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HomeMy WebLinkAboutADR COACH, INC., THE INSURANCE ON FILE A-2025-028-08 WORK MAY PROCEED UNTIL m R Ic EXPIRB ,,ITY C6 FR APR 4 2025 AGREEMENT WITH THE ADR COACH, INC. TO PROVIDE ADMINISTRATIVE HEARING OFFICER SERVICES THIS AGREEMENT is made and entered into on this 18T" day of March, 2025 by and between The ADR Coach, Inc., a California corporation ("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 California("City"). RECITALS A. On October 24,2024,the City issued Request for Proposals No. 24-127,by which it sought Consultants to provide as-needed administrative hearing officer services for various agencies of the City of Santa Ana. The scope of work includes any and all work efforts related to administrative hearings, preparation of hearings as scheduled by City staff, reviewing case documentation submitted with appeals, performing legal research, conducting hearings, and preparing written decisions. B. Consultant submitted a responsive proposal that was among those selected by the City. Consultant represents that it is able and willing to provide the services described in the scope of work that was included in UP No. 24-127 and attached as Exhibit A. C. Consultant was selected as one of eight (8) vendors which qualified for this engagement. Only those consultants approved by the City Council on March 18,2025 shall be eligible to be engaged by the City for these services. D. In undertaking the performance of this Agreement, Consultant represents that it is knowledgeable in its field and that any services performed by Consultant under this Agreement will be performed in compliance with such standards as may reasonably be expected from a professional consulting firm in the field. NOW THEREFORE, in consideration of the mutual and respective promises, and subject to the terms and conditions hereinafter set forth, the parties agree as follows: 1. SCOPE OF SERVICES a. On an as-needed basis, and at the sole discretion of the City, Consultants shall perform the services that are described in Exhibit A, attached and incorporated by reference as though fully set forth herein. b. When the need for services arise, City may initiate services through use of written correspondence, executed by authorized City staff and the Consultant. Work by the Consultant may not proceed absent a previously engaged or fully executed consultant agreement and authorizing written correspondence for a specific assignment. The Treasury& Customer Service Manager or their designee will maintain the directory of authorized staff who will be permitted to issue assignments to the Consultants. Consultants are prohibited from accepting assignments from City staff whom are not authorized to issue said assignment and work. c. Consultant shall perform and complete its assigned services as expeditiously as is consistent with generally accepted standards of professional skill and care, and the orderly progress of work, and in a fair, unbiased and neutral manner. Details of the project timelines, including a completion schedule for Consultant's services, shall be provided, in writing, to the City. Consultant and City agree that the completion schedule represents the best estimate of the schedule for services and provision of final work product to the City. Consultant shall comply with all completion dates noted, including but not limited to,preparation of written decisions, which set forth the legal and evidentiary basis for the decision, and adopt findings as required by the particular provisions of the Santa Ana Municipal Code (SAMC). d. Consultant agrees and understands that deliverables submitted to the City after the required deadline(s)may delay issuance of payment and/or allow the City to exercise its option to terminate the Agreement pursuant to Section 15,below. 2. COMPENSATION a. City neither warrants nor guarantees any minimum or maximum compensation to Consultant under this Agreement. Further, City's selection of Consultant for assignment(s) shall be at its sale discretion and not based on any expectation of favorable outcomes or decisions in any hearing(s). Consultant shall be paid only for actual approved services performed under this Agreement at the rates and charges identified in Exhibit B -- Compensation. Consultant is one of eight (8) Consultants selected to provide administrative hearing officer services on an as-needed basis under RFP No. 24-127. The total compensation for services provided by all Consultants selected under RFP No.24-127 is a collective amount not to exceed$2,770,000 during the term of the Agreement, including any extension periods. b. Consultant shall submit its invoice for payment no later than sixty (60) days from written notification to the City that an assignment, as properly assigned by the City per Section 1, above,is completed. c. Payment by City shall be made within forty-five(45)days following receipt of proper invoice evidencing work performed, subject to City accounting procedures. City and Consultant agree that all payments due and owing under this Agreement shall be made through Automated Clearing House(ACH)transfers. Consultant agrees to execute the City's standard ACH Vendor Payment Authorization and provide required documentation. Upon verification of the data provided, the City will be authorized to deposit payments directly into Consultant's account(s)with financial institutions. 3. TERM This Agreement shall commence on the date first written above for a three(3) year term ("Term") with the option for the City, at its sole discretion, to grant a two (2) year extension, ("Extended Term") exercisable by a writing signed by the City Manager and the City Attorney, with Section 15 below. unless terminated earlier in accordance , 4. INDEPENDENT CONTRACTOR Consultant shall, during the entire term of this Agreement, be construed to be an independent Consultant and not an employee of the City. This Agreement is not intended nor shall it be construed to create an employer-employee relationship, a joint venture relationship, or to allow the City to exercise discretion or control over the professional manner in which Consultant performs the services which are the subject matter of this Agreement; however,the services to be provided by Consultant shalt be provided in a manner consistent with all applicable standards and regulations governing such services.Consultant shall pay all salaries and wages,employer's social security taxes, unemployment insurance and similar taxes relating to employees and shall be responsible for all applicable withholding taxes. S. OWNERSHIP OF MATERIALS This Agreement creates a non-exclusive and perpetual license for City to copy, use, modify, reuse, or sublicense any and all copyrights, designs, and other intellectual property embodied in plans, specifications, studies, drawings, estimates, and other documents or works of authorship fixed in any tangible medium of expression, including but not limited to, physical drawings or data magnetically or otherwise recorded on computer diskettes,which are prepared or caused to be prepared by Consultant under this Agreement ("Documents & Data"). Consultant shall require all subcontractors to agree in writing that City is granted a non-exclusive and perpetual license for any Documents & Data the subcontractor prepares under this Agreement, Consultant represents and warrants that Consultant has the legal right to license any and all Documents & Data. Consultant makes no such representation and warranty in regard to Documents & Data which were provided to Consultant by the City. City shall not be limited in any way in its use of the Documents and Data at any time, provided that any such use not within the purposes intended by this Agreement shall be at City's sole risk. 6. INSURANCE; MINIMUM SCOPE AND LIMIT OF INSURANCE a. Prior to undertaking performance of work under this Agreement, Consultant shall maintain and shall require any subcontractors to obtain and maintain insurance as described below for the entire Term and Extended Term, if applicable, of this Agreement against claims for injuries to persons or damage to property which may arise from or in connection with services,products and materials supplied to City.Total cost of such insurance shall be home by Consultant. 1. Commercial General Liability (CGL): Insurance Services Office Forth CO 00 01 covering COI, 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): Insurance Services Office Form CA 00 01 covering Code 1 (any auto), with limits no less than $1,000,000 combined single limits. In the event Consultant does not maintain commercial automobile liability insurance, City will accept evidence of personal automobile insurance. 3. Workers' Compensation (WIC): 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,policy or employee,for bodily injury or disease.Coverage is not required if Consultant has no employees and signs request to waive such insurance. 4. Professional Liability Insurance (PL): with limits no less than $2,000,000 per occurrence or claim,and$4,000,000 aggregate. b. If Consultant maintains broader coverage and/or higher limits than the minimum requirements for each line of coverage shown above, City shall be entitled to the broader coverage and/or the higher limits maintained by Consultant.Where the policy limits are greater than those listed by this Agreement, the amounts provided by the certificates of insurance shall be incorporated by reference in to the Agreement. c, The above required insurance policies are to contain or be endorsed to contain the following provisions: I. City, its City Council, its officers, officials,employees, agents, and volunteers are to be covered as additional insureds,under Consultant's CGL,PL,and AL policies, with respect to any liability arising out of work or operations performed by or on behalf of the Instructor including materials, parts, equipment, and personnel furnished in connection with such work or operations. 2. Consultant and its insurance company(ies)agrees to waive all rights of subrogation against City, its City Council, its officers, officials, employees, agents, and volunteers for losses paid under the teams of the COL,AL, PL, and W/C policies, arising from work performed by Consultant under this Agreement. 3, For any claims related to this contract, Consultant'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. A severability of interest provision must apply for all the additional insureds, ensuring that Consultant'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. Insurance policies required 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 of premium. 6. Certificate Holder on each Evidence of Insurance certificate shall be: City of Santa Ana, Attention: Community Development Agency, 20 Civic Center Plaza,M-25, Santa Ana, CA 92701, The name and location of project must be included in the Description of Operations section of each certificate. d. SeIflnsured Retentions.Self-insured retentions must be declared to and approved by the City. The City may require the Consultant to purchase coverage with a lower retention or provide proof of ability to pay losses and related investigations, claim administration, and defense expenses within the retention e. Acceptability of Insurers. Insurance is to be placed with insurers authorized to conduct business in the State of California with a current A.M. Best rating of no less than A:VII,unless otherwise acceptable to City. f Verification of Coverage. Consultant shall furnish City with original Certificates of Insurance including all required amendatory endorsements(or copies of the applicable policy language effecting coverage required by this clause) and a copy of the Declarations and Endorsement Page of the CGL policy listing all policy endorsements before work begins. However, failure to obtain the required documents prior to the work beginning shall not waive Consultant's obligation to provide them. City reserves the right to require complete, certified copies of all required insurance policies,including endorsements required by these specifications,at any time. g. Special Risks or Circumstances.City reserves the right to modify these requirements, including limits,based on the nature of the risk,prior experience, insurer, coverage, or other special circumstances. 7. INDEMNIFICATION Consultant agrees to defend,and shall indemnify and hold harmless the City, its officers, agents,employees,contractors,special counsel,and representatives from liability:(1)for personal injury,damages,just compensation,restitution,judicial or equitable relief arising out of claims for personal injury, including death, and claims for property damage, which may arise from the negligent operations of the Consultant, its agents, employees,or other persons acting on its behalf which relates to the services described in section 1 of this Agreement;and(2)from any claim that personal injury, damages, just compensation, restitution, judicial or equitable relief is due by reason of the terms of or effects arising from this Agreement. This indemnity and hold harmless agreement applies to all claims for damages,just compensation, restitution,judicial or equitable relief suffered,or alleged to have been suffered,by reason of the events referred to in this Section or by reason of the terms of,or effects,arising from this Agreement. The Consultant further agrees to indemnify,hold harmless,and pay all costs for the defense of the City,including fees and costs for special counsel to be selected by the City,regarding any action by a third party challenging the validity of this Agreement, or asserting that personal injury, damages, just compensation, restitution,judicial or equitable relief due to personal or property rights arises by reason of the terms of, or effects arising from this Agreement. City may make all reasonable decisions with respect to its representation in any legal proceeding, Notwithstanding the foregoing, to the extent Consultant's services are subject to Civil Code Section 2782.8, the above indemnity shall be limited,to the extent required by Civil Code Section 2782.8,to claims that arise out of,pertain to, or relate to the negligence,recklessness, or willful misconduct of the Consultant. 8. INTELLECTUAL PROPERTY INDEMNIFICATION Consultant shall defend and indemnify the City, its officers, agents, representatives, and employees against any and all liability, including costs, for infringement of any United States' letters patent,trademark,or copyright infringement,including costs,contained in the work product or documents provided by Consultant to the City pursuant to this Agreement. 9. RECORDS Consultant shall keep records and invoices in connection with the work to be performed under this Agreement. Consultant shall maintain complete and accurate records with respect to the costs incurred under this Agreement and any services, expenditures, and disbursements charged to the City for a minimum period of three(3)years, or for any longer period required by law, from the date of final payment to Consultant under this Agreement. All such records and invoices shall be clearly identifiable. Consultant shall allow a representative of the City to examine, audit, and make transcripts or copies of such records and any other documents created pursuant to this Agreement during regular business hours. Consultant shall allow inspection of all work, data, documents,proceedings,and activities related to this Agreement for a period of three (3)years from the date of final payment to Consultant under this Agreement. 10, CONFIDENTIALITY If Consultant receives from the City information which due to the.nature of such information is reasonably understood to be confidential and/or proprietary,Consultant agrees that it shall not use or disclose such information except in the performance of this Agreement, and further agrees to exercise the same degree of care it uses to protect its own information of like importance,but in no event less than reasonable care. "Confidential Information"shall include all nonpublic information. Confidential information includes not only written information, but also information transferred orally, visually, electronically, or by ether 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,throw no fault of the Consultant disclosed in a publicly available source; (c) is in rightful possession of the Consultant without an obligation of confidentiality; (d)is required to be disclosed by operation of law; or(e) is independently developed by the Consultant without reference to information disclosed by the City. 11. CONFLICT OF INTEREST CLAUSE Consultant 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. 12. NON-DISCRIMINATION Consultant shall not discriminate because of race,color,creed,religion,sex,marital status, sexual orientation, gender identity, gender expression, gender, medical conditions, genetic information, or military and veteran status, age,national origin,ancestry, or disability, as defined and prohibited by applicable law, in the recruitment, selection, teaching, training, utilization, promotion,termination or other employment related activities or any services provided under this Agreement. Consultant affirms that it is an equal opportunity employer and shall comply with all applicable federal, state and local laws and regulations. 13. EXCLUSIVITY AND AMENDMENT This Agreement represents the complete and exclusive statement between the City and Consultant, and supersedes any and all other agreements,oral or written,between the parties. In the event of a conflict between the terms of this Agreement and any attachments hereto,the terms of this Agreement shall prevail. This Agreement may not be modified except by written instrument signed by the City and by an authorized representative of Consultant. The parties agree that any terms or conditions of any purchase order or other instrument that are inconsistent with, or in addition to,the terms and conditions hereof,shall not bind or obligate Consultant or the City.Each party to this Agreement acknowledges that no representations, inducements, promises or agreements, orally or otherwise,have been made by any party,or anyone acting on behalf of any party, which is not embodied herein. 14. ASSIGNMENT Inasmuch as this Agreement is intended to secure the specialized services of Consultant, Consultant may not assign, transfer, delegate, or subcontract any interest herein without the prior written consent of the City and any such assignment, transfer, delegation or subcontract without the City's prior written consent shall be considered null and void. Nothing in this Agreement shall be construed to limit the City's ability to have any of the services which are the subject to this Agreement performed by City personnel or by other Consultants retained by City. 15. TERMINATION This Agreement may be terminated by the City upon thirty (30) days written notice of termination. In such event, to the extent required by law, Consultant shall be entitled to receive and the City shall pay Consultant compensation for all services performed by Consultant satisfactorily and in accordance with the scope of work contained in Exhibit A and all applicable SAMC requirements prior to receipt of such notice of termination. Further,the Executive Director may require Consultant to deliver to the City all work product(s) completed as of such date, and in such case such work product shall be the property of the City unless prohibited by law, and Consultant consents to the City's use thereof for such purposes as the City deems appropriate. 16. WAIVER No waiver of breach, failure of any condition, or any right or remedy contained in or granted by the provisions of this Agreement shall be effective unless it is in writing and signed by the party waiving the breach,failure,right or remedy.No waiver of any breach, failure or right,or remedy shall be deemed a waiver of any other breach, failure, right or remedy, whether or not the party waiving the breach,failure,right or remedy, No waiver of any breach,failure or right,or remedy shall be deemed a waiver of any other breach, failure, right or remedy, whether or not similar,nor shall any waiver constitute a continuing waiver unless the writing so specifies. 17. 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. 18. PROFESSIONAL LICENSES Consultant shall, throughout the terns of this Agreement, maintain all necessary licenses, permits,approvals,waivers,and exemptions necessary for the provision of the services hereunder and required by the laws and regulations of the United States, the State of California,the City of Santa Ana and all other governmental agencies. Consultant shall notify the City immediately and in writing of its inability to obtain or maintain such permits, licenses, approvals, waivers, and exemptions. Said inability shall be cause for termination of this Agreement. 19. NOTICE Any notice,tender,demand,delivery,or other communication pursuant to this Agreement shall be in writing and shall be deemed to be properly given if delivered in person or mailed by first class or certified mail,postage prepaid, or sent by fax or other telegraphic communication in the manner provided in this Section,to the following persons: To City: City Clerk City of Santa Ana 20 Civic Center Plaza(M-30) P.Q.Box 1988 Santa Ana,CA 92702-1988 Fax: 714-647-6956 With courtesy copies to: Executive Director Finance&Management Services Agency City of Santa Ana 20 Civic Center Plaza(M-15) P.O.Box 1988 Santa Ana,California 92702 And Executive Director Community Development Agency City of Santa Ana 20 Civic Center Plaza(M-25) P.O.Box 1988 -~ Santa Ana, California 92702 To Consultant: The ADR Coach,Inc, Attn: Angela Shaw,Principal 3782 Wellington Rd. Los Angeles,CA 90016 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. 20. MISCELLANEOUS PROVISIONS a. Each undersigned represents and warrants that its signature herein below has the power, authority and right to bind their respective parties to each of the terms of this Agreement, and shall indemnify City fully, including reasonable costs and attorney's fees, for any injuries or damages to City in the event that such authority or power is not, in fact,held by the signatory or is withdrawn. b. All Exhibits referenced herein and attached hereto shall be incorporated as if fully set forth in the body of this Agreement, [signature page to follow] IN WITNESS WHEREOF,the parties hereto have executed this Agreement the date and year first above written. ATTEST: CITY OF S TA ANA ennifer L. all Alvaro Nunez City Manager APPROVED AS TO FORM: SONIA R. CARVALHO THE ADR COACH,INC. City Attorney BIX y� Melis �9 sa M. Crosthwaite Angela Shaw Senior Assistant City Attorney Principal RECOMMENDED FOR APPROVAL. NexaeXk--rl-k"�ad Alex Trinidad Acting Executive Director Finance &Management Services Agency CITY OF SANTA ANA EXHIBIT A SCOPE OF SERVICES Services performed by Consultant shall include, but are not limited to the following: A. GENERAL REQUIREMENTS 1. For firms with multiple neutrals, the City must approve in advance, in writing, any neutrals that may serve as a hearing officer for the City. 2. Comply with the Model Code of Ethics published by the National Association of Hearing Officials. 3. Comply with all City ordinances, municipal code, charter, policies, procedures, rules, and regulations. 4. Prepare for hearings as scheduled by City staff, including notification of the hearing type, date, time, and location to petitioner/appellant. 5. Review case documentation submitted with petitions or appeals, and identifying and communicating potential concerns to the City. 6. Perform legal research, and interpret complex statutes, policies, and procedural guidelines. 7. Instruct participants in hearing of their rights and applicable hearing procedures. 8. Conduct hearings in a fair, impartial, courteous, and professional manner. 9. Hear testimony and evidence from parties regarding the issues. 10. Prepare written decisions, which set forth the legal and evidentiary basis for the decision, and adopt findings as required by the particular provisions of the Santa Ana Municipal Code (SAMC). 11. Perform all other services as outlined in the resulting agreement for services upon award. 12. Hearing Officers will confirm the absence of conflicts before undertaking any new matters for the City. Hearing Officers will inform and seek the consent of the City before representing another client in any matter directly averse to the City (e.g., transactions, negotiations, proceedings, or other representations involving specific parties). 13. Hearing Officer will be required to provide Hearing Officer services upon acceptance of assignments. Failure to comply with statutory or City required timelines for scheduling hearings may be cause for termination of the Agreement with the City. 14. Hearing preparation could include, but is not limited to, reading the file materials and familiarization with SAMC provisions at issue, hearing materials, and rules of evidence. 15. Virtual Hearings: City will provide virtual meeting link to all parties. The dates and times of said hearings shall be designated by the City, but normally will be conducted during the City's Regular Business Hours. City of Santa Ana RFP No.24-127 Page 17 of 34 CITY OF SANTA ANA a. The City's Regular Business Hours, excluding City holidays, are: • Monday through Thursday from 7:30 AM to 5:30 PM; and Alternate Fridays from 8:00 AM to 5:00 PM 16. In-Person Hearings: City will provide hearing rooms, use of copiers, documents, materials, and equipment necessary for carrying out hearings. Locations and times of said hearings shall be designated by the City, but normally will be conducted during Regular Business Hours of the City. • Hearings held in person will be held at Santa Ana City Hall, 20 Civic Center Plaza, Santa Ana, CA 92701. 17. All hearings shall be conducted in English and, if necessary, with the assistance of foreign language translator as provided by petitioners/appellants/applicants/contesting parties or the City. 18. City staff will coordinate the recording of hearings, if applicable. Assistance may be requested from the Hearing Officer during recording sessions. 19. Hearing Officers shall have a duty to notify the City of any actual conflict of interest or suspected conflict of interest immediately upon discovery, for consideration of appointment of an alternative Hearing Officer. B. REPORTS AND DELIVERABLES 1. Hearing Officers shall be required to submit a typed Statement of Decision for each hearing conducted within the statutorily or City required time following the closing of the hearing record in a format approved by the City. The decision shall include findings, conclusions, and provide judicial review information. Failure to comply with required timelines for issuing written decisions may be cause for termination of the Agreement with the City. 2. Hearing Officers shall provide a detailed invoice for services rendered each month, including the case number, hearing date, time incurred, and hourly rate. C. APPLICABLE SANTA ANA MUNICIPLE CODE (SAMC) Administrative Hearing Officers and their relevant services will be made available per SAMC for the subject areas listed below. Full text for all SAMC referenced herein is available at: https-://www.santa- ana.org/charter-and-municipal-code/ 1. Code Enforcement • Related to the broad enforcement of the City of Santa Ana Municipal Code, including but not limited to administrative citations issues for property maintenance violations, nuisance abatement, building code violations, lack of a permit issuance, revocation/denial of Certificates of Occupancy, planning/zoning, and all other Code Enforcement abatement actions • Other hearings may be requested in other City of Santa Ana Agency's/Departments outside of the Planning and Building Agency at the approval of the Executive Director of Planning and Building or their designee. City of Santa Ana RFP No.24-127 Page 18 of 34 (9) CITY OF SANTA ANA 2, Environmental Sanitation Violations • SAMC § 1-18.2 and SAMC § 1-21 • Related to administrative citations issued by Sanitation Inspectors for right-of-way obstructions, illegal advertising, and weed/rubbish abatement 3. Buildings and Structures • SAMC § 8 (Various Subsections) • Related to the enforcement of state building standards and the denial of permits, approvals, certificates of occupancy, or completion 4. Rent Stabilization and ,lust Cause Eviction • SAMC § 8-3145(f) (Per Ordinance No. NS-3052) • Related to the Petition Process involving landlord(s) and tenant(s), under the City's Rent Stabilization and Just Cause Eviction Ordinance (which limits rent increases, mandates 'Just cause" requirements for termination of tenancies, and establishes a rental registry) 5. Refuse Violations • SAMC § 16 (Various Subsections) • Related to administrative citations issued for the improper dumping and elimination of paper, cans, bottles, ashtray accumulations, refuse, trash, rubbish, or other filth in any public or private properties 6, Public Safety Sensitive Business Establishments • SAMC § 18-90 through 18-105; SAMC § 22-1 through 22-16 • Related to public safety regulation of certain businesses including tobacco retail licenses and massage establishments 7. Non-Regulatory Business License Tax • SAMC § 21-41 • Related to the determination of the amount of license tax due to the City from any business operator(aside from cannabis), with any penalties, interest, and charges (including fees) 8. Cannabis Business License Tax • SAMC § 21-41 Is Related to the determination of the amount of license tax due to the City from a cannabis operator, together with any penalties, interest, and charges (including service fees) 9. Hotel Visitors Tax (more commonly known as Transient.Occupancy Tax) • SAMC § 35-133 • Related to the determination of the amount of tax due to the City from a transient occupying a hotel based upon the rent charged by the operator 10. Utility Users Tax for Electric, Gas &Telecommunications Services • SAMC § 35-173 • Related to the determination of the amount of tax due to the City from every person using electricity, gas, and telecommunication services within Santa Ana City of Santa Ana RFP No,24-127 Page 19 of 34 Exhibit B Cost Proposal for Hearing Officer Services a The ADR Coach, Inc. 1.1 ntroduotion This cost proposal outlines the fixed rates for providing hearing officer services to the City of Santa Ana,Services include conducting hearings,reviewing documents,preparing written determinations, and handling no-shows and cancellations,as per the City"s requirements. 