HomeMy WebLinkAboutAPPLEONE, INC. (2) A-2023-122-OI A
MAYOR 0"1 1 OJ ���� . CITY MANAGER
Valerie Amezcua rr < Alvaro Nuriez
MAYOR PRO TEM L CITY ATTORNEY
David PenalozaQY 2 6 2026 Sonia R.Carvalho
COUNCILMEMBERS CITY CLERK
Phil Bacerra ,, Jennifer L.Hall
Johnathan Ryan Hernandez
Jessie Lopez
Thai Viet Phan
Benjamin Vazquez CITY OF SANTA ANA
-Tv kio, (1)7-) HUMAN RESOURCES
20 Civic Center Plaza I PO Box 1988
Santa Ana,California 92702
www.santa-ana.org
May 11, 2026
AppleOne, Inc., dba AppleOne Employment Services
Attn: Brett W. Howroyd, President
327 West Broadway
Glendale, California 91204
Re: Extension of Agreement No. A-2023-122-01 to provide on-call temporary
staffing services
Pursuant to Section 3 ("Term") of the above-referenced Agreement, entered into by AppleOne, Inc.,
dba AppleOne Employment Services and the City of Santa Ana, which commenced on July 1, 2023,
the parties hereby exercise their option to extend the term of the Agreement for an additional one (1)
year through June 30, 2027. Any insurance certificates are required to be extended and/or renewed to
cover this extension. All other terms and conditions of the Agreement remain unchanged and in full
force and effect.
Sincerely,
�
on Schnaider
Executive Director of Human Resources
CIT F SANTA AN ATTEST
I MCI-
Alvaro Nunez nJ a1
City Manager City Cle
APP
ROVED AS TO FORM C LTANT
�, . �9�r1r1-L1- "mi,W. foww ad
Brett W.Hovrtayd jMay i3,2026 6T.51:53 PDT)
Laura Rossini By: Brett W. Howroyd
Chief Assistant City Attorney President
SANTA ANA CITY COUNCIL
Valerie Amezcua Davd Penaloza Thai Viet Phan Benjamin Vazquez Jessie Lopez Phil Bacerra Johnathan Ryan Hemandez
Mayor Mayor Pro Tem-Ward 5 Ward 1 Ward 2 Ward 3 Ward 4 Ward 5
vamezcuaCdlSanta-ana_org dpenalozaasanta-ana.or�, iphan(dtsanta-ana,ora bvazpuazCr�sanla-ana ara iassielooaz(oZsania-ana ord pbacemaCoTsania-ana,oro iruanhemandenAsanta-ana.oro
r.
HOWRGEN-01 D4
CERTIFICATE OF LIABILITY INSURANCE DATE(N=D,YYYY)
4r9r2o26
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($),AUTHORIZED
REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER,
IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED,the polloy(les)must have ADDITIONAL INSURED provisions or be endorsed.
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on
This certificate does not confer rights to the oertlflcate holder In llau of such endorsements.
PRODUCER RA P`CT
MG Skinner&Associates PHONe
1666 20th$t Sate 200 C No,Ex : S10 478-5041 Arc,No:(310 479-8707
Santa Monica,CA B0404-3827
INSURER(81 AFFORDING COVERAGE NAIC0
INSURER A:Underwriters at I-lo ds London 16792
INSURED INSURER B:Columbia Casualty Gomisa 31727
I ApploOne,Inc.dba AppleOne Employment Services wsuRSR n:Ace American Ins Co 22667
fka:Howrpyd Wright Employment Agency,Inc.
P.O.Box 29048 INSURERD:AXLR Surplus Ins Co 26620
Glendale,CA 91209.9048 INBURRRE:
INSURER F
E COVERAGES CERTIFICATE NUMBER: REVISION UMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPEGTTOWHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
1 EXCWSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
r INSR ADDL UBR
LTR TYPE OF INSURANCE IN sly POLICYNUNBER i'OLIpY FOP POLICY AJ(P LIMITS.
