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HomeMy WebLinkAboutFRIENDS OF SANTA ANA ZOO (FOSAZ) 7-2016INSURANCE ON FILE: WORK MAY PROCEED UNTIL INSURANCE EXPIRES CLERK OPCOUN IL D, ,,-X66216 AGREEMENT BETWEEN THE CITY OF SANTA ANA AND THE FRIENDS OF SANTA ANA ZOO FOR THE INSTALLATION AND OPERATION OF A FERRIS WHEEL CONCESSION AT THE SANTA ANA ZOO AT PRE NTICE PARK A-2016-036 THIS AGREEMENT is made and entered into on this 1sT day of March, 2016, by andbetween the City of Santa Ana, a charter city and municipal corporation duly organized and existing under the constitution and laws of the state of California ("City'), and Friends of Santa Ana Zoo, a California non-profit public benefit corporation, organized for the purpose of supporting the operation, maintenance and expansion of the Santa Ana Zoo at Prentice Park through charitable fund-raising CTOSAZ"). RECITALS A. City owns and operates for the public benefit the Santa Ana Zoo at Prentice Park ("Zoo"), which is under management and control of the Parks, Recreation and Community Services Agency. B. FOSAZ was first incorporated in 1982 as Friends of the Children's Zoo for the purpose of supporting and funding a children's petting zoo at the Zoo, and entered into its fust agreement with the City for installation of animal food dispensers at the children's zoo. In 1987, the name was changed to Friends of Santa Ana Zoo, C. For over thirty years, the City and FOSAZ (collectively, the "Parties"), have cooperated, to develop the Zoo, including the development of new animal habitats, coordination of volunteer services, concession management, and fundraising. D. Cooperation and support by FOSAZ remain ongoing. Under the Parties' "Agreement Between the City of Santa .Ana and the Friends of Santa Ana Zoo for the Benefit and Support of the Santa Ana Zoo at Prentice Park" dated December 3, 2001 and as amended ("Master Support Agreement"), the Parties may from time to time agree on new concessions at the Zoo to be operated by FOSAZ and collaborate on joint activities, including capital improvernents at the Zoo, E. The Parties now desire to enter into an agreement for the installation and operation of a Ferris Wheel at the Zoo for the benefit and betterment of the Zoo. THEREFORE, the Parties agree as follows: L CONSTRUCTION AND INSTALLATION OF FERRIS WHEEL A. The Parties shall mutually agree on a site at the Zoo that is most optimal for the construction and installation of a Ferris Wheel. Page I of 8 B. With City's input, and in accordance with all applicable City ordinances and procedures covering such matters as bid process, project administration requirements, and other legal requirements, FOSAZ shall retain qualified consultants and contractors for the geotechnical investigation, surveying, civil engineering, site plan, structural engineering, and site improvements (including but not limited to the structural foundation) necessary for the provision and installation of the Ferris Wheel. C. Prior to construction and 'installation of the Ferris Wheel, FOSAZ shall provide to City all materials related to the construction and installation of the Ferris Wheel, including without limitation reports, surveys, studies, calculations, plans, and specifications. No work shall commence without City's prior review and approval of such materials, D. FOSAZ shall provide all finding and assume all costs related to the design, construction, provision, installation, and 'inspection of the Ferris Wheel, including installation of all necessary utilities. City shall pay for utilities upon operation. All work shall be coordinated with City and Zoo staff. E. Prior to operation of the Ferris Wheel, FOSAZ shall obtain all approvals and certificates necessary under applicable federal, state, and local law, including without limitation approval from the Amusement Ride and Tramway Unit of the California Departient of Industrial Relations or other government agencies responsible for amusement ride oversight. F. Prior to operation of the Ferris Wheel, FOSAZ shall provide City with all final plans, drawings, as-builts, and similar documents. Operation of the Ferris Wheel may not commence without City's approval. 2. OPERATION, MAINTENANCE, AND INSPECTION OF FERRIS WHEEL A. At its sole cost, FOSAZ shall be responsible for the daily inspection, operation and maintenance of the Ferris Wheel with qualified personnel to ensure its safe and successful operation. Any subcontractors retained for these purposes must be approved by the City. B. FOSAZ shall operate the Ferris Wheel in accord with safety standards and protocols that are best practices in the amusement ride industry, C. FOSAZ shall comply with, coordinate, and obtain all approvals and certifications that are required by the Amusement Ride and Tramway Unit of the California Department of Industrial Relations or other government agencies responsible for amusement ride oversight, including without limitation regular safety inspections conducted by a Qualified Safety Inspector. Page 2 of 8 D. On a quarterly basis, FOSAZ shall provide City with all records of operation, maintenance, inspections, and certifications. At any time, FOSAZ shall permit City or its authorized representatives to inspect Ferris Wheel operations and equipment. F. Hours of operation and ticket prices shall be mutually agreed upon by the Parties and may be adjusted from time to time. 3. CONCESSION REVENUE SHARING All revenue generated by the operation of the Ferris Wheel shall be subject to the concession revenue-sharing provisions of the Master Support Agreement, or any updated or replacement agreement between City and FOSAZ for the benefit; and support of the Zoo. 4. OWNERSHIP OF FERRIS WHEEL City owns the Zoo property and all exhibits, support facilities, infrastructure, and animals contained within Prentice Park, including exhibits, support facilities, infrastructure, and animals previously purchased by or funded at FOSAZ expense. FOSAZ shall retain ownership of the Ferris Wheel and any other assets previously agreed to by the Parties. In the event of the dissolution of FOSAZ, any and all assets of FOSAZ shall be used to discharge any liabilities and debts of FOSAZ. The balance of such assets, if any, becomes the property of City to be used exclusively for the benefit of the Zoo. In the event that the Zoo ceases to exist, the balance of FOSAZ assets shall be distributed by a committee made up of the FOSAZ executive committee and an equal number of individuals from the City. 5. GENERAL LICENSE City hereby grants FOSAZ, its directors, officers, employees, contractors, subcontractors, and consultants a nonexclusive license to enter upon and use the Zoo facilities in connection with FOSAZ's execution of its responsibilities under this Agreement. 6. INSURANCE FOSAZ shall maintain and shall require its contractors and consultants, if any, to obtain and maintain insurance as described below: A. Commercial General Liability Insurance. FOSAZ shall maintain commercial general liability insurance naming the City, its officers, employees, agents, volunteers, and representatives as additional insured(s) and shall include, but not be limited to, protection against claims arising from bodily and personal injury, including death resulting therefrom and damage to property, resulting from any act or occurrence arising out of FOSAZ's operations in the performance of this Agreement, including, without limitation, Page 3 of 8 acts involving vehicles, The amounts of insurance shall be not less than the following: single limit coverage applying to bodily and personal injuzT, including death resulting therefrom, and property damage, in the total amount of $1,000,000 per occurrence, with $2,000,000 in the aggregate. Such insurance shall (a) name the City, its officers, employees, agents, volunteers and representatives as additional insured(s), (b) be primary and not contributory with respect to insurance or self-insurance programs maintained by the City; and (c) contain standard separation of insured's provisions. B. Business automobile liability insurance, or equivalent form, with a combined single limit of not less than $1,000,000 per occurrence. Such insurance shall include coverage for owned, hired, and non -owned automobiles. C. Worker's Compensation Insurance. In accordance with the provisions of California State Law, FOSAZ, if FOSAZ has any employees, is required to be insured against liability for worker's compensation or to undertake self-insurance, FOSAZ shall obtain and maintain any employer's liability insurance with limits not less than $1,000,000 per accident. D. For any licensed professional such as an architect or engineer performing services under this Agreement: Professional liability (errors and omissions) insurance, with a combined single limit of not less than $1,000,000 per claim with $2,000,000 in the aggregate. E. The following requirements apply to the insurance to be provided by FOSAZ pursuant to this section: i. FOSAZ shall maintain all insurance required above in full force and effect for the entire period covered by this Agreement. ii. Certificates of insurance shall be furnished to the City upon execution of this Agreement and shall be approved by the City. iii. Certificates and policies shall state that the policies shall not be canceled or reduced in coverage or changed in any other material aspect without thirty (30) days prior written notice to the City, 7. INDEMNIFICATION A. FOSAZ shall protect, indemnify, hold harmless, and defend City, its officials, officers, employees, representatives, and agents, from and against any and all claims, losses, liability, demands, damages, costs, expenses, or attorneys' fees, caused by or arising out of FOSAZ's or its subcontractors' negligent acts or omissions, or willful misconduct, in Page 4 of 8 the performance or nonperformance of their obligations under the covenants, terms, conditions, and provisions of this Agreement, B. City shall protect, indemnify, hold harmless, and defend FOSAZ, its directors, officers, employees, and agents, against any and all claims, losses, liability, demands, damages, costs, expenses, or attorneys' fees, arising out of City's negligent performance or nonperformance of its obligations under the covenants, terms, conditions, and provisions of this Agreement. &. INDEPENDENT CONTRACTOR In the exercise of its obligations under this Agreement, FOSAZ shall act at all times as an independent contractor and not as an employee of the City. Nothing in this Agreement shall be construed to establish a partnership, joint venture, group, pool, syndicate, or agency between the Parties. No provision contained herein shall be construed as authorizing or empowering either party to assume or create any obligation or responsibility, whatsoever, express or implied, on behalf, or in the name of, the other party in any manner, or to make any representation, warranty, or commitment on behalf of the other party. 9. TERM This Agreement shall commence on the date first written above and continue so long as the Master Support Agreement, or any updated or replacement agreement between City and FOSAZ for the benefit and support of the Zoo, remains effective. The Ferris Wheel shall be completed on or before January 31, 2017. Following completion of the Ferris Wheel, either Party may terminate this Agreement with ninety (90) days prior written notice. This Agreement shall automatically terminate in the event of termination of the Master Support Agreement, or any updated or replacement agreement between City and FOSAZ for the benefit and support of the Zoo. In the event of termination, FOSAZ shall arrange for the timely removal of the Ferris Wheel, and the Parties shall satisfy all their respective obligations under this Agreement that may be due and owing through the effective date of termination. 10. ASSIGNMENT The Parties shall not assign, transfer, or convey this Agreement or any interest that it may have in this Agreement without the other party's express consent or approval. Any attempted assignment without the required consent or approval shall be void and shall confer no right, title, or interest in or to this Agreement, or part thereof. In the event of an unauthorized assignment, at the option of the party not making the assignment, this Agreement may be terminated upon reasonable notice to the party making the assignment. Page 5 of 8 11. 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. Clerk of the City Council City of Santa Ana 20 Civic Center Plaza (M-30) P.O. Box 1988 Santa Ana, CA 92702-1988 Fax 714- 647-6956 With courtesy copies to: Executive Director Parks, Recreation, and Community Services Agency City of Santa Ana 20 Civic Center Plaza M-23 P.O. Box 1988 Santa Ana, California 92702 Fax 714-571-4211 City Attorney's Office City of Santa Ana 20 Civic Center Plaza (M-29) P,O. Box 1988 Santa Ana, California 92702 Fax 714- 647-6515 Executive Director Friends of Santa Ana, Zoo 1801 East Chestnut Avenue Santa Ana, CA 92701 Fax 714-550-0346 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 Page 6 of 8 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, 12. ENTITLE AGREEMENT This Agreement represents the entire agreement between the Parties regarding the subject matter Herein, and supersedes all prior negotiations, representations, and contracts, written or oral. This Agreement may only be amended by an instrument, in writing, signed by the Parties. This Agreement may be executed in any number of counterparts, each of which shall be an original, but all of which together shall constitute one and the same instrument. 13. WAIVER The waiver of either party of any breach or violation of any covenant, term, condition, or provision of this Agreement shall not be deemed to be a waiver of any such covenant, term, condition, or provision. 14. SEVERABILITY In the event that one or more of the phrases, sentences, clauses, paragraphs or sections contained in this Agreement shall be declared invalid or unenforceable by valid judgment or decree of a court of competent jurisdiction, such invalidity or unenforceability shall not affect any of the remaining phrases, sentences, clauses, paragraphs or sections of this Agreement, which shall be interpreted to carry out the intent of the parties hereunder. 