparing, approving, or failing to pre- pare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifi- cations; or (b) Giving directions or instructions, or failing to give them, if that is the primary cause of the injury or damage; or (3) Under which the insured, if an architect, engineer or surveyor, assumes liability for an injury or damage arising out of the in- sured's rendering or failure to render pro- fessional services, including those listed in (2) above and supervisory, inspection, ar- chitectural or engineering activities. CG 00 01 12 07 © ISO Properties, Inc., 2006 Page 13 of 16 10."Leased worker" means a person leased to you by a labor leasing firm under an agreement between you and the labor leasing firm, to perform duties related to the conduct of your business. "Leased worker" does not include a "temporary worker". 11."Loading or unloading" means the handling of property: a. After it is moved from the place where it is accepted for movement into or onto an aircraft, watercraft or "auto"; b. While it is in or on an aircraft, watercraft or "auto"; or c. While it is being moved from an aircraft, water- craft or "auto" to the place where it is finally de- livered; but "loading or unloading" does not include the movement of property by means of a mechanical device, other than a hand truck, that is not at- tached to the aircraft, watercraft or "auto". 12."Mobile equipment" means any of the following types of land vehicles, including any attached ma- chinery or equipment: a. Bulldozers, farm machinery, forklifts and other vehicles designed for use principally off public roads; b. Vehicles maintained for use solely on or next to premises you own or rent; c. Vehicles that travel on crawler treads; d. Vehicles, whether self-propelled or not, main- tained primarily to provide mobility to perma- nently mounted: (1) Power cranes, shovels, loaders, diggers or drills; or (2) Road construction or resurfacing equipment such as graders, scrapers or rollers; e. Vehicles not described in Paragraph a., b., c. or d. above that are not self-propelled and are maintained primarily to provide mobility to per- manently attached equipment of the following types: (1) Air compressors, pumps and generators, including spraying, welding, building clean- ing, geophysical exploration, lighting and well servicing equipment; or (2) Cherry pickers and similar devices used to raise or lower workers; f. Vehicles not described in Paragraph a., b., c. or d. above maintained primarily for purposes other than the transportation of persons or cargo. However, self-propelled vehicles with the fol- lowing types of permanently attached equip- ment are not "mobile equipment" but will be considered "autos": (1) Equipment designed primarily for: (a) Snow removal; (b) Road maintenance, but not construction or resurfacing; or (c) Street cleaning; (2) Cherry pickers and similar devices mounted on automobile or truck chassis and used to raise or lower workers; and (3) Air compressors, pumps and generators, including spraying, welding, building clean- ing, geophysical exploration, lighting and well servicing equipment. However, "mobile equipment" does not include any land vehicles that are subject to a compulsory or financial responsibility law or other motor vehi- cle insurance law in the state where it is licensed or principally garaged. Land vehicles subject to a compulsory or financial responsibility law or other motor vehicle insurance law are considered "autos". 13."Occurrence" means an accident, including con- tinuous or repeated exposure to substantially the same general harmful conditions. 14."Personal and advertising injury" means injury, including consequential "bodily injury", arising out of one or more of the following offenses: a. False arrest, detention or imprisonment; b. Malicious prosecution; c. The wrongful eviction from, wrongful entry into, or invasion of the right of private occupancy of a room, dwelling or premises that a person oc- cupies, committed by or on behalf of its owner, landlord or lessor; d. Oral or written publication, in any manner, of material that slanders or libels a person or or- ganization or disparages a person's or organi- zation's goods, products or services; e. Oral or written publication, in any manner, of material that violates a person's right of pri- vacy; f. The use of another's advertising idea in your "advertisement"; or g. Infringing upon another's copyright, trade dress or slogan in your "advertisement". Page 14 of 16 © ISO Properties, Inc., 2006 CG 00 01 12 07 0 15."Pollutants" mean any solid, liquid, gaseous or thermal irritant or contaminant, including smoke, vapor, soot, fumes, acids, alkalis, chemicals and waste. Waste includes materials to be recycled, reconditioned or reclaimed. 16."Products-completed operations hazard": a. Includes all "bodily injury" and "property dam- age" occurring away from premises you own or rent and arising out of "your product' or "your work" except: (1) Products that are still in your physical pos- session; or (2) Work that has not yet been completed or abandoned. However, "your work" will be deemed completed at the earliest of the fol- lowing times: (a) When all of the work called for in your contract has been completed. (b) When all of the work to be done at the job site has been completed if your con- tract calls for work at more than one job site. (c) When that part of the work done at a job site has been put to its intended use by any person or organization other than another contractor or subcontractor working on the same project. Work that may need service, maintenance, correction, repair or replacement, but which is otherwise complete, will be treated as completed. b. Does not include "bodily injury' or "property damage" arising out of: (1) The transportation of property, unless the injury or damage arises out of a condition in or on a vehicle not owned or operated by you, and that condition was created by the "loading or unloading" of that vehicle by any insured; (2) The existence of tools, uninstalled equip- ment or abandoned or unused materials; or (3) Products or operations for which the classi- fication, listed in the Declarations or in a policy schedule, states that products - completed operations are subject to the General Aggregate Limit. 17."Property damage" means: a. Physical injury to tangible property, including all resulting loss of use of that property. All such loss of use shall be deemed to occur at the time of the physical injury that caused it; or b. Loss of use of tangible property that is not physically injured. All such loss of use shall be deemed to occur at the time of the "occur- rence" that caused it. For the purposes of this insurance, electronic data is not tangible property. As used in this definition, electronic data means information, facts or programs stored as or on, created or used on, or transmitted to or from com- puter software, including systems and applications software, hard or floppy disks, CD-ROMS, tapes, drives, cells, data processing devices or any other media which are used with electronically controlled equipment. 