2.Fixed state Fee Schedule The following is a fixed fee schedule covering various aspects of hearing officer services as requested: A.Virtual Hearings(Flat-Fee.Per Hearing) + Rate per hearing conducted virtually:$350.00 B.In-Person Hearings at Santa Ana City Hall(Flat-Fee,Per Hearing) • Rate per hearing conducted at City Hall:$426.00 C.Hearing Preparation and Document Review(Flat-Fee,Per Hearing) + Fiat fee per hearing for preparation and document review:$150.00 D.Written Determinations and Hearing Closeouts(Flat-Fee,Per Hearing) + Flat fee per hearing for preparing written determinations and closeouts:$350.00 E.No-Short Charge Fee for no-show applicants:$350.00(virtual),In-person hearing -$425.00 F.Cancellation Rate + Cancellation tee:$350.00 within 48 hours or 2 business days of scheduled hearing Q.initial Orientation and Subsequent Training • Hourly rate for orientation and training sessions;$150.00 per hour + Minimum Charge:if applicable,include minimum charge:$150.00 H.Other Fees 3.Payment Schedule Invoices witt be submitted monthly,Itemizing the services provided per this fixed fee structure. Payments are due within 30 days of receipt. I CITY OF SANTA ANA CONTRACT - THE ADR COACH INC - FEB 18 2025 Final Audit Report 2025-02-28 Created: 2025-02-27 By: Kristin Andrade(kandrade@santa-ana.org) Status: Signed Transaction ID: CBJCHBCAABAASZusD6UbUTbNBgAtUlZxhiUxJSKRHc94 "CITY OF SANTA ANA CONTRACT - THE ADR COACH INC - FEB 18 2025" History 5 Document created by Kristin Andrade (kandrade@santa-ana.org) 2025-02-27-5:31:03 PM GMT C'. Document emailed to Alexander Trinidad (atrinidad@santa-ana.org) for signature 2025-02-27-5:31:24 PM GMT Email viewed by Alexander Trinidad (atrinidad@santa-ana.org) 2025-02-28-2:10:10 AM GMT 6a Document e-signed by Alexander Trinidad (atrinidad@santa-ana.org) Signature Date:2025-02-28-2:10:53 AM GMT-Time Source:server Agreement completed. 2025-02-28-2:10:53 AM GMT Adobe Acrobat Sign ACC> CERTIFICATE OF LIABILITY INSURANCE DATE I MMIDDIYYYY) 02/13/2025 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 1S WAIVED, subject to the terms and conditions of the policy, curtain 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 Burnette Insurance Agency, Inc. NAME: John A Burnette 3447 Lawrenceville Suwanee Rd. PHONNo,E (770) 339-8888 FAX (770) 339-1442 AC No; E-MAIL Suwanee GA 30024 ADDRESS: burnette@burnetteinsurance.com INSURERS AFFORDING COVERAGE NAIC# INSURER A:Sentinel Insurance Company Ltd 11000 INSURED INSURER B:Hisaox Insurance Company Inc 10200 Angela Shaw the ADR Coach Inc. INSURERC: Coalition Insurance Company 29530 3782 Wellington Road INSURERD: Los Angeles CA 90016 INSURERE: (323) 810-0626 INSURER F COVERAGES BB CERTIFICATE NUMBER:cart ID 12919 (11) 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 ADDL SUBR POLICY EFF POLICY EXP LTR POLICY NUMBER MMlDD1YYYY MMIDDffYYY LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S 2,000,000 DAMA E TO RENTE CLAIMS-MADE F1 OCCUR Y Y 20SBMBA6984 00/02/202408/02/2025 PREMISES Ea occurrence $ 1,000,004 MED EXP(Any one person) $ 10,000 PERSONAL&ADVINJURY S 2,000,000 GENI AGGREGATE LIMIT APPLIES PER GENFRALAGGREGATE $ 4,000,000 POLICY[:] PRO JECT ❑ LOC PRODUGTS-COMPIOPAGG $ 4,000,000 OTHER: S AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Eaaccidenl $ 2,000,000 A ANY AUTO Y 20SBMBA6984 08/02/2024 OB/02/2025 BODILY INJURY(Per parson) S OWNED SCHEDULED BODILY INJURY(Per S AUTOS ONLY AUTOS ( ) HIRED NON-OWNED PROPERTY DAMAGE $ X X AUTOS ONLY AUTOS ONLY Par accident $ UMBRELLALIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE S DED I I RETENTIONS S WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY YIN STATUTE ER ANYPROPRiETOR/PARTNERIEXECUTIVE E.L.EACH ACCIDENT S OFFICERIM EMBER EXCLUDED? NIA (Mandatory in NHI E.L.DISEASE-EA EMPLOYEE S it yes,descnho under DESCRIPTION OF OPERATIONS below EL DISEASE-POLICY LIMIT S B Professional Liability MPL230875723 08/02/2024 DB/O2/2025Each Occurrence and S 1,000,000 Aggregate C Cyber Liability C-4MQ8-506868-CYBER-2024 08/29/2024 08/29/2025Rach Occurrence $ 500,000 DESCRIPTION OF OPERATIONS 1 LOCATIONS 1 VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached it more space is required) Certificate holder is an additional insured per the Business Liability Coverage Form SS0008 and the Hired Auto and Non Owned Auto Endorsement SSO438, attached to this policy when a written contract is in place. Waiver of Subrogation applies in favor of the Certificate Holder per the Business Liability Coverage Form SS0008, attached to this policy when a written contract is in place. Notice of Cancellation will be provided in accordance with Form SS1223, attached to this policy when a written contract is in place. Coverage is primary and noncontributory per the Business Liability Coverage Form SSOODS, attached to this policy when a written contract is in place. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Santa Ana ACCORDANCE WITH THE POLICY PROVISIONS. Attn: Human Resources Department 20 CIVIC CENTER PLZ AUTHORIZED REPRESENTATIVE Santa Ana CA 92701 O 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD [APPROVED Page 1 of 1 By Luisa Najera at 1:46 pm,Feb 13,2025 it THANK YOU FOR RENEWING YOUR POLICY WITH US If you're receiving this renewal through the mail directly from The Hartford, please note that we've only attached new, changed or updated documents. These include your new declarations page, which outlines your coverage, as well as any notices and brochures with updated information. We leave out unchanged documents to help cut down on paperwork and mailing costs. You can keep the attached documents filed alongside those from your previous policy if you wish. If you're receiving this renewal electronically, or it's been mailed by your agent, it may include all of your documents-even ones that haven't changed. In either case, keep in mind that you can view, download or print any of these documents online. Just register or log into your account https:/Ibusiness.thehartford.com and click on "Documents". For added convenience,you can also pay your bill, request a Certificate of Insurance, check claims status, update preferences and more. Form G4159-0 0 2019,The Hartford Page 1 of 1 ANGELA D SHAW DBA THE ADR COACH, IN llf 3782 WELLINGTON ROAD THE LOS ANGELES CA 90016 HARTFORD Policy Number: 20 SBM BA6984 Renewal Date: 08/02/24 Thank you for being a loyal customer of The Hartford. #1: Your Hartford Policy Enclosed are renewal documents for your policy, which is scheduled to renew on 08/02/24 . Along with a new Declarations Page, which details the coverages provided by your policy, we are enclosing important policy documents. Please be aware that you will receive an invoice separately for this new policy term approximately 30 days prior to the renewal date; no action is required now. To ensure the premium you paid for this past policy term was accurate, we may contact you by letter, phone or email to conduct a premium audit. If contacted, we will advise what information is needed to complete the audit. #2: Your Business Insurance Coverage Checkup Now is a great time to complete a business insurance coverage checkup with a Hartford Insurance Professional. Because you wear so many hats each day, you may not be thinking about how changes to your business can impact the type and amount of insurance coverage needed to protect it. Together we will evaluate how your needs may have changed over the past year. Examples include: - Has your mailing address and/or the physical location of your business changed? - Has there been any increase/decrease in the amount of business property/equipment you own? - Has there been any increase/decrease in your company's payroll or sales? - Have you added or eliminated any vehicles used in your business operations? - Are the bill plan and deductible on your policy right for your business? During the review we may make coverage recommendations, provide peace of mind solutions, and possibly reduce your costs. Here is all you need to do: - Call toll free (866) 467-8730 , and select our renewal review service option any weekday from 7 A.M.to 7 P.M. CST and request your business insurance check-up. - To best serve you, please have your Policy Number or Account Number and a Copy of your current Renewal Policy in hand when you call. #3: Servicing Your Needs To login or register for our Online Business Service Center, go to www.thehartford.com/servicecenter where any time, day or night you can: - Pay your bill, view payment history and enroll in Auto Pay Request Auto ID Cards and Certificates of Insurance - View electronic copies of billing and policy documents and sign up for paperless delivery #4: If You've Had A Loss or Accident... Report It Immediately We want to help! Contact us as quickly as possible at 1-800-327-3636. - Representatives are available 24-7 to assist in helping you recover from your loss. On behalf of BURNETTE INSURANCE AGENCY INC/PHS and The Hartford, we appreciate the opportunity to have been of service to you this past year and look forward to serving your business insurance needs for the upcoming year. Sincerely, Your Hartford Team FRAUD NOTICE The following statement is added to the policy: CALIFORNIA NOTICE: For your protection California law requires the following to appear on this form: Any person who knowingly presents false or fraudulent information to obtain or amend insurance coverage or to make a claim for the payment of a loss is guilty of a crime and may be subject to fines and confinement in state prison. COLORADO NOTICE: It is unlawful to knowingly provide false, incomplete, or misleading facts or information to an insurance company for the purpose of defrauding or attempting to defraud the company. Penalties may include imprisonment, fines, denial of insurance, and civil damages. Any insurance company or agent of an insurance company who knowingly provides false, incomplete, or misleading facts or information to a policy holder or claimant for the purpose of defrauding or attempting to defraud the policy holder or claimant with regard to a settlement or award payable from insurance proceeds shall be reported to the Colorado division of insurance within the department of regulatory agencies. NEW YORK NOTICE: Any person who knowingly and with intent to defraud any insurance company or other person files an application for insurance or statement of claim containing any materially false information, or conceals for the purpose of misleading, information concerning any fact material thereto, and any person who, in connection with such application or claim, knowingly makes or knowingly assists, abets, solicits or conspires with another to make a false report of the theft, destruction, damage or conversion of any motor vehicle to a law enforcement agency, the department of motor vehicles or an insurance company, commits a fraudulent insurance act, which is a crime, and shall also be subject to a civil penalty not to exceed five thousand dollars and the value of the subject motor vehicle or the stated value of the claim for each such violation. PENNSYLVANIA NOTICE: Any person who knowingly and with intent to injure or defraud any insurance company or other person files an application for insurance or statement of claim containing any materially false, incomplete, or misleading information or conceals for the purpose of misleading, information concerning any fact material thereto commits a fraudulent insurance act, which is a crime and subjects such person to criminal and civil penalties, including imprisonment for up to seven years and payment of a fine of up to $15,000. i Form G-4190-0(ED. 11122) Page 1 of 1 ©2022, The Hartford Insurance Policy Billing Information Thank you for selecting The Hartford for your business insurance needs. Shortly, you will receive your first bill from us. You are receiving this Notice so you know what to expect as a valued customer of The Hartford. Should you have any questions after reviewing this information, please contact us at 866-467-8730, and we will be happy to assist you. o Your total policy premium will appear on your policy's Declarations Page. You will be billed based on the payment plan you selected. o You may pay the"minimum due"as it appears on your insurance bill or pay the policy balance in full. o An installment service fee is added to each installment. A late fee will also be applied if the "minimum due" is not received by the due date shown on your bill. Service and late payment fees do not apply in all states. o If you selected installment billing, any credit or additional premium due as the result of a change made to your policy, will be spread over the remaining billing installments. Additional premium due as a result of an audit will be billed in full on your next bill date following the completion of the audit. o If you elected Electronic Funds Transfer (EFT), policy changes may result in changes to the amount automatically withdrawn from your bank account. The invoice you receive following a policy change will include future withdrawal amounts. If you need to adjust or stop your next scheduled EFT withdrawal, please contact us at least 3 days prior to the scheduled withdrawal date at the telephone number shown below. o If you selected installment billing and pay the premiums for your first policy term on time, at renewal, your account may qualify for our"Equal Installment"feature. This means that the percentage due for each installment, including the initial renewal installment, will be the same throughout the policy term — helping you better manage cash flow. Equal installments will continue as long as you pay your premiums on time and no cancellation notices are issued for any policy on your account. If you no longer qualify for Equal Installments, future renewals will be billed based on the payment plan you selected, which includes a higher initial installment amount. o If your policy is eligible for renewal, your bill for the upcoming policy term will be sent to you approximately 30 days prior to your policy's renewal date. If your insurance needs change, please contact us at least 60 days prior to your renewal date so we can properly address any adjustments needed. o One bill convenience -- you have the option of combining all eligible Hartford policies on one single bill allowing you to make one payment for all policies on your account as payments are due. You're In Control In addition to selecting a bill plan option that best meets your budget, you have the flexibility to decide howyour payments are made ... o Repetitive EFT: Sign up for Repetitive EFT payments and have payments automatically withdrawn from your bank account. This option saves you money by reducing the amount of the installment service fee. o Pay Online: Register at www.thehartford.com/servicecenter. Online Bill Pay is Quick, Easy and Secure! o Pay by Check: Send a check with your remittance stub in the envelope provided with your bill. o Pay by Phone: Call toil-free 1-866-467-8730. Should you have any questions about your bill, please call Customer Service toll-free number: 1-866-467-8730 -7AM—7PM CST. We look forward to being of service to you. Form 100722 11th Rev. Printed in U.S.A. IMPORTANT NOTICE TO POLICYHOLDERS THE HARTFORD CYBER CENTER WEBSITE ACCESS Thank you for choosing The Hartford for your business insurance needs, You are receiving this Notice because you purchased a business owner's policy from The Hartford, (your Policy was issued by The Hartford writing company identified on your policy Declarations page)which includes access to The Hartford Cyber Center. This portal was created because we recognize that businesses face a variety of cyber-related exposures and need help managing the related risks. These exposures include data breaches, computer virus attacks and cyber extortion threats. Through The Hartford Cyber Center, you have access to: o A panel of third party incident response service providers o Third party cybersecurity pre-incident service providers and a list of approved services to help protect your business before a cyber-threat occurs o Risk management tools, including self-assessments, best practice guides, templates, sample incident response plans, and data breach cost calculators o White papers, blogs and webinars from leading privacy and security practitioners o Up-to-date cyber-related news and events, including examples of privacy and security related events Accessing The Hartford Cyber Center is easy 1. Visit www.thehartford.com/cybercenter 2. Enter policyholder information 3. Access code: 952689 4. Login to The Hartford Cyber Center This Notice does not amend or otherwise affect the provisions of your business owner's policy. Coverage Options: The Hartford offers a variety of endorsements to your business owner's policy that can help protect your business from a broad range of cyber-related threats. Please review your coverage with your insurance agent or broker to determine the most appropriate cyber coverages and limits for your business. Claims Reporting: If you have a claim, you can report it by calling The Hartford's toll-free claims line at 1-800-327-3636. Should you have any questions, please contact your insurance agent, broker or you may contact us directly. We appreciate your business and look forward to being of continued service to you. Please be aware that: o The Hartford Cyber Center is a proprietary web portal exclusively provided to customers of The Hartford. Please do not share the access code with anyone outside your organization. o Registration is required to access the Cyber Center. You may register as many users as necessary. o Contacting a service provider about any issue does not constitute providing The Hartford notice of a claim as required under your insurance policy. Read your insurance policy and discuss any questions with your agent or broker. The Hartford Cyber Center provides third party service provider references and materials for educational purposes only. The Hartford does not specifically endorse any such service provider within The Hartford Cyber Center and hereby disclaims all liability with respect to use of or reliance on such service providers. All service providers are independent contractors and not agents of The Hartford. The Hartford does not warrant the performance of the service providers, even if such services are covered under your Business Owners Policy. We strongly encourage you to conduct your own assessments of the service providers' services and the fitness or adequacy of such services for your particular needs. Form SS 89 93 0716 Page 1 of 1 i ©2016, The Hartford Spectrum" Business Owner's Policy THE HARTFORD Form SS 00 0103 14 Page 1 of 1 THE HARTFORD PRODUCER COMPENSATION NOTICE You can review and obtain information on The Hartford's producer compensation practices at www.TheHartford.com or at 1-800-592-5717. i i Form G-3418-0 POLICY NUMBER: 20 SBM BA6984 it THIS ENDORSEMENT IS ATTACHED TO AND MADE PART OF YOUR POLICY IN RESPONSE TO THE DISCLOSURE REQUIREMENTS OF THE TERRORISM RISK INSURANCE ACT. DISCLOSURE PURSUANT TO TERRORISM RISK INSURANCE ACT SCHEDULE Terrorism Premium: $ $11.00 A. Disclosure Of Premium United States or to influence the policy or In accordance with the federal Terrorism Risk affect the conduct of the United States Insurance Act, as amended (TRIA), we are required Government by coercion to provide you with a notice disclosing the portion of C. Disclosure Of Federal Share Of Terrorism your premium, if any, attributable to coverage for Losses certified acts of terrorism under TRIA. The portion The United States Department of the Treasury will of your premium attributable to such coverage is reimburse insurers for a portion of insured fosses, shown in the Schedule of this endorsement. as indicated in the table below, attributable to B. The following definition is added with respect to the "certified acts of terrorism" under TRIA that exceeds provisions of this endorsement: the applicable insurer deductible: 1. A"certified act of terrorism"means an act that is Calendar Year Federal Share of certified by the Secretary of the Treasury, in Terrorism Losses accordance with the provisions of TRIA, to be an act of terrorism under TRIA. The criteria 2015 85% contained in TRIA for a "certified act of 2016 84% terrorism"include the following: 2017 83% a. The act results in insured losses in excess of$5 million in the aggregate, attributable to 2018 82% all types of insurance subject to TRIA; and 2019 81% b. The act results in damage within the United 2020 or later 80% States, or outside the United States in the case of certain air carriers or vessels or the However, if aggregate industry insured losses under premises of an United States mission; and TRIA exceed $100 billion in a calendar year, the c. The act is a violent act or an act that is Treasury shall not make any payment for any dangerous to human life, property or portion of the amount of such losses that exceeds infrastructure and is committed by an $100 billion. The United States government has not individual or individuals as part of an effort charged any premium for their participation in to coerce the civilian population of the covering terrorism losses. Form SS 83 76 01 15 Page 1 of 2 ©2015 , The Hartford (Includes copyrighted material of the Insurance Services Office, Inc., with its permission.) D. Cap On Insurer Liability for Terrorism Losses If aggregate industry insured losses attributable to "certified acts of terrorism" under TRIA exceed $100 billion in a calendar year and we have met, or will meet, our insurer deductible under TRIA, we shall not be liable for the payment of any portion of the amount of such losses that exceed $100 billion. In such case, your coverage for terrorism losses may be reduced on a pro-rata basis in accordance with procedures established by the Treasury, based on its estimates of aggregate industry losses and our estimate that we will exceed our insurer deductible. In accordance with the Treasury's procedures, amounts paid for losses may be subject to further adjustments based on differences between actual losses and estimates. E. Application of Other Exclusions The terms and limitations of any terrorism exclusion, the inapplicability or omission of a terrorism exclusion, or the inclusion of terrorism coverage, do not serve to create coverage for any loss which would otherwise be excluded under this Coverage Form, Coverage Part or Policy. F. All other terms and conditions remain the same. Form SS 83 76 01 15 Page 2 of 2 it THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. NOTICE OF CANCELLATION TO CERTIFICATE HOLDER(S) This policy is subject to the following additional Conditions: A. If this policy is cancelled by the Company, other If notice is mailed, proof of mailing to the last known than for non-payment of premium, notice of such mailing address of the certificate holder(s) on file with cancellation will be provided at least thirty (30) days the agent of record or the Company will be sufficient in advance of the cancellation effective date to the proof of notice. certificate holder(s) with mailing addresses on file Any notification rights provided by this endorsement with the agent of record or the Company. apply only to active certificate holder(s) who were issued B. If this policy is cancelled by the company for non- a certificate of insurance applicable to this policy's term, payment of premium, or by the insured, notice of Failure to provide such notice to the certificate holder(s) such cancellation will be provided within ten (10) will not amend or extend the date the cancellation days of the cancellation effective date to the becomes effective, nor will it negate cancellation of the certificate holder(s) with mailing addresses on file policy. Failure to send notice shall impose no liability of with the agent of record or the Company. any kind upon the Company or its agents or representatives. Form SS 12 23 0611 page 1 of 1 C 2011, The Hartford IMPORTANT NOTICE TO POLICYHOLDERS To help your insurance keep pace with increasing costs, we have increased your amount of insurance . . . giving you better protection in case of either a partial, or total loss to your property. If you feel the new amount is not the proper one, please contact your agent or broker. Form PC-374-0 Printed in U.S.A. 84 This Spectrum Policy consists of the Declarations, Coverage Forms, Common Policy Conditions and any 69 other Forms and Endorsements issued to be a part of the Policy. This insurance is provided by the stock 13A insurance company of The Hartford Insurance Group shown below. SBM INSURER: SENTINEL INSURANCE COMPANY, LIMITED ONE HARTFORD PLAZA, HARTFORD, CT 06155 COMPANY CODE: A Policy Number: 20 SHM BA6984 DV THE HARTFORD SPECTRUM POLICY DECLARATIONS Named Insured and Mailing Address: ANGELA D SHAW DRA THE ADR COACH, IN (No., Street, Town, State, Zip Code) C. 3782 WELLINGTON ROAD LOS ANGELES CA 90016 Policy Period: From 08/02/24 To 08/02/25 1 YEAR 12:01 a.m,, Standard time at your mailing address shown above. Exception: 12 noon in New Hampshire. Name of Agent/Broker: BURNETTE INSURANCE AGENCY INC/PKS Code: 262167 Previous Policy Number: 20 SBM 8A6984 Named Insured is: INDIVIDUAL Audit Period: NON-AUDITABLE Type of Property Coverage: NONE Insurance Provided: In return for the payment of the premium and subject to all of the terms of this policy, we agree with you to provide insurance as stated in this policy. TOTAL ANNUAL PREMIUM IS: $584 DISCOUNT APPLIED: PAID IN FULL Countersigned by 05/16/24 Authorized Representative Date Form SS 00 02 12 06 Page 001 (CONTINUED ON NEXT PAGE) Process Date: 05/16/24 Policy Expiration Bate, 08/02/25 SPECTRUM POLICY DECLARATIONS (Continued) POLICY NUMBER: 20 SBM DA6984 Location(s), Building(s), Business of Named Insured and Schedule of Coverages for Premises as designated by Number below. Location: 001 Building: ooi 3782 WELLING'ZON ROAD LOS ANGELES CA 90016 Description of Business: Consultant - NOC Deductible: No COVERAGE BUILDING AND BUSINESS PERSONAL PROPERTY LIMITS OF INSURANCE BUILDING NO COVERAGE BUSINESS PERSONAL PROPERTY REPLACEMENT COST NO COVERAGE PERSONAL PROPERTY OF OTHERS REPLACEMENT COST No COVERAGE MONEY AND SECURITIES INSIDE THE PREMISES NO COVERAGE OUTSIDE THE PREMISES NO COVERAGE i Form SS 00 0212 06 Page 002 (CONTINUED ON NEXT PAGE) Process Date; 05/16/24 Policy Expiration Date: 08/02/25 SPECTRUM POLICY DECLARATIONS (Continued) POLICY NUMBER: 20 S�3M BA6984 BUSINESS LIABILITY LIMITS OF INSURANCE LIABILITY AND MEDICAL EXPENSES $2, 000, 000 MEDICAL EXPENSES -ANY ONE PERSON $ 10, 000 PERSONAL AND ADVERTISING INJURY $2,000,000 DAMAGES TO PREMISES RENTED TO YOU $1, 000, 000 ANYONE PREMISES AGGREGATE LIMITS PRODUCTS-COMPLETED OPERATIONS $4,000,000 FORM SS 05 09 GENERAL AGGREGATE $4,000,000 BUSINESS LIABILITY OPTIONAL COVERAGES HIRED/NON-OWNED AUTO LIABILITY $2, 000, 000 WAIVER OF SUBROGATION: FORM SS 12 15 LOCATION: 001 BUILDING: 001 SEE FORM IH 12 00 Form SS 00 02 12 06 Page o 0 3 (CONT TNUED ON NEXT PAGE) Process Date: 05/16/24 Policy Expiration Date; 08/02/25 SPECTRUM POLICY DECLARATIONS (Continued) POLICY NUMBER: 20 SBM BA6984 BUSINESS LIABILITY OPTIONAL COVERAGES LIMITS OF INSURANCE (Continued) U'NMAMED AIRCRAFT LIABILITY IS EXCLUDED SEE FORM: SS 42 06 I Form SS 00 0212 06 Page 004 (CONTINUED ON NEXT PAGE) Process Date: 05/16/24 Policy Expiration Date: 08/02/25 SPECTRUM POLICY DECLARATIONS (Continued) POLICY NUMBER: 20 SBM SA6984 ADDITIONAL INSUREDS: THE FOLLOWING ARE ADDITIONAL INSUREDS FOR BUSINESS LIABILITY COVERAGE IN THIS POLICY. LOCATION 001 BUILDING 001 TYPE PERSON ORGANIZATION NAME SEE FORK IH 12 00 TYPE STATE POLITICAL SUBDIVISION NAME SEE FORM III 12 00 TYPE OWNER, LESSEES OR CONTRACTORS NAME SEE FORM IH 12 00 Form SS 00 02 12 06 Page 005 (CONTINUED ON NEXT PAGE) Process Date: 05/16/24 Policy Expiration Date: 08/02/25 SPECTRUM POLICY DECLARATIONS (Continued) POLICY NUMBER: 20 SBM BA6984 Form Numbers of Forms and Endorsements that apply: SS 00 01 03 14 SS 00 05 10 08 SS 00 08 04 05 SS 00 45 12 06 SS 00 60 09 15 SS 00 64 09 16 SS 01 21 02 20 SS 42 06 03 17 SS 04 38 09 09 SS 41 63 06 11 SS 05 09 07 00 SS 05 47 09 15 G-4190-0 IH 12 05 ❑2 21 SS 12 15 03 00 SS 50 19 01 15 IH 99 40 04 09 IH 99 41 04 09 SS 83 76 01 15 SS 89 93 07 16 SS 12 23 06 11 IH 12 00 11 85 ADDITIONAL INSURED - PERSON-ORGANIZATION IH 12 00 11 85 ADDITIONAL INSURED - STATE/POLITICAL SUBDIVISION IH 12 00 11 85 WAIVER OF SUBROGATION IH 12 00 11 85 SS122000810 NOTICE OF CANCELLATION OR NON-RENEWAL TO DESIGNA'T'ED PERSON(S) OR ORGANIZATIONS) OTHER THAN THE NAMED INSURED IH 12 00 11 85 30 DAY NOTICE OF CANCELLATION IH 12 00 11 B5 ADDITIONAL INSURED - OWNER., LESSEES OR CONTRACTOR ONGOING OPERATIONS SS4170 IH 12 00 11 85 ADDITIONAL INSURED - OWNER, LESSEES OR CONTRACTOR COMPLETED OPERATIONS SS4171 i I i Form SS 00 02 12 06 Page 006 Process Date: 05/16/24 Policy Expiration Date: 08/02/25 SPECTRUM POLICY DECLARATIONS (Continued) POLICY NUMBER: 20 SBM BA6984 SUPPLEMENTAL DECLARATIONS: A service fee of$ 7.oo Is charged for each installment when your premium is paid in installments. The service fee is $ 5.oo per withdrawal when you select an electronic fund transfer payment plan. The service fee will be added to the premium amount shown on your premium billing statement. Form SS 00 45 12 06 Process Date: 05/16/24 Policy Expiration Date: 08/02/25 COMMON POLICY CONDITIONS Form SS 00 05 10 08 © 2008, The Hartford QUICK REFERENCE - SPECTRUM POLICY DECLARATIONS and COMMON POLICY CONDITIONS I. DECLARATIONS Named Insured and Mailing Address Policy Period Description and Business Location Coverages and Limits of Insurance II. COMMON POLICY CONDITIONS Beginning on Page A. Cancellation 1 B. Changes 1 C. Concealment, Misrepresentation Or Fraud 2 D. Examination Of Your Books And Records 2 E. Inspections And Surveys 2 F. Insurance Under Two Or More Coverages 2 G. Liberalization 2 H. Other Insurance- Property Coverage 2. I. Premiums 2 J. Transfer Of Rights Of Recovery Against Others To Us 2 K. Transfer Of Your Rights And Duties Under This Policy 3 L. Premium Audit 3 Form SS 00 05 10 08 it COMMON POLICY CONDITIONS All coverages of this policy are subject to the following conditions. A. Cancellation (5) Failure to: 1. The first Named Insured shown in the (a) Furnish necessary heat, water, Declarations may cancel this policy by mailing sewer service or electricity for 30 or delivering to us advance written notice of consecutive days or more, except cancellation. during a period of seasonal 2. We may cancel this policy by mailing or unoccupancy; or delivering to the first Named Insured written (b) Pay property taxes that are owing notice of cancellation at least: and have been outstanding for a. 5 days before the effective date of more than one year following the cancellation if any one of the following date due, except that this provision conditions exists at any building that is will not apply where you are in a Covered Property in this policy: bona fide dispute with the taxing authority regarding payment of (1) The building has been vacant or such taxes. unoccupied 60 or more consecutive b. 10 days before the effective date of days. This does not apply to: cancellation if we cancel for nonpayment (a) Seasonal unoccupancy; or of premium. (b) Buildings in the course of c. 30 days before the effective date of construction, renovation or cancellation if we cancel for any other addition. reason. Buildings with 65% or more of the rental 3. We will mail or deliver our notice to the first units or floor area vacant or unoccupied are Named Insured's last mailing address known to considered unoccupied under this us. provision. 