I A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 5,000,00p
I CLAIMS-MADF [:�]OCCUR X X P500040761674 41112026 4/1/2027 1p cSETORm'T�Ir1nce $ 260,000
X Contractual ED E)CP(Any one anon 5,000
PM&ONAL&AIJV INJURY $ 5,000,000
GEN'L AGGREGATE LIMITAPPLIESPIER- GENERAL AGGREGATE $ 5,000,000
I X POLICY[j ®LOG PRODUCTS-COMPIOP AOG 51000,000
OTHER:
E gUTDMOBILE LIABILITY COMBI D SINGLE LIMIT 1,000,000
f X ANY AUTO P$00040761674 41112026 4MI2027 BDD L U Y arson $
X OWNED, AUTOSSCHEDULED
UTO ONLY DGE)ILYIINJJUR €aWdon[
PaawldNO%ONLY X AUT%Xp ,AMADE $
IS X UMBRELLALWB X OCCUR EACH OCCURRENCE $ 10,000,000
>; PSLS LIAR I I CLAIMS-MADE 843739591 4/112026 41112027 AGGREGATE $ 10,000,000
DED TX I RETENTION 0
I C WORKERRSS COMPENSATffON X PER OTH-
ANC EMFLC3YER5'LIABII.lTY YIN STATUTE
ANYPROPRRTOR1PARTNERIEXECUTIVE WLRG72607960 4111202ti 41112027 E.LEACHACGIDENT 1,000,000
OFFfCE�i7NiF�ME3F..R EXCLUDED? N/A 1,000,000
` ( auda ory n[�aHH77
Ifyyea dasarlhe UndOr E.L DISEASE-EA EMPLOY
❑E RIPTiONOF,OPERATIONSbelow E,L.DWASE-POLICYL T 1,000,000
D Crime(3rd Party) P-001-001926357.01 41112026 411/2027 OccurroncelAggregate 3,000,000
A Prof,Llab1E&O PS00040781674 4/1/2026 41112027 Occurrence/Aggregate 5,000,000
DESORIPTION OF OPERATIONS!LOCATIONS 1 VEHICLES(ACORD 101,Addltfonal Remark-Schedule,may be attached If more space Is required)
,lob ID 009500724003
Re:City of Santa Ana Agreement No.A 20118440.The City of Santa Ana,oftk mrs,agents,employees and volunteers are named additional Insured on this
policy pursuant to writlen contract,agreement,or memorandum of understanding. Primary and Non•Contributory coverage will apply.Waiver of Subrogation
Is covered under Generat Liability for olorical positions only. Notice of Cancellation under applicable policies:30 days110 days for non-payment of premium.
APPROVED
CIE RT F CATE HOLDER CANCELLATION By Tu Tran Nguyen at 2:49,orri; pr30 2026
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 TIME POLICY PROVISIONS.
Attn:Jay Jenkins
20 Civic Center Plaza
Santa An a,CA 927014010 AUTHORIZED REPRESENTATIVE
ACORD 25(201610S) a 1989.2015 ACORD CORPORATION. All rights reserved,
The ACORD name and logo are registered marks of ACORD
I
s
AGENCY CUSTOMER ID:HOWRGEN-01 I]OFt71z
r^''^ LOC#:
AC4�>RV`
,.,,..� ADDITIONAL REMARKS SCHEDULE Page 9 of 1
AGENCY NAMED INSURED I
MG Skinner&Associates ApploOne,Inc,dba AppleOne Employment Services
fke:How 20 d Wright Employment Agency,Inc.
POLIEE P NU E R Glend�Ile CA 01209.9048
SEA PACE 1
CARRIER NAIL CODE
EE PAGE 1 IME P ATE: PAGE 1
ADDITIONAL REMARKS
THIS ADDITIONAL REMARKS FORM 18 A SCHEDULE TO ACORD FORM,
E FORM NUMBER: ACQRD 25 FORM TITLE: CertMaete of L10111t insurance
Cyber Liability
Insurance Carrier.,Travelers Excess and Surplus Lines CompanylLandmark American Insurance Company-Policy Number:
CYS-107947188-02-Policy Period:411126-411127-Policy Limit:$10M.
