HomeMy WebLinkAboutINTERWEST CONSULTING GROUP (3)City of Santa Ana
Clerk of the Council
AGREEMENT TERMINATION FORM
Please complete this form in its entirety when the attached agreement and all
amendments (if any) are no longer in effect.
Note: If your agreement is grant related, please ensure that all grant retention requirements
have been satisfied prior to signing the termination form.
Is the agreement(s) a permanent record? Yes El Now
Return form to the Clerk of the Council Office (M-30).
Call 647-1520 if you have any questions.
The agreement with
INTERWEST CONSULTING GROUP
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INSURANCE ON FILE A-2019-199-10
WORK MAY PROCEED
UNTIL INSURANCE EXPIRES
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CLERK OF COUNCIL
DATE AGREEMENT TO PROVIDE ON-CALL
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THIS AGREEMENT is made and entered into this 5th day of November, 2019 by and between
Interwest Consulting Group ("Consultant"), and the City of Santa Ana, a charter city and municipal
N corporation organized and existing under the Constitution and laws of the State of California
cv ("City").
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m RECITALS
A. On September 3, 2019, the City issued Request for Qualification No. 19-085, by
which it sought Consultants to provide on -call building safety consultant services
for the Planning and Building Agency of the City of Santa Ana.
B. The scope of work may include any and all work efforts related to City projects to
provide Plan Check and Building Inspection services and customer assistance for
the City of Santa Ana. The intent is to minimize response time and improve
customer services by supplementing in-house staff with consulting services on an
as -needed basis.
C. Consultant submitted a responsive proposal that was among those selected by the
City. Consultant represents that it is able and willing to provide the services
described in the scope of work that was included in RFQ No. 19-085 and attached
hereto as Exhibit A.
D. Consultant has been selected as one of the fourteen (14) vendors which qualified
for this engagement. Only those consultants approved by the City Council on
November 5, 2019, shall be eligible to be engaged by the City for these services.
E. In undertaking the performance of this Agreement, Consultant represents that it is
knowledgeable in its field and that any services performed by Consultant under this
Agreement will be performed in compliance with such standards as may reasonably
be expected from a professional contracting firm in the field.
NOW THEREFORE, in consideration of the mutual and respective promises, and subject to the
terns and conditions hereinafter set forth, the parties agree as follows:
1. SCOPE OF SERVICES
a. On an as -needed basis, and at the sole discretion of City, Consultant shall perform
the services that are described in Exhibit A. Consultant's proposal is incorporated
by reference as though fully set forth herein. Upon final execution of this
Agreement, when the need for services arise, City shall initiate services through use
of a Letter Agreement for a specific project, executed by the Executive Director of
the Planning and Building Agency and the Consultant. Work by the Consultant
may not proceed absent a previously engaged or fully executed consultant
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agreement followed by letter agreement for a specific project.
b. Schedule for Performance. Consultant shall perform the services identified in a
scope of work to be attached to a letter agreement, as detailed above, required to
commence a specific project. Said project(s) shall be completed as expeditiously
as is consistent with generally accepted standards of professional skill and care, and
the orderly progress of work. Details of the project timelines shall be provided in
a completion schedule as part of the scope of work to a letter agreement.
Consultant and City agree that the completion schedule represents the best
estimate of the schedule. Consultant shall comply with completion dates
noted unless a written waiver is granted by the City's project manager, or
by means of an amended letter agreement. In the event that Consultant fails
to complete a work product in accordance with the completion date noted
in its letter agreement, Consultant agrees to pay the City liquidated damages
in an amount to be determined as reasonable by the City, reflecting the
overall scope of the project, on a per day basis for each work product that
is delayed when such delay is caused by Consultant. Consultant and City
acknowledge that the actual value of delay is extremely difficult to
determine and any liquidated damages amount specified in the letter
agreement represents the best estimate of the daily cost of delay to City.
ii. Consultant shall not be responsible for performance delays caused by
others, or delays beyond Consultant's control. Consultant shall provide
written notice to City's project manager of such delays. If City agrees, the
project manager's written approval to the Consultant shall extend the times
for performance of the work by Consultant.
iii. The liquidated damages payable shall be in addition to amounts payable
under this Agreement, or any letter agreement, for goods sold, services
rendered and other claims and charges attributable to the period prior to the
effective date of the termination.
2. COMPENSATION
a. As Consultant is one of fourteen (14) selected vendors selected by the City, City
neither warrants nor guarantees any minimum or maximum compensation to
Consultant under this Agreement. Consultant shall be paid only for actual services
performed under this Agreement at the rates and charges identified in Exhibit A.
The total amount to be expended during the term of this Agreement, as approved
by Council amongst the fourteen (14) selected vendors, shall not exceed
$2,400,000. .
b. Where applicable, City shall recognize and pay for any outstanding invoices for
work performed by any of the fourteen (14) selected vendors for building safety
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consultant services performed by the Consultant for work previously performed for
the City.
C. Payment by City shall be made within forty-five (45) 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 fbrth in the Recitals and Scope of Work, which may reasonably be
expected by City.
3. TERM
This Agreement shall commence on the date first written above until November 5, 2022,
unless terminated earlier in accordance with Section 17, below.
4. PREVAILING WAGES
Consultant is aware of the requirements of California Labor Code Section 1720, et seq.,
and 1770, et seq., as well as California Code of Regulations, Title 8, Section 16000, et seq.,
("Prevailing Wage Laws"), which require the payment of prevailing wage rates and the
performance of other requirements on "public works" and "maintenance" projects. If the services
being performed are part of an applicable "public works" or "maintenance" project, as defined by
the Prevailing Wage Laws, and the total compensation is $1,000 or more, Consultant agrees to
fully comply with such Prevailing Wage Laws. Consultant shall defend, indemnify and hold the
City, its elected officials, officers, employees and agents free and harmless from any claim or
liability arising out of any failure or alleged failure to comply with the Prevailing Wage Laws.
5. INDEPENDENT CONTRACTOR
Consultant 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 Consultant
performs the services which are the subject matter of this Agreement; however, the services to be
provided by Consultant shall be provided in a manner consistent with all applicable standards and
regulations governing such services. Consultant 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.
6. OWNERSHIP OF MATERIALS
This Agreement creates a non-exclusive and perpetual license for City to copy, use,
modify, reuse, or sublicense any and all copyrights, designs, and other intellectual property
embodied in plans, specifications, studies, drawings, estimates, and other documents or works of
authorship fixed in any tangible medium of expression, including but not limited to, physical
drawings or data magnetically or otherwise recorded on computer diskettes, which are prepared or
caused to be prepared by Consultant under this Agreement ("Documents & Data"). Consultant
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shall require all subcontractors to agree in writing that City is granted a non-exclusive and
perpetual license for any Documents & Data the subcontractor prepares under this Agreement.
Consultant represents and warrants that Consultant has the legal right to license any and all
Documents & Data. Consultant makes no such representation and warranty in regard to
Documents & Data which were provided to Consultant by the City. City shall not be limited in
any way in its use of the Documents and Data at any time, provided that any such use not within
the purposes intended by this Agreement shall be at City's sole risk.
7. INSURANCE
Prior to undertaking performance of work under this Agreement, Consultant shall maintain
and shall require its subcontractors, if any, to obtain and maintain insurance as described below:
a. Commercial General Liability Insurance. Consultant 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 Consultant'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,
volunteers and representatives as additional insured(s); (b) be primary 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 of not less than $1,000,000 per occurrence. Such insurance shall include
coverage for owned, hired and non -owned automobiles.
C. Worker's Compensation Insurance. In accordance with the California Labor Code,
Consultant, if Consultant 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, Consultant agrees
to obtain and maintain any employer's liability insurance with limits not less than
$1,000,000 per accident.
d. If Consultant 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.
e. The following requirements apply to the insurance to be provided by Consultant
pursuant to this section:
Page 4 of 10
#12067v2
(i) Consultant 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 cancelled
or reduced in coverage or changed in any other material aspect, by
consultant, without thirty (30) days prior written notice to the City.
(iv) Where the amounts or coverage provided by the certificates of insurance
provides coverage greater than those listed by this Agreement, the amounts
provided by the certificates of insurance shall be incorporated by reference
into the Agreement.
(v) Consultant shall supply City with a fully executed additional insured
endorsement.
If Consultant 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
Consultant's right to be paid for its time and materials expended prior to notification
of termination. Consultant waives the right to receive compensation and agrees to
indemnify the City for any work performed prior to approval of insurance by the
City.
8. INDEMNIFICATION
Consultant agrees to defend, and shall indemnify and hold harmless the City, its officers,
agents, employees, consultants, 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 Consultant or its Consultants, subcontractors, agents, employees, or
other persons acting on their 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 this
Agreement. The Consultant 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 Consultant's services are subject to Civil Code
Section 2782.8, the above indemnity shall be limited, to the extent required by Civil Code Section
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2782.8, to claims that arise of, pertain to, or relate to the negligence, recklessness, or willful
misconduct of the Consultant.
9. INTELLECTUAL PROPERTY INDEMNIFICATION
Consultant shall defend, indemnify and hold harmless the City, its officers, agents,
representatives, and employees against any and all liability, including costs, and attorney's fees,
for infringement of any United States' letters patent, trademark, or copyright contained in the work
product or documents provided by Consultant to the City pursuant to this Agreement.
10. RECORDS
Consultant shall keep records and invoices in connection with the work to be performed
under this Agreement. Consultant shall maintain complete and accurate records with respect to
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 Consultant under this Agreement. All such records and
invoices shall be clearly identifiable. Consultant 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. Consultant 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 Consultant under this Agreement.
11. CONFIDENTIALITY
If Consultant receives from the City information which due to the nature of such
information is reasonably understood to be confidential and/or proprietary, Consultant 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
Consultant disclosed in a publicly available source; (c) is in rightful possession of the Consultant
without an obligation of confidentiality; (d) is required to be disclosed by operation of law; or (e)
is independently developed by the Consultant without reference to information disclosed by the
City.
12. CONFLICT OF INTEREST CLAUSE
Consultant covenants that it presently has no interest and shall not have interests, direct or
indirect, which would conflict in any manner with performance of services.
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13. NOTICE
Any notice, tender, demand, delivery, or other communication pursuant to this Agreement
shall be in writing and shall be deemed to be property 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: Clerk 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
Executive Director
Planning and Building Agency
City of Santa Ana
20 Civic Center Plaza (M-21)
P.O. Box 1988
Santa Ana, CA 92702
Fax:714-647-5897
To Consultant: Interwest Consulting Group
Ron Beehler, Director
15140 Transistor Lane
Huntington Beach, CA 92649
Phone: 899-9039
A party may change its address by giving notice in writing to the other party. Thereafter,
any communication 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.
14. EXCLUSIVITY AND AMENDMENT
This Agreement represents the complete and exclusive statement between the City and
Consultant regarding the subject matter herein, 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 signed by the City and by an authorized representative of
Consultant. 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
#12067v2 Page 7 of 10
bind or obligate Consultant 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 are not embodied herein.
15. ASSIGNMENT
Inasmuch as this Agreement is intended to secure the specialized services of Consultant,
Consultant 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 consultants retained by City.
16. 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.
17. TERMINATION
This Agreement may be terminated by the City upon thirty (30) days written notice of
termination. In such event, Consultant shall be entitled to receive and the City shall pay Consultant
compensation for all services performed by Consultant 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 Consultant to
deliver to the City all work product completed as of such date, and in such case
such work product shall be the property of the City unless prohibited by law, and
Consultant 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.
18. NON-DISCRIMINATION
Consultant shall not discriminate because of race, color, creed, religion, sex, marital status,
sexual orientation, gender identity, gender expression, gender, medical conditions, genetic
information, or military and veteran status, age, national origin, ancestry, or disability, as defined
and prohibited by applicable law, in the recruitment, selection, teaching, training, utilization,
promotion, termination or other employment related activities or any services provided under this
Agreement. Consultant affirms that it is an equal opportunity employer and shall comply with all
applicable federal, state and local laws and regulations.
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19. JURISDICTION -VENUE
This Agreement has been executed and delivered in the State of California 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 of this Agreement.
20. PROFESSIONAL LICENSES
Consultant 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 governmental agencies. Consultant 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.
21, 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.
[signature page to follow]
Page 9 of 10
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IN WITNESS WHEREOF, the parties hereto have executed this Agreement the date and year first
above written.
ATTEST:
.r' of the Council
APPROVED AS TO FORM
SONIA R. CARVALHO
City Attorney
Lisa Storck
Assistant City Attorney
RECOMMENDED FOR APPROVAL
O
MINH THAI
Executive Director
Planning and Building Agency
CITY OF SANTA ANA
R STINE RID
City Manager
CONSULTANT
CBeehler
R n
Director, Interwest Consulting Group
Page 10 of 10
#12067v2
SCOPE OF SERVICES — Exhibit A
General Description
Building Safety Division of the City of Santa Ana foresees the submittal of many construction
projects in the near future. Therefore, the City is seeking the services of professional
consultants to support the efforts of City staff in the area of Building Safety Services including
Plan Check Services, Inspection Services and Technical Services.
Scope of Services
A. Plan Review Services
Consultant shall perform the following services for each assigned building plan review.
1. Detail review of the mechanical, plumbing, electrical and building (architectural and
structural) plans. Review supporting documents for industrial, commercial, residential
and public buildings and determine compliance with applicable building standards as
related to existing and proposed buildings.
2. Review the plans for compliance with California state -mandated regulations for energy
conservation, disabled access, green building standards and City adopted ordinances.
3. Review the plans for compliance with Federal Flood Plain regulations for projects in the
special flood hazard area designated on the flood insurance rate map (FIRM) as Flood
Zone A or AE.
4. Recheck and approval of final plans and supporting documents to be provided without
additional charge for recheck.
5. Submittal of approved plans and all supporting documents to the City of Santa Ana.
6. Provide all necessary liaison with applicants via phone, e-mail or in person to expedite
the review process and consult on complex code issues with City of Santa Ana Building
Official.
7. Plan review report to be customized for each project and be delivered via fax, mail or
e-mail to City and the applicant.
8. Structural portion of the plans to be reviewed by California Licensed Civil or Structural
Engineer.
9. Plan reviewer to be consistent, accurate, available and responsive to the City and the
applicant via phone, fax, e-mail and meetings. Also, the plan reviewer shall be available
to the Building Official and his staff to help answer Code questions arising from review.
Plan reviewer shall provide assistance in evaluation of alternate materials, design and
methods of construction proposed by applicant.
10. Plan reviewer shall be available, at no expense to the City of Santa Ana, to meet at the
City office with owners, architects, engineers and contractors to discuss the Plan Check
Issues.
11. Plan reviewer to verify that the job description, square footages, occupancy
classifications and type of construction, on the permit application agrees with the plans
and specifications. Plan reviewer will also verify the building valuation based upon
valuation costs used by the City of Santa Ana.
12. Initial Plan review to be complete within ten (10) working days and recheck within five (5)
working days.
13, Consultant fee for review services to be 50% of the City of Santa Ana Plan Check Fee.
14. Hourly projects Including revisions, deferred submittals, trusses, stairs, curtain walls,
mechanical, plumbing and electrical plan reviews will be checked on an hourly rate of
$95,00/hour when performed by a Certified Plans Examiner and a rate of $120.00/hour
when performed by a registered Senior Plan Check Engineer.
15. Expedited Plan Review will be provided when requested for an individual project and will
be an additional 30% of the plan review fees above. For Expedited Plan Review, the
initial plan review to be complete within five (5) to seven (7) working days and recheck
within five (5) working days.
16. Fee(s) are charged in conformance with the Citys Miscellaneous Fee Schedule.
17. Provide in-house temporary staff.
18. Courier service for pickup and delivery of plans to the City shall be provided at no
additional cost
B. Building Inspection Services
Consultant shall perform the following services.
1. Building inspection services for industrial, commercial, residential and public buildings to
determine compliance with approved plans and documents as well as applicable building
standards as related to existing and proposed buildings.
2. Building inspection services for compliance with California state -mandated regulations
for energy conservation, disabled access, green building standards and City adopted
ordinances.
3. Building inspection services for compliance with Federal Flood Plain regulations for
projects in the special flood hazard area designated on the flood Insurance rate map
(FIRM) as Flood Zone A or AE.
4. Building inspectors shall be certified to perform inspections for compliance with
applicable California Building Standards Codes.
5. Building inspectors shall complete all necessary City forms and documents, enter
results, and follow the City's workflow when an inspection is conducted. Inspectors will
provide accurate correction notices and inspection records.
6. Building inspections shall be charged at an hourly rate of $80.00/hour when performed
by a Certified Building Inspector and a rate of $95.00/hour when performed by a Senior
Certified Building Inspector. Mileage will not be reimbursed by the City.
7. Provide accelerated building Inspection services on an as -needed basis.
8. Provide in-house temporary staff.
C. Technical Services
Consultant shall perform the following services.
1. Technical services shall be provided as -needed at hourly rates listed in Sections A and
B above, based on the qualifications of the consultant that will provide the service.
Technical services shall include training and technical studies with reporting, with rates
ranging from $80.00/hour to $120/hour.
Client#: 1086878
INTERCON35
ACORD,., CERTIFICATE OF LIABILITY INSURANCE
DATE(MMIDDIYYYYI
11107/2019
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 certifcate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed.
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on
this certificate does not confer any rights to the certificate holder in lieu of such endorsement(s).
PRODUCER CONTACT
NAME
USI Insurance Services, LLC PHONE
800 873-8500 I FAX
P.O. Box 7050 tAIC NoiEae.. -... _.. Nol:
E-MAIL
Englewood, CO 80155 ADDRESS: --- --- --' - ------ -- — - --
INSURER(S)AFFORDING COVERAGE NAIC#
800873-8500
INSURER A:TIYeInnPrupedyCae.ceerA,nero 25674
INSURED XL 3eadseY l,nuranwC.."ry
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P.O. Box 18330 INSURER C: _.
P.O.InteBox
Boulder, CO 80308 INSURER D:
INSURER E:
INSURER F :
UUVCIXAbtJ UER I IFIOA I E NUMBER: UCMIe1nM MUuoeo.
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 CONTRACTOR 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.