4. Notice of cancellation will state the effective (2) After damage by a Covered Cause of date of cancellation. The policy period will end Loss, permanent repairs to the building: on that date. (a) Have not started; and 5. If this policy is canceled, we will send the first (b) Have not been contracted for, Named Insured any premium refund due. Such within 30 days of initial payment of refund will be pro rata. If the first Named loss. Insured cancels, the refund may be less than pro rata. The cancellation will be effective even (3) The building has: if we have not made or offered a refund. (a) An outstanding order to vacate; 6. If notice is mailed, proof of mailing will be (b) An outstanding demolition order; or sufficient proof of notice. (c) Been declared unsafe by B. Changes governmental authority. This policy contains all the agreements between (4) Fixed and salvageable items have you and us concerning the insurance afforded. been or are being removed from the The first Named Insured shown in the Declarations building and are not being replaced, is authorized to make changes in the terms of this This does not apply to such removal policy with our consent. This policy's terms can be that is necessary or incidental to any amended or waived only by endorsement issued by renovation or remodeling. us and made a part of this policy. I Form SS 00 05 10 08 Page 1 of 3 © 2008, The Hartford COMMON POLICY CONDITIONS C. Concealment, Misrepresentation Or Fraud due from that other insurance, whether you can This policy is void in any case of fraud by you as it collect on it or not. But we will not pay more than relates to this policy at any time. It is also void if the applicable Limit of Insurance. you or any other insured, at any time, intentionally I. Premiums conceal or misrepresent a material fact concerning: 1. The first Named Insured shown in the 1. This policy; Declarations: 2. The Covered Property; a. Is responsible for the payment of all 3. Your interest in the Covered Property; or premiums; and 4. A claim under this policy. b. Will be the payee for any return premiums D. Examination Of Your Books And Records we pay. We may examine and audit your books and records 2. The premium shown in the Declarations was computed based on rates in effect at the time as they relate to the policy at any time during the the policy was issued. If applicable, on each policy period and up to three years afterward. renewal, continuation or anniversary of the E. Inspections And Surveys effective date of this policy, we will compute the 1. We have the right but are not obligated to: premium in accordance with our rates and rules a. Make inspections and surveys at any time; then in effect. 3. With our consent, you may continue this policy b. Give you reports on the conditions we find; in force by paying a continuation premium for and each successive one-year period. The premium c. Recommend changes. must be: 2. Any inspections, surveys, reports or a. Paid to us prior to the anniversary date; and recommendations will relate only to insurability b. Determined in accordance with Paragraph and the premiums to be charged. We do not 2.above. make safety inspections. We do not undertake to perform the duty of any person or Our forms then in effect will apply. If you do organization to provide for the health or safety not pay the continuation premium, this policy of any person. We do not represent or warrant will expire on the first anniversary date that we that conditions: have not received the premium. a. Are safe or healthful; or 4. Changes in exposures or changes in your business operation, acquisition or use of b. Comply with laws, regulations, codes or locations that are not shown in the Declarations standards, may occur during the policy y g p y period. If so, we 3. This condition applies not only to us, but also to may require an additional premium. That any rating, advisory, rate service or similar premium will be determined in accordance with organization which makes insurance our rates and rules then in effect. inspections, surveys, reports or J. Transfer Of Rights Of Recovery Against Others recommendations on our behalf. To Us F. Insurance Under Two Or More Coverages Applicable to Property Coverage: If two or more of this policy's coverages apply to the If any person or organization to or for whom we same loss or damage, we will not pay more than the actual amount of the loss or damage. make payment under this policy has rights to recover damages from another, those rights are G. Liberalization transferred to us to the extent of our payment. That If we adopt any revision that would broaden the person or organization must do everything coverage under this policy without additional necessary to secure our rights and must do nothing premium within 45 days prior to, or at any time after loss to impair them. But you may waive your during, the policy period, the broadened coverage rights against another party in writing: will immediately apply to this policy. 9. Prior to a loss to your Covered Property; or H. Other Insurance- Property Coverage 2. After a loss to your Covered Property only if, at If there is other insurance covering the same loss or time of loss, that party is one of the following: damage, we will pay only for the amount of covered loss or damage in excess of the amount Page 2 of 3 Form SS 00 05 10 08 COMMON POLICY CONDITIONS a. Someone insured by this insurance; appointed, anyone having proper temporary b. A business firm: custody of your property will have your rights and duties but only with respect to that property. (1) Owned or controlled by you; or L. Premium Audit (2) That owns or controls you; or a. We will compute all premiums for this policy in c. Your tenant. accordance with our rules and rates. You may also accept the usual bills of lading or b. The premium amount shown in the Declarations shipping receipts limiting the liability of carriers. is a deposit premium only. At the close of each This will not restrict your insurance. audit period we will compute the earned K. Transfer Of Your Rights And Duties Under This premium for that period. Any additional Policy premium found to be due as a result of the audit are due and payable on notice to the first Your rights and duties under this policy may not be Named Insured. If the deposit premium paid transferred without our written consent except in the for the policy term is greater than the earned case of death of an individual Named Insured. premium, we will return the excess to the first If you die, your rights and duties will be transferred Named Insured. to your legal representative but only while acting c. The first Named Insured must maintain all within the scope of duties as your legal records related to the coverage provided by this representative. Until your legal representative is policy and necessary to finalize the premium audit, and send us copies of the same upon our request. Our President and Secretary have signed this policy. Where required by law, the Declarations page has also been countersigned by our duly authorized representative. Kevin Barnett,Secretary M.Ross Fisher,President I Page 3 of 3 Form SS 00 0510 08 BUSINESS LIABILITY COVERAGE FORM Form SS 00 08 04 05 0 2005, The Hartford QUICK REFERENCE BUSINESS LIABILITY COVERAGE FORMA READ YOUR POLICY CAREFULLY BUSINESS LIABILITY COVERAGE FORM Beginning on Page A. COVERAGES 1 Business Liability 1 Medical Expenses 2 Coverage Extension -Supplementary Payments 2 B. EXCLUSIONS 3 C. WHO IS AN INSURED 10 D. LIABILITY AND MEDICAL EXPENSES LIMITS OF INSURANCE 14 E. LIABILITY AND MEDICAL EXPENSES GENERAL CONDITIONS 1s 1. Bankruptcy 15 2. Duties In The Event Of Occurrence, Offense, Claim Or Suit 15 3. Financial Responsibility Laws 16 4. Legal Action Against Us 16 S. Separation Of Insureds 16 6. Representations 16 7. Other Insurance 16 8. Transfer Of Rights Of Recovery Against Others To Us 17 F. OPTIONAL ADDITIONAL INSURED COVERAGES 18 Additional Insureds 18 G. LIABILITY AND MEDICAL EXPENSES DEFINITIONS 20 Form SS 00 08 04 05 I BUSINESS LIABILITY COVERAGE FORM Various provisions in this policy restrict coverage. Read the entire policy carefully to determine rights, duties and what is and is not covered. Throughout this policy the words "you" and "your" refer to the Named Insured shown in the Declarations. The words "we", IF and "our" refer to the stock insurance company member of The Hartford providing this insurance. The word "insured" means any person or organization qualifying as such under Section C. -Who Is An Insured. Other words and phrases that appear in quotation marks have special meaning. Refer to Section G. - Liability And Medical Expenses Definitions, A. COVERAGES (a) The "bodily injury" or "property 1. BUSINESS LIABILITY COVERAGE (BODILY damage" is caused by an INJURY PROPERTY DAMAGE PERSONAL "occurrence" that takes place in the AND ADVERTISING INJURY) "coverage territory"; Insuring Agreement (b) The "bodily injury" or "property a. We will a those sums that the insured damage" occurs during the policy pay period; and becomes legally obligated to pay as damages because of "bodily injury", (c) Prior to the policy period, no insured listed under Paragraph I. of Section "property damage or "personal and C. — Who Is An Insured and no advertising injury" to which this insurance "employee"authorized by you to give applies. We will have the right and duty to or receive notice of an "occurrence" defend the insured against any "suit" or claim, knew that the"bodily injury" seeking those damages. However, we will or "property damage" had occurred, have no duty to defend the insured against in whole or in part. If such a listed any suit seeking damages for bodily insured or authorized "employee" injury", "property damage" or"personal and knew, prior to the policy period, that advertising injury" to which this insurance the "bodily injury" or "property does not apply. damage" occurred, then any We may, at our discretion, investigate any continuation, change or resumption occurrence' or offense and settle any claim of such "bodily injury" or "property or"suit" that may result. But: damage" during or after the policy (1) The amount we will pay for damages is period will be deemed to have been limited as described in Section D. - known prior to the policy period. Liability And Medical Expenses Limits (2) To "personal and advertising injury" Of Insurance; and caused by an offense arising out of your (2) Our right and duty to defend ends when business, but only if the offense was we have used up the applicable limit of committed in the "coverage territory" insurance in the payment of judgments, during the policy period. settlements or medical expenses to which c. "Bodily injury" or "property damage" will be this insurance applies, deemed to have been known to have No other obligation or liability to pay sums or occurred at the earliest time when any perform acts or services is covered unless insured listed under Paragraph 1. of Section explicitly provided for under Coverage C. -- Who Is An Insured or any "employee" Extension-Supplementary Payments. authorized by you to give or receive notice b. This insurance applies: of an"occurrence" or claim: 1 To "bodily injury" and (1) Reports all, or any part, of the "bodily ( } yproperty injury" or "property damage" to us or damage"only if: any other insurer; Form SS 00 08 04 05 Page 1 of 24 0 2005, The Hartford BUSINESS LIABILITY COVERAGE FORM (2) Receives a written or verbal demand or b. We will make these payments regardless of claim for damages because of the "bodily fault. These payments will not exceed the injury"or"property damage";or applicable limit of insurance. We will pay (3) Becomes aware by any other means that reasonable expenses for: "bodily injury" or "property damage" has (1) First aid administered at the time of an occurred or has begun to occur. accident; d. Damages because of"bodily injury" include (2) Necessary medical, surgical, x-ray and damages claimed by any person or dental services, including prosthetic organization for care, loss of services or devices; and death resulting at any time from the "bodily (3) Necessary ambulance, hospital, injury". professional nursing and funeral e. Incidental Medical Malpractice services. (1) "Bodily injury" arising out of the 3. COVERAGE EXTENSION - rendering of or failure to render SUPPLEMENTARY PAYMENTS professional health care services as a a. We will pay, with respect to any claim or physician, dentist, nurse, emergency "suit" we investigate or settle, or any "suit" medical technician or paramedic shall against an insured we defend: be deemed to be caused by an "occurrence", but only if: (1) All expenses we incur. (a) The physician, dentist, nurse, (2) Up to $1,000 for the cost of bail bonds emergency medical technician or required because of accidents or traffic paramedic is employed by you to law violations arising out of the use of provide such services; and any vehicle to which Business Liability (b) You are not engaged in the Coverage for"bodily injury"applies. We business not have to furnish these bonds. or occupation of providing such services. (3) The cost of appeal bonds or bonds to release attachments, but only for bond (2) For the purpose of determining the amounts within the applicable limit of limits of insurance for incidental medical insurance. We do not have to furnish malpractice, any act or omission these bonds. together with all related acts or omissions in the furnishing of these (4) All reasonable expenses incurred by the services to any one person will be insured at our request to assist us in the considered one"occurrence". investigation or defense of the claim or "suit", including actual loss of earnings 2. MEDICAL EXPENSES up to $500 a day because of time off Insuring Agreement from work. a. We will pay medical expenses as described (6) All costs taxed against the insured in below for "bodily injury" caused by an the"suit". accident: (6) Prejudgment interest awarded against (1) On premises you own or rent; the insured on that part of the judgment (2) On ways next to premises you own or we pay. If we make an offer to pay the rent; or applicable limit of insurance, we will not (3) Because of your operations; pay any prejudgment interest based on that period of time after the offer. provided that: (7) All interest on the full amount of any 1 The accident takes lace in the � { ) p judgment that accrues after entry of the "coverage territory" and during the judgment and before we have paid, policy period; offered to pay, or deposited in court the (2) The expenses are incurred and reported part of the judgment that is within the to us within three years of the date of applicable limit of insurance. the accident; and Any amounts paid under (1) through (7) (3) The injured person submits to above will not reduce the limits of insurance. examination, at our expense, by physicians of our choice as often as we reasonably require. Page 2 of 24 Form SS 00 08 04 05 BUSINESS LIABILITY COVERAGE FORM b. If we defend an insured against a "suit" So long as the above conditions are met, and an indemnitee of the insured is also attorneys' fees incurred by us in the named as a party to the "suit", we will defense of that indemnitee, necessary defend that indemnitee if all of the litigation expenses incurred by us and following conditions are met: necessary litigation expenses incurred (1) The "suit" against the indemnitee by the indemnitee at our request will be seeks damages for which the insured paid as Supplementary Payments. has assumed the liability of the Notwithstanding the provisions of indemnitee in a contract or agreement Paragraph 1.b.(b) of Section B. — that is an "insured contract"; Exclusions, such payments will not be (2) This insurance applies to such liability deemed to be damages for "bodily assumed by the insured; injury" and "property damage" and will (3) The obligation to defend, or the cost of not reduce the limits of Insurance. the defense of, that indemnitee, has Our obligation to defend an insured's also been assumed by the insured in indemnitee and to pay for attorneys' fees the same"insured contract"; and necessary litigation expenses as (4) The allegations in the "suit" and the Supplementary Payments ends when: information we know about the (1) We have used up the applicable limit "occurrence" are such that no conflict of insurance in the payment of appears to exist between the interests judgments or settlements; or of the insured and the interest of the (2) The conditions set forth above, or the indemnitee; terms of the agreement described in (5) The indemnitee and the insured ask Paragraph(6)above, are no longer met. us to conduct and control the defense B. EXCLUSIONS of that indemnitee against such "suit" 1. Applicable To Business Liability Coverage and agree that we can assign the same counsel to defend the insured This insurance does not apply to: and the indemnitee; and a. Expected Or Intended Injury (6) The indemnitee: (1) "Bodily injury" or "property damage" (a) Agrees in writing to: expected or intended from the (1) Cooperate with us in the standpoint of the insured. This investigation, settlement or exclusion does not apply to "bodily defense of the"suit"; injury" or "property damage" resulting from the use of reasonable force to (ii) Immediately send us copies of protect persons or property; or any demands, notices, summonses or legal papers (2) "Personal and advertising injury" arising received in connection with out of an offense committed by, at the the"suit"; direction of or with the consent or acquiescence of the insured with the (iii) Notify any other insurer whose expectation of inflicting "personal and coverage is available to the advertising injury". indemnitee; and b. Contractual Liability (iv) Cooperate with us with respect to coordinating other (1) "Bodily injury"or"property damage";or applicable insurance available (2) "Personal and advertising injury" to the indemnitee; and for which the insured is obligated to pay (b) Provides us with written damages by reason of the assumption of authorization to: liability in a contract or agreement, (1) Obtain records and other This exclusion does not apply to liability information related to the for damages because of: "suit"; and (a) "Bodily injury","property damage"or (ii) Conduct and control the "personal and advertising injury"that defense of the indemnitee in the insured would have in the such "suit". absence of the contract or agreement;or Form SS 00 08 04 05 Page 3 of 24 BUSINESS LIABILITY COVERAGE FORM (b) "Bodily injury" or"property damage" (b) Performing duties related to the assumed in a contract or agreement conduct of the insured's business, or that is an "insured contract", (2) The spouse, child, parent, brother or provided the "bodily injury" or sister of that "employee" as a "property damage" occurs consequence of(1) above, subsequent to the execution of the This exclusion applies: contract or agreement. Solely for the purpose of liability assumed in (1) Whether the insured may be liable as an "insured contract", reasonable an employer or in any other capacity; attorneys' fees and necessary and litigation expenses incurred by or for (2) To any obligation to share damages a party other than an insured are with or repay someone else who must deemed to be damages because of pay damages because of the injury. "bodily injury" or"property damage" This exclusion does not apply to liability provided: assumed by the insured under an "insured (I) Liability to such party for, or for contract". the cost of, that party's defense f. Pollution has also been assumed in the ,,i (1) "Bodily injury", "property damage" or same"insured contract",and "personal and advertising injury" (!!) Such attorneys' fees and arising out of the actual, alleged or litigation expenses are for threatened discharge, dispersal, defense of that party against a seepage, migration, release or escape civil or alternative dispute of"pollutants": resolution proceeding in which (a) At or from any premises, site or damages to which this i location which is or was at any insurance applies are alleged. time owned or occupied by, or c. Liquor Liability rented or loaned to any insured. "Bodily injury" or "property damage" for However, this subparagraph does which any insured may be held liable by not apply to: reason of: (i) 'Bodily injury" if sustained within (1) Causing or contributing to the a building and caused by intoxication of any person; smoke, fumes, vapor or soot (2) The furnishing of alcoholic beverages to produced by or originating from a person under the legal drinking age or equipment that is used to heat, under the influence of alcohol;or cool or dehumidify the building, or equipment that is used to (3) Any statute, ordinance or regulation heck water for personal use, relating to the sale, gift, distribution or the building's occupants or their by use of alcoholic beverages. guests; This exclusion applies only if you are in the (ii) Bodily injury or property business of manufacturing, distributing, damage" for which you may be selling, serving or furnishing alcoholic held liable, if you are a beverages. contractor and the owner or d. Workers' Compensation And Similar lessee of such premises, site or Laws location has been added to your Any obligation of the insured under a policy as an additional insured workers' compensation, disability benefits with respect to your ongoing or unemployment compensation law or operations performed for that any similar law. additional insured at that e. Employer's Liability premises, site or location and "Bodily injury"to: such premises, site or location is not and never was owned or (1) An employee of the insured arising occupied by, or rented or out of and in the course of: loaned to, any insured, other (a) Employment by the insured; or than that additional insured;or Page 4 of 24 Form SS 00 08 04 05 BUSINESS LIABILITY COVERAGE FORM (ill) "Bodily injury" or "property released as part of the damage" arising out of heat, operations being performed smoke or fumes from a by such insured, contractor or "hostile fire"; subcontractor; (b) At or from any premises, site or (ii) "Bodily injury" or "property location which is or was at any damage" sustained within a time used by or for any insured or building and caused by the others for the handling, storage, release of gases, fumes or disposal, processing or treatment vapors from materials brought of waste; into that building in connection (c) Which are or were at any time with operations being performed transported, handled, stored, by you or on your behalf by a treated, disposed of, or processed contractor or subcontractor; or as waste by or for: (iii) "Bodily injury" or "property (i) Any insured; or damage" arising out of heat, (ii) Any person or organization for smoke or fumes from a"hostile fire"; or whom you may be legally responsible; (e) At or from any premises, site or (d) At or from any premises, site or location on which any insured or anycontractors or subcontractors location on which any insured or any contractors or subcontractors working directly or indirectly on any working directly or indirectly insured's behalf are performing operations if the operations are to any insured's behalf arere test for, monitor, clean up, remove, performing operations if the contain, treat, detoxify or neutralize "pollufants" are brought on or to or in any way respond to, or assess the premises, site or location in the effects of,"pollu#ants". connection with such operations by such insured, contractor or (2) Any loss, cost or expense arising out subcontractor. However, this of any: subparagraph does not apply to: (a) Request, demand, order or statutory (1) "Bodily injury" or "property or regulatory requirement that any damage" arising out of the insured or others test for, monitor, escape of fuels, lubricants or clean up, remove, contain, treat, other operating fluids which are detoxify or neutralize, or in any way needed to perform the normal respond to, or assess the effects of, electrical, hydraulic or "pollutants";or mechanical functions (b) Claim or suit by or on behalf of a necessary for the operation of governmental authority for "mobile equipment"or its parts, damages because of testing for, if such fuels, lubricants or other monitoring, cleaning up, removing, operating fluids escape from a containing, treating, detoxifying or vehicle part designed to hold, neutralizing, or in any way store or receive them. This responding to, or assessing the exception does not apply if the effects of, "pollutants". "bodily injury" or "property However, this paragraph does not damage" arises out of the apply to liability for damages because intentional discharge, dispersal of "property damage" that the insured or release of the fuels, would have in the absence of such lubricants or other operating request, demand, order or statutory or fluids, or if such fuels, regulatory requirement, or such claim lubricants or other operating or "suit" by or on behalf of a fluids are brought on or to the governmental authority. premises, site or location with the intent that they be discharged, dispersed or Form SS 00 08 04 05 Page 5 of 24 BUSINESS LIABILITY COVERAGE FORM g. Aircraft,Auto Or Watercraft (2) The use of "mobile equipment" in, or "Bodily injury" or "property damage" arising while in practice or preparation for, a out of the ownership, maintenance, use or prearranged racing, speed or entrustment to others of any aircraft, "auto" demolition contest or in any stunting or watercraft owned or operated by or rented activity. or loaned to any insured. Use includes i. War operation and"loading or unloading". "Bodily injury", "property damage" or This exclusion applies even if the claims "personal and advertising injury", however against any insured allege negligence or caused, arising, directly or indirectly,out of: other wrongdoing in the supervision, hiring, (1) War, including undeclared or civil war; employment, training or monitoring of others by that insured, if the "occurrence" which (2) Warlike action by a military force, caused the bodily injury or property including action in hindering or damage" involved the ownership, defending against an actual or maintenance, use or entrustment to others of expected attack, by any government, any aircraft, "auto" or watercraft that is sovereign or other authority using owned or operated by or rented or loaned to military personnel or other agents; or any insured. (3) Insurrection, rebellion, revolution, This exclusion does not apply to: usurped power, or action taken by governmental authority in hindering or (1) A watercraft while ashore on premises defending against any of these. you own or rent; Professional Services (2) A watercraft you do not own that is: li "Bodily injury", "property damage" or (a) Less than 51 feet long; and "personal and advertising injury" arising (b) Not being used to carry persons out of the rendering of or failure to render for a charge; any professional service. This includes (3) Parking an "auto" on, or on the ways but is not limited to: next to, premises you own or rent, (1) Legal, accounting or advertising provided the "auto" is not owned by or services; rented or loaned to you or the insured; (2) Preparing, approving, or failing to (4) Liability assumed under any "insured prepare or approve maps, shop contract" for the ownership, drawings, opinions, reports, surveys, maintenance or use of aircraft or field orders, change orders, designs or watercraft; drawings and specifications; (5) "Bodily injury" or "property damage" (3) Supervisory, inspection, architectural arising out of the operation of any of or engineering activities; the equipment listed in Paragraph f.