I
i
1
t
i
i
f
ACORD 101 (2008101) 0 2008 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
,t
Insurer: Underwriters at Lloyd's London
Policy Number: PS00040761674
Policy Period: 4/1/2026-4/1/2027
Additional.insureds Policy Language
We will indemnify any third party as an additional insured under this Policy, but only in
respect of sums which they become legally obliged to pay(includ ing liability for claimants'
costs and expenses)as a result of a claim arising solely out of an act committed by you,
provided that:
a.you contracted in writing to indemnify the third party for the claim prior to its first
being made against them; and
b. had the claim been made against you, then you would be entitled to indemnity under
this Policy.
Before we indemnify any additional insured they must:
a. prove to us that the claim arose solely out of an act committed by you;and
b.fully comply with CONDITION 9 as if they were you.
Where we indemnify a third party as an additional insured under this Policy,this Policy will
be primary and non-contributory to the third party's own insurance, but only if you and the
third party have entered into a contract that contains a provision requiring this.
Where a third party is treated as an additional insured as a result of this Condition, any
claim made by that third party against you will be treated by us as if they were a third
party and not as an insured.
Insurer: Underwriters at Lloyd's London
Policy Number: PS00040761674
Policy Period:4/1/2026-4/1/2027
-Waiver c#-$ubLQgaiiQtt._ec,ticy language
Notwithstanding CONDITION 18,we agree to waive our rights of recovery against any third
party if, prior to the claim or incident which you reasonably expected to give rise to a
claim,you entered into a contract that contains a provision requiring you to do this.
Policy Number: PS00040761674
COMMERCIAL GENERAL LIABILITY
CG 20 26 0413
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY,
ADDITIONAL INSURED - DESIGNATED
PERSON OR ORGANIZATION
This endorsement modifies insurance provided under the following;
COMMERCIAL GENERAL LIABILITY COVERAGE HART
,Name Of Additional Insurer!Person(s)Or Organization(s):
An organization where required by a written contract executed prior to the occurrence of a loss. Such
Any or
perm or organization is an additional Insured for'bodily injury',"property damage"or'personal and advertising
injury"but only for liability arising out of the negligence of the Named insured.
1
.Infgm2aboq r ralaired to giprll to this Schedule,if not,shown above,will be shown in the Declarations.
A. Section II — Who Is An Insured is amended to B. VAth respect to the insurance afforded to these
include as an additional insured the person(s) or additional insureds, the foQawing is added to
organization(s) shown in the Schedule, but only Section ill—Urnits Of Insurance:
with respect to liability for "bodily injury", "property If coverage provided to the additional insured is
damage" or "personal and advertising injury" required by a contract or agreement, the most we
caused, in whole or in part, by your acts or will pay on behalf of the additional insured is the
omissions or the acts or omissions of those acting amount of insurance:
on your behalf
1. In the performance of your ongoing operations; 1. Required by the contract or agreement;or
or 2. Available under the applicable Limits of
2. In connection with your premises owned by or Insurance shown in the Declarations;
rented to you. whichever Is less.
However_ This endorsement shall not increase the
1. The insurance afforded to earth additional applicable Limits of insurance shown in the
Declarations.
insured only applies to the extent permitted by
law; and
2. If coverage provided to the additional insured is
required by a contract or agreement, the
insurance afforded to such additional insured
will not be broader than that which you are
required by the contract or agreement to
provide for such additional insured.
CG 20 26 0413 0 insurance Services Of oe, Inc.,2012 Page i of 1
Policy Number: PS00040761674
COMMERCIAL GENERAL LIABILITY
CG 24 04 05 09
WAIVER, OF TRANSFER OF RIGHTS OF RECOVERY
AGAINST OTHERS TO US
This endorsement modifies Insurance provided underthe following:
COMMERCIAL GEN FRAL LIABILITY COVERAGE PART
PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART
SCHEDULE
Name Of Person Or Organization:
Any person or organization who you are required to add by written contract which is executed prior to the
occurrence of a loss to waive your rights of recovery, except for a loss resulting from the sole negligence from
that person or organization.
Information reouired to complete_.this Schedule, if not shown above,will be shown in the Declarations.