OL INSR - AOWVP -POLICY EFF POLICY EXP I --- - -- - --
LTR TYPE OF INSURANCE I SR WYO POLICY NUMBER MMIDDIYYYY (MMIDDIYYYYI LIMITS
A
GENERAL LIABILITY X X 6806H441235
_
11/14/201910/Ot/202 EACH OCC_UR_R_E_N_C_E
$1,000000CLAIMS-MADE
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-
MED EXP (My FEE dersonl
PERSONAL SAOVINJURY
S1,000,000
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s2,000,000
X 1_7
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S
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X XBAOJ093233
COMBINED
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1,000,000e
X
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BODILY INJURY (Per acodenl)
S
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AUTOS ONLY X AUTOS ONLY
RTYDAM P40PEAGE
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-
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i
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UMBRELLA LIAR X OCCUR X X CUP2F178249
11/14/2019 10/01/2020 EACHOCCURRENCE_
s4000O00
EXCESS LIAR CLAIMS -MADE. I
_
A,GREGATE_
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S
QED X RETENTION SO
_
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WORKERS COMPENSATION X ,UB8J034006
11114/2019 10/01/2020 X PER OT14
LI
AND EMPLOYERS' ABILITY YIN -
T T
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OFFICER/MEMBER EXCLUDED' NIA
E-_ EACH ACCIDENT 51 QOO OOO
_ .. 0 -_—.
(Mandalory In NH)
EL DISEASE - EA EMPLOYEE $1,000000
Iryas, desnibe under
- --
DESCRIPTIONOFOPERATIONS below
EL DISEASE -POLICY LIMIT $1,000,000
11114/2019 11/14/2020 $2,000,000 per claim
B
Professional Liab X DPR9951576
Pollution Liab
$5,000,000 anal aggr.
Claims Made
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101. AddlBonal Remarks Schedule, may be aNaeked If more space Ie required)
As required by written contract or written agreement, the following provisions apply subject to the policy
terms, conditions, limitations and exclusions: The Certificate Holder and owner are included as Automatic
Additional Insured's for ongoing and completed operations under General Liability; Designated Insured under
Automobile Liability; and Additional Insureds under Umbrella I Excess Liability but only with respect to
liability arising out of the Named Insured work performed on behalf of the certificate holder and owner.
(See Attached Descriptions)
O KISK VI NA EMENT LAVl ORIHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
City of Santa Ana THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
Risk Management Division ACCORDANCE WITH THE POLICY PROVISIONS.
20 Civic Center Plaza, A F 252019
Santa Ana, CA 92702 AUTIIORIZ OREPRESENTATIVE
4/\/kA A M. LAMBE T o-n_,
ED 1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016103) 1 Of 2 The ACORD name and logo are registered marks of ACORD
#S27092524IM27088729 ADKZP
-DESCRIPTIONS (Continued from Page 1)
The General Liability, Automobile Liability, Umbrella/Excess insurance applies on a primary andmon
contributory basis. A Blanket Waiver of Subrogation applies for General Liability, Automobile Liability,
UmbrellalExcess Liability and Workers Compensation. The Umbrella / Excess Liability policy provides excess
coverage over the General Liability, Automobile Liability and Employers Liability.
Please note that Additional Insured status does not.apply to Professional Liability or Workers'
Compensation.
Additional Insured: The City, Its officers, employees, agents, volunteers and representatives.
All policies Include 30 Day Notice of Cancellation In favor of the City of Santa Ana.
SAGITTA25.30016/03) 2 of2
#827092524/M27088729
GENERAL PURPOSE ENDORSEMENT
OFFICE PAC
POLICY NUMBER: 6306H441235
ISSUE DATE:
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
CG2037 (07-04) - ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS -
COMPLETED OPERATIONS
This endorsement modifies insurance provided under the following:
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS -COMPLETED OPERATIONS
THIS ENDORSEMENT MODIFIES INSURANCE PROVIDED UNDER THE FOLLOWING:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
NAMES OF ADDITIONAL INSURED PERSON(S) OR ORGANIZATION(S):
Any person or organization that you agree In a written contract to
Include as an additional Insured on this Coverage Part for "bodily
Injury" or "property damage" Included in the products -completed
operations hazard, provided that such contract was signed and executed by
you before, and is in effect when, the "bodily injury or "property
damage" occurs.
LOCATION AND DESCRIPTION OF COMPLETED OPERATIONS:Any project to which a
written contract with the Additional Insured Person(s) or Organization(s)
in the Schedule applies.
(INFORMATION REQUIRED TO COMPLETE THIS SCHEDULE, IF NOT SHOWN ABOVE, WILL
BE SHOWN IN THE DECLARATIONS.)
A. SECTION li - WHO IS AN INSURED IS AMENDED TO INCLUDE AS AN ADDITIONAL
INSURED THE PERSON(S) OR ORGANIZATION(S) SHOWN IN THE SCHEDULE, BUT ONLY
WITH RESPECT TO LIABILITY FOR "BODILY INJURY", "PROPERTY DAMAGE" CAUSED,
IN WHOLE OR IN PART, BY "YOUR WORK" AT THE LOCATION DESIGNATED AND
DESCRIBED IN THE SCHEDULE OF THIS ENDORSEMENT PERFORMED FOR THAT
ADDITIONAL INSURED AND INCLUDED IN THE "PRODUCTS -COMPLETED OPERATIONS
HAZARD".
CG 20 37 07 04
Copyright ISO Properties, Inc. 2004
CC TS 04 10 18 11 1260
Page 1 Of 1
GENERAL PURPOSE ENDORSEMENT
OFFICE PAC
POLICY NUMBER: 68061-1441235
ISSUE DATE:
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
CGD361 (03-05) - ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS -
SCBEDULED PERSON OR OROANIZATION
This endorsement modifies Insurance provided under the following:
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED' -.,OWNERS, LESSEES OR CONTRACTORS -
SCHEDULED PERSON OR ORGANIZATION
THIS ENDORSEMENT MODIFIES INSURANCE PROVIDED UNDER THE FOLLOWING:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
NAMES OF ADDITIONAL INSURED,PERSON(S) OR ORGANIZATION(S):
Any person or organization that you agree In a written contract to
include as an additional Insured on this Coverage Part, provided that
such written contract was signed and executed by you before,and is in
effect when, the "bodily injury" or "property damage" occurs or the
"personal Injury" or "advertising Injury" offense Is committed.
LOCATION OF COVERED OPERATIONS:
Any project to which a written contract with the Additional Insured
Person(s) or Organization(s) in the Schedule applies.
(INFORMATION REQUIRED TO COMPLETE THIS SCHEDULE, IF NOT SHOWN ABOVE, WILL
BE SHOWN IN THE DECLARATIONS.)
A. SECTION II - WHO IS AN INSURED IS AMENDED TO INCLUDE AS AN
ADDITIONALINSURED THE PERSON(S) OR ORGANIZATION(S) SHOWN IN THE SCHEDULE,
BUT ONLY WITH RESPECT TO LIABILITY FOR "BODILY INJURY", "PROPERTY
DAMAGE", PERSONAL INJURY OR -"ADVERTISING INJURY" CAUSED, IN WHOLE OR IN
PART, BY:
1. YOUR ACTS OR OMISSIONS; OR
2. THE ACTS OR OMISSIONS OF THOSE ACTING ON YOUR BEHALF; IN THE
PERFORMANCE OF YOUR ONGOING OPERATIONS FOR THE ADDITIONAL INSURED(S) AT
THE LOCATION(S) DESIGNATED ABOVE.
B. WITH RESPECT TO THE INSURANCE AFFORDED TO THESE ADDITIONAL INSURED,
THE FOLLOWING ADDITIONAL EXCLUSIONS APPLY:THIS INSURED DOES NOT APPLY TO
CO TS 03 10 1e I1lfl Page 1 of 2
3
GENERAL PURPOSE ENDORSEMENT POLICY NUMBER. 68061-1441235
OFFICE PAC ISSUE DATE:
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
CGD361 (03-05) - ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS -
SCEEDDLED PERSON OR ORGANIZATION
This endorsement modifies Insurance provided under the following:
"BODILY INJURY" OR 'PROPERTY DAMAGE" OCCURRING, OR "PERSONAL INJURY" OR
"ADVERTISING INJURY" ARISING OUT OF AN OFFENSE COMMITTED, AFTER:
1. ALL WORK, INCLUDING MATERIALS, PARTS OR EQUIPMENT FURNISHED IN
CONNECTION WITH SUCH WORK, ON THE PROJECT (OTHER THAN SERVICE,
MAINTENANCE OR REPAIRS) TO BE PERFORMED BY OR ON BEHALF OF -THE ADDITIONAL
INSURED(S) AT THE LOCATION OF THE COVERED OPERATIONS HAS BEEN COMPLETED;
OR
2. THAT PORTION OF "YOUR WORK" OUT OF WHICH THE INJURY OR DAMAGE ARISES
HAS BEEN PUT TO ITS INTENDED USE BY ANY PERSON OR ORGANIZATION OTHER THAN
ANOTHER CONTRACTOR OR SUBCONTRACTOR ENGAGED IN PERFORMING OPERATIONS FOR
A PRINCIPAL AS A PART OF THE SAME PROJECT.
CG D3 61 03 05
Copyright 2005 The St.-PaUI Travelers Companies, Inc. All rights
reserved.
Includes copyrighted material of Insurance Services Office, Ino. with its
permission.
CG TS 03 10 IS
4.111"i'l
Page 2 of 2
GENERAL PURPOSE ENDORSEMENT
OFFICE PAC
POLICY NUMBER: 88051-144t235
ISSUE DATE:
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
COD425 (07-08) - OTHER INSURANCE ADDITIONAL INSUREDS PRIMARY AND NONCONTRIBUTORY
WITH RESPECT TO CERTAIN OTHER INSURANCE
This endorsement modifies Insurance provided under the following:
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
OTHER INSURANCE - ADDITIONAL INSUREDS - PRIMARY AND NONCONTRIBUTORY WITH
RESPECT TO CERTAIN OTHER INSURANCE 1.
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
The following is added to Paragraph 4. a., Primary Insurance, of�SECTION
IV - COMMERCIAL GENERAL LIABILITY CONDITIONS;
However, if you specifically agree in a written contract or agreement
that the insurance afforded to an additional Insured under this Coverage
Part must apply on a primary basis, or a primary and non-contributory
basis, this insurance is primary to other insurance that is available to
such additional insured which covers such additional insured as a named
insured, and we will not share with that other insurance, provided that:
(1) The "bodily injury" or "property damage" for which coverage is
sought Is caused by an "occurrence" that takes place; and
(2) The "personal injury" or "advertising injury" for which coverage
is sought arises out of an offense that is committed; subsequent to the
signing and execution of that contract or agreement by you.
CG D4 25 07 08
2008 The Travelers Companies, Inc.
CG T8 pI 10 IS
Page X of 1
GENERAL PURPOSE ENDORSEMENT POLICY NUMBER: 680BH441235
OFFICE PAC ISSUE DATE:
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
CG2404 (10-93) - WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US
This endorsement modifies insurance provided under the following:
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US
This endorsement modifies Insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
Name of Person or Organization:
Any person or organization that you have agreed in a written contract or
agreement to waive your right of recovery against, but only for payments
we make because of:
1."Bodily Injury" or "property damage" that occurs; or
2."Personal Injury" or "advertising injury" caused by an offense
committed; after you have executed that contract or agreement.
(If no entry appears above, information required to complete this
endorsement will be shown in the Declarations as applicable to this
endorsement.)
The TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US Condition
(Section IV -COMMERCIAL GENERAL LIABILITY CONDITIONS) is amended by the
addition of the following:
We waive any right of recovery we may have against the person or
organization shown In the Schedule above because of payments we make for
Injury or damage arising out of your ongoing operations or "your work"
done under a contract with that person or organization and included in
the "products -completed operations hazards" This waiver applies only to
the person or organization shown In the Schedule above.
CG 24 04 10 93
Copyright, Insurance Services Office, Inc., 1992
CG TO 02 10 18 4 1
ry 11� [,I Page 1 of 2
OFFICE PAC
POLICY NUMBER: 68061-1441235
ISSUE DATE:
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
CG2404 (10-93) - WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAMST OTHERS TO US
This endorsement modifies insurance provided under the follovring:
CO TO 02 20 18
Policy #BAOJ093233
COMMERCIAL AUTO
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
AUTO COVERAGE PLUS ENDORSEMENT
This endorsement modifies insurance provided under the following:
BUSINESS AUTO COVERAGE FORM
GENERAL DESCRIPTION OF COVERAGE —This endorsement broadens coverage. However, coverage for any
injury, damage or medical expenses described in any of the provisions of this endorsement may be excluded or
limited by another endorsement to the Coverage Part, and these coverage broadening provisions do not apply to
the extent that coverage is excluded or limited by such an endorsement. The following listing is a general cover-
age description only. Limitations and exclusions may apply to these coverages. Read all the provisions of this en-
dorsement and the rest of your policy carefully to determine rights, duties, and what is and is not covered.
A. BLANKET ADDITIONAL INSURED
S. EMPLOYEE HIRED AUTO
C. EMPLOYEES AS INSURED
D. SUPPLEMENTARY PAYMENTS — INCREASED
LIMITS
E. TRAILERS —INCREASED LOAD CAPACITY
F. HIRED AUTO PHYSICAL DAMAGE
G. PHYSICAL DAMAGE — TRANSPORTATION
EXPENSES — INCREASED LIMIT
A. BLANKET ADDITIONAL INSURED
The following is added to Paragraph A.1., Who Is
An Insured, of SECTION 11— COVERED AUTOS
LIABILITY COVERAGE:
Any person or organization who is required under
a written contract or agreement between you and
that person or organization, that is signed and
executed by you before the "bodily Injury" or
"property damage" occurs and that is in effect
during the policy period, to be named as an addi.
tional Insured is an "insured" for Covered Autos
Liability Coverage, but only for damages to which
this insurance applies and only to the extent that
person or organization qualities as an "Insured"
under the Who Is An Insured provision contained
in Section II.
S. EMPLOYEE HIRED AUTO
H. AUDIO, VISUAL AND DATA ELECTRONIC
EQUIPMENT —INCREASED LIMIT
L WAIVER OF DEDUCTIBLE —GLASS
J. PERSONAL PROPERTY
K. AIRBAGS
L. AUTO LOAN LEASE GAP
M. BLANKET WAIVER OF SUBROGATION
performing duties related to the conduct of
your business.
2. The following replaces Paragraph b. in B.5.,
Other Insurance, of SECTION IV BUSI-
NESS AUTO CONDITIONS:
b. For Hired Auto Physical Damage Cover-
age, the following are deemed to be cov-
ered "autos" you own:
(1) Any covered "auto" you lease, hire,
rent or borrow; and
(2) Any covered "auto" hired or rented by
your "employee" under a contract in
an "employee's" name, with your
permission, while performing duties
related to the conduct of your busi-
ness.
1. The following is added to Paragraph A.1., However, any "auto" that is leased, hired,
Who Is An Insured, of SECTION II — COV. rented or borrowed with a driver Is not a
ERED AUTOS LIABILITY COVERAGE: covered "auto".
An "employee" of yours is an "insured" while C. EMPLOYEES AS INSURED
operating a covered "auto" hired or rented The following is added to Paragraph A.1., Who Is
under a contract or agreement in an "am- An Insured, of SECTION 11—COVERED AUTOS
ployee's" name, with your perms ion, while LIABILITY COVERAGE:
CA T4 20 0215 020 aThe velers 111 Mi4v,
ny. All rights reserved. Page t of 3
I( Includes cupyrighled malertal of I urances office, Inc, wtlh Its permission.
COMMERCIAL AUTO
Any "employee" of yours is an "insured" while us-
ing a covered "auto" you don't own, hire or borrow
In your business or your personal affairs.
D. SUPPLEMENTARY PAYMENTS — INCREASED
LIMITS
1. The following replaces Paragraph A.2.a.(2) of
SECTION 11— COVERED AUTOS LIABILITY
COVERAGE:
(2) Up to $3,000 for cost of bail bonds (in-
cluding bonds for related traffic law viDla-
lions) required because of an "accident"
we cover. We do not have to furnish
these bonds.
2: The following replaces Paragraph A.2.a.(4) of
SECTION 11— COVERED AUTOS LIABILITY
COVERAGE:
(4) All reasonable expenses incurred by the
"Insured" at our request, including actual
loss of earnings- up to $500 a day be-
cause of time off from work,
E. TRAILERS —INCREASED LOAD CAPACITY
The following replaces Paragraph C.11. of SEC-
TION I — COVERED AUTOS:
1. "Trailers" with a load capacity of 3,000
pounds or less designed primarily for travel
an public roads.
F. HIRED AUTO PHYSICAL DAMAGE
The following is added to Paragraph AA., Cover-
age Extensions, of SECTION III — PHYSICAL
DAMAGE COVERAGE:
Hired Auto Physical Damage Coverage
If hired "autos" are covered "autos" for Covered
Autos Liability Coverage but not covered "autos"
for Physical Damage Coverage, and this policy
also provides Physical Damage Coverage for an
owned "auto", then the Physical Damage Cover-
age Is extended to "autos" that you hire, rent or
borrow subject to the following:
(1) The most we will pay for "loss" to any one
"auto" that you hire, rent or borrow Is the
lesser of:
(a) $50,000;
(b) The actual cash value of the damaged or
stolen properly as of the time of the
"loss"; or
(c) The cast of repairing or replacing the
damaged or stolen property with other
property of like kind and qualityA
(2) An adjustment for depreciation and physical
condition will be made in determining actual
cash value in the event of a total "loss".
(3) If a repair at replacement results in better
than like kind or quality, we will not pay for the
amount of betterment.
(4) A deductible equal to the highest Physical
Damage deductible applicable to any owned
covered "auto".
(5) This Coverage Extension does not apply to:
(a) Any "auto" that is hired, rented or bor-
rowed with a driver; or
(b) Any "auto" that Is hired; rented or bor-
rowed from your "employee".
G. PHYSICAL DAMAGE — TRANSPORTATION
EXPENSES — INCREASED LIMIT
The following replaces the first sentence In Para-
graph AA.a., Transportation Expenses, of
SECTION III — PHYSICAL DAMAGE COVER.
AGE:
We will pay up to $50 per day to a maximum of
$1,500 for temporary transportation expense in-
curred by you because of the total theft of a cov-
ered "auto" of the private passenger type.