(2) (4) Medical, surgical, dental, x-ray or or f.(3) of the definition of "mobile nursing services treatment, advice or equipment"; or instruction; (6) An aircraft that is not owned by any (5) Any health or therapeutic service insured and is hired, chartered or loaned treatment, advice or instruction; with a paid crew. However, this (6) Any service, treatment, advice or exception does not apply if the insured instruction for the purpose of has any other insurance for such "bodily appearance or skin enhancement, hair injury" or "property damage", whether removal or replacement or personal the other insurance is primary, excess, grooming; contingent or on any other basis. h. Mobile Equipment (7) Optical or hearing aid services including the prescribing, preparation, "Bodily injury" or "property damage" fitting, demonstration or distribution of arising out of: ophthalmic lenses and similar (1) The transportation of"mobile equipment" products or hearing aid devices; by an "auto" owned or operated by or rented or loaned to any insured;or Page 6 of 24 Form SS 00 08 04 05 BUSINESS LIABILITY COVERAGE FORM (8) Optometry or optometric services Paragraphs (1), (3) and (4) of this including but not limited to examination exclusion do not apply to "property of the eyes and the prescribing, damage" (other than damage by fire) to preparation, fitting,demonstration or premises, including the contents of such distribution of ophthalmic lenses and premises, rented to you for a period of 7 or similar products; fewer consecutive days. A separate Limit (9) Any: of Insurance applies to Damage To (a) Body piercing (not including ear Premises Rented To You as described in piercing); Section D. - Limits Of Insurance. (b) Tattooing, including but not limited Paragraph (2) of this exclusion does nota I if the remises are " " to the insertion of pigments into or apply p your work and under the skin; and were never occupied, rented or held for rental by you. (c) Similar services; Paragraphs(3) and (4)of this exclusion do (10) Services in the practice of pharmacy; not apply to the use of elevators. and Paragraphs (3), (4), (5) and (6) of this (11) Computer consulting, design or exclusion do not apply to liability assumed programming services, including web under a sidetrack agreement. site design. Paragraphs(3) and (4) of this exclusion do Paragraphs(4) and (6)of this exclusion do not apply to not apply to the Incidental Medical borrowed equipment while being not b ng used Malpractice coverage afforded under to perform operations at a job site. Paragraph 1.e. in Section A.-Coverages. Paragraph (6) of this exclusion does not k. Damage To Property apply to "property damage" included in the "Property damage"to: "products-completed operations hazard". (1) Property you own, rent or occupy, I. Damage To Your Product including any costs or expenses "Property damage" to "your product" incurred by you, or any other person, arising out of it or any part of it. organization or entity, for repair, m. Damage To Your Work replacement, enhancement, restoration or maintenance of such "Property damage" to "your work" arising property for any reason, including out of it or any part of it and included in the prevention of injury to a person or "products-completed operations hazard". damage to another's property; This exclusion does not apply if the (2) Premises you sell, give away or damaged work or the work out of which abandon, if the"property damage"arises the damage arises was performed on your out of any part of those premises; behalf by a subcontractor, (3) Property loaned to you; n. Damage To Impaired Property Or (4) Personal property in the care, custody Property Not Physically Injured or control of the insured; "Property damage" to "impaired property" (5) That particular part of real property on or property that has not been physicallyinjured, arising out of: which you or any contractors or subcontractors working directly or (1) A defect, deficiency, inadequacy or indirectly on your behalf are performing dangerous condition in "your product" operations, if the "property damage" or"your work'; or arises out of those operations; or (2) A delay or failure by you or anyone (6) That particular part of any property acting on your behalf to perform a that must be restored, repaired or contract or agreement in accordance replaced because "your work" was with its terms, incorrectly performed on it. This exclusion does not apply to the loss of use of other property arising out of sudden and accidental physical injury to "your product" or "your work" after it has been put to its intended use. Form SS 00 08 04 05 Page 7 of 24 BUSINESS LIABILITY COVERAGE FORM o. Recall Of Products, Work Or Impaired (c) Title of any literary or artistic work; Property (8) Arising out of an offense committed by Damages claimed for any loss, cost or an insured whose business is: expense incurred by you or others for the (a) Advertising, broadcasting, loss of use, withdrawal, recall, inspection, publishing or telecasting; repair, replacement, adjustment, removal (b) Designing or determining content or disposal of: of web sites for others; or (1) "Your product"; (c) An Internet search, access, (2) "Your work"; or content or service provider. (3) "Impaired property"; However, this exclusion does not if such product, work or property is apply to Paragraphs a., b. and c. withdrawn or recalled from the market or under the definition of "personal and from use by any person or organization advertising injury" in Section G. -- because of a known or suspected defect, Liability And Medical Expenses deficiency, inadequacy or dangerous Definitions. condition in it. For the purposes of this exclusion, p. Personal And Advertising Injury placing an "advertisement" for or "Personal and advertising injury": linking to others on your web site, by (1) Arising out of oral, written or electronic itself, is not considered the business publication of material, if done by or at of advertising, broadcasting, the direction of the insured with publishing or telecasting; knowledge of its falsity; (9) Arising out of an electronic chat room (2) Arising out of oral,written or electronic or bulletin board the insured hosts, publication of material whose first owns, or over which the insured publication took place before the exercises control; beginning of the policy period; (10) Arising out of the unauthorized use of (3) Arising out of a criminal act committed another's name or product in your e-mail by or at the direction of the insured; address, domain name or metatags, or any other similar tactics to mislead (4) Arising out of any breach of contract, another's potential customers; except an implied contract to use (11) Arising out of the violation of a another's "advertising idea" in your person's right of privacy created by "advertisement"; any state or federal act. (6) Arising out of the failure of goods, However, this exclusion does not products or services to conform with apply to liability for damages that the any statement of quality or insured would have in the absence of performance made in your such state or federal act; "advertisement"; (6) Arising out of the wrong description of (12) Arising out of: the price of goods, products or services; (a) An "advertisement" for others on (7) Arising out of any violation of any your web site; intellectual property rights such as (b) Placing a link to a web site of copyright, patent, trademark, trade others on your web site; name, trade secret, service mark or (c) Content from a web site of others other designation of origin or displayed within a frame or border authenticity. on your web site. Content includes However, this exclusion does not information, code, sounds, text, apply to infringement, in your graphics or images;or "advertisement", of (d) Computer code, software or (a) Copyright; programming used to enable: (b) Slogan, unless the slogan is also (1) Your web site; or a trademark, trade name, service (it) The presentation or functionality mark or other designation of origin of an "advertisement' or other or authenticity; or content on your web site; Page 8 of 24 Form SS 00 08 04 06 BUSINESS LIABILITY COVERAGE FORM (13) Arising out of a violation of any anti- (a) May be awarded or incurred by trust law; reason of any claim or suit (14) Arising out of the fluctuation in price or alleging actual or threatened injury value of any stocks, bonds or other or damage of any nature or kind to securities; or persons or property which would (15) Arising out of discrimination or not have occurred in whole or in part but for the"asbestos hazard"; humiliation committed by or at the b Arise out of an request, demand, direction of any "executive officer", O Y q director, stockholder, partner or order or statutory or regulatory member of the insured, requirement that any insured or others test for, monitor, clean up, q. Electronic Data remove, encapsulate, contain, Damages arising out of the loss of, loss of treat, detoxify or neutralize or in use of, damage to, corruption of, inability any way respond to or assess the to access, or inability to manipulate effects of an"asbestos hazard"; or "electronic data". r. Employment-Related Practices (c) Arise out of any claim or suit for damages because of testing for, "Bodily injury" or"personal and advertising monitoring, cleaning up, removing, injury"to: encapsulating, containing, treating, (1) A person arising out of any: detoxifying or neutralizing or in any way responding to or assessing the (a) Refusal to employ that person; effects of an"asbestos hazard". (b) Termination of that person's t. Violation Of Statutes That Govern E- employment; or Malls, Fax, Phone Calls Or Other (c) Employment-related practices, Methods Of Sending Material Or policies, acts or omissions, such as Information coercion, demotion, evaluation, "Bodily injury", "property damage", or reassignment, discipline, personal and advertising injury arising defamation, harassment, humiliation directly or indirectly out of any action or or discrimination directed at that omission that violates or is alleged to person; or violate: (2) The spouse, child, parent, brother or (1) The Telephone Consumer Protection sister of that person as a Act(TCPA), including any amendment consequence of "bodily injury" or of or addition to such law; personal and advertising injury to the (2) The CAN-SPAM Act of 2003, including person at whom any of the employment-related practices any amendment of or addition to such law; or described in Paragraphs(a), (b), or(c) above is directed. (3) Any statute, ordinance or regulation, This exclusion applies:. other than the TCPA or CAN-SPAM Act of 2003, that prohibits or limits the (1) Whether the insured may be liable as sending, transmitting, communicating or an employer or in any other capacity; distribution of material or information. and Damage To Premises Rented To You — (2) To any obligation to share damages Exception For Damage By Fire, Lightning with or repay someone else who must or Explosion pay damages because of the injury, Exclusions c. through h. and k. through o. do s. Asbestos not apply to damage by fire, lightning or (1) "Bodily injury", "property damage" or explosion to premises rented to you or "personal and advertising injury" temporarily occupied by you with permission of arising out of the"asbestos hazard". the owner. A separate Limit of Insurance (2) Any damages, judgments, settlements, applies to this coverage as described in loss,costs or expenses that: Section D. - Liability And Medical Expenses Limits Of Insurance. Form SS 00 08 04 05 Page 9 of 24 BUSINESS LIABILITY COVERAGE FORM 2. Applicable To Medical Expenses Coverage e. A trust, you are an insured. Your trustees We will not pay expenses for"bodily injury": are also insureds, but only with respect to their duties as trustees. a. Any Insured To any insured,except"volunteer workers". 2. Each of the following is also an insured: a. Employees And Volunteer Workers b. Hired Person To a person hired to do work for or on behalf Your "volunteer workers" only while Of any insured or a tenant of any insured. performing duties related to the conduct of your business, or your"employees", other c. Injury On Normally Occupied Premises than either your"executive officers" (if you To a person injured on that part of are an organization other than a premises you own or rent that the person partnership, joint venture or limited liability normally occupies. company) or your managers (if you are a d. Workers' Compensation And Similar limited liability company), but only for acts Laws within the scope of their employment by To a person, whether or not an you or while performing duties related to "employee" of any insured, if benefits for the conduct of your business. the "bodily injury" are payable or must be However, none of these "employees" or provided under a workers' compensation "volunteer workers" are insureds for: or disability benefits law or a similar law. (1) "Bodily injury" or "personal and e. Athletics Activities advertising injury": To a person injured while practicing, (a) To you, to your partners or instructing or participating in any physical members (if you are a partnership exercises or games, sports or athletic or joint venture), to your members contests. (if you are a limited liability f. Products-Completed Operations Hazard company), or to a co-"employee" while in the course of his or her Included with the "products-completed employment or performing duties operations hazard". related to the conduct of your g. Business Liability Exclusions business, or to your other Excluded under Business Liability Coverage. "volunteer workers" while performing duties related to the C. WHO IS AN INSURED conduct of your business; 1. If you are designated in the Declarations as: (b) To the spouse, child, parent, a. An individual, you and your spouse are brother or sister of that co- insureds, but only with respect to the "employee" or that "volunteer conduct of a business of which you are the worker" as a consequence of sole owner, Paragraph (1)(a)above; b. A partnership or joint venture, you are an (c) For which there is any obligation insured. Your members, your partners, and to share damages with or repay their spouses are also insureds, but only with someone else who must pay respect to the conduct of your business. damages because of the injury c. A limited liability company, you are an described in Paragraphs (1)(a) or insured. Your members are also insureds, (b) above; or but only with respect to the conduct of your (d) Arising out of his or her providing business. Your managers are insureds, but or failing to provide professional only with respect to their duties as your health care services. managers. If you are not in the business of d. An organization other than a partnership, providing professional health care joint venture or limited liability company, you services, Paragraph (d) does not apply are an insured. Your"executive officers"and to any nurse, emergency medical directors are insureds, but only with respect technician or paramedic employed by to their duties as your officers or directors. you to provide such services. Your stockholders are also insureds, but only (2) "Property damage"to property: with respect to their liability as stockholders. (a) Owned, occupied or used by, Page 10 of 24 Form SS 00 08 04 06 BUSINESS LIABILITY COVERAGE FORM (b) Rented to, in the care, custody or b. Coverage under this provision does not control of, or over which physical apply to: control is being exercised for any (1) "Bodily injury" or "property damage" purpose by you, any of your that occurred; or "employees", "volunteer workers", (2) "personal and advertising injury" a partnership or joint venture), or any partner or member (if you are arising out of an offense committed any member (if you are a limited before you acquired or formed the liability company). organization. b. Real Estate Manager 4. Operator Of Mobile Equipment Any person (other than your"employee" or With respect to "mobile equipment" registered in "volunteer worker"), or any organization your name under any motor vehicle registration while acting as your real estate manager. law, any person is an insured while driving such c. Temporary Custodians Of Your equipment along a public highway with your Property permission. Any other person or organization responsible for the conduct of such person is Any person or organization having proper also an insured, but only with respect to liability temporary custody of your property if you arising out of the operation of the equipment, and die, but only; only if no other insurance of any kind is available (1) With respect to liability arising out of the to that person or organization for this liability. maintenance or use of that property;and However, no person or organization is an insured (2) Until your legal representative has with respect to: been appointed. a. "Bodily injury" to a co-"employee" of the d. Legal Representative If You Die person driving the equipment; or Your legal representative if you die, but b• "Property damage" to property owned by, only with respect to duties as such. That rented to, in the charge of or occupied by . representative will have all your rights and you or the employer of any person who is duties under this insurance. an insured under this provision. e. Unnamed Subsidiary 5. Operator of Nonowned Watercraft Any subsidiary and subsidiary thereof, of With respect to watercraft you do not own that yours which is a legally incorporated entity is less than 51 feet long and is not being used of which you own a financial interest of to carry persons for a charge, any person is an more than 50% of the voting stock on the insured while operating such watercraft with effective date of this Coverage Part. your permission. Any other person or The insurance afforded herein for any organization responsible for the conduct of subsidiary not shown in the Declarations such person is also an insured, but only with as a named insured does not apply to respect to liability arising out of the operation injury or damage with respect to which an of the watercraft, and only if no other insured under this insurance is also an insurance of any kind is available to that insured under another policy or would be person or organization for this liability. an insured under such policy but for its However, no person or organization is an termination or upon the exhaustion of its insured with respect to: limits of insurance. a. "Bodily injury" to a co-"employee" of the 3. Newly Acquired Or Formed Organization person operating the watercraft; or Any organization you newly acquire or form, b. "Property damage" to property owned by, other than a partnership, joint venture or rented to, in the charge of or occupied by limited liability company, and over which you you or the employer of any person who is maintain financial interest of more than 50% of an insured under this provision, the voting stock, will qualify as a Named 6. Additional Insureds When Required By Insured if there is no other similar insurance Written Contract, Written Agreement Or available to that organization. However: Permit a. Coverage under this provision is afforded The person(s) or organization(s) identified in only until the 180th day after you acquire Paragraphs a. through f. below are additional or form the organization or the end of the insureds when you have agreed, in a written policy period, whichever is earlier; and Form SS 00 08 04 05 Page 11 of 24 BUSINESS LIABILITY COVERAGE FORM contract, written agreement or because of a (e) Any failure to make such permit issued by a state or political inspections, adjustments, tests or subdivision, that such person or organization servicing as the vendor has be added as an additional insured on your agreed to make or normally policy, provided the injury or damage occurs undertakes to make in the usual subsequent to the execution of the contract or course of business, in connection agreement, or the issuance of the permit. with the distribution or sale of the A person or organization is an additional products; insured under this provision only for that (f) Demonstration, installation, period of time required by the contract, servicing or repair operations, agreement or permit. except such operations performed at the vendor's premises in However, no such person or organization is an connection with the sale of the additional insured under this provision if such product; person or organization is included as an additional insured by an endorsement issued (g) Products which, after distribution by us and made a part of this Coverage Part, or sale you, have been labeled including all persons or organizations added or relabeled used a as additional insureds under the specific container, part orr ingredient o of f any additional insured coverage grants in Section other thing or substance by or for the vendor; or F.—Optional Additional Insured Coverages. a. Vendors (h) "Bodily injury" or "property damage" arising out of the sole Any person(s) or organization(s) (referred to negligence of the vendor for its below as vendor), but only with respect to own acts or omissions or those of "bodily injury" or "property damage" arising its employees or anyone else out of"your products" which are distributed acting on its behalf. However, this or sold in the regular course of the vendor's exclusion does not apply to: business and only if this Coverage Part provides coverage for "bodily injury" or (i) The exceptions contained in "property damage" included within the Subparagraphs (d)or(f);or "products-completed operations hazard". (ii) Such inspections, adjustments, (1) The insurance afforded to the vendor tests or servicing as the vendor is subject to the following additional has agreed to make or normally exclusions: undertakes to make in the usual course of business, in This insurance does not apply to: connection with the distribution (a) "Bodily injury" or "property or sale of the products. damage" for which the vendor is (2) This insurance does not apply to any obligated to pay damages by insured person or organization from reason of the assumption of whom you have acquired such products, liability in a contract or agreement. or any ingredient, part or container, This exclusion does not apply to entering into, accompanying or liability for damages that the containing such products, vendor would have in the absence of the contract or agreement; b. Lessors Of Equipment (b) Any express warranty (1) Any person or organization from unauthorized by you; whom you lease equipment; but only with respect to their liability for "bodily (c) Any physical or chemical change injury", "property damage" or in the product made intentionally "personal and advertising injury" by the vendor; caused, in whole or in part, by your (d) Repackaging, except when maintenance, operation or use of unpacked solely for the purpose of equipment leased to you by such inspection, demonstration, testing, person or organization. or the substitution of parts under j instructions from the manufacturer, j and then repackaged in the original container; Page 12 of 24 Form SS 00 08 04 05 BUSINESS LIABILITY COVERAGE FORM (2) With respect to the insurance afforded e. Permits Issued By State Or Political to these additional insureds, this Subdivisions insurance does not apply to any (1) Any state or political subdivision, but "occurrence" which takes place after only with respect to operations you cease to lease that equipment. performed by you or on your behalf for c. Lessors Of Land Or Premises which the state or political subdivision (1) Any person or organization from has issued a permit. whom you lease land or premises, but (2) With respect to the insurance afforded only with respect to liability arising out to these additional insureds, this of the ownership, maintenance or use insurance does not apply to: of that part of the land or premises (a) "Bodily injury", "property damage" leased to.you. or "personal and advertising (2) With respect to the insurance afforded injury" arising out of operations to these additional insureds, this performed for the state or insurance does not apply to: municipality; or (a) Any "occurrence" which takes (b) "Bodily injury" or"property damage" place after you cease to lease that included within the "products- land or be a tenant in that completed operations hazard". premises; or f. Any Other Party (b) Structural alterations, new (1) Any other person or organization who construction or demolition is not an insured under Paragraphs a. operations performed by or on through e. above, but only with behalf of such person or respect to liability for "bodily injury", organization. "property damage" or "personal and d. Architects, Engineers Or Surveyors advertising injury" caused, in whole or (1) Any architect, engineer, or surveyor, but in part, by your acts or omissions or only with respect to liability for "bodily the acts or omissions of those acting injury", "property damage" or "personal on your behalf. and advertising injury" caused, in whole (a) In the performance of your or in part, by your acts or omissions or ongoing operations; the acts or omissions of those acting on (b) In connection with your premises your behalf; owned by or rented to you; or (a) In connection with your premises; (c) In connection with "your work" and or included within the "products- (b) In the performance of your completed operations hazard", but ongoing operations performed by only if you or on your behalf. (i) The written contract or written (2) With respect to the insurance afforded agreement requires you to to these additional insureds, the provide such coverage to following additional exclusion applies: such additional insured; and This insurance does not apply to (1i) This Coverage Part provides "bodily injury", "property damage" or coverage for "bodily injury" or "personal and advertising injury" "property damage" included arising out of the rendering of or the within the "products- failure to render any professional completed operations hazard". services by or for you, including: (2) With respect to the insurance afforded (a) The preparing, approving, or to these additional insureds, this failure to prepare or approve, insurance does not apply to: maps, shop drawings, opinions, "Bodily injury", "property damage" or reports, surveys, field orders, "personal and advertising injury" change orders, designs or arising out of the rendering of, or the drawings and specifications; or failure to render, any professional (b) Supervisory, inspection, architectural, engineering or surveying architectural or engineering services, including: activities. Form SS 00 08 04 05 Page 13 of 24 BUSINESS LIABILITY COVERAGE FORM (a) The preparing, approving, or This General Aggregate limit does not failure to prepare or approve, apply to "property damage" to premises maps, shop drawings, opinions, while rented to you or temporarily reports, surveys, field orders, occupied by you with permission of the change orders, designs or owner, arising out of fire, lightning or drawings and specifications; or explosion. (b) Supervisory, inspection, 3. Each Occurrence Limit architectural or engineering Subject to 2.a. or 2.b above, whichever activities. applies, the most we will pay for the sum of all The limits of insurance that apply to additional damages because of all "bodily injury", insureds are described in Section D. — Limits "property damage" and medical expenses Of Insurance. arising out of any one "occurrence" is the How this insurance applies when other Liability and Medical Expenses Limit shown in insurance is available to an additional insured the Declarations. is described in the Other Insurance Condition The most we will pay for all medical expenses in Section E.—Liability And Medical Expenses because of "bodily injury" sustained by any General Conditions. one person is the Medical Expenses Limit No person or organization is an insured with shown in the Declarations. respect to the conduct of any current or past 4. Personal And Advertising Injury Limit partnership, joint venture or limited liability Subject to 2.b. above, the most we will pay for company that is not shown as a Named Insured in the sum of all damages because of all the Declarations. "personal and advertising injury" sustained by D. LIABILITY AND MEDICAL EXPENSES any one person or organization is the Personal LIMITS OF INSURANCE and Advertising Injury Limit shown in the Declarations. 