The following is added to Paragraph 8. Transfer Of
Rights Of Recovery Against Others To Us of
Section IV—Conditions:
We waive any right of recovery we may have against
the person or organization shown in the Schedule
above because of payments we make for injury or
damage arising out of your ongoing operations or
"your work" done under a contract with that person
or organization and included in the "products-
completed operations hazard". This waiver applies
only to the person or organization shown in the
Schedule above,
CG 24 04 06 09 0 Insurance Services Office, Inc.,2008 Page'I of 1
Policy Number: PS00040761674 COMMERCIALAUTO
I CA04440310
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ R CAREFULLY,
WAIVER OF TRANSFER OF RIGHTS OF RECOVERY
AGAINST OTHERS TO US (WAIVER OF SUBROGATION)
'This endorsement modifies insurance provided under the following;
BUSINESS AUTO COVERAGE FORM
BUSINESSAUTO PHYSICAL DAMAGE COVERAGE FORM
GARAGE COVERAGE FORK]
MOTOR CARRIER COVERAGE FORM
TRUCKERS COVERAGE FORM
r
Xfth respect to coverage provided by this endorsement,the provisions of the Coverage Form apply unless rnodr
,Fled by the endorsement
iThfs endorsement changes the policy of active,on the Inception elate of the policy unless another date Is indicated
below.
----------._..............._--.-.__ �.-.. —._ ....... -— --
�INamad Insured; The Ott 1 Group, Inc
ApplleQae,Inc
AIIStem Gonnections Inc.,All's Well,lnc,AllsourcePPS,ATIMS.,ActOne Govemrnent Solutions
SCHEDULE
Name($)Of Persan(s)Or OrganlzaVon(s):
'Any person or organization who you are required to add by written contract which is executed prior to the
I occurrence of a loss to walvta your tights of recovery,except for a loss resulting from the We negligence from
that person or organization.
I_r Venation required to completo this Schedule if not shown above will toe shown in the Declarations.
The Transfer Of Rlghts Of Reaavery Against Oth-
ers To ifs Condition does not apply to the person(s)
or organization(s)shown in the Schedule, but only to
the extent that subrogation is waived prior to the "ac-
csdent"or the"loss"under a contract With that person
or o r9i?,&n.
CA 04"4310 0 Insurance Services Ofte,Inc.,2009 Page 9 of 1
Workers'Compensation and Employers'Liability_ Policy
Named Insured Endorsement Number l
I APPLEONE,INC.
A.O.BOX 29048 Policy Number -- .T-
GLENDALE CA 91209 Symbol: WLR Number-C72807960
Policy Feriod Effective Date of Endorsement
04-01-2026 TO 04-01-2027 04-01-2026
Issued By(Name of Insurance Company)
ACE AMERICAN INSURANCE COMPANY
Insert the policy number.Themainder of the Information is to be completed only when this endorsement is issued subsequent to the preparation of the policy.
This endorsemerd changes the policy to which it is attached and%effective on the date Issued unless otherwise stated.
CALIFORNIA WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT
This endorsement applies only to the insurance provided by the policy because California is shown in Item &A, of
the Information Page.
We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not
enforce our right against the person or organization named in the Schedule, but this waiver applies only with respect
to bodily injury arising out of the operations described in the Schedule, where you are required by a written contract
to obtain this waiver from us.
You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the
work described in the Schedule.
Schedule
1. ( ) Specific Waiver
Name of person or organization:
( X ) Blanket Waiver
Any person or organization for whom the Named Insured has agreed by written contract to famish this
waiver.
2. Operations:
ALL OPERATIONS CONDUCTED BY AN INSURED PURSUANT TO SUCH
WRITTEN CONTRACT
3. Premium:
The premium charge for this endorsement shall be 1.0 percent of the California premium developed
on payroll in connection with work performed for the above person(s)or organization(s)arising out of the
operations described.
4. Minimum Premium: $0
Authorized Representative
WC 90 03 75(D5118) —
Policy Number: PS00040761674
Primary and Nan-Contributory policy language - Page 6 PI-GLD-TS(11/15)
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
GENERAL LIABILITY DELUXE ENDORSEMENT:
TEMPORARY STAFFING
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
It is understood and agreed that the following extensions only apply in the event that no other specific
coverage for the indicated loss exposure Is provided under this policy. IF such specific coverage applies,
the terms, conditions and limits of that coverage are the sole and exclusive coverage applicable under
this policy, unless otherwise noted on this endorsement. The following is a summary of the Limits of
Insurance and additional coverage provided by this endorsement. For complete details on specific
coverages,consult the policy contract wording.