H. AUDIO, VISUAL AND DATA ELECTRONIC
EOUIPMENT—INCREASED LIMIT
Paragraph C.1.b. of SECTION III — PHYSICAL
DAMAGE COVERAGE Is.deleted.,
I. WAIVER OF DEDUCTIBLE —GLASS
The following is added to Paragraph D., Deducti-
ble, of SECTION III — PHYSICAL DAMAGE
COVERAGE:
No deductible for a covered "auto" will apply to
glass damage if the glass is repaired rather than
replaced.
J. PERSONAL PROPERTY
The following is added to Paragraph AA., Cover-
age Extensions, of SECTION III — PHYSICAL
DAMAGE COVERAGE:
Personal Property Coverage
We will pay up to $400 for "loss" to wearing ap-
parel and other personal property which Is:
(1) Owned by an "Insured"; and
(2) In or on your covered "auto".
This coverage only applies in the event of a total.
theft of your covered "auto`.
No deductibles apply to Personal Property cover-
age.
Page 2 of 3 02015�Tr( vkle�s (n�e�uty/C�i p Y. All rights reserved. CA T4 20 0215
Includes copyrighted met ial or In uran �e Ic s Office, Inc. with its permission.
K. AIRBAGS
The following is added to Paragraph 13.3., Exclu-
sions, of SECTION III — PHYSICAL DAMAGE
COVERAGE:
Exclusion 3.a. does not apply to "loss" to one or
more airbags In a covered "auto" you own that in-
flate due to a cause other than a cause of `loss"
set forth in Paragraphs A.i.b, and AA.c., but
only:
a. If that "auto" is a covered "auto" for Compre-
hensive Coverage under this policy;
b. The airbags are not covered under any war.
ranty; and
c. The airbags were not intentionally inflated.
We will pay up to a maximum of $1,000 for any
one "loss".
L. AUTO LOAN LEASE GAP
The following Is added to Paragraph AA., Cover-
age Extenslons, of SECTION III — PHYSICAL
DAMAGE COVERAGE:
Auto Loan Lease Gap Coverage for Private
Passenger Type Vehicles
In the event of a total "loss" to a covered "auto" of
the private passenger type shown in the Schedule
or Declarations for which Physical Damage Cov-
erage is provided, we will pay any unpaid amount
due on the lease or loan for such covered "auto"
less the following:
(1) The amount paid under the Physical Damage
Coverage Section of the policy for that "auto";
and
COMMERCIAL AUTO
(2) Any:
(a) Overdue [ease or loan payments at the
time of the 'loss';
(b) Financial penalties imposed under a
lease for excessive use, abnormal wear
and tear or high mileage;
(c) Security deposits not returned by the les-
sor;
(d) Costs for extended warranties, Credit Life
Insurance, Health, Accident or Disability
Insurance purchased with the loan or
loass;and
(a) Carly -over balances from previous loans
or leases. '
M. BLANKET WAIVER OF SUBROGATION
The following'reptaces Paragraph A.5., Transfer
Of Rights Of Recovery Against Others To Us,
of SECTION IV — BUSINESS AUTO CONDI-
TIONS:
5. Transfer Of Rights Of Recovery Against
Others To Us
We waive any right of recovery we may have
against any person or organization to'the ex-
tent required of you by a wriSen'con(ract exe.
cuted prior to any "accident" or "loss", pro-
vided that the "accident" or "Foss' arises out of
the operations contemplated by such con-
tract. The waiver applies -only to the person or
organization designated in such contract.
1r.rr r--'
CA T4 20 0215 07015 The Tr duo nil i - rights reserved.
Includes copyrighted mate at o saran! er s bbbll! e, Ina. with Its permission.
Page 3 of 3
TRAVELERS Jam'
ONE TOWER SQUARE
HARTFORD CT 06163
WORKERS COMPENSATION
AND
EMPLOYERS LIABILITY POLICY
ENDORSEMENT WC 99 03 76 ( A)
POLICYNUMBER: UE-Ss034009
WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS
ENDORSEMENT - CALIFORNIA
(BLANKET WAIVER)
We have the right to recover our payments from anyone liable for an Injury covered by this policy. We will not
enforce our right against the person or organization named In the Schedule.
The additional premium for this endorsement shall be 3.00 % of the Callrornia workers' compensation pre-
mium.
Schedule
Person or Organization Job Description
ANY PERSON OR ORGANIZATION FOR ENGINEERS PLAN
WHICH THE INSURED HAS AGREED
BY WRITTEN CONTRACT EXECUTED
PRIOR TO LASS TO FURNISH THIS
NAME.
This endorsement changes the policy to which it is attached and Is effective on the date issued unless otherwise
stated.
(The Information below is required only when this endorsement Is issued subsequent to preparation of
the policy.)
Endorsement Effective
Insured
DATE OF ISSUE:
Policy No.
Countersigned by
ST ASSI I 1 611
Endorsement No.
Premium
Page 1 of 1
Francine R. Villareal Digitally signed by Francine R.Villareal
Date: 2021.02.2615:20:06-08'00'
CERTIFICATE OAF (LIABILITY INSURANCE
OATS (RMAIOOLVYYYYN'
THIS CERTIFICATE IS ISSSUIIEID AS A MATTER Of INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DIES NOT AFFIRMATIVELY OR. NEGATIVELY AMEINNID„ EXTEND OR ALTER. THE COVERAGE AFFORDED BY THE POLIICNER
BELOi W. THIS CERTIFICATE NSF 11INSU DANCE DOES NOT CONSTITUTE A CONTRACT BE''TWF-EN THE ISSUING INNERER( )„ AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE (HOLDER.
IMPORTANT. If the cerdficate holder Is an ADDITIONAL INSURED, the polibcy(Ies) must have ADDITIONAL INSURED provisions or be endorsed.
If SUBROGATION IS WAIVED, subjIect to the terms and conditions of the policy, certain po0cles may r 4ulre on endorsoment. A statement on
PRODUCER MINI I MU I IN'tRC'h DeIIC,Nt
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INSI.'IRER',IF: Priincalcin Exm, Is & Surplos Lines In"r;,rrnr 10780
COVERAGES CERTIFICATE NUMBER. 16625112459 REVISION NUMBER.,
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE ILI'-STED BELOW WAVE', BEEN ISSLIIED TO THE INSURED NAMED ABOVE FOR. THE POLICY PERIOD
INDICATED, NOTWITHSTANDING TAINDIN G ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER
DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSLMED OR. MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED
HEREIN IIS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES,, iLIMITS SHOWN DAY HAVE, BEEN REDUCED BY PAIII C't,A,,IMS
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06:54RIIPTION Of OPERATIONS d LOCATIONS d VE`M CLE IACiC RD 101, Addillminal Remarks kho4ule., dory be allar:hed If mlwg irpwm Is fwviYr'wfjt
The laity of Sanm Ana, !its officers,, Employees, agents and repTesentaitives are adduitionval insured on a primary and
(non-coirtnbutoTy basis as respects the
General Liiabality, , Auto IL,iabiuliiity and UmlbrellaYExcess follows forn'n as required by written contract. Waiver of Subrogation applies In favor of the additional
insured as rrros � kYre General L WorkersCompensationss'folllows form as required byr wri'tt�an contract.. 30, Days
p " Its il�wkiCe Auto
iIE do
m ma rar n�aenbrella."Exa
Notice of Cain Nlaltion with 1C Day yF policy piovisions.
CERTIFICATE, HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE: DESCRIBED POLICIES BE, CANCELLED BEFORE,
THE EXPIRAT loN (DATE THEREOF,
NOTICE WIIMLL
BE DEUVERED IN
N i ly of Santa Ana
AOCORIDANCE V44TH THE. POLICY PROVISIONS.
Risk Management Division, 4th Floor
20 Civic CenterPlaza
AMrUORAZEDREPAESENTA'minp
Santa, Ana CA 92702
�"4— -
1ZisieManagzLlrLentDiviaian
,N GF
REVIEWED & APPROVEDSY.-
1988»2015 AC RD5,
, ,
. v
Ai ORD 25 (2016103) The ACORP name and logo are registered marks *If AICCMR
��--
Risk Ijar agement ftaly5t
HA 99 16 0311
THIS ENDORSEMENT CHANGESTRE POLICY. IPL,EASE IREAD IT CAREFULLY.
COMMERCIAL AUTOMOBILE BROAD FORM
ENDORSEMENT
This endorsement modifies insuraince provided under the followingr:
To the extent that the provisions of t4is endorseirneint provide broadier benefits 'to, the "insuired" than other
pirovisions of the Coverage Form, the pirovisJous of this endorsement apiply,
t BROAD FORM INSURED
A. Subsidiaries and Newly Acquired or
Formed Organizations
The Named linsured showin in the!
Declarations is arriendiedto incluide�
(1) Any legat business entity ath,er than a
partnership or Joint venture, formed as a
subsidiary in, whicli, you have an,
ownership iint8ire�8t of more than 50% on
the effectIve date of the Coverage Form.
However, the Nairi Insured does not
includeany subsidiary that is an
"iinsuired" under, any other automobile
policy or woUld be an "Insuredi'" under
such a polliicy but fbir its termination or
the exhaustion of its Limit of Insurance,
(2) Any organization that is acquired oir
(brined (by you and over, w4icb you
maintain majority owflersliip. However,
the Named Ilnsuur8di does not include any
newly formed or acquired organization:
(a) That is a pairtnership or joint
venture,
(b) That iis ail "insur8d" uindier any other
Policy,
(c) That has exhiausted its Limit of
insuraince under, any other Ipolicy, or
(d) 180 days or more after its
acquisition or forimation by you,
uNess you haive given us inali of
the acquisition or forma4ion.
Coverage does not apply to "bodily
iinjury" or "'property damag8" that results,
from an `,acdIdient" that occurred before
you formed or aoquired the orgiaNzation,
K, Employees as Insureds
Paragraph A, 1. - WHO IS AN INSURED - of
SECTION III - LIARILITY COVERAGE is,
amended to, arid:
d. Any "employee" of yours wftHe using a,
covered "auto" yo,u doin't own, hire or
borrow iin your buisiin8ss air youir
peirsonaili affairs.
C. ILes,siors as Insuireds
Paragraph A, 1. - WHO IS AN INSURED - of
Section III - Liabifity Coverage is amendedto,
add:
e. The lessor of a coveired "auto," while it
.. auto," is leased to you under a written
agreemient if:
(1 ) The agreement Irequires you to
provide direct pirinlairy insurance for
the liessor and
(2) The ""au ito" is [eased without a driver.
Suich a lieased "auto" will Ibe considered a
covered "auto"' you own and not a covered
"auto,"' you hire.
U, Additional Insured if Requiredi I4 Contract
(1) Paragraph A1. WHO IS, AN INSURED
- olf Section 11 Liability Coverage is
arnended to, add.,
U Wheiii you have agreed, in .9, written
contract or written agireeiment, thaA a
person or organization be added as
an addittionat fins -hared on your
business au ito policy, SUch person or
organization is an "insured"", bout o4ly
to the extent such person or
organization is liabte for "bodily
injury" ar "property dainiagie" caused
by flbie conduct of an "insured" under
paragraphs a, or Ib, of Who Is An
insuired with regard to the
ownersWip. rnainteinance or use of a
covered "auto."
0 2'0,11. "'rhe Hartford (Inicluides copyrighted mia,terial
Form IHiA 99,16 03 1112 of ISO IPrluperti8s, Inc., with its permission)
ep ..cF RAMwagmedDiAsiun
Jy? N,�q REVIEWED & APPROVED BY.-
VX*vd
RtWjanagementftalpt
The Iinsuurance afforded to any such,
additional) insured applies only if fliie
"bodlity injury" or "property daimage"
occurs:
During the polliicy peri(>d, and
(2) Suibs8quent to the 8xecutioin, of such
written contract, and
(3) Prior to the expiration, of the period
of time that the written rointract
requires such insurance Ibe provided
to the additional snislured,
(2) IHow Limits Applly
If you have agreed in a written cointract
or written agreeni,eint that another
p8rson or oirgainizatilon, Ibe adldedl 88 an
additionat insured on your Ipolicy, the
most we will pay an behaff of 5,uch
additionaI insured is the Illesser of:
(a) The Hirnits, of insurance specilied in
the wrrtten contract or written,
agireemilent', or
(b) The Linifts of linsurance shown in
the Declarations.
Such amount 8hailt be a, part of and not
in addition to Lirnits of Insurance shown
in the Declaratians aind desrnbed in this,
Section,
(3) Additional insureds Other, Insurance
If we cover a claim or "'suit" under this,
Coverage Pairt that may also be covered
by other insurance available to an,
additional insured, quch, additional
insuired must submit such claim or "suiV
to the other insureir for defense and
indeninfty.
How8ver, this provision does not apply
to the extent, that you have agreed in a
written contract or written agreenient
that this, iinsuranoe is p6mary and noin-
contributory with the additional insuired's
own insurance,
(4) If uties iin The! Event Of Accidient, Claim,
Suit or Loss
If you have agreed in a wiritteri contract
or written agir8eimenit that another
person or orgainization, be added as an
additional) insured on your policy, the
additionaI insured shall be required to,
comply with 'the pirovisJons in LOSS
CONDMIONS, 2. - DUTIES N I -HE
�EVENT F ACCIDENT, LAIM , SUIT
OR LOSS -- OF SECflON IV --
BUSINESS AUTO CONDITIONS, in the
same maniner as the! Named Ilns,ured,
E lPrimairy and Il on-Cont6butory, if,
Requilired by Gointiract
0,61y with resp8ct to insuirance pirolvided to
an additional) insured in I.D. - Additional
Inslured If Required by Contract, the
following provisions apply:
(3) Primary IInsuuurance When IReguuired By
Contract
This iinisuranc8 is piriimairy it you have!
agreed in a written contract or written
agreement that this insurance be
pidimairy. If other insurance is also,
primary, we illl share with aft 'that otheir
insurance by the methiod desfribed in
Other Insurance 5,.d,
(4) Primary Arid INon-Contributory To Offier
Insuraince When Required By Contract
If you) have agreed in a written contract
or written agreement that this insurance
is Iprimary and non-contribititory with the
addftionall insuir8d's owlni insuranc8, this
insurance is primary and we MCI riot
seek oontribution from that other
insuirance,
Paragraphs, (3) and (4) do, not, apply to other
insurance to Which thie aiddffional insured
has been added as an addition4l insured.
When this iinsuulralnce is excess, w,e will have no
duty to defend the insured agialn5t ainy "'suit" if
any other iinsuirer has, a duty to defend the
insured against that "suit'", If inio, other lilnsuurelr
defends, we will undertake to do so, but we w0l
be entitled to the insuired's righits against all
those other insurers.,
When this insuranc;e is excess over other
insurance, we will pay only our share of fti,e
arn0lint of the loss, if any, that exceeds, the sum
of`
(1) The toL-41 amount that all such other
msurance would pay for, the (loss in the
absence of this, insurance; and
(2) The total of alI dediuctible and self -insured
a rn011ints under' a I I that other ins uira nce,
We wfll 5liare the remaining foss, if any, by the
method described in Other Insuiraince 5.d.
2AUTOS RENTED BYEMPLOYEES
Any, "'auto"' hired or rented by your "employee"
ran your behalf and at your direction M11 bu
considered aim "auto" You hire�,
rhe o rf+ER INSURANCE Condition is amended
by adding the! followinig:
0 2'0,11."she Hartford (Incluides copyrighted maiteriial
Form H� A 99,16 03 12 of ISO Properties, Inc., with its permission)
cF RAMwagmedDMsiun
Jy? N,�q REVIEWED & APPROVED BY.-
F04c"�" z VX*vd
RtWjanagementftalpt
If an "ernployee's" p rsonall insurance also
appiies an an exce,3,9 basis to, a covered "'auto,"'
hired or Irented by your "eimployele" on your
behalf and at, youir direction, Mis insurance witl
be primary to the "'ernployee's"' personal
insuiranoL-,
3. AMENDED FELOW EMPLOYEE EXCLUSION
EXCLUSiON 5, - FELLOW EMPLOYEE - of
SECTION IIIII - LIABILITY COVERAGE does not
apply if' you have workeirs' coirripensabon
insurance in -force ooveringi all of your
"employees".
Coverage iis excess oveir any other c6lIectible
insurance,
4. HIREDiUT IPHlYSICAL MMAGE VERAGE
If hired "autos" are covered "autos" for It..laNllity
Coveirage andl il Comprehensive, Specified
Causes olf Loss,, or Collision, coverages are
provided under Mis Coverage Form for any
""'a uto"" you owfli. then, the IPhmysicalll Damage
Coverages provided are extended to "autos" you
hire or, borrow, subject to the following Iiiimit.
rhe most we mli pay for "'loss," to any hired
""auto"" is:
(1) $100"'000,
(2) "'rhe actuaii cash value of the daimaged or
stolen property at the time of the "Ioss",- or
(3) The cost of repairing or, replacing the
damagied or stolen property,
whi,chever is sim4tl8st., imilnus a deductible. The
deductible wilt be equial toth,e largest deductible
appiicable to any owined `auto)" for that
colv8irage. No deductible applies to ""loss" caused
by fire or lightning, Hired,Auto, Physical Darnage
coverage is excess over any other cZflectsble
insuiranc8, Subject to the above limit, deductible
andl excess provisions, we wilt provide coveirage
equal to thie broadest coverage appi[k"able to any
colv8ired "'auto,"' youi own,
We, M1 also cover loss of use ofthe, hired "aluto"
it it, results from an "accident",, you are ieg4llly
liable and the lessor incurs an actuat financial
lass,, subject to a rnaximum of $1000, peer
ff auidenV.
This extensiloin of Coverage does not apply to
any "auto," yo�ol hire or, borrow froirn any of youir
ff ernployees", partners (if' you are a pairtnership),
members (iif you are a Iliimlited Iliialbillllilty company),
or members of their households.
PATSICAL DAJOIiAGE w AJUWTION�
TEMPORARY TRANSPORTATION EXPENSE
COVE :
Paragraph A,,4,a of SECTION Ill - PHYSICAL
DAMAGE COVERAGE is aimiendled to provide a,
lliimit of $5,0 per day and a maximuim limit of
S,1,000,
6. LOANILEASE GAP COVERAGE
Under SECTION III - PHYSICAL DAMIAGE
COVERAGE, in the event, of a total "lass," to a
covered "auto", we will pay your additional ieg4l
obfigiation for any diffbirenc8 between the actual
cash value of the '"auto" at the tirne of lthe "loss"
a ndl the "ot4stainding b4lance" of ttle iloalntlease..