15. GOVERNING LAW AND 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. IN WITNESS WHEREOF, the parties hereto have executed this Agreement the date and year first above written. ATTEST: C' NTA A A Maria D. Huizar David Cavazos Clerk of Council City Manager -- signatures continue on following page -- Page 7 of 8 APPROVED AS TO FORM: SONIA R. CARVALHO City Attorney By; /. J(0)J( 0 )Iinbl. Ptuik Assistant City Attorney RECOMMENDED FOR APPROVAL: Gerardo Monet Exectirtive Director Parks, Recreation, and FRIENDS OF SANTA ANA ZOO Services Agency Page 8 of 8 OP ID: ROLO `#`% ' CERTIFICATE OF LIABILITY INSURANCE D03122/2ATE 01 YY) 03/22/2016 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 SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Schweickert &Company 15 Peters Canyon Road Irvine, CA 92606 CONTACT Lori Rosenfeld PHONE FA% ac Ne E:x:7'14.689-1770 ac Ne:714-436-6498 nl oeEss: lori@schweickert.com PRODUCER FRIEN-1 CUSTOMER ID #: INSURER(S) AFFORDING COVERAGE NAIC# INSURED Friends of Santa Ana Zoo INSURER A: Nonprofits' Insurance Alliance 1801 East Chestnut Ave. Santa Ana, CA 92701 INSURERS; North American Elite Insurance INSURER C: INSURER D : INSURER E: 01/17/2016 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 RJUaR I TYPE OF INSURANCE ADD B MD POLICY NUMBER MMIDDmYY MMIIDDIYVYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 $ 50,00 A X COMMERCIAL GENERAL LIABILITY X 2016 -15073 -NPO 01/17/2016 01117/2017 PREMISES Eaoccurrence CLAIMS -MADE ® OCCUR MED EXP (Any one person) $ 20,00 $ 1,000,00 PERSONAL&ADV INJURY $ 2,000,00 GENERAL AGGREGATE GEN'L AGGREGATE LIMI T APPLIES PER: $ 2,000,00 PRODUCTS - COMP/OP AGO PRO LOC POLICY JE CT $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) $ ANY AUTO BODILY INJURY (Per person) $ ALL OWNED AUTOS Vl+< BODILY INJURY (Per accident) $ SCHEDULEDAUTOS`SI HIREDAUTOE p (j e�`V 0�7 PROPERTY DAMAGE (PER ACCIDENT) $ $ NON-OWNEDAUTOS t J $ UMBRELLA LIAB EXCESS LIAB OCCUR�\LL CLAIMS -MADE 1\ �na i, EACH OCCURRENCE AGGREGATE $ $ DEDUCTIBLE $ P�s� $ RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE WCSTATU- 0— TORY LIMITS ER OFFICE RIM EMBER EXCLUDED? NIA — $ (MandalorylnNH) E. L. DISEASE - EA EMPLOYE If yes, describe under DESCRIPTION OF OPERATIONS below E. L. DISEASE -POLICY LIMIT $ B Property Policy CW60004042.12-15073 01/17/2016 01/1712017 Bldg 135,00 B BPP SPECIAL FORM $10( DED BPP 559,50 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required) City ofSanta Ana is named as additional insured as respects to the operations of the named insured. City of Santa Ana Attm:PRCSA 20 Civic Center Plaza M-23 Santa Ana, CA 92701 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE © 1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: COMMERCIAL GENERAL LIABILITY CG 20 26 04 13 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 PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s): Any person or organization that you are required to add as an additional insured on this policy, under a written contract or agreement currently in effect, or becoming effective during the term of this policy. The additional insured status will not be afforded with respect to liability arising out of or related to your activities as a real estate manager for that person or organization. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily 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: 1. In the performance of your ongoing operations; or 2. In connection with your premises owned by or rented to you. However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. aay�. S\XA\ �� Pd�� pRCi CG 20 26 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 1 COMMERCIAL GENERAL LIABILITY CG 20 2107 98 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - VOLUNTEER WORKERS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART Section II — Who Is An Insured is amended to in- clude as an insured any person(s) who are volunteer worker(s) for you, but only while acting at the direction of, and within the scope of their duties for you. How- ever, none of these volunteer worker(s) are insureds for: 1. 'Bodily injury" or "personal and advertising injury": a. To you, to your partners or members (if you are a partnership or joint venture), to your members (if you are a limited liability com- pany), to your other volunteer worker(s) or to your "employees" arising out of and in the course of their duties for you; b. To the spouse, child, parent, brother or sister of your volunteer worker(s) or your "employees" as a consequence of Para- graph 1.a. above; c. For which there is any obligation to share damages with or repay someone else who must pay damages because of the injury described in Paragraphs 1.a. or b. above; or d. Arising out of his or her providing or failing to provide professional health care services. 2. 'Property damage" to property: a. Owned, occupied, or used by, b. Rented to, in the care, custody or control of, or over which physical control is being exer- cised for any purpose by you, any of your other volunteer workers, your "employees", any partner or member (if you are a partnership or joint venture), or any member (if you are a limited liability company). Reviewed by Silvia Cuevas y;,RCSAIAdmin. CG 20 21 07 98 Copyright, Insurance Services Office, Inc., 1997 Page 1 of 1 13 COMMERCIAL GENERAL LIABILITY CG 00 0107 98 COMMERCIAL GENERAL 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, and any other person or organization qualifying as a Named Insured under this policy. The words "we", "us" and "our" refer to the company providing this insur- ance. The word "insured" means any person or organization qualifying as such under Section II — Who Is An In- sured. Other words and phrases that appear in quotation marks have special meaning. Refer to Section V — Definitions. SECTION I — COVERAGES COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY 1. Insuring Agreement b. This insurance applies to "bodily injury" and "property damage" only if: (1) The "bodily injury" or "property damage" is caused by an "occurrence" that takes place in the "coverage territory'; and (2) The "bodily injury" or "property damage" occurs during the policy period. c. Damages because of "bodily injury' include damages claimed by any person or organiza- tion for care, loss of services or death resulting at any time from the "bodily injury". 2. Exclusions This insurance does not apply to: 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" resulting from the use of reasonable force to protect persons or property. a. We will pay those sums that the insured be- b. Contractual Liability comes legally obligated to pay as damages be- cause of "bodily injury" or "property damage" to "Bodily injury" or "property damage" for which which this insurance applies. We will have the the insured is obligated to pay damages by right and duty to defend the insured against any reason of the assumption of liability in a con - "suit" seeking those damages. However, we will tract or agreement. This exclusion does not have no duty to defend the insured against any apply to liability for damages: "suit" seeking damages for "bodily injury" or (1) That the insured would have in the absence "property damage" to which this insurance does of the contract or agreement; or not apply. We may, at our discretion, investi- "occurrence" (2) Assumed in a contract or agreement that is gate any and settle any claim or "suit" that may result. But: an "insured contract", provided the "bodily "property injury" or damage" occurs subse- (1) The amount we will pay for damages is quent to the execution of the contract or limited as described in Section III — Limits agreement. Solely for the purposes of liabil- Of Insurance; and ity assumed in an "insured contract", rea- (2) Our right and duty to defend end when we sonable attorney fees and necessary litiga- have used up the applicable limit of insur- tion expenses incurred by or for a party ance in the payment of judgments or set- other than an insured are deemed to be tlements under Coverages A or B or medi- damages because of "bodily injury" or cal expenses under Coverage C. "property damage", provided: No other obligation or liability to pay sums or (a) Liability to such party for, or for the cost perform acts or services is covered unless ex- of, that party's defense has also been plicitly provided for under Supplementary Pay- assumed in the same "insured contract"; ments — Coverages A and B. and eke Zt Guevee 2k�pdPd��r P CG 00 0107 98 Copyright, Insurance Services Office, Inc., 1997 Page 1 of 13 0 (b) Such attorney fees and litigation ex- penses are for defense of that party against a civil or alternative dispute reso- lution proceeding in which damages to which this insurance applies are alleged. c. Liquor Liability "Bodily injury" or "property damage" for which any insured may be held liable by reason of: (1) Causing or contributing to the intoxication of any person; (2) The furnishing of alcoholic beverages to a person under the legal drinking age or un- der the influence of alcohol; or (3) Any statute, ordinance or regulation relating to the sale, gift, distribution or use of alco- holic beverages. This exclusion applies only if you are in the business of manufacturing, distributing, selling, serving or furnishing alcoholic beverages. d. Workers' Compensation And Similar Laws Any obligation of the insured under a workers' compensation, disability benefits or unemploy- ment compensation law or any similar law. e. Employer's Liability "Bodily injury" to: (1) An "employee" of the insured arising out of and in the course of: (a) Employment by the insured; or (b) Performing duties related to the conduct of the insured's business; or (2) The spouse, child, parent, brother or sister of that "employee" as a consequence of Paragraph (1) above. This exclusion applies: (1) Whether the insured may be liable as an employer or in any other capacity; and (2) To any obligation to share damages with or repay someone else who must pay dam- ages because of the injury. This exclusion does not apply to liability as- sumed by the insured under an "insured con- tract". f. Pollution (1) "Bodily injury" or "property damage" arising out of the actual, alleged or threatened dis- charge, dispersal, seepage, migration, re- lease or escape of "pollutants": (a) At or from any premises, site or location which is or was at any time owned or occupied by, or rented or loaned to, any insured. However, this subparagraph does not apply to: (i) "Bodily injury" if sustained within a building and caused by smoke, fumes, vapor or soot from equipment used to heat that building; (ii) "Bodily injury" or "property damage" for which you may be held liable, if you are a contractor and the owner or lessee of such premises, site or location has been added to your pol- icy as an additional insured with re- spect to your ongoing operations per- formed for that additional insured at that premises, site or location and such premises, site or location is not and never was owned or occupied by, or rented or loaned to, any in- sured, other than that additional in- sured; or (iii) "Bodily injury" or "property damage" arising out of heat, smoke or fumes from a "hostile fire" (b) At or from any premises, site or location which is or was at any time used by or for any insured or others for the han- dling, storage, disposal, processing or treatment of waste; (c) Which are or were at any time trans- ported, handled, stored, treated, dis- posed of, or processed as waste by or for any insured or any person or organi- zation for whom you may be legally re- sponsible; or Page 2 of 13 Copyright, Insurance Services Office, Inc., 1997 CG 00 01 07 98 0 (d) At or from any premises, site or location on which any insured or any contractors or subcontractors working directly or in- directly on any insured's behalf are per- forming operations if the "pollutants" are brought on or to the premises, site or lo- cation in connection with such opera- tions by such insured, contractor or sub- contractor. However, this subparagraph does not apply to: (i) "Bodily injury" or "property damage" arising out of the escape of fuels, lu- bricants or other operating fluids which are needed to perform the normal electrical, hydraulic or me- chanical functions necessary for the operation of "mobile equipment" or its parts, if such fuels, lubricants or other operating fluids escape from a vehicle part designed to hold, store or receive them. This exception does not apply if the "bodily injury" or "property damage" arises out of the intentional discharge, dispersal or re- lease of the fuels, lubricants or other operating fluids, or if such fuels, lu- bricants or other operating fluids are brought on or to the premises, site or location with the intent that they be discharged, dispersed or released as part of the operations being per- formed by such insured, contractor or subcontractor; (ii) "Bodily injury" or "property damage" sustained within a building and caused by the release of gases, fumes or vapors from materials brought into that building in connec- tion with operations being performed by you or on your behalf by a con- tractor or subcontractor; or (iii) "Bodily injury" or "property damage" arising out of heat, smoke or fumes from a "hostile fire". (e) At or from any premises, site or location on which any insured or any contractors or subcontractors working directly or in- directly on any insured's behalf are per- forming operations if the operations are to test for, monitor, clean up, remove, contain, treat, detoxify or neutralize, or in any way respond to, or assess the ef- fects of, "pollutants". (2) Any loss, cost or expense arising out of any (a) Request, demand, order or statutory or regulatory requirement that any insured or others test for, monitor, clean up, re- move, contain, treat, detoxify or neutral- ize, or in any way respond to, or assess the effects of, "pollutants"; or (b) Claim or suit by or on behalf of a gov- ernmental authority for damages be- cause of testing for, monitoring, cleaning up, removing, containing, treating, de- toxifying or neutralizing, or in any way responding to, or assessing the effects of, "pollutants". However, this paragraph does not apply to liability for damages because of "property damage" that the insured would have in the absence of such request, demand, order or statutory or regulatory requirement, or such claim or "suit" by or on behalf of a govern- mental authority. g. Aircraft, Auto Or Watercraft "Bodily injury" or "property damage" arising out of the ownership, maintenance, use or en- trustment to others of any aircraft, "auto" or wa- tercraft owned or operated by or rented or loaned to any insured. Use includes operation and "loading or unloading". This exclusion does not apply to: (1) A watercraft while ashore on premises you own or rent; (2) A watercraft you do not own that is: (a) Less than 26 feet long; and (b) Not being used to carry persons or property for a charge; (3) Parking an "auto" on, or on the ways next to, premises you own or rent, provided the "auto" is not owned by or rented or loaned to you or the insured; (4) Liability assumed under any "insured con- tract" for the ownership, maintenance or use of aircraft or watercraft; or (5) "Bodily injury" or "property damage" arising out of the operation of any of the equipment listed in Paragraph f.(2) or f.