1. The Most We Will Pay 5. Damage To Premises Rented To You Limit The Limits of Insurance shown in the The Damage To Premises Rented To You Declarations and the rules below fix the most Limit is the most we will pay under Business we will pay regardless of the number of: Liability Coverage for damages because of a. Insureds; "property damage"to any one premises, while b. Claims made or"suits" brought; or rented to you, or in the case of damage by fire, c. Persons or organizations making claims or lightning or explosion, while rented to you or bringing"suits". temporarily occupied by you with permission of 2. Aggregate Limits the owner. The most we will pay for: In the case of damage by fire, lightning or explosion, the Damage to Premises Rented To a. Damages because of "bodily injury" and You Limit applies to all damage proximately "property damage" included in the caused by the same event, whether such "products-completed operations hazard" is damage results from fire, lightning or explosion the Products-Completed Operations or any combination of these. Aggregate Limit shown in the 6. How Limits Apply To Additional Insureds Declarations. b. Damages because of all other "bodily The most we will pay on behalf of a person or organization who is an additional insured injury", "property damage" or "personal and advertising injury", including medical under this Coverage Part is the lesser of: expenses, is the General Aggregate Limit a. The limits of insurance specified in a shown in the Declarations. written contract, written agreement or This General Aggregate Limit applies permit issued by a state or political separately to each of your "locations" subdivision; or owned by or rented to you. b. The Limits of Insurance shown in the "Location" means premises involving the Declarations. same or connecting lots, or premises Such amount shall be a part of and not in whose connection is interrupted only by a addition to the Limits of Insurance shown in street, roadway or right-of-way of a the Declarations and described in this Section. railroad. Page 14 of 24 Form SS 00 08 04 05 BUSINESS LIABILITY COVERAGE FORM If more than one limit of insurance under this (1) Immediately send us copies of any policy and any endorsements attached thereto demands, notices, summonses or applies to any claim or"suit", the most we will pay legal papers received in connection under this policy and the endorsements is the with the claim or"suit'; single highest limit of liability of all coverages (2) Authorize us to obtain records and applicable to such claim or "suit". However, this other information; paragraph does not apply to the Medical Expenses limit set forth in Paragraph 3.above. (3) Cooperate with us in the investigation, settlement of the claim or defense The Limits of Insurance of this Coverage Part apply against the"suit"; and separately to each consecutive annual period and to (4) Assist us, upon our request, in the any remaining period of less than 12 months, starting enforcement of any right against any with the beginning of the policy period shown in the person or organization that may be Declarations, unless the policy period is extended liable to the insured because of injury after issuance for an additional period of less than 12 or damage to which this insurance months. in that case, the additional period will be may also apply. deemed part of the last preceding period for purposes of determining the Limits of Insurance. d. Obligations At The Insureds Own Cost E. LIABILITY AND MEDICAL EXPENSES No insured will, except at that insured's own cost, voluntarily make a payment, assume. GENERAL CONDITIONS any obligation, or incur any expense, other 1. Bankruptcy than for first aid,without our consent. Bankruptcy or insolvency of the insured or of e. Additional Insured's Other Insurance the insured's estate will not relieve us of our If we cover a claim or "suit" under this obligations under this Coverage Part. Coverage Part that may also be covered 2. Duties In The Event Of Occurrence, by other insurance available to an Offense,Claim Or Suit additional insured, such additional insured a. Notice Of Occurrence Or Offense must submit such claim or "suit" to the You or any additional insured must see to other insurer for defense and indemnity. it that we are notified as soon as However, this provision does not apply to practicable of an "occurrence" or an the extent that you have agreed in a offense which may result in a claim. To written contract, written agreement or the extent possible, notice should include; permit that this insurance is primary and (1) How, when and where the"occurrence" non-contributory with the additional insured's own insurance. - or offense took place; f. Knowledge Of An Occurrence, Offense, (2) The names and addresses of any Claim Or Suit injured persons and witnesses; and Paragraphs a. and b. apply to you or to (3) The nature and location of any injury any additional insured only when such or damage arising out of the 'occurrence", offense, claim or "suit" is occurrence or offense. known to: b. Notice Of Claim (1) You or any additional insured that is If a claim is made or "suit" is brought an individual; against any insured, you or any additional (2) Any partner, if you or an additional insured must: insured is a partnership; (1) Immediately record the specifics of the (3) Any manager, if you or an additional claim or "suit" and the date received; insured is a limited liability company; and (4) Any "executive officer" or insurance {2) Notify us as soon as practicable. manager, if you or an additional You or any additional insured must see to insured is a corporation; it that we receive a written notice of the c (5) Any trustee, if you or an additional claim or"suit" as soon as practicable. insured is a trust; or c. Assistance And Cooperation Of The (6) Any elected or appointed official, if you Insured or an additional insured is a political You and any other involved insured must: subdivision or public entity. Form SS 00 08 04 05 Page 15 of 24 BUSINESS LIABILITY COVERAGE FORM This Paragraph f. applies separately to (3) We have issued this policy in reliance you and any additional insured. upon your representations. 3. Financial Responsibility Laws b. Unintentional Failure To Disclose a. When this policy is certified as proof of Hazards financial responsibility for the future under If unintentionally you should Fail to disclose the provisions of any motor vehicle all hazards relating to the conduct of your financial responsibility law, the insurance business at the inception date of this provided by the policy for "bodily injury" Coverage Part, we shall not deny any liability and "property damage" liability will coverage under this Coverage Part comply with the provisions of the law to because of such failure. the extent of the coverage and limits of 7. Other Insurance insurance required by that law. If other valid and collectible insurance is b. With respect to "mobile equipment" to available for a loss we cover under this which this insurance applies, we will Coverage Part, our obligations are limited as provide any liability, uninsured motorists, follows: underinsured motorists, no-fault or other coverage required by any motor vehicle a. Primary Insurance law. We will provide the required limits for This insurance is primary except when b. those coverages. below applies. If other insurance is also 4. Legal Action Against Us primary, we will share with all that other No person or organization has a right under insurance by the method described in c. below. this Coverage Form: b, Excess Insurance a. To join us as a party or otherwise bring us into a "suit" asking for damages from an This insurance is excess over any of the insured;or other insurance, whether primary, excess, b. To sue us on this Coverage Form unless contingent or on any other basis: all of its terms have been fully complied (1) Your Work with. That is Fire, Extended Coverage, A person or organization may sue us to recover Builder's Risk, Installation Risk or on an agreed settlement or on a final judgment similar coverage for"your work'; against an insured; but we will not be liable for (2) Premises Rented To You damages that are not payable under the terms of That is fire, lightning or explosion this insurance or that are in excess of the insurance for premises rented to you applicable limit of insurance. An agreed or temporarily occupied by you with settlement means a settlement and release of permission of the owner; liability signed by us, the insured and the claimant or the claimant's legal representative. (3) Tenant Liability 5. Separation Of Insureds That is insurance purchased by you to cover your liability as a tenant for Except with respect to the Limits of Insurance, "property damage" to premises rented and any rights or duties specifically assigned to you or temporarily occupied by you in this policy to the first Named Insured, this with permission of the owner; insurance applies: a. As if each Named Insured were the only (4) Aircraft,Auto Or Watercraft Named Insured; and If the loss arises out of the maintenance b or use of aircraft, "autos"or watercraft to . Separately to each insured against whom a claim is made or"suit" is brought. the extent not subject to Exclusion g. of Section A.—Coverages. 6. Representations (5) Property Damage To Borrowed a. When You Accept This Policy Equipment Or Use Of Elevators By accepting this policy, you agree: If the loss arises out of "property (1) The statements in the Declarations damage" to borrowed equipment or are accurate and complete; the use of elevators to the extent not 2 subject to Exclusion k. of Section A.— O Those statements are based upon Coverages, representations you made to us; and Page 16 of 24 Form SS 00 08 04 05 BUSINESS LIABILITY COVERAGE FORM (6) When You Are Added As An When this insurance is excess over other Additional Insured To Other insurance, we will pay only our share of Insurance the amount of the loss, if any, that That is other insurance available to exceeds the sum of: you covering liability for damages (1) The total amount that all such other arising out of the premises or insurance would pay for the loss in the operations, or products and completed absence of this insurance; and operations, for which you have been (2) The total of all deductible and self- added as an additional insured by that insured amounts under all that other insurance; or insurance. (7) When You Add Others As An We will share the remaining loss, if any, with Additional Insured To This any other insurance that is not described in Insurance this Excess Insurance provision and was not That is other insurance available to an bought specifically to apply in excess of the additional insured. Limits of Insurance shown in the However, the following provisions Declarations of this Coverage Part. apply to other insurance available to c. Method Of Sharing any person or organization who is an If all the other insurance permits additional insured under this Coverage contribution by equal shares, we will follow Part. this method also. Under this approach, (a) Primary Insurance When each insurer contributes equal amounts Required By Contract until it has paid its applicable limit of This insurance is primary if you insurance or none of the foss remains, have agreed in a written contract, whichever comes first. written agreement or permit that If any of the other insurance does not permit this insurance be primary. If other contribution by equal shares, we will insurance is also primary, we will contribute by limits. Under this method,each share with all that other insurance insurer's share is based on the ratio of its by the method described in c. applicable limit of insurance to the total below. applicable limits of insurance of all insurers. (b) Primary And Non-Contributory 8. Transfer Of Rights Of Recovery Against To Other Insurance When Others To Us Required By Contract a. Transfer Of Rights Of Recovery If you have agreed in a written If the insured has rights to recover all or contract, written agreement or p Part of any payment, including permit that this insurance is Supplementary Payments, we have made primary and non-contributory with under this Coverage Part, those rights are the additional insured's own transferred to us. The insured must do insurance, this insurance is nothing after loss to impair them. At our primary and we will not seek request, the insured will bring "suit" or contribution from that other transfer those rights to us and help us insurance. enforce them. This condition does not Paragraphs(a) and (b) do not apply to apply to Medical Expenses Coverage. other insurance to which the additional b. Waiver Of Rights Of Recovery (Waiver insured has been added as an Of Subrogation) additional insured. If the insured has waived any rights of When this insurance is excess, we will recovery against any person or have no duty under this Coverage Part to reorganization for all or art of an p y payment, defend the insured against any"suit" if any including Supplementary Payments, we other insurer has a duty to defend the have made under this Coverage Part, we insured against that "suit". If no other also waive that right, provided the insured insurer defends, we will undertake to do waived their rights of recovery against so, but we will be entitled to the insured's such person or organization in a contract, rights against all those other insurers. agreement or permit that was executed prior to the injury or damage. Form SS 00 08 04 06 Page 17 of 24 BUSINESS LIABILITY COVERAGE FORM F. OPTIONAL ADDITIONAL INSURED 3. Additional Insured -Grantor Of Franchise COVERAGES WHO IS AN INSURED under Section C. is If listed or shown as applicable in the Declarations, amended to include as an additional insured one or more of the following Optional Additional the person(s) or organization(s) shown in the Insured Coverages also apply. When any of these Declarations as an Additional Insured - Optional Additional Insured Coverages apply, Grantor Of Franchise, but only with respect to Paragraph 6. (Additional Insureds When Required their liability as grantor of franchise to you, by Written Contract, Written Agreement or Permit) 4. Additional Insured - Lessor Of Leased of Section C., Who Is An Insured, does not apply Equipment to the person or organization shown in the a. WHO IS AN INSURED under Section C. is Declarations. These coverages are subject to the amended to include as an additional terms and conditions applicable to Business insured the person(s) or organization(s) Liability Coverage in this policy, except as shown in the Declarations as an Additional provided below: Insured — Lessor of Leased Equipment, 1. Additional Insured - Designated Person Or but only with respect to liability for "bodily Organization injury", "property damage" or "personal WHO IS AN INSURED under Section C. is and advertising injury" caused, in whole or amended to include as an additional insured in part, by your maintenance, operation or the person(s) or organization(s) shown in the use of equipment leased to you by such Declarations, but only with respect to liability person(s)or organization(s). for "bodily injury", "property damage" or b. With respect to the insurance afforded to "personal and advertising injury" caused, in these additional insureds, this insurance whole or in part, by your acts or omissions or does not apply to any "occurrence" which the acts or omissions of those acting on your takes place after you cease to lease that behalf: equipment. a. In the performance of your ongoing 5. Additional Insured - Owners Or Other operations; or Interests From Whom Land Has Been b. In connection with your premises owned Leased by or,rented to you. a. WHO IS AN INSURED under Section C.is 2. Additional Insured - Managers Or Lessors amended to include as an additional Of Premises insured the person(s) or organization(s) shown in the Declarations as an Additional a. WHO IS AN INSURED under Section C. is Insured --Owners Or Other Interests From amended to include as an additional insured Whom Land Has Been Leased, but only the person(s)or organization(s)shown in the with respect to liability arising out of the Declarations as an Additional Insured - ownership, maintenance or use of that part Designated Person Or Organization;but only of the land leased to you and shown in the with respect to liability arising out of the Declarations. ownership, maintenance or use of that part of b. With respect to the insurance afforded to the premises leased to you and shown in the these additional insureds, the following Declarations. additional exclusions apply: b. With respect to the insurance afforded to This insurance does not apply to: these additional insureds, the following additional exclusions apply: (1) Any 'occurrence" that takes place This insurance does not apply to: after you cease to lease that land; or (1) Any 'occurrence" which takes place (2) Structural alterations, new after you cease to be a tenant in that construction or demolition operations premises; or performed by or on behalf of such person or organization. (2) Structural alterations, new 6. Additional Insured - State Or Political construction or demolition operations Subdivision—Permits performed by or on behalf of such person or organization. a. WHO IS AN INSURED under Section C. is amended to include as an additional insured the state or political subdivision shown in the Declarations as an Additional Page 18 of 24 Form SS 00 08 04 05 BUSINESS LIABILITY COVERAGE FORM Insured — State Or Political Subdivision - (e) Any failure to make such Permits, but only with respect to inspections, adjustments, tests or operations performed by you or on your servicing as the vendor has agreed behalf for which the state or political to make or normally undertakes to subdivision has issued a permit. make in the usual course of b. With respect to the insurance afforded to business, in connection with the these additional insureds, the following distribution or sale of the products; additional exclusions apply: (f) Demonstration, installation, This insurance does not apply to: servicing or repair operations, (1) Bodily injury", property damage except such operations performed or at the vendor's premises in "personal and advertising injury" connection with the sale of the arising out of operations performed for product; the state or municipality; or (2) "Bodily injury" or "property damage" (g) Products which after distribution or sale by you, have been labeled included in the "product-completed or relabeled or used as a operations" hazard. container, part or ingredient of any 7. Additional Insured—Vendors other thing or substance by or for a. WHO IS AN INSURED under Section C. is the vendor; or amended to include as an additional (h) "Bodily injury" or "property insured the person(s) or organization(s) damage" arising out of the sole (referred to below as vendor) shown in the negligence of the vendor for its Declarations as an Additional Insured - own acts or omissions or those of Vendor, but only with respect to "bodily its employees or anyone else injury" or "property damage" arising out of acting on its behalf. However, this "your products" which are distributed or exclusion does not apply to: sold in the regular course of the vendor's business and only if this Coverage Part (I) The exceptions contained in Subparagraphs (d) or(f); or provides coverage for bodily injury or "property damage" included within the (ii) Such inspections, "products-completed operations hazard". adjustments, tests or servicing b. The insurance afforded to the vendor is as the vendor has agreed to make or normally undertakes subject to the following additional exclusions: to make in the usual course of (1) This insurance does not apply to: business, in connection with (a) "Bodily injury" or "property the distribution or sale of the damage" for which the vendor is products, obligated to pay damages by (2) This insurance does not apply to any reason of the assumption of insured person or organization from liability in a contract or agreement, whom you have acquired such This exclusion does not apply to products, or any ingredient, part or liability for damages that the container, entering into, vendor would have in the absence accompanying or containing such of the contract or agreement; products. (b) Any express warranty 8. Additional Insured—Controlling Interest unauthorized by you; WHO IS AN INSURED under Section C. is (c) Any physical or chemical change amended to include as an additional insured in the product made intentionally the person(s) or organization(s) shown in the by the vendor; Declarations as an Additional Insured — (d) Repackaging, unless unpacked Controlling Interest, but only with respect to solely for the purpose of inspection, their liability arising out of: demonstration, testing, or the a. Their financial control of you; or substitution of parts under b. Premises they own, maintain or control instructions from the manufacturer, while you lease or occupy these premises. and then repackaged in the original container; Form SS 00 08 04 05 Page 19 of 24 BUSINESS LIABILITY COVERAGE FORM This insurance does not apply to structural The limits of insurance that apply to additional alterations, new construction and demolition insureds are described in Section D. -- Limits Of operations performed by or for that person or Insurance. organization. How this insurance applies when other insurance 9. Additional Insured — Owners, Lessees Or is available to an additional insured is described in Contractors - Scheduled Person Or the Other Insurance Condition in Section E. — Organization Liability And Medical Expenses General a. WHO IS AN INSURED under Section C. is Conditions. amended to include as an additional G. LIABILITY AND MEDICAL EXPENSES insured the person(s) or organization(s) DEFINITIONS shown in the Declarations as an Additional Insured—Owner, Lessees Or Contractors, 1. "Advertisement" means the widespread public but only with respect to liability for "bodily dissemination of information or images that injury", "property damage" or "personal has the purpose of inducing the sale of goods, and advertising injury" caused, in whole or products or services through: in part, by your acts or omissions or the a. (1) Radio; acts or omissions of those acting on your (2) Television; behalf: (3) Billboard; (1) In the performance of your ongoing (4) Magazine; operations for the additional insured(s); or (3) Newspaper; b. The Internet, but only that part of a web (2) In connection with "your work" site that is about goods, products or performed for that additional insured and included within the "products- services for the purposes of inducing the sale of goods, products or services; or completed operations hazard", but only if this Coverage Part provides c. Any other publication that is given coverage for "bodily injury" or widespread public distribution. "property damage" included within the However, "advertisement" does not include: products-completed operations a. The design, printed material, information hazard". or images contained in, on or upon the b. With respect to the insurance afforded to packaging or labeling of any goods or these additional insureds, this insurance products; or does not apply to "bodily injury", "property b. An interactive conversation between or damage" or "personal an advertising among persons through a computer network. injury arising out of the rendering of, or the failure to render, any professional 2. "Advertising idea" means any idea for an architectural, engineering or surveying "advertisement". services, including: 3. "Asbestos hazard" means an exposure or (1) The preparing, approving, or failure to threat of exposure to the actual or alleged prepare or approve, maps, shop properties of asbestos and includes the mere drawings, opinions, reports, surveys, presence of asbestos in any form. field orders, change orders, designs or 4. "Auto" means a land motor vehicle, trailer or drawings and specifications; or semi-trailer designed for travel on public (2) Supervisory, inspection, architectural roads, including any attached machinery or or engineering activities. equipment. But "auto" does not include 10. Additional Insured — Co-Owner Of Insured "mobile equipment". Premises 5. "Bodily injury" means physical: WHO IS AN INSURED under Section C. is a. Injury; amended to include as an additional insured b. Sickness; or the person(s) or Organization(s) shown in the c. Disease Declarations as an Additional Insured — Co- Owner Of Insured Premises, but only with sustained by a person and, if arising out of the respect to their liability as co-owner of the above, mental anguish or death at any time. premises shown in the Declarations, 6. "Coverage territory" means: Page 20 of4 Form SS 00 08 04 06 BUSINESS LIABILITY COVERAGE FORM a. The United States of America (including its b. You have failed to fulfill the terms of a territories and possessions), Puerto Rico contract or agreement; and Canada; if such property can be restored to use by: b. International waters or airspace, but only if a. The repair, replacement, adjustment or the injury or damage occurs in the course removal of "your product" or "your work"; of travel or transportation between any or places included in a.above; b. Your fulfilling the terms of the contract or c. All other parts of the world if the injury or agreement. damage arises out of: 12. "Insured contract" means: (1) Goods or products made or sold by you a. A contract for a lease of premises. in the territory described in a.above; However, that portion of the contract for a (2) The activities of a person whose home lease of premises that indemnifies any is in the territory described in a, person or organization for damage by fire, above, but is away for a short time on lightning or explosion to premises while your business; or rented to you or temporarily occupied by (3) "Personal and advertising injury" you with permission of the owner is offenses that take place through the subject to the Damage To Premises Internet or similar electronic means of Rented To You limit described in Section communication D.— Liability and Medical Expenses Limits provided the insured's responsibility to pay of Insurance. damages is determined in the United States of b. A sidetrack agreement; America (including its territories and c. Any easement or license agreement, possessions), Puerto Rico or Canada, in a including an easement or license "suit" on the merits according to the agreement in connection with construction substantive law in such territory, or in a or demolition operations on or within 50 settlement we agree to. feet of a railroad; 7. "Electronic data" means information, facts or d. Any obligation, as required by ordinance, programs: to indemnify a municipality, except in a. Stored as or on; connection with work for a municipality; b. Created or used on; or e. An elevator maintenance agreement; or c. Transmitted to or from f. That part of any other contract or computer software, including systems and agreement pertaining to your business applications software, hard or floppy disks, (including an indemnification of a CD-ROMS, tapes, drives, cells, data municipality in connection with work processing devices or any other media which performed for a municipality) under which are used with electronically controlled you assume the tort liability of another equipment. party to pay for"bodily injury" or "property 8. "Employee" includes a "leased worker". damage" to a third person or organization, "Employee" does not include a "temporary provided the "bodily injury" or "property worker". damage" is caused, in whole or in part, by you or by those acting on your behalf. 9. "Executive officer" means a person holding Tort liability means a liability that would be any of the officer positions created by your imposed by law in the absence of any charter, constitution, by-laws or any other contract or agreement. similar governing document. 10. "Hostile fire" means one which becomes Paragraph f. includes that part of any contract or agreement that indemnifies a uncontrollable or breaks out from where it was railroad for "bodily injury" or "property intended to be, damage" arising out of construction or 11. "Impaired property" means tangible property, demolition operations within 50 feet of any other than "your product" or "your work", that railroad property and affecting any railroad cannot be used or is less useful because: bridge or trestle, tracks, road-beds, tunnel, a. It incorporates "your product' or"your work" underpass or crossing. that is known or thought to be defective, However, Paragraph f. does not include deficient, inadequate or dangerous;or that part of any contract or agreement: Form SS 00 08 04 05 Page 21 of 24 BUSINESS LIABILITY COVERAGE FORM (1) That indemnifies an architect, (1) Power cranes, shovels, loaders, engineer or surveyor for injury or diggers or drills; or damage arising out of, (2) Road construction or resurfacing (a) Preparing, approving or failing to equipment such as graders, scrapers prepare or approve maps, shop or rollers; drawings, opinions, reports, e. Vehicles not described in a., b., c., or d. surveys, field orders, change above that are not self-propelled and are orders, designs or drawings and maintained primarily to provide mobility to specifications; or permanently attached equipment of the (b) Giving directions or instructions, following types: or failing to give them, if that is the (1) Air compressors, pumps and primary cause of the injury or generators, including spraying, damage; or welding, building cleaning, (2) Under which the insured, if an geophysical exploration, lighting and architect, engineer or surveyor, well servicing equipment; or assumes liability for an injury or (2) Cherry pickers and similar devices damage arising out of the insured's used to raise or lower workers; rendering or failure to render f. Vehicles not described in a., b., c., or d. professional services, including those listed in (1) above and supervisory, above maintained primarily for purposes other than the transportation of persons or inspection, architectural or engineering activities. cargo. 13. "Leased worker" means a person leased to However, self-propelled vehicles with the following types of permanently attached you by a labor leasing firm under an equipment are not "mobile equipment but agreement between you and the labor leasing will be considered "autos": firm, to perform duties related to the conduct of your business, "Leased worker' does not (1) Equipment, of at least 1,000 pounds include a "temporary worker". gross vehicle weight, designed 14. "Loading or unloading" means the handling of primarily for: property: (a) Snow removal; a. After it is moved from the place where it is (b) Road maintenance, but not accepted for movement into or onto an construction or resurfacing; or aircraft, watercraft or"auto'; (c) Street cleaning; b. While it is in or on an aircraft, watercraft or (2) Cherry pickers and similar devices "auto"; or mounted on automobile or truck c. While it is being moved from an aircraft, chassis and used to raise or lower watercraft or"auto" to the place where it is workers; and finally delivered; (3) Air compressors, pumps and but "loading or unloading" does not include the generators, including spraying, movement of property by means of a mechanical welding, building cleaning, device, other than a hand truck, that is not geophysical exploration, lighting and attached to the aircraft,watercraft or"auto". well servicing equipment. 