"Outstanding balaince" means the amount you
owe an the, loan/lease at, the firne of "lass" liess
any arnotints representing taxes; overdue
paymeints; pen4lties, interest or charges
resulting from overdue payments; additional
mileage chairges; excess wear and tear diiarges;
lease termination fees-1 security deposits not
returned by the lessor; costs for extended
warranties, credit life lnsurance, Ih ealth, acdcleint
or disability linsurance purchased with the Moan or
lease; andl carry-over balances from Ipreviious
loans or llease5,
7. AIRBAG COVERAGE
Under Paragraph B, EXGLUSIONS - of'
SEC nON 11i - PHYSICAL DAMIAGE
COVERAGE, t1he FoNlowing is aidded:
The exclusion relatingto, mechanicat Ibrea kdown
does not apply to the acrideintal discharge of an
airbag,
8. ELECTRONIC EQUIPMENT ® BROADENED
COVERAGE
a. Thie exceptions to Paragraphs BA -
EXCLUSIONS - of SECTION III - PHYSICAL.
DAMAGE COVERAGE are replaced by t1hie
foNlowing:
Exclusions 4.c. and 4.d. do not apply to
equipment de5iginecl to be operated solely
by U88 of the power from the "a,uto's"i
electrical system that, at the firne, of"'loss",
(1) Permainendy installed in or upon
the covered "auto,";
(2) Removable friomi a Ilmirauusingi unk
which is permanently iilnstallled in
or upon the covered "auto";
(3) An integiral part of the same luunit
hnousingi any ellectronic
equiprnent described in
Plara[grapiks dl) And 19% Pihnknm° nr
0 2'0,11. "t-he Hartford (Incluides copyrighted material
Form HA 9916 03 12 of I u IPlropelrtues, Inc., with it8 permission)
cF Risk MmRgmerdDMsiun
K�q REVIEWED & APPROVED BY.-
F04c.�" z VX*vd
RtWjanagementftalptl
(4) Necessary for, tho normal
operatio,n of the oovered "'auto," or
the monitoring of the cover d
aluto's" operating system,,
b,Section III - 'Version CA 00 01 03 1110 of the
Business Auto Coverage Form, Physical
Darnage Coverage, Lirnit of Insurance,
Paragraplii C,2 and Version CA 00 01 10 01 of
thie Business Auto Coverage Forim, IPlhysiical
Darnage Coverage, 1-imit of Insurance,
Paragrap1li C are eacl'i� amended to adld the
following:
$1,5100 is the most we will pay for "'loss" in
any one "accident." to all electronic
equipment (other than equip,ment designed
solely for the reproduction of sound, and
accessories u5ect with such equipment)
that reproduces, ret8iv8s or transimiits,
audio,, visual or data signals whir-h, at the
time of "toss", is:
(1 ) Permainiently instaCled in or upon,
the covered "auto" in a housing,
ople,rung or other ilocation that is iniot
normatly used by the "'auto,"'
manufacturer for the installation of
such equipment;
(2) Removable from a permanently
installed housing unit as described
in Paragraph 2,a, above or is an,
iintegiral part of that equipimentl- or
(3),An iintegwral part, of -such, equiprnent,
c. For each covered slio,Wd loss be limited
to, electiranic equipment only, our 6bligabioin to,
pay for, repair, return or replace darnaged or
Stolen electronic equ4p,ment wilt be reduced by
thie apipficable deductible shown in the
Declarations, or 510, whichever deductible is
�less,
91. EXTRA EXPENSE - BROADENED
COVERAGE
Under Paragraph A, - COVERAGE - of SEC nON
III - PHYSICAL If AMAGE COVERAGE, we will
pay for Me expense of returining a stolen covered
"'auto""' to you,
10. GLASS, REPAIR - CAP ER, OF DEDUCTIBLE
Under, Paragraph D. - DEDUCTIBLE - of SECTION
III - PHYSICAL DAMAGE COVERAGE, the
following iis added:
No, deductible applies to glass damage it the
glass is repairect rather than replaced.
11. TWO OR MORE DEDUCTIBLES
Under, Paragraph D. - DEDUCTIBLE - of'SECTIONCI
III - PHYSICAL DAMAGE COVERAGE, the
following iis added:
If anoMer Hartford Financial Services Group,
Inc, company pollicy or coverage form throat ii5 not
an automobile, policy or coverage form applliies to,
the same ""accident"", the fotloMing applies.,
(1) iIf the deduotible under this Business Auto
ICoverag IFornm iis the smaller (or simafl8st)
dedactible, it wifl be waivedl;
(2) iIf the deductible under this Business Auto
Coverage IFoirm is not the smaller (,or
smallest) deductible, it will be reduced by
the arnotint of thie smatter (or smatlest)
dieductible,
12. AMENDED DUTIES IN THE EVENT OF
ACCIDENT', GLAIM, SUIT OR LOSS,
The requirement in ILOSS CONDMIONS Za, -
DUTIES, IN THE EVENT OFAGGIDENT,CLAW,
sui r, OR iLOSS - of SECTION tV - BUSINESS
AUTO CONDITIONS that youi MUSt notify L18, Of
an `,acdOent" applies only whenthe "accident" is
knownl to:
(1) YOU, if you are an individual-,
(2) A pairtneir, if you are a pairtnersWp;
(3) A member, if youi are a limited liability
cornpainyor
(4) An execlutive, officer, or ilnsuirance manager, i�f
you are a corporation.
'13. UNINTENTIONAL FAILURE TO DISCLOSE
HAZARDS
If you unintentionally failI to disclose any hazards
existing at the inception date of your pality, we!
will not deiny coverage under this Coverage
Form because of qudli� faflure,
14. HIRED AUTO - COVERAGE TERRITORY
Paragraph e, of GENERAL CONDITIONS 7,
POLICY PERIOD. COVERAGE I-EWITORY
of SECTION 1V - BUSINESS AUTO
CONDITIONS ins replaced bythe followinq
e.. For short-term hired "autos", thie coverage
territory with resp,8ct to, Liability Cov8irage is
anywbere in the world provided that if the
"Insured's"' responsibility to pay damages for
"bodilly injuiry" or "property damag8,, is
determined iin a, "'suit," the, "'suit" pis brought in
the United States of America, the territories,
and possessions of the United States of
Arriedca, Puerto Rico or Canada or, in a
settlement we agree to,.
15. WAI'VER OF SLIBROGATION
TRANSFER OF RIGHTOF RECOVERY
AGAiNs r OTHERS, "TO US - of SEC n0,N 1V -
�BIUISITN' EAUTO CONDITIONS iis aimeinded Iby
adding the following:
(5) 2'0,11. "rhe Hartford (Includes copy6ghtect maiteriial
Form II� A 99,16 03 12 of ISO IPlruupelrtlos, IInc., with its permission)
ep ..cF RAN[wagmed]DMsiun
Jy? N,�q REVIEWED & APPROVED BY.-
F04c.�" z VX*vd
RtWjanagementftalpt
We, waNe any right of recovery we nray have
agasn51 array pleirson or organization withi whom
you have a Written contract that requires, such
waiver because of payments we make for
damagies i,in,der this Coverage Form,
16. RESULTANT MENTAL ANGUISH COVERAGE,
The definition of "bodfly injury"' in SECTION
DEFINt nONS is, replaced by the following;
"Bodily iinjury means bodiilly iiinjuiry, sickness or
disease, sustained by any person, including
ri ainguish, or death, resulting from any of
these.
17. IEXTIENDED CANCELLATION CONDITION
Paragraph 2. of the CINS MON~,rl POLICY
CONID]TIIONS - CANCELLAT�10,N - applies
except as follows,.,
if we cancel for any reason ai than
nonipaymileinit of premium,, we wiilllll maill or diefiver
to the first Warned insured written notice of
cancellatiani at least 60 days Ibefore biie effectiive
date of cancellation,
18. HYRRID, ELECTRIC,, OR NATURAL GAS
VEHIu L 1PA1IMIENT COVERAGE
In the event of a total loss, to a "inan-hybirid" auto,
I& wNchi Comprehensive, Specified Causes of
Loss, or Colfislion coverages are provided under
this Coverage Form, then, such Physical
Darnage Coverages are, amended as follows.
a.If the atito is replaced with a, "hybrid" auto, or
an auto, powe�red solely by electricity oir natuiral
gas, we W11 pay an additional) 10%, to a
maximum of $2.500. of the "'non -hybrid" auto's
actualll Cash value or replacernent cost,
wMihever is less,
lb� rbe auto mi Ilse replaced and a oopy of ai bitil
of 8,41e or i lease agireleiment received by us
within 160 calendar days of the date of "loss,"'
c. IRegrandless of the in uiiin beir of, autos dieeimed a
totail lo5,s, the ni we will pay under this,
�Hlybrid, Electric, or Natural has Veh4c[e
Payrnent Coverage provision for any one,
"loss," is $10,000,
For the purposes of the coverage provision,
a,,A, "non -hybrid" auto is defined as an, auto'li
uses, only an internal ourribuslion engine to
move the auto, bust does, not include autos
�powered solely by electricity or, na,li gas.
b,A "hylbrid'" auto is defined as an auito with an
internal cornbuistion, engine and oine or more
electric motors; aii that uses the iinterinal
combusi engine and one or more electric
motors to, move th,e auto, or the internal
combustion engine to charge one or, moire
elleci motors, w1i4ch miove the auto,
19. VEHICLE WRAP COVERAGE
In the event of total loss to an, "auto" for which
Cornprehe,nsive, Specified Causes of Loss, or
Collision coverages are provided under this
Coverage Form, then such Physical Damage
Coverages are amended to add the following;
In additio,in to the actual cash value of the "auto",
we, will pay up to $1l,000, for vinyl vehicle wraps
which are 65plaiyed on fliie covered "auto)" at the
time of total loss. Regardless of thie nuimbeir of
autos deemed a tot6l loss, the most we will pay
under this Vehicle Wrap Coverage provision for
any one ""loss" is $5,000, For purposes of this
coverage provision, sii or, other graphics
pairi or magnetically affixed to t1lie vehicle are
not considered vehicle wraps,
0 2011."The Hartford (Includes copyrighted) mi
Form INS A 9916 03 12 of ISO Properties, Inc., with its permission)
cF RAN[wagmedDiMsiun
Jy? N,�q REVIEWED & APPROVED BY.-
VX*vd
Risk iPjanagementAnalyst
FOL � CYO: � 8 3 U EN ZV 3 95 �
Various provisions in this policy restrict coverage.
Read the entire policy carefully to determine rights,
duties and what is and is riot covered,,
ThrOLI"gl)OUII this poficy, the words ,"you" and "your"
refer to, the Named Insured sliown in the
DecWatjons, arid any other person or organizatbon
qualifyingi ass a Narned 111SUred under this, policy, The
words "we"', "us" and "our" refer to the stock
insurance company member of "'r''he Hartford
providing thiis hisurainoe.
The word "insured'" mearis any person or
organization qualifying as such under Section 11 -
Who Is, An Insured.
Other words and phrases that appear in qtjotathon
marks have speciall mearring. 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 ffiat the insured
becomes, legally obligated to pay as damages
because of "bodliilly iinjuiry" or "property
d1amage" to, which thiis iinsurainoe applies. We
will have the righit arid duty to defend the
insured against any "'suit"' seeking those
damages. However, we wflll have no duty to
defend the insured against any "suit" seeking
dlamages for, "'bodily injury" or, "property
darnage" to which this insurance does not
apply. We may, at our discrefion, i4ivosfigate
any "occurrence"and sottle any dairri or "'suit"
that may result, But
(1), The amount we will pay for damages is
limited as described In Section III - (Lin its
Of llnsurancew and
(2), Our righl ' and deity to defend wh ends en
we [rave used up the applicable linift of
insurance in the payment of judgments or
settlerneints, under Coverages A or B, or
niedir,al expenses under Coverage .
No other obfigiation or liabiflty to, pay sunis, or
perform acts or services is covered unless
explicitly provided for under Supplementary
Payments - Coverages A and B.
b. This, insuirance applies to "bodilly injury" and
"property daimage" only if:
(1�), The "bodily injury""' or "'property damage"' is
caused by an "occurrence" that takes
place in the "'coveragie territory"',,
(2), The "bodily injjk,iry" or "property damage"
w;curs, duringi the policy periods; and
(3), Prior to the policy period, no, !insured listed
under Paragraph I., of Sect ' iion If - Whol is
An insured and no "ernpiloyee` authorized
by you to give or receive notice of an
Hlurre am, knew that the
o(x n,re` or di "bodily injury" or "properly dainiage" iiad
occurred., in whole or in part. If auch a
Misted insured or authiorized "employele"
knew. prior to the policy period, that the
"'bodily injury' or "Property damage"
occuirred, then any continuation, change
or iresuirnptioinl of such 7bodily injury" Or
"property darnage" during or after the
policy period will be deleirned to have been
known prior to the policy period.
C. "Bodily iinjury"' or "property darriage" will be
deemed to have been known to have
occurred at the earliest time wtien any
insured listed under Paragraph 1. of Section 11
- Whol Is An Insured or ainy "employee"'
authorized by you to give or receive notice, of
an "occurrence" or claim,-
(1), Reports all, or any part, of than "bodHy
injury" or "property damage" to US or, any
other insurer-,
(2) Receives a, written or verbal dernand or
clairni 'for dart"tages because of''the ""bodily
inj . ury" or "property darnage"; or
(3), Becomes aware by any other means that
"bodily injlLtry" or "property darnage" has
occurred or has begun to occur.
d. Daimages, because of "bodily !injury' include
darriages claimed by any person or,
organization f6r care, loss of services, or
dleathi resulting at any time frorni the "bodily
injury",
e. Incidental Medical Malpiractlice And G�ood
Samaritan Coverage
"Bodily injury"' arising out of the rendering of
or failure to render the flotlowing health care
services iby any "employee" or "volunteer
worker""' shaH be deerned to be caused by, an
Mnjpplmrrencn" fnr
ep ..cF RAMwagmedDMsiun
R0, 1 16 Jy? N,�q REVIEWED & APPROVED BY.'
G 00109
(4)
F04c"�" P, VX*wi 2016 The Hartford
(hiiclludes copyrighted material of kisurancde Services Office, Inc. withi its per Wsk Pjanagement Analpt
[/7
�(1) Prafession6i health care services suich as:
(a) IMediical, surgical, dental, laboratory, x-
ray or nuirgiing services or treatment,
advice or instruction, or the related
furnishing of food or beverages-,
(b) Any health air theirapeutic seirvice,
treatment, advice or instruction; or
(c), The fuir6ishiing or dispensing of drugs
air medical, dental, or suiii supplies
air appliances; oir
(2) First i services, which include:
(a), Cardliopulmonary resuscitaition,
whether performed maInUafly or with a
defibrillator„ or
(b) Services perifornied as a GocA
Samaritan.
For ift purpose of determining 'the limits or
insurance, any act or ornission togeRter with
aill related acts oir, emissions in the furnishing
of these services to any one person wffl be
considered one "'olcourren,ce".
However, this Incidental it Malprattice
And Good Sarriaritan Coverage provision
applies only if you are not engaged in the
business air, occupation of pir,oviiding any of the
services described in this provision,
2. IExclusions
"This insurance does not appliy to:
a. IExpected Or Intended Injury
"Bodily injury"" or "propierty damage" expected
or linteinided from the standpoint of the
insured, This exclusion doeq not apply to
"bodily injury" or "property darnage" resulting
from the use of reasonable force to protect
persons, or property,
lb. Contractual Liability
"Bodily injury" or "'property damage" for whiciii
the insured is obligated to pay damages by
reason of thiei assumption of liability, in a
contract oir agireeiment. This, exclusion does
not apply to liability for damiages-
(1) That the insured would have in the
absence of the contract or agreement-, or
(2), Assurned in a contract or agreernien't that
iis an "insured contract"', provided the
"bodily injury" or "property damage"
accuirs 5ubsequient to, the execution of the
contract or agreement. Solely for the
purposes of liability assumed in an
"insured cori reasoniabile attorney
fees and necessary litigation expenses
incurred by or for a, party either than an
insured are deenied to be damages
because of ""bodily injury"" or "proiperty
damage", provided,
Page 2 of 21
(a) Liability to such party for, air for the
cost of, that party's defense has also
been assumed in the same "Insured
contract"; and
(b) Such attorney fees, and libation
expenses are fair defense of that party
against a civil or alternative dispute
resolution proceeding in which
claimages to which this iinsurance
applies, are allegied.
c. Liquor Liability
"Bodily injury"" or "'property darni for which
any insured may be held liable Iby reason of
(11), Causing or contributing to the intoxication
of any parson;
(2), The furnishing of alcoholic beverages to, a
person undler the legal drinking age of
under the influence of a[cohol; or
(3), Any statute, ordinance or reguilatiort
re0fing to Me sale, gift, distribuition or, use
of alcoholic beverages,
This exclusion applies even if 'the clainis
against ari insured aillege negligence or,
other wrongdoing in.,
(a), The supervision, hiriing, employment,
training or monitoring of others by that
iinsured:1 or
(b) Providing or failing to provide
transportation with respect to any
piefsoin that may be under the influence
of allcolhol;
if lie, `ocx,.,urrence"which caused the 'i
injury" air ""property dani involved that
which is described in Paragraph (11), (2) or 1(3)
above,
However, this exch)sion applies only if your
are in, the business of manufacli)nagi,
distributing, selling, serving or furnishing
allcoihollic beverages. For the purposes of this
exd,usion, permitting a persoin to bring
alcoholic beverages on your premises, for
consuinipition on your premises, whether or
not a fee is chairgedl or a license is required
for such activity, is not by itself considered the
business of sell1iiing, serving or furnishing
alcoholic beverages.
d. Workers' Compensation And) Similar Laws
Any obligation of the insuired under a, workers,"
compensation disability benefits or
uirierriployment compensation, law or any
sirniflar, law,
ei Employeri Liability
"Bodily injury"" to',
(1i), An "em ployee" of' tl
and in course c ep ..cF RAMwagmedDiAsiun
Jy,�q REVIEWED & APPROVED BY.-
F04c..." z VX*vd
Rusk iPjanagementAnali
(a) IEm p loymeint by the insured; or
(b) IPerforming duties related to the
conduct of the insured's businoss; or
1(2) "1 spouise, child, parent,, brother or sister
of that "employee" as a consequence of
Paragraph (1 ) albove
This, exclusion apipfies:
(1) Whether the insured may be liable as an
employer or in any other capacity: and
(2) To any obliigatJion to, share darnages, with,
or repay someone else wihoi mius,t pay
damages because of the injury..