(3) of the defini- tion of "mobile equipment". eddy'. k?e�,e�N �Ir CG 00 01 07 98 Copyright, Insurance Services Office, Inc., 1997 Page 3 of 13 0 h. Mobile Equipment "Bodily injury" or "property damage" arising out of: (1) The transportation of "mobile equipment" by an "auto" owned or operated by or rented or loaned to any insured; or (2) The use of "mobile equipment" in, or while in practice for, or while being prepared for, any prearranged racing, speed, demolition, or stunting activity. I. War "Bodily injury" or "property damage" due to war, whether or not declared, or any act or condition incident to war. War includes civil war, insurrec- tion, rebellion or revolution. This exclusion ap- plies only to liability assumed under a contract or agreement. j. Damage To Property "Property damage" to: (1) Property you own, rent, or occupy; (2) Premises you sell, give away or abandon, if the "property damage" arises out of any part of those premises; (3) Property loaned to you; (4) Personal property in the care, custody or control of the insured; (5) That particular part of real property on which you or any contractors or subcontractors working directly or indirectly on your behalf are performing operations, if the "property damage" arises out of those operations; or (6) That particular part of any property that must be restored, repaired or replaced be- cause "your work" was incorrectly per- formed on it. Paragraphs (1), (3) and (4) of this exclusion do not apply to "property damage" (other than damage by fire) to premises, including the con- tents of such premises, rented to you for a pe- riod of 7 or fewer consecutive days. A separate limit of insurance applies to Damage To Prem- ises Rented To You as described in Section III — Limits Of Insurance. Paragraph (2) of this exclusion does not apply if the premises are "your work" and were never occupied, rented or held for rental by you. Paragraphs (3), (4), (5) and (6) of this exclusion do not apply to liability assumed under a side- track agreement. Paragraph (6) of this exclusion does not apply to "property damage" included in the "products - completed operations hazard". Page 4 of 13 k. Damage To Your Product "Property damage" to "your product" arising out of it or any part of it. I. Damage To Your Work "Property damage" to "your work" arising out of it or any part of it and included in the "products - completed operations hazard". This exclusion does not apply if the damaged work or the work out of which the damage arises was performed on your behalf by a sub- contractor. m. Damage To Impaired Property Or Property Not Physically Injured "Property damage" to "impaired property" or property that has not been physically injured, arising out of: (1) A defect, deficiency, inadequacy or danger- ous condition in "your product" or "your work" or (2) A delay or failure by you or anyone acting on your behalf to perform a contract or agreement in accordance with its terms. This exclusion does not apply to the loss of use of other property arising out of sudden and ac- cidental physical injury to "your product" or "your work" after it has been put to its intended use. n. Recall Of Products, Work Or Impaired Property Damages claimed for any loss, cost or expense incurred by you or others for the loss of use, withdrawal, recall, inspection, repair, replace- ment, adjustment, removal or disposal of: (1) "Your product" (2) "Your work" or (3) "Impaired property"; if such product, work, or property is withdrawn or recalled from the market or from use by any person or organization because of a known or suspected defect, deficiency, inadequacy or dangerous condition in it. o. Personal And Advertising Injury "Bodily injury" arising out of "personal and ad- vertising injury". Exclusions c. through n. do not apply to damage by fire to premises while rented to you or temporar- ily occupied by you with permission of the owner. A separate limit of insurance applies%Jt;overage tq as described in Section III — Limjt I s rance. 2 G�Pdm0 Copyright, Insurance Services Office, Inc., 1997 Q�G G 00 01 07 98 COVERAGE B PERSONAL AND ADVERTISING INJURY LIABILITY 1. Insuring Agreement a. We will pay those sums that the insured be- comes legally obligated to pay as damages be- cause of "personal and advertising injury" to which this insurance applies. We will have the right and duty to defend the insured against any "suit" seeking those damages. However, we will have no duty to defend the insured against any "suit" seeking damages for "personal and ad- vertising injury" to which this insurance does not apply. We may, at our discretion, investi- gate any offense and settle any claim or "suit" that may result. But: (1) The amount we will pay for damages is limited as described in Section III — Limits Of Insurance ; and (2) Our right and duty to defend end when we have used up the applicable limit of insur- ance in the payment of judgments or set- tlements under Coverages A or B or medi- cal expenses under Coverage C. No other obligation or liability to pay sums or perform acts or services is covered unless ex- plicitly provided for under Supplementary Pay- ments — Coverages A and B. b. This insurance applies to "personal and adver- tising injury" caused by an offense arising out of your business but only if the offense was com- mitted in the "coverage territory" during the pol- icy period. 2. Exclusions This insurance does not apply to: a. "Personal and advertising injury": (1) Caused by or at the direction of the insured with the knowledge that the act would vio- late the rights of another and would inflict "personal and advertising injury" (2) Arising out of oral or written publication of material, if done by or at the direction of the insured with knowledge of its falsity; (3) Arising out of oral or written publication of material whose first publication took place before the beginning of the policy period; (4) Arising out of a criminal act committed by or at the direction of any insured; (6) Arising out of a breach of contract, except an implied contract to use another's adver- tising idea in your "advertisement"; (7) Arising out of the failure of goods, products or services to conform with any statement of quality or performance made in your "adver- tisement' (8) Arising out of the wrong description of the price of goods, products or services stated in your "advertisement"; (9) Committed by an insured whose business is advertising, broadcasting, publishing or telecasting. However, this exclusion does not apply to Paragraphs 14.a., b, and c. of "personal and advertising injury" under the Definitions Section; or (10) Arising out of the actual, alleged or threat- ened discharge, dispersal, seepage, migra- tion, release or escape of "pollutants" at any time. b. Any loss, cost or expense arising out of any: (1) Request, demand or order that any insured or others test for, monitor, clean up, re- move, contain, treat, detoxify or neutralize, or in any way respond to, or assess the ef- fects of, "pollutants"; or (2) Claim or suit by or on behalf of a govern- mental authority for damages because of testing for, monitoring, cleaning up, remov- ing, containing, treating, detoxifying or neu- tralizing, or in any way responding to, or as- sessing the effects of, "pollutants". COVERAGE C MEDICAL PAYMENTS 1. Insuring Agreement a. We will pay medical expenses as described below for "bodily injury" caused by an accident: (1) On premises you own or rent; (2) On ways next to premises you own or rent; or (3) Because of your operations; provided that: (1) The accident takes place in the "coverage territory" and during the policy period; (2) The expenses are incurred and reported to us within one year of the date of the acci- dent; and (5) For which the insured has assumed liability (3) The injured person submits to examination, in a contract or agreement. This exclusion at our expense, by physicians of our choice does not apply to liability for damages that as often as we reasonably req�u'trey the insured would have in the absence of �Q the contract or agreement; �O�Op`die G;I 1 CyN\1 CG 00 01 07 98 Copyright, Insurance Services Office, Inc., 1997 `7�.GS Page 5 of 13 ❑ b. We will make these payments regardless of fault. These payments will not exceed the ap- plicable limit of insurance. We will pay reason- able expenses for: (1) First aid administered at the time of an accident; (2) Necessary medical, surgical, x-ray and dental services, including prosthetic de- vices; and (3) Necessary ambulance, hospital, profes- sional nursing and funeral services. 2. Exclusions We will not pay expenses for "bodily injury": a. To any insured. b. To a person hired to do work for or on behalf of any insured or a tenant of any insured. c. To a person injured on that part of premises you own or rent that the person normally occu- pies. d. To a person, whether or not an "employee" of any insured, if benefits for the "bodily injury" are payable or must be provided under a workers' compensation or disability benefits law or a similar law. e. To a person injured while taking part in athlet- ics. f. Included within the "products -completed opera- tions hazard". g. Excluded under Coverage A. h. Due to war, whether or not declared, or any act or condition incident to war. War includes civil war, insurrection, rebellion or revolution. SUPPLEMENTARY PAYMENTS — COVERAGES A AND B 1. We will pay, with respect to any claim we investi- gate or settle, or any "suit" against an insured we defend: a. All expenses we incur. b. Up to $250 for cost of bail bonds required be- cause of accidents or traffic law violations aris- ing out of the use of any vehicle to which the Bodily Injury Liability Coverage applies. We do not have to furnish these bonds. c. The cost of bonds to release attachments, but only for bond amounts within the applicable limit of insurance. We do not have to furnish these bonds. d. All reasonable expenses incurred by the in- sured at our request to assist us in the investi- gation or defense of the claim or "suit", includ- ing actual loss of earnings up to $250 a day because of time off from work. e. All costs taxed against the insured in the "suit". f. Prejudgment interest awarded against the insured on that part of the judgment we pay. If we make an offer to pay the applicable limit of insurance, we will not pay any prejudgment in- terest based on that period of time after the of- fer. g. All interest on the full amount of any judgment that accrues after entry of the judgment and be- fore we have paid, offered to pay, or deposited in court the part of the judgment that is within the applicable limit of insurance. These payments will not reduce the limits of insur- ance. 2. If we defend an insured against a "suit" and an indemnitee of the insured is also named as a party to the "suit", we will defend that indemnitee if all of the following conditions are met: a. The "suit" against the indemnitee seeks dam- ages for which the insured has assumed the li- ability of the indemnitee in a contract or agree- ment that is an "insured contract"; b. This insurance applies to such liability assumed by the insured; c. The obligation to defend, or the cost of the defense of, that indemnitee, has also been as- sumed by the insured in the same "insured contract" d. The allegations in the "suit" and the information we know about the "occurrence" are such that no conflict appears to exist between the inter- ests of the insured and the interests of the in- demnitee; e. The indemnitee and the insured ask us to con- duct and control the defense of that indemnitee against such "suit" and agree that we can as- sign the same counsel to defend the insured and the indemnitee; and f. The indemnitee: (1) Agrees in writing to: (a) Cooperate with us in the investigation, settlement or defense of the "suit"; (b) Immediately send us copies of any de- mands, notices, summonses or legal papers received in connection with the "suit"; (c) Notify any other insurer whose coverage is available to the indemnitee; and (d) Cooperate with us with res tp coor- dinating other applic` �g ``ii surance available to theygdsMWMe; and Page 6 of 13 Copyright, Insurance Services Office, Inc., 1997 CG 00 0107 98 0 (2) Provides us with written authorization to (a) Obtain records and other information related to the "suit'; and (b) Conduct and control the defense of the indemnitee in such "suit". So long as the above conditions are met, attor- neys' fees incurred by us in the defense of that in- demnitee, necessary litigation expenses incurred by us and necessary litigation expenses incurred by the indemnitee at our request will be paid as Supplementary Payments. Notwithstanding the provisions of Paragraph 2.b.(2) of Section I — Cov- erage A — Bodily Injury And Property Damage Li- ability, such payments will not be deemed to be damages for "bodily injury" and "property damage" and will not reduce the limits of insurance. Our obligation to defend an insured's indemnitee and to pay for attorneys' fees and necessary litiga- tion expenses as Supplementary Payments ends when: a. We have used up the applicable limit of insur- ance in the payment of judgments or settle- ments; or b. The conditions set forth above, or the terms of the agreement described in Paragraph f. above, are no longer met. SECTION II —WHO IS AN INSURED 1. If you are designated in the Declarations as: a. An individual, you and your spouse are insur- eds, but only with respect to the conduct of a business of which you are the sole owner. b. A partnership or joint venture, you are an in- sured. Your members, your partners, and their spouses are also insureds, but only with re- spect to the conduct of your business. c. A limited liability company, you are an insured. Your members are also insureds, but only with respect to the conduct of your business. Your managers are insureds, but only with respect to their duties as your managers, d. An organization other than a partnership, joint venture or limited liability company, you are an insured. Your "executive officers" and directors are insureds, but only with respect to their du- ties as your officers or directors. Your stock- holders are also insureds, but only with respect to their liability as stockholders. 2. Each of the following is also an insured: a. Your "employees", other than either your "ex- ecutive officers" (if you are an organization other than a partnership, joint venture or limited liability company) or your managers (if you are a limited liability company), but only for acts within the scope of their employment by you or while performing duties related to the conduct of your business. However, none of these "em- ployees" is an insured for: (1) "Bodily injury' or "personal and advertising injury": (a) To you, to your partners or members (if you are a partnership or joint venture), to your members (if you are a limited liabil- ity company), or to a co -"employee" while that co"employee" is either in the course of his or her employment or per- forming duties related to the conduct of your business; (b) To the spouse, child, parent, brother or sister of that co -"employee" as a conse- quence of Paragraph (1)(a) above; (c) For which there is any obligation to share damages with or repay someone else who must pay damages because of the injury described in Paragraphs (1)(a) or (b) above; or (d) Arising out of his or her providing or failing to provide professional health care services. (2) "Property damage" to property: (a) Owned, occupied or used by, (b) Rented to, in the care, custody or control of, or over which physical control is be- ing exercised for any purpose by you, any of your "employees", any partner or member (if you are a partnership or joint venture), or any member (if you are a lim- ited liability company). b. Any person (other than your "employee"), or any organization while acting as your real es- tate manager. c. Any person or organization having proper tem- porary custody of your property if you die, but only: (1) With respect to liability arising out of the maintenance or use of that property; and (2) Until your legal repre'has been appointed. ue�as CG 00 01 07 98 Copyright, Insurance Services Office, Inc., 1997 Page 7 of 13 0 d. Your legal representative if you die, but only with respect to duties as such. That representa- tive will have all your rights and duties under this Coverage Part. 3. With respect to "mobile equipment" registered in your name under any motor vehicle registration law, any person is an insured while driving such equipment along a public highway with your per- mission. Any other person or organization respon- sible for the conduct of such person is also an in- sured, but only with respect to liability arising out of the operation of the equipment, and only if no other insurance of any kind is available to that person or organization for this liability. However, no person or organization is an insured with respect to: a. 