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HomeMy WebLinkAboutPOLLY'S PIES, INC.INSURANCE ON FILE N-2024-157 WORK MAY PROCEED UNTIL INSURANCE EXPIRES -7 11 1 2oz�4 CITY CLERK DATE: MAY 0 31024 D•. PIZCSA(A) PARTNERSHIP AGREEMENT WITH POLLY'S PIES, INC., (C. L Ar )We FOR TITLE LEVEL PARTNERSHIP THIS PARTNERSHIP AGREEMENT ("Agreement") is made and entered into this 15th day of April 2024 by and between Polly's Pies, Inc., a California corporation ("Partner"), and the City of Santa Ana, a charter city and municipal corporation organized and existing under the Constitution and laws of the State of California ("City"). RECITALS A. The City is producing its Me Encanta Santa Ana event on Saturday, April 20, 2024, and desires to retain partners for such City event. B. Partner represents that it is able and willing to enter into a partnership for City event(s). C. In undertaking the performance of this Agreement, Partner represents that it is knowledgeable in its field and that any activities conducted by Partner under this Agreement will be performed in compliance with such standards as may reasonably be expected from a professional firm in such field. NOW THEREFORE, in consideration of the mutual and respective promises, and subject to the terms and conditions hereinafter set forth, the parties agree as follows: 1. PARTNER BENEFITS In exchange for the consideration specified in Section 3 below, Partner shall be entitled to the benefits at the City event(s) as described in Exhibit A ("Event(s)"), attached hereto and incorporated by reference. Partner grants to City the right to use Partner's trademark(s), trade name(s), logo designs and company descriptions ("Marks") as prepared and delivered to City by Partner in any medium of advertising, marketing materials, and/or promotional goods distributed in conjunction with the Event(s) and in accordance with Partner's usage guidelines. The manner and display of Partner's Marks must be specifically approved in writing and in advance by an authorized representative of Partner. 2. CITY RESPONSIBILITIES In exchange for the benefits specified in Section I above and for the consideration specified in Section 3 below, City shall be obligated to provide and perform the responsibilities as described in Exhibit A. 3. PARTNERSHIP CONSIDERATION For its participation as a Partner for the Event(s), Partner shall provide to the City in -kind contributions valued at Eleven Thousand, Three Hundred Dollars and Zero Cents ($11,300) as further described in Exhibit A. Partner shall not be entitled to the partnership benefits under this Page 1 of 9 Agreement, or to otherwise participate in the Event(s), if Partner fails to provide the in -kind contributions described in Exhibit A. 4. TERM This Agreement shall commence on April 20, 2024 and terminate on December 31, 2024, unless terminated as otherwise provided in this Agreement. 5. INDEPENDENT CONTRACTOR Partner shall, during the entire tern of this Agreement, be construed to be an independent contractor and not an employee of the City. This Agreement is not intended nor shall it be construed to create an employer -employee relationship, a joint venture relationship, or to allow the City to exercise discretion or control over the professional manner in which Partner performs the services which are the subject matter of this Agreement; however, the services to be provided by Partner shall be provided in a manner consistent with all applicable standards and regulations governing such services. Partner shall pay all salaries and wages, employer's social security taxes, unemployment insurance and similar taxes relating to employees and shall be responsible for all applicable withholding taxes. 6. INSURANCE Partner shall procure and maintain for the duration of the Agreement and shall require any subcontractors to obtain and maintain the following insurance coverage: a. Minimum Scope and Limit of Insurance (1) Commercial General Liability (CGL). Insurance Services Office ("ISO") Form CG 00 01 covering CGL on an "occurrence" basis, including products and completed operations, property damage, bodily injury and personal & advertising injury with limits no less than $1,000,000 per occurrence and $2,000,000 aggregate. Required policy limits can be met with primary and umbrella/excess insurance policies. (2) Automobile Liability (AL). ISO Form CA 00 01 covering Code 1 (any auto), with limits no less than $1,000,000 per accident for bodily injury and property damage. In the event Partner does not maintain commercial automobile liability insurance, City will accept evidence of personal automobile insurance as compliance with this requirement. (3) Workers' Compensation. As required by the State of California, with Statutory Limits, and Employer's Liability Insurance with limit of no less than $1,000,000 per accident for bodily injury or disease. Coverage is not required if Partner has no employees and signs request to waive. Page 2 of 9 (4) Broader Coverage. If the Partner maintains broader coverage and/or higher limits than the minimums shown above, the City requires and shall be entitled to the broader coverage and/or the higher limits maintained by the Partner. Any available insurance proceeds in excess of the specified minimum limits of insurance and coverage shall be available to the City. b. Other Insurance Provisions The above required insurance policies are to contain or be endorsed to contain the following provisions: (1) Additional Insured Status. The City, its officers, officials, employees, and volunteers are to be covered as additional insureds on the CGL and AL policies required above, with respect to liability arising out of work or operations performed by or on behalf of the Partner including materials, parts, or equipment furnished in connectionwith such work or operations. (2) Waiver of Subrogation. Partner's insurance company(ies) agree(s) to waive all rights of subrogation against the City, its City Council, its officers, officials, employees, agents, and volunteers for losses paid under the terms of any policy which arise from work performed by Partner under this Agreement. (3) Primary Coverage. For any claims related to this Agreement, Partner's insurance coverage shall be primary and any insurance maintained by City, its City Council, its officers, officials, employees, agents, or volunteers shall not contribute with it. (4) Severability. A severability of interest provision must apply for all the additional insured, ensuring that Partner's insurance shall apply separately to each insured against whom a claim is made or suit is brought, except with respect to the insurer's limits of liability. (5) Cancellation. Insurance policy(ies) herein shall provide that coverage shall not be canceled, suspended, voided, reduced in coverage or in limits, non -renewed by the carrier, or materially changed except after thirty (30) days prior written notice has been given to City. Ten (10) days prior written notice shall be provided to City for policy cancellation or non -renewal due to non-payment. (6) Certificate Holder. The Certificate Holder on each evidence of insurance certificate shall be: City of Santa Ana, 20 Civic Center Plaza, Santa Ana, CA 92701. The name and location of event should be included in the description of operations section of each certificate. G. Self -Insured Retentions. Self -insured retentions must be declared to and approved by the City. City may require Partner to purchase coverage with a lower Page 3 of 9 retention or provide proof of ability to pay losses and related investigations, claim administration, and defense expenses within the retention. d. Acceptability of Insurers. Insurance is to be placed with insurers authorized to conduct business in the state with a current A.M. Best's rating of no less than A: VII, unless otherwise acceptable to the City. e. Verification of Coverage. Partner shall furnish the City with original Certificates of Insurance including all required amendatory endorsements (or copies of the applicable policy language effecting coverage requiredby this clause) and a copy of the Declarations and Endorsement Page of the CGL policy listing all policy endorsements to City before work begins. However, failure to obtain the required documents prior to the work beginning shall not waive the Partner's obligation to provide them. The City reserves the right to require complete, certified copies of all required insurance policies, including endorsements required by these specifications, at any time. f. Claims Made Policies. If any of the required policies provide coverage on a claims -made basis: 1. The retroactive date must be shown and must be before the date of the contract or the beginning of work. 2. Insurance must be maintained and evidence of insurance must be provided for at least three (3) years after completion of work. 3. If coverage is canceled or non -renewed, and not replaced with another claims -made policy form with a retroactive date prior to the contract effective date, Company must purchase "extended reporting" coverage for a minimum of three (3) years after completion of work. g. Subcontractors Partner shall require and verify that all sub -contractors maintain insurance meeting all the requirements stated herein, and Partner shall ensure that City is an additional insured on insurance required from sub -contractors. h. Special Risks or Circumstances. City reserves the right to modify these requirements, including limits, based on the nature of therisk, prior experience, insurer, coverage, or other special circumstances. 7. INDEMNIFICATION To the fullest extent permitted by law, Partner shall indemnify, defend and hold harmless City, its officers, agents and employees (collectively, the "City Indemnified Parties") from and against any and all claims (including, without limitation, claims for bodily injury, death or damage to property), demands, obligations, damages, actions, causes of action, suits, losses, judgments, fines, penalties, liabilities, costs and expenses (including, without limitation, attorney's fees, Page 4 of 9 disbursements and court costs) of every kind and nature whatsoever (individually, a "Claim"; collectively, "Claims"), which may arise from or in any manner are related (directly or indirectly) to Partner's breach of this Agreement or Partner's presence or activities at the Event (including the negligent and/or willful acts, errors and/or omissions of Partner, its principals, officers, agents, employees, vendors, suppliers, contractors, subcontractors, anyone employed directly or indirectly by any of them or for whose acts they may be liable for any or all of them). Notwithstanding the foregoing, nothing herein shall be construed to require Partner to indemnify the City Indemnified Parties from any claim arising from the negligence or willful misconduct of the City Indemnified Parties. This indemnity shall apply to all claims and liability regardless of whether any insurance policies are applicable. The policy limits do not act as a limitation upon the amount of indemnification to be provided by the Partner. 8. CONFIDENTIALITY If either party receives from the other party information which due to the nature of such information is reasonably understood to be confidential and/or proprietary, the receiving party agrees that it shall not use or disclose such information except in the performance of this Agreement, and further agrees to exercise the same degree of care it uses to protect its own information of like importance, but in no event less than reasonable care. "Confidential Information" shall include all nonpublic information. Confidential information includes not only written information, but also information transferred orally, visually, electronically, or by other means. Confidential information disclosed to either party by any subsidiary and/or agent of the other party is covered by this Agreement. The foregoing obligations of non-use and nondisclosure shall not apply to any information that (a) has been disclosed in publicly available sources; (b) is, through no fault of the receiving party disclosed in a publicly available source; (c) is in rightful possession of the receiving party without an obligation of confidentiality; (d) is required to be disclosed by operation of law; or (e) is independently developed by the Partner without reference to information disclosed by the City. 9. CONFLICT OF INTEREST CLAUSE Each party covenants that it presently has no interests and shall not have interests, direct or indirect, which would conflict in any manner with performance of services specified under this Agreement. 10. NOTICE Any notice, tender, demand, delivery, or other communication pursuant to this Agreement shall be in writing and shall be deemed to be properly given if delivered in person or mailed by first class or certified mail, postage prepaid, or sent by facsimile or other telegraphic communication in the manner provided in this Section, to the following persons: To City: City Clerk City of Santa Ana 20 Civic Center Plaza (M-30) P.O. Box 1988 Page 5 of 9 Santa Ana, CA 92702-1988 Fax: 714-647-6956 Copies to: Parks, Recreation & Community Services Agency City of Santa Ana 20 Civic Center Plaza (M-23) P.O. Box 1988 Santa Ana, California 92702 To Partner: Polly's Pies, Inc. 1150 E. Orangethorpe Ave., Ste. 101 Placentia, CA 92870 A party may change its address by giving notice in writing to the other party. Thereafter, any communication shall be addressed and transmitted to the new address. If sent by mail, communication shall be effective or deemed to have been given three (3) days after it has been deposited in the United States mail, duly registered or certified, with postage prepaid, and addressed as set forth above. If sent by fax, communication shall be effective or deemed to have been given twenty-four (24) hours after the time set forth on the transmission report issued by the transmitting facsimile machine, addressed as set forth above. For purposes of calculating these time frames, weekends, federal, state, County or City holidays shall be excluded. 