This exclusion does not apply to liability
assumed by tho inSLIred under an "insured
contrac.t".
(1), "'Bodily injuri or "'property damiage"
arising Out Of the actual, alleged or
threatened discharge, dispersal, seepage,
migration, release or, escape of
"pollutants":
(a), At air froini any premises, site or
location which is or was, at any time
owned or Occupied by, or rented or
(loaned to, any insuired. However, this
subparagraph does, not apply to-.
(1) "Bodily injury' if sustained within a
building and caused by srnioke,
fumes, vapor or soot produced by
or oidgiinatingi firorn equspmeiit that:
is, used to heat, cool or dehumidify
the buildling, or eqUipmant that is
used to heat, water for persoinail
use, by the building's, occupants or
tbeir guests:
(I li) "Bodily, injury'oir "'property darriage"
fair which you may be held liable, if
you are a, contractor avid the owner
,or lessee of such premises, Sifto or
location has been added to your,
policy as, an additional insured with,
respect to YOUr ongoing operations
performed for' that: additional
insured at that pine Irises" site of
location and such prerriisies, site or
location is not and never was
owned Or'OCCLIp,iled by, or rented or
loaned 'to, any insured, other than
i additionial incurred; or
(fill) "Bodily infury" or "'property damage"
airiisiing out of heat, smoke, or fumes
from a, "hostile fire"';
(b) At or frorn any premises, site or
location whicb is air, was at any tirne
used by or for any inisured or others for
the handiiiniq, storage, disposal,,
processing or treatment of waste;
0 MI -11"I Kips
(c) Which are or were at any time
transported, handled, stored, treated,
disposed of, or processed as waste by
a, r fair:
(1) Any insured; or
(11) Any person air organization for
whom you may be (legally
responsible,
(d) At or frvn any premises, site or
11olication an which any insured or any
contractors or subcontractors working
directly or indirectly on any insured's
behalf are performing operations if the!
""'pollutants" are brought on or to the
premises, site or locationi in, coninection
with, such operations by such insured,
contractor or subcontractor. However,
this subparagraph does not apply to;
(1) "'Bodily i nju ry' or "'property da rt"tage"
i out of the escape of fuels,
lubricants or oth,er, operating fluids
which are needed to perform the
normal electrical, hydraulic or
rriec[ianical functions necessary for,
the operation of "'mobile equipirrient"
or iits, parts, if such fuels, k,ibdoants
or other operating fluids escape
from a veNcle part designed to
hold, store or receive them. This
exception dries not apply If the
""bodily hijurV'ar "'property damage"
,arises, out: of the inteintional
discharge, diispersall air release of
thie fuels, lubricants or other
operating fluids, or if such fuels,,
lulbrl,cainIs or oi 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 pleirformed by such insiured,
contractor air subcontractor;
(11) "Bodily injury"or ""property damage"
8u8tainedi w[tNin a building and
caused by the release of gaises,
fumes air vapors, from materiais
biro,ught into thiat building in
coinnection with operations being
performed by you or on your behAtf
by a contractor or" subcontrii, or
(M) "Bodily, injury' or "'property darnage"
,arising out of heat, srnoke or furinies
from a, "hostile fired; or
(e), At or from any premises, site or
location on which any insured or any
contractors or subcontractors workinai
directly or inidii ep .. RAMwagmedDMsiun
behatif are perf Jy? N\° REVIEWED & APPROVED BY.-
F04C"�" P, VX*vd
RtWjanagementftalpt
operafions are to test for, moiniftor .
clean up, remove, containi, treat,
dietoix.ify or neutrallize, air in ainy way
respond) to, or assess the effects, of,
141poIllutants".
(2), Any loss, cost or expense arising out, of
any-,
(a) Request, demaind, order or statutory or
regulatory requirement that any
insured oir others test for, monitor,
c1leani up, r8mlove, contain, treat,
detoxify or neutrallize,, or in any way
respond tq, or assess, the effects of„
141pollutiants"; or
(b) Claim or sti iby or on behalf of a
governm,enta] authority for darinages
because of testing for, rrioniitoring,
cleaniing up, removing, containing,
treating, detoxifying or neutralizing, of
in any may responding to, or assessing
the effects of, "p011uitants".
However, this paragraph does not apply to
liability for damages because of "property
damage" that the insured would have iiirr
the absence of such irequieis,t, demand,
,order or statutory or regulatory
requirement, or such claim or ""suit" by or
on behalf of a governmental authority.
g. Aircraft, Auto Or Watercraft
"Bodily injury" or "'property daimage" arising
out of the ownierShip, rinainteinaince, use or
entrustment to others of any aircraft, "auto" air
watercraft owned or operated by or ranted or
loaned to any iinsured. Use includes operation
and "loaffling or unloading"".
this exr,4,isloini applies even if the clairnis
against any insured allege negligence or
other wrongdoing in the supervision, hiring,
employment, training or monlitofing of others
by that insured, if thie "accurrence" which
causedl the "bodily injury" car "property
damage" involved the ownership,,
maintenance, use or entrustment to others, of
any aircrat, "auto" or watercraft that is, owined
or operated by air rented or loaned to any
instired.
This exclusion does not apply to:
A watercraft whileashare on prerniises You
own or rent:
(2), A watercraft you do not own, that is.
(a), Less than 51 feet long; and
(b) Not being used to carry persons for a
charge;
(3), Par Ikingian, "auto" on, air on the ways next
to, prernises you own or rant, provided the
"auto'" is not owned by or ranted or loaned
to you or the insured,
Page 4 of 21
(4) Liability asauimed under any "insured
contract"" for the ownership, maintenance
air use of aircraft air watercraft;
(5) "'Bodily injury" air "property darnage"
ahsing out of."
,(a) Theoperation of mactninery or
equipment that is attached to. or part
of, a laind vehicle that wo,uld qualify
kinder the definition of `rniobfle
equipmenC' !if it were, not, subject to a
colimpulsoiry or finiancial responsibility
law or other motor vehicle insurance
law where iit iis licensed or phincipaifly
garaged; air
M The operation of any of the machinery
air equipment ilisted iin Paragraph Q2)
air f '(3) of the definition of "lmiobiile
equipri or,
(6) An aircraft that is not lmanned by any
iins,uireid and is hired, chartered or loaned
with a paiid crew. However, this exceptia,,n
does not apply if the iinsiured has any other
insuirance for such ""(bodily injury" or
"'property damagie", whether the other
insuirance is piriimairy, excess, contingent
or on any other basis.
hIMobile Equipmerrit
"Bodily iinjury" or '"property daini arising
out Of:
(1), The transportation of "ni equipment"
by an "auto" owned or operated by or,
rented air loaned,to any insured,, or
(2) The use of "mobile equipment" in,, or while
iin practice for, air whilebeing prepared for,
any prearranged racing, speed,
demolition, or stunfing actiivity.
ii. War
"Bodily injury" or "property damage', however
caused, arising, directly air ind irectly, carrot of:
(1) War", including undeclared or" civil war,,
(2), Wairlike action by a military force, including
action in hindering or defending against' ani
actual or expected attack, by any
govemment, sovereign air other authority
using military personnel or other agents,,
air
(3), Insurreclion, rebellion, usurped
power, or action taken by governrriientall
authority in hindering air, dieferiOng against
any of thiese.
J. Damage'T'o Property
"Property d1amage" to,:
tl Property you own, rent. air occupy,
including any costs air expenses incurred
by you , or any oth -
air entity, for ep .. RAMwagmedDMsiun
Jy? N,�q REVIEWED & APPROVED BY.-
F04c"�" P, VX*vd
RtWjanagementftalpt
enhiancerrient, restoration or maintenance
of such, property for any reason, including
prevention of iinfury to a, person or damage
to another's property;
(2) Premises you siell, giive away or abandon,
if the "property dairnage" arises out of any
part of those premises;
(3) Property loaned to you,
(4), Personal property, in, the care, custody or,
cantrol of the ins,ured�
(5) That particular part of real property on
which you or any oontractors or
subcontractors
working directly or indirectly on your behalf
are performing operations, if the "property
darriage" anuses out of those operations; or
(6) That Iparticullar, part of any property that
rnust be restored, repaired or replaced
because "your work,"' was incorrectly
performed on it.
Paragraphs (3), and (4) of this excluisiioln
do not apply to "property damage"' (other than
damage by fire) to, premises, in,oluding I'he
contents of such premises, rented to yo,u fora
period of seven, or fewer consecutive days. A
separate limit of insurance applies, to, Damage
To IPreurnuses Rented To You as, described iin
Section III - ILiimiits Of IInsuirance.
Paragraph, (2) ofthis exclusion does not apply
if the promises are "your wofk" and were
never occupied:, rented or fteld for, rental) by
you.
Paragraphs (3) and 1(4) of thus exclusion do
not applly to "'property damage"' arising from,
the use, of elevators,
Paragrziphis. (3), (4),, (5) and (6) of this
exclusion do not apply to Iliabillity assumed
undeir a sidetrack agreerneint,
Paragraphis (3) and 1(4) of this exiclusion do
not apply to "properly damage" to borrowed
equipment while not being used to perform
operations at the job, site,
Paragraph, (6) of this exclusion does not apply
to, "property damage"" included in the
.1 products-corripleted operations hazard'%
k. IDamage To Youiir IProdu.mct
"Property darriage" 'to "your, product." arising
out of it or any part of it.
1. IDamage To Youiir Work
"Property damage" to "your work" arising out
of ut or any part of it and included in the
"prod ucts-com p leted operations hazard"".
This exolusion does, not apply if the damaged
work or the work out of which the damage
arises was performed on your ibehalf by a
subcontractor,
m (Damage 'To Impaired Property Or Property
Not Physically Injured
"Property damage'" to "impair8dl property' or
property that has not been physically injuired,
arising out of:
(1l) A defect, deficiency, inadequacy or
dangerous condition in "'your piroduc" or
"lyouir 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
2nd accidental) physical injury to "your
product" or "YOUir work" after it has been put
to, its intended use,
m Recall Of Products, Work, Or Impaired
Property
Darnages, clairried -for any loss, cost or,
expense incurred by you or, other's for the loss
of use, withdrawal, reicafl, inspecti an, repair,
replacement, adfustrnient, rernoval or disposai
of:
(1I), "Your product";
(2), "'Your work": or
(3) "Impaired property";
if such produict, work, or property is withdrawn
or recalled from, the market or frorn 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
advertising injury'.
p. Access, or Disclosure Of Confidentiall Or
Personal Information And Dat,a-rellated
Liability
Damages, arising out of:
(1l), Any access, to, or disclosure of any
peirson's or organization's confidential or
personal information, including patents,
trade secrets,, pirolicessing methods,
customer lists, financial information, credit
card information, heaKh iiniformakilon or any
other type of nonpublic inforniatioinil or
(2), The loss of, loss of use of, darnage to,
corruption of, inability to access, or
inability to manipulate electironic data,
This exclusion applies even if darnages are
claimed for notification costs, oredit
monitoring expenses, lerensic expenses,
pubfic relations expenses or any other loss,
cost or expense, incuir ull hv vau nir n-thArAz
airising out of that RAMmVmedDMsiun
Paragraph (1) or (2),6
Jy? N,�q REVIEWED & APPROVED BY.-
, VX*vd
RG 00, 01019 16 Wsk Pjanagement Analpt
However, unless Pairagraph (1) above
applies, this exclusion does not apply to
damages because of "bodily iinjury"',
As used in this exclusion, letectronic data
means information, facts, or Iprogiramns stored
as or, on, created air, uised on, or transrnitted to
or from computer software, including systems
and apphicatibins softwaire, hard or floppy
disks, CD-ROMS, t,apes, drjives, cells, data
processing devices or any other media whictt
are uised with electroinJcally controlled
equiprinenit.
q. Employment Related Practices
"Bodily injury"' to:
(1) A (person arising out of ainy "employment
-
related p,racfiQes`;1 or
�2) The spouise, eftild, parent, biroth,er, or sister,
afthat person, as a consequenice of"bodHy
injury" to that person at whom any
..i ert"ilploynieri't-,rel,a,ted pracdoes" are
directed,
i exclusion applies:
(1) Whether the injury-calusing event
described inthe definition of"erniployrnient-
r0ated practices" OCCUNS before
ernployment, during employment or, after,
employrnen't oftbat persona�
1(2) Whether the insured may be Hable as an
employer or in any other capacity; and
(3) To any oblJgafion to shiaire darnages with,
or repay someone else who, must pay
damages because of the injury
r. Asbestos
(11), "'Bodily injury" air "property diarriage"
arising out of the "asbestois, ha,zard".
(2), Any damages, Judgments, settlernents,
loss, costs or expenses that:
(a), May be awarded or incurred by reason
of any claim or suit alleging actual) or
threatened injury or daimage of any
nature or kiind to, persons or property
which, would not have occurred in
whole oir iin part but for the "asbestos
hazard";
(b) Arise out of any request, demand,
order or statutory or regulatory
requirement that any insured or others
test for, ni clean up, remove,
encapsulate, contain, treat, detoxify or
neutrafi7e or in any way respondi to, or
assess the effects of ,an, `asbestos
hazard"; or
(c) Arise out of any cla4n or suit for
daimages because of testiing for,
nioniftoring, clleaningl up, rernioving,
encaips,Jating, containing, treating,
Page 6 of 21
detaxifyingi or neutralizing or in any
way respoindling to, or assessing the
effects, of an "asbestos, hazard".
s» Recordinndl istribution Of Material Or,
Information In Violation Of Law
"Bodily injury" or "property damage" arising
directly air indirectly out of any action, or
ornissloini that violates or is allegied to violate:
(1) The Telephone Consumer Protection Act
JCPA), inCtUding any arniendment of or
addifionto such, llaw',
(2) The CAN-SPAM Act of 2003, including
any amendment of or addiction to SLAch law;
(3), The Fair" Credit Reporting Aict (FCRA), and
any amendment of or addition to, such law,
includling the Fair and Accurate Credit
Transaction Act (FACTA); or
(4) Any federM, stale or tocial statute,
ordiriaince or regulation, other than the
"i or CAN-SPAIiiiiiil Act of 20013 or FCRA
and their amendments and aidditions, that
addresses, prohibits car fimits, the printing,
dissemination, disposal. collecting,
recording, sendling, transmitting,
communicating or distribution of material
or information.
Irnage To Premises If To You -
Exception For Darnage By Fire, Lightning Or
Explosion
Exclusions ic through Ih. and ji through in. do, not
apply to, daini by fire, l'ightninlgl or explo5ion to
premises whiflle rented to your or temporarily
occtipiled by you with permission of the owner, A
separate hirmt of insurance apphes to this
coverage, as destribed in SecAiioln III - UirniAg Of
linsuraince.
COVERAGE B PERSONAL AND ADVERTISING
INJURY LIABILITY
1. Insuring Agreement
a-� We will pay those surris that, Die insured
becomes legaily, obligated to pay as damages
because of "personat and advertising injury"
to which this insurance applies. We wilt have
the right and duty to, defend the insured
against any "'suit"' seeking those damages.
However', we will have Inc, duty to defend the
insured agahist. any ""suit"" see) ing dariniagies
for "personal and advertising injury" to which
this insurance does not apply.'We may, at our,
discretioni, investigate ainy offense aind settle
any (Jaimi or "sult"tbat may result, But:
(11), The amount we will pay for dainiages is
lilmitedl as described in Section IIIIII - ILiimiits,
Of Insurance- ' and
(2) Our right andduty to defend end when we
have used up tl
insurance in the pii ep ..cF RAMwagmedDMsian
Jy? N,�q REVIEWED & APPROVED BY.-
F04C.�" P, VX*vd
RtWjanagementftalpt
settlements under Coverages A air B, or
medlical expenses under Coverage .
No other obligatiloin or liability to, pay suirris, or
perform acts or services is covered unless
explicitly pirolvilded for under SL!ppllementary
Payments - Coverages,A, and B.
b. This insiuraince, applies to "peirsonaI and
advertising injuiry" caused by an offense
Brisingi out of youir business but: only if the
offense wais comirmittedl in the "coveragle
territiory"' duiriing the polli,cy peiriiold,
2. Exclusions
Thies insurance does not apply to:
a. Knowing Violation Of Rights Of Another
"Personal and advertising injury"arising out of
an offenise committed by, atthe direction or
with the consent or acquiescence of the
insured with the expectation of inflicting
.1pe'rsonall and adver Using injury".
b. Material Published With Knowledge Oif
Falsity
"Peri and advertising injury"' i out of
oral), written or electronic publication, in any
manner, of rria'i i�f done by or, at the
direction of the insured with knowledge of its
fi
ic. IVaterial Pub] ished Prior To (Policy Perfod
"Personal and adverbsmnq injury" ariisung out of
oral, written or electronic publication, in, any
manneri, of material whose first pu0cation,
took place befdre tine beginning of the policy
period.
d. Ciriminial Acts,
"Personial andadvertisiiii injury" arising out of
a criminal act committed by or at the directicin
of the insured,
e. Contractual Liabliflity
""Personal and advertising injury" for which the
insured has assumed Iliabiliity in a contract or
agreement. This exclusion does not apply to
fiabillity for damages that the insured would
heave 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 contract to
uise another's "advertising idea" in your
"advertisement".
Quality Or Performance of goods i- Failure
To Conform To Statements,
"Personal anid advertisirig injury" ' arising out of
the failure of goods, products or, services to
conform with, any staternenit of quality or,
perrori rice, made in your '"aidliverlislement".
MMI X11119*11
FED. Wrong IDe,sclrilption Of Prices
"Personal and adverbsinq injury" ariising out of
the wroing description of the price of gloods,
�prodlu,cts or services.
L Infringement Of Intellectual Property,
Rights
""Personal and adiverfisiing injury" arising
out of any actual or allegied ini'dingieiraent.