Coverage Applicable Limit of Insurance Page
Damage to Premises Rented to You - - - �$1,000,000 2
Expected or Intended Injury—Property Damage Included 2
Limited Rental Lease Agreement Contractual Liability $50,000 �T 2
Non-Owned Watercraft ; Less than 58 feet _ 3
Damage to Property You Own,Rent or Occupy I $30,000 3 1
Medical Payments $20,000 3
Medical Payments Reporting Period 3 Years 3
Athletic Activities �_— Amended 3
Supplementary Payments—Bail Bonds $2,500 4
_ ......._...
.. T
Supplementary Payments—Loss of Earnings $500 per day 4
Employee Indemnification Defense Coverage $25,000 4
?V11ho Is An Insured �.� �.�-...w..u.�._�.....�A......_- - ---^Included
Additional Insured—Newly Acquired or Formed Organization
Additional Insured—Broadened Named Insured
Additional Insured—Blanket Additional Insureds When required by
Contract i
Duties in the Event of Occurrence, Offense,Claim or Suit Included
Transfer of Rights of Recovery Against Others To Us Clarification 5
Liberalization Included 5
Unintentional Failure to Disclose Hazards s Included 5
Bodily Injury—Includes Mental Anguish Included 5
3
Personal and Advertising injury—Includes Abuse of Process, Included 6
Discrimination _ ---_------- ! _r
plher Insurance—Primary Clarifcatian _ ��`�® -Clarification I
PI-GLD-TS(11/15)
Page 1 of 8
Includes copyrighted material of Insurance Services Office, Inc.,with its permission.
PI-GLD-TS(I I/15)
Staffing g Services Exduslons Clarification
Staffing Services Definitions Clariflcation 8 ^
,.�
A. Damage to Premises Rented to You
If damage by fire to premises rented to you is not otherwise excluded from this Coverage Part:
3. The Damage To Premises Rented To You Limit section of the Declarations is amended to the
greater of:
a. $1,000,000;or
b. The amount shown in the Declarations as the Damage to Premises Rented to You Limit.
This is the most we will pay for all damage proximately caused by the same event,whether such
damage results from fire,lightning, explosion,smoke,or leaks from automatic fire protective
systems or any combination thereof;
2. The word fire is changed to fire,lightning,explosion,smoke,or leakage from automatic fire
protective systems where it appears in:
a. The last paragraph of SECTION I—COVERAGES,COVERAGE A BODILY INJURY AND
PROPERTY DAMAGE LIABILITY,Subsection 2.Exclusions;
b. SECTION Ili—LIMITS OF INSURANCE, Paragraph 6.;and
c. SECTION V—DEFINITIONS, Paragraph 9.a.; and
3. The words fire insurance are changed to insurance for fire, lightning,explosion, smoke,or
leakage from automatic fire protective systems where it appears in SECTION IV—
COMMERCIAL GENERAL LIABILITY CONDITIONS,Subsection 4.Other Insurance,
Paragraph b.Excess Insurance,
B. .Expected or Intended Injury—Property Damage
SECTION 1—COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE
LIABILITY,2. Exclusions, Paragraph a. Expected Or Intended Injury is deleted in its entirety and
replaced by the following:
a_ Expected Or Intended Injury
"Bodily injury"or'property damage"expected or intended from the standpoint of the insured.
This exclusion does not apply to"bodily injury"or"property damage"resulting from the use of
reasonable force to protect persons or property.
C. Limited Rental Lease Agreement Contractual Liability
SECTION I—COVERAGES,COVERAGE A BODILY INJURY AND PROPERTY DAMAGE
LIABILITY,2.Exclusions, Paragraph b.Contractual Liability is amended by adding the following:
Based on the named Insured's request at the time of claim,we agree to indemnify the named insured
for their liability assumed in a contract or agreement regarding the rental or lease of a premises on
behalf of their client,up to$50,000.
PI-GLQ-TS(11115)
Page 2 of 8
Includes copyrighted material of Insurance Services Office, Inc.,with its permission.
PI-GLD-TS(11116)
This coverage extension only applies to rental lease agreements and is excess over any renter's
liability insurance of the client.