'Bodily injury" to a co -"employee" of the person driving the equipment; or b. 'Property damage" to property owned by, rented to, in the charge of or occupied by you or the employer of any person who is an in- sured under this provision. 4. Any organization you newly acquire or form, other than a partnership, joint venture or limited liability company, and over which you maintain ownership or majority interest, will qualify as a Named Insured if there is no other similar insurance available to that organization. However: a. Coverage under this provision is afforded only until the 90th day after you acquire or form the organization or the end of the policy period, whichever is earlier; b. Coverage A does not apply to "bodily injury' or "property damage" that occurred before you acquired or formed the organization; and c. Coverage B does not apply to 'personal and advertising injury' arising out of an offense committed before you acquired or formed the organization. No person or organization is an insured with respect to the conduct of any current or past partnership, joint venture or limited liability company that is not shown as a Named Insured in the Declarations. SECTION III — LIMITS OF INSURANCE The Limits of Insurance shown in the Declarations and the rules below fix the most we will pay re- gardless of the number of: a. Insureds; b. Claims made or "suits" brought; or c. Persons or organizations making claims or bringing "suits". 2. The General Aggregate Limit is the most we will pay for the sum of: a. Medical expenses under Coverage C; b. Damages under Coverage A, except damages because of "bodily injury' or "property damage" included in the "products -completed operations hazard"; and c. Damages under Coverage B. 3. The Products -Completed Operations Aggregate Limit is the most we will pay under Coverage A for damages because of "bodily injury' and 'property damage" included in the 'products -completed op- erations hazard". 4. Subject to 2. above, the Personal and Advertising Injury Limit is the most we will pay under Coverage B for the sum of all damages because of all "per- sonal and advertising injury' sustained by any one person or organization. 5. Subject to 2. or 3. above, whichever applies, the Each Occurrence Limit is the most we will pay for the sum of: a. Damages under Coverage A; and b. Medical expenses under Coverage C because of all "bodily injury' and 'property dam- age" arising out of any one "occurrence". 6. Subject to 5. above, the Damage To Premises Rented To You Limit is the most we will pay under Coverage A for damages because of 'property damage" to any one premises, while rented to you, or in the case of damage by fire, while rented to you or temporarily occupied by you with permission of the owner. 7. Subject to 5. above, the Medical Expense Limit is the most we will pay under Coverage C for all medical expenses because of "bodily injury' sus- tained by any one person. 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. Gum - •\�. P� Page 8 of 13 Copyright, Insurance Services Office, Inc., 1997 CG 00 01 07 98 ❑ SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS 1. Bankruptcy Bankruptcy or insolvency of the insured or of the insured's estate will not relieve us of our obliga- tions under this Coverage Part. 2. Duties In The Event Of Occurrence, Offense, Claim Or Suit a. You 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 pos- sible, 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. If a claim is made or "suit" is brought against any insured, you must: (1) Immediately record the specifics of the claim or "suit" and the date received; and (2) Notify us as soon as practicable. You must see to it that we receive written no- tice of the claim or "suit" as soon as practica- ble. c. You and any other involved insured must: (1) Immediately send us copies of any de- mands, notices, summonses or legal pa- pers received in connection with the claim or "suit" (2) Authorize us to obtain records and other information; (3) Cooperate with us in the investigation or settlement of the claim or defense against the "suit"; and (4) Assist us, upon our request, in the en- forcement of any right against any person or organization which may be liable to the in- sured because of injury or damage to which this insurance may also apply. d. 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. 3. Legal Action Against Us No person or organization has a right under this Coverage Part: a. To join us as a party or otherwise bring us into a "suit" asking for damages from an insured; or b. To sue us on this Coverage Part unless all of its terms have been fully complied with. A person or organization may sue us to recover on an agreed settlement or on a final judgment against an insured obtained after an actual trial; but we will not be liable for damages that are not payable under the terms of this Coverage Part or that are in excess of the applicable limit of insur- ance. An agreed settlement means a settlement and release of liability signed by us, the insured and the claimant or the claimant's legal represen- tative. 4. Other Insurance If other valid and collectible insurance is available to the insured for a loss we cover under Cover- ages A or B of this Coverage Part, our obligations are limited as follows: a. Primary Insurance This insurance is primary except when b. below applies. If this insurance is primary, our obliga- tions are not affected unless any of the other insurance is also primary. Then, we will share with all that other insurance by the method de- scribed in c, below. b. Excess Insurance This insurance is excess over: (1) Any of the other insurance, whether pri- mary, excess, contingent or on any other basis: (a) That is Fire, Extended Coverage, Builder's Risk, Installation Risk or similar coverage for "your work"; (b) That is Fire insurance for premises rented to you or temporarily occupied by you with permission of the owner; (c) That is insurance purchased by you to cover your liability as a tenant for "prop- erty damage" to premises rented to you or temporarily occupied by you with permission of the owner; or (d) 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 I — Coverage A — Bodily Injury And Property Damage Liability. (2) Any other primary insurance available to you covering liability for damages arising out of the premises or operations for which you have been added as an t,".onal in- sured by attachmentol rsement. �eqr\ CG 00 0107 98 Copyright, Insurance Services Office, Inc., 1997 Page 9 of 13 0 When this insurance is excess, we will have no duty under Coverages A or B to defend the in- sured 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 in- surance, 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 insur- ance 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 of the other insurance permits contribution by equal shares, we will follow this method also. Under this approach each insurer contrib- utes equal amounts until it has paid its applica- ble limit of insurance or none of the loss re- mains, whichever comes first. 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 in- surance of all insurers. 5. Premium Audit a. We will compute all premiums for this Cover- age Part in accordance with our rules and rates. b. Premium shown in this Coverage Part as ad- vance premium is a deposit premium only. At the close of each audit period we will compute the earned premium for that period. Audit pre- miums are due and payable on notice to the first Named Insured. If the sum of the advance and audit premiums paid for the policy period is greater than the earned premium, we will return the excess to the first Named Insured. c. The first Named Insured must keep records of the information we need for premium computa- tion, and send us copies at such times as we may request. Page 10 of 13 6. Representations By accepting this policy, you agree: a. The statements in the Declarations are accu- rate and complete; b. Those statements are based upon representa- tions you made to us; and c. We have issued this policy in reliance upon your representations. 7. Separation Of Insureds Except with respect to the Limits of Insurance, and any rights or duties specifically assigned in this Coverage Part to the first Named Insured, this in- surance applies: a. As if each Named Insured were the only Named Insured; and b. Separately to each insured against whom claim is made or "suit" is brought. 8. Transfer Of Rights Of Recovery Against Others To Us If the insured has rights to recover all or part of any payment 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. 9. When We Do Not Renew If we decide not to renew this Coverage Part, we will mail or deliver to the first Named Insured shown in the Declarations written notice of the nonrenewal not less than 30 days before the expi- ration date. If notice is mailed, proof of mailing will be sufficient proof of notice. SECTION V — DEFINITIONS 1. "Advertisement" means a notice that is broadcast or published to the general public or specific mar- ket segments about your goods, products or ser- vices for the purpose of attracting customers or supporters. 2. "Auto" means a land motor vehicle, trailer or semi- trailer designed for travel on public roads, including any attached machinery or equipment. But "auto" does not include "mobile equipment". 3. "Bodily injury" means bodily injury, sickness or disease sustained by a person, including death re- sulting from any of these at any time. 4. "Coverage territory" means: a. The United States of America (including its territories and possessions), Puerto Rico and Canada; aby. x Copyright, Insurance Services Office, Inc., e`4`9 Fz 4\ .F Gam" \r• W \�I� �a 1 PAG 00 01 07 98 ❑ Q�G b. International waters or airspace, provided the injury or damage does not occur in the course of travel or transportation to or from any place not included in a. above; or c. All parts of the world if: (1) The injury or damage arises out of: (a) Goods or products made or sold by you in the territory described in a, above; or (b) The activities of a person whose home is in the territory described in a. above, but is away for a short time on your busi- ness; and (2) The insured's responsibility to pay damages is determined in a "suit" on the merits, in the territory described in a. above or in a set- tlement we agree to. 5."Employee" includes a "leased worker". "Employee" does not include a "temporary worker". 6. "Executive officer" means a person holding any of the officer positions created by your charter, con- stitution, by-laws or any other similar governing document. 7 "Hostile fire" means one which becomes uncontrol- lable or breaks out from where it was intended to be. 8. "Impaired property" means tangible property, other than "your product" or "your work", that cannot be used or is less useful because: a. It incorporates "your product" or "your work" that is known or thought to be defective, defi- cient, inadequate or dangerous; or b. You have failed to fulfill the terms of a contract or agreement; if such property can be restored to use by: a. The repair, replacement, adjustment or re- moval of "your product" or "your work"; or b. Your fulfilling the terms of the contract or agreement. 9."Insured contract" means: a. A contract for a lease of premises. However, that portion of the contract for a lease of prem- ises that indemnifies any person or organiza- tion for damage by fire to premises while rented to you or temporarily occupied by you with permission of the owner is not an "insured con- tract" b. A sidetrack agreement; c. Any easement or license agreement, except in connection with construction or demolition op- erations on or within 50 feet of a railroad; d. An obligation, as required by ordinance, to indemnify a municipality, except in connection with work for a municipality; e. An elevator maintenance agreement; f. That part of any other contract or agreement pertaining to your business (including an in- demnification 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 dam- age" to a third person or organization. Tort li- ability means a liability that would be imposed by law in the absence of any contract or agreement. Paragraph f. does not include that part of any contract or agreement: (1) That indemnifies a railroad for "bodily injury" or "property damage" arising out of con- struction or demolition operations, within 50 feet of any railroad property and affecting any railroad bridge or trestle, tracks, road- beds, tunnel, underpass or crossing; (2) That indemnifies an architect, engineer or surveyor for injury or damage arising out of: (a) Preparing, approving, or failing to pre- pare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifi- cations; or (b) Giving directions or instructions, or fail- ing to give them, if that is the primary cause of the injury or damage; or (3) Under which the insured, if an architect, engineer or surveyor, assumes liability for an injury or damage arising out of the in- sured's rendering or failure to render pro- fessional services, including those listed in (2) above and supervisory, inspection, ar- chitectural or engineering activities. 10."Leased worker" means a person leased to you by a labor leasing firm under an agreement between you and the labor leasing firm, to perform duties related to the conduct of your business. "Leased worker" does not include a "temporary worker". 