HomeMy WebLinkAboutACTIVE LEARNING, INC. 2-2016City of Santa Ana
�1 Clerk of the Council core Office Use Only
AGREEMENT TERMINATION FORM
Please complete this form in its entirety when the attached agreement andq
amendments (if any) are no longer in effect. AM 22 Ij: 14
Note: If your agreement is grant related, please ensure that all grant retention requirements C i T Ii OF SANTA ANA
have been satisfied prior to signing the termination form. CLERK OF COUNCIL
Is the agreement(s) a permanent record? Yes _ No
Return form to the Clerk of the Council Office (M-30). i
Call 647-1520 if you have any questions
The agreement with
No. N-2016A85 was completed on
(List all amendments. Use space below if needed.)
Revised: 10-18-16
I431 1 1 1 and final payment has been made.
Department: F 0,0,. *A- I Ad Y1Mio,
Phone/Ext.: Sp
Signature: L1 OA 0Pn/GVl
Date: % We I l �
INSURANCE ON FILE
WORK MAY PROCEED N-2016-185
UNTIL. INSURANCE EXPIRES
CLERK OF COUNCIL
DATE` U 2 2 20s RECREATION SERVICES AGREEMENT
THIS AGREEMENT is made and entered into this 9"' day of November 2016, by and
between Active Learning, Inc., a California corporation ("Provider") and the City of Santa Ana,
a charter city and municipal corporation organized and existing under the Constitution and laws
of the State of California ("City"),
RECITALS
A. The City desires to retain a recreation service provider having special skills, resources and
knowledge to provide Zumba classes in its leisure class program.
B. Provider represents that it is able and willing to provide such services to the City.
C. In undertaking the performance of this Agreement, Provider represents that it is
knowledgeable in its field and that any services performed by Provider under this
Agreement will be performed in compliance with such standards as may reasonably be
expected.
NOW THEREFORE, in consideration of the mutual and respective promises, and subject to the
terms and conditions hereinafter set forth, the parties agree as follows:
1. SCOPE OF SERVICES
Provider shall perform those services as set forth in Exhibit A to this Agreement.
COMPENSATION
In consideration for the provision of the programs set forth in Exhibit A, City agrees to
pay the Provider seventy percent (70%) of all gross revenue received from program participants.
Total revenue to Provider shall not exceed $25,000 annually. Payment to Provider shall be made
monthly within thirty (30) days following completion of the last class taught by Provider the
prior month. City shall be responsible for collecting all fees from program participants.
Provider shall not collect fees but will refer all interested participants to City for registration
information. Provider agrees that City shall retain thirty percent (30%) of all gross revenue
received from program participants as an administrative fee.
0§01199RTIU
This Agreement shall commence on January 1, 2017 and end on Decernber 31, 2017,
unless terminated earlier in accordance with Section 12 below. The tern of this Agreement may
be extended upon a writing executed by the City Manager and the City Attorney.
4. INDEPENDENT CONTRACTOR
Provider shall, during the entire term of this Agreement, be construed to be an
independent contractor and not an employee of the City. This Agreement is not intended nor
Page l of 8
shall it be construed to create an employer-employce relationship, a joint venture relationship, or
to allow the City to exercise discretion or control over the manner in which Provider performs
the services which are the subject matter of this Agreement; however, the services to be provided
by Provider shall be provided in a manner consistent with all applicable standards and
regulations governing such services. Provider shall pay all salaries and wages, employer's social
security taxes, unemployment insurance and similar taxes relating to employees and shall be
responsible for all applicable withholding taxes. Provider is not an agent, representative or
employee of City and Provider shall have no authority to act on behalf of the City.
5. INSURANCE
Prior to undertaking performance of work under this Agreement, Provider shall maintain
and shall require its subcontractors, if any, to obtain acid maintain insurance as described below:
a. Commercial General Liability Insurance. Provider shall maintain commercial general
liability insurance which 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 negligent act or occurrence arising out of Provider's operations in the
performance of this Agreement, including, without limitation, acts involving vehicles. The
amounts of insurance shall be not less than the following: single limit coverage applying to
bodily and personal injury, including death resulting therefrom, and property damage, in the total
amount of $1,000,000 per occurrence and $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 insureds provisions.
b. Worker's Compensation Insurance. In accordance with California State law, Provider,
if Provider has any employees, is required to be insured against liability for worker's
compensation or to undertake self-insurance. Prior to commencing the performance of the work
under this Agreement, Provider agrees to obtain and maintain any employer's liability insurance
with limits not less than $1,000,000 per accident.
c. The following requirements apply to the insurance to be provided by Provider pursuant
to this section:
(i) Provider shall maintain all insurance required above in frill force and
effect for the entire period covered by this Agreement. Certificates
of insurance shall be furnished to the City upon execution of this
Agreement and shall be approved in form by the City.
(ii) 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.
d. If Provider fails or refuses to produce or maintain the insurance required by this
section or fails or refuses to furnish the City with required proof that insurance has been procured
Page 2 of 8
and is in force and paid for, the City shall have the right, at the City's election, to terminate this
Agreement. Such termination shall not affect Provider's right to be paid for its time and
materials expended prior to noti6eation of termination. Provider waives the right to receive
compensation and agrees to indemnify the City for any work performed prior to approval of
insurance by the City.