15. "Mobile equipment" means any of the following 16. "Occurrence" means an accident, including types of land vehicles, including any attached continuous or repeated exposure to substantially machinery or equipment: the same general harmful conditions. a. Bulldozers, farm machinery, forklifts and 17. "Personal and advertising injury" means injury, other vehicles designed for use principally including consequential "bodily injury", arising Off public roads; out of one or more of the following offenses: b. Vehicles maintained for use solely on or a. False arrest, detention or imprisonment; next to premises you own or rent; b. Malicious prosecution; c. Vehicles that travel on crawler treads; d. Vehicles, whether self-propelled or not, on which are permanently mounted: j Page 22 of 24 Form SS 00 08 04 05 BUSINESS LIABILITY COVERAGE FORM c. The wrongful eviction from, wrongful entry Work that may need service, maintenance, into, or invasion of the right of private correction, repair, or replacement, but occupancy of a room, dwelling or which is otherwise complete, will be premises that the person occupies, treated as completed. committed by or on behalf of its owner, The "bodily injury" or "property damage" landlord or lessor; must occur away from premises you own d. Oral, written or electronic publication of or rent, unless your business includes the material that slanders or libels a person or selling, handling or distribution of "your organization or disparages a person's or product" for consumption on premises you organization's goods, products or services; own or rent. e. Oral, written or electronic publication of b. Does not include "bodily injury" or material that violates a person's right of "property damage"arising out of: privacy; (1) The transportation of property, unless f. Copying, in your "advertisement", a the injury or damage arises out of a person's or organization's "advertising condition in or on a vehicle not owned idea"or style of"advertisement"; or operated by you, and that condition g. Infringement of copyright, slogan, or title of was created by the "loading or any literary or artistic work, in your unloading" of that vehicle by any "advertisement"; or insured; or h. Discrimination or humiliation that results in (2) The existence of tools, uninstalled injury to the feelings or reputation of a equipment or abandoned or unused natural person. materials. 18. "Pollutants" means any solid, liquid, gaseous or 20. "Property damage"means: thermal irritant or contaminant, including smoke, a. Physical injury to tangible property, vapor, soot, fumes, acids, alkalis, chemicals and including all resulting loss of use of that waste. Waste includes materials to be recycled, property. All such loss of use shall be reconditioned or reclaimed. deemed to occur at the time of the 19. "Products-completed operations hazard"; physical injury that caused it; or a. Includes all "bodily injury" and "property b. Loss of use of tangible property that is not damage" occurring away from premises physically injured. All such loss of use you own or rent and arising out of "your shall be deemed to occur at the time of product" or"your work" except: "occurrence"that caused it. (1) Products that are still in your physical As used in this definition, "electronic data" is possession; or not tangible property. (2) Work that has not yet been completed 21. "Suit" means a civil proceeding in which or abandoned. However, "your work" damages because of "bodily injury", "property will be deemed to be completed at the damage" or "personal and advertising injury" earliest of the following times: to which this insurance applies are alleged. (a) When all of the work called for in "Suit" includes: your contract has been completed, a. An arbitration proceeding in which such (b) When all of the work to be done at damages are claimed and to which the. the job site has been completed if insured must submit or does submit with your contract calls for work at our consent; or more than one job site. b. Any other alternative dispute resolution (c) When that part of the work done at proceeding in which such damages are a job site has been put to its claimed and to which the insured submits intended use by any person or with our consent. organization other than another 22. "Temporary worker" means a person who is contractor or subcontractor furnished to you to substitute for a permanent working on the same project. "employee" on leave or to meet seasonal or short-term workload conditions, 23. "Volunteer worker" means a person Who: a. Is not your"employee"; Form SS 00 08 04 06 Page 23 of 24 . BUSINESS LIABILITY COVERAGE FORM b. Donates his or her work; (2) The providing of or failure to provide c. Acts at the direction of and within the warnings or instructions. 'scope of duties determined by you; and c. Does not include vending machines or d. Is not paid a fee, salary or other other property rented to or located for the compensation by you or anyone else for use of others but not sold. their work performed for you. 25. "Your work": 24. "Your product": a. Means: a. Means: (1) Work or operations performed by you (1) Any goods or products, other than real or on your behalf; and property, manufactured, sold, handled, (2) Materials, parts or equipment distributed or disposed of by: furnished in connection with such work (a) You; or operations. (b) Others trading under your name; b. Includes: or (1) Warranties or representations made at (c) A person or organization whose any time with respect to the fitness, business or assets you have quality, durability, performance or use acquired; and of"your work'; and (2) Containers (other than vehicles), (2) The providing of or failure to provide materials, parts or equipment warnings or instructions. furnished in connection with such goods or products. b. Includes: (1) Warranties or representations made at any time with respect to the fitness, quality, durability, performance or use of"your product"; and Page 24 of 24 Form SS 00 08 04 05 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY, BUSINESS LIABILITY COVERAGE FORM AMENDATORY ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESS LIABILITY COVERAGE FORM A. Sub-subparagraphs 1.p. (7), (8), (15) of Paragraph (c) An Internet search, access, content or 2., of Section B. Exclusions are deleted and service provider. replaced with the following: However, this exclusion does not p. Personal and Advertising Injury: apply to Paragraphs a., b. and c. of (7) (a) Arising out of any actual or alleged the definition of "personal and infringement or violation of any intellectual advertising injury" under the property right, such as copyright, patent, Definitions Section. trademark, trade name, trade secret, For the purposes of this exclusion, the service mark or other designation of origin placing of frames, borders or links, or or authenticity; or advertising, for you or others (b) Any injury or damage alleged in any anywhere on the Internet, is not by claim or "suit" that also alleges an itself, considered the business of infringement or violation of any advertising, broadcasting, publishing intellectual property right, whether or telecasting. such allegation of infringement or (15)Arising out of any access to or disclosure violation is made by you or by any of any person's or organization's other party involved in the claim or confidential or personal information, "suit", regardless of whether this including patents, trade secrets, insurance would otherwise apply. processing methods, customer lists, However, this exclusion does not apply if the financial information, credit card only allegation in the claim or "suit" involving information, health information or any any intellectual property right is limited to: other type of nonpublic information.This (1) Infringement, in your "advertisement", exclusion applies even if damages are of: claimed for notification costs, credit monitoring expenses, forensic expenses, {a) Copyright; public relations expenses or any other (b) Slogan; or loss, cost or expense incurred by you or (c) Title of any literary or artistic work; others arising out of any access to or or disclosure of any person's or (2) Copying, in your "advertisement", a organization's confidential or personal person's or organization's "advertising information. idea"or style of"advertisement". B. Subparagraph 1.r. of Section B. Exclusions is (8) Arising out of an offense committed by an deleted and replaced with the following: insured whose business is: r. Employment-Related Practices (a) Advertising, broadcasting, publishing "Personal and advertising injury"to: or telecasting; (1) A person arising out of any"employment— (b) Designing or determining content of related practices"; or web sites for others; or Form SS 00 60 0915 Page 1 of 2 (2) The spouse, child, parent, brother or sister However, unless Paragraph (1) above applies, this of that person as a consequence of exclusion does not apply to damages because of "personal and advertising injury" to that "bodily injury". person at whom any "employment-related As used in this exclusion, electronic data means practices"are directed. information, facts or computer programs stored as This exclusion applies: or on, created or used on, or transmitted to or (a) Whether the injury-causing event from computer software (including systems and described in the definition of applications software), on hard or floppy disks, "employment-related practices" CD-ROMs, tapes, drives, cells, data processing occurs before employment, during devices or any other repositories of computer employment or after employment of software which are used with electronically that person; controlled equipment. The term computer programs, referred to in the foregoing description (b) Whether the insured may be liable as of electronic data, means a set of related an employer or in any other capacity; electronic instructions which direct the operations and and functions of a computer or device connected (c) To any obligation to share damages to it, which enable the computer or device to with or repay someone else who must receive, process, store, retrieve or send data. pay damages because of the injury. D. Sub-subparagraph 7.b.(1) Other Insurance of C. Subparagraph 1.q. "Electronic Data" of Section B. Section E. Liability and Medical Expenses Exclusions is deleted and replaced with the General Conditions is deleted and replaced with following: the following: q. Access Or Disclosure Of Confidential Or b. Excess Insurance Personal Information And Data-related (1) Your Work Liability That is Fire, Extended Coverage, Builder's (1) Damages, other than damages because Risk, Installation Risk, Owner Controlled of "personal and advertising injury", Insurance Program or OCIP, Wrap Up arising out of any access to or disclosure Insurance or similar coverage for "your of any person's or organization's work". confidential or personal information, E. Subparagraph 17. c. "Personal and Advertising including patents, trade secrets, Injury" of Section G, Liability and Medical processing methods, customer lists, Expenses Definitions is deleted and replaced financial information, credit card with the following: information, health information or any other type of nonpublic information; or "Personal and advertising injury" means injury, (2) Damages arising out of the loss of, loss of including consequential "bodily injury", arising out use of, damage to, corruption of, inability of one or more of the following offenses: to access, or inability to manipulate c. The wrongful eviction from, wrongful entry electronic data. into, or invasion of the right of private This exclusion applies even if damages are occupancy of a room, dwelling or premises claimed for notification costs, credit monitoring that a person or organization occupies, expenses, forensic expenses, public relations committed by or on behalf of its owner, expenses or any other loss, cost or expense landlord or lessor; incurred by you or others arising out of that which F. Subparagraph 17.h. of Section G, Liability and is described in Paragraph (1)or(2) above. Medical Expenses Definitions deleted. Page 2 of 2 Form SS 00 60 09 16 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BUSINESS LIABILITY COVERAGE FORM AMENDATORY ENDORSEMENT- SUPPLEMENTARY PAYMENTS This endorsement modifies insurance provided under the following: BUSINESS LIABILITY COVERAGE FORM A. Sub-subparagraph 3.a.(5)of Paragraph 3., Section A. Coverages is deleted and replaced with the following: 3. Coverage Extension-Supplementary Payments: a. (5) All court costs taxed against the insured in the "suit". However, these payments do not include attorneys'fees or attorneys' expenses taxed against the insured. Form SS 00 64 09 16 Page 1 of 1 0 2016, The Hartford THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CALIFORNIA CHANGES This endorsement modifies insurance provided under the following: COMMON POLICY CONDITIONS SPECIAL PROPERTY COVERAGE FORM STANDARD PROPERTY COVERAGE FORM BUSINESS LIABILITY COVERAGE FORM EMPLOYMENT PRACTICES LIABILITY COVERAGE FORM A. Paragraphs 2. and 3. of the Cancellation Common (b) You or your representative in Policy Condition are replaced by the following: pursuing a claim under this policy. 2. All Policies in Effect for 60 Days Or Less: (3) A judgment by a court or an If this policy has been in effect for 60 days or administrative tribunal that you have less, and is not a renewal of a policy we have violated a California or Federal law, previously issued,we may cancel this policy by having as one of its necessary mailing or delivering to the first Named Insured elements an act which materially at the mailing address shown in the policy and increases any of the risks insured to the producer of record, advance written against. notice of cancellation, stating the reason for (4) Discovery of willful or grossly negligent cancellation, at least: acts or omissions, or of any violations a. 10 days before the effective date of of state laws or regulations establishing cancellation if we cancel for: safety standards, by you or your (1) Nonpayment of premium; or representative, which materially increase any of the risks insured (2) Discovery of fraud or material against. misrepresentation by: (5) Failure by you or your representative (a) Any insured or his or her to implement reasonable loss control representative in obtaining this requirements, agreed to by you as a insurance; or condition of policy issuance, or which (b) You or your representative in were conditions precedent to our use pursuing a claim under this policy. of a particular rate or rating plan, if that b. 30 days before the effective date of failure materially increases any of the cancellation if we cancel for any other risks insured against. reason. (6) A determination by the Commissioner 3. All Policies in Effect For More Than 60 Days of Insurance that the: a. If this policy has been in effect for more (a) Loss of, or changes in, our than 60 days, or is a renewal of a policy we reinsurance covering all or part of issued,we may cancel this policy only upon the risk would threaten our the occurrence, after the effective date of financial integrity or solvency; or the policy, of one or more of the following, (b) Continuation of the policy or as permitted under applicable California coverage would: law: i. Place us in violation of (1) Nonpayment of premium, including California law or the laws of payment due on a prior policy we the state where we are issued and due during the current domiciled; or policy term covering the same risks. li, Threaten our solvency. (2) Discovery of fraud or material (7) A change by you or your misrepresentation by: representative in the activities or (a) Any insured or his or her property of the commercial or industrial representative in obtaining this enterprise, which results in a materially insurance; or added, increased or changed risk, unless the added, increased or changed risk is included in the policy. Form SS 01 21 02 20 Page 1 of 5 a 2019,The Hartford (Includes copyrighted material of Insurance Services Office, Inc., with its permission) b. We will mail or deliver advance written from the date the state of emergency is notice of cancellation, stating the reason declared, solely because the dwelling or other for cancellation, to the first Named Insured, structure is located in an area in which a wild at the mailing address shown in the policy, fire has occurred. and to the producer of record, at least: However, we may cancel: (1) 10 days before the effective date of a. When you have not paid the cancellation if we cancel for premium, at any time by letting nonpayment of premium or discovery you know at least 10 days before of fraud, or the date cancellation takes effect; (2) 30 days before the effective date of b. If willful or grossly negligent acts cancellation if we cancel for any other or omissions by the named reason listed in paragraph 3.a. insured, or his or her B. The following provision is added to the representatives, are discovered Cancellation Common Policy Condition: that materially increase any of the 7. Residential Property risks insured against; or This provision applies to coverage on real c. If there are physical changes in property which is used predominantly for the property insured against, residential purposes and consisting of not beyond the catastrophe- damaged more than four dwelling units, and to condition of the structures and surface landscape, which result in coverage on tenants' household personal the property becoming uninsur- property in a residential unit, if such able. coverage is written under this policy: a. If such coverage has been in effect for C. The following is added and supersedes any 60 days or less, and is not a renewal of provisions to the contrary: coverage we previously issued, we NONRENEWAL may cancel this coverage for any 1. Subject to the provisions of paragraphs C.2. reason, except as provided in b. and c. and C.3. below, if we elect not to renew this below. policy, we will mail or deliver written notice b. We may not cancel solely because the stating the reason for nonrenewal to the first first Named Insured has: Named Insured shown in the Declarations and (1) Accepted an offer of earthquake to the producer of record, at least 60 days but coverage; or not more than 120 days, before the expiration (2) Cancelled or did not renew a policy or anniversary date. issued by the California We will mail or deliver our notice to the first Earthquake Authority (CEA) that Named Insured, and to the producer of record, included and earthquake policy at the mailing address shown in the policy, premium surcharge. 2. Residential Property However, we shall cancel this policy if This provision applies to coverage on real the first Named Insured has accepted a property used predominantly for residential new or renewal policy issued by the purposes and consisting of not more than four CEA that includes an earthquake policy dwelling units, and to coverage on tenants' premium surcharge but fails to pay the household property contained in a residential earthquake policy premium surcharge unit, if such coverage is written under this authorized by the CEA. policy. G. We may not cancel such coverage a. We may elect not to renew such coverage solely because corrosive soil for any reason, except as provided in b., c. conditions exist on the premises. This and d. below: restriction (c.) applies only if coverage b. We will not refuse to renew such coverage under the Special Property Coverage Solely because the first Named Insured Form, which excludes loss or damage has accepted an offer of earthquake caused by or resulting from corrosive coverage. soil conditions. If a state of emergency under California However, the following applies only to Law is declared and the residential insurers who are associated participating property is located in any ZIP Code within insurers as established by Cal. Ins, Code Section 10089.16. We may elect not to or adjacent to the Fire perimeter, as renew such coverage after the first Named determined by California Law, we may not cancel this policy for one year, beginning Insured has accepted an offer ofearthquake coverage, if one or more of the following reasons applies: Page 2 of 5 Form SS 01 21 02 20 (1) The nonrenewal is based on sound year, beginning from the date the state of underwriting principles that relate to emergency is declared, solely because the coverages provided by this policy the dwelling or other structure is located and that are consistent with the in an area in which a wildfire has approved rating plan and related occurred. documents filed with the Department However, we may nonrenew: of insurance as required by existing (1) If willful or grossly negligent acts or law; omissions by the named insured, or (2) The Commissioner of Insurance finds his or her representatives, are that the exposure to potential losses discovered that materially increase will threaten our solvency or place us any of the risk insured against. in a hazardous condition. A (2) If losses unrelated to the post disaster hazardous condition in which we loss condition of the property have make claims payments for losses occurred that would collectively resulting from an earthquake that render the risk ineligible for renewal; occurred within the preceding two or years and that required a reduction in policyholder surplus of at least 2b% (3} If there are physical changes in the for payment of those claims; or property insured against, beyond the catastrophe-damaged condition of the (3) We have: structures and surface landscape, (a) Lost or experienced a substantial which result in the property becoming reduction in the availability or uninsurable. scope of reinsurance coverage; or 3. We are not required to send notice of (b) Experienced a substantial nonrenewal in the following situations: increase in the premium charged a. If the transfer or renewal of a policy, for reinsurance coverage of our without any changes in terms, conditions, residential property insurance or rates, is between us and a member of policies; and our insurance group. the Commissioner has approved b. If the policy has been extended for 90 a plan for the nonrenewals that is days or less, provided that notice has fair and equitable, and that is been given in accordance with paragraph responsive to the changes in our C.1. reinsurance position. c. If you have obtained replacement c. We will not refuse to renew such coverage coverage, or if the first Named Insured solely because the first Named Insured has has agreed, in writing, within 60 days of cancelled or did not renew a policy, issued by the termination of the policy, to obtain the California Earthquake Authority that that coverage. included an earthquake policy premium d. If the policy is for a period of no more surcharge. than 60 days and you are notified at the d. We will not refuse to renew such coverage time of issuance that it will not be solely because corrosive soil conditions exist renewed. on the premises. This restriction (d) applies e, If the first Named Insured requests a only if coverage is subject to the Special change in the terms or conditions or risks Property Coverage Form, which excludes loss covered by the policy within 60 days of or damage caused by or resulting from the end of the policy period. corrosive soil conditions. If a state of emergency under California Law f. If we have made a written offer to the first Named Insured, in accordance with the is declared and the residential property is time frames shown in paragraph C.1., to located in any ZIP Code within or adjacent to the fire perimeter, as determined by California renew the policy under changed terms or Law,we may not nonrenew this policy for one conditions or at an increased premium rate, when the increase exceeds 25%. If there is an appraisal, we will still retain our right to deny the claim. Form 85 01 21 02 20 Page 3 of 5 D. The Concealment, Misrepresentation Or Fraud If there is an appraisal, we will still retain our right Condition is replaced by the following with respect to deny the claim. to loss of damage.caused by fire: H. With respect to an. "Open Policy", the Loss We do not provide coverage to the insured who, Payment Condition of the.Standard and Special whether before or after a loss, has committed Property Form is amended by the following: fraud or intentionally concealed or misrepresented 1. The following changes are made to Section•E. any material fact or circumstance concerning: PROPERTY LOSS CONDITIONS: 1. This Coverage Part; a. Paragraph 5.d.(1)(b) of the Loss Payment 2. The Covered Property; condition is deleted and replaced by: 3. That insured's interest in the Covered (b) We will not pay on a replacement Property; or cost basis ' for any loss or 4. A claim under this Coverage Part or Coverage damage until the lost or damaged property is actually repaired or Form. replaced, and then only subject to E. The Concealment, Misrepresentation Or Fraud deduction for depreciation. Prior Condition is replaced by the following with respect to such repair or replacement, to loss of damage caused by a Covered Cause of and in accordance with.the:terms Loss other than fire: applicable in this Paragraph S., This Coverage Part is void if any insured, whether Loss Payment, we will pay the before or after a loss, has committed fraud or actual cash value of the. lost or intentionally concealed or misrepresented any damaged property as described in material fact or circumstance concerning: Paragraph 2. below. If the actual cash value does not exhaust the !. This Coverage Part; applicable Limit of Insurance, we 2. The Covered Property; will then pay the difference 3. That insured's interest in the Covered between the actual cash value Property; or and the replacement cost, provided that the repair or 4. A claim under this Coverage Part or Coverage replacement is completed: Form. (1) Within 12 months after our F. The Other Insurance - Property Coverage payment of the actual cash Condition is replaced by the following: value; or If there is other insurance covering the same loss (ii) Within 36 months after our or damage, we will pay our share of the covered payment of the actual cash loss or damage. Our share is the proportion that value if the loss or damage the applicable limit of insurance bears to the limits relates. to a state of of insurance of all insurance covering on same emergency under California basis. Law. G. Paragraph E.2., Appraisal of the Standard and The following provision applies to real property which is used Special Property Form is deleted and replaced predominantly for residential by the following: purposes and consisting of not 2. If we and you disagree on the value of the more than four-dwelling units, and property or the amount of loss, either may to coverage on tenants' make written request for an appraisal of the household personal.property in a loss. If the request is accepted, each party will residential unit. select a competent and impartial appraiser. if you acting in good: Each party shall notify the other of the with reasonable diligence,. appraiser selected within 20 days of the encounter a delay or. delays in request. The two appraisers will select an approval for, or reconstruction of, umpire. If they cannot agree within 15 days, the residence that are beyond either may request that selection be made by your control, we shall provide one a judge of a court having jurisdiction. The or more .additional extensions of appraisers will state separately the value of six months for good cause. the property and amount of loss. If they fail to Circumstances beyond your agree, they will submit their differences to the control include, but are not limited umpire. A decision agreed to by any two will to: be binding. Each party will: (i) Unavoidable construction a. Pay its chosen appraiser; and permit delays; b. Bear the other expenses of the appraisal (ii) The lack of necessary and umpire equally. construction materials; or Page 4 of 5 Form SS 01 2102 20 (iti)The unavailability of contractors b. In the event of a partial or total loss to to perform the necessary work. Covered Property other than a building or The foregoing provisions do not structure, actual cash value is calculated constitute a waiver of our right to deny as the lesser of the following: the claim for any valid reason or to (1) The amount it would cost to repair or restrict payment in cases of suspected replace the property less a fair and fraud. reasonable deduction for physical 2. The following provision is added: depreciation, based on the condition of the property at the time of loss; or Provision Applicable to California (2) The Limit of Insurance applicable to Actual cash value is determined as follows: the property. a. In the event of a partial or total loss to a I. With respect to this endorsement, the following building or structure, actual cash value is definition is added to Section G. PROPERTY calculated as shown below, whichever is DEFINITIONS less: (1) The amount it would cost to repair, "Open Policy" means a policy under which the rebuild or replace the property less a value of Covered Property is not fixed at fair and reasonable deduction for policy inception, but is determined at the time physical depreciation of the of loss in accordance with policy provisions components of the building or on valuation. The term 'open policy" does structure that are normally subject to not apply to Covered Property that is subject repair or replacement during its useful to an Agreed Value clause or similar clause life. Physical depreciation is based that establishes an agreed value prior to loss, upon the condition of the property at unless such clause has expired. the time of the loss; or (2) The limit of Insurance applicable to the property. Page 5 of 5 Form SS 01 21 02 20 POLICY NUMBER: 20 SBrn BA6984 it THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. UNMANNED AIRCRAFT - LIABILITY ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESS LIABILITY COVERAGE FORM SCHEDULE Option 1: If an "X" is shown in this box, Bodily Injury and Property Damage coverage for Unmanned Aircraft applies and the Unmanned Aircraft Exclusion in Paragraph A.1.g.