18."Suit' means a civil proceeding in which damages because of "bodily injury', "property damage" or "personal and advertising injury" to which this in- surance applies are alleged. "Suit' includes: a. An arbitration proceeding in which such dam- ages are claimed and to which the insured must submit or does submit with our consent; or b. Any other alternative dispute resolution pro- ceeding in which such damages are claimed and to which the insured submits with our con- sent. 19."Temporary worker" means a person who is fur- nished to you to substitute for a permanent "em- ployee" on leave or to meet seasonal or short-term workload conditions. 20."Volunteer worker" means a person who is not your "employee", and who donates his or her work and acts at the direction of and within the scope of duties determined by you, and is not paid a fee, salary or other compensation by you or anyone else for their work performed for you. 21. "Your product': a. Means: (1) Any goods or products, other than real property, manufactured, sold, handled, dis- tributed or disposed of by: (a) You; (b) Others trading under your name; or (c) A person or organization whose busi- ness or assets you have acquired; and (2) Containers (other than vehicles), materials, parts or equipment furnished in connection with such goods or products. b. Includes: (1) Warranties or representations made at any time with respect to the fitness, quality, du- rability, performance or use of "your prod- uct'; and CG 00 01 12 07 0 ISO Properties, Inc., 2006 Page 15 of 16 0 (2) The providing of or failure to provide warn- ings or instructions. c. Does not include vending machines or other property rented to or located for the use of oth- ers but not sold. 22. "Your work": a. Means: (1) Work or operations performed by you or on your behalf; and (2) Materials, parts or equipment furnished in connection with such work or operations. b. Includes: (1) Warranties or representations made at any time with respect to the fitness, quality, du- rability, performance or use of 'your work", and (2) The providing of or failure to provide warn- ings or instructions. Page 16 of 16 0 ISO Properties, Inc., 2006 CG 00 01 12 07 o ^,M H I SCOX GET THE RIGHT INSURANCE, RIGHT NOW Ods+ HISCOX Policy Number: Named Insured: Endorsement Number: Endorsement Effective: UDC -2163525 -CGL -18 MICHAEL RANESES 1 February 01, 2018 Hiscox Insurance Company Inc. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - AUTOMATIC STATUS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Section II — Who Is An Insured is amended to include as an additional insured any per- son(s) or organization(s) for whom you are performing operations or leasing a premises when you and such person(s) or organiza- tion(s) have agreed in writing in a contract or agreement that such person(s) or organiza- tion(s) be added as an additional insured on your policy. Such person or organization is an additional insured only with respect to lia- bility for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf: 1. In the performance of your ongoing opera- tions; or 2. In connection with your premises owned by or rented to you. A person's or organization's status as an addi- tional insured under this endorsement ends when your operations or lease agreement for that additional insured are completed. CGL E5421 CW (02114) Includes copyrighted material of Insurance Services Office, Inc., with its Page 1 of 1 permission. f 40 H I SCOX Policy Number: UDC -2163525 -CGL -18 Named Insured: MICHAEL RANESES Endorsement Number: 2 Endorsement Effective: February 01, 2018 Hiscox Insurance Company Inc. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. RIGHT AND DUTY TO SELECT DEFENSE COUNSEL This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART In regard to any covered "suit' seeking damages under Section I — COVERAGE A — BODILY IN- JURY AND PROPERTY DAMAGE LIABILITY or COVERAGE B — PERSONAL AND ADVERTISING INJURY LIABILITY, our right and duty to defend shall include the right to select defense counsel. CGL E5409 CW (03/10) Page 1 of 1 Policy Number: Named Insured: Endorsement Number: Endorsement Effective: UDC -2163525 -CGL -18 MICHAEL RANESES 3 February 01, 2018 Hiscox Insurance Company Inc. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EXCLUSION - PERSONAL INFORMATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART Paragraph 2. Exclusions under Section I — COV- ERAGE A — BODILY INJURY AND PROPERTY DAMAGE LIABILITY, COVERAGE B — PERSONAL AND ADVERTISING INJURY LIABILITY, and COVERAGE C — MEDICAL PAYMENTS is amended to include the following exclusion: Personal Information "Bodily injury", "property damage" or "personal and advertising injury" caused by the insured's failure to protect any non-public, personally identifiable infor- mation in the insured's care, custody or control. CGL E5404 CW (03/10) Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 1 Policy Number: UDC -2163525 -CGL -18 Named Insured: MICHAEL RANESES Endorsement Number: 4 Endorsement Effective: February 01, 2018 Hiscox Insurance Company Inc. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CANCELLATION PROVISION (14 DAY FULL REFUND) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART All Coverage Parts included in this policy are subject to the following condition: Notwithstanding anything in the "COMMON POLICY CONDITIONS" or any other cancellation provision to the contrary, if the first Named Insured cancels within 14 days of the inception of the policy period shown in the Declarations without there having been: (i) an 'occurrence" that caused `bodily in- jury" or "property damage"; (ii) an offense arising out of your business that caused a "personal and advertising injury"; or (iii) an accident that caused "bodily injury"; then we shall return in full any pre- mium amount actually paid to us. In such event, the effective date of cancellation shall be deemed to be the inception date of the policy period shown in the Declarations. CGL E5408 CW (03/10) Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 1 AM HISCOX Policy Number: UDC -2163525 -CGL -18 Named Insured: MICHAEL RANESES Endorsement Number: 5 Endorsement Effective: February 01, 2018 Hiscox Insurance Company Inc. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. NOTICE INFORMATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Where To Send Notice Phone: 866-424-8508 Email: reportaclaim@hiscox.com Mail: Hiscox 520 Madison Avenue -32nd Floor Attn: Direct Claims New York, NY, 10022 Subparagraph 2. Duties In The Event Of Occur- rence, Offense, Claim Or Suit in Section IV — COMMERCIAL GENERAL LIABILITY CONDI- TIONS is amended to include the following: Any notification required by this policy shall be pro- vided to us at the address listed in the above SCHEDULE. CGL E5403 CW (03/10) Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 1 40 H I SCO% Policy Number: Named Insured: Endorsement Number: Endorsement Effective UDC -2163525 -CGL -18 MICHAEL RANESES 6 February 01, 2018 Hiscox Insurance Company Inc. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DEFINITION OF EMPLOYEE This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART In Section V — DEFINITIONS, Definition 5. "Employee" is deleted and replaced with the following: 5. "Employee" includes a "leased worker" and a "temporary worker". CGL E5401 CW (03/10) Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 1 4,0 H I SCOX Policy Number: UDC -2163525 -CGL -18 Named Insured: MICHAEL RANESES Endorsement Number: 7 Endorsement Effective: February 01, 2018 Hiscox Insurance Company Inc. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EXCLUSION - PROFESSIONAL SERVICES This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART Paragraph 2. Exclusions under Section I — COVERAGE A — BODILY INJURY AND PROPER- TY DAMAGE LIABILITY, and COVERAGE B — PERSONAL AND ADVERTISING INJURY LIABILITY, is amended to include the following exclusion: Professional Services 'Bodily injury', "property damage" or "personal and advertising injury' caused by the rendering or failure to render any professional service. CGL E5407 CW (03/10) This exclusion applies even if the claims allege neg- ligence or other wrongdoing in the supervision, hir- ing, employment, training or monitoring of others by an insured, if the "occurrence" which caused the "bodily injury" or "property damage", or the offense which caused the "personal and advertising injury', involved the rendering or failure to render any pro- fessional service. Includes copyrighted material of Insurance Services Office, Inc., with Its permission. Page 1 of i Policy Number: UDC -2163525 -CGL -18 Named Insured: MICHAEL RANESES Endorsement Number: 8 Endorsement Effective: February 01, 2018 Hiscox Insurance Company Inc. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. NUCLEAR ENERGY LIABILITY EXCLUSION ENDORSEMENT (Broad Form) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART 1. The insurance does not apply: A. Under any Liability Coverage, to "bodily injury" or "property damage": (1) With respect to which an "insured" under the policy is also an insured under a nuc- lear energy liability policy issued by Nuclear Energy Liability Insurance Association, Mu- tual Atomic Energy Liability Underwriters, Nuclear Insurance Association of Canada or any of their successors, or would be an insured under any such policy but for its termination upon exhaustion of its limit of liability; or (2) Resulting from the "hazardous properties" of "nuclear material' and with respect to which (a) any person or organization is re- quired to maintain financial protection pur- suant to the Atomic Energy Act of 1954, or any law amendatory thereof, or (b) the "in- sured" is, or had this policy not been issued would be, entitled to indemnity from the United States of America, or any agency thereof, under any agreement entered into by the United States of America, or any agency thereof, with any person or organi- zation. B. Under any Medical Payments coverage, to expenses incurred with respect to "bodily in- jury" resulting from the "hazardous properties" of "nuclear material' and arising out of the op- eration of a "nuclear facility" by any person or organization. C. Under any Liability Coverage, to 'bodily injury" or "property damage" resulting from "hazard- ous properties" of "nuclear material', if: (1) The "nuclear material' (a) is at any "nuclear facility' owned by, or operated by or on be- half of, an "insured" or (b) has been dis- charged or dispersed therefrom; (2) The "nuclear material' is contained in "spent fuel" or "waste" at any time pos- sessed, handled, used, processed, stored, transported or disposed of, by or on behalf of an "insured"; or (3) The 'bodily injury' or "property damage" arises out of the furnishing by an "insured" of services, materials, parts or equipment in connection with the planning, construction, maintenance, operation or use of any "nuc- lear facility', but if such facility is located within the United States of America, its terri- tories or possessions or Canada, this ex- clusion (3) applies only to "property dam- age" to such "nuclear facility' and any property thereat. 2. As used in this endorsement: IL 00 21 09 08 0 ISO Properties, Inc., 2007 Page 1 of 2 "Hazardous properties" includes radioactive, toxic or explosive properties. "Nuclear material" means "source material', "spe- cial nuclear material' or "by-product material'. "Source material", "special nuclear material', and "by-product material" have the meanings given them in the Atomic Energy Act of 1954 or in any law amendatory thereof. "Spent fuel" means any fuel element or fuel com- ponent, solid or liquid, which has been used or ex- posed to radiation in a "nuclear reactor". "Waste" means any waste material (a) containing "by-product material" other than the tailings or wastes produced by the extraction or concentra- tion of uranium or thorium from any ore processed primarily for its "source material' content, and (b) resulting from the operation by any person or or- ganization of any "nuclear facility' included under the first two paragraphs of the definition of "nuc- lear facility'. "Nuclear facility" means: (a) Any "nuclear reactor"; (b) Any equipment or device designed or used for (1) separating the isotopes of uranium or plutonium, (2) processing or utilizing "spent fuel', or (3) handling, processing or packag- ing "waste"; (c) Any equipment or device used for the processing, fabricating or alloying of "spe- cial nuclear material' if at any time the total amount of such material in the custody of the "insured" at the premises where such equipment or device is located consists of or contains more than 25 grams of pluto- nium or uranium 233 or any combination thereof, or more than 250 grams of uranium 235; (d) Any structure, basin, excavation, premises or place prepared or used for the storage or disposal of "waste"; and includes the site on which any of the foregoing is located, all operations conducted on such site and all premises used for such operations. "Nuclear reactor" means any apparatus designed or used to sustain nuclear fission in a self- supporting chain reaction or to contain a critical mass of fissionable material. "Property damage" includes all forms of radioac- tive contamination of property. Page 2 of 2 © ISO Properties, Inc., 2007 IL 00 21 09 08 F on Policy Number: UDC -2163525 -CGL -18 Named Insured: MICHAEL RANESES Endorsement Number: 9 Endorsement Effective: February 01, 2018 Hiscox Insurance Company Inc. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CALIFORNIA CHANGES - CANCELLATION AND NONRENEWAL This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Paragraphs 2. and 3. of the Cancellation Com- mon Policy Condition are replaced by the follow- ing: 2. All Policies In Effect For 60 Days Or Less If this policy has been in effect for 60 days or less, and is not a renewal of a policy we have previously issued, we may cancel this policy by mailing or delivering to the first Named Insured at the mailing address shown in the policy and to the producer of record, advance written no- tice of cancellation, stating the reason for can- cellation, at least: a. 10 days before the effective date of cancel- lation if we cancel for: (1) Nonpayment of premium; or (2) Discovery of fraud by: (a) Any insured or his or her representa- tive in obtaining this insurance; or (b) You or your representative in pur- suing a claim under this policy. b. 30 days before the effective date of cancel- lation if we cancel for any other reason. 3. All Policies In Effect For More Than 60 Days a. If this policy has been in effect for more than 60 days, or is a renewal of a policy we issued, we may cancel this policy only upon the occurrence, after the effective date of the policy, of one or more of the following: (1) Nonpayment of premium, including payment due on a prior policy we issued and due during the current policy term covering the same risks. (2) Discovery of fraud or material misrepre- sentation by: (a) Any insured or his or her representa- tive in obtaining this insurance; or (b) You or your representative in pur- suing a claim under this policy. (3) A judgment by a court or an administra- tive tribunal that you have violated a California or Federal law, having as one of its necessary elements an act which materially increases any of the risks in- sured against. IL 02 70 09 08 © ISO Properties, Inc., 2007 Page 1 of 4 (4) Discovery of willful or grossly negligent acts or omissions, or of any violations of state laws or regulations establishing safety standards, by you or your repre- sentative, which materially increase any of the risks insured against. (5) Failure by you or your representative to implement reasonable loss control re- quirements, agreed to by you as a con- dition of policy issuance, or which were conditions precedent to our use of a par- ticular rate or rating plan, if that failure materially increases any of the risks in- sured against. (6) A determination by the Commissioner of Insurance that the: (a) Loss of, or changes in, our reinsur- ance covering all or part of the risk would threaten our financial integrity or solvency; or (b) Continuation of the policy coverage would: (t) Place us in violation of California law or the laws of the state where we are domiciled; or (ti) Threaten our solvency. (7) A change by you or your representative in the activities or property of the com- mercial or industrial enterprise, which results in a materially added, increased or changed risk, unless the added, in- creased or changed risk is included in the policy. b. We will mail or deliver advance written notice of cancellation, stating the reason for cancellation, to the first Named Insured, at the mailing address shown in the policy, and to the producer of record, at least: (1) 10 days before the effective date of cancellation if we cancel for nonpay- ment of premium or discovery of fraud; or (2) 30 days before the effective date of cancellation if we cancel for any other reason listed in Paragraph 3.a. B. The following provision is added to the Cancella- tion Common Policy Condition: 7. Residential Property This provision applies to coverage on real property which is used predominantly for resi- dential purposes and consisting of not more than four dwelling units, and to coverage on tenants' household personal property in a resi- dential unit, if such coverage is written under one of the following: Commercial Property Coverage Part Farm Coverage Part — Farm Property — Farm Dwellings, Appurtenant Structures And House- hold Personal Property Coverage Form a. If such coverage has been in effect for 60 days or less, and is not a renewal of cover- age we previously issued, we may cancel this coverage for any reason, except as provided in b. and c. below. b. We may not cancel this policy solely be- cause the first Named Insured has: (1) Accepted an offer of earthquake cover- age; or (2) Cancelled or did not renew a policy issued by the California Earthquake Au- thority (CEA) that included an earth- quake policy premium surcharge. However, we shall cancel this policy if the first Named Insured has accepted a new or renewal policy issued by the CEA that in- cludes an earthquake policy premium sur- charge but fails to pay the earthquake poli- cy premium surcharge authorized by the CEA. c. We may not cancel such coverage solely because corrosive soil conditions exist on the premises. This Restriction (c.) applies only if coverage is subject to one of the fol- lowing, which exclude loss or damage caused by or resulting from corrosive soil conditions: (1) Capital Assets Program Coverage Form (Output Policy); (2) Commercial Property Coverage Part — Causes Of Loss — Special Form; or (3) Farm Coverage Part — Causes Of Loss Form — Farm Property, Paragraph D. Covered Causes Of Loss — Special. Page 2 of 4 © ISO Properties, Inc., 2007 IL 02 70 09 08 C. The following is added and supersedes any provi- (2) The Commissioner of Insurance finds sions to the contrary: that the exposure to potential losses will NONRENEWAL threaten our solvency or place us in a t. Subject to the provisions of Paragraphs C.2. hazardous condition. A hazardous con- dition includes, but is not limited to, and C.3. below, if we elect not to renew this a condition in which we make claims policy, we will mail or deliver written notice stat- payments for losses resulting from an ing the reason for nonrenewal to the first earthquake that occurred within the pre - Named Insured shown in the Declarations and ceding two years and that required a re - to the producer of record, at least 60 days, but duction in policyholder surplus of at not more than 120 days, before the expiration least 25% for payment of those claims; or anniversary date. or We will mail or deliver our notice to the first (3) We have: Named Insured, and to the producer of record, at the mailing address shown in the policy. (a) Lost or experienced a substantial 2. Residential Property reduction in the availability or scope of reinsurance coverage; or This provision applies to coverage on real property used predominantly for residential (b) Experienced a substantial increase purposes and consisting of not more than four in the premium charged for reinsur- dwelling units, and to coverage on tenants' ance coverage of our residential property insurance policies; and household property contained in a residential unit, if such coverage is written under one of the Commissioner has approved a plan the following: for the nonrenewals that is fair and Capital Assets Program (Output Policy) Cover- equitable, and that is responsive to the