11. EXCLUSIVITY AND AMENDMENT This Agreement represents the complete and exclusive statement between the City and Partner regarding the subject matter herein, and supersedes any and all other agreements, oral or written, between the parties. In the event of a conflict between the terms of this Agreement and any attachments hereto, the terms of this Agreement shall prevail. This Agreement may not be modified except by written instrument signed by the City and by an authorized representative of Partner. The parties agree that any terms or conditions of any purchase order or other instrument that are inconsistent with, or in addition to, the terms and conditions hereof, shall not bind or obligate Partner or the City. Each party to this Agreement acknowledges that no representations, inducements, promises or agreements, orally or otherwise, have been made by any party, or anyone acting on behalf of any party, which are not embodied herein. 12. ASSIGNMENT Inasmuch as this Agreement is intended to secure the specialized services of Partner, Partner may not assign, transfer, delegate, or subcontract any interest herein without the prior written consent of the City and any such assignment, transfer, delegation or subcontract without the City's prior written consent shall be considered null and void. Nothing in this Agreement shall be construed to limit the City's ability to have any of the services which are the subject to this Agreement performed by City personnel or by other partners retained by City. Page 6 of 9 13. CANCELLLATION OR TERMINATION a. If, because of war, fire, strike, civil strife, government regulation, natural catastrophe, an act of terrorism or public enemy, an act of God, or any reason beyond the reasonable control of City, the Event or any part thereof is prevented from being held or is cancelled by City, City, in its sole discretion, shall determine and refund to the Partner its proportionate share of the balance of the aggregate partner fees received that remain after deducting actual expenses incurred by City. In no case shall the amount of the refund to the Partner exceed the amount of the fee paid. City reserves the right to cancel any portion of the Event as it deems necessary and appropriate and in such event, shall refund to the Partner the applicable share of Partner fees applicable to such cancelled portion of the Event. b. Cancellation by the Partner will be accepted only in writing. In the event of cancellation by Partner, not due to an event in section 13(a) of this Agreement or City's breach of this Agreement, Partner will remain obligated for 100% of the partnership fee, and City will retain the right to seek and retain an alternate partner in City's sole discretion. 14. NONDISCRIMINATION Partner shall not discriminate because of race, color, creed, religion, sex, marital status, sexual orientation, age, national origin, ancestry, or disability, as defined and prohibited by applicable law, in the recruitment, selection, training, utilization, promotion, termination or other employment related activities or any activities in connection with this Agreement. Partner affirms that it is an equal opportunity employer and shall comply with all applicable federal, state and local laws and regulations. 15, JURISDICTION — VENUE This Agreement has been executed and delivered in the State of California and the validity, interpretation, performance, and enforcement of any of the clauses of this Agreement shall be determined and governed by the laws of the State of California. Both parties further agree that Orange County, California, shall be the venue for any action or proceeding that may be brought or arise out of, in connection with or by reason of this Agreement. 16. PROFESSIONAL LICENSES Partner shall, throughout the term of this Agreement, maintain all necessary licenses, permits, approvals, waivers, and exemptions necessary hereunder and required by the laws and regulations of the United States, the State of California, the City of Santa Ana and all other governmental agencies. Partner shall notify the City immediately and in writing of its inability to obtain or maintain such permits, licenses, approvals, waivers, and exemptions. Said inability shall be cause for termination of this Agreement. Page 7 of 9 17. MISCELLANEOUS PROVISIONS a. Each undersigned represents and warrants that its signature below has the power, authority and right to bind their respective parties to each of the terms of this Agreement, and shall indemnify City fully, including reasonable costs and attorney's fees, for any injuries or damages to City in the event that such authority or power is not, in fact, held by the signatory or is withdrawn. b. All Exhibits referenced herein and attached hereto shall be incorporated as if fully set forth in the body of this Agreement. [signature page follows] Page 8 of 9 N-2024-157 SIGNATURE PAGE FOR PARTNERSHIP AGREEMENT WITH POLLY'S PIES, INC. FOR TITLE LEVEL PARTNERSHIP IN WITNESS WHEREOF, the parties hereto have executed this Partnership Agreement the date and year first above written. ATTEST: APPROVED AS TO FORM: SONIA R. CARVALHO City Attorney By: randon Salvatierra Deputy City Attorney FOR APPROVAL: Hawk Scott Executive Director of Parks, Recreation and Community Services Agency CITY OF SANTA AN Alvaro Nunez Acting City Manager PARTNER A A ' Name: Title: Social Media and LSM Coordinator Page 9 of 9 EXHIBIT A Santa Ana ;DTd%& "d RMW44e CITY OF SANTA ANA Parks, Recreation, & Community Services Agency 2024 Event Title Level Partnership: Polly's Pies Inc. Program overview: Polly's Pies will be providing $11,300 value of in -kind contributions to the City of Santa's Parks, Recreation, and Community Services Agency (PRCSA) as an event Title Level Partner to participate in planning efforts for one city-wide standard event. In exchange, PRCSA will provide marketing recognition and designated exhibitor space. The allowable activations will provide opportunities for city-wide community engagement, distribution of information, interactive activities, and food for participants. An event Title Level Partnership streamlines participation in PRCSA events and allows for additional collaborative opportunities with an in -person presence in Santa Ana events and programs. Polly's Pies physical activations will be included at the following: • Standard Event: o Me Encanta Santa Ana • Saturday, April 20, 2024 • Jerome Park Polly's Pies responsibilities: • A value of $11,300 in -kind contributions will be made up of staffing assistance, event