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ECONOMICS, INC (2)
INSUIIAWV ON FILE VVOM MAY PROCEED UNTIL INSURANCE EXPIRES 10/1/20 CLERK D ITc. A-2020-127 0- pw(z) FIRST AMENDMENT TO CONSULTANT AGREEMENT WITH ECONOMICS. INC. (C6ri5A" Q'- lG; MJd ) THIS FIRST AMENDMENT to the above -referenced agreement is entered into on June 16, 2020 by and between-EcoNomics Inc. ("Consultant"), and the City of Santa Ana, a charter city and municipal corporation organized and existing under the Constitution and laws of the State of N California ("City"). ti cv RECITALS �i A. The parties entered into Agreement No. Al 9-Mo, dated April 1, 2019, by which Consultant agreed to provide services to assist the City's Public Works Agency in developing cost projections for an organics diversion program that is compliant with state law ("Agreement"). B. The Agreement remains in effect through June 30, 2020, with provision for extension. C. The parties now wish to extend the Agreement, amend the scope of services, and increase the amount to be expended under the Agreement. The Parties therefore agree: 1. Section 1, Scope of Services, is amended to include the services described on Exhibit A. 2. Section 2, Compensation, is amended to increase the total amount to be expended under the Agreement by $64,-964, which is comprised of (1) the base sum of $49,970 plus (2) a contingency of $14,994 for additional services at the City's sole discretion. 3. Section 3, Term, is amended to extend the term of the Agreement through June30, 2021. 4. Except as modified by this First Amendment, all terms and conditions of the Agreement shall remain in full force and effect. IN WITNESS WHEREOF, the parties hereto have executed this First Amendment to the Agreement on the date and year first written above. ATTEST CITY OF SANTA ANA Daisy Gomez Kristine Ridge r Clerk of the Council City Manager signatures continue on next page Page 1 of 2 A-2020-127 APPROVED AS TO FORM Sonia R. Carvalho City Attorney By:_ 71�'. -f. L Jo i M. Funk Assistant City Attorney RECOMMENDED FOR APPROVAL Nabil Saba Executive Director Public Works Agency CONSULTANT Imo --- Name: T{LevvX S f3 L�T+Iz Title: Page 2 of 2 V1Le Priespo yr /Se[RzfNR I EXHIBIT City of Santa Ana Proposal to Assist with State Compliance Analysis Project Description: The City has tasked EcoNomics with developing cost projections for a fully AB 1826-compliant organics program for use in the Request for Proposals (RFP) process it is currently undergoing. The analysis would determine the total cost of an organics program assuming 100% participation among all covered generators. Further, the City has asked EcoNomics to assist it with programmatic evaluation during its RFP process to ensure all proposed programs and rates will facilitate compliance with state mandates, including AB 1826, SB 1383, and AB 341. Lastly, EcoNomics will provide general compliance assistance to the City as it pertains to C&D recycling to comply with CALGreen and other CalRecycle compliance assistance tasks, including compliance reporting, assistance with annual compliance assessments, and other tasks as assigned. Task 1: AB 1826 Compliance Analysis EcoNomics will conduct the following steps to develop this analysis. Task 1A: Develop Costs of Organics Program As a first step, EcoNomics will use the organics program cost information provided by Waste Management to develop estimated organics program costs for all different container configurations. The organics costs provided by Waste Management assume the same route density and collection costs as equivalent MSW service and use low organics density assumptions. Both of these factors result in lower costs, which may not be realistic to expect from proposers. EcoNomics will develop an organics collection cost analysis that allows for real-time entry of variable productivity, processing costs, and density assumptions. These key assumptions can be manipulated to allow for various different cost projections. EcoNomics will develop a 'default'value based on industry averages that will be included in the cost build-up to represent a reasonable cost scenario. Task 18: Develop service recommendations for non -compliant generators to determine projected service levels and MSW reductions by compliance tier. EcoNomics will use an existing cost -calculator tool it has developed for the City of Santa Ana to project service adjustments needed for individual generators to comply with AB 1826. This calculator will compare the baseline service levels to the projected service levels to become compliant with AB 1826, which will include organics service and may include reduce MSW service. EcoNomics will also analyze AB 341 compliance options which will include the deployment of dry recycling bins and may result in further MSW reductions. EcoNomics will select a representative sample from each compliance tier in order to obtain a 95% confidence level with a 10-point confidence interval. EcoNomics will conduct the service analysis for the following number of generators, by compliance Tier: 1 Compliance Tier Total Population Sample Size Needed for 95% Confidence with Cl of 10 1 66 39 2 291 72 3 310 74 4 615 83 Total 1282 268 Prior to the service analysis, EcoNomics staff will cross-reference each generators' service levels from Waste Management's customer listing. Generators that do not have an individual account will not be included in the service analysis. As each generator's service information is calculated, the data will be aggregated into a roll -up work sheet so data for all generators can be analyzed to make conclusions about the projected service levels for individual generators and for the entire commercial sector. Task 1C: Analyze aggregated data As a next step, EcoNomics will analyze the aggregated data to determine the average organics service levels per generator and per compliance tier as well as the average MSW service reductions. Using this data, EcoNomics will determine the hauler's total cost of providing organics service assuming various participation levels as well as the revenue lost from customer's 'right -sizing' their MSW service. These two cost components will provide the City with a total cost of AB 1826 compliance that can be communicated to proposers during the RFP process or used to check proposers' cost assumptions during the evaluation process. Task 1D: Calculate Estimated Outreach Hours Needed and Determine Cost A key factor that is rarely factored into the cost of organics recycling programs is the cost of outreach required to implement and maintain organics programs. Each organics program can take between 10 -25 hours of staff time to implement. EcoNomics will include the projected outreach costs for implementing organics programs and make recommendations for how to provide adequate staffing levels. Task 2: Assistance with Incorporating State -Mandated Diversion Programs into RFP Evaluation Process Upon engagement, EcoNomics will distill complicated legislative concepts and directives into clearly understood evaluation criteria metrics. EcoNomics will use its on -the -ground knowledge of working within the City to assess feasibility of proposed diversion programs provided by 2 haulers. An initial listing of items that will be considered as part of EcoNomics' evaluation assistance is included below. • Examination of what programs and participation rates are proposed to meet diversion goals/mandates set forth in SB 1383, AB 1826, and AB 341 • Review of options proposed for residential curbside organics diversion programs to comply with SB 1383, including 2-cart wet/dry routing, 3-cart co -collection of food scraps in yard trimmings container, or 4-cart system with an additional cart for source -separated food scraps only. • Cost evaluation of organics diversion requirements set forth in 513 1383, AB 1826, and AB 1594. Implementation could be expensive unless the method (composting vs. anaerobic digestion) and facility siting (local County -run facilities versus long hauls of over 50 miles) are anticipated in the agreement between the selected hauler and the City. The City's ability to direct the flow of organics and to change to the most cost-effective manner of processing will be critical. As such, a review of the timing of expanding of a long-term restaurant organics diversion program that provides cost -incentives to the restaurant community will need to be coordinated with processing options. • Evaluation of the proposed rate for single -stream recycling and organics collection to determine if an incentive for the remaining businesses and multi -family properties in the City to implement cost-effective recycling programs to be in compliance with AB 341. • Review of feasibility of proposed hauler staffing to implement state -mandated diversion programs. • Evaluate "niche recycling" approach for the collection and diversion of Household Hazardous Waste, Medical Waste, Sharps, Electronic Waste, and Universal Waste. • Review any issues of tonnage origin verification, tracking and reporting from the MRF's, compost facilities and any transfer stations used for the City's waste and recyclables. • Evaluate the accuracy of tonnage data and to document the allocation methodology that will be used to calculate and report the City's diversion tonnages and to comply with enhanced reporting requirements included in AB 901. • Evaluate proposed incentives and disincentives to ensure that the selected hauler meets or exceeds diversion requirements. At the direction of the City, EcoNomics can prepare a presentation of its findings/recommendations for delivery to the Ad Hoc committee, consulting team, or the Council -at- large. EcoNomics will work with the City and its consultant team to determine how best to evaluate key programmatic elements into the scope of work and contract body. Task 3: Assistance with CALGreen Compliance CALGreen requires nearly all building projects to divert 65% or more of C&D waste away from landfills. The next triennial update, effective January 1, 2020, may increase this diversion rate requirement to 75% and will reduce the amount of project exemptions. The City may need to overhaul its current permitting and application processes to strengthen compliance incentives 3 and non-compliance disincentives to comply with CALGreen. EcoNomics can provide technical assistance to enhance existing processes to ensure higher levels of compliance with CALGreen. It is our understanding that the City is considering adopting an ordinance that would require all AB 341, AB 1826 and SB 1383 generators to have waste diversion programs in place or face enforcement action from the City. Further, this ordinance will develop a refundable compliance deposit system for building projects covered by CALGreen that will provide a monetary incentive divert 65% of the C&D waste generated. For the CALGreen ordinance, Economics recently worked with Lake Forest to adopt a C&D ordinance in July of 2019 and is familiar with this process. Further, EcoNomics has assisted the cities of Tustin, Laguna Hills, Newport Beach, Stanton, and Laguna Niguel with enhancing C&D recycling programs and policies to comply with CALGreen. Non -legal staff from EcoNomics would be available to assist in providing ordinance feedback from our extensive experience in program implementation in the City of Santa Ana. These field-tested 'best practices' for program implementation can then be 'translated' into legal language by the City Attorney's office and included in the ordinance to ensure the practical application of the requirements. Task 4: General Assistance with Solid Waste and Recycling Compliance In addition to the work items identified above, EcoNomics will be'on-call'to assist with legislative interpretation, CalRecycle compliance assistance, recycling -related projects, etc. Similarly, the City may direct EcoNomics staff to assist with other work tasks, as needed. Specific CalRecycle general compliance assistance task assignments may include: Assistance with filing CalRecycle Electronic Annual Reports Develop narrative for AB 1826 and AB 341-related DPS codes; analyze and process data from implementation efforts and develop compliance analysis for inclusion in report; request and process data from hauler, City, County, and other agencies to provide compelling narrative for AB 341 and AB 1826 efforts; develop draft of AB 341 and AB 1826 sections of 2019 and 2020 EAR for City review; coordinate City review and incorporate feedback. Assistance with CalRecycle Site Visit and Conference Call Prepare for CalRecycle conference call and site visit; annotate conference call and site visit agendas with requested data; answer questions re: compliance status; calculate and verify AB 341 and AB 1826 compliance rates. CalRecycle Compliance Troubleshooting Assist City with compliance issues from CalRecycle; develop and assist in implementing formal or informal plans; provide compliance data to CalRecycle; compile recurring progress reports; etc. Please note, this task does not include interactions with CalRecycle if the City is referred to the Jurisdictional Compliance Unit (JCU). If City is referred to the JCU, additional consulting resources will be needed end the referral. 12 Assistance with AB 341, AB 1826, and SIB 1383 components of the mandatory ordinance drafting It is our understanding that the City is considering adopting an ordinance that would require all AB 341, AB 1826 and SB 1383 generators to have waste diversion programs in place or face enforcement action from the City. EcoNomics has assisted the City of Newport Beach with developing an AB 341 and AB 1826 mandatory ordinance and may be able to use some components of that ordinance to adapt to the City of Santa Ana. Non- legal staff from EcoNomics would be available to assist in providing ordinance feedback from our extensive experience in program implementation in the City of Santa Ana. These field-tested 'best practices' for program implementation can then be 'translated' into legal language by the City Attorney's office and included in the ordinance to ensure the practical application of the requirements. Other CalRecycle Compliance Tasks, as assigned Assist City with other CalRecycle compliance tasks, including grant reporting and/or grant administration for City County Payment Program, as well other CalRecycle compliance tasks, as needed. Proposed Budget President VicPVice Project Manager Imp]. Percent of SANTA ANA PROPOSED BUDGET - resident Hours Budget Pmi+ated $205.00 $230.00 $90.00 $45.00 Budget Task 1: AB 1826 Compliance Analysis 2 20 12 56 90 $ 6,610.00 9% Task 2: Assistance with Incorporating State -Mandated Diversion Programs 6 38 16 6 66 $ 7,880.00 11% into RFP Evaluation Process Task 3: Assistance with CALGreen Compliance 10 75 76 18 179 $ 19,450.00 26% Task 4: General Assistance with Solid Waste and Recycling Compliance 20 210 98 18 346 $ 41,030.00 55% TOTAL PROJECT HOURS 1 38 343 202 1 98 1 681 36% TOTAL NOT TO EXCEED (Cost per $7,790.00 $44,590.00 $18,180.00 $4,410.00 74,970.00 Person & Grand Total) +' Hours may be moved between tasks to respond to changing conditions and work -flow prioritization, with City permission. 5 _6 CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDNYYY( 0113112020 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: NICOe Hardin Advanced Brokers Insurance Services PHONE (858) 436-7999 FAX N (858) 436-7998 360 N El Camino Real 1A E-MAIL ADDRESSservim advancedbrokersinc.com INSURER § AFFORDING COVERAGE NAIC N Encinitas INSUREBA: Liberty Mutual Insurance CA 92024 INSURED INSURER B: AXIS Surplus Insurance Company Eco/Nomics, Inc. dba Ecallnomics, Inc. INSURERC: 832 Camino Del Mar Stet INSURER D INSURER E Del Mar CA 92014 INSURER F: rnvoonr_ce THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LT ILT X TYPE OF INSURANCEAM COMMERCIAL GENERAL LIABILITY ADDL SUBR _wa POLICY NUMBER MMIDICDY EFF MMIODMYY LIMITS CLAIMS -MADE � OCCUR EACH OCCURRENCE $ 1,000,000 PREMSES EaoN �nce $ 500,000 $ 15,000 A X X BKS57048355 12/09/2019 1W09/2020 MED EXP (My one peman) PERSONAL &ADV INJURY $ 1.000,000 GEN'L X AGGREGATE LIMIT APPLIES PER: POLICY PRO- ❑ JECT LOC GENERALAGGREGATE $ 2,000,000 PRODUCTS - COMPIOP AGO $ 2,000,000 OTHER: I I $ A AUTOMOBILE X X LIABILITY ANY AUTO OWNED SCHEDULED ADIOS ONLY AUTOS HIRED X NONOWNEDPROPERTY AUTOS ONLY /� AUTOS ONLY X X BAS57048355 12l11/2019 12/09/2020 COMBINED SINGLE LIMIT Ea awi eni $ 1.000,000 BODILY INJURY(Perperson) § BODILY INJURY (PeraccidenU $ DAMAGE P r PERT ni $ UMBRELLA LIAR EXCESS DAB OCCUR CLAIMS -MADE EACH OCCURRENCE § AGGREGATE $ DED I I RETENTION$ WORKERS COMPENSATION LIABILITY YIN ANYCEWMEETORIPARTNERIE%ECUTIVE (Mandatory NH)EXCLUDEDy ❑ If yes, story in NH) If yes, describe under NIA PER STATUTE ER E.L. EACH ACCIDENT $ E.L. DISEASE -EA EMPLOY $ DESCRIPTION OF OPERATIONSImm E.L. DISEASE -POLICY LIMIT $ B Professional Liability X X EMP19001661-01 10/01/2019 - - 10/01/2020 Each Claim Aggregate $1,000,000 $2,000,000 - — Deductible $5,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) City of Santa Ana, its officers, employees, agents, and representatives are Additional Insureds with respect to General Liability, Auto Liability, Professional and Pollution Liability per the attached endorsements or as required by written Contract. Insurance is Primary and Non -Contributory. *30 Days' Notice of Cancellation with 10 days' notice of Non -Payment of premium in accordance with the policy provisions. Operations of the insured covered under the above policies. rvorrorme un, `A,_ -REVIR/W A, APPROVED City of Santa Ana Risk Management Division, 20 Civic Center Plaza Santa Ana CA 92702 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS, AUTHORIZED REPRESENTATIVE Cassie Morris 1988-2015 ACORD CORPORATION. All rights reserved. •••o .+.......