changes in our reinsurance position. age Part Commercial Property Coverage Part c. We will not refuse to renew such coverage Farm Coverage Part — Farm Property — Farm solely because the first Named Insured has Dwellings, Appurtenant Structures And House- cancelled or did not renew a policy, issued by the California Earthquake Authority that hold Personal Property Coverage Form included an earthquake policy premium a. We may elect not to renew such coverage surcharge. for any reason, except as provided in b., c. d. We will not refuse to renew such coverage and d. below: solely because corrosive soil conditions ex - b. We will not refuse to renew such coverage ist on the premises. This Restriction (d.) solely because the first Named Insured has applies only if coverage is subject to one of accepted an offer of earthquake coverage. the following, which exclude loss or dam - However, the following applies only to in- age caused by or resulting from corrosive surers who are associate participating in- soil conditions: surers as established by Cal. Ins. Code (1) Capital Assets Program Coverage Form Section 10089.16. We may elect not to re- (Output Policy); new such coverage after the first Named (2) Commercial Property Coverage Part — Insured has accepted an offer of earth- Causes Of Loss—Special Form; or quake coverage, if one or more of the fol- lowing reasons applies: (3) Farm Coverage Part — Causes Of Loss (1) The nonrenewal is based on sound Form — Farm Property, Paragraph D. Covered Causes Of Loss — Special. underwriting principles that relate to the coverages provided by this policy and 3. We are not required to send notice of nonre- that are consistent with the approved newal in the following situations: rating plan and related documents filed a. If the transfer or renewal of a policy, without with the Department of Insurance as re- any changes in terms, conditions, or rates, quired by existing law; is between us and a member of our insur- ance group. IL 02 70 09 08 © ISO Properties, Inc., 2007 Page 3 of 4 b. If the policy has been extended for 90 days or less, provided that notice has been given in accordance with Paragraph C.1. c. If you have obtained replacement coverage, or if the first Named Insured has agreed, in writing, within 60 days of the termination of the policy, to obtain that coverage. d. If the policy is for a period of no more than 60 days and you are notified at the time of issuance that it will not be renewed. e. If the first Named Insured requests a change in the terms or conditions or risks covered by the policy within 60 days of the end of the policy period. f. If we have made a written offer to the first Named Insured, in accordance with the timeframes shown in Paragraph C.1., to re- new the policy under changed terms or conditions or at an increased premium rate, when the increase exceeds 25%. Page 4 of 4 © ISO Properties, Inc., 2007 IL 02 70 09 08 Policy Number: Named Insured: Endorsement Number: Endorsement Effective: UDC -2163525 -CGL -18 MICHAEL RANESES 10 February 01, 2018 Hiscox Insurance Company Inc. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CALIFORNIA CHANGES This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART The term "spouse" is replaced by the following: Spouse or registered domestic partner under Califor- nia law. CG 32 34 01 05 0 ISO Properties, Inc., 2004 Page 1 of 1 Am HISCOX Policy Number: Named Insured: Endorsement Number: Endorsement Effective Hiscox Insurance Company Inc. UDC -2163525 -CGL -18 MICHAEL RANESES 11 February 01, 2018 COMMON POLICY CONDITIONS All Coverage Parts included in this policy are subject to the following conditions. A. Cancellation 1. The first Named Insured shown in the Declara- tions may cancel this policy by mailing or deli- vering to us advance written notice of cancella- tion. 2. We may cancel this policy by mailing or deliver- ing to the first Named Insured written notice of cancellation at least: a. 10 days before the effective date of cancel- lation if we cancel for nonpayment of pre- mium; or b. 30 days before the effective date of cancel- lation if we cancel for any other reason. 3. We will mail or deliver our notice to the first Named Insured's last mailing address known to US. 4. Notice of cancellation will state the effective date of cancellation. The policy period will end on that date. 5. If this policy is cancelled, we will send the first Named Insured any premium refund due. If we cancel, the refund will be pro rata. If the first Named Insured cancels, the refund may be less than pro rata. The cancellation will be ef- fective even if we have not made or offered a refund. 6. If notice is mailed, proof of mailing will be suffi- cient proof of notice. B. Changes This policy contains all the agreements between you and us concerning the insurance afforded. The first Named Insured shown in the Declarations is authorized to make changes in the terms of this policy with our consent. This policy's terms can be amended or waived only by endorsement issued by us and made a part of this policy. C. Examination Of Your Books And Records We may examine and audit your books and records as they relate to this policy at any time dur- ing the policy period and up to three years after- ward. D. Inspections And Surveys 1. We have the right to: a. Make inspections and surveys at any time; b. Give you reports on the conditions we find; and c. Recommend changes. 2. We are not obligated to make any inspections, surveys, reports or recommendations and any such actions we do undertake relate only to in- surability and the premiums to be charged. We do not make safety inspections. We do not un- dertake to perform the duty of any person or organization to provide for the health or safety of workers or the public. And we do not warrant that conditions: a. Are safe or healthful; or b. Comply with laws, regulations, codes or standards. 3. Paragraphs 1. and 2. of this condition apply not only to us, but also to any rating, advisory, rate service or similar organization which makes in- surance Inspections, surveys, reports or rec- ommendations. 4. Paragraph 2. of this condition does not apply to any inspections, surveys, reports or recom- mendations we may make relative to certifica- tion, under state or municipal statutes, ordin- ances or regulations, of boilers, pressure ves- sels or elevators. E. Premiums The first Named Insured shown in the Declara- tions: 1. Is responsible for the payment of all premiums; and 2. Will be the payee for any return premiums we pay. IL 00 17 11 98 Copyright, Insurance Services Office, Inc., 1998 Page 1 of 2 F. Transfer Of Your Rights And Duties Under This Policy Your rights and duties under this policy may not be transferred without our written consent except in the case of death of an individual named insured. If you die, your rights and duties will be transferred to your legal representative but only while acting within the scope of duties as your legal representa- tive. Until your legal representative is appointed, anyone having proper temporary custody of your property will have your rights and duties but only with respect to that property. Page 2 of 2 Copyright, Insurance Services Office, Inc., 1982, 1983 IL 00 17 11 98 N on Policy Number: Named Insured: Endorsement Number: Endorsement Effective UDC -2163525 -CGL -18 MICHAEL RANESES 12 February 01, 2018 Hiscox Insurance Company Inc. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ELECTRONIC DATA LIABILITY This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART Schedule Loss Of Electronic Data Limit: 1$25,000 Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Exclusion 2.p. of Coverage A— Bodily Injury And D. For the purposes of the coverage provided by this Property Damage Liability in Section I — Cove- endorsement, the definition of "Property Damage" rages is replaced by the following: in the Definitions Section is replaced by the fol - 2. Exclusions lowing: This insurance does not apply to: 17. 'Property damage" means: p. Electronic Data a. Physical injury to tangible property, includ- Damages arising out of the loss of, loss of ing all resulting loss of use of that property. All such loss of use shall be deemed to oc- use of, damage to, corruption of, inability to cur at the time of the physical injury that access, or inability to manipulate "electronic caused it; data" that does not result from physical in- jury to tangible property. b. Loss of use of tangible property that is not B. The following paragraph is added to Section III — physically injured. All such loss of use shall be deemed to occur at the time of the "oc- Limits Of Insurance: currence" that caused it; or Subject to 5. above, the Loss of Electronic Data c. Loss of, loss of use of, damage to, corrup- Limit shown in the Schedule above is the most we tion of, inability to access, or inability to will pay under Coverage A for "property damage" properly manipulate "electronic data", result - because of all loss of "electronic data" arising out "occurrence". ing from physical injury to tangible property. of any one All such loss of "electronic data" shall be C. The following definition is added to the Definitions deemed to occur at the time of the "occur - Section: rence" that caused it. "Electronic data" means information, facts or pro- For the purposes of this insurance, "electronic grams stored as or on, created or used on, or data" is not tangible property. transmitted to or from computer software (includ- ing systems and applications software), hard or floppy disks, CD-ROMS, tapes, drives, cells, data processing devices or any other media which are used with electronically controlled equipment. CG 04 37 12 04 © ISO Properties, Inc., 2003 Page 1 of 1 Policy Number: UDC -2163525 -CGL -18 Named Insured: MICHAEL RANESES Endorsement Number: 13 Endorsement Effective: February 01, 2018 Hiscox Insurance Company Inc. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EXCLUSION - INTERCOMPANY PRODUCTS SUITS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART This insurance does not apply to any claim for dam- ages by any Named Insured against another Named Insured because of "bodily injury' or "property dam- age" arising out of "your products" and included within the "products -completed operations hazard." CG 21 41 11 85 Copyright, Insurance Services Office, Inc., 1984 Page 1 of 1 Policy Number: UDC -2163525 -CGL -18 Named Insured: MICHAEL RANESES Endorsement Number: 14 Endorsement Effective: February 01, 2018 Hiscox Insurance Company Inc. RECORDING AND DISTRIBUTION OF MATERIAL OR INFORMATION IN VIOLATION OF LAW EXCLUSION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Exclusion q. of Paragraph 2. Exclusions of Sec- tion I — Coverage A — Bodily Injury And Proper- ty Damage Liability is replaced by the following: 2. Exclusions This insurance does not apply to: q. Recording And Distribution Of Material Or Information In Violation Of Law "Bodily injury" or "property damage" arising directly or indirectly out of any action or omission that violates or is alleged to vi- olate: (1) The Telephone Consumer Protection Act (TCPA), including any amendment of or addition to such law; (2) The CAN -SPAM Act of 2003, including any amendment of or addition to such law; (3) The Fair Credit Reporting Act (FCRA), and any amendment of or addition to such law, including the Fair and Accu- rate Credit Transaction Act (FACTA); or (4) Any federal, state or local statute, ordin- ance or regulation, other than the TCPA, CAN -SPAM Act of 2003 or FCRA and their amendments and additions, that addresses, prohibits, or limits the print- ing, dissemination, disposal, collecting, recording, sending, transmitting, com- municating or distribution of material or information. B. Exclusion p. of Paragraph 2. Exclusions of Sec- tion I — Coverage B — Personal And Advertising Injury Liability is replaced by the following: 2. Exclusions This insurance does not apply to: p. Recording And Distribution Of Material Or Information In Violation Of Law "Personal and advertising injury" arising di- rectly or indirectly out of any action or omis- sion that violates or is alleged to violate: (1) The Telephone Consumer Protection Act (TCPA), including any amendment of or addition to such law; (2) The CAN -SPAM Act of 2003, including any amendment of or addition to such law; (3) The Fair Credit Reporting Act (FCRA), and any amendment of or addition to such law, including the Fair and Accu- rate Credit Transaction Act (FACTA); or (4) Any federal, state or local statute, ordin- ance or regulation, other than the TCPA, CAN -SPAM Act of 2003 or FCRA and their amendments and additions, that addresses, prohibits, or limits the print- ing, dissemination, disposal, collecting, recording, sending, transmitting, com- municating or distribution of material or information. CG 00 68 05 09 ©insurance Services Office, Inc., 2008 Page 1 of 1 N!J Policy Number: Named Insured: Endorsement Number: Endorsement Effective: UDC -2163525 -CGL -18 MICHAEL RANESES 15 February 01, 2018 Hiscox Insurance Company Inc. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CAP ON LOSSES FROM CERTIFIED ACTS OF TERRORISM This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. If aggregate insured losses attributable to terrorist acts certified under the federal Terrorism Risk In- surance Act exceed $100 billion in a calendar year and we have met our insurer deductible under the Terrorism Risk Insurance Act, we shall not be lia- ble for the payment of any portion of the amount of such losses that exceeds $100 billion, and in such case insured losses up to that amount are subject to pro rata allocation in accordance with proce- dures established by the Secretary of the Trea- sury. "Certified act of terrorism" means an act that is certified by the Secretary of the Treasury, in ac- cordance with the provisions of the federal Terror- ism Risk Insurance Act, to be an act of terrorism pursuant to such Act. The criteria contained in the Terrorism Risk Insurance Act for a 'certified act of terrorism" include the following: 1. The act resulted in insured losses in excess of $5 million in the aggregate, attributable to all types of insurance subject to the Terrorism Risk Insurance Act: and 2. The act is a violent act or an act that is dan- gerous to human life, property or infrastructure and is committed by an individual or individuals as part of an effort to coerce the civilian popu- lation of the United States or to influence the policy or affect the conduct of the United States Government by coercion. B. The terms and limitations of any terrorism exclu- sion, or the inapplicability or omission of a terror- ism exclusion, do not serve to create coverage for injury or damage that is otherwise excluded under this Coverage Part. CG 21 70 01 15 © Insurance Services Office, Inc., 2015 Page 1 of 1 40 HISCOX Policy Number: UDC -2163525 -CGL -18 Named Insured: MICHAEL RANESES Endorsement Number: 16 Endorsement Effective: February 01, 2018 Hiscox Insurance Company Inc. THIS ENDORSEMENT IS ATTACHED TO AND MADE PART OF YOUR POLICY IN RESPONSE TO THE DISCLOSURE REQUIREMENTS OF THE TERRORISM RISK INSURANCE ACT. THIS ENDORSEMENT DOES NOT GRANT ANY COVERAGE OR CHANGE THE TERMS AND CONDITIONS OF ANY COVERAGE UNDER THE POLICY. DISCLOSURE PURSUANT TO TERRORISM RISK INSURANCE ACT SCHEDULE SCHEDULE — PART I Terrorism Premium (Certified Acts) $ 4.00 This premium is the total Certified Acts premium attributable to the following Coverage Part(s), Cover- age Form(s) and/or Policy(ies): Additional information, if any, concerning the terrorism premium: SCHEDULE — PART II Federal share of terrorism losses 85% year 2015; 84% year 2016; 83% year 2017; 82% year 2018; 81 % year 2019 and 80% year 2020. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Disclosure Of Premium In accordance with the federal Terrorism Risk In- surance Act, we are required to provide you with a notice disclosing the portion of your premium, if any, attributable to coverage for terrorist acts certi- fied under the Terrorism Risk Insurance Act. The portion of your premium attributable to such cov- erage is shown in the Schedule of this endorse- ment or in the policy Declarations. IL 09 85 01 15 0 Insurance Services Office, Inc., 2015 Page 1 of 2 B. Disclosure Of Federal Participation In Payment Of Terrorism Losses The United States Government, Department of the Treasury, will pay a share of terrorism losses in- sured under the federal program. The federal share equals a percentage (as shown in Part 11 of the Schedule of this endorsement or in the policy Declarations) of that portion of the amount of such insured losses that exceeds the applicable insurer retention. However, if aggregate insured losses at- tributable to terrorist acts certified under the Ter- rorism Risk Insurance Act exceed $100 billion in a calendar year, the Treasury shall not make any payment for any portion of the amount of such losses that exceeds $100 billion. C. Cap On Insurer Participation In Payment Of Terrorism Losses If aggregate insured losses attributable to terrorist acts certified under the Terrorism Risk Insurance Act exceed $100 billion in a calendar year and we have met our insurer deductible under the Terror- ism Risk Insurance Act, we shall not be liable for the payment of any portion of the amount of such losses that exceeds $100 billion, and in such case insured losses up to that amount are subject to pro rata allocation in accordance with procedures es- tablished by the Secretary of the Treasury. Page 2 of 2 © Insurance Services Office, Inc., 2015 IL 09 85 01 15 Ott HISCOX GET THE RIGHT INSURANCE, RIGHT NOW I AM H I SCOX Hiscox Insurance Company Inc. ECONOMIC AND TRADE SANCTIONS POLICYHOLDER NOTICE Hiscox is committed to complying with the U.S. Department of Treasury Office of Foreign Assets Control (OFAC) requirements. OFAC administers and enforces economic sanctions policy based on Presidential declarations of national emergency. OFAC has identified and listed numerous foreign agents, front organizations, terrorists, and narcotics traffickers as Specially Designated Nationals (SDN's) and Blocked Persons. OFAC has also identified Sanctioned Countries. A list of Specially Designated Nationals, Blocked Persons and Sanctioned Countries may be found on the United States Treasury's web site http://www.treas.ciov/offices/enforcement/ofac/ Economic sanctions prohibit all United States citizens (including corporations and other entities) and permanent resident aliens from engaging in transactions with Specially Designated Nationals, Blocked Persons and Sanctioned Countries. Hiscox may not accept premium from or issue a policy to insure property of or make a claim payment to a Specially Designated National or Blocked Person. Hiscox may not engage in business transactions with a Sanctioned Country. A Specially Designated National or Blocked Person is any person who is determined as such by the Secretary of Treasury. A Sanctioned Country is any country that is the subject of trade or economic embargoes imposed by the laws or regulations of the United States. In accordance with laws and regulations of the United States concerning economic and trade embargoes, this policy may be rendered void from its inception with respect to any term or condition of this policy that violates any laws or regulations of the United States concerning economic and trade embargoes including, but not limited to the following: (1) Any insured under this Policy, or any person or entity claiming the benefits of such insured, who is or becomes a Specially Designated National or Blocked Person or who is otherwise subject to US economic trade sanctions; (2) Any claim or suit that is brought in a Sanctioned Country or by a Sanctioned Country government, where any action in connection with such claim or suit is prohibited by US economic or trade sanctions; (3) Any claim or suit that is brought by any Specially Designated National or Blocked Person or any person or entity who is otherwise subject to US economic or trade sanctions; (4) Property that is located in a Sanctioned Country or that is owned by, rented to or in the care, custody or control of a Sanctioned Country government, where any activities related to such property are prohibited by US economic or trade sanctions; or (5) Property that is owned by, rented to or in the care, custody or control of a Specially Designated National or Blocked Person, or any person or entity who is otherwise subject to US economic or trade sanctions. Please read your Policy carefully and discuss with your broker/agent or insurance professional. You may also visit the US Treasury's website at http://www.treas.gov/offices/enforcement/ofac/. INT N001 CW 01 09 Page 1 of 1 qr HISCOX GET THE RIGHT INSURANCE, RIGHT NOW Application Summary Aeo HISCOX Hiscox Insurance Company Inc. The following outlines the details you have given us about your business. We have relied on the accuracy of this information in order to issue your policy. If any of the items below are incorrect or have changed, please call us at 888-202-3007 so that we can update your policy details. Policy number: UDC -2163525 -CGL -18 Quote reference number: 6990696 Product: _ l _._, ____ _._.. __ _...... _ -,_. --_. - ., Commercial General Liability .Business name: MICHAEL RANESES� _ Business address. ..... �� T1 _.._ _ _, 2409 MIRAMONTE CT � �. ..