D. Non-Owned Watercraft
SECTION I—COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE
LIABILITY,2. Exclusions,g.Aircraft,Auto Or Watercraft,Paragraph(2)is amended to read as
follows:
(2) A watercraft you do not own that is:
(a) Less than 58 feet long;and
(b) Not being used to carry persons or property for a charge;
This provision applies to any person, who with your consent,either uses or is responsible for
the use of a watercraft. This insurance is excess over any other valid and collectible
insurance available to the insured whether primary,excess or contingent.
E. Damage to Property You Own, Rent or Occupy
SECTION I--COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE
LIABILITY,2.Exclusions,j. Damage To Property,Paragraph(1)is deleted in its entirety and
replaced with the following:
(1) Property you own,rent or occupy,including any costs or expenses Incurred by you,or
any other person, organization or entity,for repair,replacement,enhancement,
restoration or maintenance of such property for any reason,including prevention of injury
to a person or damage to another's property, unless the damage to property is caused by
your client,up to a$30,000 limit. A client Is defined as a person under your direct care
and supervision.
F. Medical Payments
1. If COVERAGE C MEDICAL PAYMENTS is not otherwise excluded from this Coverage Part the
Medical Expense Limit is changed subject to all of the terms of SECTION 111—LIMITS OF
INSURANCE to the greater of:
a. $20,000;or
b. The Medical Expense limit shown in the Declarations of this Coverage Part.
2. Under SECTION I—COVERAGES,COVERAGE C MEDICAL PAYMENTS,Subsection I.
Insuring Agreement,Paragraph a., Item(b)is amended to read:
(b) The expenses are incurred and reported to us within three years of the date of the
accident,and
G. Athletic Activities
SECTION I—COVERAGES,COVERAGE C MEDICAL PAYMENTS,2.Exclusions,Paragraph e.
Athletics Activities is deleted in its entirety and replaced with the following:
PI-GLD-TS(11115)
Page 3 of 8
Includes copyrighted material of Insurance Services Office, Inc.,with its permission.
PI-GLD-TS(11115)
e. Athletics Activities
To a person injured while taking part in athletics.
H. Supplementary Payments
SECTION I—COVERAGES,SUPPLEMENTARY PAYMENTS—COVERAGES A AND B, items 1.b.
and 1,d.are amended as Follows:
b. The limit for the cost of bail bonds is changed from$250 to$2,500,and
d. The limit for loss of earnings is changed from $250 a day to$500 a day.
1. Employee Indemnification Defense Coverage
SECTION I—COVERAGES,SUPPLEMENTARY PAYMENTS—COVERAGES A AND B is
amended to include the following:
We will pay, on your behalf,defense costs incurred by an"employee"in a criminal proceeding.
The most we will pay For any"employee" who is directly involved in a criminal proceeding is$25,00
regardless of the numbers of"employees,"claims or'suits"brought or persons or organizations
making claims or bringing'suits."
J. Who is An Insured
SECTION II—WHO IS AN INSURED is amended as follows:
1. Newly Acquired or Formed Organization
If coverage for newly acquired or formed organizations is not otherwise excluded from this
Coverage Part, Paragraph 3.a.Is amended to read:
a. Coverage under this provision is afforded until the end of the policy period;
2. Each of the following Is also an insured:
a. Broadened Named Insured—Any organization and subsidiary thereof which you control
and actively manage on the effective date of this Coverage Part. However,coverage does
not apply to any organization or subsidiary not named in the Declarations as Named Insured,
if they are also insured under another similar policy, but far its termination or the exhaustion
of its limits of insurance.
b. Blanket Additional Insureds When Requires!by Contract—Any person or organization
where required by a written contract executed prior to the occurrence of a loss. Such person
or organization is an additional insured for"bodily injury,""property damage"or"personal and
advertising injury"but only for liability arising out of the negligence of the named insured,The
limits of insurance applicable to these additional insureds are the lesser of the policy limits or
those limits specified in a contract or agreement. These limits are included within and not in
addition to the limits of insurance shown in the Declarations.
The Additional Insured's limits of insurance do not increase our limits of insurance,as
described in SECTION III—LIMITS OF INSURANCE_
PI.GLD-TS(11/15)
Page 4 of a
Includes copyrighted material of Insurance Services Office, Inc.,with its permission.