food, and food serving supplies. o $9,000 of in -kind contributions towards breakfast food • 750 servings at $12 per plate o $1,300 of in -kind contributions towards food service, serving ware, and utensils o $1,000 of in -kind contributions towards restaurant coupons • Polly's Pies grants PRCSA the right to use Partner's trademark(s), trade name(s), logo designs and company descriptions as prepared and delivered to City by Partner in any medium of advertising, marketing materials, and/ or promotional goods distributed in conjunction with the Event and in accordance with the Partner's usage guidelines. PRCSA responsibilities: • Title Partner Level inclusions for event: o Designated space (10'x40') during event breakfast o Stage mention at event o Day -of event social media acknowledgment in form of a story on @santanaparks o Social media acknowledgment in caption of recap event post on @santaanaparks o Designated advertising printed signage provided by PRCSA with Polly's Pies advertisement, marks, and/ or reference, as supplied by Poly's Pies, on signage as appropriate for the individual event that may include, but is not limited to stage banner(s), 24" x36" A-frame(s), photography backdrop, etc. o Inclusion of Polly's Pies advertisement, marks, and/ or reference, as supplied by Polly's Pies, on signage as appropriate for the individual event that may include, but is not limited to main event marketing materials with logo placements, such as fliers, posters, day -of signage, and event website subpage(s). THE CITY OF SANTA ANA 20 Civic Center Plaza • 2nd Floor • Santa Ana, CA 92701 (714) 571-4200 • Web Site: www.santa-ana.org/departments/parks-recreation o Partnership recognition in event(s) press release THE CITY OF SANTA ANA 20 Civic Center Plaza • 2nd Floor • Santa Ana. CA 92701 (714) 571-4200 • Web Site: www.santa-ana.org/departments/parks-recreation PULLING-03 SHIVAKUN OATD0IYYYY) 4118/16/2024 CERTIFICATE OF LIABILITY INSURANCE 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 terns and conditions of the policy, c rt may require an endorsement. A statement on Min t ' certificate does not confer rights to the certific it o e P c 7s B t rn I I�s ce Services Inc. 9855 Scranto ad Acevedo Suite 100 Sa iego, CA 92121 Date: 20 N M :c my o PHONE FAX AIc,Nc, Eat: (858)255-3277 A/c, No>:(951)231-2572 E-mr�IL . Ca1.CPU@Hubinternational.com DD E . I GCOVERAGE NAICN INSURER A: Regent Insurance Coman 24449 — UR — INSURER B: General Casualty Company of Wisconsin 24414 INSURER C : Great American Insurance Company 16691 Polly's Inc. Kentucky Fried Chicken Of Polly's, Inc. INSURER D : Pacific Compensation Insurance Company11555 1150 E. Orangethrope Ave., Suite 101 Placentia, CA 92870 INSURER E INSURER F : 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 TYPE OF INSURANCE ADOLSUBR POLICY NUMBER POLICY EFF POLICY EXPLTR LIMITS A X COMMERCIAL GENERAL LIABILITY FU7CLAIMS-MADE OCCUR X X CGA1391303 7/1/2023 7/1/2024 EACH OCCURRENCE $ 1,000,000 DAMAGE TOE RENTED $ 100,000 MED EXP (My one erson 5,00g PERSONAL B ADV INJURY 11000,000 GENT X AGGREGATE LIMIT APPLIES PER: POLICY E zRT LOC GENERAL AGGREGATE 25,000,000 PRODUCTS - COMP/OP AGG 2,000,000 LIQUOR LIAB AGG 2,000,000 OTHER: B AUTOMOBILE LIABILITY COMBINEDSINGLELIMIT 100000 BODILY INJURY Perperson) X ANYAUTO OWNED SCHEDULED AUTOS ONLY AUTOSW X X CBA1391303 71112023 7/1/2024 BODILY INJURY Per accident EPIOPEItle^t AMAGE AUTOS ONLY AUTOS ONL� Ded Comp/Coll 1,000 C X UMBRELLALIAB X OCCUR EACH OCCURRENCE 10,000,000 AGGREGATE 10,000,000 EXCESS LIAB CLAIMS -MADE UMB 4370083 711/2023 711/2024 DED X RETENTION$ 10,000 D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETORJPARTNERIEXECUTIVE ❑ OFFICERIMEMBER EXCLUDED? (Mandatory In NH) H yes, describe under DESCRIPTION OF OPERATIONS below N /A X 1D24198 7/1/2923 7/112D24 X PER OTF4 E EL EACH ACCIDENT 11000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,00D E.L DISEASE - POLICY LIMIT 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101. Additional Remarks Schedule, may be aaached if more space is required) City of Santa Ana, its City Council, its officers, officials, employees, agents, and volunteers are Additional Insured With regard to the General Liability policy, when required by written contract, per the attached endorsement form CG8155 03109. Coverage is Primary & Non -Contributory with regard to the General Liability policy, when required by written contract, per the attached endorsement form CG2001 04113. Waiver of Subrogation applies to the General Liability Policy, when required by written contract, per the attached endorsement form CG8224 05112. Additional Insured applies with regard to the Auto Liability policy, per endorsement to follow from carrier. Primary & Non -Contributory wording applies to the Auto Liability policy, per endorsement to follow from carrier. Waiver of Subrogation applies to the Auto Liability policy, per endorsement to follow from carrier. Waiver of Subrogation applies to the Workers Compensation City of Santa Ana Attn: Stephanie Garcia 20 Civic Center Plaza Santa Ana, CA 92701 ACORD 25 (2016103) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCEI THE E%PIRATION DATE THEREO ACCORDANCE WITH THE POLICY PR( AUTHORIZED REPRESENTATIVE 2E�fGL`1 1-L— ED BEFORF Risk Marugoneat DMafm1 REVIEWED & APPRovED Or '--�� Risk Management Spedaist of 91988.2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: POLLINC-03 LOC #: 1 MSHIVAKUM A�O ADDITIONAL REMARKS SCHEDULE AGENCY License # 0757776 NAMED INSURED HUB International Insurance Services Inc. Polly's Inc. Kentucky Fried Chicken Of Polly's, Inc. 1150 E. Orangethrope Ave., Suite 101 POLICY NUMBER Placentia, CA 92870 SEE PAGE 1 CARRIER NAIC CODE SEE PAGE 1 SEE P 1 EFFECTIVE DATE: E. PAGE 1 THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Liability Insurance Description of Operations/Locations/Vehicles: 30 Days Notice of Cancellation with regard to General liability per endorsement to follow upon issuance by carrier. ACORD 101 (2008/01) © 2008 ACORD CI The ACORD name and logo are registered marks of ACORD Page 1 of 1 Risk Mxwgemmt DtvivioD REVIEWED & APPRovED BY: �, A� AcWGia �--� Risk Management Spea Aht CGA1391303 COMMERCIAL GENERAL LIABILITY CG 8155 03 09 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. NONCONTRACTOR'S ADDITIONAL INSUREDS ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. WHO IS AN INSURED (Section II) is amended to include as an insured any person or organization (called additional insured) described in Paragraphs A.I. through A.8. below whom you are required to add as an additional insured on this policy under a written contract or written agreement; but the written contract or written agreement must be currently in effect or becoming effective during the term of this policy; executed prior to the 'bodily injury," "property damage" or "personal injury and advertising injury," but this paragraph does not apply to any additional insured more specifically identified elsewhere in the policy. 