,or violation of any intellectual property
rights such as copyright, patent,
trademark, trade narne, trade secret, trade
i serMce mark or other designation
of origin or auth,enticity-, or
(2), Any iinjury or darnage alleged in any clarni
or "suit"' 'that. also, alleges an infriagernent
or violation of any intellectual properly
right, whether such allegation of
infringement or violation is made by your of
by any offier party involved in, the clairni or
".suit'i regairdless of wheffier this
insurance would otherwise i
However, this exclusion does not apply if the
only allegaborr in the claim, of "suit"' involving
any intelliectual property right. is firrijited to,
(1), Infringement. in youir "advertisement", of:
(a) Copyright:
(b) Slogan; or
(c) Title of any literary or artistic work; or
1(2) Copying, in your "advertise mien 11", a
personi's, or organiization's "advertising
idea" or style of "adverflisemenit"',
j. Insureds In Media And linteinnet Type
Buisiniesses,
""Personal and advertising injury" comirnitted
�by an insured whose business is:
(1) Advertising, broadcasting, publishing or
telecasting;
(2), Desigining or doteirrinirfling content of web
sites for otheirs; i
(3), An Inteirflet search, access, content or
service pirolvider-
However, thiis exclusion does not ap#ly to
Pariagraphis ai., b. and c. of 'the definition oil,
"pergoinall and advertising injury"" under the
Definitions Section.
For the purposes of this exclluisioiii the placingi
of frarnes, bordlers or Iiii or advertising, for
you or others ainywheirei on the Internet,, is not
by itself, considered the business of
advertising, broadcasting, publishing or
telecasting,,
�k. IElectroinic Chatroorns Or Bulletin iBoards
"Peri and advertiiE
an ellectiroinic chatrooep ..cF RAMwagmedDMsiun
Jy? N,�q REii & APPROVED Sr:
F04C.�" z VX*vd
RtWjanagementftalpt
insured hials1s, owns, or over whichi the
insured exercises control,
if. Unauthorized Use Of Another's Name Or
Product
"Personal and advertising injuiry"' arising out of
the unauthiciflized use of another's name or
product in your e-maill address:, domain name
or metaitags, or any other similair tactics to,
mislead anotheir"s Potential customers,..
mi. IPollution
"Personal and advertising injuiry"' arising ai of
the actual, alleged or threatened discharge,
dlispileirsial, seepage, rinigration, releaseor
escape of "pollutants"at any time.
M11111012=0 IMM
Ainy loss, cost or expense arising o,ut of any
(1) Requiest, demand, order or" statutory or,
regulatory requirement that any insured or
others test i 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 suft by or on b6hialf of a
governmentali authority for darriiiages
because of testing for, monitoring,
olleaniiing up, removing, containing,
treating, detoxifying or neutralizing. or in
any ,may responding to, or ,assessing the
effects of, "plotiuitants".
u. War
"Persoinia] and advertising injury", however
causedi, arising, directly air indirectly, out of.
(if), 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
govemirrient, sovereign or other authaMy
usingi military pleirsoninel or other agerits;,
air
(3), linsurrection, rebeillion, revolution, usurped
power, or action taken by governmental
authority in hiiindefingi or defending against
any of these,
p. Internet Advertisernents And Content Of
Others
"Personal and advertising injury"" arising out
off;
(1), An "adveritislernient" for othiers on yolur web
site;
(2) Placing a link to a web site of others, on
your web site
(3), Content., incilluding inforrination, sounds,
text, graphics, or irnages frorn a, web site
of others displayed within a -frame or
border on your web site,, or
Page 8 of 21
(41 Corniputeir code, safe or pirogiramiiming
used to enable.,
(a), Your web site; or
(b) The presentation or fuinictiloinallity of an
Madveirtiserneint" or other conteint on
your web, site,
gl® Righit of Privacy Created By, Statute
""Personal and advertising injuiry"' arising out of
the violation of ai persion's, righit of pirivacy
created Iby any state or federal act -
However, thiis exclusion does not aipply to
liablilifty for daimages that the insured would
have in the absence i of such state or federal
2CL
r. Violation OfAinti-Trusit law
"Personal and advertising injury"' arising Out Of
a, violation of any anti-trust law,
s, Securities
"Personiall and advertising injury"' arising out of
the fliuctuation in Ipriice or valiue of any stocks,
bonds or other SeCUritiles.
ti, Recording And Distribution Of Materiall Or
Information In Violation Of tLaw
"Personal and advertising injury"' arising
diirectliy or, indirectly out of any action, or
ornissloini thaitviolates or is alleged to violate:
(1) The reiephone Consurner IProtection Act
(TCIPA), including any amendment of or
addlition to such, law;
(2) The CAN-SPAM Act, of 20,03. including
any amendment of or addlition to such liaw;
(3) The Faiir Credit IReportiing Act (FCRA), and
any amendment of or addition to, such law,
lincludiing the Fair and Accurate Credit
Transaction Act (FACTA); or
(4) Any federal, state air local statute,
ordinance or regulation, other fli the
TCPA or CAN-SPAIiiiiiT Act of 20013 or FCRA
and their aimendments and additilons, that
addlresses,, piroili or limits, the printing,
dissemiination,, disposaill, coliectinig,
recording, sending, transirinittinig,
communicatingi or distribUtiOlin of material
air infoirmation.
u. EmployrnierrtRelatedi IPractices
"Personal and adiverfiisiflg injuiry"' to:
1person arisinig out. ofany "ernpiloyrnient-
relaiteld practices"; or
(2) The spouse, child, parent., brother or sister
of that person as a consequence of
..i peirsonaii and adliverfising injury'" to that
person at whorr
practices" are di
cF Risk MmWmentDiAsiun
Jy? 'K�q REVIEWED & APPROVED BY.-
F04C"�" P, VX*vd
Rusk iPjanagementAnali
rhis, exok),91on apphes'.
(1) Whether the inj uiry-calusing event
describled iin the definition of `empl4oyment-
related practices'" occurs before
employment, during employmielnt or after
employment of that person,
(2), Whether the insured may be liable as an
employeir oir iin any other capacity, and
(3), To any obligation to share damages with
or repay someolne else who, mius,t pay
damages because of the injury.,
VWX71
(11), "Personal and adverfising injury" arising
out of the ""asbestos hazarl
(2), Any damages, judgirnents, settlements,
costs or expenses fliat:
(a) May be awarded or incurred by reason
of any clai�r'n or suit altegiing actual of
threatened injury or clairl of any
nature or, kind to persons or property
which, would not have occurred in
whole or in, part but 'for the "'asbestos
hazard",
(b) Arise out of any request, demand,
order or statutory or, regulatory
requirement that any insured or others
test for, monitor, clean up, remove,,
enclapsuW,tel, contain, treat, detoxify or
neutrahze or in any way respond to, or
assess the effects of an "as-bestos
hazaird"; or
(c) Arise out of any claim or suit for
damages because of testing for,
moniftoring, cleaning up, removing,
encapslulating treating,
detoxifying or neutralizing or in any
way responding to or assessing the
effects, of an "asbestos, ha,zard".
w., Access, Or Disclosure Of Confidential Or
Personal Information
"Personal and advertising injuiry"' arising out of
any access to, air disclosluire of ainy person's or
organization's covifidentidli or pleirsondli
information, iiindluding patents, trade secirets,
�processiing methods, customer financial
information, credit card inforniation, health
information or any other type of nainplubfic
information.
This exclusion applies elven if darr)ages are
claimed for notificaboin costs, ael
monitoring expenses, forensic expenses,
pubtic relations expenses or any other loss,
cost or expense incurred by you or others
arising out of any access to or dlsclols,ure of
any person's or organization's confidential or
personal information,
0 M1 _I114 KIRR
GOVERAGE C MEDICAL PAYMENTS
1. Insuring Agreement
a. We will play medical expleinges as described
below for '"bodily iinjury" caused by an
2ccideint..
(11) On preiniisels, You own or rent;
(2), On ways next to, premises youi own or
reint; or
(3), Because of your operations,'
providled that:
(11) The accident takes place in the "'coverage
territory"' and duiriing the poliicy peiriold;
(2), The expenses are incurred and reported
to us within three years, of the date of the
accident; and
(3), The injUred person Submits to
examination, at our expense" Eby
physicians Of our choice as often as we
reasonably require.
b. We will make these payrnents regardless of
fault. These payments will not exceed the
applicable limit of insurance. We w0t pay
reasonable expenses for
(1) First aid administered at the time of an
accident;
(2) Necessary maned (al, surgical, X-ray and
dental services, including prosthetic
devices; and
(3), Necessary ambulance, hospital,
professional nursing and funeral services,
2. IExclulsiolns
"fie l will not pay expenses for "bodlilly Injury"";
la. Any insured
To any insured, except "volunteer workers",
b. Hired Person
ro as person hired to do work for or on behalf
of any insured or a, teinant of any insured,
ic. Injury On, Normally Occupied Premilses,
To, a person injuredl an that part of preimises
you own, or rent that the persoin normally
occupies.
d. Workers Corrilpenisation, And Similar Ll
To a person, whether or not an "employee" of
any in5uir8d, if benefits, for the "bodily injury" are
payable or muist be provided under a, workers!
compensation or disabdity benefits law or a
similar laws.
le. Athletics Activities
To a person injured wbile, practicing,
instructing or, participating ins any physical
exercises or garne�
contests ep .. RAMwagmedDMsiun
Jy? N,�q REVIEWED & APPROVED BY.-
F04c.�" z VX*vd
Risk Pjanagement Analyst
f. IPlrodulot-Cornplteted Opp erations, Hazard
assumed Iby the insured in the same "'insured
Included within the "prodUcts-complieted
contract";
operations hazard".
dw The allegabons in 'the "'suit" and the
g. Coverage A Exclusions
inlorrnation, we know about the "'occurrence"
EXC[Lided under Coverl
are such that no conflict appears to exist
between the interests of' the insured and the
SUPPLEMENTARY PAYMENTS - COVERAGES
interests of the indlemnitee;
A AND 183
e the indemnitee and the insured ask us to
1. We will play, with respect to, any claim we
conduct and control the defense of float
investigate or settle, or any "'suit" again nst a
inderninitee against such "'suit"' and agree that
we dlefend:
we can assligin 'the same counsel to defend
la» N expenses we nn CU r,
the insured and the indernnitee.- and
lb. Up to $1I,000 for cost of bail bonds required
f. the indemnitee:
because of accidents oir traffic law A6lations
(1�), Agrees, in wri(fing to:
arising out of the use of any vehicle to which
the Bodilly Injury Liabflity Colveraige applliies.
(a), Cooperate Mh us in the inivestigation,
We do not have to, furnish these bonds.
settlement or defense of the "suit";
c,, "'rhe cost ofappeW bonds or bonds to release
(b) iImmediately send us copies of any
attachments, but only for bond arnounts
demands, notices, s,unimons,es, or Ile ,all
withinthe applicable limit of insurance. We do
papers, received in connection wit1h the
not have 'to,,furnish these bo,nds,,
"suit";
d. AJI reasonable expenses incurred by the
(c), Notify any otheir insurer whose
insured at our request to assist us, in the
coverage is available to the
investigation oar defense of the claim or "suit",
indemnitee; and
inclulding actual lo5,s of earnings- LIP, to $5100 a
(dl) Cooperate wiith us with Irespect to
day because of time off from work.
collordinatiing other applicable
e,, AJI court oosts, taxed against the insuired In
insluirance available to the indemnitee-1
the "'suit"'. However, such costs do not
and
include attorneys' fees, attorneys' expenses,
(2) Provides us with written authorization to:
witness or expert fees, or any, oth,er, expensies
of a party taxed to the Insured.
(a), Obtain recoirds and other information
f. Prejudgment interest awardled algain,st the
related to, the ",suit"-, andl
insured an that part of the judgment we pay, If
(b) CondaU and control) the defense of flie
we, make alnl offeir to pay the applicable limit. of
inidemnitee in such "suit".
insurance, we will niot pay any prejudgment
So long as the above conditions are met,
inteirest based an that period of timie after the
attorneys! fees, incurred by LIS, in the defense of
offer.
that inderninitele, necessary iffigatilon expenses
AJI interest on the full amount of any judgment
incurred by us and necessary Ifligatio,n expenses
that accrues after entry of the judgment and
incurred by the inderninitee at our Irllequest. will be
before we have paiiid, offered to pay, or
paid as Supplernentary Payments.
deposited in court the Part of the judgraent
Notwithstanding the provisions of Paragraph
that is within the appli,caWe limit ofinsurance.
2lb.(2) of Section I - Coverage A, - Bodily Injury
These payments, will not reduce the flimits of
And Property Darnage Liabffity, such payInerits
insiuraince-
will not Ibe deerl 'to Ibe damages for "bodily
Z It we defend an lins,ured against a "suft" and an
Injury"" and "'property darl and will not reduce
indeminitee of t ' he insured Is also named as a
'the limits of insurance
party to the "suit", we will defend that indemnitee
OUr obhigationito defend an insured's indernjnitee
if all of the follow ilng conditions are met
and to pay for attorneys' fees and necessary
a. The "suit!' against the iindleminitee seeks
litligation expenses as S,uppl,ernentary Paymient�s
damages for which the insured has assumed
ends, when,,,
the liability of the inderninitee in a contract olrr
al. We have used up the applicable hmit of
agreement that is an "insiured cc retract"'";
insurance in the payment, of judgments or
b. This insurance applies to such liabifity
sett'lenients; or
assIl,inied Iby the insured;,
b. The conditions set forth above, or the terms of
C. The obfigiation to, defeind, or the cost of the
the algireelment described in Paragraph f.
defense of, that inderninitele, has also (been
above, are no longer
ep ..cF RAMwagmedDiAsiun
Jy? N,�q RE & APPROVEDBY:
F04c.11
P, VX*vd
Page 10 of 21
Risk Pjanagement Analyst
SECTION 11 - WHO IS AN INSURED
M vollunteer worker" as a, oansequence
1. If your are designated in the Declarations as
of IParagraplh (1)(a), above;1
a. An iindividu4l, you andl your spouse are
(c), IFor which there is any obligation to
insureds, but only with respect to the conduct
share damages, with or repay someone
of a business of which you are the sole
else who must pay damages because
owner.
of the injury described in Paragraphs
(1)(a), or (11),(b) above, or
b. A partnership or joint venture, you are an
insured. Your members, Your partners, and
(dl) Arising Out of his or her piroviding or
their spouses, are also, insureds, but oinillywith
failing to provide professional health
respect to the conduct of your business.
care services-
ic. A, limited liabilfty company, you are an
If you are not in the business of providing
insured. Your members are also insureds, but
professional health care services:
only with respect to the conduct of your
(a), Subparagraph's (1)(a), (1)(b), and (11)(c)
business. Your imanagers are insureds, but
above do not apply to any "employee"
only with respect to their duties as your,
or "vd1unteer worker"® providing first aid
managors,
services; and
dw Ain organization other than a partnership, joint
(b) Subparagrapti (1)(d) above does not
venture or limited 4ability company, you are
applly to any nurse, erriergency medical
an insured Your "'execu,five officers"' and
tectinician or pararnedit erriployed by
directors are insureds, but only wiffi respect to
you to provide such ser0ces,
their duties as your officers or, directors. YOUr
(2), "'Property darriage" to, propeirty',,
stockholders are also insureds, but only with
(a) Owned, occuipledl air used by,
respect,to their liability as stockholders.
e,, A trust, you are an insured, Your trustees are
(b) Rented to, in the care, custody or
also, insureds, abut only with respect to their
control of, or over which pl'iyisical
duties as trustees,
control is being exercised for any
2. Mach of the following is also, an insured:
purpose by
'you, any of youir "employees', "volunteer
a. Employees And VoluinteerWorkers
workers", any partner or member (if you
your volunteer workers"only while
are a partnership or joint venture), or any
performing duties reWted to, the conduct of
member (if you are a, limited liability
your business, or your "'employees"', other
company).
than either your "executive officers"" (if you are.
b. Real IEstate Manager
an orgianization other than a partnership. Joint
venture or linifted habililly company) or Your
My person) (other than your, "employee" or
managers (if you are a limited liabifity
""volunteer worker"). or any organization while
company), but only for acts within the scope
acting as your real estate manager,
of their employment by your or while
c. Temporary Custodians Of Y�oiur Property
performing duties related to, the conduct of
Any person or organization having proper
your business.
temporary custody of your property if you die,
However, none of these "employees" or
but only:.
iii volunteer workers" are iinsureds for:
(11), With respect to liability arisingi out of the
0) "'Bodily injuiry"' or "",personal and advertising
maintenance or use of that property; and
injury:
(2) Until your legal representative has been
(a), To yo%to your partners or members (if
appointed.
your are a partnership or joint venture),
d. Legial Representative If You Die
to your members, (if you are a limited
Your legal irepiresentative if you die, but only
liability company), to a co-'"ernployele"
wiith respect to duties as, such. That
while in the couirse of his or her
erriployment or perforrriing duties
representative will have all1l your rights and
related to the conduct of your,
dILIUC-S under this Coverage Part,
business, or to, your, other "volunteer,
e. 'Unnamed Subsidiary
workers" while performing duties
Any subsidli�ary, and subsidiary thereof, of
related to 'the conductof your"
yours which is a legally incorporated entity of
business,,
which yolu own a financial interest of more
(b)'ro the spouse, child, parent, brother or
than, 50% of the votin
sisteir of that co -"'employee" or that
d1ate ofthe Coverage I ep ..cF RAMwagmedDMsiun
N,�q
Jy? REVIEWED & APPROVED BY.-
F04C.�" P, VX*vd
HG 00, 01019 16
Wsk Pjanagement Analpt
rhe insurance afforded herein for any
subsidiary not named in this Coverage Part
as a naimed insured does not apply to injury
or damage wiith respect to, which such, insured
is also a nainied insured under ainother pollicy
or would be a, named insured under such
policy but for its termination or the, exhaustion
of its Ililmits of lrisurainc8,
3. Newly Acq uJI red Or Formed Ori nizatio n
Any arganization you newly acquire or form,
other than a partnership, joint venture, or Illlimlited
liability company, and over which your maintain
financial interest of more than 50% of the voting
stock, wiII qL[alify as a Named Insured if there is
no other similar insurance available to that
orgainizatilon, However:
a» Coverage under this provision is afforded only
until 'the 180th day after you acquire or form
the organization or the end of the poticy
1perjiod, whichever is i
b. Coverage A does not aipi#ly to "bodily injury"'
or "property darnage" 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
corrimitted before you acquired or formed flee
organization
4. Noniownied Watercraft
With respei watercraft you do, not. own that is
less than, 5,1 feet long and is, not b6ng used to
carry, persons for a charge, any person is an
insured while operating such watercraft with your
perrnission. Any other person or' organization
responsible for" the conduct of such person is
also an, insured, but only with respect to liability
arising out of the operation of the watercraft. and
only if no other insurance of any kind is available
to that person or organization for this liability,
However, no, person or organization is an insured
with respect to:
a» "Bodily injury" to, a co -"employee" of the
person operafing the waterciraft;, or
b. "Property damage" to property owined by,
rented to, in the charge of or occupied by you
or the eimpiloyer of any person who is an
insured under this provision.