Pi-GLD-TS(11115)
c. Interns—Your Interns only while performing duties related to the conduct of your business.
d. Contractors—Any individual or organization under written contractor written agreement with
you who provides"staffing services"on your behalf and at your direction for your clients.
K, Duties in the Event of Occurrence,Offense,Ciairn or Suit
1. SECTION IV—COMMERCIAL GENERAL LIABILITY CONDITIONS,2.a.the requirement that
you must see to it that we are notified as soon as practicable of an"occurrence"or an offense,
applies only when th6"occurrence"or offense is known to:
a. You, if you are an individual;
b. A partner,F you area partnership; or
c. An "executive officer"or insurance manager, if you are a corporation.
2. SECTION IV—COMMERCIAL GENERAL LIABILITY CONDITIONS,2.b,the requirement
that you must see to it that we receive notice of a claim or"suit"as soon as practicable will not be
considered breached unless the breach occurs after such claim or"suit° is known to:
a. You,if you are an individual;
b. A partner,if you are a partnership; or
c. An"executive officer"or insurance manager, if you are a corporation.
L. Transfer of Rights of Recovery Against Others To Us
SECTION IV--COMMERCIAL GENERAL LIABILITY CONDITIONS, Paragraph 8.Transfer Of
Rights Of Recovery Against Others To Us includes the following clarification-
Therefore,the insured can waive the insurer's rights of recovery prior to the occurrence of a loss,
provided the waiver is made in a written contract.
M. Liberalization
SECTION IV—COMMERCIAL GENERAL LIABILITY CONDITIONS is amended to include the
following additional condition;
Liberalization
If we revise this endorsement to provide more coverage without additional premium charge,we
will automatically provide the additional coverage to all endorsement holders as of the day the
revision is effective in your state.
N. Unintentional Failure To Disclose Hazards
SECTION IV—COMMERCIAL GENERAL LIABILITY CONDITIONS is amended to include the
following additional condition;
Unintentional Failure To Disclose Hazards
It is agreed that,based on our reliance on your representations as to existing hazards,if you
should unintentionally fail to disclose all such Hazards prior to the beginning of the policy period
PI-GLD-TS(11l15)
Page 5 of 8
Includes copyrighted material of Insurance Services Office, Inc.,with its permission.
PI-GLD-TS(11/15)
of this Coverage Part,we shall not deny coverage under this Coverage Part because of such
failure.
O. Bodily Injury—Mental Anguish
SECTION V—DEFINITIONS, Paragraph 3. is amended to read:
"Bodily injury':
a. Means bodily injury,sickness or disease sustained by a person,and includes mental anguish
resulting from any of these; and
b. Except for mental anguish, includes death resulting from the foregoing(Item a.above)at any
time.
P. Personal and Advertising Injury—Abuse of Process,Discrimination
If COVERAGE B PERSONAL AND ADVERTISING INJURY LIABILITY COVERAGE is not
otherwise excluded from this Coverage Part,the definition of"personal and advertising injury"is
amended as follows:
1. SECTION V—DEFINITIONS,Paragraph 14., Item b.is revised to read:
b. Malicious prosecution or abuse of process;
2. SECTION V—DEFINITIONS, Paragraph 14. is amended to include the following:
`Personal and advertising injury"also means discrimination based on race, color, religion,sex,
age or national origin, except when:
a. Done intentionally by or at the direction of,or with the knowledge or consent of:
(1) Any insured; or
(2) Any executive officer,director,stockholder, partner or member of the insured;or
b. Directly or indirectly related to the employment,former or prospective employment,
termination of employment, or application for employment of any person or persons by an
insured;or
c. Directly or indirectly related to the sale, rental, lease or sublease or prospective sale,rental,
lease or sub-lease of any room,dwelling or premises by or at the direction of any insured; or
d. Insurance for such discrimination is prohibited by or held in violation of law,public policy,
legislation,court decision or administrative ruling.
The above does not apply to fines or penalties imposed because of discrimination.
Q. Section IV—Commercial General Liability Conditions is amended by the addition of the following:
The following language is added to Item 4.Other Insurance:
Insurance under this endorsement is primary to and non-contributory with any other insurance
maintained by the person or organization(Additional Insured),except for loss resulting from the sole
negligence of that person or organization.