1. ADDITIONAL INSURED —STATE OR POLITICAL SUBDIVISIONS — PERMITS A state or political subdivision subject to the following provisions: a. A state or political subdivision is an additional insured only with respect to the following hazards for which the state or political subdivision has issued a permit in connection, with premises you own, rent, or control to which this insurance applies: (1) The existence, maintenance, repair, construction, erection, or removal of advertising signs, awnings, canopies, cellar entrances, coal holes, drive- ways, manholes, marquees, hoistaway openings, sidewalk vaults, street banners, or decorations and similar exposures; or (2) The construction, erection, or removal of elevators; or (3) The ownership, maintenance, or use of any elevators covered by this insurance. b. A state or political subdivision is an additional insured only with respect to operations performed by you or on your behalf for which the state or political subdivision has issued a permit. This insurance does not apply to 'bodily injury," property damage' or "personal and advertising injury" arising out of operations performed by or for you for the state or political subdivision. 2. ADDITIONAL INSURED — CONTROLLING INTEREST Any person or organizations with a controlling interest in you but only with respect to their liability arising out of: a. Their financial control of you; or b. Premises they own, maintain or control while you lease or occupy these premises. This insurance does not apply to structural alterations, new construction and demolition operations performed by or for such additional insured. 3, ADDITIONAL INSURED — MANAGERS OR LESSORS OF PREMISES A manager or lessor of premises but only with respect to liability arising out of the ownership, maintenance or use of that specific part of the premises leased to you and subject to the following additional exclusions: This insurance does .s"�f.•"c RleleMmcganmtIXNaion ReneA o6APPRw Br. Risk Management Specialist .y Includes copyrighted material of Insurance Services Office, Inc. CG 81 55 03 09 with its permission. Page 1 of 3 a. Any "occurrence" which takes place after you can cease to be a tenant in that premises: or b. Structural alterations, new construction or demolition operations performed by or on behalf of such additional insured. 4. ADDITIONAL INSURED — MORTGAGEE, ASSIGNEE OR RECEIVER A mortgagee. assignee or receiver but only with respect to their liability as mortgagee, assignee or receiver and arising out of the ownership, maintenance, or use of a premises by you. This insurance does not apply to structural alterations, new construction or demolition operations performed by or for such additional insured. 5. ADDITIONAL INSURED — OWNERS OR, OTHER INTERESTS FROM WHOM LAND HAS BEEN LEASED An owner or other interest from whom land has been leased by you but only with respect to liability arising out of the ownership, maintenance or use of that specific part of the land leased to you and subject to the following additional exclusions. This insurance does not apply to: a. Any "occurrence" which takes place after you cease to lease that land; or b. Structural alterations, new construction or demolition operations performed by or an behalf of such additional insured. 6. ADDITIONAL INSURED — CO-OWNER OF INSURED PREMISES A co-owner of a premises co -owned by you and covered under this insurance but only with respect to the co -owners liability as co- owner of such premises. 7. ADDITIONAL INSURED — LESSOR OF LEASED -EQUIPMENT Any person or organization from whom you lease equipment. Such person or organization are insured only with respect to their liability arising out of the maintenance, operation or use by you or equipment leased to you by such person or organization. A person's or organization's status as an insured under this endorsement ends when their contract or agreement with you for such leased equipment ends. With respect to the insurance afforded these additional insureds, the following additional exclusions apply: This insurance does not apply: a. To any "occurrence" which takes place after the equipment lease expires; or b. To "bodily injury" or "property damage" arising out of the sole negligence of such additional insured. Any insurance provided to an additional insured designated under Paragraphs A.I. through A.8. above does not apply to "bodily injury" or "property damage" included within the "products -completed operations hazard." 8. ADDITIONAL INSURED —VENDORS Any "vendor', but only with respect to "bodily injury" or "property damage" arising out of "your products" which are distributed or sold in the regular course of the vendor's business, subject to the following additional exclusions: a. The insurance afforded the vendor does not apply to: (1) "Bodily injury" or "property damage" for which the vendor is obligated to pay damages by reason of the assumption of liability in a contract or agreement. This exclusion does not apply to liability for damages that the vendor would have in the absence of the contract or agreement; (2) Any express warranty unauthorized by you; (3) Any physical or chemical change in the product made intentionally by the vendor; (4) Repackaging, except when unpacked solely for the purpose of inspection, demonstration, testing, or the substitution of parts under instructions from the manufacturer, and then repackaged in the original container; (5) Any failure to make such inspections, adjustments, tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business, in connection with the distribution or sale of the products; (6) Demonstration, installation, servicing or repair operations, except such operations performed at the vendor's premises in connection with the sale of the produt Rnk MmugarvntDMdmt REM & APPROVa Sr. ` EE IM A�Aev44 �. ® R6k Management SpeaAnt Includes copyrighted material of Insurance Services Office, Inc Page 2 of 3 with its permission. CG 8155 03 09 CGA1391303 (7) Products which, after distribution or b. This insurance does not apply to any sale by you, have been labeled or insured person or organization, from relabeled or used as a container, part whom -you have acquired such products, or ingredient of any other thing or or any ingredient, part or container, substance by or for the vendor, or entering into, accompanying or containing (8) 'Bodily injury" or "property damage" such products. arising out of the sole negligence of B. As respects the coverage provided under this the vendor for its own acts or endorsement, Paragraph. 4.b.(3.) SECTION N — omissions or those of its employees COMMERCIAL GENERAL LIABILITY CONDITIONS or anyone else acting on Its behalf. is added: However, this exclusion does not apply to: 4.b.