(1) of this endorsement does not apply. Option 2: If an "X" is shown in this box, Personal And Advertising Injury coverage for Unmanned Aircraft applies and the Unmanned Aircraft - Personal And Advertising Injury Exclusion in Paragraph A.2. of this endorsement does not apply. Except as otherwise stated in this endorsement or the owned or operated by or rented or schedule above, the terms and conditions of the policy loaned to any insured. Use includes apply to the insurance stated below. operation and 'loading or unloading". A. The following changes are made to Section B.1., This Paragraph g.(2) applies even if the EXCLUSIONS: claims against any insured allege 1. Paragraph g., Aircraft, Auto or Watercraft, is negligence or other wrongdoing in the deleted and replaced with the following: supervision, hiring, employment, training g. Aircraft,Auto or Watercraft or monitoring of others by that insured, if the occurrence which caused the (1) Unmanned Aircraft "bodily injury" or "property damage" "Bodily injury" or "property damage" involved the ownership, maintenance, arising out of the ownership, use or entrustment to others of any maintenance, use or entrustment to aircraft (other than "unmanned aircraft), others of any aircraft that is an "auto" or watercraft that is owned or "unmanned aircraft". Use includes operated by or rented or loaned to any operation and "loading or unloading". insured, This Paragraph g.(1) applies even if the Paragraph g. (2) does not apply to: claims against any insured allege (a) A watercraft while ashore on negligence or other wrongdoing in the premises you own or rent; supervision, hiring, employment, training (b) A watercraft you do not own that is: or monitoring of others by that insured, if i Less than 51 feet Ion the `occurrence" which caused the (i) g; and "bodily injury" or "property damage" (ii) Not being used to carry persons involved the ownership, maintenance, for a charge; use or entrustment to others of any (c) Parking an "auto' on, or on the aircraft that is an"unmanned aircraft". ways next to, premises you own or (2) Aircraft (Other Than Unmanned rent, provided the "auto" is not Aircraft),Auto Or Watercraft owned by or rented or loaned to you "Bodily injury" or "property damage" or the insured; arising out of the ownership, (d) Liability assumed under any maintenance, use or entrustment to "insured contract"for the ownership, others of any aircraft (other than maintenance or use of aircraft or "unmanned aircraft), "auto" or watercraft watercraft; Form SS 42 06 03 17 Page 1 of 2 Process Date: 05/16/24 Policy Expiration Date: 08/02/25 (e) "Bodily injury" or"property damage" B. The following changes apply to Section G. arising out of the operation of any of LIABILITY AND MEDICAL EXPENSES the equipment listed in Section G DEFINITIONS: Liability and Medical Expenses 1, The following definition is added: Definitions, Paragraph 15 f. (2) or f. (3) of the definition of "mobile "Unmanned aircraft" means an aircraft that is equipment"; or not: (f) An aircraft (other than unmanned a. Designed; aircraft) that is not owned by any b. Manufactured; or insured and is hired, chartered or c. Modified after manufacture loaned with a paid crew. However, to be controlled directly by a person from within this exception does not apply if the insured has any other insurance for or an the aircraft. such "bodily injury" or "property damage", whether the other insurance is primary, excess, contingent or on any other basis. 2. The following is added to Section B. EXCLUSIONS Paragraph p., Personal and Advertising Injury: Unmanned Aircraft - Personal and Advertising Injury Arising out of the ownership, maintenance, use or entrustment to others of any aircraft that is an "unmanned aircraft". Use includes operation and"loading or unloading". This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by that insured, if the offense which caused the "personal and advertising injury" involved the ownership, maintenance, use or entrustment to others of any aircraft that is an"unmanned aircraft". However, this exclusion does not apply if the only allegation in the claim or"suit" involves an intellectual property right which is limited to: (a) Infringement, in your "advertisement",of: (i) Copyright; (ii) Slogan; or (iii) Title of any literary or artistic work;or (b) Copying, in your "advertisement", a person or organization's "advertising idea" or style of "advertisement". Page 2 of 2 Form SS 42 06 0317 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. HIRED AUTO AND NON-OWNED AUTO This endorsement modifies insurance provided under the following: BUSINESS LIABILITY COVERAGE FORM This coverage is subject to all provisions in the moved from the place where they are BUSINESS LIABILITY COVERAGE FORM not accepted by the "insured"for movement into expressly modified herein: or onto the covered "auto"; or c. After the "pollutants" or any property in A. Amended Coverage: which the "pollutants" are contained are Coverage is extended to "bodily injury" and moved from the covered "auto" to the placewhere they are finally delivered, disposed of "property damage" arising out of the use of a "hired or abandoned finally the"insured", auto'and non-owned auto". Paragraph a. above does not apply to fuels, B. Paragraph B. EXCLUSIONS is amended as lubricants, fluids, exhaust gases or other follows: similar "pollutants" that are needed for or 1. Exclusion g. Aircraft, Auto or Watercraft does result from the normal electrical, hydraulic not apply to a "hired auto" or a "non-owned or mechanical functioning of the covered auto". "auto"or its parts, if: 2. Exclusion e. Employers Liability does not (1) The "pollutants" escape, seep, migrate, apply to "bodily injury" to domestic "employees" or are discharged or released directly not entitled to workers' compensation benefits from an "auto" part designed by its or to liability assumed by the"insured" under an manufacturer to hold, store, receive, or "insured contract". dispose of such"pollutants"; and 3. Exclusion f. Pollution is replaced by the (2) The "bodily injury" and "property following: damage" does not arise out of the "Bodily injury" or "property damage" arising out operation of any equipment listed in of the actual, alleged or threatened discharge, paragraphs 15.b. and 15.c. of the dispersal, seepage, migration, release or definition of"mobile equipment". escape of"pollutants": Paragraphs b. and c_ above do not apply to a. That are, or that are contained in any "accidents" that occur away from premises property that is: owned by or rented to an "insured" with (1) Being transported or towed by, handled, respect to "pollutants" not in or upon a or handled for movement into, onto or covered auto if: from, the covered "auto"; (1) The "pollutants" or any property in (2) Otherwise in the course of transit by or which the "pollutants" are contained are on behalf of the"insured"; or upset, overturned or damaged as a result of the maintenance or use of a (3) Being stored, disposed of, treated or covered "auto"; and processed in or upon the covered "auto". b. Before the "pollutants" or any property in which the "pollutants" are contained are Form SS 04 38 09 09 Page 1 of 3 c0 2009, The Hartford (Includes copyrighted material of ISO Properties, Inc., with its permission) -(2) The discharge, dispersal, seepage, company)for an "auto"owned by him or her migration, release or escape of the or a member of his or her household. "pollutants" is caused directly by such d. Anyone liable for the conduct of an "insured" upset, overturn or damage as a result of described above but only to the extent of that the maintenance or use of a covered liability. "auto". D. With respect to the operation of a "hired auto" and 4. With respect to this coverage, the following "non-owned auto", the following additional additional exclusions apply: conditions apply: a. Fellow employee 1. OTHER INSURANCE Coverage does not apply to"bodily injury"to a. Except for any liability assumed under an any fellow "employee" of the "insured" "insured contract"the insurance provided by arising out of the operation of an "auto" this Coverage Farm is excess over any owned by the "insured" in the course of the other collectible insurance. fellow"employee's"employment. However, if your business is the selling, b. Care,custody or control servicing, repairing, parking or storage of Coverage does not apply to "property "autos", the insurance provided by this damage" involving property owned or endorsement is primary when covered transported by the "insured" or in the "bodily injury" or "property damage" arises "insured's"care, custody or control. out of the operation of a customer's "auto" C. With respect to "hired auto" and "non-owned auto" by you or your"employee". coverage, Paragraph C. WHO IS AN INSURED is b. When this Coverage Form and any other deleted and replaced by the following: Coverage Form or policy covers on the The following are"insureds": same basis, either excess or primary, we will pay only our share. Our share is the a. You. proportion that the Limit of Insurance of our b. Your "employee" while using with your Coverage Form bears to the total of the permission: limits of all the Coverage Forms and policies „ (1) An 'auto you hire or borrow;or covering on the same basis. (2) An "auto" you don't own, hire or borrow in 2. TWO OR MORE COVERAGE FORMS OR your business or personal affairs; or POLICIES ISSUED BY US (3) An "auto" hired or rented by your If the Coverage Form and any other Coverage "employee" on your behalf and at your Form or policy issued to you by us or any direction. company affiliated with us apply to the same c. Anyone else while using a "hired auto" "accident", the aggregate maximum Limit of or "non- o Insurance under all the Coverage Forms or owned auto"with your permission except: policies shall not exceed the highest applicable (1) The owner or anyone else from whom you Limit of Insurance under any one Coverage hire or borrow an "auto". Form or policy. This condition does not apply to (2) Someone using an auto while he or she is any Coverage Form or policy issued by us or an working in a business of selling, servicing, affiliated company specifically to apply as repairing, parking or storing "autos" unless excess insurance over this Coverage Form. that business is yours. E. The following definitions are added: (3) Anyone other than your "employees", G. LIABILITY AND MEDICAL EXPENSES partners(if you are a partnership), members DEFINITIONS: (if you are a limited liability company), or a 1. "Hired auto" means any "auto" you lease, lessee or borrower or any of their hire, rent or borrow. This does not include "employees", while moving property to or any auto you lease, hire, rent or borrow from an"auto". from any of your"employees", your partners (4) A partner (if you are a partnership), or a (if you are a partnership), members (if you member (if you are a limited liability are a limited liability company), Page 2 of 3 Form SS 04 38 09 09 or your "executive officers" or members of their households. This does not include a long-term leased "auto" that you insure as an owned "auto" under any other auto liability insurance policy or a temporary substitute for an "auto" you own that is out of service because of its breakdown, repair, servicing or destruction. 2. "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: a. "Autos" owned by your "employees" your partners (if you are a partnership), members (if you are a limited liability company), or your "executive officers", or members of their households, but only while used in your business or your personal affairs. b. Customer's "auto" that is in your care, custody or control for service. Form SS 04 38 09 09 Page 3 of 3 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. AMENDMENT - DEFINITION OF INSURED CONTRACT This endorsement modifies insurance provided under the following: BUSINESS LIABILITY COVERAGE FORM Paragraph f. of the definition of"insured contract" in the Liability And Medical Expenses Definitions Section is replaced by the following: f. That part of any other contract or agreement pertaining to your business (including an indemnification of a municipality in connection with work performed for a municipality) under which you assume the tort liability of another party to pay for "bodily injury" or "property damage" to a third person or organization. Tort liability means a liability that would be imposed by law in the absence of any contract or agreement. Paragraph f. includes that part of any contract or agreement that indemnifies a railroad for "bodily injury" or "property damage" arising out of construction or demolition operations within 50 feet of any railroad property and affecting any railroad bridge or trestle, tracks, road-beds, tunnel, underpass or crossing. However, Paragraph f. does not include that part of any contract or agreement: (1) That indemnifies an architect, engineer or surveyor for injury or damage arising out of: (a) Preparing, approving or failing to prepare or approve maps, shop drawings, opinions, reports surveys, field orders, change orders, designs or drawings and specifications; or (b) Giving directions or instructions, or failing to give them, if that is the primary cause of the injury or damage; or (2) Under which the insured, if an architect, engineer or surveyor, assumes liability for an injury or damage arising out of the insured's rendering or failure to render professional services, including those listed in (1) above and supervisory, inspection, architectural or engineering activities. i Form SS 4163 06 11 Page 1 of 1 ©2011, The Hartford (Includes copyrighted material of Insurance Services Office, Inc.with its permission.) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EXCLUSION - TESTING OR CONSULTING ERRORS AND OMISSIONS This endorsement modifies insurance provided under the following: BUSINESS LIABILITY COVERAGE FORM This insurance does not apply to "bodily injury", "property damage" or"personal and advertising injury" arising out of: 1. An error, omission, defect or deficiency in: a. Any test performed; or b. An evaluation, a consultation or advice given, by or on behalf of any insured; 2. The reporting of or reliance upon any such test, evaluation, consultation or advice; or 3. The rendering of or failure to render any service by you or on your behalf in connection with the selling, licensing, franchising or furnishing of your computer software to others including electronic data processing programs, designs, specifications, manuals and instructions. Form SS 05 09 07 00 Page 1 of 1 © 2000, The Hartford THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EXCLUSION - NUCLEAR ENERGY LIABILITY 1. This insurance does not apply: (3) The injury or damage arises out of the a. To any injury or damage: furnishing by any insured of any"technology services" in connection with the planning, (1) With respect to which an insured under the construction, maintenance, operation or use policy is also an insured under a nuclear of any"nuclear facility"; or energy liability policy issued by Nuclear (4) The injury or damage arises out of the Energy Liability Insurance Association, furnishing by an insured of services, Mutual Atomic Energy Liability Underwriters or Nuclear Insurance Association of materials, parts or equipment in connection Canada, or any of their successors, or with the planning, construction, would be an insured under any such policy maintenance, operation or use of any but for its termination upon exhaustion of its - "nuclear facility"; but if such facility is located limit of liability; or within the United States of America, its territories or possessions or Canada, this (2) Resulting from the"hazardous properties"of exclusion (4) applies only to "property "nuclear material"and with respect to which: damage" to such "nuclear facility" and any (a) Any person or organization is required property thereat. to maintain financial protection pursuant 2. As used in this exclusion: to the Atomic Energy Act of 1954, or any law amendatory thereof; or a. "Byproduct material", "source material" and 'special nuclear material" have the meanings (b) The insured is, or had this policy not given them in the Atomic Energy Act of 1954 or been issued would be, entitled to in any law amendatory thereof. indemnity from the United States of America, or any agency thereof, under b. "Computer system and network" means: any agreement entered into by the (1) Leased or owned computer hardware United States of America, or any agency including mobile, networked, and data thereof, with any person or organization. storage computing equipment; b. Under any Medical Payments or Medical (2) Owned or licensed software; Expenses Coverage, to expenses incurred with (3) Owned websites; respect to bodily injury resulting from the "hazardous properties" of"nuclear material" and (4) Leased or owned wireless input and output arising out of the operation of a "nuclear facility" devices; and by any person or organization. (5) Electronic backup facilities and data storage c. To any injury or damage resulting from the repositories employed in conjunction with "hazardous properties"of"nuclear material"; if: items 1 through 4 above. (1) The"nuclear material": c. "Hazardous properties" include radioactive, toxic (a) Is at any "nuclear facility" owned by, or or explosive properties. operated by or on behalf of, an insured; d. "Nuclear facility"means: or (1) Any"nuclear reactor'; (b) Has been discharged or dispersed (2) Any equipment or device designed or used therefrom; for: (2) The"nuclear material" is contained in "spent (a) Separating the isotopes of uranium or fuel" or "waste" at any time possessed, plutonium; handled, used, processed, stored, (b) Processing or utilizing "spent fuel"; or transported or disposed of by or on behalf of an insured; or (c) Handling, processing or packaging 'Waste", Form SS 05 47 09 15 Page 1 of 2 © 2015, The Hartford I (3) Any equipment or device used for the b. Integration of systems; processing, fabricating or alloying of"special c. Processing of, management of, mining nuclear material" if at any time the total or warehousing of data; amount of such material in the custody of the insured at the premises where such d. Administration, management, operation equipment or device is located consists of or or hosting of; another party's systems, contains more than 25 grams of plutonium technology or computer facilities; or uranium 233 or any combination thereof, e. Website development;website hosting; or more than 250 grams of uranium 235; f. Internet access services; intranet, (4) Any structure, basin, excavation, premises extranet or electronic information or place prepared or used for the storage or connectivity services; software disposal of"waste"; application connectivity services; and includes the site on which any of the g. Manufacture, sale, licensing, foregoing is located, all operations conducted on distribution, or marketing of: software, such site and all premises used for such wireless applications, firmware, operations. shareware, networks, systems, e. "Nuclear material" means "byproduct material", hardware,devices or components; "source material"or"special nuclear material". h. Design and development of: code, f. "Nuclear reactor" means any apparatus software or programming; designed or used to sustain nuclear fission in a 1. Providing software application: self-supporting chain reaction or to contain a services, rental or leasing; critical mass of fissionable material. j. Screening, selection, recruitment or g. Injury or damage and "property damage" include placement of candidates for temporary all forms of radioactive contamination of or permanent employment by others as property, information technology professionals; h. "Spent fuel" means any fuel element or fuel k. "Telecommunication services'; and component, solid or liquid, which has been used 1. "Telecommunication products". or exposed to radiation in a"nuclear reactor". L "Technology services" means: 2• web-related software and connectivity services performed for others; and 1. the fallowing services performed for others: 3. activities on the "named insured's" a. Consulting, analysis, design, installation, "computer system and network". training, maintenance, support and repair of or on: software, wireless applications, firmware, shareware, networks, systems, hardware, devices or components; Page 2 of 2 Form SS 05 47 0915 toy THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CAP ON LOSSES FROM CERTIFIED ACTS OF TERRORISM This endorsement modifies insurance provided under the following: BUSINESS LIABILITY COVERAGE FORM OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE FORM SPECIAL PROPERTY COVERAGE FORM STANDARD PROPERTY COVERAGE FORM UMBRELLA LIABILTY PROVISIONS A. Disclosure Of Federal Share Of Terrorism Losses 2. The act results in damage within the United The United States Department of the Treasury will States, or outside the United States in the case reimburse insurers for a portion of such insured of certain air carriers or vessels or the premises losses, as indicated in the table below that exceeds of an United States mission; and the applicable insurer deductible: 3. The act is a violent act or an act that is Calendar Year Federal Share of dangerous to human life, property or Terrorism Losses infrastructure and is committed by an individual or 2015 g5% individuals acting as part of an effort to coerce the civilian population of the United States or to 2016 84% influence the policy or affect the conduct of the 2017 83% United States Government by coercion. 2018 82% If aggregate industry insured losses attributable to 2019 81% "certified acts of terrorism" under TRIA exceed $100 billion in a calendar year, and we have met, or will 2020 or later 80% meet, our insurer deductible under TRIA, we shall not be liable for the payment of any portion of the However, if aggregate industry insured losses, amount of such losses that exceed $100 billion. In attributable to "certified acts of terrorism" under the such case, your coverage for terrorism losses may federal Terrorism Risk Insurance Act, as amended be reduced on a pro-rats basis in accordance with (TRIA), exceed $100 billion in a calendar year, the procedures established by the Treasury, based on Treasury shall not make any payment for any its estimates of aggregate industry losses and our portion of the amount of such losses that exceeds estimate that we will exceed our insurer deductible. $100 billion. The United States government has not In accordance with the Treasury's procedures, charged any premium for their participation in amounts paid for losses may be subject to further covering terrorism losses. adjustments based on differences between actual B. Cap On Insurer Liability for Terrorism Losses losses and estimates. A "certified act of terrorism" means an act that is C. Application Of Exclusions certified by the Secretary of the Treasury, in The terms and limitations of any terrorism exclusion, accordance with the provisions of federal Terrorism the inapplicability or omission of a terrorism Risk Insurance Act, to be an act of terrorism under exclusion, or the inclusion of terrorism coverage, do TRIA. The criteria contained in TRIA for a "certified not serve to create coverage for any loss which act of terrorism" include the fallowing: would otherwise be excluded under this Coverage 1. The act results in insured losses in excess of$5 Form or Policy, such as losses excluded by the million in the aggregate, attributable to all types Pollution Exclusion, Nuclear Hazard Exclusion and of insurance subject to TRIA; and the War And Military Action Exclusion. Form SS 5019 01 15 Page 1 of 1 ©2015, The Hartford (Includes copyrighted material of Insurance Services Office, Inc.with its permission) POLICY NUMBER: 20 SBM BA6984 JIL THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - PERSON-ORGANIZATION COUNTY OF LOS ANGELES, ETAL. 3333 WILSHIRE BLVD. STE 820 LOS ANGELES, CA 90010 WILLIE L SHAW 3782 WELLINGTON RD LOS ANGELES, CA 90008 CITY OF NORWALK HOUSING AUTHORITY 12700 NORWALK BLVD RM 11 NORWALK, CA 90650-3144 MICHAEL TRAVIS 3782 WELLINGTON RD LOS ANGELES CA 90016 THE CITY OF BURBANK 275 EAST OLIVE AVENUE BURBANK, CA, 91502 LACDA THE LOS ANGELES COUNTY DEVELOPMENT AUTHORITY 700 WEST MAIN ST ALHAMBRA, CA 91081 BEVERLY HILLS POLICE DEPARTMENT 464 N REXFORD DR BEVERLY HILLS, CA 90210-4873 CITY OF WEST HOLLYWOOD PO BOX 947 MURRIETA CA 92564 LACDA THE LOS ANGELES COUNTY DEVELOPMENT AUTHORITY 700 WEST MAIN ST ALHAMBRA, CA 91081 Form IH 12 00 1185 T SEQ. NO. 002 Printed in U.S.A. Page 001 (CONTINUED ON NEXT PAGE) Process Date: 05/16/24 Expiration Date: 08/02/25 POLICY NUMBER: 20 SBM BA6984 14L THIS ENDORSEMENT CHANGES THE POLICY. PLI=ASE READ IT CAREFULLY. ADDITIONAL INSURED - PERSON-ORGANIZATION CITY OF BURBANK COMMUNITY DEVELOPMENT 150 N 3RD ST PO BOX 6459 BURBANK, CA 91510-6459 CITY OF BURBANK COMMUNITY DEVELOPMENT 150 N 3RD S`i' PO BOX 6459 BURBANK, CA 91510-6459 THE CITY OF BEVERLY HILLS COMMUNITY DEVELOPMENT DEPARTMENT 455 N REXFORD DR BEVERLY HILLS, CA 90210 THE CITY OF BURBANK 275 E OLIVE AVE BURBANK, CA 91502 CITY OF WEST HOLLYWOOD 8300 SANTA MONICA BLVD WEST HOLLYWOOD, CA 90069--6216 COUNT OF LOS ANGELAS DER - MEDIATION 222 S FIELI?S ST STE 600 LOS ANGELAS, CA 90012 COUNTY OF LOS ANGELES DEPARTMENT OF HUMAN RESOURCES DISPUTE RESOLUTION & MEDIATION 500 W TEMPLE ST STE 555 LOS ANGELES CA 90012-4276 THE COUNTY OF LOS ANGELES, ITS SPECIAL DISTRICTS, ELECTED OFFICIALS, OFFICERS, AGENTS, EMPLOYEES & VOLUNTEERS COLLECTIVELY COUNTY & ITS AGENTS - DEPARTMENT OF HUMAN RESOURCES FOR "MASTER AGREEMENT BY Form IH 12 00 11 85 T SEQ. NO. 002 Printed in U.S.A. Page 002 (CONTINUED ON NEXT PAGE) Process Date: 05/16/24 Expiration Date: 08/02/25 POLICY NUMBER: 20 SBM BA6984 1 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - PERSON--ORGANIZATION AND BETWEEN COUNTY OF LOS ANGELES AND THE ADR COACH, INC. FOR DISPUTE RESOLUTION, MEDIATION, AND RELATED SERVICES Form IH 12 00 11 85 T SEQ. NO. 002 Printed in U.S.A. Page 003 (CONTINUED ON NEXT PAGE) Process Date: 05/16/24 Expiration Date: 08/02/25 It tz�l POLICY NUMBER: 20 SBM BA6984 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - STATE/POLITICAL SUBDIVISION CITY NORWALK HOUSING AUTHORITY ("PUBLIC AGENCY") ITS OFFICERS, ATTORNEYS, AGENTS, EMPLOYEES, AND VOLUNTEERS 12035 FIRESTONE BLVD NORWALK, CA 90650 THE CITY OF NORWALK HOUSING AUTORITY ("PUBLIC AGENCY") , ITS OFFICERS, ATTORNEYS, AGENTS, EMPLOYEES, AND VOLUNTEERS ARE LISTED AS ADDITIONAL INSURFDS. THE NAMED INSURED'S COVERAGE IS PRIMARY AND THE CITY OF NORWALK IS NON-CONTRIBUTORY LACDA THE LOS ANGELES COUNTY DEVELOPMENT AUTHORITY V00 WEST MAIN ST ALHAMBRA, CA 91081 Form Ill 12 00 11 85 T SEQ.NO. 003 Printed in U.S.A. Page 001 (CONTINUED ON NEXT PAGE) Process Date: 05/7.6/24 Expiration Date: 08/02/25 POLICY NUMBER: 20 SBM BA6984 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF SUBROGATION CITY NORWALK HOUSING AUTHORITY ("PUBLIC AGENCY") ITS OFFICERS, ATTORNEYS, AGENTS, EMPLOYEES, AND VOLUNTEERS 12035 FIRESTONE BLVD NORWALK, CA 90650 BEVERLY HILLS POLICE DEPARTMENT 464 N REXFORD DR BEVERLY HILLS CA 90210 CITY OF BEVERLY HILLS COMMUNITY DEVELOPMENT DEPARTMENT 455 N REXFORD D BEVERLY HILLS CA 90210 CITY OF WEST HOLLYWOOD PO BOX 947 MURRIETA CA 92564 LACDA THE LOS ANGELES COUNTY DEVELOPMENT AUTHORITY 700 WEST MAIN ST ALHAMBRA, CA 91081 Form IH 12 00 11 85 T SEQ. NO, 004 Printed in U.S.A. Page 001 (CONTINUED ON NEXT PAGE) Process Date: 05/16/24 Expiration Date: 08/02/23 POLICY NUMBER: 20 SBM BA6984 JOL THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. SS122000810 NOTICE OF CANCELLATION OR NON-RENEWAL TO DESIGNATED PERSON(S) OR ORGANIZATION(S) OTI4RR THAN THE NAMED INSURED IT IS HEREBY AGREED AND UNDERSTOOD THAT THE FOLLOWING FORM IS ADDED TO THE POLICY SS12200810 NOTICE OF CANCELLATION OR NON-RENWAL TO DESIGNATED PERSON(S) OR ORGANIZATION(S) OTHER THAN THE NAMED INSURED PER ATTACHED X Form IH 12 00 11 85 T SEQ. NO. 005 Printed in U.S.A. Page 001 (CONTINUED ON NEXT PAGE) Process Date: 05/16/24 Expiration Date: 08/02/25 POLICY NUMBER: 20 SBM BA6984 Aid THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. 