11.1oading or unloading" means the handling of property: a. After it is moved from the place where it is accepted for movement into or onto an aircraft, watercraft or "auto", b. While it is in or on an all atercraft or "auto" or c/ CG 00 01 07 98 Copyright, Insurance Services Office, Inc., 1997 Page 11 of 13 ❑ c. While it is being moved from an aircraft, water- 13."Occurrence" means an accident, including con - craft or "auto" to the place where it is finally de- tinuous or repeated exposure to substantially the livered; same general harmful conditions. but "loading or unloading" does not include the 14."Personal and advertising injury" means injury, movement of property by means of a mechanical including consequential "bodily injury", arising out device, other than a hand truck, that is not at- of one or more of the following offenses: tached to the aircraft, watercraft or "auto". a. False arrest, detention or imprisonment; 12."Mobile equipment" means any of the following b. Malicious prosecution; types of land vehicles, including any attached ma- c. The wrongful eviction from, wrongful entry into, chinery or equipment: or invasion of the right of private occupancy of a. Bulldozers, farm machinery, forklifts and other a room, dwelling or premises that a person oc- vehicles designed for use principally off public cupies, committed by or on behalf of its owner, roads; landlord or lessor; b. Vehicles maintained for use solely on or next to d. Oral or written publication of material that slan- premises you own or rent; ders or libels a person or organization or dis- c. Vehicles that travel on crawler treads; parages a person's or organization's goods, d. Vehicles, whether self-propelled or not, main- products or services; tained primarily to provide mobility to perma- e. Oral or written publication of material that vio- nently mounted: lates a person's right of privacy; (1) Power cranes, shovels, loaders, diggers or f. The use of another's advertising idea in your drills; or "advertisement" or (2) Road construction or resurfacing equipment g. Infringing upon another's copyright, trade dress such as graders, scrapers or rollers; or slogan in your "advertisement". e. Vehicles not described in a., b., c, or d, above 15."Pollutants" mean any solid, liquid, gaseous or that are not self-propelled and are maintained thermal irritant or contaminant, including smoke, primarily to provide mobility to permanently at- vapor, soot, fumes, acids, alkalis, chemicals and tached equipment of the following types: waste. Waste includes materials to be recycled, (1) Air compressors, pumps and generators, reconditioned or reclaimed. including spraying, welding, building clean- 16."Products-completed operations hazard": ing, geophysical exploration, lighting and a. Includes all "bodily injury" and "property dam - well servicing equipment; or age" occurring away from premises you own or (2) Cherry pickers and similar devices used to rent and arising out of "your product" or "your raise or lower workers; work" except: f. Vehicles not described in a., b., c. or d. above (1) Products that are still in your physical pos- maintained primarily for purposes other than session; or the transportation of persons or cargo. (2) Work that has not yet been completed or However, self-propelled vehicles with the fol- abandoned. However, "your work" will be lowing types of permanently attached equip- deemed completed at the earliest of the fol- ment are not "mobile equipment" but will be lowing times: considered "autos": (a) When all of the work called for in your (1) Equipment designed primarily for: contract has been completed. (a) Snow removal; (b) When all of the work to be done at the (b) Road maintenance, but not construction job site has been completed if your Con- or resurfacing; or tract calls for work at more than one job site. (c) Street cleaning; `0Jc) When th t part of the work done at a job (2) Cherry pickers and similar devices mounted �Q�d i, a een put to its intended use by on automobile or truck chassis and used to Q, �N person or organization other than raise or lower workers; and �1,6 either contractor or subcontractor (3) Air compressors, pumps and generators, including building 7 eJ 4r ling on the same project. Cr�What spraying, welding, clean- ing, exploration, lighting and may need service, maintenance, geophysical cJ��J�a orrection, repair or replacement, but which well servicing equipment.GGJ is otherwise complete, will be treated as ecompleted. Page 12 of 13 Copyright, Insurance Services Office, Inc., 1997 CG 00 01 07 98 ❑ b. Does not include "bodily injury" or "property damage" arising out of: (1) The transportation of property, unless the injury or damage arises out of a condition in or on a vehicle not owned or operated by you, and that condition was created by the "loading or unloading" of that vehicle by any insured; (2) The existence of tools, uninstalled equip- ment or abandoned or unused materials; or (3) Products or operations for which the classi- fication, listed in the Declarations or in a pol- icy schedule, states that products - completed operations are subject to the General Aggregate Limit. 17."Property damage" means: a. Physical injury to tangible property, including all resulting loss of use of that property. All such loss of use shall be deemed to occur at the time of the physical injury that caused it; or b. Loss of use of tangible property that is not physically injured. All such loss of use shall be deemed to occur at the time of the 'occur- rence" that caused it. 18."Suit' means a civil proceeding in which damages because of "bodily injury", "property damage" or "personal and advertising injury" to which this in- surance applies are alleged. "Suit' includes: a. An arbitration proceeding in which such dam- ages are claimed and to which the insured must submit or does submit with our consent; or b. Any other alternative dispute resolution pro- ceeding in which such damages are claimed and to which the insured submits with our con- sent. 19.'Temporary worker" means a person who is fur- nished to you to substitute for a permanent "em- ployee" on leave or to meet seasonal or short-term workload conditions. 20."Your product' means: a. Any goods or products, other than real prop- erty, manufactured, sold, handled, distributed or disposed of by: (1) You; (2) Others trading under your name; or (3) A person or organization whose business or assets you have acquired; and b. Containers (other than vehicles), materials, parts or equipment furnished in connection with such goods or products. "Your product" includes: a. Warranties or representations made at any time with respect to the fitness, quality, durabil- ity, performance or use of "your product; and b. The providing of or failure to provide warnings or instructions. "Your product" does not include vending machines or other property rented to or located for the use of others but not sold. 21. "Your work" means: a. Work or operations performed by you or on your behalf; and b. Materials, parts or equipment furnished in con- nection with such work or operations. "Your work" includes: a. Warranties or representations made at any time with respect to the fitness, quality, durabil- ity, performance or use of "your work"; and b. The providing of or failure to provide warnings or instructions. �ea.py. c P� CG 00 01 07 98 Copyright, Insurance Services Office, Inc., 1997 Page 13 of 13 ❑ THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. NONPROFITS' OWN ENHANCEMENT ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART Except where designated below, the terms of the coverage part to which this endorsement is attached apply to the insurance provided by this endorsement. I. SCHEDULE OF ADDITIONAL COVERAGES AND LIMITS The following is a summary of additional coverages and limits provided by this endorsement: Limit Non -owned Watercraft (up to 75 feet) N/A Supplementary Payments — Bail Bonds $5,000 Supplementary Payments — Investigation or Defense $1,000 / per day Newly Formed Entities - until end of policy period N/A Workplace Violence Counseling $50,000 Unsatisfied Contributions $25,000 Identity Theft Expense $30,000 Terrorism Travel Reimbursement $30,000 Kidnap Expense $50,000 Executive Recruitment Expense $50,000 Abuse of Process Included Damage to Property of Others $5,000 Occurrence/ $25,000 Aggregate V,ev\eked by . P� NPO -001 04 09 Page 1 of 5 ENDORSEMENT AGREEMENT CALIFORNIA SHORT -RATE CANCELATION HOME OFFICE SAN FRANCISCO EFFECTIVE JULY 1, 2015 AT 12.01 A.M. ALLEFFECTIVE DATESARE TO JULY 1, 2016 AT 12.01 A.M. AT 12:01 AM PACIFIC STANDARD TIME OR THE TIME INDICATED AT PACIFIC STANDARD TIME FRIENDS OF SANTA ANA ZOO 1801 E CHESTNUT AVE SANTA ANA, CA 92701 THE INSURANCE UNDER THIS POLICY IS LIMITED AS FOLLOWS - 9048876 -15 RENEWAL SP 3-68-03-58 PAGE 1 OF IT IS AGREED THAT ANYTHING IN THE POLICY TO THE CONTRARY NOTWITHSTANDING, SUCH INSURANCE AS IS AFFORDED BY THIS POLICY IS SUBJECT TO THE FOLLOWING PROVISIONS: IF YOU CANCEL THE POLICY AND A DISCLOSURE WAS PROVIDED IN ACCORDANCE WITH SECTION 481(C) OF THE CALIFORNIA INSURANCE CODE, FINAL PREMIUM WILL BE BASED ON THE TIME THIS POLICY WAS IN FORCE AND INCREASED BY THE SHORT -RATE CANCELATION TABLE BELOW: SHORT -RATE CANCELATION TABLE FINAL PREMIUM BASED ON THE TABLE BELOW WILL NOT BE LESS THAN THE MINIMUM PREMIUM FOR THIS POLICY. CO�NyTIIN� NOTHING IN THIS ENDORSEMENT CONTAINED SHALL BE HELD TO VARY, ALTER, yAp,'NE tr OR EXTEND ANY OF THE TERMS, CONDITIONS, AGREEMENTS, OR LIMITATIONS OF THIS POLICY OTHER THAN AS STATED. NOTHING ELSEWHERE IN THIS POLICY SHALL 8E HELD TO VARY, ALTER, WAIVE OR LIMIT THE TERMS, CONDITIONS, AGREEMENTS\�J\a' 15,1 LIMITATIONS OF THIS ENDORSEMENT. COUNTERSIGNED AND ISSUED AT SAN FRFRANCISCO: AUTHORIZED 11EPRESEN'� � FuIiVE SCID FORM 10217 (REV.7T2014) JUNE 26, 2015 F //Gt.•r,.,�� �.eer2.t1, PRESIDENT AND CEO 2029 OLD OF 217 DAYS = EXTENDED NUMBER OF DAYS % = PERCENTAGE OF FULL POLICY PREMIUM DAYS % DAYS % DAYS % 2 5°1. 2 6% 3-4 7% 5-6 8% 7--8 9% 9-10 10% 11-12 11% 13-14 12% 15-16 13% 17-18 14% 19-20 15% 21-22 16% 23-25 17% 26-29 18% 30-32 19% 33-36 20% 37-40 21% 41-43 22% 44-47 23% 48-51 24% 52-54 25% 55-58 26% 59-62 27% 63-65 28% CO�NyTIIN� NOTHING IN THIS ENDORSEMENT CONTAINED SHALL BE HELD TO VARY, ALTER, yAp,'NE tr OR EXTEND ANY OF THE TERMS, CONDITIONS, AGREEMENTS, OR LIMITATIONS OF THIS POLICY OTHER THAN AS STATED. NOTHING ELSEWHERE IN THIS POLICY SHALL 8E HELD TO VARY, ALTER, WAIVE OR LIMIT THE TERMS, CONDITIONS, AGREEMENTS\�J\a' 15,1 LIMITATIONS OF THIS ENDORSEMENT. COUNTERSIGNED AND ISSUED AT SAN FRFRANCISCO: AUTHORIZED 11EPRESEN'� � FuIiVE SCID FORM 10217 (REV.7T2014) JUNE 26, 2015 F //Gt.•r,.,�� �.eer2.t1, PRESIDENT AND CEO 2029 OLD OF 217 ENDORSEMENT AGREEMENT CALIFORNIA SHORT -RATE CANCELATION HOME OFFICE SAN FRANCISCO EFFECTIVE JULY 1, 2015 AT 12.01 A.N. ALL EFFECTIVE DATES ARE TO JULY 1, 2016 AT 12.01 A.N. AT 12:01 AM PACIFIC STANDARD TIME OR THE TIME INDICATED AT PACIFIC STANDARD TIME FRIENDS OF SANTA ANA ZOO 1801 E CHESTNUT AVE SANTA ANA, CA 92701 CONTINUED. 66-69 29% 70-73 30% 74-76 31% 77-80 32% 81-83 33% 84-87 34% 88-91 35% 92-94 36% 95-98 37% 99-102 38% 103-105 39% 106-109 40% 110-113 41% 114-116 42% 117-120 43% 121-124 44% 125-127 45% 128-131 46% 132-135 47% 136-138 48% 139-142 49% 143-146 50% 147-149 51% 150-153 52% 154-156 53% 157-160 54% 161-164 55% 165-167 56% 168-171' 57% 172-175 '58% 176-178 59% 179-182 60% 183-187 61% 188-191 62% 192-196 63% 197-200 64% 201-205 65% 206-209 66% 210-214 67% 215-218 68% 219-223 69% 224-228 70% 229-232 71% 233-237 72% 238-241 73% 242-246 74% 247-250 75% 251-255 76% 256-260 77% 261-264 78% 265-269 79% 270-273 80% 274-278 81% 279-282 82% 283-287 83% 288-291 84% 292-296 85% 297-301 86% 302-305 87% 306-310 88% 311-314 89% 315-319 90% 320-323 91% 324-328 92% 329-332 93% 333-937 94% 338-342 95% 343-346 96% 347-351 97% 352-355 98% 356-360 99% 361-365 100% 9048876-15 RENEWAL SP 3-68-03-58 PAGE 2 OF NOTHING IN THIS ENDORSEMENT CONTAINED SHALL BE HELD TO VARY, ALTER, WAIVE `f OR EXTEND ANY OF THE TERMS, CONDITIONS, AGREEMENTS, OR LIMITATIONS OF THIS POLICY OTHER THAN AS STATED. NOTHING ELSEWHERE IN THIS POLICY SHALL BE • �No HELD TO VARY, ALTER, WAIVE OR LIMIT THE TERMS, CONDITIONS, AGREEMENT -A LIMITATIONS OF THIS ENDORSEMENT. 7' AND ISSUED AT SAN FRANCISCO: JUNE 26, 2015�� r\`q\'c¢�It�(�.'C�\r 2029 AUTHORIZED REPRESENT IVE PRESIDENT AND CEO 2 HOME OFFICE SAN FRANCISCO ALL EFFECTIVE DATES ARE AT 12:01 AM PACIFIC STANDARD TIME OR THE TIME INDICATED AT PACIFIC STANDARD TIME ENDORSEMENT AGREEMENT STATUTORY ACCOUNTING PRINCIPLES BILL RECEIVABLE EFFECTIVE JULY 1, 2015 AT 12.01 A.M. FRIENDS OF SANTA ANA ZOO 1801 E CHESTNUT AVE SANTA ANA, CA 92701 9048876-15 RENEWAL SP 3-68-03-58 PAGE 1 OF ANY CONTRADICTION BETWEEN THE POLICY AND THIS ENDORSEMENT WILL BE CONTROLLED BY THIS ENDORSEMENT. IT IS AGREED THAT THIS ENDORSEMENT AMENDS SECTION D. OF PART FIVE OF THE POLICY, YOUR POLICY HAS BEEN WRITTEN ON 14ONTHLY ADJUSTMENT PERIOD. YOU WILL PAY ALL PREMIUM WHEN DUE. PAYROLL REPORTS AND PREMIUM ARE DUE WITHIN IO DAYS (TEN) AFTER THE LAST DAY OF THE REPORTING PERIOD. PAYMENT OF OUTSTANDING PREMIUM IS DUE WITHIN 10 DAYS (TEN) FROM THE BILL DATE. NOTHING IN THIS ENDORSEMENT CONTAINED SHALL BE HELD TO VARY, AGER, OR EXTEND ANY OF THE TERMS, CONDITIONS, AGREEMENTS, OR LIMITATIONS OF THIS POLICY OTHER THAN AS STATED. NOTHING ELSEWHERE IN THIS POLICY SHALL BE HELD TO VARY, ALTER, WAIVE OR LIMIT THE TERMS, CONDITIONS, AGREEMENTS OR LIMITATIONS OF THIS ENDORSEMENT. 1 COUNTERSIGNED AND ISSUED AT SAN /FRANCISCO: JUNE 26, 2015 AUTHORIZED REPflESEN`2C PRESIDENT AND CEO 2089 SCIF FORM 10217 (REV.7.2014) OLD OF 217 HOME OFFICE SAN FRANCISCO ALL EFFECTIVE DATES ARE AT 12x1 AM PACIFIC STANDARD TIME OR THE TIME INDICATED AT PACIFIC STANDARD TIME ENDORSEMENT AGREEMENT MEDICAL PROVIDER NETWORK EFFECTIVE JULY 1, 2015 AT 12,01 A.M FRIENDS OF SANTA ANA ZOO 1801 E CHESTNUT AVE SANTA'ANA, CA 92701 9048876-15 RENEWAL SP 3--68-03-58 PAGE 1 OF ANY CONTRADICTION BETWEEN THE POLICY AND THIS ENDORSEMENT WILL BE CONTROLLED BY THIS ENDORSEMENT. THE STATE COMPENSATION INSURANCE FUND MEDICAL PROVIDER NETWORK IS ESTABLISHED IN ACCORDANCE WITH CALIFORNIA LABOR CODE 4600 ET SEQ AND APPROVED BY THE CALIFORNIA DIVISION OF WORKERS' COMPENSATION ADMINISTRATIVE DIRECTOR. THE INTENT OF THE 2004 LEGISLATION REQUIRING THE ESTABLISHMENT OF THE MEDICAL PROVIDER NETWORK IS INCREASED EMPLOYER CONTROL OVER THE COSTS OF'TREATING'EMPLOYEE'WORK RELATED INJURIES AND DISEASE. PART FOUR OF THE POLICY, YOUR DUTIES IF INJURY OCCURS, IS AMENDED AS FOLLOWS, IT IS AGREED THAT THE POLICYHOLDER SHALL REFER ALL WORK RELATED INJURIES OR DISEASE TO THE STATE COMPENSATION INSURANCE FUND MEDICAL PROVIDER NETWORK AT THE TIME OF AN OCCUPATIONAL INJURY OR UPON KNOWLEDGE OF AN OCCUPATIONAL INJURY OR DISEASE. IT IS FURTHER AGREED THAT WHEN AN EMPLOYEE NOTIFIES THE POLICYHOLDER OF AN OCCUPATIONAL INJURY OR FILES A CLAIM FOR WORKERS' COMPENSATION WITH THE POLICYHOLDER, THE POLICY- HOLDER SHALL ARRANGE AN INITIAL MEDICAL EVALUATION AND BEGIN TREATMENT WITHIN THE MEDICAL PROVIDER NETWORK. THE POLICYHOLDER SHALL NOTIFY THE EMPLOYEE OF HIS OR HER RIGHT CONTINUED NOTHING IN THIS ENDORSEMENT CONTAINED SHALL BE HELD TO VARY, ALTER, WAIVE OR EXTEND ANY OF THE TERMS, CONDITIONS, AGREEMENTS, OR LIMITATIONS OF THIS POLICY OTHER THAN AS STATED. NOTHING ELSEWHERE IN THIS POLICY SHAL,A..e L\ C)'' HELD TO' VARY, ALTER, WAIVE OR LIMIT THE TERMS, CONDITIONS, AGHEEMEN''�K§§.. R lv" LIMITATIONS OF THIS ENDORSEMENT. ( �0q42116\� COUNTERSIGNED AND ISSUED AT SAN FRANCISCO: JUNE 26, 2015a 2437 AUTHORIZED HEPRESEIV�tC..A?i"iVE PRESIDENT AND CEO r n , 3 HOME OFFICE SAN FRANCISCO ALLEFFECTIVE DATES ARE AT 1241 AM PACIFIC STANDARD TIME OR THE TIME INDICATED AT PACIFIC STANDARD TIME ENDORSEMENT AGREEMENT MEDICAL PROVIDER NETWORK EFFECTIVE JULY 1, 2015 AT 12.01 A.M. FRIENDS OF SANTA ANA ZOO 1801 E CHESTNUT AVE SANTA ANA, CA 92701 CONTINUED. 9048676-15 RENEWAL SP 3-68-03-58 PAGE 2 OF TO BE TREATED BY A PHYSICIAN OF HIS OR HER CHOICE FROM WITHIN THE MEDICAL PROVIDER NETWORK AFTER THE FIRST VISIT. THE POLICYHOLDER SHALL NOTIFY EMPLOYEE OF THE METHOD BY WHICH THE LIST OF PARTICIPATING PROVIDERS MAY BE ACCESSED BY EMPLOYEES. IT IS FURTHER AGREED THAT IF AN INJURED EMPLOYEE DISPUTES EITHER THE DIAGNOSIS OR THE TREATMENT PRESCRIBED BY THE TREATING PHYSICIAN, THE EMPLOYEE MAY SEEK THE OPINION OF - ANOTHER PHYSICIAN WITHIN THE MEDICAL PROVIDER NETWORK.. IF THE INJURED EMPLOYEE DISPUTES THE DIAGNOSIS OR TREATMENT PRESCRIBED BY THE SECOND PHYSICIAN, THE EMPLOYEE MAY SEEK THE OPINION OF A THIRD PHYSICIAN WITHIN THE MEDICAL PROVIDER NETWORK, IT IS FURTHER AGREED THAT THIS ENDORSEMENT IN NO WAY AFFECTS THE RIGHTS OF AN INJURED WORKER TO PREDESIGNATE A PHYSICIAN. AN EMPLOYEE MUST FILE WRITTEN NOTICE OF THE PREDESIGNATION WITH THE EMPLOYER PRIOR TO THE DATE OF INJURY. THE NOTICE MUST INCLUDE THE PHYSICIAN'S SIGNATURE OF AGREEMENT TO THE PREDESIGNATION, AND THE FOLLOWING CONDITIONS MUST APPLY; THE PHYSICIAN IS THE EMPLOYEE'S REGULAR PHYSICIAN. THE PHYSICIAN IS THE EMPLOYEE'S PRIMARY CARE PROVIDER WHO HAS PREVIOUSLY DIRECTED THE MEDICAL TREATMENT OF THE d��e CONI�1 7 3 NOTHING IN THIS ENDORSEMENT CONTAINED SHALL BE HELD TO VARY, ALTER, 110WAIVE '�t'•'�\'C\` OR EXTEND ANY OF THE TERMS, CONDITIONS, AGREEMENTS, OR LIMITATIONS OF THIS ,S\- �� POLICY OTHER THAN AS STATED, NOTHING ELSEWHERE IN THIS POLICY SHAL".0\r HELD TO VARY, ALTER, WAIVE OR LIMIT THE TERMS, CONDITIONS, AGREEMEN s OR LIMITATIONS OF THIS ENDORSEMENT. COUNTERSIGNED AND ISSUED AT SAN FRANCISCO: 11 AUTHORIZED REPRESENT IVE SCIF FORM 10217 IREV,7.2014I JUNE 26, 2015 PRESIDENT AND CEO 2437 OLD OP 217 HOME OFFICE SAN FRANCISCO ALL EFFECTIVE DATES ARE AT 12:01 AM PACIFIC STANDARD TIME OR THE TIME INDICATED AT PACIFIC STANDARD TIME ENDORSEMENT AGREEMENT MEDICAL PROVIDER NETWORK EFFECTIVE JULY 1, 2015 AT 12.01 A.M FRIENDS OF SANTA ANA ZOO 1801 E CHESTNUT AVE SANTA ANA, CA 92701 CONTINUED. 