+,,a, 1c of ILA rvgu are regisTerea marKs or ACORD POLICYHOLDER COPY SP P.O. BOX 8192, PLEASANTON, CA 94588 CERTIFICATE OF WORKERS' COMPENSATION INSURANCE ISSUE DATE: 01-06-2020 CITY OF SANTA ANA SIR 20 CIVIC CENTER PLZ SANTA ANA CA 92701-4058 GROUP: POLICY NUMBER: 1397885-2019 CERTIFICATE ID: 117 CERTIFICATE EXPIRES: 10-01-2020 10-01-2019/10-01-2020 THIS CERTIFICATE SUPERSEDES AND CORRECTS CERTIFICATE 9 116 DATED 10-09-2019 This is to certify that we have issued a valid Workers' Compensation insurance policy in a form approved by the California Insurance Commissioner to the employer named below for the policy period indicated. This policy is not subject to cancellation by the Fund except upon 30 days advance written notice to the employer. We will also give you 30 days advance notice should this policy be cancelled prior to its normal expiration. This certificate of insurance is not an insurance policy and does not amend, extend or alter the coverage afforded by the policy listed herein. Notwithstanding any requirement, term or condition of any contract or other document with respect to which this certificate of insurance may be issued or to which it may pertain, the insurance afforded by the policy described herein is subject to all the terms, exclusions, and conditions, of such policy. Authorized Representative President and CEO EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: $1,000,000 PER OCCURRENCE. ENDORSEMENT X2065 ENTITLED CERTIFICATE HOLDERS' NOTICE EFFECTIVE 10-01-2003 IS ATTACHED TO AND FORMS A PART OF THIS POLICY. E VIEWiskED & APPRpOVED JEB � EMPLOYER ECAL/NOMICS, INC ECO/NOMICS, INC. SP PO BOX 2790 DEL MAR CA 92014 [PI 7,SDI (REV.7-2014) I PRINTED : 01-06-2020 Francine R. D§naly speed by Francine R. Wheat Villareal Date: 20M.11.09 14:m93 -0a OT A� o® CERTIFICATE OF LIABILITY INSURANCE DATEIMwoorvvyri 10/28/2020 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and Conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Advanced Brokers Insurance Services CONNAME:TACT Nicole Hardin PXO% ) FAX (858)436-7998 (858 436-7999 ,Vc wo: A t26 a, service@advancedbrokeminc.COm 360 N El Camino Real 1A INSURER 3 AFFORDING COVERAGE NAIL # INSURER A: Liberty Mutual Insurance Encinitas CA 92024 INSURED INSURERB: AXIS Surplus Insurance Company INSURER C: Eco/Nomics, Inc. dba Ecal/nomics, Inc. INSURER D: 832 Camino Del Mar Stet INSURERE: INSURER F: Del Mar CA 92014 COVERAGES CFRTIFICATF MIIMRFR- REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR TYPE OF INSURANCE AMITIM ADDL SUBR POLICY NUMBER NO D�DY EFF mpWDNFyxypn LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE 19 OCCUR DAMAGETO E TIED PREMISES Eaeccurr $ MED EXP (Airy one person) $ 15,000 PERSONAL&ADV INJURY $ 1,000,000 A X X BKS57048355 12/09/2019 12JO912020 GEN'L AGGREGATE LIMB APPLIES PER: GENERALAGGREGATE $ 2,000,000 PRODUCTS-COMP/OP AGO $ 2,000,000 X POLICY D ECT LOC OTHER: AUTOMOBILE LIABILITY A COMBINED SINGLE LIMIT Ea awidem $ 1,000,000 BODILY INJURY (Per Person) $ ANYAUTO BODILY INJURY (Per amident) $ A �/ OWNED SCHEDULED /� AUTOS ONLY AUTOS XHIRED NON -OWNED AUTOS ONLY x AUTOS ONLY X X BAS57048355 12/11/2019 12/09/2020 PROPERTY DAMAGE Per accident $ $ UMBRELLA LIM OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIM CLAIMS -MADE DEO I I RETENTION $ $ WORHERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNER/EXECUTIVE YIN STATUTE ER E.L. EACH ACCIDENT $ E.L. DISEASE -EA EMPLOYE $ OFFICERIMEMSER EXCLUDED? (Mandatory In NH) NIA E.L. DISEASE -POLICY LIMIT $ IT yes, describe under DESCRIPTION OF OPERATIONS below B Professional Liability X X EMP19001661-01 10101/2019 10/01/2020 Each Claim Aggregate $1,000,000 $2,000,000 Deductible $5,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached a mere space is required) City of Santa Ana, its officers, employees, agents, and representatives are Additional Insureds with respect to General Liability, Auto Liability, Professional and Pollution Liability per the attached endorsements or as required by written Contract. Insurance is Primary and Non -Contributory. *30 Days' Notice of Cancellation with 10 days' notice of Non -Payment of premium in accordance with the policy provisions. Operations of the insured Covered under the above policies. City of Santa Ana Risk Management Division, 4th floor 20 Civic Center Plaza Santa Ana CA 92702 ACORD25(2016/03)- The ACORD-name and logo are SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Rime Mrnlaganad Diaisian REVIEWED &{APPRcrvED By., rr 'nsil"ni'l[m Risk Management Analyst ACORO® CERTIFICATE OF LIABILITY INSURANCE DAM(MMIDDIYYYY) 10/07/2020 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Nicole Hardin NAME: Advanced Brokers Insurance Services AICNNo Ext: (858) 436-7999 FAX, No: (858) 436-7998 E-MADDRESS: service@advancedbrokersinc.com 360 N El Camino Real 1A INSURERS) AFFORDING COVERAGE NAICN INSURERA: Liberty Mutual Insurance Co 23043 Encinitas CA 92024 INSURED INSURER B: AXIS Surplus Insurance Company 26620 INSURERC: Eco/Nomics, Inc. dba Ecal/nomics, Inc. INSURER D: 832 Camino Del Mar Stet INSURER E 1 INSURER F: Del Mar CA 92014 COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR R TYPE OF INSURANCE ADDL MDSUBR POLICYNUMBER POLICY EFF MMIDDIYYYY POLICY EXP MMIDDI, YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE X OCCUR PREMSEs Ea occ EO nce $ 500,000 MED EXP (Any one person) $ 15,000 PERSONAL SADV INJURY $ 1,000,000 A X X BKS57048355 12/09/2019 12/09/2020 GENU AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ 2,000,000 POLICY PRO-JECT LOC X PRODUCTS - COMP/OP AGG $ 2,000,000 $ OTHER'. AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1000000 BCD I LV INJURY (Per person) $ MY AUTO A OWNED SCHEDULED AUTOS ONLY AUTOS X X BKS57048355 12/09/2019 12/09/2020 BODILY INJURY (Per accident) $ X HIRED INON-OWNEDAUTOS AUTOS ONLY ONLY PROPERTY DAMAGE Per accident $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED RETENTION$ $ WORKERS COMPENSATION ANDEMPLOYERS'LIABILITY YIN PER OTH- STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE E. L EACHACCIDENT $ OFFI CER/MEM BER EXCLUDED? ❑ NIA E. L. DISEASE - EA EMPLOYE $ (Mandatory in NH) f yes, describe under DESCRIPTION OF OPERATIONS below E. L. DISEASE - POL ICY LIM IT $ Professional Liability Each Claim $1,000,000 B X X EMP19001661-01 10/01/2020 10/01/2021 Aggregate $2,000,000 Deductible $5,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may beattached if more space is required) CERTIFICATE HOLDER CANCELLATION City of Santa Ana Risk Management Division, 4th floor 20 Civic Center Plaza Santa Ana CA 92702 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Cassie Morris ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD IUBa Manag¢ nadDivision ram. REVIEWED &{APPROVm By., oll lli111.1� /-z' rb6HlM�e vdt i t¢bl. ® Risk Management Analyst Coverage Is Provided In: Policy Number: Liberty Ohio Security Insurance Company - a stock company BNS (20) 57 04 83 55 MUtUd�. Policy Period: INSURANCE From 12/09/2019 To 12/09/2020 12:01 am Standard Time at Insured Mailing Location Common Policy Declarations Named Insured Agent ECONOMICS INC DBA ECAL/NOMICS (800) 962-7132 832 CAMINO DEL MAR STE I R.I.C. INSURANCE GENERAL AGENCY DEL MAR, CA 92014 PO BOX 12279 SANTA ROSA. CA 95406-2279 SUMMARY OF LOCATIONS This policy provides coverage for the following under one or more coverage parts. Please refer to the individual Coverage Declarations Schedules, or, the individual Coverage Forms for locations or territory definition for that specific Coverage Part. 0001 832 Camino Del Mar Ste 2, Del Mar, CA 92014-2808 0002 33155 Camino Capistrano Ste E. San luau Capistrano, CA 926754829 0003 206 W 4th St Ste 429, Santa Ana, CA 92701-4678 POLICY FORMS AND ENDORSEMENTS This section lists the Forms and Endorsements for your policy. Refer to these doctunents as needed for detailed information concerning your coverage. FORM NUMBER TITLE CG 00 01 04 13 Commercial General Liability Coverage Form - Occurrence g CG 20 10 04 13 Additional Insured - Owners, Lessees or Contractors - Scheduled Person or s Organization CG 20 37 04 13 Additional Insured - Owners, Lessees or Contractors - Completed Operations CG 21 06 05 14 Exclusion - Access Or Disclosure Of Confidential Or Personal Information And Data -Related Liability - With Limited Bodily Injury Exception CG 21 47 12 07 Employment -Related Practices Exclusion In witness whereof, Gwe(�havecaused this policy to be signed by our authorized officers. Mark Touhey David Long Secretary President To report a claim, call yourAgent or 1.844-325-2467 DS 70 21 11 16 10/25/19 57048355 POLSVCS NO NCXFPPND INSURED COPY WS Rime Managxnlent Diuisian REVIEWED&APPROVED BY: '� Risk Management Analyst DS 70 21 11 16 10/25/19 57048355 POLSVCS 290 NCXFPPNO INSURED COPY CO2 'A Coverage Is Provided In: Policy Number: Liberty Ohio Security Insurance Company - a stock company BKS (20) 57 04 83 55 MUtUdl- Policy Period: INSURANCE From 12/09/2019 To 12/09/2020 12:01 am Standard Time at Insured Mailing Location Common Policy Declarations Named Insured Agent ECONOMICS INC DBA ECAL/NOMICS (800) 962-7132 832 CAMINO DEL MAR STE 1 R.I.C. INSURANCE GENERAL AGENCY DEL MAR, CA 92014 PO BOX 12279 SANTA ROSA. CA 95406-2279 POLICY FORMS AND ENDORSEMENTS - CONTINUED This section lists all of the Forms and Endorsements for your policy. Refer to these documents as needed for detailed information concerning your coverage. FORM NUMBER TITLE CG 21 67 12 04 Fungi or Bacteria Exclusion CG 21 7001 15 Cap on Losses from Certified Acts- of Terrorism CG 21 7601 15 Exclusion of Punitive Damages Related to a Certified Act of Terrorism CG 24 2604 13 Amendment of Insured Contract Definition CG 80 61 05 11 Amendment of Cancellation Provisions CO 84 9901 12 Non -Cumulation Of Liability Limits Same Occurrence E CG 85 15 0903 Exclusion - Professional Services CG 88 1004 13 Commercial General Liability Extension CG 88 60 12 08 Each Location General Aggregate Limit CO 88 61 12 08 Property Damage - Customers' Goods CG 88 66 1208 Property Damage - Burrowed Equipment CG 88 77 12 08 Medical Expense At Your Request Endorsement CG 88 86 1208 Exclusion - Asbestos Liability CG 90 41 01 13 Amendment Of Coverage B Personal And Advertising Injury CP 00 10 04 02 Building and Personal Property Coverage Form CP 0090 07 88 Commercial Property Conditions CP Ol 40 0706 Exclusion of Loss Due to Virus or Bacteria CP 04 49 1205 California Changes - Replacement Cost s CP 1030 0402 Causes of Loss - Special Form CP 10 32 08 08 Water Exclusion Endorsement CP 72 97 0402 Equipment Breakdown Enhancement Endorsement - Special Form CP 88 04 03 10 Removal Permit CP 88 17 08 12 California Custom Protector - Extended Period of Indemnity CP 90 40 08 12 Office / Lessors Custom Protectors Endorsement To report a claim, call your Agent or 1-844-325.2467 Ride Management Diuisian REVIEWED&APPROVED By: Risk Management Analyst Is DS 70 21 11 16 10/25/19 57048355 POLSVCS 290 NCXFPPNO INSURED COPY 00. Coverage Is Provided In: Policy Number: Liberty Ohio Security Insurance Company - a stock company BRS (20) 57 04 83 55 MUtUa�. Policy Period: INSURANCE From 12/09/2019 To 12/09/2020 12:01 am Standard Time at Insured Mailing Location Common Policy Declarations Named Insured Agent ECONOMICS INC DBA ECAL/NOMICS 832 CAMINO DEL MAR STE 1 DEL MAR, CA 92014 (800) 962-7132 R.I.C. INSURANCE GENERAL AGENCY PO BOX 12279 SANTA ROSA. CA 95406-2279 POLICY FORMS AND ENDORSEMENTS - CONTINUED This section lists all of the Forms and Endorsements for your policy. Refer to these documents as needed for detailed information concerning your coverage. FORM NUMBER TITLE CP 90 59 12 12 Identity Theft Administrative Services and Expense Coverage CP 91 42 08 12 Custom Protector Plus Endorsement IL 00 17 11 98 Common Policy Conditions IL 0021 0908 Nuclear Energy Liability Exclusion Endorsement (Broad Form) IL 01 02 05 05 California Changes - Actual Cash Value IL Ol 04 0907 California Changes IL 02 70 09 12 California Changes - Cancellation and NonRenewal IL 0935 07 02 Exclusion of Certain Computer -Related Losses IL 09 52 01 15 Cap On Losses From Certified Acts Of Terrorism LC 87 10 01 00 Punitive or Exemplary Damages Exclusion NP 74 26 04 13 Notice to Policyholder Fully Earned Minimum Premium Endorsements To report a claim, call your Agent or 1.844-325.2467 Rime ManagxRlent Diuiaian REVIEWED&APPROVED BY: Risk Management Analyst COMMERCIAL GENERAL LIABILITY CG 88 10 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. COMMERCIAL GENERAL LIABILITY EXTENSION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART INDEX SUBJECT PAGE w NON -OWNED AIRCRAFT 2 NON -OWNED WATERCRAFT 2 PROPERTY DAMAGE LIABILITY -ELEVATORS 2 a EXTENDED DAMAGE TO PROPERTY RENTED TO YOU (Tenant's Property Damage) 2 MEDICAL PAYMENTS EXTENSION 3 EXTENSION OF SUPPLEMENTARY PAYMENTS - COVERAGES A AND B 3 ADDITIONAL INSUREDS -BY CONTRACT, AGREEMENT OR PERMIT 3 PRIMARY AND NON-CONTRIBUTORY- ADDITIONAL INSURED EXTENSION 5 ADDITIONAL INSUREDS -EXTENDED PROTECTION OF YOUR "LIMITS OF INSURANCE" 6 WHO IS AN INSURED - INCIDENTAL MEDICAL ERRORS/MALPRACTICE AND WHO IS AN INSURED -FELLOW EMPLOYEE EXTENSION -MANAGEMENT EMPLOYEES 6 NEWLY FORMED OR ADDITIONALLY ACQUIRED ENTITIES 7 FAILURE TO DISCLOSE HAZARDS AND PRIOR OCCURRENCES 7 KNOWLEDGE OF OCCURRENCE, OFFENSE, CLAIM OR SUIT 7 s LIBERALIZATION CLAUSE 7 BODILY INJURY REDEFINED 7 EXTENDED PROPERTY DAMAGE 8 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US - 8 WHEN REQUIRED IN A CONTRACT OR AGREEMENT WITH YOU © 2013 Liberty Mutual Insurance CG 88 10 04 13 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Rime Management Diaisian REVIEWED&APPROVED BY: '� Risk Management Analyst With respect to coverage afforded by this endorsement, the provisions of the policy apply unless modified by the endorsement. A. NON -OWNED AIRCRAFT Under Paragraph 2. Exclusions of Section I - Coverage A - Bodily Injury And Property Damage Liability, exclusion g. Aircraft, Auto Or Watercraft does not apply to an aircraft provided: 1. it is not owned by any insured; 2. It is hired, chartered or loaned with a trained paid crew; 3. The pilot in command holds a currently effective certificate, issued by the duly constituted authority of the United States of America or Canada, designating her or him a commercial or airline pilot; and 4. It is not being used to carry persons or property for a charge. However, the insurance afforded by this provision does not apply if there is available to the insured other valid and collectible insurance, whether primary, excess (other than insurance written to apply specifically in excess of this policy), contingent or on any other basis, that would also apply to the loss covered under this provision. B. NON -OWNED WATERCRAFT Under Paragraph 2. Exclusions of Section I - Coverage A - Bodily Injury And Property Damage Liability, Subparagraph (2) of exclusion g. Aircraft, Auto Or Watercraft is replaced by the following: This exclusion does not apply to: (2) A watercraft you do not own that is: (a) Less than 52 feet long; and (b) Not being used to carry persons or property for a charge. C. PROPERTY DAMAGE LIABILITY - ELEVATORS 1. Under Paragraph 2. Exclusions of Section 1 - Coverage A - Bodily Injury And Property Damage Liabil- ity, Subparagraphs (3), (4) and (6) of exclusion j. Damage To Property do not apply if such "property damage" results from the use of elevators. For the purpose of this provision, elevators do not include vehicle lifts. Vehicle lifts are lifts or hoists used in automobile service or repair operations. 2. The following is added to Section IV - Commercial General Liability Conditions, Condition 4. Other Insurance, Paragraph b. Excess Insurance: The insurance afforded by this provision of this endorsement is excess over any property insurance, whether primary, excess, contingent or on any other basis. D. EXTENDED DAMAGE TO PROPERTY RENTED TO YOU (Tenant's Property Damage) a If Damage To Premises Rented To You is not otherwise excluded from this Coverage Part: 1. Under Paragraph 2. Exclusions of Section I - Coverage A - Bodily Injury and Property Damage Liability: a. The fourth from the last paragraph of exclusion j. Damage To Property is replaced by the follow- s ing: Paragraphs (1), (3) and (4) of this exclusion do not apply to "property damage" (other than damage by fire, lightning, explosion, smoke, or leakage from an automatic fire protection system) to: (i) Premises rented to you for a period of 7 or fewer consecutive days; or (11) Contents that you rent or lease as part of a premises rental or lease agreement for a period of more than 7 days. Paragraphs (1), (3) and (4) of this exclusion do not apply to "property damage" to contents of premises rented to you for a period of 7 or fewer consecutive days. A separate limit of insurance applies to this coverage as described in Section III - Limits of Insurance. © 2013 Liberty Mutual Insurance CG 88 10 04 13 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Rime lituaganent Diaisian REVIEWED&APPRovED BY: ' Fw� R. v d k '� Risk Management Analyst b. The last paragraph of subsection 2. Exclusions is replaced by the following: Exclusions c. through In. do not apply to damage by fire, lightning, explosion, smoke or leakage from automatic fire protection systems to premises while rented to you or temporarily occupied by you with permission of the owner. A separate limit of insurance applies to Damage To Premises Rented To You as described in Section III - Limits Of Insurance. 2. Paragraph 6. under Section III - Limits Of Insurance is replaced by the following: 6. Subject to Paragraph 5. above, the Damage To Premises Rented To You Limit is the most we will pay under Coverage A for damages because of "property damage" to: a. Any one premise: (1) While rented to you; or (2) While rented to you or temporarily occupied by you with permission of the owner for damage by fire, lightning, explosion, smoke or leakage from automatic protection sys- s �_ tems; or a b. Contents that you rent or lease as part of a premises rental or lease agreement. I� 3. As regards coverage provided by this provision D. EXTENDED DAMAGE TO PROPERTY RENTED TO := YOU (Tenant's Property Damage) - Paragraph 9.a. of Definitions is replaced with the following: c 9.a. A contract for a lease of premises. However, that portion of the contract for a lease of premises s that indemnifies any person or organization for damage by fire, lightning, explosion, smoke, or c leakage from automatic fire protection systems to premises while rented to you or temporarily occupied by you with the permission of the owner, or for damage to contents of such premises that are included in your premises rental or lease agreement, is not an "insured contract'. E. MEDICAL PAYMENTS EXTENSION $ If Coverage C Medical Payments is not otherwise excluded, the Medical Payments provided by this policy are amended as follows: Under Paragraph 1. Insuring Agreement of Section I - Coverage C . Medical Payments, Subparagraph (b) of Paragraph a. is replaced by the following: (b) The expenses are incurred and reported within three years of the date of the accident; and F. EXTENSION OF SUPPLEMENTARY PAYMENTS - COVERAGES A AND B 1. Under Supplementary Payments - Coverages A and B, Paragraph t.b. is replaced by the following: b. Up to $3,000 for cost of bail bonds required because of accidents or traffic law violations arising out of the use of any vehicle to which the Bodily Injury Liability Coverage applies. We do not have to furnish these bonds. x 2. Paragraph 1.d. is replaced by the following: $ d. All reasonable expenses incurred by the insured at our request to assist us in the investigation or defense of the claim or "suit', including actual loss of earnings up to $500 a day because of time off from work. $ G. ADDITIONAL INSUREDS -BY CONTRACT, AGREEMENT OR PERMIT 1. Paragraph 2. under Section II - Who Is An Insured is amended to include as an insured any person or organization whom you have agreed to add as an additional insured in a written contract, written agreement or permit. Such person or organization is an additional insured but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused in whole or in part by: a. Your acts or omissions, or the acts or omissions of those acting on your behalf, in the performance of your on going operations for the additional insured that are the subject of the written contract or written agreement provided that the "bodily injury" or "property damage" occurs, or the "per- sonal and advertising injury" is committed, subsequent to the signing of such written contract or written agreement; or ® 2013 Liberty Mutual Insurance CG 88 10 04 13 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Rime 1VIw agnnent Diuisian REVIEWED & APPROVED By: R. Mozd ® Risk Management Analyst b. Premises or facilities rented by you or used by you; or c. The maintenance, operation or use by you of equipment rented or leased to you by such person or organization; or d. Operations performed by you or on your behalf for which the slate or political subdivision has issued a permit subject to the following additional provisions: (1) This insurance does not apply to "bodily injury", "property damage", or "personal and ad- vertising injury" arising out of the operations performed for the state or political subdivision; (2) This insurance does not apply to "bodily injury" or "property damage" included within the "completed operations hazard". (3) Insurance applies to premises you own, rent, or control but only with respect to the following hazards: (a) The existence, maintenance, repair, construction, erection, or removal of advertising signs, awnings, canopies, cellar entrances, coal holes, driveways, manholes, marquees, hoist away openings, sidewalk vaults, street banners, or decorations and similar expo- sures; or (b) The construction, erection, or removal of elevators; or (c) The ownership, maintenance, or use of any elevators covered by this insurance. However. 