6. INDEMNIFICATION
Provider agrees to and shall indemnify, defend, and hold harmless the City, its officers,
agents, employees, consultants, special counsel, and representatives from liability: (1) for
personal injury, damages, just compensation, restitution, judicial or equitable relief arising out of
claims for personal injury, including death, and claims for property damage, which may arise
from the direct or indirect operations of Provider or its contractors, subcontractors, agents,
employees, or other persons acting on their behalf which relates to the services described in
section 1 of this Agreement; and (2) from any claim that personal injury, damages, just
compensation, restitution, judicial or equitable relief is due by reason of the terms of or effects
arising from this Agreement. This indemnity and hold harmless agreement applies to all claims
for damages, just compensation, restitution, judicial or equitable relief suffered, or alleged to
have been suffered, by reason of the events referred to in this Section or by reason of the terms
of, or effects, arising from this Agreement. Provider further agrees to indemnify, hold harmless,
and pay all costs for the defense of the City, including fees and costs for special counsel to be
selected by the City, regarding any action by a third party challenging the validity of this
Agreement, or asserting that personal injury, damages, just compensation, restitution, judicial or
equitable relief due to personal or property rights arises by reason of the terms of, or effects
arising from this Agreement. City may make all reasonable decisions with respect to its
representation in any legal proceeding. In no case will Provider be required to indemnify or hold
harmless the City for injury, damages, just compensation, restitution, judicial or equitable relief
caused by the sole negligence of the City.
CONFLICT OF INTEREST
Provider covenants that it presently has no interests and shall not have interests, direct or
indirect, which would conflict in any manner with performance of services specified under this
Agreement.
S. LIVE SCAN BACKGROUND CHECK
Provider, and any employees, subcontractors or substitutes, in contact with minors under
eighteen (IS) years of age shall arrange for and submit to a Live Scan electronic background
check for criminal history available through the California Department of Justice as a condition
of this Agreement and provide proof of compliance prior to performing services hereunder.
9. NOTICE
Any notice, tender, dernand, 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
Page 3 of 8
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 Council
City of Santa Ana
20 Civic Center Plaza (M-30)
P.O. Box 1988
With copy to:
Santa Ana, CA 92702-1988
Fax (714) 647-6956
Executive Director of Parks, Recreation and Community Services
City of Santa Ana
20 Civic Center Plaza (M-23)
P.O. Box 1988
Santa Ana, California 92702
Fax (714) 571-4211
To Provider: Active Learning, Inc.
Hiba Shublak
14 Surfside Court
Newport Beach, CA 92663
hiba itactiveteamin =us�
A party may change its address by giving notice in writing to the other party. Thereafter,
any communication shall be addressed and transmitted to the new address. If sent by mail,
communication shall be effective or deemed to have been given three (3) days after it has been
deposited in the United States mail, duly registered or certified, with postage prepaid, and
addressed as set forth above. If sent by fax, communication shall be effective or deemed to have
been given twenty-four (24) hours after the time set forth on the transmission report issued by the
transmitting facsimile machine, addressed as set forth above. For purposes of calculating these
time frames, weekends, federal, state, County or City holidays shall be excluded.
10. EXCLIJSIVITY AND AMENDMENT
This Agreement represents the complete and exclusive statement between the City and
Provider regarding the subject matter herein, and supersedes any and all other agreements, oral
or written, between the parties. In the event of a conflict between the terms of this Agreement
and any attachments hereto, the terms of this Agreement shall prevail. This Agreement may not
be modified except by written instrument signed by the City and by an authorized representative
of Provider. The parties agree that any terms or conditions of any purchase order or other
instrument that are inconsistent with, or in addition to, the terms and conditions hereof, shall not
bind or obligate Provider or the City. Each party to this Agreement acknowledges that no
representations, inducements, promises or agreements, orally or otherwise, have been made by
any party, or anyone acting on behalf of any party, which is not embodied herein.
Page 4 of 8
II. ASSIGNMfENT/SUBSTITUTIES
a. Assigtunent. The experience, knowledge, capability and reputation of Provider were a
substantial inducement for City to enter into this Agreement. Therefore, Provider may not assign,
transfer, delegate, or subcontract any interest herein without the prior written consent of the City
and any such assignment, transfer, delegation or subcontract without the City's prior written
consent shall be considered null and void.
b. Substitutes. In the event Provider is not able to teach a class due to illness or some
other cause beyond Provider's reasonable control, Provider must procure, at its sole expense, a
qualified substitute instructor to teach the class at its regular time and place. Provider shall
ensure that substitute instructors are at least twenty-one (21) years of age and comply with the
City's insurance and live scan requirements contained herein. Evidence of compliance with
City's insurance and live scan requirements shall be provided upon request. Provider must
immediately notify the City of the substitute instructor's name, qualifications, address and phone
number. If Provider cannot procure a qualified substitute and the City is unable to assist in this
regard, then the class shall be canceled and a make-up class must be added to the session.
Provider must notify participants as soon as possible of any class cancellation and make-up class.
Provider must personally teach at least severity -five percent (75%) of its offered classes.
12. TERtbIINATION
a. This Agreement may be terminated by the City upon thirty (30) days written notice of
termination. In such event, Provider shall be entitled to receive, and City shall pay Provider,
compensation for all services rendered prior to the effective date of termination.
b. Termination or cancellation of classes by the Provider outside of Section t I.b. must be
given to the City at least thirty (30) days prior to termination/cancellation. Failure to provide
adequate cancellation notice to the City may put future contracting of business with the City at
risk and will result in the City's retention of ten (10%) percent of the final payment to Provider.
13. RECORDS
Provider shall use attendance sheets generated and supplied by the City to record
attendance in each class. Provider shall keep these and any other records in connection with the
work to be performed under this Agreement and shall permit City, upon request, to review such
records for a period of three (3) years from the date of final payment to Provider under this
Agreement.
14. NON-DISCRIMINATION
Provider shall not discriminate because of race, color, creed, religion, sex, marital status,
sexual orientation, age, national origin, ancestry, or disability, as defined and prohibited by
applicable law, in the recruitment, selection,, teaching, training, utilization, promotion,
termination or other employment related activities or in connection with any activities related to
Page 5 of 8
this Agreement. Provider affirms that it is an equal opportunity employer and shall comply with
all applicable federal, state and local laws and regulations.