30 DAY NOTICE OF CANCELLATION IN CONSIDERATION OF NO CHANGE IN PREMIUM, IT IS HEREBY AGREED ,AND UNDERSTOOD THAT FORM (SS1223) IS ADDED PER THE ATTACHED. Form IH 12 00 11 85 T SEQ. NO. 006 Printed in U.S.A. Page 001 (CONTINUED ON NEXT PAGE) Process Date: 05/16/24 Expiration Date: 08/02/25 POLICY NUMBER: 20 SBM BA6984 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNER, LESSEES OR CONTRACTOR. ONGOING OPERATIONS SS4170 BEVERLY HILLS POLICE DEPARTMENT 464 N REXFORD DR BEVERLY HILLS CA 90210 CITY OF BEVERLY HILLS COMMUNITY DEVELOPMENT DEPARTMENT 455 N REXFORD DR BEVERLY HILLS CA 90210 CITY OF WEST HOLLYWOOD PO BOX 947 MURRIETA CA 92564 LACDA THE LOS ANGELES COUNTY DEVELOPMENT AUTHORITY 700 WEST MAIN ST ALHAMBRA, CA 91081 i Form IH 12 00 11 85 T SEQ. NO. 007 Printed in U.S.A. Page 001 (CONTINUED ON NEXT PAGE) Process Date: 05/16/24 Expiration Date: 08/02/25 POLICY NUMBER: 20 SBM BA6984 Ac THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNER, LESSEES OR CONTRACTOR COMPLETED OPERATIONS SS4171 LACDA THE LOS ANGELES COUNTY DEVELOPMENT AUTHORITY 700 WEST MAIN ST ALHAMBRA, CA 91081 Form IH 12 0011 85 T SEQ. NO. 008 Printed in U.S.A. Page 001 (CONTINUED ON NEXT PAGE) Process Date: 05/16/24 Expiration Date: 08/02/25 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. GOODS AND SERVICES ENDORSEMENT This endorsement modifies insurance provided under all Coverage Parts of this Policy. We may offer or make "goods or services" available to you through this underwriting company, a non-insurer subsidiary, or unaffiliated third parties as a part of this policy. The "goods or services" may be provided for a charge, at a discount, on a subsidized basis, or free of charge. In some cases, we may receive a fee from the unaffiliated third parties that provide "goods or services". We do not warrant or guarantee the "goods or services" provided by third parties, and such third parties shall be solely liable and responsible for the "goods or services" they provide. The "goods or services" offered or made available by us may be modified or discontinued at any time. "Goods or services" means goods, products or services, including but not limited to risk mitigation, safety, and/or loss prevention services or equipment. i . IH 12 05 02 21 Page 1 of 1 ©2021, The Hartford i THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF SUBROGATION This endorsement modifies insurance provided under the following: BUSINESS LIABILITY COVERAGE FORM We waive any right of recovery we may have against: 1. Any person or organization shown in the Declarations, or 2. Any person or organization with whom you have a contract that requires such waiver. Form SS 12 15 03 00 Page 1 of 1 0 2000, The Hartford THE HARTFORD U.S. DEPARTMENT OF THE TREASURY, OFFICE OF FOREIGN ASSETS CONTROL ("OFAC") ADVISORY NOTICE TO POLICYHOLDERS No coverage is provided by this Policyholder Notice nor can it be construed to replace any provisions of your policy. You should read your policy and review your Declarations page for complete information on the coverages you are provided. This Notice provides information concerning possible impact on your insurance coverage due to directives issued by the United States. Please read this Notice carefully. The Office of Foreign Assets Control ("OFAC") of the U.S. Department of the Treasury administers and enforces economic and trade sanctions based on U.S. foreign policy and national security goals against targeted foreign countries and regimes, terrorists, international narcotics traffickers, those engaged in activities related to the proliferation of weapons of mass destruction, and other threats to the national security, foreign policy or economy of the United States. OFAC acts under Presidential national emergency powers, as well as authority granted by specific legislation, to impose controls on transactions and freeze assets under U.S. jurisdiction. OFAC publishes a list of individuals and companies owned or controlled by, or acting for or on behalf of, targeted countries. It also lists individuals, groups, and entities, such as terrorists and narcotics traffickers designated under programs that are not country-specific. Collectively, such individuals and companies are called "Specially Designated Nationals and Blocked Persons" or "SDNs". Their assets are blocked and U.S. persons are generally prohibited from dealing with them. This list can be located on OFAC's web site at—http//www.treas.gov/ofac. In accordance with OFAC regulations, if it is determined that you or any other insured, or any person or entity claiming the benefits of this insurance has violated U.S. sanctions law or is an SDN, as identified by OFAC, the policy is a blocked contract and all dealings with it must involve OFAC. When an insurance policy is considered to be such a blocked or frozen contract, no payments nor premium refunds may be made without authorization from OFAC. Form IH 99 40 04 09 Page 1 of 1 TiiE !a HARTFORD Named Insured: ANGELA D SHAW DBA THE ADR COACH, IN Policy Number: 20 SBM BA6984 Effective Date: 08/02/24 Expiration Date: 08/02/25 Company Name: SENTINEL INSURANCE COMPANY, LIMITED THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. TRADE OR ECONOMIC SANCTIONS ENDORSEMENT This insurance does not apply to the extent that trade or economic sanctions or other laws or regulations prohibit us from providing insurance, including, but not limited to, the payment of claims. All other terms and conditions remain unchanged. Form IH 99 4104 09 Page 1 of 1 DATE(MM/DD/YYYY) ; ►► CERTIFICATE OF LIABILITY INSURANCE 08/05/2025 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 be endorsed. If SUBROGATIONIS 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 BURNETTE INSURANCE AGENCY INC/PHS NAME: 20262167 PHONE (866)467-8730 FAX (A/C,No,Ext): (A/C,No): The Hartford Business Service Center 3600 Wiseman Blvd E-MAIL San Antonio,TX 78251 ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# INSURED INSURERA: Hartford Underwriters Insurance Company 30104 THE ADR COACH, INC.,ANGELA D SHAW DBA THE ADR COACH INSURERB: HISCOX 10200 3782 WELLINGTON RD INSURERC: LOS ANGELES CA 90016-5859 INSURER D 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 ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR INSR WVD MM/DD/YYYY MM/DD/YYY COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $2,000,000 CLAIMS-MADE OCCUR DAMAGE TO RENTED $1,000,000 PREMISES Ea occurrence X General Liability MED EXP(Any one person) $10,000 A X X 20SBMBN3U1F 08/02/2025 08/02/2026 PERSONAL&ADV INJURY $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $4,000,000 X JECT ❑LOC PRODUCTS-COMP/OPAGG $4,000,000 POLICY❑PRO- OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $2,000,000 Ea accident ANY AUTO BODILY INJURY(Per person) A ALL OWNED SCHEDULED 20SBMBN3U1F 08/02/2025 08/02/2026 BODILY INJURY(Per accident) AUTOS AUTOS HIRED NON-OWNED PROPERTY DAMAGE X AUTOS X AUTOS (Per accident) UMBRELLA LIAB OCCUR EACH OCCURRENCE EXCESS LIAB CLAIMS- AGGREGATE MADE DED RETENTION$ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY STATUTE I ER ANY Y/N E.L.EACH ACCIDENT PROPRIETOR/PARTNER/EXECUTIVE N/A OFFICER/MEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE (Mandatory in NH) If yes,describe under E.L.DISEASE-POLICY LIMIT DESCRIPTION OF OPERATIONS below B Professional Liability MPL230875725 08/02/2025 08/02/2026 Each Occurrence $1,000,000 Aggregate $1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Those usual to the Insured's Operations. Please see Additional Remarks Schedule Acord 101 Form attached. CERTIFICATE HOLDER CANCELLATION City of Santa Ana SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED 20 CIVIC CENTER PLZ BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED SANTA ANA CA 92701-4058 IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE �ileall cf ©1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD Tu Tran Digit flYN9 e�dby H) Tkm To°air N r�yrerr at 8,37 seta,A. 07,2B 25J Da,2o25.08.07 ___._._._._._._._._._._._._._._._._._._._._._._._._._._._._._._. ���,,,JJJlll Nguyen 0837:22-07'00' AGENCY CUSTOMER ID: LOC#: ADDITIONAL REMARKS SCHEDULE Page 2 of 2 AGENCY NAMED INSURED BURNETTE INSURANCE AGENCY INC/PHS THE ADR COACH, INC., ANGELA D SHAW DBA THE ADR POLICY NUMBER COACH SEE ACORD 25 3782 WELLINGTON RD CARRIER NAIC CODE LOS ANGELES CA 90016-5859 SEE ACORD 25 EFFECTIVE DATE:SEE ACORD 25 ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM FORM NUMBER: ACORD 25 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE Notice of Cancellation will be provided in accordance with Form SL9013, attached to this policy. Waiver of Subrogation applies in favor of the Certificate Holder per the Business Liability Coverage Form SL 00 00, attached to this policy. Coverage is primary and noncontributory per the Business Liability Coverage Form SL 00 00, attached to this policy. The Business Liability Coverage Part includes a Blanket Additional Insured By Contract Endorsement, Form SL 30 32. ACORD 101 (2014/01) ©2014 ACORD CORPORATION.All rights reserved. The ACORD name and logo are registered marks of ACORD T coverages applicable to such claim or "suit". However, this paragraph does not apply to the Medical Expenses limit set forth in Paragraph 3. above. The Limits of Insurance of this Coverage Part apply separately to each consecutive annual period and to any remaining period of less than 12 months, starting with the beginning of the policy period shown in the Declarations, unless the policy period is extended after issuance for an additional period of less than 12 months. In that case, the additional period will be deemed part of the last preceding period for purposes of determining the Limits of Insurance. E. LIABILITY AND MEDICAL EXPENSES GENERAL CONDITIONS 1. Bankruptcy Bankruptcy or insolvency of the insured or of the insured's estate will not relieve us of our obligations under this Coverage Part. 2. Duties In The Event Of Occurrence, Offense, Claim Or Suit a. Notice Of Occurrence Or Offense You or any additional insured under this Coverage Part must see to it that we are notified as soon as practicable of an "occurrence"or an offense which may result in a claim. To the extent possible, notice should include: (1) How, when and where the "occurrence"or offense took place; (2) The names and addresses of any injured persons and witnesses; and (3) The nature and location of any injury or damage arising out of the "occurrence"or offense. b. Notice Of Claim If a claim is made or "suit" is brought against any insured, you or any additional insured under this Coverage Part must: (1) Immediately record the specifics of the claim or"suit" and the date received; and (2) Notify us as soon as practicable. You or any additional insured under this Coverage Part must see to it that we receive a written notice of the claim or"suit" as soon as practicable. c. Assistance And Cooperation Of The Insured You and any other involved insured must: (1) Immediately send us copies of any demands, notices, summonses or legal papers received in connection with the claim or"suit"; (2) Authorize us to obtain records and other information; (3) Cooperate with us in the investigation, settlement of the claim or defense against the "suit"; and (4) Assist us, upon our request, in the enforcement of any right against any person or organization that may be liable to the insured because of injury or damage to which this insurance may also apply. d. Obligations At The Insured's Own Cost No insured will, except at that insured's own cost, voluntarily make a payment, assume any obligation, or incur any expense, other than for first aid, without our consent. e. Additional Insured's Other Insurance If we cover a claim or "suit" under this Coverage Part that may also be covered by other insurance available to an additional insured under this Coverage Part, such additional insured must submit such claim or "suit" to the other insurer for defense and indemnity. However, this provision does not apply to the extent that you have agreed in a written contract, written agreement or permit that this insurance is primary and non-contributory with such additional insured's own insurance. f. Knowledge Of An Occurrence, Offense, Claim Or Suit Paragraphs a. and b. apply to you or to any additional insured under this Coverage Part only when such "occurrence", offense, claim or"suit" is known to: Form SL 00 00 10 18 Page 15 of 22 ©2018, The Hartford (May include copyrighted material of Insurance Services Office, Inc., with its permission) T (2) Premises Rented To You That is fire, lightning or explosion insurance for premises rented to you or temporarily occupied by you with permission of the owner; (3) Tenant Liability That is insurance purchased by you to cover your liability as a tenant for "property damage" to premises rented to you or temporarily occupied by you with permission of the owner; (4) Aircraft,Auto Or Watercraft If the loss arises out of the maintenance or use of aircraft, "autos"or watercraft to the extent not subject to Exclusion g. of Section B. Exclusions. (5) Property Damage To Borrowed Equipment Or Use Of Elevators If the loss arises out of"property damage" to borrowed equipment or the use of elevators to the extent not subject to Exclusion k. of Section B. Exclusions. (6) When You Are Added As An Additional Insured To Other Insurance That is other insurance available to you covering liability for damages arising out of the premises or operations, or products and completed operations, for which you have been added as an additional insured by that insurance; or (7) When You Add Others As An Additional Insured To This Insurance That is other insurance available to an additional insured. However, the following provisions apply to other insurance available to any person or organization who is an additional insured under this Coverage Part: (a) Primary Insurance When Required By Contract This insurance is primary if you have agreed in a written contract, written agreement or permit that this insurance be primary. If other insurance is also primary, we will share with all that other insurance by the method described in c. below. (b) Primary And Non-Contributory To Other Insurance When Required By Contract If you have agreed in a written contract, written agreement or permit that this insurance is primary and non-contributory with the additional insured's own insurance, this insurance is primary and we will not seek contribution from that other insurance. Paragraphs (a) and (b) do not apply to other insurance to which the additional insured has been added as an additional insured. When this insurance is excess, we will have no duty under this Coverage Part to defend the insured against any "suit" if any other insurer has a duty to defend the insured against that "suit". If no other insurer defends, we will undertake to do so, but we will be entitled to the insured's rights against all those other insurers. When this insurance is excess over other insurance, we will pay only our share of the amount of the loss, if any, that exceeds the sum of: (1) The total amount that all such other insurance would pay for the loss in the absence of this insurance; and (2) The total of all deductible and self-insured amounts under all that other insurance. We will share the remaining loss, if any, with any other insurance that is not described in this Excess Insurance provision and was not bought specifically to apply in excess of the Limits of Insurance shown in the Declarations of this Coverage Part. c. Method Of Sharing If all the other insurance permits contribution by equal shares, we will follow this method also. Under this approach, each insurer contributes equal amounts until it has paid its applicable limit of insurance or none of the loss remains, whichever comes first. Form SL 00 00 10 18 Page 17 of 22 ©2018, The Hartford (May include copyrighted material of Insurance Services Office, Inc., with its permission) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. Tl,, kAk"TIFOA10, BLANKET ADDITIONAL INSURED BY CONTRACT This endorsement modifies insurance provided under the following: BUSINESS LIABILITY COVERAGE FORM Except as otherwise stated in this endorsement, the terms and conditions of the Policy apply. A. The following is added to Section C.WHO IS AN INSURED: Additional Insureds When Required By Written Contract,Written Agreement Or Permit The person(s) or organization(s) identified in Paragraphs a. through f. below are additional insureds when you have agreed, in a written contract or written agreement, or when required by a written permit issued by a state or governmental agency or subdivision or political subdivision that such person or organization be added as an additional insured on your Coverage Part, provided the injury or damage occurs subsequent to the execution of the contract or agreement, or the issuance of the permit. A person or organization is an additional insured under this provision only for that period of time required by the contract, agreement or permit. However, no such person or organization is an additional insured under this provision if such person or organization is included as an additional insured by any other endorsement issued by us and made a part of this Coverage Part. The insurance afforded to such additional insured will not be broader than that which you are required by the contract, agreement, or permit to provide for such additional insured. The insurance afforded to such additional insured only applies to the extent permitted by law. The limits of insurance that apply to additional insureds are described in Section D. LIABILITY AND MEDICAL EXPENSES LIMITS OF INSURANCE. How this insurance applies when other insurance is available to an additional insured is described in the Other Insurance Condition in Section E. LIABILITY AND MEDICAL EXPENSES GENERAL CONDITIONS. a. Vendors Any person(s) or organization(s) (referred to below as 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 and only if this Coverage Part provides coverage for "bodily injury" or "property damage" included within the "products-completed operations hazard". (1) The insurance afforded to the vendor is subject to the following additional exclusions: This insurance does not apply to: (a) "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; (b) Any express warranty unauthorized by you; (c) Any physical or chemical change in the product made intentionally by the vendor; (d) 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; (e) 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; (f) Demonstration, installation, servicing or repair operations, except such operations performed at the vendor's premises in connection with the sale of the product; Form SL 30 32 06 21 Page 1 of 3 ©2021, The Hartford (May include copyrighted material of Insurance Services Office, Inc., with its permission) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. Tl,, kAk"TIFOA10, (g) Products which, after distribution or sale by you, have been labeled or relabeled or used as a container, part or ingredient of any other thing or substance by or for the vendor; or (h) "Bodily injury"or"property damage" arising out of the sole negligence of the vendor for its own acts or omissions or those of its employees or anyone else acting on its behalf. However, this exclusion does not apply to: (i) The exceptions contained in Paragraphs (d) or(f); or (ii) Such inspections, adjustments, tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business, in connection with the distribution or sale of the products. (2) This insurance does not apply to any insured person or organization from whom you have acquired such products, or any ingredient, part or container, entering into, accompanying or containing such products. b. Lessors Of Equipment (1) Any person or organization from whom you lease equipment; but only with respect to their liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by your maintenance, operation or use of equipment leased to you by such person or organization. (2) With respect to the insurance afforded to these additional insureds, this insurance does not apply to any "occurrence"which takes place after you cease to lease that equipment. c. Lessors Of Land Or Premises (1) Any person or organization from whom you lease land or premises, but only with respect to liability arising out of the ownership, maintenance or use of that part of the land or premises leased to you. (2) With respect to the insurance afforded to these additional insureds, this insurance does not apply to: (a) Any"occurrence"which takes place after you cease to lease that land or be a tenant in that premises; or (b) Structural alterations, new construction or demolition operations performed by or on behalf of such person or organization. d. Architects, Engineers Or Surveyors (1) Any architect, engineer, or surveyor, but only with respect to liability for"bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf: (a) In connection with your premises; (b) In the performance of your ongoing operations performed by you or on your behalf; or (c) In connection with "your work" and included within the "products-completed operations hazard", but only if: (i) The written contract, written agreement or permit requires you to provide such coverage to such additional insured; and (ii) This Coverage Part provides coverage for"bodily injury" or"property damage" included within the "products-completed operations hazard". (2) With respect to the insurance afforded to these additional insureds, the following additional exclusion applies: This insurance does not apply to "bodily injury", "property damage" or "personal and advertising injury" arising out of the rendering of or the failure to render any professional services, including: (i) The preparing, approving, or failure to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders, designs or drawings and specifications; or (ii) Supervisory, surveying, inspection, architectural or engineering activities. This exclusion applies even if the claims allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by an insured, if the "bodily injury", "property Form SL 30 32 06 21 Page 2 of 3 ©2021, The Hartford (May include copyrighted material of Insurance Services Office, Inc., with its permission) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. Tl,, kAk"TIFOA10, damage", or"personal and advertising injury" arises out of the rendering of or the failure to render any professional service. e. State Or Governmental Agency Or Subdivision Or Political Subdivision Issuing Permit (1) Any state or governmental agency or subdivision or political subdivision, but only with respect to operations performed by you or on your behalf for which the state or governmental agency or subdivision or political subdivision has issued a permit. (2) With respect to the insurance afforded to these additional insureds, this insurance does not apply to: (a) "Bodily injury", "property damage" or "personal and advertising injury" arising out of operations performed for the federal government, state or municipality; or (b) "Bodily injury" or"property damage" included within the "products-completed operations hazard". f. Any Other Party (1) Any other person or organization who is not in one of the categories or classes listed above in Paragraphs a. through e. above, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf: (a) In the performance of your ongoing operations performed by you or on your behalf; (b) In connection with your premises owned by or rented to you; or (c) In connection with "your work" and included within the "products-completed operations hazard", but only if: (i) The written contract, written agreement or permit requires you to provide such coverage to such additional insured; and (ii) This Coverage Part provides coverage for "bodily injury" or "property damage" included within the "products-completed operations hazard". (2) With respect to the insurance afforded to these additional insureds, the following additional exclusion applies: This insurance does not apply to "bodily injury", "property damage" or "personal and advertising injury" arising out of the rendering of, or the failure to render, any professional architectural, engineering or surveying services, including: (a) The preparing, approving, or failure to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders, designs or drawings and specifications; or (b) Supervisory, surveying, inspection, architectural or engineering activities. This exclusion applies even if the claims allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by an insured, if the "bodily injury", "property damage", or "personal and advertising injury" arises out of the rendering of or the failure to render any professional service described in Paragraphs f.(2)(a) or f.(2)(b) above. Form SL 30 32 06 21 Page 3 of 3 ©2021, The Hartford (May include copyrighted material of Insurance Services Office, Inc., with its permission) T If any of the other insurance does not permit contribution by equal shares, we will contribute by limits. Under this method, each insurer's share is based on the ratio of its applicable limit of insurance to the total applicable limits of insurance of all insurers. 7. Transfer Of Rights Of Recovery Against Others To Us a. Transfer Of Rights Of Recovery If the insured has rights to recover all or part of any payment, including Supplementary Payments, we have made under this Coverage Part, those rights are transferred to us. The insured must do nothing after loss to impair them. At our request, the insured will bring "suit" or transfer those rights to us and help us enforce them. This condition does not apply to Medical Expenses Coverage. b. Waiver Of Rights Of Recovery (Waiver Of Subrogation) If the insured has waived any rights of recovery against any person or organization for all or part of any payment, including Supplementary Payments, we have made under this Coverage Part, we also waive that right, provided the insured waived their rights of recovery against such person or organization in a contract, agreement or permit that was executed prior to the injury or damage. F. LIABILITY AND MEDICAL EXPENSES DEFINITIONS 1. "Advertisement" means a notice that is broadcast or published to the general public or specific market segments about your goods, products or services for the purpose of attracting customers or supporters. For the purpose of this definition: a. Notices that are published include material placed on the Internet or on similar electronic means of communication; and b. Regarding web sites, only that part of a web site that is about your goods, products or services for the purpose of attracting customers or supporters is considered an advertisement. 2. "Advertising idea" means any idea for an "advertisement". 3. "Asbestos hazard" means an exposure or threat of exposure to the actual or alleged properties of asbestos and includes the mere presence of asbestos in any form. 4. "Auto" means: a. A land motor vehicle, trailer or semi-trailer designed for travel on public roads, including any attached machinery or equipment; or b. Any other land vehicle that is subject to a compulsory or financial responsibility law or other motor vehicle insurance or motor vehicle registration law where it is licensed or principally garaged. However, "auto" does not include "mobile equipment". 5. "Bodily injury" means physical: a. Injury; b. Sickness; or c. Disease sustained by a person and, if arising out of the above, mental anguish or death at any time. 6. "Coverage territory" means: a. The United States of America (including its territories and possessions), Puerto Rico and Canada; b. International waters or airspace, but only if the injury or damage occurs in the course of travel or transportation between any places included in a. above; c. All other parts of the world if the injury or damage arises out of: (1) Goods or products made or sold by you in the territory described in a. above; (2) The activities of a person whose home is in the territory described in a. above, but is away for a short time on your business; or Form SL 00 00 10 18 Page 18 of 22 ©2018, The Hartford (May include copyrighted material of Insurance Services Office, Inc., with its permission) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. Tl', kAk"TIFOA10, WAIVER OF SUBROGATION This endorsement modifies insurance provided under the following: BUSINESS LIABILITY COVERAGE FORM Except as otherwise stated in this endorsement, the terms and conditions of the Policy apply. The following is added to Section E. LIABILITY AND MEDICAL EXPENSES GENERAL CONDITIONS: We waive any right of recovery we may have against: a. Any person or organization shown in the Declarations, or b. Any person or organization with whom you have a contract that requires such waiver. Form SL 30 03 10 18 Page 1 of 1 ©2018, The Hartford (May include copyrighted material of Insurance Services Office, Inc., with its permission) CITY OF SANTA ANA ffiskManag i ng i t vough am ns Sri coon � ,r,�� C' ���a u.i�� �I I���� �I�� AFFIDAVIT OF EXEMPTION FOR WORKERS COMPENSATION INSURANCE I Angela Shaw ("Representative"),attest that I authorized Q,4 d"f"itle of Vendor o tartWe) The ADR Coach Inc. representative of.......................I ....... ,_, ......ConniftwWCompany..... ...,,,....,,............ ('Company"), d (".................'.. ) Nmse possess authority to legally bind Company. In my capacity s Representative of Company,I represent and confirmthe following,as relates tot e agreement Company and City of Santa Ana,agreement nu r A-2025-028-08 ("Agreement")to provide Hearing Officer ("Services"): (Sewim to be proven t/ ) During the course and scope of Company's agreement wi e City of Santa Ana,Company will not employ any personin any manner so as to become subject to the workers'compensation laws of California,and agree that if Company should become subject to the workers' compensation provisions of Section7 of the Labor Code,Company shall forthwith comply with the provisions vie proof of workers' compensation coverage immediately. If at any time it is found that Company is not adhering to any r all of the statements in this document and does not maintain the minimum workers'compensation insurance coverage as required in the Agreement, it will be considered r h of Agreement rendering the Agreement null and void Company will be fully i le for any and all damages. 08/07/2025 ..---...... _..._._ .m.......,, s, . .. Angela Shaw ...,",,,,......... ,,,,,, ,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,.,.,,,.,,,.,,,,,... .... _,,,,,,,,,,,................................. ,,,,,,,,��mm ... ,,,,,.,,,,,,.,,,._,..,,,�.._w. _,,,,,,,,,,......,,,,,,,,,,.,,,,,,,,,,,,.... ,......."...., ,,,,,............................ Nww Principal Ti (323) 810-0626 and theadreoach@aol.com CmIact Inforii ors,U..,Telephone Nundwr or E WARNING: FAILURE TO SECURE E 'C E S T COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES TO E HUNDRED THOUSANT DOLLARS($100,000).IN ADDITIONTO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FORSECTION 3706 OF THE LABOR CODE, INTEREST,AN Y'S FEES. Affidavit of Exemption forWorkers'Compensation Insurance 11.12.202