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insur- ance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. With respect to Paragraph 1.a. above, a person's or organization's status as an additional insured under this endorsement ends when: (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. With respect to Paragraph 1.b. above, a person's or organization's status as an additional insured under this endorsement ends when their written contract or written agreement with you for such premises or facilities ends. a s With respects to Paragraph 1.c. above, this insurance does not apply to any "occurrence" which takes place after the equipment rental or lease agreement has expired or you have returned such equipment to the lessor. 12 The insurance provided by this endorsement applies only if the written contract or written agreement is signed prior to the "bodily injury" or "property damage". We have no duty to defend an additional insured under this endorsement until we receive written notice of a "suit" by the additional insured as required in Paragraph b. of Condition 2. Duties In the Event Of Occurrence, Offense, Claim Or Suit under Section IV - Commercial General Liability Condi- tions. ® 2013Liberty Mutual Insurance CG 88 10 04 13 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Rime Management Diuisian REVIEWED&APPROVED By: ' Fw� R. v d k '� Risk Management Analyst 2. With respect to the insurance provided by this endorsement, the following are added to Paragraph 2. Exclusions under Section 1 - Coverage A - Bodily Injury And Property Damage Liability: This insurance does not apply to: a. "Bodily injury" or "property damage" arising from the sole negligence of the additional insured. b. "Bodily injury" or "property damage" that occurs prior to you commencing operations at the location where such "bodily injury" or "property damage" occurs. c. "Bodily injury", "property damage" or "personal and advertising injury' arising out of the render- ing of, or the failure to render, any professional architectural, engineering or surveying services, c including: (1) The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reportsI surveys, field orders, change orders or drawings and specifications; or (2) Supervisory, inspection, architectural or engineering activities. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in " the supervision, hiring, employment, training or monitoring of others by that insured, if the "occur- rence" which caused the "bodily injury" or "property damage", or the offense which caused the "personal and advertising injury", involved the rendering of, or the failure to render, any professional architectural, engineering or surveying services. s d. "Bodily injury" or "property damage" occurring 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. e. Any person or organization specifically designated as an additional insured for ongoing operations by a separate ADDITIONAL INSURED -OWNERS, LESSEES OR CONTRACTORS endorsement is- sued by us and made a part of this policy. 3. With respect to the insurance afforded to these additional insureds, the following is added to Section III - Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: a. Required by the contract or agreement; or b. Available under the applicable Limits of Insurance shown in the Declarations; s whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declaratio ns. H. PRIMARY AND NON-CONTRIBUTORY ADDITIONAL INSURED EXTENSION This provision applies to any person or organization who qualifies as an additional insured under any form or endorsement under this policy. Condition 4. Other Insurance of SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS is amend- ed as follows: a. The following is added to Paragraph a. Primary Insurance: If an additional insured's policy has an Other Insurance provision making its policy excess, and you have agreed in a written contract or written agreement to provide the additional insured coverage on a primary and noncontributory basis, this policy shall be primary and we will not seek contribution from the additional insured's policy for damages we cover. ® 2013Liberty Mutual Insurance CG 88 10 04 13 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Rime Management t)iuisian REVIEWED&APPROVED BY: R. MA44d ® Risk Management Analyst b. The following is added to Paragraph b. Excess Insurance: When a written contract or written agreement, other than a premises lease, facilities rental contract or agreement, an equipment rental or lease contract or agreement, or permit issued by a state or political subdivision between you and an additional insured does not require this insurance to be primary or primary and non-contributory, this insurance is excess over any other insurance for which the addi- tional insured is designated as a Named Insured. Regardless of the written agreement between you and an additional insured, this insurance is excess over any other insurance whether primary, excess, contingent or on any other basis for which the additional insured has been added as an additional insured on other policies. I. ADDITIONAL INSUREDS - EXTENDED PROTECTION OF YOUR "LIMITS OF INSURANCE" This provision applies to any person or organization who qualifies as an additional insured under any form or endorsement under this policy. 1. The following is added to Condition 2. Duties In The Event Of Occurrence, Offense, Claim or Suit: An additional insured under this endorsement will as soon as practicable: a. Give written notice of an "occurrence" or an offense that may result in a claim or "suit" under this insurance to us; b. Tender the defense and indemnity of any claim or "suit" to all insurers whom also have insurance available to the additional insured; and c. Agree to make available any other insurance which the additional insured has for a loss we cover under this Coverage Part. d. We have no duty to defend or indemnify an additional insured under this endorsement until we receive written notice of a "suit" by the additional insured. 2. The limits of insurance applicable to the additional insured are those specified in a written contract or written agreement or the limits of insurance as stated in the Declarations of this policy and defined in Section III - Limits of Insurance of this policy, whichever are less. These limits are inclusive of and not in addifion to the limits of insurance available under this policy. J. WHO IS AN INSURED -INCIDENTAL MEDICAL ERRORS/ MALPRACTICE WHO IS AN INSURED - FELLOW EMPLOYEE EXTENSION - MANAGEMENT EMPLOYEES Paragraph 2.a.(1) of Section II -Who Is An Insured is replaced with the following: (1) "Bodily injury" or "personal and advertising injury": (a) To you, to your partners or members (if you are a partnership or joint venture), to your members (if you are a limited liability company), to a co -"employee" while in the course of his or her employ- ment or performing duties related to the conduct of your business, or to your other "volunteer s workers" while performing duties related to the conduct of your business; (b) To the spouse, child, parent, brother or sister of that co "employee" or "volunteer worker" as a consequence of Paragraph (1) (a) above; (c) For which there is any obligation to share damages with or repay someone else who must pay damages because of the injury described in Paragraphs (1) (a) or (b) above; or (d) Arising out of his or her providing or failing to provide professional health care services. However, if you are not in the business of providing professional health care services or providing profes- sional health care personnel to others, or if coverage for providing professional health care ser- vices is not otherwise excluded by separate endorsement, this provision (Paragraph (d)) does not apply. Paragraphs (a) and (b) above do not apply to "bodily injury" or "personal and advertising injury" caused by an "employee" who is acting in a supervisory capacity for you. Supervisory capacity as used herein means the "employee's" job responsibilities assigned by you, includes the direct supervision of other "employ- ees" of yours. However, none of these "employees" are insureds for "bodily injury" or "personal and ® 2013 Liberty Mutual Insurance CG 88 10 04 13 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Rime Management Diaisian REVIEWED & APPROVED BY: '� Risk Management Analyst advertising injury" arising out of their willful conduct, which is defined as the purposeful or willful intent to cause "bodily injury" or "personal and advertising injury", or caused in whole or in part by their intoxica- tion by liquor or controlled substances. The coverage provided by provision J. is excess over any other valid and collectable insurance available to your "employee". K. NEWLY FORMED OR ADDITIONALLY ACQUIRED ENTITIES Paragraph 3. of Section II - Who Is An Insured is replaced by the following: 3. Any organization you newly acquire or form and over which you maintain ownership or majority interest, will qualify as a Named Insured if there is no other similar insurance available to that c organization. However: i� a. Coverage under this provision is afforded only until the expiration of the policy period in which the entity was acquired or formed by you; E= b. Coverage A does not apply to "bodily injury" or "property damage" that occurred before you acquired or formed the organization; and "a —_ c. Coverage B does not apply to "personal and advertising injury" arising out of an offense committed before you acquired or formed the organization. d. Records and descriptions of operations must be maintained by the first Named Insured. No person or organization is an insured with respect to the conduct of any current or past partnership, joint s venture or limited liability company that is not shown as a Named Insured in the Declarations or qualifies as an insured under this provision. L. FAILURE TO DISCLOSE HAZARDS AND PRIOR OCCURRENCES Under Section IV - Commercial General Liability Conditions, the following is added to Condition 6. Repre- sentations: Your failure to disclose all hazards or prior "occurrences" existing as of the inception date of the policy shall not prejudice the coverage afforded by this policy provided such failure to disclose all hazards or prior "occurrences" is not intentional. M. KNOWLEDGE OF OCCURRENCE, OFFENSE, CLAIM OR SUIT Under Section IV - Commercial General Liability Conditions, the following is added to Condition 2. Duties In The Event of Occurrence, Offense, Claim Or Suit: Knowledge of an "occurrence", offense, claim or "suit" by an agent, servant or "employee" of any insured shall not in itself constitute knowledge of the insured unless an insured listed under Paragraph 1. of Section 11 - Who Is An Insured or a person who has been designated by them to receive reports of "occurrences", offenses, claims or "suits" shall have received such notice from the agent, servant or "employee". s N. LIBERALIZATION CLAUSE If we revise this Commercial General Liability Extension Endorsement to provide more coverage without additional premium charge, your policy will automatically provide the coverage as of the day the revision is effective in your state. O. BODILY INJURY REDEFINED Under Section V - Definitions, Definition 3. is replaced by the following: 3. "Bodily Injury" means physical injury, sickness or disease sustained by a person. This includes mental anguish, mental injury, shock, fright or death that results from such physical injury, sick- ness or disease. © 2013 Liberty Mutual Insurance CG 88 10 04 13 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Rime htu agnnent Diaisian REVIEWED&APPROVED BY: ' Fw� R. v d k '� Risk Management Analyst P. EXTENDED PROPERTY DAMAGE Exclusion a. of COVERAGE A. BODILY INJURY AND PROPERTY DAMAGE LIABILITY is replaced by the following: a. Expected Or Intended Injury "Bodily injury" or "property damage" expected or intended from the standpoint of the insured. This exclusion does not apply to "bodily injury" or "property damage" resulting from the use of reasonable force to protect persons or property. Q. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US - WHEN REQUIRED IN A CONTRACT OR AGREEMENT WITH YOU Under Section IV -Commercial General Liability Conditions, the following is added to Condition 8. Trans- fer Of Rights Of Recovery Against Others To Us: We waive any right of recovery we may have against a person or organization because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the "products -completed operations hazard" provided: 1. You and that person or organization have agreed in writing in a contract or agreement that you waive such rights against that person or organization; and 2. The injury or damage occurs subsequent to the execution of the written contract or written agree- ment. ® 20131-iberty Mutual Insurance CO 88 10 04 13 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Ride Management Diuisian REVIEWED & APPROVED BY: '� Risk Management Analyst I COMMERCIAL GENERAL LIABILITY CG 80 61 05 11 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. AMENDMENT OF CANCELLATION PROVISIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART Any term or provision of the Cancellation Conditions of the policy or any endorsement amending or replac- ing such Conditions is amended by the following: A. If we cancel this policy for any reason other than nonpayment of premium, we will notify the person or organization shown in the Schedule below. In no event will the notice to the person or organization scheduled below exceed the notice to the first named insured. B. Our obligation to send notice to the person or organization listed in the Schedule below will terminate at the earlier of the current policy period expiration or when you no longer have a legal or contractual obligation to such person or organization to maintain insurance coverage under a policy which requires that such person or organization be notified in the event of cancellation. SCHEDULE 1. Name: City of Santa Ana 2. Address: 20 Civic Center Plaza SANTA ANA, CA 92701 3. Number of days advance notice: 30 All other terms and conditions of this policy remain unchanged. © 2011 Liberty Mutual Agency Corporation. All rights reserved. CG 80 61 05 11 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Rime Management Diaisian REVIEWED&APPROVED BY: '� Risk Management Analyst a a 9 CNA 04 01 06 18 CALIFORNIA ADVISORY NOTICE TO POLICYHOLDERS COMMERCIAL AUTO FORMS REVISIONS Dear Valued Policyholder, Thank you for selecting us as your carrier for your commercial insurance. We are in the process of im- plementing policy administration system improvements. As a result, we are replacing certain coverage forms and endorsements with other forms, which will result in changes to your coverage. This notice contains a brief summary of coverage changes organized by individual endorsement. Please note that not all of the endorsements indicated may apply to your specific policy. In addition, this notice does not reference every editorial change made to the endorsement or coverage form; it only reflects significant coverage changes. Please read your policy and review your Declarations page for complete coverage information. No coverage is provided by this notice, nor can it be construed to replace any provisions of your policy. If there are discrepancies between your policy and this notice, the provisions of the policy shall prevail. These changes shall become effective as of the effective date of your replacement policy. Please note that this notice does not apply to you or your policy in the event you have received, or do receive, a notice of cancellation or nonrenewal. Should you have questions after reviewing the changes below, please contact your independent agent. Thank you for your business. Expiring Form Expiring Form Number New Form New Form Number Auto Plus Endorsement CA 71 10 03 07 California Business Auto AC 85 43 06 18 Coverage Enhancement Endorsement Safeco Optimum CA 72 42 12 08 Package Waiver of Collision CA 71 20 05 98 Deductible AC 85 43 0618 - California Business Auto Coverage Enhancement Endorsement If your policy previously included CA 71 10 03 07 - Auto Plus Endorsement, this endorsement has been replaced by the AC 85 43 06 18 - California Business Auto Coverage Enhancement Endorsement. In some cases, the limits previously provided are being increased and several additional provisions and reductions are included. The summary below provides a brief description of these changes. BROADENING IN COVERAGE • Supplementary Payments The limit for bail bonds has been increased from $2,000 in the Business Auto Coverage Form to $3,000 in the new California Business Auto Coverage Enhancement Endorsement (AC 85 43 06 18). The limit for reasonable expenses incurred by you at our request have been increased from $250 per day to $500 per day. • Employees as Insureds Coverage is being expanded to include as insureds, your employees while operating an auto hired or borrowed under a written contract or agreement in that employee's name with your permission and in your business. This coverage is excess over any other insurance available to the employee. • Waiver of Subrogation The policy is amended to provide that subrogation rights are now waived for any person or or- ganization that has waived those rights, in a written contract or written agreement, prior to an accident or loss. ® 20181-iberty