9048876-15 RENEWAL SP 3-68-03-58 PAGE 3 OF EMPLOYEE AND RETAINS RECORDS OF THE TREATMENT AND MEDICAL HISTORY. THE EMPLOYER PROVIDES THE STAFF WITH NONOCCUPATIONAL GROUP HEALTH COVERAGE IN A HEALTH-CARE SERVICE PLAN (SUCH AS AN HMO/PPO PROGRAM). OR THE EMPLOYER PROVIDES NONOCCUPATIONAL HEALTH COVERAGE IN A GROUP HEALTH PLAN OR A GROUP HEALTH INSURANCE POLICY, PER LABOR CODE 4616.7. NOTHING IN THIS ENDORSEMENT CONTAINED SHALL BE HELD TO VARY, ALTER, W�AIV NS 7,F�G�,�I OR EXTEND ANY OF THE TERMS, CONDITIONS, AGREEMENTS, OR LIMITATIOQ�- POLICY OTHER THAN AS STATED, NOTHING ELSEWHERE IN THIS POLICY SHA L BE HELD TO VARY, ALTER, WAIVE OR LIMIT THE TERMS, CONDITIONS, AGREEMENTS OR LIMITATIONS OF THIS ENDORSEMENT. I - 16G �r COUNTERSIGNED AND ISSUED AT SANNFRFRANCISCO: JUNE 26, 2015 ��� GfM I« -,../.•... 2437 AUTFIORIZED REPRESENT IVE PRESIDENT AND CEO _ 3 JUNE 26, 2015 FRIENDS OF SANTA ANA ZOO 1801 E CHESTNUT AVE SANTA ANA, CA 92701 Dear Policyholder IN REPLY REFER T0: 9048876-15 Thank you for choosing us as your workers' compensation insurance carrier. This package contains your renewal documents as listed on the following page. Please keep these together. Our goal is to provide you with fast, efficient, and the most convenient service possible. We truly appreciate your business. If you have any questions about the information in this mailing, please contact your broker of record or your local State Compensation Insurance Fund office. State Compensation Insurance Fund G�PIN(NO 0 5880 Owens Or . Pleasanton, CA 94588-3900 Mailing Address: P.O. Box 8192 . Pleasanton, CA 94588-8792 IN REPLY REFER TO: 9048876-15 WORKERS' COMPENSATION AND EMPLOYER'S LIABILITY INSURANCE POLICY STATE COMPENSATION INSURANCE FUND Forms and Endorsements Applicable List Policy FORM NUMBER FORM DESCRIPTION 10963A ANNUAL RATING ENDORSEMENT 10217 2029 -ENDORSEMENT AGREEMENT - CALIFORNIA SHORT -RATE CANCELATION 10217 2089 -ENDORSEMENT AGREEMENT - STATUTORY ACCOUNTING PRINCIPLES - BILL RECEIVABLE 10217 2437 -ENDORSEMENT AGREEMENT - MEDICAL PROVIDER NETWORK ENDORSEMENT 10217 2559A -ENDORSEMENT AGREEMENT - TERRORISM RISK INSURANCE PROGRAM REAUTHORIZATION ACT OF 2015 10217 3015 -ENDORSEMENT AGREEMENT - EXECUTIVE OFFICERS - MINIMUM/MAXIMUM LIMITS 10610D POLICY HOLDER NOTICE 15302 POLICY DIVIDEND DISCLOSURE STATEMENT \�J ,GgP�P�t� 5880 Owens Dr . Pleasanton, CA 94588-3900 . Mailinq Address: P.O. Box 8192 . Pleasanton, CA 94588-8792 ENDORSEMENT AGREEMENT TERRORISM RISK INSURANCE PROGRAM REAUTHORIZATION ACT OF 2015 HOME OFFICE SAN FRANCISCO EFFECTIVE JULY 1, 2015 AT 12.01 A.M. ALL EFFECTIVE DATES ARE TO JULY 1, 2016 AT 12,01 A.M. AT 92:01 AM PACIFIC STANDARD TIME OR THE TIME INDICATED AT PACIFIC STANDARD TIME FRIENDS OF SANTA ANA ZOO 1801 E CHESTNUT AVE SANTA ANA, CA 92701 9048876-15 RENEWAL SP 3-68-03-58 PAGE 1 OF THIS ENDORSEMENT ADDRESSES THE REQUIREMENTS OF THE TERRORISM RISK INSURANCE ACT OF 2002 AS AMENDED AND EXTENDED BY THE TERRORISM RISK INSURANCE PROGRAM REAUTHORIZATION ACT OF 2015. IT SERVES TO NOTIFY YOU OF CERTAIN LIMITATIONS UNDER THE ACT, AND THAT YOUR INSURANCE CARRIER IS CHARGING PREMIUM FOR LOSSES THAT MAY OCCUR IN THE EVENT OF AN ACT OF TERRORISM. YOUR POLICY PROVIDES COVERAGE FOR WORKERS COMPENSATION LOSSES CAUSED BY ACTS OF TERRORISM, INCLUDING WORKERS COMPENSATION -..BENEFIT OBLIGATIONS- DIC'T'ATED BY STATE LAW... COVERAGE FOR SUCH LOSSES IS STILL SUBJECT TO ALL TERMS, DEFINITIONS, EXCLUSIONS, AND CONDITIONS IN YOUR POLICY, AND ANY APPLICABLE FEDERAL AND/OR STATE LAWS, RULES, OR REGULATIONS. DEFINITIONS THE DEFINITIONS PROVIDED IN THIS ENDORSEMENT ARE BASED ON AND HAVE THE SAME MEANING AS THE DEFINITIONS IN THE ACT. IF WORDS OR PHRASES NOT DEFINED IN THIS ENDORSEMENT ARE DEFINED IN THE ACT, THE DEFINITIONS IN THE ACT WILL APPLY. 5 "ACT" MEANS THE TERRORISM RISK INSURANCE ACT OF 2002, WHICH TOOK EFFECT ON NOVEMBER 26, 2002, AND ANY AMENDMENTS THERETO, INCLUDING ANY AMENDMENTS RESULTING FROM THE TERRORISM RISK INSURANCE PROGRAM REAUTHORIZATION ACT OF 2015. CCNTIIpN,,,� NOTHING IN THIS ENDORSEMENT CONTAINED SHALL BE HELD TO VARY, ALTER, WgI a$ OR EXTEND ANY OF THE TERMS, CONDITIONS, AGREEMENTS, OR LIMITATIONS OF POLICY OTHER THAN AS STATED. NOTHING ELSEWHERE IN THIS POLICY SHALL B,Fsr„•,�JYZn`l�(�f� HELD TO VARY, ALTER, WAIVE OR LIMIT THE TERMS, CONDITIONS, AGREEMEOR LIMITATIONS OF THIS ENDORSEMENT. COUNTERSIGNED AND ISSUED AAT/SAN /FRANCISCO: JUNE 26, 2015 AUTHORIZED REPRESENT IVE PRESIDENT AND CEO 2559A SCIF FORM 10217 (REV.7-2014} OLD OF 217 ENDORSEMENT AGREEMENT TERRORISM RISK 'INSURANCE PROGRAM REAUTHORIZATION ACT OF 2015 HOME OFFICE SAN FRANCISCO EFFECTIVE JULY 1, 2015 AT 12.01 A.M. ALL EFFECTIVE DATES ARE TO JULY 1, 2016 AT 12.01 A.M. AT 12:01 AM PACIFIC STANDARD TIME OR THE TIME INDICATED AT PACIFIC STANDARD TIME FRIENDS OF SANTA ANA ZOO 1801 E CHESTNUT AVE SANTA ANA, CA 92701 CONTINUED. 9048876-15 RENEWAL SP 3-68-03-58 PAGE 2 OF "ACT OF TERRORISM" MEANS ANY ACT THAT IS CERTIFIED BY THE SECRETARY OF THE TREASURY, IN CONSULTATION WITH THE SECRETARY OF HOMELAND SECURITY, AND THE ATTORNEY GENERAL OF THE UNITED STATES AS MEETING ALL OF THE FOLLOWING REQUIREMENTS: A. THE ACT IS AN ACT OF TERRORISM. B. THE ACT IS VIOLENT OR DANGEROUS TO HUMAN LIFE, PROPERTY OR INFRASTRUCTURE. C. THE ACT RESULTED IN DAMAGE WITHIN THE UNITED STATES, OR OUTSIDE OF THE UNITED STATES IN THE CASE OF THE PREMISES OF UNITED STATES MISSIONS OR CERTAIN AIR CARRIERS OR VESSELS. D. THE ACT HAS BEEN COMMITTED BY AN INDIVIDUAL OR INDIVIDUALS AS PART OF AN EFFORT TO COERCE THE CIVILIAN POPULATION OF THE UNITED STATES OR TO INFLUENCE THE POLICY OR AFFECT THE CONDUCT OF THE UNITED STATES GOVERNMENT BY COERCION. "INSURED LOSS" MEANS ANY LOSS RESULTING FROM AN ACT OF TERRORISM (AND, EXCEPT FOR PENNSYLVANIA, INCLUDING AN ACT OF WAR, IN THE CASE OF WORKERS COMPENSATION) THAT IS COVERED BY PRIMARY OR EXCESS PROPERTY AND CASUALTY INSURANCE ISSUED BY AN INSURER IF THE LOSS OCCURS IN THE UNITED STATES OR AT THE PREMISES OF UNITED STATES MISSIONS OR TO CERTAIN AIR CARRIERS OR VESSELS. E CONTINUED NOTHING IN THIS ENDORSEMENT CONTAINED SHALL BE HELD TO VARY, ALTER, WAIVE ,�Q,C��� OR EXTEND ANY OF THE TERMS, CONDITIONS, AGREEMENTS, OR LIMITATIONS OF POLICY OTHER THAN AS STATED. NOTHING ELSEWHERE IN THIS POLICY SHAD HELD TO VARY, ALTER, WAIVE OR LIMIT THE TERMS, CONDITIONS, AGREEMENTS OR Ja.S LIMITATIONS OF THIS ENDORSEMENT. Cj�e' o\N COUNTERSIGNED AND ISSUED AT SAN FRANCISCO: JUNE 26, 2015��' Q�G� �� /Gy�,•,� ,r«•w. 2559A AUTHORIZED REPRESENJ2 PRESIDENT AND CEO ENDORSEMENT AGREEMENT TERRORISM RISK INSURANCE PROGRAM REAUTHORIZATION ACT OF 2015 HOME OFFICE SAN FRANCISCO EFFECTIVE JULY 1, 2015 AT 12.01 A.M. ALL EFFECTIVE DATESARE TO JULY 1, 2016 AT 12.01 A.M. AT 12.02 AM PACIFIC STANDARD TIME OR THE TIME INDICATED AT PACIFIC STANDARD TIME FRIENDS OF SANTA ANA ZOO 1801 E CHESTNUT AVE SANTA ANA, CA 92701 CONTINUED. "INSURER DEDUCTIBLE" MEANS, FOR THE PERIOD BEGINNING ON JANUARY 1, 2015, AND ENDING ON DECEMBER 31, 2020, AN AMOUNT EQUAL TO 20% OF OUR DIRECT EARNED PREMIUMS, DURING THE IMMEDIATELY PRECEDING CALENDAR YEAR. LIMITATION OF LIABILITY 9048876-15 RENEWAL SP 3-68-03-58 PAGE 3 OF THE ACT LIMITS OUR LIABILITY TO YOU UNDER THIS POLICY. IF AGGREGATE INSURED LOSSES EXCEED $100,000,000,000 IN A CALENDAR YEAR AND IF WE HAVE MET OUR INSURER DEDUCTIBLE, WE ARE NOT LIABLE FOR THE PAYMENT OF ANY PORTION OF THE AMOUNT OF INSURED LOSSES THAT EXCEEDS $100,000,000,000; AND FOR AGGREGATE INSURED LOSSES UP TO $100,000,000,000, WE WILL PAY ONLY A PRO RATA SHARE OF SUCH INSURED LOSSES AS DETERMINED BY THE SECRETARY OF THE TREASURY. POLICYHOLDER DISCLOSURE NOTICE 1. INSURED LOSSES WOULD BE PARTIALLY REIMBURSED BY THE UNITED STATES GOVERNMENT. IF THE AGGREGATE INDUSTRY INSURED LOSSES EXCEED: E A. $100,000,000, WITH RESPECT TO SUCH INSURED LOSSES OCCURRING IN CALENDAR YEAR 2015, THE UNITED STATES GOVERNMENT WOULD PAY 85% OF OUR INSURED LOSSES THAT EXCEED OUR INSURER DEDUCTIBLE. CONTINUEe,,oe . e,4\ NOTHING IN THIS ENDORSEMENT CONTAINED SHALL BE HELD TO VARY, ALTER, WAIF C -i 1 OR EXTEND ANY OF THE TERMS, CONDITIONS, AGREEMENTS, OR LIMITATIONS OF THIS a POLICY OTHER THAN AS STATED. NOTHING ELSEWHERE IN THIS POLICY SHALL BE r �✓ \�° HELD TO VARY, ALTER, WAIVE OR LIMIT THE TERMS, CONDITIONS, AGREEMENT,os'r�\�a\ LIMITATIONS OF THIS ENDORSEMENT. r��I COUNTERSIGNED AND ISSUEDD AATSAN FRANCISCO: JUNE 26, 2015�� AUTHORIZED REPRESENT IVE PRESIDENT AND CEO 2559A SCIF fORM 10217 (3EV.7-2014) OLD OP 217 CONTINUED. B. $120,000,000, WITH RESPECT TO SUCH INSURED LOSSES OCCURRING IN CALENDAR YEAR 2016, THE UNITED STATES GOVERNMENT WOULD PAY 84% OF OUR INSURED LOSSES THAT EXCEED OUR INSURER DEDUCTIBLE. C. $140,000,000, WITH RESPECT TO SUCH INSURED LOSSES OCCURRING IN CALENDAR YEAR 2017, THE UNITED STATES GOVERNMENT WOULD PAY 83% OF OUR INSURED LOSSES THAT EXCEED OUR INSURER DEDUCTIBLE. D. $160,000,000, WITH RESPECT TO SUCH INSURED LOSSES OCCURRING IN CALENDAR YEAR 2018, THE UNITED STATES GOVERNMENT WOULD PAY 82% OF OUR. INSURED LOSSES THAT EXCEED OUR INSURER DEDUCTIBLE. E. $180,000,000, WITH RESPECT TO SUCH INSURED LOSSES OCCURRING IN CALENDAR YEAR 2019, THE UNITED STATES GOVERNMENT WOULD PAY 81% OF OUR INSURED LOSSES THAT EXCEED OUR INSURER DEDUCTIBLE. F. $200,000,000, WITH RESPECT TO SUCH INSURED LOSSES OCCURRING IN CALENDAR YEAR 2020, THE UNITED STATES GOVERNMENT WOULD PAY 80% OF OUR INSURED LOSSES THAT EXCEED OUR INSURER DEDUCTIBLE. CONTINUED e6�]e NOTHING IN THIS ENDORSEMENT CONTAINED SHALL BE HELD TO VARY, ALTER, WADI\e ', OR EXTEND ANY OF THE TERMS, CONDITIONS, AGREEMENTS, OR LIMITATIONS OTHERPOLICY SNOTHING POLICY HELD TO VARY, ALTER, WAIVE OR LIMIT THE TERMS, CONDITIONS, AGREEMENTS OR LIMITATIONS OF THIS ENDORSEMENT. COUNTERSIGNED AND ISSUED AT SAN FRANCISCO: JUNE 26, 2015 2559A AUTHORIZED REPRESENT IVE PRESIDENT AND CEO ENDORSEMENT AGREEMENT TERRORISM RISK INSURANCE PROGRAM REAUTHORIZATION ACT OF 2015 9048876-15 RENEWAL SP HOME OFFICE 3-68-03-58 SAN FRANCISCO EFFECTIVE JULY 1, 2015 AT 12.01 A.M. PAGE 4 OF 5 ALLEFFECTIVE DATESARE TO JULY 1, 2016 AT 12.01 A.M. AT 12:01 AM PACIFIC STANDARD TIME OR THE TIME INDICATED AT PACIFIC STANDARD TIME FRIENDS OF SANTA ANA ZOO 1801 E CHESTNUT AVE SANTA ANA, CA 92701 CONTINUED. B. $120,000,000, WITH RESPECT TO SUCH INSURED LOSSES OCCURRING IN CALENDAR YEAR 2016, THE UNITED STATES GOVERNMENT WOULD PAY 84% OF OUR INSURED LOSSES THAT EXCEED OUR INSURER DEDUCTIBLE. C. $140,000,000, WITH RESPECT TO SUCH INSURED LOSSES OCCURRING IN CALENDAR YEAR 2017, THE UNITED STATES GOVERNMENT WOULD PAY 83% OF OUR INSURED LOSSES THAT EXCEED OUR INSURER DEDUCTIBLE. D. $160,000,000, WITH RESPECT TO SUCH INSURED LOSSES OCCURRING IN CALENDAR YEAR 2018, THE UNITED STATES GOVERNMENT WOULD PAY 82% OF OUR. INSURED LOSSES THAT EXCEED OUR INSURER DEDUCTIBLE. E. $180,000,000, WITH RESPECT TO SUCH INSURED LOSSES OCCURRING IN CALENDAR YEAR 2019, THE UNITED STATES GOVERNMENT WOULD PAY 81% OF OUR INSURED LOSSES THAT EXCEED OUR INSURER DEDUCTIBLE. F. $200,000,000, WITH RESPECT TO SUCH INSURED LOSSES OCCURRING IN CALENDAR YEAR 2020, THE UNITED STATES GOVERNMENT WOULD PAY 80% OF OUR INSURED LOSSES THAT EXCEED OUR INSURER DEDUCTIBLE. CONTINUED e6�]e NOTHING IN THIS ENDORSEMENT CONTAINED SHALL BE HELD TO VARY, ALTER, WADI\e ', OR EXTEND ANY OF THE TERMS, CONDITIONS, AGREEMENTS, OR LIMITATIONS OTHERPOLICY SNOTHING POLICY HELD TO VARY, ALTER, WAIVE OR LIMIT THE TERMS, CONDITIONS, AGREEMENTS OR LIMITATIONS OF THIS ENDORSEMENT. COUNTERSIGNED AND ISSUED AT SAN FRANCISCO: JUNE 26, 2015 2559A AUTHORIZED REPRESENT IVE PRESIDENT AND CEO ENDORSEMENT AGREEMENT TERRORISM RISK INSURANCE PROGRAM REAUTHORIZATION ACT OF 2015 HOME OFFICE SAN FRANCISCO EFFECTIVE JULY 1, 2015 AT 12.01 A.M. ALLEFFECTIVE DATESARE TO JULY 1, 2016 AT 12.01 A.M. AT 12;01 AM PACIFIC STANDARD TIME OR THE TIME INDICATED AT PACIFIC STANDARD TIME FRIENDS OF SANTA ANA ZOO 1801 E CHESTNUT AVE SANTA ANA, CA 92701 CONTINUED. 9048876-15 RENEWAL SP 3-68-03-58 PAGE 5 OF 2. NOTWITHSTANDING ITEM 1 ABOVE, THE UNITED STATES GOVERNMENT WILL NOT MAKE ANY PAYMENT UNDER THE ACT FOR ANY PORTION OF INSURED LOSSES THAT EXCEED $100,000,000,000. 3. THE PREMIUM CHARGE FOR THE COVERAGE YOUR POLICY PROVIDES FOR INSURED LOSSES IS INCLUDED IN THE AMOUNT SHOWN IN ITEM 4 OF THE INFORMATION PAGE OR IN THE SCHEDULE BELOW. THIS ENDORSEMENT CHANGES THE POLICY TO WHICH IT IS ATTACHED AND IS EFFECTIVE ON THE DATE ISSUED UNLESS OTHERWISE STATED. WC 00 04 22 B NOTHING IN THIS ENDORSEMENT CONTAINED SHALL BE HELD TO VARY, ALTER, VWEI��t OR .EXTEND ANY OF THE TERMS, CONDITIONS, AGREEMENTS, OR LIMITATIONS OF THIS �' 5 POLICY OTHER THAN AS STATED. NOTHING ELSEWHERE IN THIS POLICY SHALL BE HELD EL LIMITAVARY, ALTER, WAIVE TIONS OF THIS ENDORSEMENT, LIMIT THE TERMS, CONDITIONS, AGREEMENTS COUNTERSIGNED AND jISSUED DAAT' SAN FRANCISCO: AUTHORIZED REPRESENT IVE SCIF FORM 10217 (REVJ-2014) 10 JUNE 26, 2015 5 PRESIDENT AND CEO 2559A OLD OP 217 HOME OFFICE SAN FRANCISCO ALL EFFECTIVE DATES ARE AT 12:01 AM PACIFIC STANDARD TIME OR THE TIME INDICATED AT PACIFIC STANDARD TIME ENDORSEMENT AGREEMENT EXECUTIVE OFFICERS MINIMUM MAXIMUM LIMITS EFFECTIVE JULY 1, 2015 AT 12.01 A.M. FRIENDS OF SANTA ANA ZOO 1801 E CHESTNUT AVE SANTA ANA, CA 92701 9048876-15 RENEWAL SP 3-68-03-58 PAGE 1 OF ANY CONTRADICTION BETWEEN THE POLICY AND THIS ENDORSEMENT WILL BE CONTROLLED BY THIS ENDORSEMENT. IT IS AGREED THAT UNLESS OTHERWISE EXCLUDED BY ENDORSEMENT THE ACTUAL REMUNERATION EARNED BY EACH EXECUTIVE OFFICER DURING THE POLICY PERIOD SHALL. BE USED AS THE BASIS OF PREMIUM, SUBJECT TO THE MINIMUM AMOUNT OF $ 44,200 PER ANNUM AND THE MAXIMUM AMOUNT OF $ 111,800 PER ANNUM AS SPECIFIED IN THE CALIFORNIA WORKERS" COMPENSATION UNIFORM STATISTICAL REPORTING PLAN, FOR WORKERS` COMPENSATION INSURANCE IN EFFECT DURING THE POLICY PERIOD. 1 NOTHING IN THIS ENDORSEMENT CONTAINED SHALL BE HELD TO VARY, ALTER, CtRI OR EXTEND ANY OF THE TERMS, CONDITIONS, AGREEMENTS, OR LIMITATIONS O S POLICY OTHER THAN AS STATED, NOTHING ELSEWHERE IN THIS POLICY SHALL BE J�ca i✓ HELD TO VARY, ALTER, WAIVE OR LIMIT THE LIMITATIONS OF THIS ENDORSEMENT. TERMS, CONDITIONS, AGREEMENTS OR r^ u COUNTERSIGNED AND ISSUED AT SAWN, FRANCISCO: JUNE 26, 2015 3 015 AUTHORIZED REPRESENT IVE PRESIDENT AND CEO R CIC C110M 1091] lP9V 7-9O\AI OLI1 DP 217 9048876-15 Dear Policyholder: These endorsements amend and are part of your policy. Please Keep them with your documents for future reference. If you have any questions concerning these endorsements, Please contact your local State Fund a-ffice. 