5w Additional Insureds When Required By
Written Contract, Written Agreement Or
Permit
The following persons) or organization(s) are an
additional insured when you have agreed, iin, a
written contract, written agreement or because of
a permit issued by a state or poilifical subdIvision,
thiat such person or organization be added as an
additional insured on your pollicy, provided the
injury or damage occurs subseq&lient to the
execution of the contract or agireeiryi,ent.
Page 12 of 21
,A person air organization is ainadditional insured
under this provision only for that period of firne
required by the, contract or agreement.
However, no such person or organization is an
insured undler this provision if sucth person or
organization is included as an insured by an
endorsement issued by us and made a part of
this, Coverage Par I..
ia. Vendors
Any, person(s) or organization(s) (referred to
below as vendlor), but orilly with respect 'to
"bodily injury' or "property darnage"' arising
out of "'your products" which are distributed of
sold in, the regular course of the vendor's
blusiness and only if i Coverage Part
provides coverage for "bodily injury" or
property darinage" included Mi the
products-corripleted operations hazard".
(i), The insuirance afforded the vendor is
subject to the following additional
exclusions:
This insurance does not apply to:
(a), "i injury" or "property damage"' for
whijch the vendor is obligated to pay
damages, by reason of the assumpifion
of liabiillity in a cointract or agreement,
This exclusion does not apply to,
liability for damages that the vendor
would have in, the absence of the
contract or agirelement',
M Any express warranty unaluthorized by
you "
(c) Any physical air chemicall change in the
piroduct made intentionally by the
vendor;
(d) Repackaging, except when unpacked
solely for the purposle of inspection,,
demonstration, testing, or the
subStitUtion of parts, under instructions
from -the manufacturer, and i
repackaged in'the original container;
(e) Any fafluirei to make such linspections,
adijustments, tests or s8irviiciing as the
vendor has agreed to make or nofmaifly
undertakes to, make in the usual
course of business, in connection with
the distriiblution or sale of the products-,
(f) Demonstration, installation, servicing
or repair operations, except such
operabons perfornied ait the vendor's
premises in (A)rinection with the sale of
the product;
(S) Products which, after distribution or
sale by you, have been lalbeledl or
relabeled or used as a cointainer, part
,or ingredient
substaince by o ep ..cF RAMwagmedDMsiun
Jy? N,�q REVIEWED & APPROVED BY.-
F04C.�" z VX*vd
RtWjanagementftalpt
(hi) Todilly injury" or "°property damage"
arlisling out of the solle negligence of the
vendor for its own acts or emissions or
thios,e of its employees or anyone else
acting on its behailf. IHlowever, this
exclusioin does not apply to:
(1) The exceptions cantained in Sub-
paragraphs, (d) or (f); or
(H) Such inspections, adjustments,
tests or servicing as the vendor has
agreed to make or normally
undertakes to, make in the usual
course of business,, in connection
with the distribution Or sale of the
products.
(2) "1 iim,urance does mot apply to, any
insured person or oryanJzation, from
wliom you have acquired such products,
or, any ingredient, part or container,
entering intoi, accorrilpanying or containing
such products,
b. Lessors Of Equipment
(1), Any persiori(s) or oirgaNzaflon(s) frorn
whorn, ,you lease eqUilpirnent; but o,nly with,
respect to their liabifity for "bodily injury",
"property dari or, "personal and
advertising injury" Ctl'Used, in whole or iini
part, Iby your mainiteriance, operal ' lon, or
use of equipment leased to yore by sudii
person(s), of organization(s),
(2), With respect to, the insuirance afforded to
these additional insureds this insurance
does not apply to any "loccurrence" which
takes place after the equipment lease
expires,
c. Lessoirs Of Land Or Premises
Any pleirson or airganization from whom you
lease Land or pirenrises, but only wiith respect
to, liability arising out Of the ownership,
maintenance or use of that part of the, land orr
preirnises, leased to you.
With respect to (lie insurance afforded these
additional insureds the follming additiOnat
exok,isions applly:
This insurance does not apply to:
1. Any "accurren,oe" which takes place after
your cease to Iease that land; or
2. Structural alterations, new construction or
deiniolition operations, performed by or on
behalf of such per$0r,1 or orgainization,
rfw Axichitects, Engineers Or Surveyors
Any arc-hitect, engineer, or surveyor, but only
with respect to, flability for "biodHy iinjUry"',
M property damage" or ""personal and
advertising injury"caused, in, whole or in part,
by your arts or ornisssons, or the acts, or
MIMN X11119*1
om issJonis of those acti ngi on your behalf;
(1), in connection with your premises; or,
(2) In the performance of your ongioing
operations performed by you or an your
behalf,
With respect to the insurance afforded these
additional insureds, the following additionat
exclusion applies:
i insurance does not appjly to
InjUry', "property damage" or ""personal and
advertising Injury"' arising out of the rendering
of or thie failure to render any professional
services by or for you, including,'
1. The prepiadrig, approving, or failing 'to
prepare i or approve, snaps„ shop drawings,
opinions, reports, surveys,, fiend orders,
change orders or, drawings and
specifications; or
2. Supervisory, i nispection, archiftectural or
enginelering activities.
This exclusion applies even if the claims
against ainy insuired allege negligence or
other wirongdoing in the supervision" hiiring,
employrnient, training or rinonftorinig of others
�by that insured, if the "oecurrence" which
caused the "i injury'" or "property
darnage", or i offense whioh caused the
."personal sand advertising injury, involved the
rendering of or the failure to rendler any
professional services by or for you,
e. Permits Issued By State Or Political
Sublidivisions,
Any, state or political sub,division, but only with
respect to operations performed by you or, on
your behalf for, which the state or, political
subdivision has issued a perri
With respect to, the insurance afforded these
addiflonat inSiUreds, this insurance does not
apply to;
(1) "'Bodily injury"', "property darnage" or
"personal) and adverfising injury" arising
out of operations performed for the state
air municipality" Or"
(2) "'Bodily injury"' or "'property darrage"
included within the "produicts-completed
Operations hazard",
f. Any, Other Party
Amy oil ' her person or organization who is, not
an additional insured under Paragraphs a.
throu,jgh e, above, but only with respect to
liability for "bodily injury"', "property damagie"
or "per5oniial and advertising injury` Gaiiised, in
wholle or in part, by your, acts or ornissions or
the acts, Or ornissions of those acting on your
behalf:
(1) In the per(ormar ep .. RAMwagmedDMsiun
operations; 40?i� N,�q REii & APPROVED BY.-
F04C"�" P, VX*vd
RtWjanagementAnalyst
(2) In connection with your premises owned
by or rented to you; or
(3), In connection with "your work" and
includled within the "products -completed
operations hazard", but only iif
(a), The written contract air agreement
reqjUires you to provide such coverage
to such additilaniall insuired; anal
(b) This Coverage Part provides coverage
fur "bodily iinjury"' or "'property damage"
included Within the 111piroducts-
completed operations haizard".
I:
(11), The insurance afforded to sucl"i additionat
insured only applies to the extent
permitted by, (law; and
(2) If coverage providlied to the additional
insured is required by a contract or
agreement, ffie insurance afforded to such
additiori insured vM not be biroiadier, than
that vi you are required by the contract
air agreement to provide for such
addifionail insured
With respect 'to, the insurance afforded to
these additional insureds, this insurance does
not apply to
"Bodily injury"', "property daimage'" or
"personal and adverUsing injury" arisingi out of
the rendering of, or the failure to render, any
professionat arohitectu rail, engineering of
suiroeyiing services. incIrAing,
(1) The prepairing, appiroviing, or failing to
prepare or, approve, maps, shop, drawings,
opinions, reports,, surveys, field orders,
ohanige orders or drawings and
specifications: or
(2) Supervisory, iinispiection,, architecturdl or
engineeiring activities.
This, exclusion applies even iif the claims
against ainy insuired allege negligence or
other wirongidaing in the supervision, hiring,
empiloyment, traiiniing or moinitofling of others
by that insured, lif the "'occurrence" which
caused the "bodliilly injuiry" or "property
darnage", or the offense which caused the
"pleirsional and advertising iinjiury", involved the
rendering of or the failuire to render any
professional services by or for YOU.
The lirnifts of insurance that apply 'to additional
insureds is deschbed in Section III - Limits Of
Insurance,
How this insurance applies when other insurance
is available to the additional insured is deschbed
in the Other, Insurance Condition in Section JV -
Commercial General Liability Conditions.
Page 14 of 21
No person or organization is an insured wit1ii respect
110 the conduct of any CUrrent or past partnership,,.
Joint venture or limited liability compainy that is not
shown as a Naimed Insured in the Declarations.
SECTION III i- L1MITS OF INSURANCE
1. The Most We Will Pay
The Limits of Insuirance shown in the
Declarations and the rules bellow fix the most we
will pay regardless of the niumber of::
a. Insureds;
b. Claims maide or "Suits" brought, or
c. Peri or, organizations rinaking d1aims or,
bringing "suilits",
2. Generail Aggregate, Limit
The General Aggregate I..irnit is the most we vM
pay for the sum of.
a,, Medical expenses under Coverag,e C;
b. Darnages under Coverage A, except
damages because of "'bodily injury" or,
.'property darri included) in the "products -
completed operations, hazard"; and
c,, Damagies, underCoverage R,
3. Products -Completed Operations Aggregate
Limit
The Products - Completed Operations Aggregate
Urnit is the most we wilil pay undeir Coverage A
for damages because of "Nudity injury" and
"property damage" included in the "products -
completed operations, hazaird",
4. Personial And Advertising Injury Limit
Subject to 2. above, the Peirsoin4l and
kliverfising Injury Limit is the most we will pay
under Coverage Bi for the suim of all damages
because of M `persoinail and advertising uijury"
sustained byany one person or orgairuzation,
5. Each Occurrence Limit
Subject to 2. or 3. above, whichever aiii the
Each 0ocuirrence Limit is the most,we will pay for
the sum of:
a. Damages under Colverage ki, and
b. Medical expenses; under Coverage's
because of aill "bodfly inJiury" and "property
damage" arising out of any one "occurrence'"".
6. Damage To IPremises Rented To You Limit
Subject, to 5., above, the Damage To, Preri
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 darriage by 'hire,
lightning or, explosion, while rented to you of
ternporarily occupied by, you with permission of
the owner,
ep ..cF RAMwagmedDiAsiun
Jy? N,�q REVIEWED & APPROVED BY.-
VX*vd
RtWjanagementftali
In, the case of darriage by fire, lightAng or
explosion, the If amage to, Premises Rented To
You Limit aipipfies to, afl damage proxiniat6ly
caused by the sainie event,, whetheir suich
damage iresuults from fiire, Iliightninig or explosion
or any combination of these.
7. Medical Expense Limit
Subject to 5. above, the Medic4l Expense Liftit is
the miost we will Ipay under Coverage C for, all
medical expenses because of "bodfly iinjurV"
sustained by any one persona.
8. lFlowLimits Apply, ToAdlidifional Insureds
If YOU have agreed in a written contratt or written
agreement that another person or organizatio-n
be addled as an additional insured on your poticy,
the most we will pay on behalf' Of Such additional
insured isthe losser of.
ai» The lirr"rits of insurance specified in the written
contract or written agreernent; or,
b. The Limits, of Insurance shown in the
Dedarafions.
Such amount shalt be a part of and riot in
addition 'to Limits of Insurance shown in the
Declarations and described in this Sectiort,
The Uirnits, of linsurance of this Coveragie Part apply
separately to each, consecutive afinival period and to
any remaining period of less than 112 months,
starting with the beginning of the policy period
shown hii the Dedlarations, unless, the polliicy period
is extended after issuance for an additional period of
Less than, 12 months. In that case, the additional
period MH ibe deemed part of the ilast preceding
periodl for, purposes of determining the Limits of
Inisurance,
SECTION IV - COMMERCIAL GENERAL
UABILITY CONDITIONS
t Bankruiptcy
Bankruptcy of insolvency of the insured or of the
insuredli's estate will not relieve us of our
oblilgations undeir this Coverage Part..
2. Duties In The Event Of Occurrence, Offense,
Claim Ot Suit
a. Notice, Of Occuirrence Or Offense
You or any additionail insured must see to, iit
Mat we are notified as soon as practicable of
an "acturren,ce'" or an, offense which may
result in a claim. To the extent possible,
notice should include:
(1) Holw, wheni and where the wo,Gc.urrence" or
offense toak plla,ce',,
(2), The names and addresses of ainy injuired
persons and witnesses; and
(3), The nature andl locatlloini of any injury'mar
damage arising out of the "occurrence"' or
offense.
MIMN X11119*11
If a, claim is made oir "suit" is brought againist
any insured, you or any addibon,41 insured
Must:
(1I), Immediately record the specifics of the
clainii or "suit"' and the date received; and
(2), Noldfy us as soon as practicable.
You or any additilonaill insured must see, to iit
that we receive wriitten notice of the claim or
%uit!'as sooin as practicable.
c. Assistance And Coopeiration Of The
Insured
You and any other involved insured must:
(1l), Irrimediately send us copiies of any
deimiands, notices, surnmonses or legal)
papers received in connection with the
clairn or "suit";
(2), Authorize us to obtain records and other
information',,
(3), Cooperate with us in the iinvestigation or
settlement of tine clairn or dofenise against
the -suit""„ and
(4), Assist us, upon our request in, flie
enforcement of any rigiht against any person
o'er ofganization which im,ay be lia,bte to the
insured because of injiury or darriage to
which this insurance may also, apply,
d. Ob ligat! ons, At The I ns uireds Own Ccyst
No ins,ured will, except at that insured's own
cost, vok,rintarily make a payment, assume
any obligation, or incur any expense, other
than for first aid. withouit our consent,
e. Additional IIInsuredls, Other linsurainice
If -we cover a claim or "suit" under this
Coverage Part that may also be covered by
other instirance available to, an additional
insuired, suich additional insured must submit
such, claim or "'suit" to, the other insurer for
defense and indemnity,
However, this, provision does not applly to the
extent that youi have agreed in a written
cointract or written agireemleinit that thiis
insiuraince is primary and non-contributory
with the additional insured's own insurance.
f. Knowledge Of An Occurrence, Offense,
Claim Or Suit
Paragraphs a. and b., applly to you or to any
additionall iinsuredl only when such
occurrence", offense, clairn or, "'suit" is known
to�.
(1), You or any additioniall inStrred that is art
individual,
(2) Any partner, if
insured is a partne ep ..cF RAMwagmedDiAsiun
Jy? N,�q REVIEWED & APPROVED BY.-
F04c"�" z VX*vd
Rtiementftali
(3) Any manager, if you or the addition6ll
insured is a limited Hab4ity company;
(4), Any ""executive officer' air insurance
rnainager,, if you or the additional insuired is
a corporation;
(5) Any trustee, if you or the additional
insured is a trust-, or
(6), Any elected or appointed official, if you or
the additional insured is a pofiticW
subdliiviisiioln or public: eintity..
This duty applies separately to, your and any
additional insuiired,
a
No person or organization has a right under this
beverage Pi,
ia.� To join UIS as a pairty or otherwise bring us
into a "suit"" asking for darnages from an
insured,,, or,
b. To sue us on this Coverage Partunless all of
its terms have (been fu I I y complied with ,
A person or organization may sue LIS to recover
on, an agreed setilloment or ori a finaf judgment
against an insureds but we will not be liable for
damages that are riot IpayaNe un,der ffie terms of
this Coverage Part or ffiat are in excess of the
appl[Gable line of insurance, An agreed
settlement means a settlement and release of
liability signed by us, Oie insured and the
claimant or the cla,imant's legal representative.
4. Other Insurance
If other valid and ootlectible insurance is
available to the insured for a foss we cover under
Coverages, A or B, of this, Coverage Part, our
obligationsare limited as followsry
a. Primary Insurance
This insuraince is primary except when, lb.
below applies. If other insurance its, also
primary, we will share with alit that other
insurance by the miethod described in c.
below.
b. Excess Insurance
This insurance is excess over any of the other
insurance, whether primary, excess,
contingent or on any other ba8jis:�
(11), Youir Work
That is Fire, Btended Coverage, Builider's
Risk.,, Installation If or similar coverage
for'" ou.ur work.'i
,(2) Premises iRented To You
That is 'fire, lightning or ex#onion
insurance for, premises rented to you or
temporarily ocoupied by you with
permission of the owner;
(3) 'Tenant Liablility
That is insurance purchased by you to
cover yoiuir liability ag a teinant for
"property daimage"' to, preirnises irented to
you or temporarily occupied by you with
permission of the owner;
(4), Aircraft, Auto Or Watercraft
If the loss arises o,ut of the Maintenance or
use of aircraft, '"autos" or watercraft to the
extent snot subject to, Exclusion g. of
Section I - Coverage A - Bodily Injury And
Property Damage Liability,
(5), Property Diarnage To Borrowed
Equipment Or Use Of Elevators
If the loss airises out of "property damage"
to borrowed equipment or 'the use of
elevators to, the extent not subjoct. to
Exclusion j. of Section I - Coverage A -
BodHy Injury Arid Property Diarriage
Liability,"
(6), When You Are Added As An Additional
Insured To Other Insurance
Any other insurance available to you
covering liability for darriages arising out
of the pro rnises or, operations, or iproducts
,and oornpl,eted operations, for which you
have been added as an additional insiured
by that insurance; or
(7), When Yoiui Add Otheirs, As An
Additional InsuredToThis Insurance
Any other ins,urance availabite to an
addifioinali insured,
However. the folicii provisions apply to
other insurance avaHaWe to any person or
organization, who is an additional linsured
under this coverage part,
(a) Primary Insurance When Required
By Contract
This insurance is primary if you have
agreed in a written cointract or writtain
agreement that this insurance be
primary, If other insuiraince is also
pirimairy, we will share with all that
other insiuraince, by the, method
described in c. below.