Mutual Insurance CNA 04 01 06 18 Includes copyrighted material of Insurance Services Office. Inc., with its permission. Rime Management I)Msian rREmEWED &{APPROyvva7 By., �_4.Ilil _II.IP:L' rb6HlM�e ram. V�RRE44d ® Risk Management Analyst • Hired Autos Physical damage coverage is extended to autos your employee hires or rents under a written contract or agreement in that employee's name but only if the damage occurs in the conduct of your business. The deductible will be the largest deductible applicable to any owned auto. • Towing or Labor This new coverage applies: Private passenger autos - $75 per disablement; Light trucks (Gross Vehicle Weight) 10,000 lbs. or less -$75 per disablement; and Medium trucks (Gross Vehicle Weight) 10,001 to 20,000 lbs. - $150 per disablement. • Rental Reimbursement Coverage has been expanded from $50 per day to $75 per day for rental expenses incurred by you for the rental of an auto. We will also pay $500 for reasonable and necessary expenses incurred by you to remove and replace your tools and equipment from the covered auto. • Audio, Visual and Data Electronic Equipment Coverage The sublimit has been eliminated. Coverage is now provided at the lesser of the actual cash value or the cost to repair or replace. It is, however, subject to an adjustment for depreciatio n and physical condition. • Loan/Lease Gap Coverage The sublimit has been eliminated. Coverage is now provided for the total loss to a covered auto in any one accident limited to the greater of the balance due (subject to certain limitations) on the loan or lease or the actual cash value of the damaged or stolen property at the time of loss. • Parked Auto Collision Coverage (Waiver of Deductible) If an owned private passenger type or light truck is legally parked and unoccupied, and is struck by another vehicle, your collision deductible will not apply. This coverage does not apply to any loss if the covered auto is In the charge of any person or organization engaged in the automobile busi- ness. Two or More Deductibles Under Physical Damage Coverages, if two are more Liberty Mutual Insurance Company policies or coverage forms apply to the same accident, the smallest deductible will be waived or if this policy is not the smallest deductible, the deductible under this policy will be reduced by the smaller deductible. • Hired Auto Physical Damage Coverage Territory The coverage territory for all Hired Autos is changed to anywhere in the world. Additionally , the coverage is excess over other collectible insurance. • Bodily Injury Redefined Bodily injury has been redefined to include mental injury, shock or fright. • Personal Effects Coverage The limit is increased from $500 to $600 for "personal effects." • Physical Damage Deductible -Vehicle Tracking System Any comprehensive deductible will be reduced by 50% for a theft 'loss" in which a vehicle tracking device was used as the method to recover the vehicle. • Primary and Non -Contributing if Required by Written Contract or Written Agreement If an insured agrees to be primary and non-contributing in a written contract we will be primary and without right of contribution. IN COVERAGE Blanket Additional Insured The designated person or organization is included as an insured for the operation, maintenance or use of a covered auto. Coverage for bodily injury or property damage applies if the accident occurs after the contract, agreement or permit is issued and applies for the duration of the contract, permit or agreement. © 20181-iberty Mutual Insurance CNA 04 01 0618 includes copyrighted material of Insurance Services Office, Inc., with its permission. Rime Management Dial sian REVIEWED&APPRDVEDBy., '� Risk Management Analyst • Amended Fellow Employee Exclusion This coverage now requires you have workers compensation in force for all your employees in order for coverage to apply. Additionally, the coverage is now excess over any other collectible insurance (i.e. the employee's personal auto policy). If there is no coverage, other than workers compensation, available, this coverage will be primary. • Audio, Visual and Data Electronic Equipment Coverage Changes in format to make the coverage easier to read. • Accidental Airbag Deployment This insurance is excess over any other collectible insurance or reimbursement from a manufac- turer's warranty. However, we will pay any deductible applicable to that other coverage or war- ranty. o REDUCTION IN COVERAGE • Extra Expense - Broadened Coverage The amount we pay to return your stolen covered auto to you is $1000. This may be considered a a =_ reduction in your limit. Personal Effects Coverage This coverage applies to personal effects up to $600 stolen with your covered auto and is excess over any other collectible insurance. Personal effects are defined as tangible property that is worn or carried by an insured. Personal effects do not include tools, equipment, jewelry, money or securities. • New Vehicle Replacement Cost New Vehicle purchase price cost is not included as part of your new policy. • Newly Formed or Acquired Subsidiaries This coverage now includes limited liability company's (LLC's) which represents a broadening in s language. However, coverage is now limited to only newly acquired or formed entities for a period " of ninety (90) days after formation. When the insured purchases or forms a new entity, the entity should be disclosed to Liberty Mutual within ninety (90) days. • Additional Insured by Contract, Agreement or Permit The coverage now specifies that a written contract or written agreement must be in place for additional insured status to be granted. It also requires the insured to submit a claim to the addi- tional insured's insurer if the insured has not agreed in writing to be primary and non-contributing. • Waiver of Transfer of Rights of Recovery Against Others to Us This coverage now requires the insured to have expressly waived the right to subrogation in a written contract or written agreement. • Extended Cancellation Condition The extended cancellation condition is being removed - Please contact your agent for information on adding this condition on your policy. Broad Form Insured a This coverage is now limited to newly acquired or formed entities, other than partnerships or join ventures, for a period of 90 days after acquisition or formation. CA 72 4212 08 - Safeco Optimum Package If your policy previously included this endorsement, the following coverages will no longer be provided: • Diminishing Deductible; • Waiver of Adjustment for Depreciation; • Emergency Expenses; and • Electronic Lock and Key Replacement. The following coverage can be included if requested. Contact your agent for additional information. Original Equipment and Manufactured Parts CA 7120 05 98 - Waiver of Collision Deductible This endorsement is being discontinued. If you do not have AC 85 43 06 18 - California Business Auto Coverage Enhancement Endorsement on your policy, you will have a collision deductible regardless of the type of vehicle or if the other "auto" involved in the collision is insured by Safeco Insurance Company of America or any of its affiliated companies. Rime Mrxnagment DMsinn REVIEWED&APPROVED By: R. MA44d 18, ® Risk Management Analyst ® 2018 Liberty Mutual Insurance CNA 04 01 06 18 Includes copyrighted material of Insurance Services Office, Inc., with its permission. CNA 04 02 09 19 CALIFORNIA IMPORTANT NOTICE TO POLICYHOLDERS Dear Valued Policyholder, Thank you for selecting us as your carrier for your commercial insurance. This notice contains a brief summary of coverage changes being made to your policy. It does not reference every editorial change made to the endorsement; it only reflects significant coverage changes. Expiring Form Expiring Form Number New Form New Form Number California Business Business Auto Coverage Auto Coverage Enhancement CA 88 10 01 13 Enhancement AC 85 43 06 18 Endorsement Endorsement This Notice does not form a part of your policy nor is any coverage provided by this Notice. It should not be construed as replacing any provision of your policy. You should read your policy and review your Declara- tions page for complete information on the coverages you are provided. If there is any conflict between the Policy and this Notice, THE PROVISIONS OF THE POLICY SHALL PREVAIL. This Notice provides information concerning the following forms and endorsements which apply to your renewal policy being issued by us. The forms and endorsements may reduce or broaden coverage. Should you have questions after reviewing the changes outlined below, please contact your independent agent. Thank you for your business. COVERAGE CHANGES BROADENING AND NEW COVERAGE Primary and Non -Contributing if Required by Written Contract or Written Agreement. If an insured agrees to be primary and non-contributing in a written contract we will be primary and without right of contribution. Physical Damage Deductible -Vehicle Tracking System Any comprehensive deductible will be reduced by 50% for a theft loss in which a vehicle tracking device was used as the method to recover the vehicle. Towing and Labor Coverage for private passenger vehicles and light trucks is now $75 per tow. CLARIFICATIONS AND REDUCTIONS Audio, Visual and Data Electronic Equipment Coverage Changes in format to make the coverage easier to read. Waiver of Transfer of Rights of Recovery Against Others to Us This coverage now requires the insured to have waived the right to subrogation in a written contract or written agreement. Rental Reimbursement Coverage now requires rental of a comparable or lesser vehicle. The $500 in tools coverage and rental reimbursement is excess over other collectible insurance. Additionally, if you elect to schedule higher limits in your policy - the coverage in this endorsement is in addition to the coverage you have purchased. ® 20191-iberty, Mutual Insurance CNA 04 02 09 19 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Rime Mw agmnent Diuiaian REVIEWED&APPROVED By., '� Risk Management Analyst Hired Auto Physical Damage The coverage extension does not include autos rented or borrowed from an insured's employee or any member of the employee's household. Additionally, the coverage is excess over other collectible insurance. Amended Fellow Employee Exclusion This coverage now requires you have workers compensation in force for all your employees in order for coverage to apply. Additionally, the coverage is now excess over any other collectible insurance (i.e. the employee's personal auto policy). If there is no coverage available, this coverage will be primary. Additional Insured by Contract, Agreement or permit The coverage now specifies that a written contract or written agreement must be in place for additional insured status to be granted. It also requires the insured submit a claim to the additional insured's insurer if the insured has not agreed in writing to be primary and noncontributing. Newly Formed or Acquired Subsidiaries This coverage now includes LLC's which represents a broadening in language. However, coverage is now a limited to only newly acquired or formed subsidiaries for a period of 90 days after formation. When the insured purchases or fors a new entity, we ask that that entity be disclosed to Liberty within 90 days. 9 © 20191-ibeny Mutual Insurance CNA 04 02 09 19 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Rime Management Diaisian REVIEWED&APPROVED BY: R. MA44d ® Risk Management Analyst NP 91 91 02 13 IMPORTANT POLICYHOLDER INFORMATION CONCERNING BILLING PRACTICES -CALIFORNIA Dear Valued Policyholder: This insert provides you with important information about our policy billing practices that may affect you. Please review it carefully and contact your agent if you have any questions. Premium Notice: We will mail you a policy Premium Notice separately. The Premium Notice will provide you with specifics regarding your agent, the account and policy billed, the billing company, payment plan, policy number, transaction dates, description of transactions, charges/credits, policy amount balance, mini- mum amount, and payment due date. This insert explains fees that may apply to and be shown on your Premium Notice. Available Premium Payment Plans: • Annual Payment Plan: When this plan applies, you have elected to pay the entire premium amount balance shown on your Premium Notice in full. No installment billing fee applies when the Annual Payment Plan applies. • Installment Payment Plan: When this plan applies, you have elected to pay your policy premium in installments (e.g.: quarterly or monthly installments - Installment Payment Plans vary by stale). As noted below, an installment fee may apply when the Installment Payment Plan applies. The Premium Payment Plan that applies to your policy is shown on the top of your Premium Notice. Please contact your agent If you want to change your Payment Plan election. Installment Payment Plan Fee: If you elected to pay your premiums in installments using the Installment Premium Payment Plan, an installment billing fee applies to each installment bill. The installment billing a charge will not apply, however, if you pay the entire balance due when you receive the bill for the first " installment. Because the amount of the installment charge varies from state to state, please consult your Premium Notice for the actual fee that applies. Dishonored Payment Fee: Your financial institution may refuse to honor the premium payment withdrawal request you submit to us due to insufficient funds in your account or for some other reason. If that is the case, and your premium payment withdrawal request is returned to us dishonored, a payment return fee will apply. Because the amount of the return fee varies from state to state, please consult your Premium Notice for the actual fee that applies. Late Payment Fee: If we do not receive the minimum amount due on or before the date or time the payment is due, as indicated on your Premium Notice, you will receive a policy cancellation notice effective at a future date that will also reflect a late payment fee charge. Issuance of the cancellation notice due to non-payment of a scheduled installment(s) may result in the billing and collection of all or part of any outstanding premiums due for the policy period. Late Payment Fees vary from state to state and are not " applicable in some states. s Special Note: Please note that some states do not permit the charging of certain fees. Therefore, if your state does not allow the charging of an Installment Payment Plan, Dishonored Payment or Late Payment Fee, the disallowed fee will not be charged and will not be included on your Premium Notice. EFT -Automatic Withdrawals Payment Option: When you select this option, you will not be sent Premium Notices and, in most cases, will not be charged installment fees. For more information on our EFT -Auto- matic Withdrawals payment option, refer to the attached policyholder plan notice and enrollment sheet. Schedule of Fees Type of Fee Fee Amount Installment Payment Plan Non Recurring Payment Option $10.00 EFT -Automatic Withdrawals Payment Option $0.00 Dishonored Payment $20.00 Late Payment $25.00 Once again, please contact your agent if you have any questions about the above billing practice informa- tion. Rime Management DMsian REVIEWED & APPRDVED BY: �'l uill Id'1_z' Faa� Z. v i� ® Risk Management Analyst Thank you for selecting us to service your insurance needs. NP 91 91 02 13 © 2013 Liberty Mutual Insurance PDLICTN01-0ER COPY SIP PO BOX 8192. PLEASANTON, CA 94588 CERTIFICATE OF WORKERS' COMPENSATION INSURANCE 15511E DATE. fo-01-2020 CITY OF SANTA ANA SP 20 CIVIC CENTER PL.I SAN.TA RNA CA 112701-605A GROURP POLICY WJM9fiR 120"196-2020 CERTIFICATE Q 117 CERTFICATE EXPIRES 10-01-2021 10-01-W20/10-01-2021 This +s 'o catt,ty IIMi we r" ILsr" a Valid VVorsarF Cp[rpvnsauan arai W policy n a form appr`oued by 1he CNtornw IryiY. a comm-sqi to lte emplovair rei helm for The policy parrpd Indicated This polwv is MI subject to creceltalie+• by 4y Pund l.esm Loon aD ores advance wrdten WtKv to Nw vrrployr. We will also 9" you 90. days advance �c shoeld IN; poliC be 'incased V'Qf 10 111 norTn/ v15OirataPR Thm crtrfrcna of l[t ,vuns to not an msutenc! Alegie aid does rest arrspnd, extend er altW the CWAga afforded by the policy lifted hreln hlotwith' datg xV fepJromieM term or C"dif on of A"W conWai of OtIHr docJnent wrath refit to w CN tills Car-fifICATI, e1 e+yvanc! Miry be I"tRfd or to wtsC41 It nW partYM Cho rvsLArarca atlordad by the policy 0wrlbad rNKefl is sabjaet Co all M Cr". ■rCludrons_ fie condition'. of such pol[ v Au[horued AmpralanuLye FrePdrR Hid CEO Cage ER'S LIAOLLITT LIMIT TNC1.11004 OFFENSE POSTS: t/,0W.DW PER 0004R+REMM, EMDRSENEITT 1701n ENTITLED CERTIFICATE HOLDERS' NOTICE EF FECT WE 10 01-2000 15 AnAptieO TO AMU Fpt06 A PART Of 11115 POLICY. - ENDORSEMENT 01561 - YILLIsII D'TOOCE. PRESTOENT - EXCLUDED. ENDORSEMENT 01091 - TREYoll BLY-THE, 5 - EXCLLMED. I]VPLOYJR ECALINa1f CS, INC ECVNC1ll INC. 5F PO ODX 2120 DEL W CA 92014 .}{y.➢ ICA, N�d to PRINTED . 