(3.) This insurance is excess over any other (a) The exceptions contained in Sub- insurance covering the additional insured paragraphs d. or f.; or as an insured whether primary, excess, contingent or on any other basis, unless (b) Such inspections, adjustments, a written contract or written agreement tests or servicing as the vendor specifically requires that this insurance has agreed to make or normally be either primary or primary and undertakes to make in the usual noncontributing. course of business, in connection with the distribution or sale of the products. "o£r ieV1EWFD•• APPRWD®8 Rek Management Specialist 01 Includes copyrighted material of Insurance Services Office, Inc. CG 8155 03 09 with its permission. Page 3 of 3 Policy No. CGA1391303 COMMERCIAL GENERAL LIABILITY CG 20 01 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NONCONTRIBUTORY - OTHER INSURANCE CONDITION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to the Other Insurance Condition and supersedes any provision to the contrary: Primary And Noncontributory Insurance This insurance is primary to and will not seek contribution from any other insurance available to an additional insured under your policy provided that: (1) The additional insured is a Named Insured under such other insurance, and (2) You have agreed in writing in a contract or agreement that this insurance would be primary and would not seek contribution from any other insurance available to the additional insured. Evr R , �. Risk Management Sped Mist `a CG 20 01 04 13 © Insurance Services Office, Inc.,2012 Page 1 of 1 COA1391303 Policy No: CGA1391303 Term: 07/01/2023 - 07/01/2024 Polly's Inc. Kentucky Fried Chicken Of Polly's, Inc. COMMERCIAL GENERAL LIABILITY CG 82 24 0512 PREMIER GENERAL LIABILITY COVERAGE EXTENSION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE FORM A. REASONABLE FORCE g. Aircraft, Auto Or Watercraft Paragraph 2.a. Expected or Intended Injury under COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY of SECTION I — COVERAGES within the COMMERCIAL GENERAL LIABILITY COVERAGE FORM is replaced by: a. Expected or Intended Injury "Bodily injury" or "property damage' expected or intended from the standpoint of the in- sured. This exclusion does not apply to "bod- ily injury" or "property damage' resulting from the use of reasonable force to protect any person or property. B. CONTRACTUAL LIABILITY Paragraph 2.b. Contractual Liability under COVERAGE A. BODILY INJURY AND PROP- ERTY DAMAGE LIABILITY of SECTION I — COVERAGES within the COMMERCIAL GEN- ERAL LIABILITY COVERAGE FORM is replaced by: b. Contractual Liability "Bodily injury" or "property damage" for which the insured is obligated to pay damages by reason of the assumption of liability in a con- tract or agreement. This exclusion does not apply to liability for damages: (1) That the insured would have had in the absence of the contract or agreement, or (2) Assumed in a contract or agreement that is an "insured contract', provided the "bo- dily injury" or "property damage' occurs subsequent to the execution of the con- tract or agreement. C. NON OWNED WATERCRAFT Paragraph 2.g.(2) in the Aircraft, Auto Or Wa- tercraft exclusion under COVERAGE A. BODILY INJURY AND PROPERTY DAMAGE LIABILITY of SECTION I — COVERAGES within the COM- MERCIAL GENERAL LIABILITY COVERAGE FORM is replaced by: CG 82 24 0512 (2) A watercraft you do not own that is: (a) less than 75 feet long, and (b) Not being used to carry persons or property for a charge. D. ELECTRONIC DATA LIABILITY 1. Paragraph 2.p. Electronic Data under COV- ERAGE A. BODILY INJURY AND PROPERTY DAMAGE LIABILITY of SECTION I — COV- ERAGES within the COMMERCIAL GENERAL LIABILITY COVERAGE FORM is replaced by: p. Electronic Data Damages arising out of the loss of, loss of use of, damage to, corruption of, inability to access, or inability to manipulate "elec- tronic data" that does not result from physical injury to tangible property. However, this exclusion does not apply to liability for damages because of 'bodily injury". 2. The following definition is added to SEC- TION V — DEFINITIONS: "Electronic data" means information, facts or programs stored as or on, created or used on, or transmitted to or from computer software, hard or floppy disks, CD-ROMS, tapes, drives, cells, data processing devices or any other media which are used with electronically controlled equipment. 3. For purposes of the coverage provided for "Electronic Data", Paragraph 17. in SEC- TION V —DEFINITIONS is replaced by: 17. 'Property damage" means: Risk Mwugement 01i& i REMe D&APPRo RD BY: A+�z, Acwd� ® Risk Management Speci Mis[ Includes copyrighted material of Insurance Services Office, Inc., with its permission. a. Physical injury to tangible property, including all resulting loss of use of that property. All such loss of use shall be des of the physic Page 1 of 6 b. Loss of use of tangible property that is not physically injured. All such loss of use shall be deemed to occur at the time of the "occurrence" that caused it; or c. Loss of, loss of use of, damage to, corruption of, inability to access, or inability to properly manipulate "elec- tronic data", resulting from physical injury to tangible property. All such loss of "electronic data" shall be deemed to occur at the time of the "occurrence" that caused it. For purposes of this insurance, "elec- tronic data" is not tangible property. E. DAMAGE TO PREMISES RENTED TO YOU 1. The last paragraph after the listed exclusions under COVERAGE A. BODILY INJURY AND PROPERTY DAMAGE LIABILITY of SEC- TION I — COVERAGES within the COM- MERCIAL GENERAL LIABILITY COVER- AGE FORM is replaced by: Exclusions c. through n. do not apply to "property damage" by fire; smoke from a "hostile fire"; explosion; lightning; smoke re- sulting from such explosion or lightning; colli- sion by "mobile equipment" or leakage from 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 this coverage as de- scribed in SECTION III — LIMITS OF IN- SURANCE. 2. Paragraph 6. of SECTION III — LIMITS OF INSURANCE within the COMMERCIAL GENERAL LIABILITY COVERAGE FORM is replaced by: S. Subject to Paragraph 5. above, the Dam- age To Premises Rented To You Limit is the most we will pay in any one event un- der COVERAGE A. BODILY INJURY AND PROPERTY DAMAGE for damages because of "property damage" from fire; smoke from a "hostile fire"; explosion; lightning; smoke resulting from such ex- plosion or lightning; collision by "mobile equipment" or leakage from fire protection systems to premises while rented to you or temporarily occupied by you with per- mission of the owner. F. MEDICAL PAYMENTS 1. Paragraph 1.e. under COVERAGE C. MEDICAL PAYMENTS of SECTION I — COVERAGES within the COMMERCIAL GENERAL LIABILITY COVERAGE FORM is replaced by: 1. Insuring Agreement a. We will pay medical expenses as de- scribed below for "bodily injury" caused by an accident: (1) On premises you own or rent; (2) On ways next to premises you own or rent; or (3) Because of your operations: Provided that: (a) The accident takes place in the "coverage territory" and during the policy period; (b) The expenses are incurred and reported to us within three years of the date of the accident; and (c) The injured person submits to examination, at our expense, by physicians of our choice as often as we reasonable require. G. SUPPLEMENTARY PAYMENTS SUPPLEMENTARY PAYMENTS — COVER- AGES A AND B of SECTION I COVERAGES within the COMMERCIAL GENERAL LIABILITY COVERAGE FORM is replaced by: 1. We will pay, with respect to any claim we investigate or settle, or any "suit" against an insured we defend: a. All expenses we incur. b. Up to $5,000 for cost of bail bonds re- quired 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 fur- nish these bonds. c. The cost of bonds to release attach- ments, but only for bond amounts within the applicable limit of insurance. We do have to furnish these bonds. 