15. JURISDICTION —VENUE
This Agreement has been executed and delivered in the State of California and the
validity, interpretation, performance, and enforcement of any of the clauses of this Agreement
shall be determined and governed by the laws of the State of California. Both parties further
agree that Orange County, California, shall be the venue for any action or proceeding that may
be brought or arise out of, in connection with or by reason of this Agreement.
16. LICENSES
Provider shall, throughout the teen of this Agreement, maintain all necessary licenses,
permits, approvals, waivers, and exemptions necessary for the provision of the services
hereunder and required by the laws and regulations of the United States, the State of California,
the City of Santa Ana and all other governmental agencies.
17. 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.
18. EXHIBITS
All Exhibits referenced herein and attached hereto shall be incorporated as if fully set forth
in the body of this Agreement.
19. AUTIiORITY
The person(s) executing this Agreement on behalf of the parties hereto warrant that they are
duly authorized to execute this Agreement on behalf of said parties and that by so executing this
Agreement, the parties hereto are formally bound to the provisions of this Agreement.
Page 6 of 8
IN WITNESS WHEREOF, the parties hereto have executed this Agreement the date and
year first above written.
ATTEST: CITY OF SANTA ANA
MA.RLA D. HUIZAR DAVID CAV OS
6 Clerk of the Council City Manager
APPROVED AS TO FORM:
SONIA R. CARVALHO
City Attorney
By: G t:! c_ A i2c•- Z
Lisa Storck
Assistant City Attorney
RECOMMENDED FOR APPROVAL: PROVIDER:
GERARDO MOUET RIBA SHUBLAK
Executive Director of Parks, Active Learning Inc.
Recreation and Community Services Agency Tax ID# 4.7-2532288
Page 7 of 8
Exhibit A
SCOPE OR SERVICES— Active Lear ning/I-Itba Shublak
A. Provider shall conduct various classes
B. Provider shall teach such or similar classes (1) at the times below at facilities to be designated by the
City, or (2) on a schedule agreed upon by the parties for each class session or term, including the
location, specific days and hours when classes will be held, and holidays to be observed, in accordance
with City's needs.
• Zomba class will consist of monthly sessions, two days per week, 1 hour per day, 18 years old +
$20/monthly (El Salvador & Memorial)
C. Provider will provide and be responsible for equipment, records, and personnel and cleanup of the
facilities and materials necessary to ensure the safety and effectiveness of said instruction.
CLASS SIZE.
A. Each class must have a n mini rm of 3 paid students and no more than a maxirnune of 20,
B. No registration will be accepted after the second meeting of class.
C. In the event the minimum number of enrollees is not realized by the second meeting of the class,
the class shall be canceled. Provider will be under no obligation to provide services and the City
will have no obligations to pay Provider Compensation
CLASS PEES
A. Each participant shall pay a $20 for registration fee per month.
Anticipated annual revenue not to exceed $25,000.00.
B. No refituds will be made to participants after the first week of class unless the class is cancelled
by the City.
C. The City shall collect registration fees from each participant during the registration period.
Provider shall not collect fees, but shall refer all interested participants to City for registration.
D. Provider shall receive seventy percent (70%) of the total fees collected each month. City and
Provider agree that City shall retain thirty percent (30%) of the fees collected as an administration
fee.
E. Provider agrees that City is entitled to audit Provider's records and classes to Insure compliance
with this Agreement.
F. Provider may not waive class participation/registration fees.
G. City shall prepare class rosters and provide a copy to Provider. Only registered participants may
participate in class.
Page 8 of 8
FAPM RIA RI IIAI 1Al/ RL-A1 I1 TIARIC
Renewalof SCOTTSDALE INSURANCE COMPANY'' Policy Number
CPS2237135 CF'52561230
Home Office:
One Nationwide Plaza R Columbus, Ohio 43215
Administrative Office:
8877 North Gainey Center Drive e Scottsdale, Arizona 85258
1-800-423-7675
A STOCK COMPANY
ITEM 1. Named Insured and Mailing Address
HIBA SHUBLAK DBA: ACTIVE LEARNING
.t/ 14 SURFSIDE COURT
NEWPORT BEACH, CA 92663
Agent Name and Address
✓COASTAL BROKERS INSURANCE SERVICES
6602 OWENS DRIVE SUITE 300
PLEASANTON, CA 94588 Agent No.: 04068 Program No.: BM
ITEM 2. Policy Period From: 11/26/20IG TO: 11/26/2017 / Term: 365 DAYS
12:01 A.M., Standard Time at the mailing address shown in ITEM 1.
Business Description: DANCE INSTRUCTOR
In return for the payment of the premium, and subject to all the 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.
Where no premium is shown, there is no coverage. This premium may be subject to adjustment.
Coverage Part(s) Premium Summary
Commercial General Liability Coverage Part
Commercial Property Coverage Part
Commercial Crime And Fidelity Coverage Part
Commercial Inland Marine Coverage Part
Commercial Auto Coverage Part
Professional Liability Coverage Part
Gov
�®\gib (NO
$ NOT COVERED
Total Policy Premium: $ 1. 920.00
3W State Tax $ 57.60
0.200% Stamp Fee $ 3.84
Total: $ 1,981.44
Form(s) and Endorsement(s) made a part of this policy at time of issue:
SEE SCHEDULE OF FORMS AND ENDORSEMENTS
B. HAUN/CY
Countersigned Date:
11/2/16
THIS COMMON POLICY DECLARATION AND THE SUPPLEMENTAL DECLARATION(S), TOGETHER WITH
THE COMMON POLICY CONDITIONS, COVERAGE PART(S), COVERAGE FORM(S) AND FORMS AND ENDORSEMENTS, IF ANY,
COMPLETE THE ABOVE NUMBERED POLICY.