06-17-2020 Rime Managmient DMI flan REVIEWED&APPROVED By., ' F�W� R. M.Wd '� Risk Management Analyst COMMON POLICY CONDITIONS ENDORSEMENT This endorsement changes the Policy. Please read it carefully. In consideration of the premium charged, and notwithstanding anything contained in this policy to the contrary, it is hereby agreed that all coverage parts included in this policy are subject to the following conditions: A. CANCELLATION The named insured may cancel this policy by mailing to the Company written notice stating when thereafter such cancellation shall become effective. The Company may cancel this policy by mailing to the named insured, at the mailing address specified the Declarations, written notice stating when not less than thirty (30) days thereafter such cancellation shall become effective, except in the event of the named insured's nonpayment of premium, not less than ten (10) days advance notice of cancellation shall be given. The mailing of notice as aforesaid, shall be sufficient proof of either party's intent to cancel. The effective date of cancellation specified in such notice shall terminate this policy period. Delivery of such notice shall be equivalent to mailing. If the named insured cancels, the earned premium shall be computed in accordance with the customary short rate table. If the Company cancels, the earned premium shall be computed pro rata. The Company will tender any return premium subject to retaining a minimum earned premium equal to 25% of the amount specified in the Declarations. Premium adjustment may be made either at the time cancellation is effective or as soon as practicable thereafter, but tender of the unearned premium or return of this policy, shall not be conditions precedent to cancellation hereunder. B. CHANGES No provision of this policy may be amended, waived or otherwise changed, except by endorsement hereto. C. EXAMINATION OF YOUR BOOKS AND RECORDS We may examine and audit your books and records as they relate to this policy at any time during the policy period and up to three (3) years afterward. D. INSPECTIONS AND SURVEYS We have the right, but are not obliged to: 1. Make inspections and surveys at any time; and PGI EL 036 0210 s� R7n1D & APnentDiviaia , REVIEWED&APPROVED BY: ®J Risk Management Analyst 2. Give you reports on the conditions we find; and 3. Recommend changes. Any inspections, surveys, reports or recommendations relate only to insurability and the premiums to be charged. We do not make safety inspections. We do not undertake to perform the duty of any person or organization to provide for the health or safety of workers or the public. We do not warrant that conditions: 1. Are safe or healthful; or 2. Comply with laws, regulations, codes or standards. This condition applies not only to us, but also to any rating, advisory, rate service, engineering firm or similar organization which makes insurance inspections, surveys, reports or recommendations. E. NAMED INSURED AS AGENT The named insured specified in the Declarations shall be deemed agent of each insured with respect to all matters involving this policy, however, the Company shall have the right to seek indemnification from any insured or any other person who may be legally liable for the debts of the named insured. F. PREMIUMS The first Named Insured shown in the Declarations: 1. Is responsible for the payment of all premiums; and 2. Will be the payee for any return premiums we pay; and 3. Is responsible for the payment of all deductibles and self -insured retention amounts under this policy. G. ADDITIONAL PREMIUMS If, during this policy period, an increase in the risk or hazards covered hereunder occurs, the Company shall have the right to charge the appropriate additional premium. H. TRANSFER OF YOUR RIGHTS AND DUTIES UNDER THIS POLICY Your rights and duties under this policy may not be transferred without our written consent except in the case of death of an individual Named Insured. If you die, your rights and duties will be transferred to your legal representative but only while acting within the scope of duties as your legal representative. Until your legal representative is appointed, anyone having proper temporary custody of your property will have your rights and duties but only with respect to that property. PGI EL 036 0210 raaktaa„agmentoiNalan REVIE & APPRO m By: ®, ® Risk Management Malyst BANKRUPTCY Bankruptcy or insolvency of the insured or of the insured's estate will not relieve us of our obligations under this Coverage Part. PGI EL 036 0210 "A an MagementDMsian [REVIEWED &pAP'PIRaVVED BYE: o_\.Il�l:lll� L' r A�f1�Nf.Q 1�, l"+4cNd(RG ®, ® Risk Management Analyst POLICY NUMBER: EMP 1900166 1 -01 ADDITIONAL INSURED ENDORSEMENT This endorsement changes the Policy. Please read it carefully. This endorsement modifies insurance provided under the following: CONTRACTORS POLLUTION LIABILITY COVERAGE Name of Person or Organization: Any person(s) or organization(s) whom the Named Insured agrees, in a written contract, to name as an additional insured. However, this status exists only for the project specified in that contract. The person or organization shown in this Schedule is included as an insured, but only with respect to that person's or organization's liability arising out of COVERED OPERATIONS performed for that insured. PGI EL 018 0210 so_ RiskM»sgmtentDiAsian � REVIEWED&APPRO mBy: `'1niD.11i`:L' F�.s.r�.ne �, V:ffcnaaP ® Risk M a nagement Analyst Policy Number: PGIARK05448-02 IQRILTJF \:\/a10170 W0MaIe]0Y1I:1R14110I31 This endorsement changes the Policy. Please read it carefully. SCHEDULE Name of Person or Organization: Any person(s) or organization(s) whom the Named Insured agrees, in a written contract, to provide Primary and/or Non-contributory status of this insurance. However, this status exists only for the project specified in that contract. In consideration of the premium charged, it is hereby agreed that this policy shall be considered primary to any similar insurance held by third parties in respect to work performed by you under any written contractual agreement with such third party. It is further agreed that any other insurance which the person(s) or organization(s) named in the schedule may have is excess and non-contributory to this insurance. PGI EL 020 0210 Risk Metwgzmn eDMNsian REVIEWED &APPROVED By: ® Risk Management Analyst POLICY: EMP19001661-01 WAIVER OF SUBROGATION ENDORSEMENT This endorsement changes the Policy. Please read it carefully. This endorsement modifies insurance provided under the following: PROFESSIONAL LIABILITY COVERAGE CONTRACTORS POLLUTION LIABILITY COVERAGE SCHEDULE Name of Person or Organization: Any person(s) or organization(s) to whom the Named Insured agrees, in a written contract, to provide a waiver of subrogation. However, this status exists only for the project specified in that contract. The Company waives any right of recovery it may have against the person or organization shown in the above Schedule because of payments the Company makes for injury or damage arising out of the insured's work done under a contract with that person or organization. The waiver applies only to the person or organization in the above Schedule. Under no circumstances shall this endorsement act to extend the policy period, change the scope of coverage or increase the Aggregate Limits of Insurance shown in the Declarations. PGI EL 019 0210 Risk Managnnn eDivision RE\ D & APaaovm Bv: �JIli.1-I-1[:d' F:ti•e �'. V.,@@.a1ac� Risk M a nagement Analyst TRANSPORTATION OF CARGO — POLLUTION ENDORSEMENT This endorsement, effective attaches to and forms a part of the Policy. This endorsement changes the Policy. Please read it carefully. This endorsement modifies insurance provided under the following: CONTRACTORS POLLUTION LIABILITY COVERAGE In consideration of an additional premium in the amount of $INCLUDED it is hereby agreed that Exclusion H. is deleted and replaced with the following: A CLAIM related to POLLUTION CONDITIONS which result from the use, ownership, operation, maintenance or entrustment to others of any AUTO, aircraft, watercraft or rolling stock or operated by, or leased, rented or loaned to any Insured. The exclusion shall not apply to POLLUTION CONDITIONS which: resulting from the release from a COVERED AUTO and emanating from the TRANSPORTED CARGO. ii) occur during loading or unloading operations or; iii) commence during the transportation of YOUR PRODUCT or wastes by a CARRIER; and iv) result in BODILY INJURY, PROPERTY DAMAGE, or CLEANUP COSTS during the transportation of YOUR PRODUCT or wastes; and V) commence on or after the inception of this policy. No coverage is provided for the WRONGFUL DELIVERY of any liquid product by AUTO, aircraft, watercraft or rolling stock. The following definitions are added to this policy: II. DEFINITIONS A. COVERED AUTO means the following provided they are indicated with an "X" Specifically described AUTO listed below in the Schedule of AUTO. X Owned AUTO only. Only those AUTOS the INSURED owns (and any trailers the INSURED does not own while connected to a power unit the INSURED owns). This includes those AUTOS the INSURED acquires ownership of after the policy begins. PGI EL 0101017 R i s kMwwgementDMsian REVIEWED&APPROVED By: �_Iui1lllt':L' Fac.r.o:a-e Risk Management Analyst X Hired AUTO only. Only those AUTOS the INSURED leases, hires, rents or borrows. This does not include any private passenger type AUTO the INSURED leases, hires, rents or borrows from the INSURED, any of its employees, partners or agents. X Non -owned AUTO only. Only those AUTOS the INSURED does not own lease, hire, rent or borrow that are used in connection with the INSURED(S) business. This includes AUTOS owned by employees or partners or members of their households but only while used in the INSURED(S) business. B. CARGO means goods, products or wastes carried for delivery on or within a COVERED AUTOM that is properly licensed to transport such goods, products or wastes. C. CARRIER means a person or entity, other than the INSURED or any subsidiary or affiliated company of the INSURED, engaged in the business of transporting property for hire by AUTO, rolling stock, aircraft or watercraft. D. TRANSPORTED CARGO means CARGO after it is moved from the place where it is accepted for movement into or on to the COVERED AUTO, until the CARGO is moved from the COVERED AUTO to the place where it is finally delivered. TRANSPORTED CARGO also includes CARGO during the loading and unloading to or from a COVERED AUTO, provided that the loading or unloading is performed by the INSURED. TRANSPORTED CARGO does not include CARGO at rest for a period of longer than seventy-two (72) hours, after it has been accepted for movement into or onto a COVERED AUTO but before it reaches the place of final delivery. E. WRONGFUL DELIVERY means the delivery of any CARGO into the wrong receptacle or to the wrong address, or the delivery of one type of CARGO in error for another. SCHEDULE OF AUTOS PGI EL 0101017 RinkMnnaganentDMsian �I CRmEWED& APPROVED BY.' �MELLLIC:L� I �. Ytt4¢RL ® Risk Management Analyst Digitally signed by Francine R. Francine R. Villareal Villareal Date: 2021.03.24 17:05:34-07'00' ��►�o® CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDDIYYYY) 02108/2021 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements}, PRODUCER CONTACT NAME: Nicole Hardin Advanced Brokers Insurance Services 360 N El Camino Real 1A PHONIE {85$} 436-7999 FAX hlol: {858} d3fi-7998 ADDRE , servic advanoedbrokersinc.com AQQRE I NS U RFRIAI AFFORDING COVERAGE NAIL INSURER A: Liberty Mutual insurance Encinitas CA 92024 INSURED INSURER B : AXIS Surplus Insurance Company INSURER C : Em/Nomics, Inc. dba Ecallnomics, Inc. INSURER D : B32 Camino Del Mar Stet INSURER E . INSURER F Del Mar CA 92014 COVERAGES CERTIFICATE NUMBER: REVISION NUMBER,. THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTAiVDING ANY REQUIREMENT, TERM OR CONDI-PON OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, ILTR NSR I OF INSURANCE ADDTYPE NNW) wBR POLICY NUMBER POLICY EFF MNOIla fD�Y LIMITS X COMMERCIAL GENERALUABILITY EACHOCCURRENCE $ 1,000,000 _ /\ OCCUR CLAIMS -MADE X - AMAOE T ^NTED _PREMISES {Ea occurrence{ $ 500,000 MED EXP (Any one person) _ $ 155,D00 A _ _ _ X X BKS57048355 12/0912020 12 O912021 PERSONAL &ADV INJURY $ 1,000,000 $ 2,000,000 LIMIT APPLIES PER: GENERALAGGREGATE �GEN'LAGGREGATE PRO - POLICY 11 JECT Li LOC PRODUCTS-COMROPAGG $ 2,000,000 $ OTHER AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT [Ea accrtlentI $ 1,000,000 BODILY INJURY (Per peram) $ ANY AUTO A SCHEDULED AUTOS ONLY AUTOS X X BAS57048355 12/1112020 12JO912021 XOWNED BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per aceir;er $ V h HIRED NON -OWNED AUTOS ONLY �i+�• AUTOS ONLY $ UMBRELLALIAM OCCUR EACHOCCURRENCE $ AGGREGATE $ EXCESS LIAR CLAIMS -MADE DED I I RETENTIONS $ WORKERS COMPENSATION EMPLOYERS' LIABILITY Y I N ANY PROPRiETORIPARTNERIEXECUTIVE SPA E, L EACH ACCIDENT E OFFiCERIMEMSER EXCLUDED? F NIA (Mandatary in NH) E,L. DISEASE - EA EMPLOYEE $ K yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $ Professional Liability Each Claim $1,00%000 B X X EMP19001661-01 10/0112020 10/0112021 Aggregate $2,000,000 Deductible $5,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101. Additional Remarks Schedule, may be attached If more space is requlred) City of Santa Ana, its officers, employees, agents, and representatives are Additional Insureds with respect to General Liability, Auto Liability, Professional and Pollubon Liability per the attached endorsements or as required by written contract. Insurance is Primary and Nan -Contributory. *30 Days' Notice of Cancellation with 10 days" notice of Non -Payment Of pre miurn in accordance with the policy provisions. Operations of the insured covered under the above policies. TE HOLDER City of Santa Ana Risk Management Division, 4th floor 20 Civic Center Plaza Santa Ana CA 92702 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. A U T HORIZ ED REPRE S£ NTATi VE O 1968-2015 ACORD ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD - . ttialt hdxnrgemertt t7al+i>�rnL REVIEWED & AFPRavED 8Y: Mr k NtanayenlerTt Anahy;[ 10/25/20 Coverage Is Provided In: Policy Number: _ I.1 7Ci'ty Ohio Security Insurance Company - a stock company BKS (21) 57 04 83 55 Mutual. Policy Period: INSURANCE From 12/09/2020 To 12/09/2021 12:01 am Standard Time at Insured Mailing Location Common Policy Declarations Named Insured Agent ECONOMICS INC DBA ECAL/NOMICS 832 Camino Del Mar Ste 2 Del Mar, CA 92014 SUMMARY OF LOCATIONS (844) 547-9382 WORLDWIDE FACILITIES, LLC PO BOX 12279 SANTA ROSA, CA 95406-2279 This policy provides coverage for the following under one or more coverage parts. Please refer to the individual Coverage Declarations Schedules, or, the individual Coverage Forms for locations or territory definition for that specific Coverage Part. 0001 832 Camino Del Mar Ste 2, Del Mar, CA 92014-2808 0002 33155 Camino Capistrano Ste E, San Juan Capistrano, CA 92675-4829 0003 206 W 4th St Ste 429, Santa Ana, CA 92701-4678 POLICY FORMS AND ENDORSEMENTS This section lists the Forms and Endorsements for your policy. Refer to these documents as needed for detailed information concerning your coverage. FORM NUMBER TITLE CG 00 01 04 13 Commercial General Liability Coverage Form - Occurrence CG 20 10 04 13 Additional Insured - Owners, Lessees or Contractors - Scheduled Person or Organization CG 20 37 04 13 Additional Insured - Owners, Lessees or Contractors - Completed Operations CG 21 06 05 14 Exclusion - Access Or Disclosure Of Confidential Or Personal Information And Data -Related Liability - With Limited Bodily Injury Exception CG 21 47 12 07 Employment -Related Practices Exclusion In witness whereof, we have caused this policy to be signed by our authorized officers. �V Mark Touhey David Long Secretary President R To report a claim, call your Agent or 1-844-325-2467 P . RoAEwEo & APPRovED Sr. DS 70 21 11 16 ''...1il v' �n�cy.�as i '. Vim" Risk Management Analyst 57048355 PDLSVCS 290 NCXFPPNO INSURED COPY Coverage Is Provided In: Policy Number: Liberty Ohio Security Insurance Company - a stock company BKS (21) 57 04 83 55 Mutual Policy Period: INSURANCE From 12/09/2020 To 12/09/2021 12:01 am Standard Time at Insured Mailing Location Common Policy Declarations Named Insured Agent ECONOMICS INC DBA ECAL/NOMICS 832 Camino Del Mar Ste 2 Del Mar, CA 92014 POLICY FORMS AND ENDORSEMENTS - CONTINUED (844) 547-9382 WORLDWIDE FACILITIES, LLC PO BOX 12279 SANTA ROSA, CA 95406-2279 This section lists all of the Forms and Endorsements for your policy. Refer to these documents as needed for detailed information concerning your coverage. FORM NUMBER TITLE CG 21 67 12 04 Fungi or Bacteria Exclusion CG 21 73 01 15 Exclusion of Certified Acts of Terrorism CG 21 87 01 15 Conditional Exclusion of Terrorism - (Relating to Disposition of Federal Terrorism Risk Insurance Act) CG 24 26 04 13 Amendment of Insured Contract Definition CG 80 61 05 11 Amendment of Cancellation Provisions CG 84 99 01 12 Non -Cumulation Of Liability Limits Same Occurrence CG 85 15 09 03 Exclusion - Professional Services CG 88 10 04 13 Commercial General Liability Extension CG 88 60 12 08 Each Location General Aggregate Limit CG 88 61 12 08 Property Damage - Customers' Goods CG 88 66 12 08 Property Damage - Borrowed Equipment CG 88 77 12 08 Medical Expense At Your Request Endorsement CG 88 86 12 08 Exclusion - Asbestos Liability CG 89 01 12 08 Hired Auto And Non -Owned Auto Liability CG 90 41 01 13 Amendment Of Coverage B Personal And Advertising Injury CP 00 10 04 02 Building and Personal Property Coverage Form CP 00 90 07 88 Commercial Property Conditions CP 01 40 07 06 Exclusion of Loss Due to Virus or Bacteria CP 04 49 02 20 California Changes - Replacement Cost CP 10 30 04 02 Causes of Loss - Special Form CP 10 32 08 08 Water Exclusion Endorsement CP 72 97 0402 Equipment Breakdown Enhancement Endorsement - Special Form CP 88 04 03 10 Removal Permit To report a claim, call your Agent or 1-844-325-2467 DS 70 21 11 16 10/25/20 57048355 PDLSVCS 290 NCXFPPNO INSURED COPY £ Risk Management I] Wim P REVIEWED & APPROVED 8r- Risk Management Analyst Coverage Is Provided In: Policy Number: Lihel" Ohio Security Insurance Company - a stock company BKS (21) 57 04 83 55 Mutu�71° Policy Period: INSURANCE From 12/09/2020 To 12/09/2021 12:01 am Standard Time at Insured Mailing Location Common Policy Declarations Named Insured Agent ECONOMICS INC DBA ECAL/NOMICS 832 Camino Del Mar Ste 2 Del Mar, CA 92014 POLICY FORMS AND ENDORSEMENTS - CONTINUED (844) 547-9382 WORLDWIDE FACILITIES, LLC PO BOX 12279 SANTA ROSA, CA 95406-2279 This section lists all of the Forms and Endorsements for your policy. Refer to these documents as needed for detailed information concerning your coverage. FORM NUMBER TITLE CP 88 17 08 12 California Custom Protector - Extended Period of Indemnity CP 90 40 08 12 Office / Lessors Custom Protectors Endorsement CP 90 59 12 12 Identity Theft Administrative Services and Expense Coverage CP 91 42 08 12 Custom Protector Plus Endorsement IL 00 17 11 98 Common Policy Conditions IL 00 21 09 08 Nuclear Energy Liability Exclusion Endorsement (Broad Form) IL 01 02 02 20 California Changes - Actual Cash Value IL 01 04 09 07 California Changes IL 02 70 12 19 California Changes - Cancellation and NonRenewal IL 09 35 07 02 Exclusion of Certain Computer -Related Losses IL 09 53 01 15 Exclusion Of Certified Acts Of Terrorism Endorsement IL 09 95 01 07 Conditional Exclusion of Terrorism (Relating to Disposition of Federal Terrorism Risk Insurance Act) LC 87 10 05 00 Punitive or Exemplary Damages Exclusion NP 74 26 04 13 Notice to Policyholder Fully Earned Minimum Premium Endorsements To report a claim, call your Agent or 1-844-325-2467 DS 70 21 11 16 10/25/20 57048355 PDLSVCS 290 NCXFPPNO INSURED COPY £ Risk Management I] Wim P REVrEWED & APPRov® 8r- Risk ranagement Analyst POLICY NUMBER: COMMERCIAL GENERAL LIABILITY CG20100413 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 Name Of Additional Insured Person(s) Or Organization(s): City of Santa Ana 20 Civic Center Plaza SANTA ANA, CA 92701 Location(s) Of Covered Operations All Locations 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 additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily in- jury", "property damage" or "personal and advertising injury" caused, in whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing oper- ations for the additional insured(s) at the lo- cation(s) designated above. However: 1. The insurance afforded to such additional insured only applies to the extent permit- ted by law; and 2. If coverage provided to the additional in- sured is required by a contract or agree- ment, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds, the following addi- tional exclusions apply: This insurance does not apply to "bodily in- jury" or" property damage" occurring after: 1. All work, including materials, parts or equipment furnished in connection with such work, on the project (other than ser- vice, maintenance or repairs) to be per- formed 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 or- ganization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. CG 20 10 04 13 Insurance Services Office, Inc., 2012 Risk Manwmuent maim 3, REVIEWED & AP{PRov® 8v- Risk Management Amlyst C. With respect to the insurance afforded to these additional insureds, the following is added to Section III - Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the ap- plicable Limits of Insurance shown in the Dec- larations. Page 2 of 2 Insurance Services Office, Inc., 2012 Risk Management I] wim ii REviEwED & APPRovEo 8r- Risk Management Analyst COMMERCIAL GENERAL LIABILITY CG 21 87 01 15 19:1M=101big] :4-.i=1Jil=1011 Kai: /_10rcl*S9:I=8191IrWA»=r_E.'1=1:»_1U11Ke7_1:7=11U4WA CONDITIONAL EXCLUSION OF TERRORISM (RELATING TO DISPOSITION OF FEDERAL TERRORISM RISK INSURANCE ACT) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART RAILROAD PROTECTIVE LIABILITY COVERAGE PART UNDERGROUND STORAGE TANK POLICY A. Applicability Of The Provisions Of This En- dorsement 1. The provisions of this endorsement be- come applicable commencing on the date when any one or more of the fol- lowing first occurs. But if your policy (meaning the policy period in which this endorsement applies) begins after such date, then the provisions of this endorse- ment become applicable on the date your policy begins. a. The federal Terrorism Risk Insur- ance Program ("Program"), estab- lished by the Terrorism Risk Insur- ance Act, has terminated with respect to the type of insurance pro- vided under this Coverage Part or Policy; or b. A renewal, extension or replacement of the Program has become effective without a requirement to make ter- rorism coverage available to you and with revisions that: (1) Increase our statutory percent- age deductible under the Pro- gram for terrorism losses. (That deductible determines the amount of all certified terrorism losses we must pay in a calen- dar year, before the federal gov- ernment shares in subsequent payment of certified terrorism losses.); or (2) Decrease the federal govern- ment's statutory percentage share in potential terrorism losses above such deductible; or CG 21 87 01 15 (3) Redefine terrorism or make in- surance coverage for terrorism subject to provisions or require- ments that differ from those that apply to other types of events or occurrences under this policy. 