5�\�`�a GUPdm\r P POLICYHOLDER NOTICE Page 1 of 3 YOUR RIGHT TO RATING AND DIVIDEND INFORMATION PN 04 99 01 F (Ed. 03-15) FRIENDS OF SANTA ANA ZOO 1801 E CHESTNUT AVE SANTA ANA, CALIF 92701 POLICY NO. 9048876-15 NR SP Information Available to You. A. Information Available from Us -State Compensation Insurance Fund (1) General questions regarding your policy should be directed to: State Fund, Customer Service Center 1020 Vaquero Circle Vacaville, CA 95688 Telephone: 888-782-8338 (2) Dividend Calculation. If this is a participating policy (a policy on which a dividend may be paid), upon payment or non-payment of a dividend, we shall provide a written explanation to you that sets forth the basis of the dividend calculation. The explanation will be in clear, understandable language and will express the dividend as a dollar amount and as a percentage of the earned premium for the policy year on which the dividend is calculated. (3) ClaimsInformatioii: Pursuant`to Sections 3761 and 3762 or""the California Labor Code, `you are entitled to receive information in our claim files that affects your premium. Copies of documents will be supplied at your expense during reasonable business hours. For claims covered under this policy, we will estimate the ultimate cost of unsettled claims for statistical purposes eighteen months after the policy becomes effective and will report those estimates to the Workers' Compensation Insurance Rating Bureau of California (WCIRB) no later than twenty months after the policy becomes effective. The cost of any settled claims will also be reported at that time. At twelve-month intervals thereafter, we will update and report to the WCIRB the estimated cost of any unsettled claims and the actual final cost of any claims settled in the interim.The amounts we report will be used by the WCIRB to compute your experience modification if you are eligible for experience rating. B. Information Available from the Workers' Compensation Insurance Rating Bureau of California (1) The WCIRB is a licensed rating organization and the California Insurance Commissioner's designated statistical agent. As such, the WCIRB is responsible for administering the California Workers' Compensation Uniform Statistical Reporting Plan-4995(USRP) and the California Workers'Compensation Experience Rating Plan— I 995(ERP). Contact information for the WCIRB is: WCIRB, 1221 Broadway, Suite 900, Oakland, California 94612, Attention: Customer Service. You may also contact WCIRB Customer Service at 1.888-229-2472, by fax at 415-778-7272, or via the Internet at the WCIRB's website: http:/Iwww.wcirb.com. The regulations contained in the USRP and the ERP are available for PO4f"ic,� viewing through the WCIRB's website. (2) Policyholder Information. Pursuant to California Insurance Code (CIC) Secti52.6, upon w' n request, you are entitled to information relating to loss experience, claims, classification assign . and policy contracts as well as rating plans, rating systems, manual rules, or other information ' fir premium that is maintained in the records of the WCIRB. Complaints and Requests f i9 policyholder information should be forwarded to: WCIRB, 1221 Broadway, Suit �� P California 94612, Attention: Custodian of Records. The Custodian of Record can be �g �d by telephone at 415-777-0777 and by fax at 415-778.7272. 0 POLICYHOLDER NOTICE Your Right to Rating and Dividend Information (3) iM Page 2 of 3 POLICY NO. 9048876-15 NR SP Experience Rating Form. Each experience rated risk may receive a single copy of Its current Experience Rating Form free of charge by completing a Policyholder Rate Sheet Request Form on the WCIRB's website at http://wcirb.com/ratesheet. The Experience Rating Form will include a Loss -Free Rating, which is the experience modification that would have been calculated if $0 (zero) actual losses were incurred during the experience period. This hypothetical rating calculation is provided for informational purposes only, Dispute Process You may dispute our actions or the actions of the WCIRB pursuant to CIC Sections 11737 and 11753.1. Our Dispute Resolution Process. You may request in writing that we reconsider a change in a classification assignment that results in an increased premium. You may also request, in writing, that we review the manner in which our rating system has been applied in connection with the insurance afforded or offered you. Written requests that we reconsider or review our actions should be forwarded to: State Compensation Insurance Fund, Attention: Manager, Customer Assistance Program, 5880 Owens Drive, Pleasanton, CA 94588 or call us at 925-460-6530 or fax us at 925-460-6633. B. Disputing the Actions of the WCIRB. If you have been aggrieved by any decision, action, or omission to act of the WCIRB, you may request, in writing, that the WCIRB reconsider its decision, action, or omission to art. You may also request, in writing, that the WCIRB review the manner in which its rating system has been applied in connection with the insurance afforded or offered you. For requests related to classification disputes, the reporting of experience, or coverage issues, your initial request for review must be received by the WCIRB within 12 months after the expiration date of the policy to which the request for review pertains; except -if the request involves, the application of the -Revision -of Losses rule: dor-requests related - to your experience modificaton, your initial request for review must be received by the WCIRB within 6 month! after the issuance, or 12 months after the expiration date, of the experience modification to which the request for review pertains, whichever is later, except if the request for review involves the application of the Revision of Losses rule. If the request involves the Revision of Losses rule, the time to state your appeal may be longer. (See Section VI, Rule 14 of the ERP). You may commence the review process by sending the WCIRB a written Inquiry. Written Inquiries should be sent to: WCIRB, 1221 Broadway, Suite 900, Oakland, California 94612, Attention: Customer Service. Customer Service can be reached by telephone at 1-888-229-2472, and by fax at 415-778-7272. If you are dissatisfied with the WCIRB's decision upon an Inquiry, or if the WCIRB fails to respond within 90 days after receipt of the Inquiry, you may pursue the subject of the Inquiry by sending the WCIRB a written Complaint and Request for Action. After you send your Complaint and Request for Action, the WCIRB has 30 days to send you written notice indicating whether or not your written request will be reviewed. If the WCIRB agrees to review your request, it must conduct the review and issue a decision granting or rejecting your request within 60 days after sending you the written notice granting review. If the WCIRB declines to review your request, if you are dissatisfied with the decision upon review, or if the WCIRB fails to grant or reject your request or issue a decision upon review, you may appeal to the insurance commissioner as described in paragraph II.C., below. Written Complaints and Requests for Action should be forwarded to: WCIRB, 1221 Broadway, Suite 900, Oakland, California 94612, Attention: Complaints and Reconsiderations. The WCIRB's telephone number is 1-888-229-2472, and the fax number is 415-371-5204. ed py'. l ue�as SCIF 1061D B (R.V. 04-10 POLICYHOLDER NOTICE Your Right to Rating and Dividend Information Page 3 of 3 POLICY NO. 9048876-15 NR SP C. California Department of Insurance - Appeals to the Insurance Commissioner. If, after you follow the appropriate dispute resolution process described above, we or the WCIRB decline to review your request, if you are dissatisfied with the decision upon review, or if we or the WCIRB fail to grant or reject your request or issue a decision upon review, you may appeal to the insurance commissioner pursuant to CIC Sections 11737, 11752.6, 11753.1 and Title 10, California Code of Regulations, Section 2509.40 at seq. You must file your appeal within 30 days after we or the WCIRB send you the notice rejecting review of your request for reconsideration or the decision upon your request for reconsideration. If no written decision regarding your request is sent, your appeal must be filed within 120 days after you sent your request for reconsideration to us or to the WCIRB. The filing address for all appeals to the insurance commissioner is: Administrative Hearing Bureau California Department of Insurance 45 Fremont Street, 22nd Floor San Francisco, California 94105 You have the right to a hearing before the insurance commissioner, and our action, or the action of the WCIRB, may be affirmed, modified, or reversed. III. Resources Available to You in Obtaining Information and Pursuing Disputes A. Policyholder Ombudsman. Pursuant to California Insurance Code Section 11752.6, a policyholder ombudsman is available at the WCIRB to assist you in obtaining and evaluating the rating, policy, and claims information referenced in I.A. and I.B., above. The ombudsman may advise you on any dispute with us, the WCIRB, or on an appeal to the insurance commissioner pursuant to Section 11737 of the Insurance Code. The address of the policyholder ombudsman is WCIRB, 1221 Broadway, Suite 900, Oakland, California 94612, Attention: Policyholder Ombudsman. The policyholder ombudsman can be reached by telephone at 415-778-7159 and by fax at 415-371-5288. B. California Department of Insurance - Information and Assistance. Information and assistance on policy questions can be obtained from the Department of Insurance Consumer HOTLINE, 1 -800 -927 - HELP (4357) or http:/Iwww.insurance.ca.gov. For questions and correspondence regarding appeals to the Administrative Hearing Bureau, see the contact information in paragraph II.C. This notice does not change the policy to which it is attached. a Guev P� GGp�pd .SCIF 1RRM R IR>V. U -M INSURER: STATE COMPENSATION INSURANCE FUND BROKERAGE: N/A POLICY NO. 9048876-15 DATE: June 26, 2015 PAGE 1 OF 4 CALIFORNIA WORKERS' COMPENSATION INSURANCE Policyholder Dividend Disclosure Statement FRIENDS OF SANTA ANA ZOO 1801 E CHESTNUT AVE SANTA ANA, CA 92701 EMPLOYERIINSURED: FRIENDS OF SANTA ANA Z00 EFFECTIVE DATE: July 1, 2015 ESTIMATED ANNUAL PREMIUM: $24,706.00 ESTIMATED DIVIDEND PLAN PREMIUM: $24,706.00 TERM OF DIVIDEND PLAN: ONE YEAR Workers' compensation insurers are authorized to issue participating policies. A dividend (refund) under such a policy can only be paid from surplus accumulated from premiums on workers' compensation policies issued pursuant to the laws of California. Under California law it is unlawful for an insurer to promise the future payment of dividends under an unexpired workers' compensation policy or to misrepresent the conditions for dividend payment. Dividends are payable only pursuant to conditions determined by the Board of Directors of the State Compensation Insurance Fund following policy expiration. It is a misdemeanor for any insurer or officer or agent thereof, or any insurance broker or solicitor, to promise the payment of future workers' compensation dividends. Past dividend performance is no guarantee of an insurer's future dividend performance. PART I: HISTORICAL DISCLOSURE This dividend statement is based on the most recent dividend declaration by our Board of Directors for policyholders with characteristics similar to yours and a dividend plan premium of $24,706.00. This declaration applied to policies whose term of coverage began January 1, 2014 to December 31, 2014 and whose term of coverage ended during the period January 1, 2015 to December 31, 2015. The dividend formula was: Dividend = Estimated Annual Premium X 2.6% 2.6% is the percentage factor set by the Board of Directors d ��• for the 2014 policy year. Ov,eNJO C, K: ' evas 16302 (04- 2015) POLICY NO:9048876-15 DATE: June 26, 2015 PAGE 2 OF 4 "Premium" means the sum derived from the application of California workers' compensation rates to the remuneration of employees or other unit of exposure after application of any duly authorized experience modification. Premium was not otherwise modified except as follows: Premium reflected rating -plan modifiers and premium discount. Estimated annual premium (EAP) is that premium, based upon information supplied by the policyholder or its broker at the time of policy inception, which will be earned during the policy period. The EAP used in the dividend calculation may be greater than the initial EAP provided that during the policy term A) the policyholder notifies STATE FUND of an increase in payroll, B) STATE FUND recalculates the EAP, and C) the policyholder pays all bills resulting from the recalculation on a timely basis. No dividend shall be paid on any premium owed or paid as a result of an audit. Surcharges or assessments were not included in the premium for dividend purposes. EAP is sometimes a different amount than "earned premium". Earned premium is not a factor in the calculation of the dividend. "Losses" means only the case incurred losses on all claims reported under the policy including both paid losses and reserves for the unpaid portion of such claims. No IBNR (Incurred But Not Reported), LDF (Loss Development Factor), LCF (Loss Conversion Factor) or any other factors, charges or provisions were utilized in the determination of losses for dividend purposes, except as follows: Losses were not a factor in the calculation of the dividend. RETENTION Retention was not a factor in the calculation of the dividend. DIVIDEND DETERMINATION AND TIMING The number of policy years' experience used in our plan(s) and our practice concerning loss valuation date(s), dividend calculation date(s), payment schedule and, if applicable, recapture provision, recalculation schedule, forfeiture, reduction or deferral was as follows: Dividends were scheduled for calculation at 18 months AJ6 'the_, policy inception date. Only policies whose initial written term of coverage in t ✓ 4 policy year exceeded 335 days were eligible to receiv am, 15302 I04-2015) POLICY NO:9048876-15 DATE: June 26, 2015 PAGE 3 OF 4 Any policy that was cancelled during the 2014 policy year did not receive a dividend. Policies for which the final audit had not been completed by 18 months after the policy inception date did not receive a dividend. Only policyholders with no overdue premium for the 2014 policy at the time of scheduled dividend.disbursement were eligible to receive a dividend. No other factors, considerations or practices were used, other than those described above. PART II: PROPOSAL DISCLOSURE The provisions, factors, and arrangements which are expected to be used in your Dividend Plan are identical to those contained in the prior POLICYHOLDER DIVIDEND DISCLOSURE STATEMENT, PART I: HISTORICAL DISCLOSURE displaying our actual performance as paid except as identified in the following proposal: The dividend formula remains: Dividend= Estimated Annual Premium X the percentage factor. I€ a future dividend is authorized by the Board of Directors, the percent amount (the percentage % factor) will be set by the Board of Directors. As of the date printed on this Dividend Disclosure Statement, the Board of Directors has not'declav ed any dividend for the 2015 policy year. Under California law it is unlawful for an insurer to promise the future payment of dividends under an unexpired workers' compensation policy or to misrepresent the conditions for dividend payment. Dividends are payable only pursuant to conditions determined by the Board of Directors of the State Compensation Insurance Fund following policy expiration. PREMIUM Changes, if any: NONE Changes, if any: NONE In accordance with California Administrative Code, Title 10, Section 2504, no workers' compensation insurer or officer or agent thereof or insurance broker or solicitor shall represent, either orally or in writing as an inducement either to insure or to continue or to renew insurance, that the insurer has agreed or will agree (a) to pay a