OPS-D-1 (8-10) INSURED opsdij . fap
A, SCOTTSDALE INSURANCE COMPANY=
SCHEDULE OF FORMSAND ENDORSEMENTS
Policy No. CPS2561230 Effective Date: 11/26/2016
12:01 A.M., Standard Time
Named Insured HIBA SHUBLAK DBA: ACTIVE LEARNING Agent No. 04068
COMMON FORMS
UTS-COVPG
1-16
Cover Page
OPS-D-1
8-10
Common Policy Declarations
UTS-SP-2
12-95
Schedule Of Forms and Endorsements
UTS-SP-3
8-96
Locations Schedule
GENERAL LIABILITY
FORMS
CLS-SD-IL
8-01
GL Supplemental Dec
CLS-SP-IL
10-93
GL Ext Supplemental Dec
CG 00 01
4-13
General Liab Coverage
CG 20 02
11-85
Al -Club Members
CG 21 73
1-15
Exclusion -Certified Acts Of Terrorism
CG 24 26
4-13
Amend Of Insured Contract Definition
GLS-44s
9-10
Sexual -Physical Abuse Liab Cov
GLS-150s
7-06
Blanket Additional Insured Endt ✓
GLS-1728
6-14
Errors And Omissions Coverage Part
GLS-289s
11-07
Known Injury/Dm5 Excl-Personal/Advertise
GLS-455s
8-14
Marijuana -Cannabis Products Excl
UTS-128s
8-15
Optional Provisions Endorsement
UTS-1909
10-08
Communicable Disease Excl
UTS-246s
2-15
Amendatory Endorsements -Without Med Pay
7JTS-303g
1-09
Fungi Or Bacteria Exclusion
UTS-365s
2-09
Amend Of Nonpayment Cancel Condition
STATE FORMS
CG 32 34
1-05
CA -Changes
UTS-253-CA 1-97
CA -Amendatory Endorsement
POLICYHOLDER NOTICES
NOTX0178CW
2-06
Claim Reporting Information
day°.
?Qel �� . .
s
S°\v°�
P�OS�
ADDITIONAL FORMS
Injury
Excl
UTS-SP-2 (12-95) INSURED ut55p2h. fap
SCOTTSDALE INSURANCE COMPANY,
SCHEDULE OF LOCATIONS
Policy No. CPS2561230 Effective Date 11/26/2016
12:01 A.M. Standard Time
Named Insured HIBA SHUBLAK DBA: ACTIVE LEARNING Agent No. 04068
Prem.
No.
Bldg.
No.
Designated Premises
(Address, City, State, Zip Code)
Occupancy
1
1
14 SURFSIDE COURT
DANCE INSTRUCTOR
NEWPORT BEACH, CA 92663
UTS-SP-3 (8-96) INSURED
-)� SCOTTSDALE INSURANCE COMPANY'
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SUPPLEMENTAL DECLARATIONS
Policy No. __cPs2sGL23o Effective Date
12:01 A.M., Standard Time
Named Insured x>sA SaUaLAx pJ_&cTiME LE&R r*c _Agent No.
Item 1. Limits of Insurance
Coverage
Limit of Liability
Aggregate Limits of Liability
Products/ Completed
$_
2,000,000_ Operations Aggregate
General Aggregate (other than
$___
2 000 000 _ Products/Completed Operations)
Coverage A - Bodily Injury and
any one occurrence subject
Property Damage Liability
to the Products/Completed
Operations and General
$_�0001000__
Aggregate Limits of Liability
anyone premises subject to the
Coverage A occurrence and
the General Aggregate Limits
Damage to Premises Rented to You Limit
$
1001000of Liability
Coverage B - Personal and
any one person or organization
Advertising Injury Liability
subject to the General Aggregate
$__�i
0001000 Limits of Liability
Coverage C - Medical Payments
any one person subject to the
Coverage A occurrence and
$
5,000 the General Aggregate Limits
Item 2. Description of Business
Form of Business:
® Individual Cl Partnership ❑ Joint Venture
❑ Trust ❑ Limited Liability Company
❑ Organization including a corporation (other than Partnership,
Joint Venture or LimilVd'lily Company)
Location of All Premises You Own, Rent or Occupy:
See Schedule of Locations
Item 3. Forms and Endorsements
Form(s) and Endorsement(s) made apart of this policy at time of issue:
See Schedule of Forms and Endorsements
Item 4. Premiums
Coverage Part Premium:
$ 1,920
Other Premium:
$
Total Premium:
$ 1, 920
THESE DECLARATIONS ARE PART OF THE POLICY DECLARATIONS CONTAINING THE NAME OF THE INSURED AND
THE POLICY PERIOD.
CLS-SD-1 L (8-01) INSURED c l s ed11 g. f ap
WORKERS' COMPENSATION DECLARATION
I Hiba Shublak, Executive Director hereby affirm under penalty of perjury, the
(Name/Title)
following declaration
I certify on behalf of Active Learning, Inc, that during the term of my
(Consultant/Company Name)
contract for 2017 services with the City of Santa Ana, I will not employ any person in
any manner so as to become subject to the workers' compensation laws of California, and
agree that if I should become subject to the workers' compensation provisions of Section
3700 of the Labor Code, I shall forthwith comply with those provisions and provide proof
of workers' compensation coverage.
DATE: 12/20/16
By: Active Learning, Inc.
Name: Hiba Shublak 1*r a Sh"Nak
Title Executive Director
Telephone: 714.717.4534
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS
UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES
AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000). IN
ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR
IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
Reviewed by:
5,16
Silvia Cuevas
PRf,,SA/Admin.