2. If the provisions of this endorsement be- come applicable, such provisions: a. Supersede any terrorism endorse- ment already endorsed to this policy that addresses "certified acts of ter- rorism" and/or "other acts of terror- ism", but only with respect to an in- cident(s) of terrorism (however defined) which results in injury or damage that occurs on or after the date when the provisions of this en- dorsement become applicable (for claims made policies, such an en- dorsement is superseded only with respect to an incident of terrorism (however defined) that results in a claim for injury or damage first be- ing made on or after the date when the provisions of this endorsement become applicable); and b. Remain applicable unless we notify you of changes in these provisions, in response to federal law. 3. If the provisions of this endorsement do NOT become applicable, any terrorism endorsement already endorsed to this policy, that addresses "certified acts of terrorism" and/or "other acts of terror- ism", will continue in effect unless we notify you of c ment in respons Insurance Services Office, Inc., 2015 Risk MaraWement I] Dim 3, REVIEWED & APPRov® 8v- { Risk N1anagement Analyst B. The following definitions are added and apply under this endorsement wherever the term terrorism, or the phrase any injury or dam- age, are enclosed in quotation marks: 1. "Terrorism" means activities against per- sons, organizations or property of any na- ture: a. That involve the following or preparation for the following: (1) Use or threat of force or vio- lence; or (2) Commission or threat of a dan- gerous act; or (3) Commission or threat of an act that interferes with or disrupts an electronic, communication, information, or mechanical sys- tem; and b. When one or both of the following applies: (1) The effect is to intimidate or co- erce a government or the civilian population or any segment thereof, or to disrupt any seg- ment of the economy; or (2) It appears that the intent is to in- timidate or coerce a govern- ment, or to further political, ideological, religious, social or economic objectives or to ex- press (or express opposition to) a philosophy or ideology. 2. "Any injury or damage" means any in- jury or damage covered under any Cov- erage Part or Policy to which this en- dorsement is applicable, and includes but is not limited to "bodily injury", "prop- erty damage", "personal and advertising injury", "injury" or "environmental dam- age" as may be defined in any applicable Coverage Part or Policy. C. The following exclusion is added: EXCLUSION OF TERRORISM We will not pay for "any injury or damage" caused directly or indirectly by "terrorism", including action in hindering or defending against an actual or expected incident of "ter- rorism". "Any injury or damage" is excluded regardless of any other cause or event that contributes concurrently or in any sequence to such injury or damage. But this exclusion applies only when one or more of the follow- ing are attributed to an incident of "terror- ism": 1. The "terrorism" is carried out by means of the dispersal or application of radioac- tive material, or through the use of a nu- clear weapon or device that involves or produces a nuclear reaction, nuclear radi- ation or radioactive contamination; or 2. Radioactive material is released, and it appears that one purpose of the "terror- ism" was to release such material; or 3. The "terrorism" is carried out by means of the dispersal or application of patho- genic or poisonous biological or chemi- cal materials; or 4. Pathogenic or poisonous biological or chemical materials are released, and it appears that one purpose of the "terror- ism" was to release such materials; or 5. The total of insured damage to all types of property exceeds $25,000,000. In de- termining whether the $25,000,000 threshold is exceeded, we will include all insured damage sustained by property of all persons and entities affected by the "terrorism" and business interruption losses sustained by owners or occupants of the damaged property. For the purpose of this provision, insured damage means damage that is covered by any insurance plus damage that would be covered by any insurance but for the application of any terrorism exclusions; or 6. Fifty or more persons sustain death or se- rious physical injury. For the purposes of this provision, serious physical injury means: a. Physical injury that involves a sub- stantial risk of death; or b. Protracted and obvious physical dis- figurement; or c. Protracted loss of or impairment of the function of a bodily member or organ. Multiple incidents of "terrorism" which occur within a 72-hour period and appear to be car- ried out in concert or to have a related pur- pose or common leadership will be deemed to be one incident, for the purpose of deter- mining whether the thresholds in Paragraphs C.S. or C.6. are exceeded. Page 2 of 3 Insurance Services Office, Inc., 2015 Risk Management I] wim ii REwEwED & APPRov® 8r- Risk Management Analyst With respect to this Exclusion, Paragraphs C.S. and C.6. describe the threshold used to measure the magnitude of an incident of "ter- rorism" and the circumstances in which the threshold will apply, for the purpose of deter- mining whether this Exclusion will apply to that incident. When the Exclusion applies to an incident of "terrorism", there is no cov- erage under this Coverage Part or Policy. The terms and limitations of any terrorism ex- clusion, or the inapplicability or omission of a terrorism exclusion, do not serve to create coverage for injury or damage that is other- wise excluded under this Coverage Part. CG 21 87 01 15 Insurance Services Office, Inc., 2015 Risk Management I] wim ii REVIEWED & APPRovEo Sr. RisK Management Analyst COMMERCIAL GENERAL LIABILITY CG 24 26 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. AMENDMENT OF INSURED CONTRACT DEFINITION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART The definition of "insured contract" in the Defini- Paragraph f. does not include that part of tions section is replaced by the following: any contract or agreement: "Insured contract" means: (1) That indemnifies a railroad for "bod- a. A contract for a lease of premises. How- ily injury" or "property damage" ever, that portion of the contract for a arising out of construction or lease of premises that indemnifies any demolition operations, within 50 feet person or organization for damage by fire of any railroad property and affecting to premises while rented to you or tem- any railroad bridge or trestle, tracks, porarily occupied by you with permission road -beds, tunnel, underpass or of the owner is not an "insured contract''; crossing; b. A sidetrack agreement; (2) That indemnifies an architect, engi- neer or surveyor for injury or dam- c. Any easement or license agreement, ex- cept in connection with construction or demolition operations on or within 50 (a) Preparing, approving, or failing feet of a railroad; to prepare or approve, maps, shop drawings, opinions, re - d. An obligation, as required by ordinance, ports, surveys, field orders, to indemnify a municipality, except in change orders or drawings and connection with work for a municipality; specifications; or e. An elevator maintenance agreement; (b) Giving directions or instructions, f. That part of any other contract or agree- or failing to give them, if that is ment pertaining to your business (includ- the primary cause of the injury ing an indemnification of a municipality or damage; or in connection with work performed for a (3) Under which the insured, if an archi- municipality) under which you assume tect, engineer or surveyor, assumes the tort liability of another party to pay liability for an injury or damage aris- for "bodily injury" or "property damage" ing out of the insured's rendering or to a third person or organization, pro- failure to render professional ser- vided the "bodily injury" or "property vices, including those listed in (2) damage" is caused, in whole or in part, above and supervisory, inspection, by you or by those acting on your behalf. architectural or engineering activi- However, such part of a contract or ties. agreement shall only be considered an "insured contract" to the extent your as- sumption of the tort liability is permitted by law. Tort liability means a liability that would be imposed by law in the absence of any contract or agreement. CG 24 26 04 13 Insurance Services Office, Inc., 2012 Risk Management I] wim ii REVIEWED & APPRovED 8r- Risk Management Analyst COMMERCIAL GENERAL LIABILITY CG 80 61 05 11 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. AMENDMENT OF CANCELLATION PROVISIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART Any term or provision of the Cancellation Conditions of the policy or any endorsement amending or replac- ing such Conditions is amended by the following: A. If we cancel this policy for any reason other than nonpayment of premium, we will notify the person or organization shown in the Schedule below. In no event will the notice to the person or organization scheduled below exceed the notice to the first named insured. B. Our obligation to send notice to the person or organization listed in the Schedule below will terminate at the earlier of the current policy period expiration or when you no longer have a legal or contractual obligation to such person or organization to maintain insurance coverage under a policy which requires that such person or organization be notified in the event of cancellation. SCHEDULE 1. Name: City of Rancho Mirage 2. Address: 69825 Highway 111 RANCHO MIRAGE, CA 92270 3. Number of days advance notice: 30 All other terms and conditions of this policy remain unchanged. 4ti£ Risk Management I] wiva 2011 Liberty Mutual Agency Corporation. All rights reserved. REvIEWED&APPRovEo8r. CG 80 61 05 11 Includes copyrighted material of Insurance Services Office, Inc., with its permissi ea';; v�r --�� Risk Management AnaEyst COMMERCIAL GENERAL LIABILITY CG 80 61 05 11 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. AMENDMENT OF CANCELLATION PROVISIONS This endorsement modifies insurance provided under the following: [off]JiIJiI=1Zia] /_1 Ill =1ZI=1:7_1MI/_1-7141WK919171=101-1w=1111:7_1AI Any term or provision of the Cancellation Conditions of the policy or any endorsement amending or replac- ing such Conditions is amended by the following: A. If we cancel this policy for any reason other than nonpayment of premium, we will notify the person or organization shown in the Schedule below. In no event will the notice to the person or organization scheduled below exceed the notice to the first named insured. B. Our obligation to send notice to the person or organization listed in the Schedule below will terminate at the earlier of the current policy period expiration or when you no longer have a legal or contractual obligation to such person or organization to maintain insurance coverage under a policy which requires that such person or organization be notified in the event of cancellation. SCHEDULE 1. Name: City of Santa Ana 2. Address: 20 Civic Center Plaza SANTA ANA, CA 92701 3. Number of days advance notice: 30 All other terms and conditions of this policy remain unchanged. 4 Risk Mana16 gement I] oiun 2011 Liberty Mutual Agency Corporation. All rights reserved. 3 REviEwEo&APPRov®81" CG 80 61 05 11 Includes copyrighted material of Insurance Services Office, Inc., with its permissi ?: .' P. vim' —�—�—Y Risk Kanagement Analyst COMMERCIAL GENERAL LIABILITY CG 84 99 01 12 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. NON -CUMULATION OF LIABILITY LIMITS (SAME OCCURRENCE) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART a The following is added to Paragraph 5. under Section III - Limits Of Insurance: Non -Cumulation of Liability - Same Occurrence - If one "occurrence" causes "bodily injury" or "property damage" during the policy period and during the policy period of one or more prior, or future, general liability policies issued to you by us, then this policy's Each Occurrence Limit will be reduced by the amount of each payment made by us under the other policies because of such "occurrence." "For purposes of this endorsement, the term "us" also includes any other company that is or was part of the Liberty Mutual Agency Corporation division of Liberty Mutual Group." 2011 Liberty Mutual Insurance. All rights reserved. Risk mwmgementtlii wimt CG 84 99 01 12 Includes copyrighted material of Insurance Services Office, Inc., with its peirmissic REvIEWED & APPRov® 8r- Risk Management AnaEyst COMMERCIAL GENERAL LIABILITY CG 85 15 09 03 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EXCLUSION -PROFESSIONAL SERVICES This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART The following exclusion is added to Paragraph 2., d. Checking or reporting of credit; Exclusions of Section I - Coverage A - Bodily In- e. Maintaining of financial accounts or jury And Property Damage Liability and Section I records; Coverage B - Personal And Advertising Injury Li- f. Tax planning, tax advising or the prep- ability: aration of tax returns; or This insurance does not apply to "bodily injury", "property "personal g• Selling or issuing travelers checks, letters damage", or and advertising of credit, certified checks, bank checks or injury" resulting from the rendering of or the fail- money orders. ure to render any professional services by any in- sured to others. For the purpose of this exclusion, 2. Providing any medical services. professional services include but are not limited 3. Providing any legal services. to: 4. Providing any architectural or engineering 1. Providing expert advice, analysis or planning services. regarding financial matters including: 5. Providing expert advice, analysis or planning a. Acting as a dividend disbursing agent, to others regarding product development or exchange agent, redemption or subscrip- design. tion agent, warrant or scrip agent, fiscal 6. Providing expert advice, analysis or planning or paying agent, tax withholding agent, regarding counseling services such as: escrow agent, clearing agent, or electron- a. Mental health; ic funds transfer agent; b. Lending, or arranging for the lending of, b. Crisis prevention; money, including credit card, debit card, c. Social services; leasing or mortgage operations or activi- d. Drug and alcohol rehabilitation; or ties or interbank transfers; e. Similar subjects. c. Repossessing of real or personal proper- ty from a borrower or acting as an as- signee of the benefit of creditors; REVIEWED & APPRov® 8r- nAlk" Includes copyrighted material of ISO Properties, Inc., with its permis F",,� Z. V CG 85 15 09 03 ISO Properties, Inc., 2003 Risk Management Analyst COMMERCIAL GENERAL LIABILITY CG88100413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. COMMERCIAL GENERAL LIABILITY EXTENSION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART INDEX SUBJECT PAGE NON -OWNED AIRCRAFT 2 NON -OWNED WATERCRAFT 2 PROPERTY DAMAGE LIABILITY -ELEVATORS 2 EXTENDED DAMAGE TO PROPERTY RENTED TO YOU (Tenant's Property Damage) 2 MEDICAL PAYMENTS EXTENSION 3 EXTENSION OF SUPPLEMENTARY PAYMENTS - COVERAGES A AND B " ADDITIONAL INSUREDS -BY CONTRACT, AGREEMENT OR PERMIT 3 PRIMARY AND NON-CONTRIBUTORY- ADDITIONAL INSURED EXTENSION ADDITIONAL INSUREDS - EXTENDED PROTECTION OF YOUR "LIMITS OF INSURANCE" 6 WHO IS AN INSURED - INCIDENTAL MEDICAL ERRORS/MALPRACTICE AND WHO IS AN INSURED - FELLOW EMPLOYEE EXTENSION - MANAGEMENT EMPLOYEES 6 NEWLY FORMED OR ADDITIONALLY ACQUIRED ENTITIES FAILURE TO DISCLOSE HAZARDS AND PRIOR OCCURRENCES 7 N KNOWLEDGE OF OCCURRENCE, OFFENSE, CLAIM OR SUIT 7 LIBERALIZATION CLAUSE 7 BODILY INJURY REDEFINED 7 EXTENDED PROPERTY DAMAGE 8 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US - 8 WHEN REQUIRED IN A CONTRACT OR AGREEMENT WITH YOU a�„ _ 4 Risk Manag�muent Iyiv�un 3, REVIEWED & APPRov® 8v- 2013 Liberty Mutual Insurance o I F" ' P. v Risk Pa Rna[yst CG 88 10 04 13 Includes copyrighted material of Insurance Services Office, Inc., with its permissi `` With respect to coverage afforded by this endorsement, the provisions of the policy apply unless modified by the endorsement. A. NON -OWNED AIRCRAFT Under Paragraph 2. Exclusions of Section I - Coverage A - Bodily Injury And Property Damage Liability, exclusion g. Aircraft, Auto Or Watercraft does not apply to an aircraft provided: 1. It is not owned by any insured; 2. It is hired, chartered or loaned with a trained paid crew; 3. The pilot in command holds a currently effective certificate, issued by the duly constituted authority of the United States of America or Canada, designating her or him a commercial or airline pilot; and 4. It is not being used to carry persons or property for a charge. However, the insurance afforded by this provision does not apply if there is available to the insured other valid and collectible insurance, whether primary, excess (other than insurance written to apply specifically in excess of this policy), contingent or on any other basis, that would also apply to the loss covered under this provision. B. NON -OWNED WATERCRAFT Under Paragraph 2. Exclusions of Section I - Coverage A - Bodily Injury And Property Damage Liability, Subparagraph (2) of exclusion g. Aircraft, Auto Or Watercraft is replaced by the following: This exclusion does not apply to: (2) A watercraft you do not own that is: (a) Less than 52 feet long; and (b) Not being used to carry persons or property for a charge. C. PROPERTY DAMAGE LIABILITY -ELEVATORS 1. Under Paragraph 2. Exclusions of Section I - Coverage A - Bodily Injury And Property Damage Liabil- ity, Subparagraphs (3), (4) and (6) of exclusion j. Damage To Property do not apply if such "property damage" results from the use of elevators. For the purpose of this provision, elevators do not include vehicle lifts. Vehicle lifts are lifts or hoists used in automobile service or repair operations. 