specified polic��p dhy holder's dividend or (b) upon a formula, criteria or factors which set forth or can be�Ml`��� to determine the amount of dividend, or percentage of premium to be paid asa�l�didend , or amount or percentage of premium to be retained by the insurer after payment of dividend. Gue��� 15302 104.20101 POLICY NO:9048876-15 DATE: June 26, 2015 PAGE 4 OF 4 Comments: NONE DIVIDEND DETERMINATION AND TIMING Changes, if any: NONE At the time of dividend payment, you will be provided with a "Policyholder Dividend Result Disclosure Statement" which will include all essential data employed to compute the dividend result, This document will identify any exceptions to the procedures, factors and timing of payment described in this Policyholder Dividend Disclosure Statement and explains such variances. You should be aware that forfeiture of a right to, reduction in the amount of, reduction in any other benefit plan, or delaying the payment of, a policyholder's dividend due to the policyholder's failure to accept renewal of the policy or subsequent policies issued by the same insurer is coercive and illegal and constitutes an unfair practice. However, a reasonable reduction in the amount of policyholder dividend is permissible if the policyholder has elected to be considered for policyholder dividends under a plan which utilizes the premium and loss experience of the policyholder for two or more policy years and the policyholder does not remain insured by the same insurer during the complete term of the multi-year dividend plan. In such instances, the nature of the adjustment must be set forth in this Policyholder Dividend Disclosure Statement and provided to the policyholder within thirty days after the inception of the first policy year for which such election has been made. A "reasonable reduction" in the amount of policyholder dividends is defined as a specifically limited to the application of the most favorable dividend plan for which the policyholder then qualified under the dividend procedures of the insurer unless some alternative dividend plan has been set forth in the Policyholder Dividend Disclosure Statement provided the policyholder. Comments: NONE 15302 (0420151 Authorized Representative fed ay•. e cj�\Vva T_H_E_ INSURANCE c(DIVIPAINY Now Orleans, Louisiana COMMERCIAL GENERAL LIABILITY COVERAGE PART DECLARATIONS Named Insured and Mailing Address Policy No. cpp 0105807 00 FRIENDS OF SANTA ANA ZOO 1801 EAST CHESTNUT AVE 2 SANTA ANA CA 92701 Policy Period: From 01/17/2017 to 01/17/2018 at 12:01 A.M. Standard Time at mailing address shown above. IN RETURN FOR THE PAYMENT OF THE PREMIUM, AND SUBJECT TO ALL TERMS OF THIS POLICY, WE AGREE WITH YOU TO PROVIDE THE INSURANCE AS STATED IN THIS POLICY. LIMITS OF INSURANCE General Aggregate Limit (Other than Products -Completed Operations) $ 2,000,000 Products -Completed Operations Aggregate Limit $ 2,000,000 Personal and Advertising Injury Limit $ 1,000,000 Each Occurrence Limit $ 1,000,000 Damage to Premises Rented to You Limit $ 500,000 Any One Premises Medical Expense Limit N/A RETROACTIVE DATE (CG 00 02 only) Coverage A of this Insurance does not apply to "bodily injury" or "property damage', which occurs before the Retroactive Date, if any, shown here: DESCRIPTION OF BUSINESS AND LOCATION OF PREMISES Form of Business: NOT FOR PROFIT ORGANIZATION Location of All Premises You Own, Rent or Occupy: 001 1.801 EAST CHESTNUT AVE SANTA ANA CA 92701 FULL TERM PREMIUM Premium Rate Advance Premium Classification Code No. Pr/Co All Other Pr/Co All Other GIFT SHOPS -OTHER THAN NOT-FOR-PROPI 13506 $ 1,165.00 AMUSEMENT DEVICES {NOCJ 40040 $ 7,050.00 0 Full Term Premium: $ 8,215.00 0 Total Tax/Fee/Surcharge: Tax: Fee: Sur: Total Due: $ 8,215.00 FORMS AND ENDORSEMENTS Form(s) and Endcrsement(s) made part of this policy at time of issue CGO001 04/13 CGO02 07/95 CG0300 01/96 CG0435 12/07 CG150 04/13 CG158 01/87 CG169 04/91 CG2001 04/13 CC2011 04/13 CG2101 11/85 CG2106 05/14 CG2133 11/85 CG2135 10/01 CG2147 12/07 CG2149 09/99 CG2167 12/04 CG2196 03/05 CG2407 01/96 CG305 07/95 CG3234 01/05 IL1201 11/85 GL DEC INSURED COPY F�= Now Orleans, Louisiana COMMERCIAL GENERAL LIABILITY SCHEDULE Named Insured FRIENDS OF SANTA ANA ZOO Policy No. CPP 0105807 00 Premises No. 001 1801 EAST CHESTNUT AVE SANTA. ANA CA 92701 -----_------------------------------------------------------- DESCRIPTION ------ SERIAL NUMBER - GIFT SHOP N/A (2) HURLBUT TRAINS 1030 & 1036 2008 CHANCE CAROUSEL 404-06708 2016 CHANCE CENTURY WHEEL 406-05816 SPECIAL EVENTS: N/A FOSAZ MEMBER DAY: 02/04/17 N/A ZOO VOLUNTEER, LUNCH: 04,/29/17 N/A DREAMNIGHT: 05/27/17 N/A ZOOFARI: 08/26/17 N/A SUNSET AT THE ZOO: JUNE AND JULY IN 2017 N/A BOO AT THE ZOO: OCTOBER IN 2017 N/A FOSAZ BOARD MEETING: 11/07/17 N/A WHITE ELEPHANT SALE: 12/02/17 N/A STAFF POTLUCK: 12/07/17 N/A INSURED COPY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.. Puolecy Change Number 01 (POLICY NUMBER POLICY CHANGES COMPANY EFFECTIVE CPP 0105807 010 02/0112017 T.H.E. INSURANCE COMPANY NAMED INSURED AUTHORIZED REPRESENTATIVE. FRIENDS OF SANTA ANA ZOO 1801 EAST CHESTNUT AVE SANTA ANA CA 92701 COVERAGE PARTS AFFECTED COMMERCIAL GENERAL LIABILITY CHANCES IN CONSIDERATION OF THE PREMIUM CHARGED, IT IS HEREBY UNDERSTOOD AND AGREED THAT THE POLICY IS AMENDED AS FOLLOWS: FORM CG2011 04/13 ADDITIONAL INSURED - MANAGERS OR LESSORS OF PREMISES IS AMENDED TO READ: CITY OF SANTA ANA, ITS OFFICERS, EMPLOYEES, AGENTS, AND REPRESENTATIVES WITH REGARD TO LIABILITY AND DEFENSE OF SUITS ARISING FROM THE OPERATIONS AND USES PERFORMED BY OR ON BEHALF OF THE NAMED INSURED. 26 CIVIC CENTER PLAZA SANTA ANA, CA 92701 ALL OTHER TERMS AND CONDITIONS REMAIN UNCHANGED. —a 110��Q . Q-0� Authorized Representative Signature LM State. CA. Hart Forms & Services Reorder NO r 14-9286 Copyright, Insurance Services Office, Inc., 1983 IL 12 01 11 85 Copyright„ ISO Commercial Risk. Services, Inc., 1983 Page 1 of 2 CHANGES (cont.) Copyright, Insurance Services Office, Inc., 1983 IL 12 01 11 85 Copyright, ISO Commercial Risk Services, Inc., 1983 (Page 2 of 2 T.H.,E.. INS U R A N C E CC) M Pe4NY New Orleans, Louisiana COMMERCIAL INLAND MARINE COVERAGE PART DECLARATIONS Named Insured and Mailing Address FRIENDS OF SANTA ANA ZOO 1801 EAST CHESTNUT AVE SANTA ANA CA 92701 Policy No. CPP 0105807 00 Policy Period: From 01/17/2017 To 01/17/2o1s at 12:01 A.M. Standard Time at mailing address shown above. IN RETURN FOR THE PAYMENT OF THE PREMIUM, AND SUBJECT TO ALL TERMS OF THIS POLICY, WE AGREE WITH YOU TO PROVIDE THE INSURANCE AS STATED IN THIS POLICY. TOTAL LIMIT OF INSURANCE $ 20,000 PREMIUM Full Term Premium: $ 620.00 Total Tax/Fee/Surcharge: $ Tex: Fee: Sur: Total Due: $ 620.00 Deductible: Equipment Breakdown: FORMS AND ENDORSEMENTS $1,000 YES Form(s) and Endorsement(s) made part of this policy at time of issue: CM0001 09/04 IMEB02 04/14 SIM0094 04/14 INSURED COPY T.H.E_ CC)MIPIAevY New Orleans, Louisiana COMMERCIAL INLAND MARINE COVERAGE PART DECLARATIONS Named Insured FRIENDS OF SANTA. ANA ZOO Policy No. CPP 0105807 00 Premises No. On Bldg. No. 000 mmT---~~~~Wu—~uu~u--~—u--W ~T~~-_�._ ITEM AND DESCRIPTION LIMIT ®F INSURANCE ------------------------------------------------------------------ 00001 2004 BOBCAT TRACTOR WITH FORKLIFT AND BUCKET $20,000 6712927CR&6540182R Renewal of Dumber NEW T.H-E- CC)MP,ANY New Orleans, Louisiana COMMERCIAL LINES POLICY COMMON POLICY DECLARATIONS AMENDED DECLARATION -Policy Changes Effective: 02./01/2017 No change in Premium or any applicable taxes/fees. Policy No. CPP 0105807 00 Named Insured and Failing Address Producer FRIENDS OF SANTA ANA ZOO SCHWEICKERT & COMPANY 1801 EAST' CHESTNUT AVE 17300 RED HILL AVENUE #$210 SANTA ANA CA 92701 IRVINE CA 9261.4 Policy Period: From 01/1.7/2017 To 01/17/2018 at 12:01 A.M. Standard Time at mailing address shown above. Business Description: NOT FOR PROFIT ORGANIZATION IN RETURN FOR THE PAYMENT OF THE PREMIUM, AND SUBJECT TO ALL TERMS OF'THIS POLICY, WE AGREE WITH YOU TO PROVIDE THE INSURANCE AS STATED IN THIS POLICY. THIS POLICY CONSISTS OF THE FOLLOWING COVERAGE PARTS FOR WHICH A PREMIUM IS INDICATED. THIS PREMIUM MAY BE SUBJECT TO ADJUSTMENT. COMMERCIAL PROPERTY COVERAGE PART COMMERCIAL GENERAL LIABILITY COVERAGE PART COMMERCIAL INLAND MARINE COVERAGE PART CA Surplus Lines Tax: $453.87 CA Stamping Fee: $ 3 0.2 6 FULL TERM PREMIUM $ 6,294.00 $ 8,21.5.00 $ 620.00 $ $ $ $ $ TOTAL PREMIUMS $ 15, 129.00 TAXJFEEPSURCHARGE $ 484.13 TOTAL $ 15,613.13 TOTAL AMOUNTDUE: $15,613.13 PAYABLE ACCORDING TO SCHEDULE. Form(s) and Endorsement(s) made part of this policy at time of issue: D-2 07/11 SL001 01/87 IL0003 09/08 IL0017 11/98 IL00 1 09/08 IL0102 05/05 IL01.04 09/07 IL0270 09/12 IL0935 07/02 �� a ..: e�... .o, r1\ T.H.E. Insurance Company (A Stock Company) 03/21/2017 LM Authorized Representative INSURED COPY Named Insured and Mailing Address FRIENDS OF SANTA ANA ZOO 1901 EAST CHESTNUT AVE SANTA ANA CA 92701 T_H_E INsuR,onkr.l(ZE C« M P'6tNy New Orleans, Louisiana COMMERCIAL PROPERTY COVERAGE PART DECLARATIONS Policy No. CPP 0105007 00 Policy Period: From 01/17/2017 To 01/17/24718 at 12:01 A.M. Standard Time at mailing address shown alcove. IN RETURN FOR THE PAYMENT OF THE PREMIUM, AND SUBJECT TO ALL TERMS OF THIS POLICY, WE AGREE WITH YOU TO PROVIDE THE INSURANCE AS STATED IN THIS POLICY. DESCRIPTION OF PREMISES Prem. No. Bldgi. No. Location, Construction and Occupancy 00001 00001 1801 EAST CHESTNUT AVE SANTA ANA CA foisted Masonry GIFT SHOP COVERAGES PROVIDED - INSURANCE AT THE DESCRIBED PREMISES APPLIES ONLY FOR COVERAGES FOR WHICH A LIMIT OF INSURANCE IS SHOWN Limit of Covered Coverage Insurance Cause of Loss Coinsurance* Building 135,000 SPECIAL FORM 90 Personal Property 31,500 SPECIAL FORM 90 * If Extra E ense Coverage, Limits on Lass Payment OPTIONAL COVERAGES - APPLICABLE ONLY WHEN ENTRIES MADE IN THE SCHEDULE BELOW Agreed Value Replacement Cost Expire Date Coverage Amount Bldg, Personal Property Building 135,000 X Personal Property 31,500 X Inflation Guard *Monthly Limit *Max. Period *Ext. Period Equment Bldg. Personal Property of Indemnity of Indemnity of Indemnity Breakdown X *Applies To Business Income Only MORTGAGE HOLDER(S) DEDUCTIBLE $250 EXCEPTIONS: BLDG DED $1,000 PERS DED $1,000 FORMS AND ENDORSEMENTS Applying to this coverage part and made part of the policy at the time of is Ce - APPLICABLE TO ALL COVERAGES: CP0010 1.0/12 CP0090 07/88 CP1030 10/12 CP1218 10/1,2 CPEB02 01/10 fir, fi- APPLICABLE TO SPECIFIC PREMISES:e'' —C' Full Term Premium: $ 361.00 Total Due: $ 361.00 INSURED COPY Named Insured and Mailing Address FRIENDS OF SANTA ANA ZOO 1801 EAST CHESTNUT AVE SANTA ANA CA 92701 T_H_E_ INSURA,11NICE CC:)MPA".Ny New Orleans, Louisiana COMMERCIAL PROPERTY COVERAGE PART DECLARATIONS Policy No. CPP 010580'7 00 PollcyPerlod: From 01/17/2017 To 01/17/2o1B at 12:01 A.M. Standard Time at mailing address shown above. IN RETURN FOR THE PAYMENT OF THE PREMIUM, AND SUBJECT TO ALL TERMS OF' THIS POLICY, WE AGREE WITH YOU TO PROVIDE THE INSURANCE AS STATED IN THIS POLICY. DESCRIPTION OF PREMISES Prem. No. Bldg. No. Location, Construction and Occupancy 00001 00002 1801 EAST CHESTNUT AVE SANTA ANA CA Non -Combustible CHANCE CAROUSEL COVERAGES PROVIDED - INSURANCE AT THE DESCRIBED PREMISES APPLIES ONLY FOR COVERAGES FOR WHICH A LIMIT OF INSURANCE IS SHOWN Coverage Building Limit of Covered Insurance Cause of Loss Coinsurance* 436,000 SPECIAL FORM 90 * If Extra E.2spense Coverage, Limits on Loss Payment OPTIONAL COVERAGES - APPLICABLE ONLY WHEN ENTRIES MADE IN THE SCHEDULE BELOW Agreed Value Expire Date Coverage Building Inflation Guard *Monthly Limit Bldg. Personal Property of Indemnity MORTGAGE HOLDER(S) BLE Replacement Cost Amount Bldg, Personal Property 436,000 X *Max. Period *Ext. Period Breakdown Equipment of Indemnity of Indemnity rea down X *Applies To Business Income Only $250 EXCEPTIONS: BLDG DED $1,000 PERS DED FORMS AND ENDORSEMENTS Applying to this coverage part and made part of this policy at the time of issu APPLICABLE TO ALL COVERAGES: CP0010 10/12 CP0090 07/88 CP014Q /06 CP1030 10/12 CP1218 10/12 CPEB02 0,1/10 APPLICABLE TO SPECIFIC PREMISES: Full Term Premium: $ 1,931.00 Total Due: $ 1, 931.00 INSURED COPY T_H_E_ IINSURA�LNCE <--C:) M PINY New Orleans, Louisiana DECLARATIONS Named Insured and Mailing Address FRIENDS OF SANTA ANA ZOO 1801 EAST CHESTNUT AVE SANTA ANA CA 92701 Policy No. CPP 0105807 00 Policy Period: From 01/17/2017 To 01/17/2018 at 12:01 A.M. Standard Time at mailing address shown above. IN RETURN FOR THE PAYMENT OF THE PREMIUM, AND SUBJECT TO ALL TERMS OF THIS POLICY, WE AGREE WITH YOU TO PROVIDE THE INSURANCE AS STATED IN THIS POLICY. DESCRIPTION OF PREMISES Prem. No. Bldg. No. Location, Construction and Occupancy 00001 00003 1801 EAST CHESTNUT AVE SANTA ANA CA Non -Combustible CHANCE CENTURY WHEEL COVERAGES PROVIDED - INSURANCE AT THE DESCRIBED PREMISES APPLIES ONLY FOR COVERAGES FOR WHICH A LIMIT OF INSURANCE IS SHOWN Coverage Building Limit of Covered Insurance Cause of Loss Coinsurance* 871,400 SPECIAL FORM 90 * If Extra Expense Coverage, Limits on Loss OPTIONAL COVERAGES - APPLICABLE ONLY WHEN ENTRIES MADE IN THE SCHEDULE BELOW Agreed Value Replacement Cost Expire Date Coverage Amount Bldg. Personal Property Building 871,400 X Inflation Guard *Monthly Limit *Max. Period *Ext. Period Equippment Personal Property Bldg. of Indemnity of Indemnity of Indemnity Breakdown X *Applies To Business Income Only MORTGAGE HOLDER(S) DEDUCTIBLE $250 EXCEPTIONS, BLDG DED $1,000 PERS DED FORMS AND ENDORSEMENTS t. Applying to this coverage part and made part of this policy at the time ofC P 0 eb iss, IV i APPLICABLE TO ALL COVERAGES: CP0010 10/12 CP0090 07/88 , �06\\ CP1030 10/12 CP1218 10/12 CPEB02 01/10 '0,APPLICABLE TO SPECIFIC PREMISES:e Gx� Full Term Premium: $ 3,807.00 Total Due: $ 3, 807.00 Named Insured and Mailing Address FRIENDS OF SANTA ANA ZOO 1801 EAST CHESTNUT AVE SANTA ANA CA 92701 T.H-E. IINSUR.&.N(_—E ' CC3 M IPAi�JY New Orleans, Louisiana COMMERCIAL PROPERTY COVERAGE PART DECLARATIONS Policy No. CPP 0105807 00 Policy Period: From 01/17/2017 To 01/17/2o18 at 12:01 A.M. Standard Time at mailing address shown above. IN RETURN FOR THE PAYMENT OF THE PREMIUM, AND SUBJECT TO ALL TERMS OF THIS POLICY, WE AGREE WITH YOU TO PROVIDE THE INSURANCE AS STATED IN THIS POLICY. DESCRIPTION OF PREMISES Prem. No. Bldg. No. Location, Construction and Occupancy 00001 00004 1801 EAST CHESTNUT AVE SANTA ANA CA Nan -Combustible STORAGE TRAILER COVERAGES PROVIDED - INSURANCE AT THE DESCRIBED PREMISES APPLIES ONLY FOR COVERAGES FOR WHICH A LIMIT OF INSURANCE IS SHOWN Limit of Covered Coverage Insurance Cause of Loss Coinsurance* Personal Property 72,000 SPECIAL FORM 90 * If Extra Expense Coveraqe, Limits on Loss Payment OPTIONAL COVERAGES - APPLICABLE ONLY WHEN ENTRIES MADE IN THE SCHEDULE BELOW Agreed Value Replacement Cost Expire Date Coverage Amount Bldg. Personal Property Personal Property 72,600 X Inflation Guard *Monthly Limit *Max. Period *Ext. Period Equipment Bldg. Personal Property of Indemnity of Indemnity of Indemnity Breakdown X *Applies To Business Income Only MORTGAGE HOLDER($) -........-- DEDUCTIBLE $250 EXCEPTIONS: BLDG DED PERS DED $1,000 FORMS AND ENDORSEMENTS Applying to this.coverage part and made part of this policy at the time of issue: APPLICABLE TQ ALL COVERAGES: CP0010 10/12 CP0090 07/88 CP0140��7Qj6 CP1030 10/12 C?1218 10/12 CPEB02 01/10 APPLICABLE TO SPECIFIC PREMISES: �� j, �r'CO Full 'Term Premium: $ 195.00 (�)\ Total Due: $ 195.00 INSURED COPY