Policy No.
A SCOTTSDALE INSURANCE COMPANY'
COMMERCIAL GENERAL LIABILITY COVERAGE PART
EXTENSION OF SUPPLEMENTAL DECLARATIONS
CPS2561230
Effective Date: 11 / 2 6 / 2 016
12:01 A.M., Standard Time
Named Insured HIBA SHUBLAK DBA: ACTIVE LEARNING Agent No, 04068
Prem. No. Bldg, No.
1 1
Class Code
47475
Exposure
80, 000
Basis
GROSS SALES
Class Description:
SCHOOLS - PRIVATE - ELEMENTARY, KINDERGARTEN OR
JUNIOR HIGH (OTHER -THAN -NOT -FOR -PROFIT)
(PRODUCTS -COMPLETED OPERATIONS ARE SUBJECT TO THE
GENERAL AGGREGATE LIMIT)
Premises/ Operations
Rate
Premium
24
1,920
Products/ Comp Operations
Rate
Premium
INCLUDED
INCLUDED
Prem, No. Bldg, No.
Class Code
Exposure
Basis
Class Description:
Premises/ Operations
Rate
Premium
Products/Comp Operations
Rate
Premium
Prem, No. Bldg. No.
Class Code
Exposure
Basis
Class Description:
d Q`•
Premises/ Operations
Rate
Premium
Products/ Comp Operations
Rate
Premium
Prem. No. Bldg. No.
Class Code
Exposure
Basis
Class Description:�\�®� �iP
Premises/ Operations
Rate
Premium
Products/ Comp Operations
Rate
Premium
CLS-SP-1 L(10-93) INSURED clsspllf . fap
A SCOTTSDALE INSURANCE COMPANY"
ENDORSEMENT
NO.
ATTACHED TO AND
END ORSEM ENT EFFECTIVE DATE
FORMING APART OF
POLICY NUMBER
(12:01 A.M. STANDARD TIME)
NAMED INSURED
AGENT NO.
CPS2561230
11/26/2016
HIBA SHUBLAK DBA: ACTIVE LEARNING
04068
THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ IT CAREFULLY.
BLANKET ADDITIONAL INSURED ENDORSEMENT
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
With respect to this endorsement, SECTION 11 - WHO IS
AN INSURED is amended to include as an additional in-
sured any person or organization whom you are required
to add as an additional insured on this policy under a writ-
ten contract, written agreement or written permit which
must be:
a. Currently in effect or becoming effective during
the term of the policy; and
b. Executed prior to the "bodily injury," "property
damage," or "personal and advertising injury."
The insurance provided to these additional insureds is lim-
ited as follows:
1. That person or organization is an additional in-
sured only with respect to liability for "bodily
injury," "property damage" or "personal and adver-
tising injury" caused, in whole or in part, by:
a. Your acts cr omissions; or
b. The acts or omissions of those acting on your
behalf.
A person's or organization's status as an additional
insured under this endorsement ends when
your operations for that additional insured are
completed. 5. The insurance provided to the additional insured
2. With respect to the insurance afforded to these ad- does not apply to "bodily injury," "property dam-
ditional insureds, the following exclusions are age," or "personal and advertising injury" arising
added to item 2. Exclusions of SECTION I - out of an architect's, engineer's or surveyor's ren-
COVERAGES: dering of or failure to render any professional serv-
ces including:
This insurance does not apply to "bodily injury;'
"property damage" or "personal and advertising in-®g,�
jury" occurring after:
Includes copyrighted material of ISO Properties, Inc., with its permission.
Copyright, ISO Properties, Inc., 2004
GLS-150s (7-06) Page 1 of 2:%b`'p'°I
INSURED
a. All work, including materials, parts or equip-
ment furnished in connection with such work,
on the project (other than service, mainte-
nance or repairs) to be performed by or on be-
half of the additional insured(s) at the location
of the covered operations has been com-
pleted; or
b. That portion of "your work" out of which the in-
jury or damage arises has been put to its in-
tended use by any person or organization
otherthan another contractor or subcontractor
engaged in performing operations for a princi-
pal as a part of the same project.
3. The limits of insurance applicable to the additional
insured are those specified in the written contract,
written agreement or written permit or in the Decla-
rations for this policy, whichever is less. These lim-
its of insurance are inclusive of, and not in addition
to, the Limits of Insurance shown in the Declara-
tions for this policy.
4. Coverage is not provided for "bodily injury," "prop-
erty damage," or "personal and advertising injury"
arising out of the sole negligence of the additional
insured.
a. The preparing, approving or failing to prepare
or approve maps, shop drawings, opinions, re-
ports, surveys, field orders, change orders or
drawings and specifications; and
b. Supervisory, inspection, architectural or engi-
neering activities.
6. Any coverage provided hereunder will be excess
over any other valid and collectible insurance avail-
able to the additional insured whether primary, ex-
cess, contingent or on any other basis unless a
written contract specifically requires that this insur-
ance be primary.
When this insurance is excess, we will have no du-
ty under SECTION I • COVERAGES to defend the
additional insured against any "suit" if any other in-
surer has a duty to defend the additional insured
against that "suit." If no other insurer defends, we
will undertake to do so, but we will be entitled to
the additional insured's rights against all those oth-
er insurers.
AUTHORIZED REPRESENTATIVE DATE
Includes copyrighted material of 150 Properties, Inc., with its permission.
Copyright, 150 Properties, Inc., 2004
GLS-150s (7-06) Page 2 or 2
SCOTTSDALE INSURANCE COMPANY,
A Stock Insurance Company, herein called the Company
ERRORS AND OMISSIONS COVERAGE PART
Various provisions in this Coverage Part restrict coverage. Read the entire Coverage Part carefully to deter-
mine rights, duties, and what is and is not covered.