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. e. All costs taxed against the "insured" in any "suit". f. Prejudgment interest awarded against the insured on that part of the judgment we pay. If we make an offer to pay the appli- cable limit of in: any prejudgmen w.kn+mqm Includes copyrighted material of Insurance Services Office, Inc. Page 2 of 6 with its permission. en CGA1391303 g. All interest on the full amount of any judgment that accrues after entry of the judgment and before we have paid, of- fered to pay, or deposited in court the part of the judgment that is within the applica- ble limit of insurance. These payments will not reduce the limits of insurance. 2. If we defend an insured against a "suit" and an indemnitee of the insured is also named as a party to the "suit", we will defend that indern- nitee if all of the following conditions are met: a. The "suit" against the indemnitee seeks damages for which the insured has as- sumed the liability of the indemnitee in a contract or agreement that is an "insured contract'; b. This insurance applies to such liability as- sumed by the insured; c. The obligation to defend, or the cost of the defense of, that indemnitee, has also been assumed by the insured in the same "insured contract"; d. The allegations in the "suit" and the in- formation we know about the "occur- rence" are such that no conflict appears to exist between the interests of the in- sured and the interests of the indemnitee; e. The indemnitee and the insured ask us to conduct and control the defense of that in- demnitee against such "suit" and agree that we can assign the same counsel to defend the insured and the indemnitee; and f. The indemnitee: (1) Agrees in writing to: (a) Cooperate with us in the investi- gation, settlement or defense of the "suit"; (b) Immediately send us copies of any demands, notices, sum- monses or legal papers received in connection with the "suit"; (c) Notify any other insurer whose coverage is available to the in- demnitee; and (d) Cooperate with us with respect to coordinating other applicable insurance available to the in- demnitee; and (2) Provides us with written authoriza- tion to: (a) Obtain records and other infor- mation related to the "suit": and (b) Conduct and control the defense of the indemnitee in such "suit". Our obligation to defend an insured's in- demnitee and to pay for attorneys' fees and necessary litigation expenses as Supplementary Payments ends when we have used up the applicable limit of in- surance in the payment of judgments or settlements or the conditions set forth above, or the terms of the agreement de- scribed in Paragraph f. above, are no longer met. H. FELLOW EMPLOYEE COVERAGE — SUPERVISOR OR HIGHER Paragraph 2.a.(1) of SECTION 11 — WHO IS AN INSURED within the COMMERCIAL GENERAL LIABILITY COVERAGE FORM does not apply to the following: Your supervisory or management "employees" for "bodily injury" only. Damages owed to an injured co -"employee" or "volunteer worker" will be reduced by any amount paid or available to the injured co -"employee" or 'volunteer worker" under any other valid and collectible insurance. I. NEWLY ACQUIRED ORGANIZATIONS Paragraph 3.a. of SECTION II — WHO IS AN INSURED within the COMMERCIAL GENERAL LIABILITY COVERAGE FORM is replaced by: a. Coverage under this provision is afforded only until the end of the current policy period. J. BROAD FORM NAMED INSURED The following is added to SECTION II — WHO IS AN INSURED within the COMMERCIAL GEN- ERAL LIABILITY COVERAGE FORM: Throughout this policy the words "you" and "your" refer to any corporation or other business organi- zation, other than a joint venture, in which the first Named Insured has or acquires during the policy period an ownership interest of more than 50% and is subject to the management control of the first Named Insured or its subsidiaries, and which is domiciled within the United States of America or its territories or possessions. K. AMENDMENT OF AGGREGATE LIMIT OF INSURANCE The General Aggregate Limit Of Insurance refer- enced in Paragraph 2. of SECTION III — LIMITS OF INSURANCE within the COMMERCIAL GENERAL LIABILITY COVERAGE FORM applies separately to: 1. Each of your "locati to you; and _.n�40 Qlllt iv:@tigC111gr�iWBIOrt Reneum 6 Awae Mar. Risk Management Spea Mist Includes copyrighted material of Insurance Services Office, Inc., with its permission. Cd�I�Yi�Z[tiika Page 3of6 2. Each of your projects away from premises (III) That is insurance to cover your owned by or rented to you, liability as a tenant for "prop - "Location" means premises involving the same or erty damage' to premises connecting lots, or premises whose connection is while rented to you or tempo - interrupted only by a street, roadway, waterway or rarily occupied by you with right-of-way of a railroad. permission of the owner; or L. KNOWLEDGE OF OCCURRENCE The following is added to Paragraph 2. Duties In The Event Of Occurrence, Offense, Claim Or Suit of SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS within the COMMERCIAL GENERAL LIABILITY COVERAGE FORM: Knowledge of an 'occurrence', offense, claim or "suit" by your agent, servant or "employee' shall not be considered knowledge by you unless you, your insurance manager or any other person you designate has received notice of the "occur- rence', offense, claim or "suit" from your agent, servant, or "employee." M. OTHER INSURANCE Paragraph 4.b.