PI-GLD-TS(11/15)
Page 5 of 8
Includes copyrighted material of Insurance Services Office, Inc.,with its permission.
PI-GILD-TS(11l15)
This condition applies even if other valid and collectible insurance is available to the Additional Insured
for a loss or'occurrence'we cover for this Additional Insured.
R. Staffing Services Exclusions
The following exclusions are added to SECTION I—COVERAGES,COVERAGE A BODILY INJURY
AND PROPERTY DAMAGE:
Actions Or Activities Of PEO Worker
"Bodily injury"or"property damage"arising from the actions or activities of any"PEO worker".
Professional Services Exclusion
"Bodily Injury"or"property damage"due to the rendering of or failure to render any professional
service.This exclusion does not apply to your liability for"bodily injury"or"property damage"arising
out of your"employee's"providing or failing to provide professional health care services to another of
your"employees",but no"employee"is an insured for his or her providing or failure to provide such
professional health care services.
Wrongful Acts
"Bodily injury"or"property damage"arising from a wrongful act in the rendering or failure to render
services to or for your client.
For the purposes of this exclusion,wrongful act shall mean any actual or alleged act,error,or
omission, misstatement, or misleading statement in the course of providing"staffing services"to your
clients by you or by any person for whose acts you are legally responsible.
SECTION I—COVERAGES,COVERAGE B PERSONAL AND ADVERTISING INJURY LIABILITY
COVERAGE is amended as follows:
1. Exclusion k.does not apply.
2. Exclusions a., b.,e.,f.,g.,h., t., L,and p.do not apply to any insured who did not personally
acquiesce in or remain passive after having personal knowledge of such conduct. Our obligation
to pay shall begin once the full extent of the assets of the responsible insured has been
exhausted and once the Deductible as shown in the Declarations of the policy has been satisfied_
3. The following exclusions are added to Paragraph 2.Exclusions;
Actions Or Activities Of PEO Worker
"Personal and advertising injury'arising from the actions or activities of any"PEO worker-
Professional Services Services Exclusion
"Personal and advertising injury"due to the rendering of or failure to render any professional
service.
Wrongful Acts
"Personal and advertising injury"arising from a wrongful act in the rendering or failure to render
services to or for your client.
PI-GLD-TS(11115)
Page 7 of 8
Includes copyrighted material of Insurance Services Office, Inc.,with its permission.
PI-GLD-TS(I Ill 5)
For the purposes of this exclusion,wrongful act shall mean any actual or alleged act,error,or
omission, misstatement,or misleading statement in the course of providing"staffing services'to
your clients by you or by any person for whose acts you are legally responsible-
S. Staffing Services Definitions
1. SECTION V—DEFINITIONS, Paragraph S.is revised to read:
"Employee"includes but is not limited to a"leased worker"and a"staffing service employee".
"Employee"does not include a"temporary worker'or a`PEO worker".
2. The following definitions are added to SECTION V—DEFINITIONS;
a. "PEO service"means staffing related services as a Professional Employer Organization
(PEO)you provide to your clients and to"PEO workers" in connection with employment of
such workers.
b. 'PEO worker"means a person you lease to your client under a written"PEO service"
agreement or contract.
c. "Staffing Services'means services provided by a staffing company to their clients including
but not limited to:
(1) Fulfillment of any of the administrative functions which would otherwise be normally
fulfilled by an employer's human resource function;
(2) Staffing related administrative services provided by an Administrative Services
Organization(ASO);
(3) "PEO service";
(4) Staffing related services provided to your clients for the recruitment,selection and
placement of a person for employment with a client.
(5) Temporary, contingent or contract placement services;
(6) Vendor Management Service(VMS),means the facilitation, purchase and management
of"staffing services"for clients including the placement and fulfillment of orders for
"staffing service employees";
(7) Services performed on behalf of your client by a"staffing service employee"who is not a
direct hire or permanent placement;
(8) Services performed for a client company to supply that client company with a"staffing
service employee".
d. "Staffing service employee" means a person who is furnished by you to your client to perform
the duties to which you have agreed.
PI-GLD-TS(Ill15)
Page 8 of 8
Includes copyrighted material of Insurance Services Office,Inc.,with its permission.