Throughout this Coverage Part the words "you" and "your" refer to the Named Insured shown in the Declara-
tions, and any other person or organization qualifying as a Named Insured under this Coverage Part. The
words "we, "us,"and "our" refer to the company providing this insurance.
The word "insured" means any person or organization qualifying as such under WHO IS AN INSURED
(SECTION II).
Other words and phrases that appear in quotation marks have special meaning. Refer to DEFINITIONS
(SECTION VI).
SCHEDULE
Description of Services:
Coverage
Limits Of Insurance
Errors or Omissions
$-----------1000 000---------
000--------
Each Claim
—_Aggregate
Premium Basis
Rate
Premium
$
INCLUDED
SECTION I • COVERAGE
1. Insuring Agreement
a. We will pay those sums that the insured becomes legally obligated to pay as "damages" as a result
of an "error or omission" 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 an "error or omission" to which this insurance
does not apply. We may, at our discretion, investigate any "error or omission" and settle any "claim"
or "suit" that may result. But:
(1) The amount we will pay for "damages" is limited as described in LIMITS OF INSURANCE
(SECTION III); and
(2) Our right and duty to defend ends when we have used up the applicable limit of insurance in the
payment of judgments or settlements.
No other obligation or liability to pay sums or perform acts or services is covered unle s explic-
itly provided for under SUPPLEMENTARY PAYMENTS. N O6°QN'
b. This insurance applies to"errors or omissions"only if:\eav`
(1) The "error or omission" takes place in the coverage territory; an
(2) The "error or omission" occurs during the policy period
GLS-172s (6-14) Pagel of 10
INSURED 91s172s-d.fap
(3) Prior to the policy period, no insured listed under paragraph 1. of SECTION II -WHO IS AN IN-
SURED and no employee authorized by you to give or receive notice of an occurrence or
claim, knew that the "damages' had occurred, in whole or in part. If such a listed insured knew,
prior to the policy period, that the "damages" occurred, then any continuation, change or re-
sumption of such "damages" during or after the policy period will be deemed to have been
known prior to the policy period.
c. "Damages" which occurred during the policy period and were not, prior to the policy period, known
to have occurred by any insured listed under paragraph 1. of SECTION II - WHO IS AN INSURED
or any employee authorized by you to give or receive notice of an occurrence or claim, includes
any continuation, change or resumption of "damages" after the end of the policy period.
d. "Damages" will be deemed to have been known to have occurred at the earliest time when any in-
sured listed under paragraph 1. of SECTION II - WHO IS AN INSURED or any employee autho-
rized by you to give or receive notice of an occurrence or claim:
(1) Reports all, or any part, of the "damages" to us or any other insurer;
(2) Receives a written or verbal demand or claim for "damages"; or
(3) Becomes aware by any other means that "damages" have occurred or have begun to occur.
e. "Damages" because of "errors or omissions" include "damages" claimed by any person or organiza-
tion for care, loss of services or death resulting at anytime from the "error or omission."
2. Exclusions
This insurance does not apply to:
a. "Errors or omissions" for which the insured is obligated to pay "damages" by reason of the assump-
tion of liability in a contract or agreement. This exclusion does not apply to liability for "damages"
thatthe insured would have in the absence of the contract or agreement.
Ill Any obligation of any insured under any workers' compensation, unemployment compensation,
disability benefits law, Federal Securities Act of 1933, Employee Retirement Income Security Act of
1974 (ERISA) or under any similar law.
c. Injury arising out of the ownership, maintenance, use or entrustment to others of any aircraft, "auto,"
or watercraft owned or operated by or rented or loaned to any insured. Use includes operation and
"loading or unloading."
d. Injury arising out of a dishonest, fraudulent, malicious or criminal act by any insured.
e. (1) Injury arising out of the actual, alleged or threatened discharge, dispersal, seepage, migration,
release 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;
(b) At or from any premises, site or location which is or was at any time used by or for any in-
sured or others for the handling, storage, disposal, processing or treatment of waste;
(c) Which are or were at any time transported, handled, stored, treated, disposed of, or pro-
cessed as waste by or for any insured or any person or organization for whom you may be
legally responsible; or
(d) At or from any premises, site or location on which any insured or any contractors or
subcontractors working directly or indirectly on any insured's behalf aredp�jirming
operations: ie�e
�e4 tol e
(1) If the pollutants are brought on or to the premises, site or location i n ctio
such operations by such insured, contractor or subcontractor; or evas
G13
a GLS-172s (6-14) Page 2 of 10
(ii) 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 effects of pollutants.
(2) Any loss, cost, or expense arising out of any:
(a) Request, demand, order, statutory or regulatory requirement that any insured or others test
for, monitor, clean up, remove, contain, treat, detoxify or neutralize, or in any way respond
to, or assess the effects of pollutants; or
(b) "Claim" or "suit" by or on behalf of a government authority for "damages" because of testing
for, monitoring, cleaning up, removing, containing, treating, detoxifying or neutralizing, or
in any way responding to, or assessing the effects of pollutants.
Pollutants means any solid, liquid, gaseous or thermal irritant or contaminant, including smoke, va-
por, soot, fumes, acids, alkalis, chemicals and waste. Waste includes materials to be recycled, re-
conditioned or reclaimed,
f. "Damages" caused or arising, directly or indirectly, out of:
(1) War, including undeclared or civil war;
(2) Warlike action by a military force, including action in hindering or defending against an actual or
expected attack, by any government, sovereign or other authority using military personnel or
other agents; or
(3) Insurrection, rebellion, revolution, usurped power, or action taken by governmental authority in
hindering or defending against any of these.
g. Damageto:
(1) Property you own, rent, or occupy, including any costs or expenses incurred by you, or any
other person, organization or entity, for repair, replacement, enhancement, restoration or main-
tenance of such property for any reason, including prevention of injury to a person or damage
to another's property;
(2) Premises you sell, give away or abandon, if the damage arises out of any part of those
premises;
(3) Property loaned to you, except property loaned to you and held as evidence;
(4) Personal property in the care, custody or control of the insured, except when the property is
being held as evidence;
(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 damage arises out of those
operations; or
(6) That particular part of any property that must be restored, repaired or replaced because "your
work" was incorrectly performed on it.