�� ���� _.__.,_— --- City: TUSTIN State: CA Zip code. 92782 Name: MICHAEL RANESES Email address: __ _ ...__ - _ _ MIKERANESES@GMAIL-COM -- --------- - _.._------ . Telephone number. _ _ . _.... 714-287-4999 Per occurrence limit of liability: $ 1,000,000 When would you like your policy to start? February 01, 2018 What is your primary type of business? Other consulting services Your business's ownership structure (please select one). Individual/Sole Do you currently have an insurance policy in effect for the coverage requested? No._.___ 0 Hiscox Inc. 2010 Page 1 11AM HISCOX Hiscox Insurance Company Inc. Including yourself, how many full-time, part-time, and temporary employees does 1-4 your business have? (Do not include subcontractors.) Is your business operated out of your home? No��� Other than the business address provided above, how many additional locations 0 does your business own or rent? Address: NotApplicable Do you or your business supply, manufacture, or distribute any tangible goods or No products? Note: Brochures, documents and reports are not considered as tangible goods. __ w Does your business perform any design, construction, installation, removal or ,- No physical repair of any property or tangible good? Does your business provide any of the following services? No • Aerospace consulting or advice • Architecture or engineering advice • Construction management or advice • Environmental consulting or advice • General contracting • Land acquisition • Law enforcement training • Medical advice • Mining consulting or advice • Oil, gas, or petroleum consulting or advice • Safety consulting or advice • Sales representative. For the next 12 months, what is your estimated payroll expense for yourself, your $ 5,000 full-time, part-time, and temporary employees? (Do not include subcontractors.) As the individual completing this transaction, you are authorized to purchase and I have read and agree bind this insurance on behalf of the entity applying for coverage. Your business is not controlled or owned by any other firm, corporation, or entity.. I have read and agree For the entire period of time that you have owned and controlled the business, You I have read and agree have not sold, purchased or acquired, discontinued, merged into or consolidated with another business. Your business has never had any commercial insurance cancelled or rescinded. I have read and agree © Hiscox Inc. 2010 Page 2 AM H I SCOX Hiscox Insurance Company Inc. Your Business does not conduct any of the following activities: I have read and agree -Automotive repair or sales - Food service/restaurant operations - Medical services - Retail operations Note: This does not include the activities of your clients in any of these industries Based upon your knowledge and the knowledge of your business's current and past I have read and agree partners, officers, directors and employees, during the last five years a third party has never made a claim against your business and you do not know of any reason why someone may make a claim. The limits of liability represent the total amount available to pay judgments and settlements for any not liable for any amounts that exceed these limits. If coverage is provided, it shall apply only to occurrences that take place during the policy period. We are Judgments, settlements and claims expenses incurred are subject to a deductible amount. The deductible is the amount you must pay before we will make any payments under the policy. Some coverage may not be subject to a deductible, in which case you are not required to make payments before any payments are made under the policy. Please consult the policy language for details. If you have knowledge of any circumstance that may lead to a loss or a claim being made against you, coverage will be excluded if such loss occurs or claim is made. Occurrences that took place prior to the inception of the policy are excluded. Fraud Warning It is a crime to knowingly and intentionally attempt to defraud an insurance company by providing false or misleading information or concealing material information during the application process or when filing a claim. Such conduct could result in your policy being voided and subject you to criminal and civil penalties. Optional Terrorism coverage You have elected to purchase optional terrorism coverage. Yes Optional Waiver of Subrogation You have declined to purchase a Waiver of Subrogation. Yes You have confirmed that you agree with the General Statements provided. Yes I agree to accept delivery of my insurance policy via email to the address provided. Yes I have read the information above and confirm it is all correct. I understand that by Yes checking this box I am agreeing to enter into a binding agreement with Hiscox Insurance. Optional Business Personal Property Coverage You have declined to purchase optional business personal property and equipment Yes coverage: © Hiscox Inc. 2010 Page 3 -Ao HISCOX For MICHAEL RANESES General Liability: UDC -2163525 -CGL -18 April 26, 2018 Below is your payment schedule that includes your policy number(s), coverage dates, payment received, and outstanding balances due. Since you have chosen to pay monthly, Hiscox will collect funds automatically on or around the dates listed below. You will not receive any further billing statements unless you make a change to your policy so be sure to keep this summary for your records. Please call us at 888-202-3007 (Mon -Fri, 8am-10pm EST) or send us an e-mail at contact@hiscox.com if you have any questions about your payment or insurance coverage. Our advisors are available and ready to help you. Please update us if any of your payment details change. Thank you for choosing Hiscox for your small business insurance needs. General Liability Start date End date Amount due Ltd Payment collected Payment collection date Remaining balance UDC -2163525 -CGL -18 February 01, 2018 February 01, 2019 $ 350.00 $ 116.72 April 01, 2018 $ 233.28 C Hiscox Inc. 2010 Page 1 March 01, 2018 $ 29.16 April 01, 2018 $ 29.16 May 01, 2018 $ 29.16 June 01, 2018 $ 29.16 July 01, 2018 $ 29.16 August 01, 2018 $ 29.16 September 01, 2018 $ 29.16 October 01, 2018 $ 29.16 November 01, 2018 $ 29.16 December 01, 2018 $ 29.16 © Hiscox Inc. 2010 Please remember that we do not charge any fees for monthly payments, so that you can spread out your insurance costs. Page 2