(b) Primary .and Ton- ontr➢ibuitory To
ether Insurance When Required By,
Contract
If you have agreed in a written
contract, written agreemeint, or perrnJit
that thIs insurance is primary and non-
contributory wiith 'the additionai
insured's own insurance, this insurance
is Apr irriary are' lixtra i IIII i seek
contribution froi ep .. RAMwagmedDMsian
Jy? N,�q REVIEWED & APPROVED BY.-
F04c.�" P, VX*vd
Page 116 of 21 RIA Pjanagement ftalpt
Paragraphs (a) and (b) do not apply to
other insurance 110 which the addifionat
insured has been added as an additional
insured.
When thiis insurance is excess, we will have
no duty under Coverages A or B to defend
the insuired against any "suit" if any other
insurer has a duty to defend the iinsuired
against that "suit". If no other insurer defeinds,
we will undertake to do 5o,, but we will be,
enUtiedl to the insuired's rights against all
those other insurers.
When this insurance is excess over other
insurance, we will pay only our share of the
arnoluint of the loss, if' any, thait exceeds the
sulm of:
(1l), The toil,M arriounit 11"lat all such other,
insuirance would Ipay for the loss, in the
absence of this insurance and
(2), the total of all deductible aind self-iins,ured
amounts under ail) that ether insurance.
We will sbaire the remaining ioss, if any, with
any other insurance thiat is not described in
thisxcegg Insurance provision and was not:
bought SpedfiCailly to apply in excess of the
Limits of Insuranceshown in the Declarations
of this Coverage Part.,
c. IMethod Of Sharing
If all of the other iinsurance permits
cont,riibludon by equ4i shares,, 'we willll follow
this method also. Under this approach each
insurer cointribiates oqual amounts until it has
paid its applicable )unfit of insurance or intone
of the loss, remains, whichever comes first.
11'any of the other insurance does not permit
contribution by ectual shares, we will
contribute by limits. Under this miethod, each
insurer's share is based on, the ratio of its
apipficablie limil ' of insurance to tbie total
apipficable limitsof insuranice of all insurers,
5. Preirrillurn Midit
a.� We wilt compute alt preMILAims, for this
his
Coverage Part hii accordance with our rules
and rates,
b. Premium shown, iin this Coverage Part as
advance piremilurn is a deposit prerri ody.
At the close of each audlit period we will
compute the earned piremium for that period
and send notice to the first Warned Insured_
Thedue date for audit and retrospective
preirriums is the date shown as the due date
on the bill, If the surn of the advance and
audit prerniums, paid iior, the policy period is
greater than the earned premium,, we will
return the excess to the first INlarnedl Insured,
c. 'The first Named Insured must keep, reoords, of
the information we need for premilum
0 IMN -11"I KIPS
computation, and send tis copies at such
tunes as we may request.
6. Representations,
a, When You Accept This IPollicy
By accepting this policy, you agree,
(1) The staternents sin the IDeclarations, are
accurate and complete;
(2) Those statements are based upoin
representations you made tam us; and
(3), We have issued this policy in reliance
upon your ire piresie nta tions,
b. Unintentionall Fallu, re T Ip isclose IHazards
If tinintentionally you should fall to 65,close all
ihiazlards, relating to the conduct Of Your
business that exist at the inception date of
this Coverage Part, we shall not deny
coverage under this Coverage Part ibecause
of such failure,
7. Separation Of Insureds
Except with respect to the ILinnits of Insurance,
and any rights or dutles specificaky assigned in
thiis Coverage Part to the first Named Inistired,
this insurance apphes'.
a. As if each Named Insured were the only
Named Insured; and
b. Separately to, each insuired against whorn
claim is made or "suiV' is brought.
8. Transfer Of Rights Of Recovery Against
Others To Us
a. Transfer Of Rights Of Recov,M
If the insured has, rights to recover all or part
of any payment, iincluldingi Sup#lernientary
Payments, we have made undler this
Coverage Part, those rights are transferred to
uis. The, insured must do, nothing after ioss, to
impair thern. At our request, the insured wiilll
bring "suiit" or transfer those rights to us, and
help UIS enfbrce thern.
b. Waiver OfRights Of Recovery (Waiver Olf
Subroglation),
If the insured has wairved any rights of
recovery, against any pi or, organization
for, all or part of any+ Ipayment, indiLding
Supplementary Payrrients, we have made
u1ndeirthis Coverage Part, we also, waive that
6ght, provided 'the insured waived th,eir rig[its
of recovery against such, person or
organization in a contract, agireerrient or
perimit that was executed prior to the injury or
damage,
9. When We Do INot Renew
If we decide not to renew this, Coverage Part, 'we
will mail or deliver to, t
shown in the Declaratior ep ..cF RAMwagmedDiAsiun
40? N,�q REVIEWED & APPROVED BY.-
F04C.�" z VX*vd
RM
RiA Pjanagement Anali
nonrenewal not less, than 30, days before the
expiration date.
If nofice is mailed, proof of maifinq will be
sufficient proof of notice.
SECTION V - D E FINIT IONS
1. ""Advertisement"" means the widespread public
dissemination of information or images that has
the purpose of inducing the sale of goods,,,
pirodiucts; or services, through:
a. (1) Radio;
(2) Televisione
(3), Billboard;
(4), Magazine,'
(5), Newispaiper; or
b. Any other publication tbiat is, given widespread
pubtic distriblubon.
However, "adverlislernent'" does not include',
ia» The design, printed material, inforritijaition of
images contained in, on or, upon the
packaging or, labeling of any goods or
products or
b. An, interactive conversation between or
arnong persons through a computer netrwork-
Z "Advertising idea" means, any idea for an
"advertisement""
3. "Asibestosi hazard" means an exposure or
threat of exposure to the actual or alleged
properties of asbestos and includes the mere
presence of asbestos in any form,
4. "'Auto"' means:
a. A land motor vehicle, trailer or semitrailer
designed for travel on, public roads,, including
any attacbed machinery or equipment; or
b. Any other land vehicle that is, subject to a
compulsory or financial responsi b 11 illy laiw or
other motor vel-ricle inisurance law where it 15
licensed or principally garaged.
However, "auto" does not include "imobile
8quipiment",
5. "'Bodilly injury" means physicak,
0. Injury;
b. Sickness; or
c,. Disease
sustained by a person and, if arising out of the
above, mental anguish or death at any tirne.
6. "Coverage territory" means:
a. The United Stales of America (including its
territories and possessions), Puerto Riico and
Canada;
b. International waters or airspace, but only if
the injury or darnage occurs in the couirsie of
travel or trainsportation, betweein, any places
included in a. above, or
Page it 8 of 21
c. a other parts of the world if the injury or
darnage arises out of:
(11), Goods, or products made or sold by you in
the territory describled in a. above�-,
(2), The activities of a person whose hoinie is
in the territory described in a. above, but is
away for a, short time on your business-1 or
(3), "Persoinal and advertising injury" offoins8
that take place through the Internet or
similar electronic means, of communication
provided the insuired's responsibility to pay
damages is determined in the 'United States of
America (including its territories and possessions),
Puerto Rico or Canada,, in a "suit"on the merits
according to the substantive law, in such territory or
in a, settlement we agree to.
71, "Employee" includes a, "leased worker"'.
"Ernployee" does riot include a "'terniporary
worker".
8. "'Employment -Related Practices," rneans��
ia-� Refusal to employ that person,,,
b "Termination of that per5on"s employment; or
c. Ernployment-reliated practices, policies, acts
or ornissions, such as coercion, demotion,
evaluation, reassignment, discipline,
defamation, harassment, humillation,
discrinnination or maliclotis prosecution
directed at that person,
9. "'Executive officer"" means a person holding any
of the officer positions created by your charter,,
constitution, by-Wws or any other similar
governing document.
1O."Hostille fire" means, one which becomes
uncontrollable or breaks out from where it was
intended to be.
11.,"Impaired property" nieains taingibile property,
other than 'yo,ur product" or 'i work", that
cannot be used or is less useful becausw
a. It incorporates "your product"" or "youir work"
that is, known, or thought to be defect[ve,
deficient, inadequate or danigerous; or
b. You have failed to, fulfill the terms of a
contract or agreement,;
if such property i be restored to useby the
repair, replacement, adjustment or Irelmoval of
11 your prodluct" or "'your work", or your fulfilling the
terms of the contract air agreement.
12.'"Insured! contract" rineans.
ia» A, contract for a lease of Ipremises, However',
that portion of the contract for a lease of
preirnises that indemnities any person or
organization for clarniage by, fiire, lightning or,
explosion to, prernisieS,i M6illa ri i, le) ynj� ny
ternporarily occupied I - Risk MmRgmadDMsiun
of the owner is sut� 40? N1 REVIEWED & APPROVED BY.-
F04c.�" z VX*vd
Risk Pjanagement Analyst
Piremiges Rented ro, You Limit described lint
Section III - ILilmnilts of Insurance;
lb. A, sid etrack. agreemo nt ,
c. Any easement or license agreement
including an easement or license aigre,ement
in connection with cxnistruction air demolition
operations an or 50 feet ofa railroi
d. An obligations, as required by ordirrance, to
indeiminify a municipality, except in connection
with work, for a municipality;
e. M, elevator maintenance agreement
f. That part of any other contract or agreement
pertaining to your busineiss, (iinclulding an
indiamnificabon of a municipality in connection
wiith work performed for a municipality) under
which your aissurne the toirt fiabillity of another
party W pay for ""bodily iiniury' or "property
darnage" to, a third person or organization,
provided the "bodily injury" or "property
d1arriage" is caused, in whole or, in part by
you or, by those i on youir behaif. Tort
liability rneans a liability that would be
imposed by llaw 4,1 the absence of any
contract or agreement.
Paragraph f. includes that part all any contract
,or agreernent that indemnifies a railroad for
"'bodily injury" or "'property damage" arising
i of construction or deimalition operations,
witffin it feet of any railroad property and
affecting any ra,droadl biridge or trestle, tracks,
road -beds, tunnel, underpass or crossing.
However, Paragraph f. does, not incluide that
(part of any contract or agreernent.,
(1l), That indemnifies an architect, engineer or
surveyor for injury or damage aris,iing out of:
(a), IPreparirngl, approVing, or i to
prepare or approve, rrraps, shop
drawings, opinionis, reports,, surveys"
field orders, change orders or drawings
and specifications; or
(b) Giving directions or instructions, or
failing to give them, if that is the
pidimary i of the iinfury or darnagie,-,
oir
(2), Under which the insured, 0 an architect,
eingineeir oir surveyoir'. aSSUrnes Iliabiliity for
an injury, or dairinage ansiing out of tho
insured's rendering or failure to render
professional services, including those listed
in (1), above, and supervisory, inspection,
architectural or engineeringactivities,
13."Leasied workeir" 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"' doeis, not include a
"ternporary worker".
MMI XMIKIPI
U."Loading oruinloading" means the handling of
proiperty�
a. After it iis moved from the place wMere it is
accepted fair movement into or ointa, an
aircraft, watercraft or "i
lb. Wli it iis in or on an aircraft, watercraft or
"i or
ic. Whfle it iis being moved from ain aircraft,
watercraft or "auto,"to the place 'where it is
finally delivered;
but "lloading or unloading" does not indlude the
movement of property by meanis of a mechanical
deviice, other than a hand truck, that is not
attached to the aircraft, watercraft or "auto'".
15,"'Mobile equipment" means, any of the following
types of land vehicles, inCtUding any attached
machinery or equipment:
a, Bulldozers, farm rriachineiry,forklifts and other
vehicles designed for use princip,afly off public
roads;
b. Vehicles maintained for use solely on or next
to, prernses you own or rent;,
c. Vehicles that travel on crawler treads,
d. Vehicles. whether self-propelled or aoit,
maintained primairily to, provide mobflity to
pen,flanently mounted:
(1), Poweir oranegi, shiovels, loaders., diggers or
dh0s: or
(2), Roads construction or resurfacing
equipment suc.h as graiders, scrapers or
rollers;
ei. Vehicles not described iin a,., lb., c. or d. above
that are not self-propelled and are In
primarily to provide mobility to permanently
attached equipment of the foilowiing types:
(1) Air compressors, pumps and generators,
including spraying, welding, building
cleaning, geophysi,c6l explioration, lighting
and wall seirviecing equipment; or
(2), Cherry pickers and simiillar devices used to
raise air lower workers;
f. Vehicles not described iin ai., lb., C. or d. above
maintained primarily for purposes other than)
the transportation of persons or cargiol.
However, self-propelled vehicles wiith the
following types of peirinianently attached
equipment are not "mobile equipment" bUtWill
be considered "autos":
(1) Equipment. designed Ipriiumroarily for.,
(a), Snow rerriova I.,,,
(b) IPoadl rinaJintenance, but not
construction or
(c) Street cleaning
resurfacing or
ep .. RAMwagmedDMsiun
Jy? N,�q REVIEWED & APPROVED BY.-
F04C"�" P, VX*vd
RtWjanagementftalpt
(2) Cherry pickers and sir illar devices
mounted on autornobile or truck chassis
and used to raise or lower workers�; and
(3), Aiir compressors, pumps and generators,
including spraying, welding, building
cleaning, gieophysi,c,61 exploration, lligihting
anvil well servicing eqdipiment.
However, "irriabile 8quipirri does not include
any land vehicle that is subject to, a compulsory
,or finainicial responsibility la:w or other motor
vehicle insurance law where iit us licensed or
principally garaged, Land vehicles subject to a
compulsory or flinaincial responsili law or othierr
motor vehicle insurance law are considered
1. autos",
16,"Occurrence" meanis an, accident" including
continuous or repeated exposure to substantially
the sarne general harnii-ful Conditions.
17,"'Personall and advertising injury"' rrieans
injury, incluuding consequenfl,61 "IbodCly injury",
arising out of one or more of the following
offenses:
a, False arrest', detention or imprisonirnent;
b. Malicious prosecutionm
c,, The wrongful eOctio,in from, wirongiful entry
into, or hwasloin of the right of private
occupancy of a room, dwelliing or premises
that a person or organizat ion, occupies,
comirnittedi by or on behalf of iii olwner,
landlord or lessor;
d. Oral, wnittein or electronic publication, iin any
manner, of material that slainclers, or libels a
person or orgaNzation or disparages a
person's or organization's goods, products of
services;
e.� Oral, wiritten, or electronic publication, in any
mannier, of material that violates a persoirt"s
right of privacy;
f. Copyingi, iin your "adverflisement"', a person's
or orgainization's "advertising idea'" or style of
M advertisement": or
gi. Infringement of copyright, slogan, or, title of
any literary ar artistic work., in your
.1 advert isem e in't".
18."Poflutaints" mean any solid, kquid, gaseous or
therrnall irritant or contanilinanit, including smoke,
vapor. soot,, furnes, acids, alkalis, chemierWs ancl
waste, Waste includes materia,ils to be recycled,
reconditioned or reclairned,
19."Piroducts-completedi operations hazaii
a. Includes all "bodily injury" and "property
damage" occurring away from premises you
own or rent and arlisOig out of "your product"
or "Your work" exoept-
(1i), Products that are still in youir physical
possession; or
Page 20 of 21
(2) Work that has not yet been completed or
abandoned, However, "'your work" will be
d8eri completed at the earliest of the
following times:
(a), When all of the workcalled 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
contract calls for work at more than
one job site -
(c), Whien that (part of the work done at a
job, siite has been put to its intended
use by any person or organization
other than another contractor or
subcoritractor working on the same
project
or that may need service,
irriaintenance, correction, repair or
reptacernent, but wl"iicti is otherwise
cornplete, will be treated as completed
b. Does not include "bodily injury"' or "property
d1arnage" arising out of,
(1i), Thie transportation of property, unless the
injury or dlamage 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 veNcle
by any insuredi:
(2), Thee existeace of tools, uninstalled
equipment or abandoned or unuised
materials: or
(3) Products air operations for which the
cliassifirAition, histed In the it eclaraltons or
in a policy SchedUle, states that produicts-
oornplei operations are subject to the
Generall Aggregate Limilt,
20."Property darnage"' means:
a. Physical injuiry to tan gible property, including
ali resulting loss of use of that property, All
such loss of use shall be dleemed to accuir at
the firnie of the physical injury that caused it;
or
b. Loss of uise of' tangiblo property 'that is not
physically injuired, All suich loss of use 81h6NIl
be deleini,ed to occuir at the firne of the
"oliccuirren,ce" that caused it -
As uised in i definition, computerized or
electronically stored data, programs or software
are not tangible property. IElectrork data n"reans
inforn"ration, facts or, prograrris:
a,, Stored as or oin;
4, Created or used end or
c,, Transmitted to or from"
computer software, inii
applications software, he ep ..cF RAMwagmedDiAsiun
Jy? N,�q REVIEWED & APPROVED BY.-
F04C"�" z VX*vd
RtWjanagementftali
THIS ENDORSEMENT CHAIN GES'TIME POLICY. PLEASE READ IT CAREFULLY.
i AI'll pig I iff, 0 0, �w 1;�� ' 1 0 0
k 11 . "ZI L.
L. d
Foos A: 'L L- n E.
Policy Number 83 WE CE0623 Endorsement Number:
Effective IDate: 05/112120 Effective hour is Me same as stated on the Information Page of the pollicy.
Named Insured and Address: SAFEBULT LLC INTERWEST CONSULTING GROUP
3755 PRECISION R. ST 140 PO BOX 10
LOVELAND CO 8,0538 BOULDER CO 8,0308
We have the right to recover OUr payments from anyone liable for an injury covered by this policy. We will not enforce our
right against, the person or organization named in the Schedule,
This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule,
RIC199"
Any Iperson or organization from whom you are required by contract or agreement to obtain this waiver from us.
Endorsement is not applicable in KY, NH. NJ or for any M01 construction risk
COUntersignEK1 by
cF RAMwagmedDMsiun
N,�q RE�AEWED & APPROVED BY.-
P, VX*vd
Form W'C 00 03 13 Printed in U-S,A-
Process, Dae. 05/11,120 P o I i c y' E) 6-01 W—Fl� WA Pjanagement Analy5t
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