Paragraph (2) of this exclusion does not apply if the premises are "your work" and were never occu-
pied, rented or held for rental by you.
h. Damage to "your work" arising out of it or any part of it.
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 subcontractor.
I. Damage to "impaired property" or property that has not been physically injured, arising out of:
ed)D�.
(1) A defect, deficiency, inadequacy or dangerous condition in "your product" 1;ko ;or v` I �
(2) A delay or failure by you or anyone acting on your behalf to perform a contractor agerrt i
accordance with its term s. oeU SCS
Sm\�
GLS-172s (6-14) Page 3 of 10 �,I o
This exclusion does not apply to the loss of use of other property arising out of sudden and acci-
dental physical injury to "your product" or "your work" after it has been put to its intended use.
j. "Damages" claimed for any loss, cost or expense incurred by you or others for the loss of use, with-
drawal, recall, inspection, repair, replacement, 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 per-
son or organization because of a known or suspected defect, deficiency, inadequacy or dangerous
condition in it.
k. Injury to:
(1) An employee of the insured arising out of and in the course of employment by the insured, in-
cluding wrongful termination; or
(2) The spouse, child, parent, brother, sister of that employee as a consequence of k.(1) above;
This exclusion applies:
(a) Whether the insured may be liable as an employer or in any other capacity; and
(b) To any obligation to share "damages" with or repay someone else who must pay "dam-
ages" because of the injury,
I. Injury to:
(1) A person arising out of any:
(a) Refusal to employ that person;
(b) Termination of that person's employment; or
(c) Employment -related practices, policies, acts or omissions, such as coercion, demotion,
evaluation, reassignment, discipline, defamation, harassment, humiliation or discrimination
directed at that person; or
(2) The spouse, child, parent, brother or sister of that person as a consequence of injury to that
person at whom any of the employment -related practices described in paragraphs (a), (b), or
(c) above is directed.
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 "damages" be-
cause of the injury.
m. Any injury arising out of any circumstances due to nuclear reaction, radiation, or contamination re-
gardless of cause.
n. Injury arising out of:
(1) Inhaling, ingesting or prolonged physical exposure to asbestos or goods or products contain-
ing asbestos;
(2) The use of asbestos in construction or manufacturing any good, product or strucctttue 916
(3) The removal of asbestos from any good, product or structure; or
GLS-172s (6-14) Page 4of 10�
(4) The manufacture, sale, transportation, storage or disposal of asbestos or goods or products
containing asbestos.
o. Any "error or omission" arising out of the rendering or failure to render any service provided by any
architect, engineer, accountant, land surveyor, actuary, insurance agent or broker, financial man-
agement consultant, physician or attorney.
p. Any claims covered under the Commercial General Liability Coverage Part, Liquor Liability Cover-
age Part or any other coverages included in this policy.
q. "Damages" arising out of the loss of, loss of use of, damage to, corruption of, inability to access,
or inability to manipulate electronic data. As used in this exclusion, electronic data means informa-
tion, facts or programs stored as or on, created or used on, or transmitted to or from computer soft-
ware, including systems and applications software, hard or floppy disks, CD-ROMs, tapes, drives,
cells, data processing devices or any other media which are used with electronically controlled
equipment.
r. Damages arising out of:
(1) Any access to or disclosure of any person's or organization's confidential or personal informa-
tion, including patents, trade secrets, processing methods, customer lists, financial information,
credit card information, health information or any other type of nonpublic information; or
(2) The loss of, loss of use of, damage to, corruption of, inability to access, or inability to manipu-
late electronic data.
This exclusion applies even if damages are claimed for notification costs, credit monitoring ex-
penses, forensic expenses, public relations expenses or any other loss, cost or expense incurred
by you or others arising out of that which is described in paragraph (1) or (2) above.
However, unless paragraph (1) above applies, this exclusion does not apply to damages because
of "bodily injury."
As used in this exclusion, electronic data means information, facts or programs stored as or on, cre-
ated or used on, or transmitted to or from computer software, including systems and applications
software, hard or floppy disks, CD-ROMs, tapes, drives, cells, data processing devices or any other
media which are used with electronically controlled equipment.
SUPPLEMENTARY PAYMENTS
We will pay, with respect to any "claim" we investigate or settle, or any "suit" against an insured we defend:
1. All expenses we incur.
2. The cost of bonds to release attachments, but only for bond amounts within the applicable limit of insur-
ance. We do not have to furnish these bonds.
3. All reasonable expenses incurred by the insured at our request to assist us in the investigation or de-
fense of the "claim" or "suit," including actual loss of earnings up to two hundred fifty dollars ($250) a
day because of time off from work.
4. All costs taxed against the insured in the "suit"
5. 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 interest based on that pe-
riod of time after the offer.
6. All interest on the full amount of any judgment that accrues after entry of the judgment and before we
have paid, offered to pay, or deposited in court the part of the judgment that is within the apLimit
of insurance. ?1eA\e\N OI i 4
e`,lsS
GLS-172s (6-14) Page 5 of 10
These payments will not reduce the limits of insurance.
SECTION II -WHO IS AN INSURED
If you are designated in the Declarations as:
1. An individual, you and your spouse are insureds, but only with respect to the conduct of a business of
which you are sole owner.