2. The following is added to Section IV - Commercial General Liability Conditions, Condition 4. Other Insurance, Paragraph b. Excess Insurance: The insurance afforded by this provision of this endorsement is excess over any property insurance, whether primary, excess, contingent or on any other basis. D. EXTENDED DAMAGE TO PROPERTY RENTED TO YOU (Tenant's Property Damage) If Damage To Premises Rented To You is not otherwise excluded from this Coverage Part: 1. Under Paragraph 2. Exclusions of Section I - Coverage A - Bodily Injury and Property Damage Liability: a. The fourth from the last paragraph of exclusion j. Damage To Property is replaced by the follow- ing: Paragraphs (1), (3) and (4) of this exclusion do not apply to "property damage" (other than damage by fire, lightning, explosion, smoke, or leakage from an automatic fire protection system) to: (i) Premises rented to you for a period of 7 or fewer consecutive days; or (ii) Contents that you rent or lease as part of a premises rental or lease agreement for a period of more than 7 days. Paragraphs (1), (3) and (4) of this exclusion do not apply to "property damage" to contents of premises rented to you for a period of 7 or fewer consecutive days. A separate limit of insurance applies to this coverage as described Insurance. 2013 Liberty Mutual Insurance CG 88 10 04 13 Includes copyrighted material of Insurance Services Office, Inc., with its perm �, . £ Risk Mwwgement DhWiun P i REviEWED & APPRovED 8r- i Risk r0anagement Analyst b. The last paragraph of subsection 2. Exclusions is replaced by the following: Exclusions c. through n. do not apply to damage by fire, lightning, explosion, smoke or leakage from automatic fire protection systems to premises while rented to you or temporarily occupied by you with permission of the owner. A separate limit of insurance applies to Damage To Premises Rented To You as described in Section III - Limits Of Insurance. 2. Paragraph 6. under Section III - Limits Of Insurance is replaced by the following: 6. Subject to Paragraph 5. above, the Damage To Premises Rented To You Limit is the most we will pay under Coverage A for damages because of "property damage" to: a. Any one premise: (1) While rented to you; or (2) While rented to you or temporarily occupied by you with permission of the owner for damage by fire, lightning, explosion, smoke or leakage from automatic protection sys- tems; or b. Contents that you rent or lease as part of a premises rental or lease agreement. 3. As regards coverage provided by this provision D. EXTENDED DAMAGE TO PROPERTY RENTED TO YOU (Tenant's Property Damage) - Paragraph 9.a. of Definitions is replaced with the following: 9.a. A contract for a lease of premises. However, that portion of the contract for a lease of premises that indemnifies any person or organization for damage by fire, lightning, explosion, smoke, or leakage from automatic fire protection systems to premises while rented to you or temporarily occupied by you with the permission of the owner, or for damage to contents of such premises that are included in your premises rental or lease agreement, is not an "insured contract". E. MEDICAL PAYMENTS EXTENSION N If Coverage C Medical Payments is not otherwise excluded, the Medical Payments provided by this policy are amended as follows: Under Paragraph 1. Insuring Agreement of Section I - Coverage C - Medical Payments, Subparagraph (b) of Paragraph a. is replaced by the following: (b) The expenses are incurred and reported within three years of the date of the accident; and F. EXTENSION OF SUPPLEMENTARY PAYMENTS - COVERAGES A AND B 1. Under Supplementary Payments - Coverages A and B, Paragraph 1.b. is replaced by the following: b. Up to $3,000 for cost of bail bonds required because of accidents or traffic law violations arising out of the use of any vehicle to which the Bodily Injury Liability Coverage applies. We do not have to furnish these bonds. 2. Paragraph 1.d. is replaced by the following: d. All reasonable expenses incurred by the insured at our request to assist us in the investigation or defense of the claim or "suit", including actual loss of earnings up to $500 a day because of time off from work. G. ADDITIONAL INSUREDS -BY CONTRACT, AGREEMENT OR PERMIT 1. Paragraph 2. under Section II - Who Is An Insured is amended to include as an insured any person or organization whom you have agreed to add as an additional insured in a written contract, written agreement or permit. Such person or organization is an additional insured but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused in whole or in part by: a. Your acts or omissions, or the acts or omissions of those acting on your behalf, in the performance of your on going operations for the additional insured that are the subject of the written contract or written agreement provided that the "bodily injury" or "property damage" occurs, or the "per- sonal and advertising injury" is committed, subsequent to the signing written agreement; or 2013 Liberty Mutual Insurance CG 88 10 04 13 Includes copyrighted material of Insurance Services Office, Inc., with its perm £ Risk Mwmgement I]i Wi m P i REvrEWED & APPRovED 8r. Risk r0anagement Analyst b. Premises or facilities rented by you or used by you; or c. The maintenance, operation or use by you of equipment rented or leased to you by such person or organization; or d. Operations performed by you or on your behalf for which the state or political subdivision has issued a permit subject to the following additional provisions: (1) This insurance does not apply to "bodily injury", "property damage", or "personal and ad- vertising injury" arising out of the operations performed for the state or political subdivision; (2) This insurance does not apply to "bodily injury" or "property damage" included within the "completed operations hazard". (3) Insurance applies to premises you own, rent, or control but only with respect to the following hazards: (a) The existence, maintenance, repair, construction, erection, or removal of advertising signs, awnings, canopies, cellar entrances, coal holes, driveways, manholes, marquees, hoist away openings, sidewalk vaults, street banners, or decorations and similar expo- sures; or (b) The construction, erection, or removal of elevators; or (c) The ownership, maintenance, or use of any elevators covered by this insurance. However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insur- ance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. With respect to Paragraph 1.a. above, a person's or organization's status as an additional insured under this endorsement ends when: (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. With respect to Paragraph 1.b. above, a person's or organization's status as an additional insured under this endorsement ends when their written contract or written agreement with you for such premises or facilities ends. With respects to Paragraph 1.c. above, this insurance does not apply to any "occurrence" which takes place after the equipment rental or lease agreement has expired or you have returned such equipment to the lessor. The insurance provided by this endorsement applies only if the written contract or written agreement is signed prior to the "bodily injury" or "property damage". We have no duty to defend an additional insured under this endorsement until we receive written notice of a "suit" by the additional insured as required in Paragraph b. of Condition 2. Duties In the Event Of Occurrence, Offense, Claim Or Suit under Section IV - Commercial General Liability Condi- tions. I Risk Manwemuent Iyhw= REVIEWED & APPRovED $v' 2013 Liberty Mutual Insurance o h F" ' P. v CG 88 10 04 13 Includes copyrighted material of Insurance Services Office, Inc., with its permissi `` Risk KIanagement Ama[yst 2. With respect to the insurance provided by this endorsement, the following are added to Paragraph 2. Exclusions under Section I - Coverage A - Bodily Injury And Property Damage Liability: This insurance does not apply to: a. "Bodily injury" or "property damage" arising from the sole negligence of the additional insured. b. "Bodily injury" or "property damage" that occurs prior to you commencing operations at the location where such "bodily injury" or "property damage" occurs. c. "Bodily injury", "property damage" or "personal and advertising injury" arising out of the render- ing of, or the failure to render, any professional architectural, engineering or surveying services, including: (1) The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or (2) Supervisory, inspection, architectural or engineering activities. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by that insured, if the "occur- rence" which caused the "bodily injury" or "property damage", or the offense which caused the "personal and advertising injury", involved the rendering of, or the failure to render, any professional architectural, engineering or surveying services. d. "Bodily injury" or "property damage" occurring 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. e. Any person or organization specifically designated as an additional insured for ongoing operations by a separate ADDITIONAL INSURED -OWNERS, LESSEES OR CONTRACTORS endorsement is- sued by us and made a part of this policy. 3. With respect to the insurance afforded to these additional insureds, the following is added to Section III - Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: a. Required by the contract or agreement; or b. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declaratio ns. H. PRIMARY AND NON-CONTRIBUTORY ADDITIONAL INSURED EXTENSION This provision applies to any person or organization who qualifies as an additional insured under any form or endorsement under this policy. Condition 4. Other Insurance of SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS is amend- ed as follows: a. The following is added to Paragraph a. Primary Insurance: If an additional insured's policy has an Other Insurance provision making its policy excess, and you have agreed in a written contract or written agreement to provide the additional insured coverage on a primary and noncontributory basis, this policy shall be primary and we will not seek contribution from the additional insured's policy for damages we cover. to Management stun REvrEWED & APPRovED 8r- 2013 Liberty Mutual Insurance CG 88 10 04 13 Includes copyrighted material of Insurance Services Office, Inc., with its permissi `` Risk r0anagement Analyst b. The following is added to Paragraph b. Excess Insurance: When a written contract or written agreement, other than a premises lease, facilities rental contract or agreement, an equipment rental or lease contract or agreement, or permit issued by a state or political subdivision between you and an additional insured does not require this insurance to be primary or primary and non-contributory, this insurance is excess over any other insurance for which the addi- tional insured is designated as a Named Insured. Regardless of the written agreement between you and an additional insured, this insurance is excess over any other insurance whether primary, excess, contingent or on any other basis for which the additional insured has been added as an additional insured on other policies. I. ADDITIONAL INSUREDS - EXTENDED PROTECTION OF YOUR "LIMITS OF INSURANCE" This provision applies to any person or organization who qualifies as an additional insured under any form or endorsement under this policy. 1. The following is added to Condition 2. Duties In The Event Of Occurrence, Offense, Claim or Suit: An additional insured under this endorsement will as soon as practicable: a. Give written notice of an "occurrence" or an offense that may result in a claim or "suit" under this insurance to us; b. Tender the defense and indemnity of any claim or "suit" to all insurers whom also have insurance available to the additional insured; and c. Agree to make available any other insurance which the additional insured has for a loss we cover under this Coverage Part. d. We have no duty to defend or indemnify an additional insured under this endorsement until we receive written notice of a "suit" by the additional insured. 2. The limits of insurance applicable to the additional insured are those specified in a written contract or written agreement or the limits of insurance as stated in the Declarations of this policy and defined in Section III - Limits of Insurance of this policy, whichever are less. These limits are inclusive of and not in addition to the limits of insurance available under this policy. J. WHO IS AN INSURED - INCIDENTAL MEDICAL ERRORS / MALPRACTICE WHO IS AN INSURED - FELLOW EMPLOYEE EXTENSION - MANAGEMENT EMPLOYEES Paragraph 2.a.(1) of Section II -Who Is An Insured is replaced with the following: (1) "Bodily injury" or "personal and advertising injury": (a) To you, to your partners or members (if you are a partnership or joint venture), to your members (if you are a limited liability company), to a co -"employee" while in the course of his or her employ- ment or performing duties related to the conduct of your business, or to your other "volunteer workers" while performing duties related to the conduct of your business; (b) To the spouse, child, parent, brother or sister of that co -"employee" or "volunteer worker" as a consequence of Paragraph (1) (a) above; (c) For which there is any obligation to share damages with or repay someone else who must pay damages because of the injury described in Paragraphs (1) (a) or (b) above; or (d) Arising out of his or her providing or failing to provide professional health care services. However, if you are not in the business of providing professional health care services or providing profes- sional health care personnel to others, or if coverage for providing professional health care ser- vices is not otherwise excluded by separate endorsement, this provision (Paragraph (d)) does not apply. Paragraphs (a) and (b) above do not apply to "bodily injury" or "personal and advertising injury" caused by an "employee" who is acting in a supervisory capacity for you. Supervisory capacity as used herein means the "employee's" job responsibilities assigned by you, includes the direct superv' - ees" of yours. However, none of these "employees" are insureds for "bodily ir Risk mwmgm�mt i= • REvrEWED & APPRovED 8r- 2013 Liberty Mutual Insurance CG 88 10 04 13 Includes copyrighted material of Insurance Services Office, Inc., with its permissk Risk r0anagement Analyst advertising injury" arising out of their willful conduct, which is defined as the purposeful or willful intent to cause "bodily injury" or "personal and advertising injury", or caused in whole or in part by their intoxica- tion by liquor or controlled substances. The coverage provided by provision J. is excess over any other valid and collectable insurance available to your "employee". K. NEWLY FORMED OR ADDITIONALLY ACQUIRED ENTITIES Paragraph 3. of Section II -Who Is An Insured is replaced by the following: 3. Any organization you newly acquire or form and over which you maintain ownership or majority interest, will qualify as a Named Insured if there is no other similar insurance available to that organization. However: a. Coverage under this provision is afforded only until the expiration of the policy period in which the entity was acquired or formed by you; b. Coverage A does not apply to "bodily injury" or "property damage" that occurred before you a acquired or formed the organization; and C. Coverage B does not apply to "personal and advertising injury" arising out of an offense committed before you acquired or formed the organization. d. Records and descriptions of operations must be maintained by the first Named Insured. No person or organization is an insured with respect to the conduct of any current or past partnership, joint venture or limited liability company that is not shown as a Named Insured in the Declarations or qualifies as an insured under this provision. L. FAILURE TO DISCLOSE HAZARDS AND PRIOR OCCURRENCES Under Section IV - Commercial General Liability Conditions, the following is added to Condition 6. Repre- sentations: Your failure to disclose all hazards or prior 'occurrences" existing as of the inception date of the policy shall not prejudice the coverage afforded by this policy provided such failure to disclose all hazards or prior 'occurrences" is not intentional. M. KNOWLEDGE OF OCCURRENCE, OFFENSE, CLAIM OR SUIT Under Section IV - Commercial General Liability Conditions, the following is added to Condition 2. Duties In The Event of Occurrence, Offense, Claim Or Suit: Knowledge of an 'occurrence", offense, claim or "suit' by an agent, servant or "employee" of any insured shall not in itself constitute knowledge of the insured unless an insured listed under Paragraph 1. of Section II - Who Is An Insured or a person who has been designated by them to receive reports of "occurrences", offenses, claims or "suits" shall have received such notice from the agent, servant or "employee". N. LIBERALIZATION CLAUSE If we revise this Commercial General Liability Extension Endorsement to provide more coverage without additional premium charge, your policy will automatically provide the coverage as of the day the revision is effective in your state. O. BODILY INJURY REDEFINED Under Section V - Definitions, Definition 3. is replaced by the following: 3. "Bodily Injury" means physical injury, sickness or disease sustained by a person. This includes mental anguish, mental injury, shock, fright or death that results from such physical injury, sick- ness or disease. I „REVIEWED & APPRov® 8v- 2013Liberty Mutual Insurance "F" ' P. v CG 88 10 04 13 Includes copyrighted material of Insurance Services Office, Inc., with its permissi `` Risk N1anagement Ama[yst P. EXTENDED PROPERTY DAMAGE Exclusion a. of COVERAGE A. BODILY INJURY AND PROPERTY DAMAGE LIABILITY is replaced by the following: a. Expected Or Intended Injury "Bodily injury" or "property damage" expected or intended from the standpoint of the insured. This exclusion does not apply to "bodily injury" or "property damage" resulting from the use of reasonable force to protect persons or property. Q. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US - WHEN REQUIRED IN A CONTRACT OR AGREEMENT WITH YOU Under Section IV - Commercial General Liability Conditions, the following is added to Condition 8. Trans- fer Of Rights Of Recovery Against Others To Us: We waive any right of recovery we may have against a person or organization because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the "products -completed operations hazard" provided: 1. You and that person or organization have agreed in writing in a contract or agreement that you waive such rights against that person or organization; and 2. The injury or damage occurs subsequent to the execution of the written contract or written agree- ment. I „REVIEWED & APPRL3V® 8v- 2013Liberty Mutual Insurance "F" ' P. v CG 88 10 04 13 Includes copyrighted material of Insurance Services Office, Inc., with its permissi `` Risk KIanagement Ama[yst COMMERCIAL GENERAL LIABILITY CG 89 01 12 08 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. HIRED AUTO AND NON -OWNED AUTO LIABILITY This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART Coverage 13 A. Hired Auto Liability 13 B. Non -Ownership Liability A. Insurance is provided only for those coverages when an "X" is shown in the Declarations or in the Schedule. 1. Hired Auto Liability The insurance provided under Section I - Coverage A - Bodily Injury And Property Damage Liabil- ity, applies to "bodily injury" or "property damage" arising out of the maintenance or use of a "hired auto" by you or your "employees" in the course of your business. 2. Non -Owned Auto Liability The insurance provided under Section I - Coverage A - Bodily Injury And Property Damage Liabil- ity, applies to "bodily injury" or "property damage" arising out of the use of any "non -owned auto" in your business by any person. B. For insurance provided by this endorsement only: 1. The exclusions, under Paragraph 2. Exclusion of Section 1 - Coverage A - Bodily Injury and Prop- erty Damage Liability, other than exclusions a., b., d., f., and i. and the Nuclear Energy Liability Exclusion, are deleted and replaced by the following: a. "Bodily injury" to: (1) An "employee" of the insured arising out of and in the course of: (a) Employment by the insured; or (b) Performing duties related to the conduct of the insured's business; or (2) The spouse, child, parent, brother or sister of that "employee" as a consequence of Para- graph (1) above. This exclusion applies: (1) Whether the insured may be liable as an employer or in any other capacity; and (2) To any obligation to share damages with or repay someone else who must pay the dam- ages because of the injury. This exclusion does not apply to: (1) Liability assumed by the insured under an "insured contract'; or (2) "Bodily Injury" arising out of and in the course of domestic employment by the insured unless benefits for such injury are in whole or in part either payable or required to be provided under any workers compensation law. b. "Property damage" to: Includes copyrighted material of Insurance Services Office, Inc., CG 89 01 12 08 with its permission. Risk Manwmuent moiun 3, REVIEWED & APPRov® 8v- { Risk Management An.ifyst (1) Property owned or being transported by, or rented or loaned to the insured; or (2) Property in the care, custody or control of the insured. 2. Section II, Who Is An Insured, is replaced by the following: 1. Each of the following is an insured under this endorsement to the extent set forth below: a. You; b. Any other person using a "hired auto" with your permission; c. For a "non -owned auto": (1) any partner or "executive officer" of yours; or (2) any "employee" of yours but only while such "non -owned auto" is being used in your business; and d. Any other person or organization, but only for their liability because of acts or omissions of an insured under a., b. or c. above. 2. None of the following is an insured: a. Any person engaged in the business of his or her employer for "bodily injury" to any co -"employee" of such person injured in the course of employment, or to the spouse, child, parent, brother or sister of that co -"employee" as a consequence of such "bodily injury", or for any obligation to share damages with or repay someone else who must pay damages because of the injury. b. Any partner or "executive officer" for any "auto" owned by such partner or officer or a member of his or her household; c. Any person while employed in or otherwise engaged in duties in connection with an "auto business", other than an "auto business" you operate; d. The owner or lessee (of whom you are a sublessee) of a "hired auto" or the owner of a "non -owned auto" or any agent or "employee" of any such owner or lessee; e. Any person or organization for the conduct of any current or past partnership or joint venture that is not shown as a Named Insured in the Declarations. C. Section III - Limits of Insurance, Paragraph 2., The General Aggregate Limit, does not apply. D. The following additional definitions apply: 1. "Business" means the business or occupation of selling, repairing, servicing, storing or parking "autos". 2. "Hired Auto" means any "auto" you lease, hire, rent or borrow. This does not include any "auto" you lease, hire, rent or borrow from any of your "employees", your partners or you "executive Officers" or members of their households. 3. "Non -Owned Auto" means any "auto" you do not own, lease, hire, rent or borrow which is used in connection with your business. This includes "autos" owned by your "employees", your partners or "executive officers", or members of their households, but only while used in your business or your personal affairs. Includes copyrighted material of Insurance Services Office, Inc., CG 89 01 12 08 with its permission. Risk Manwmuent Moiun 3, REVIEWED & APPRov® 8v- { Risk Management An.ifyst COMMON POLICY CONDITIONS ENDORSEMENT This endorsement changes the Policy. Please read it carefully. In consideration of the premium charged, and notwithstanding anything contained in this policy to the contrary, it is hereby agreed that all coverage parts included in this policy are subject to the following conditions: A. CANCELLATION The named insured may cancel this policy by mailing to the Company written notice stating when thereafter such cancellation shall become effective. The Company may cancel this policy by mailing to the named insured, at the mailing address specified the Declarations, written notice stating when not less than thirty (30) days thereafter such cancellation shall become effective, except in the event of the named insured's nonpayment of premium, not less than ten (10) days advance notice of cancellation shall be given. The mailing of notice as aforesaid, shall be sufficient proof of either party's intent to cancel. The effective date of cancellation specified in such notice shall terminate this policy period. Delivery of such notice shall be equivalent to mailing. If the named insured cancels, the earned premium shall be computed in accordance with the customary short rate table. If the Company cancels, the earned premium shall be computed pro rata. The Company will tender any return premium subject to retaining a minimum earned premium equal to 25% of the amount specified in the Declarations. Premium adjustment may be made either at the time cancellation is effective or as soon as practicable thereafter, but tender of the unearned premium or return of this policy, shall not be conditions precedent to cancellation hereunder. A SSurlLLc3*: No provision of this policy may be amended, waived or otherwise changed, except by endorsement hereto. C. EXAMINATION OF YOUR BOOKS AND RECORDS We may examine and audit your books and records as they relate to this policy at any time during the policy period and up to three (3) years afterward. D. INSPECTIONS AND SURVEYS We have the right, but are not obliged to: 1. Make inspections and surveys at any time; and PGI EL 036 0210 P. n[?EVIE= &�yAP{PRo�vm Ry:: �10111 r i�CvFe h. V+4�Fi✓1fhL - _�— - Rok P.3.ir�.�yesrfer�l H�i.rlyst 2. Give you reports on the conditions we find; and 3. Recommend changes. Any inspections, surveys, reports or recommendations relate only to insurability and the premiums to be charged. We do not make safety inspections. We do not undertake to perform the duty of any person or organization to provide for the health or safety of workers or the public. We do not warrant that conditions: 1. Are safe or healthful; or 2. Comply with laws, regulations, codes or standards. This condition applies not only to us, but also to any rating, advisory, rate service, engineering firm or similar organization which makes insurance inspections, surveys, reports or recommendations. E. NAMED INSURED A5 AGENT The named insured specified in the Declarations shall be deemed agent of each insured with respect to all matters involving this policy, however, the Company shall have the right to seek indemnification from any insured or any other person who may be legally Iiable for the debts of the named insured. F. PREMIUMS The first Named Insured shown in the Declarations: 1. Is responsible for the payment of all premiums; and 2. Will be the payee for any return premiums we pay; and 3. Is responsible for the payment of all deductibles and self -insured retention amounts under this policy. G. ADDITIONAL PREMIUMS If, during this policy period, an increase in the risk or hazards covered hereunder occurs, the Company shall have the right to charge the appropriate additional premium. H. TRANSFER OF YOUR RIGHTS AND DUTIES UNDER THIS POLICY Your rights and duties under this policy may not be transferred without our written consent except in the case of death of an individual Named Insured. If you die, your rights and duties will be transferred to your legal representative but only while acting within the scope of duties as your legal representative. Until your legal representative is appointed, anyone having proper temporary custody of your property will have your rights and duties but only with respect to that property. PGI EL 036 0210 Risk Maugament oision �_ REvIEwm & ArPRo= By. 1 F')*� Z Vib'W'1 kukt-1AF1,Igt!T ReIitAri pt BANKRUPTCY Bankruptcy or insolvency of the insured or of the insured's estate will not relieve us of our obligations under this Coverage Part. PGI EL 036 0210 Risk MaA� DivisLm Reno � AP�v� 9•fi: F44""L-z Z VXxU u. Risk Management Flnalys! POLICY NUMBER: EMP19001661-01 ADDITIONAL INSURED ENDORSEMENT This endorsement changes the Policy. Please read it carefully. This endorsement modifies insurance provided under the fallowing: CONTRACTORS POLLUTION LIABILITY COVERAGE Name of Person or Organization: Any person(s) or organization(s) whom the Named Insured agrees, in a written contract, to name as an additional insured. However, this status exists only for the project specified in that contract. The {person or organization shown in this Schedule is included as an insured, but only with respect to that person's or organization's liability arising out of COVERED OPERATIONS performed for that insured. PGI EL 018 0210 g. RL4c T aRenEWED & APPRov® 8 r: ��� Risk Managemen! IUzatysi Policy Number: PGIARK05448-02 PRIMARY AND NON-CONTRIBUTORY ENDORSEMENT This endorsement changes the Policy. Please read it carefully. SCHEDULE Name of Person or Organization: Any person(s) or organization(s) whom the Named Insured agrees, in a written contract, to provide Primary and/or Non-contributory status of this insurance. However, this status exists only for the project specified in that contract. In consideration of the premium charged, it is hereby agreed that this policy shall be considered primary to any similar insurance held by third parties in respect to work performed by you under any written contractual agreement with such third party. It is further agreed that any other insurance which the person(s) or organization(s) named in the schedule may have is excess and non-contributory to this insurance. PG1 EL 020 0210 IF R eren� 8 an �-" �� Ruk70anagcnimt Auiatyst POLICY: EMP19001661-01 WAIVER OF SUBROGATION ENDORSEMENT This endorsement changes the Policy. Please read it carefully. This endorsement modifies insurance provided under the following: PROFESSIONAL LIABILITY COVERAGE CONTRACTORS POLLUTION LIABILITY COVERAGE SCHEDULE Name of Person or Organization. Any person(s) or organizations) to whom the Named Insured agrees, in a written contract, to provide a waiver of subrogation. However, this status exists only for the project specified in that contract. The Company waives any right of recovery it may have against the person or organization shown in the above Schedule because of payments the Company makes for injury or damage arising out of the insured's work done under a contract with that person or organization. The waiver applies only to the person or organization in the above Schedule. Under no circumstances shall this endorsement act to extend the policy period, change the scope of coverage or increase the Aggregate Limits of Insurance shown in the Declarations. PGI EL 019 0210 x�k Man�gen�ne o�sion REVIEWED & Appw= By. fey � F,)* Z Vib'W'd ilukF:i.jr�.iyerree��lA��.tiGysl TRANSPORTATION OF CARGO —POLLUTION ENDORSEMENT This endorsement, effective attaches to and forms a part of the Policy. This endorsement changes the Policy. Please read it carefully. This endorsement modifies insurance provided under the following: CONTRACTORS POLLUTION LIABILITY COVERAGE. In consideration of an additional premium in the amount of $INCLUDED it is hereby agreed that Exclusion H. is deleted and replaced with the following: A CLAIM related to POLLUTION CONDITIONS which result from the use, ownership, operation, maintenance or entrustment to others of any AUTO, aircraft, watercraft or rolling stock or operated by, or leased, rented or loaned to any Insured. The exclusion shall not apply to POLLUTION CONDITIONS which: i) resulting from the release from a COVERED AUTO and emanating from the TRANSPORTED CARGO. iij occur during loading or unloading operations or; iii) commence during the transportation of YOUR PRODUCT or wastes by a CARRIER; and ivj result in BODILY INJURY, PROPERTY DAMAGE, or CLEANUP COSTS during the transportation of YOUR PRODUCT or wastes; and A commence on or after the inception of this policy_ No coverage is provided for the WRONGFUL DELIVERY of any liquid product by AUTO, aircraft, watercraft or rolling stock. The following definitions are added to this policy: II. DEFINITIONS A. COVERED AUTO means the following provided they are indicated with an "X". Specifically described AUTO listed below in the Schedule of AUTO. X Owned AUTO only. Only those AUTOS the INSURED owns (and any trailers the INSURED does not own while connected to a power unit the INSURED owns). This includes those AUTOS the INSURED acquires ownership of after the policy begins. PGI €L 010 1017 Risk MRnWmicrdDhi6m RwEwEu &�APPR♦♦o��v/�Eo 8ryA: TWOMM —��� Risk1'vlanagementAna1y5t 7[ Hired AUTO only. Only those AUTOS the INSURED leases, hires, rents or borrows. This does not include any private passenger type AUTO the INSURED leases, hires, rents or borrows from the INSURED, any of its employees, partners or agents. X Non -owned AUTO only. Only those AUTOS the INSURED dries not own lease, hire, rent or borrow that are used in connection with the INSURED(S) business. This includes AUTOS owned by employees or partners or members of their households but only while used in the INSURED(S) business, B. CARGO means goods, products or wastes carried for delivery on or within a COVERED AUTOM that is properly licensed to transport such goods, products or wastes. C. CARRIER means a person or entity, other than the INSURED or any subsidiary or affiliated company of the INSURED, engaged in the business of transporting property for hire by AUTO, rolling stock, aircraft or watercraft. D. TRANSPORTED CARGO means CARGO after it is moved from the place where it is accepted for movement into or on to the COVERED AUTO, until the CARGO is moved from the COVERED AUTO to the place where it is finally delivered. TRANSPORTED CARGO also includes CARGO during the loading and unloading to or from a COVERED AUTO, provided that the loading or unloading is performed by the INSURED. TRANSPORTED CARGO} does not include CARGO at rest for a period of longer than seventy-two (72) hours, after it has been accepted for movement into or onto a COVERED AUTO but before it reaches the place of final delivery. E. WRONGFUL DELIVERY means the delivery of any CARGO into the wrong receptacle or to the wrong address, or the delivery of one type of CARGO in error for another. SCHEDULE OF AUTOS FGI €L 010 1017 Risk ManWn,�d Dim REvi o & APpwv® &f.' Risk Managemem Anaipst PDLICTMLDeR COPY PO BOX 8192. PL.EASANTON, CA 94588 CERTIFICATE OF WORKERS` COMPENSATION INSURANCE ISSUE DATE: 10-01-2010 CITY 0P SANTA ANA SP 20 CIVIC CEINTER PL2 SANTA ANA CA 92701-40M GROUP: POLICY fUkMER 1397886-2020 CER11FCATE ID: 117 CERTIFICATE EXPOES 10-01-2021 10-01-2020/10-01-2021 This is to cartrly taws we have "-4W a valid Workers' COsrpops;rlron r.surar,.Ce policy n i form approved by the Cahtomia trFrra a Cormmissuonor to the emploYer maimed below for the Policy period Indicated, Th.; policy is not suopect to canced3aticr by ttse Fund except txR on 30 dais advance written notice is &a arrplayer. We will also give you 3p days advance niotice should this pcbcv be carceaed Prior to roe normal ■xt)iralium This certificate at insurance is not an mgurance policy and does rpt arra.rr4, extend or alter, the Ca,,eerage attorded by the ,policy listed herein. Notwithrmclweg any reQJrenrlerrt, term or condition of aria contract Or other docvrnent wish resdpect to wvch tMp cartiticate of ".ranee may be Isaue+l or to wnrh it may porlarn, the rxurarCe atforcled by the policy /ddeejterlbed heree Is 5Jo}ecl to all " ter", eveluvort, and conditions. of such pol" Authorrapd Ripproventative Fres+d" and CEO EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: $1,000,000 PER OCCURRENCE - ENDORSEMENT` #2Oe5 ENTITLED CERTIFICATE HOLDERS' NDTICE EFFECTIVE 10 01 2003 IS ATTACHED TO AND FDRM.S A PART OF TF42S POLICY. ENDORSEMeNT 018111 - WILLIAM O'TDGLE, PRESIDENT - CXCLtAED. "WUR5EMENT 01851 - TREVOR BLYTHE. S - EXCLUDED. EMPLOYER ECAL/N MICS, INC ECOMCNICS, INC. SP PO gDx 9100 DEL MAR CA 92014 TCk.' 7Crtl 104 ' 0 P"1471 O : 09 -17 _ 202C nAk' Risk Ma}tsg23 ent Drsiun.REVIEwEr] & APPROVED BY: .rsrr�.c.-.A.t Y �� Risk KTimatgement Am ilyst