(1)(a) in the Other Insurance condition of SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS within the COMMERCIAL GENERAL LIABILITY COVER- AGE FORM is replaced by: 4. Other Insurance b. Excess Insurance (1) This insurance is excess over (a) any of the other insurance, whether primary, excess, contin- gent or on any other basis: (I) That is Fire, Extended Cov- erage, Builders Risk; Installa- tion Risk or similar coverage for "your work", (ii) That is insurance covering Fire; smoke from a "hostile fire'; explosion; lightning; smoke resulting from such explosion or lightning; colli- sion by "mobile equipment" or leakage from fire protec- tion systems for premises while rented to you or tempo- rarily occupied by you with permission of the owner; or (iv) If the loss arises out of the maintenance or use of aircraft, "autos", or watercraft to the extent not subject to Para- graph 2.g. Aircraft, Auto Or Watercraft under COVER- AGE A. BODILY INJURY AND PROPERTY DAMAGE LIABILITY of SECTION I — COVERAGES within the COMMERCIAL GENERAL LIABILITY COVERAGE FORM. N. UNINTENTIONAL FAILURE TO DISCLOSE HAZARDS The following is added to Paragraph 6. Representations of SECTION IV — COM- MERCIAL GENERAL LIABILITY CONDITIONS within the COMMERCIAL GENERAL LIABILITY COVERAGE FORM: Any unintentional failure to disclose all exposures or hazards existing as of the effective date of the Commercial General Liability Coverage Form or at any time during the policy period will not invali- date or adversely affect the coverage for such exposure or hazard. However, you must report the undisclosed exposure or hazard to us as soon as reasonably possible after the exposure or hazard is discovered. O. WAIVER OF SUBROGATION The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS within the COMMER- CIAL GENERAL LIABILITY COVERAGE FORM: This condition does not apply to any person or organization to which you waived this condition by written contract or agreement, but only to the extent that subrogation is waived prior to the "bodily injury" or 'property damage" under a contract with that person or organization. P. LIMITED WORLDWIDE LIABILITY COVERAGE The following is added to SECTION IV — COW DITIONS within the COMMERCIAL GENERAL LIABILITY COVERAGE FORM: Includes copyrighted material of Insurance Services Office, Inc. Page 4 of 6 with its permission. Risk Mmagemad Dimimi REVIE &APPRO mBY: A, f, Aowdd ® Risk Management Spetlalirt CGA1391303 Expanded Coverage Territory 1. If a "suit" is brought in a part of the "coverage territory" that is outside the United States of America (including its territories and posses- sions), Puerto Rico or Canada, and we are prevented by law, or otherwise, from defend- ing the insured, the insured will initiate a de- fense of the "suit". We will reimburse the in- sured, under Supplementary Payments, for any reasonable and necessary expenses in- curred for the defense of a "suit" seeking damages to which this insurance applies, that we would have paid had we been able to ex- ercise our right and duty to defend. If the insured becomes legally obligated to pay sums because of damages to which this insurance applies in a part of the "coverage territory" that is outside the United States of America (including its territories and posses- sions), Puerto Rico or Canada, and we are prevented by law, or otherwise, from paying such sums on the insured's behalf, we will re- imburse the insured for such sums. 2. All payments or reimbursements we make for damages because of judgments or settle- ments will be made in U.S. currency at the prevailing exchange rate at the time the in- sured became legally obligated to pay such sums. All payments or reimbursements we make for expenses under Supplementary Payments will be made in U.S. currency at the prevailing exchange rate at the time the expenses were incurred. 3. Any disputes between you and us as to whether there is coverage under this policy must be filed in the courts of the United States of America (including its territories and possessions), Puerto Rico or Canada. 4. The insured must fully maintain any coverage required by law, regulation or other governmen- tal authority during the policy period, except for reduction of the aggregate limits due to pay- ments of claims, judgments or settlements. Failure to maintain such coverage required by law, regulation or other governmental author- ity will not invalidate this insurance. However, this insurance will apply as it the required coverage by law, regulation or other govern- mental authority was in full effect. For purposes of this coverage only, the following is added to Paragraph 4.b.(1)(a) under Other Insurance of SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS within the COMMERCIAL GENERAL LIABILITY COVER- AGE FORM: CG 82 24 0512 If the insured's liability to pay damages is deter- mined in a "suit" brought outside the United States of America (including its territories and possessions), Puerto Rico or Canada; or That is coverage required by law, regulation or other governmental authority in a part of the "coverage territory" that is outside the United States of America (including its territories and possessions), Puerto Rico or Canada. For purposes of this coverage only, Paragraph 4. of SECTION V — DEFINITIONS within the COMMERCIAL GENERAL LIABILITY COVER- AGE FORM is replaced by: 4. "Coverage territory" means anywhere in the world with the exception of any country or ju- risdiction which is subject to trade or other economic sanction or embargo by the United States of America. Q. BODILY INJURY REDEFINITION Paragraph 3. of SECTION V. — DEFINITIONS within the COMMERCIAL GENERAL LIABILITY COVERAGE FORM is replaced by: 3. "Bodily injury" means bodily injury, sickness or disease sustained by a person, including mental anguish, injury or illness or emotional distress and/or death resulting from any of these at any time. R. INSURED CONTRACT —LEASE OF PREMISES Paragraph 9.a. of SECTION V — DEFINITIONS within the COMMERCIAL GENERAL LIABILITY COVERAGE FORM is replaced by: 9. "Insured contract" means: a. a contract for lease of premises. How- ever, that portion of the contract for a lease of premises that indemnifies any person or organization for "property dam- age" by fire; smoke from a "hostile fire", explosion; lightning; smoke resulting from such explosion or lightning; collision by "mobile equipment" or leakage from fire protection systems to premises while rented to you or temporarily occupied by you with permission of the owner is not an "insured contract". S. LIBERALIZATION If we revise this 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. R7.kMRtngmimenn;,iwi Reaeum n APPRO ar �. 114, c' A1wula ® Risk Management Spetlalis[ Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 5 of 6 T. GOOD SAMARITAN SERVICES 1. Under SECTION II —WHO IS AN INSURED, paragraph 2.d., the following is added: This exclusion does not apply to your em- ployees or volunteer workers, other than an employed or volunteer physician, rendering "Good Samaritan services". 2. The following definition is added to SECTION V — DEFINITIONS: "Good Samaritan services" means any emer- gency medical services for which no compen- sation is demanded or received. Includes copyrighted material of Insurance Services Office, Inc. Page 6 of 6 with its permission. RAMougemadDh6lon RenemED&APPROV®BY: . °®' A�� AcP, �® - Risk Management Specialist