2. A partnership or joint venture, you are an insured. Your members, your partners and their spouses are
also insureds, but only with respect to the conduct of your business.
3. 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.
4. A trust, you are an insured. Your trustees are also insureds, but only with respect to their duties as
trustees.
S. An organization other than a partnership, joint venture, limited liability company or trust you are an
insured. Your executive officers and directors are insureds, but only with respect to their duties as your
officers or directors. Your stockholders are also insureds, but only with respect to their liability as
stockholders.
6. Your employees are insureds but only for acts within the scope of their employment by you or while per-
forming duties related to the conduct of your business.
7. A trust, you are an insured. Your trustees are also insureds, but only with respect to their duties as
trustees.
8. Your "volunteer workers" and your employees are insureds but only for acts within the scope of their
employment for you or while performing duties related to the conduct of your business.
SECTION III - LIMITS OF INSURANCE
1. The Limits of Insurance shown in the Schedule of this Coverage Part and the rules belowfix the most we
will pay regardless of the number of:
a. Insureds;
b. "Claims" made or "suits" brought; or
c. Persons or organizations making "claims" or bringing "suits."
2. The Aggregate Limit is the most we will pay for all "damages" because of an "error or omission" under
this insurance regardless of the number of "claims"
3. Subject to the Aggregate Limit, the Each Claim Limit is the most we will pay for all "damages" arising out
of any one "claim."
The Limits of Insurance of this Coverage Part apply separately to each consecutive annual period and to
any remaining period of less than twelve (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
twelve (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.
��,�Iae��� s�a•C�LE��
NOS
GLS-172s (6-14) Page 6 of 10
SECTION IV - COVERAGE PART CONDITIONS
1. Bankruptcy
Bankruptcy or insolvency of the insured or of the insured's estate will not relieve us of our obligations
under this Coverage Part.
2. Duties in the event ofan'Error orOmission ,"'.Claim"or'Suit"
a. You must see to it that we are notified as soon as practicable of an "error or omission" which may
result in a "claim." To the extent possible, notice should include:
(1) How, when and where the "error or omission" 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 "error or omission."
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 notice of the "claim" or "suit" as soon as practicable.
c. You and any other involved insured must:
(1) Immediately send us copies of any demands, notices, summonses or legal papers received in
connection with the "claim"or "suit";
(2) Authorize usto obtain records and other information;
(3) Cooperate with us in the investigation, settlement or defense of the "claim" or "suit"; and
(4) Assist us, upon our request, in the enforcement of any right against any person or organization
which may be liable to the insured because of injury or damage to which this insurance may
also apply.
d. No insured will, except at their own cost, voluntarily make a payment, assume any obligation, or in-
cur any expense, 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 insurance. An agreed settlement
means a settlement and release of liability signed by us, the insured and the claimant or the claimant's legal
representative.
4. Other Insurance
If other valid and collectible insurance is available to the insured for a loss we cover, our obligations are
limited as follows:
a. Primary Insurance �n {
\ ee �r
GLS-172s (6-14) Page 7 of 10
This insurance is primary except when b. below applies. If this insurance is primary, our obligations
are not affected unless any of the other insurance is also primary. Then, we will share with all that
other insurance by the method described below.
b. Excess Insurance
This insurance is excess over any other insurance, whether primary, excess, contingent or on any
other basis that is valid and collectible insurance available to you under any other policy.
When this insurance is excess, we have no duty to defend the insured against any "suit" if any other
insurer has a duty to defend the insured against that "suit." If no other insurer defends, we will
undertake to do so, but we will be entitled to the insured's rights against those other insurers,
When this insurance is excess over other insurance, we will pay only the amount of the loss, if any,
that exceeds the sum of:
(1) The total amount that all such other insurance would pay for the loss in the absence of this in-
surance; and
(2) The total of all deductible and self -insured amounts under all other insurance.
If a loss occurs involving two or more policies, each of which states that its insurance will be ex-
cess, then our policy will contribute on a pro rata basis.
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 contributes equal amounts until it has paid its applicable limit of
Insurance or none of the loss remains, 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 insur-
ance to the total applicable limits of insurance of all insurers.
5. Premium Audit
a. We will compute all premiums for this Coverage Part in accordance with our rules and rates.
b. Premium shown in this Coverage Part as advance premium is a deposit premium only. At the close
of each audit period we will compute the earned premium for that period. Audit premiums 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 computation,
and send us copies at such times as we may request.
6. Representations
By accepting this policy, you agree;
a. The statements in the Declarations are accurate and complete;
b. Those statements are based upon representations you made to us; and
c. We have issued this policy in reliance upon your representations,
Separation of Insureds
Except with respect to the Limits of Insurance, and any rights or duties specifically assign,�e
erage Part to the first Named Insured, the insurance applies: ?1e A
a. As if each Named Insured were the only Named Insured; and
GLS-172s (6-14.)
�x
Page 8 of 10
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 the 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.
SECTION V- COVERAGE TERRITORY
This insurance applies to "damages" for injury caused by an "error or omission" anywhere in the world, so
long as the original "claim" or "suit" for such "damages" is brought in the United States of America (including
its territories and possessions), Puerto Rico and Canada.
SECTION VI - DEFINITIONS
1. "Auto" means a land motor vehicle, trailer or semi -trailer designated for travel on public roads, including
any attached machinery or equipment.
2. "Claim" means an oral or written notice from any party that it is their intention to hold you responsible for
any "error or omission."
3. "Damages" means monetary judgments, awards or settlements the insured is legally obligated to pay as
a result of an "error or omission" to which this insurance applies.
"Damages" shall not include:
a. Amounts paid to you as fees or expenses for services performed which are to be reimbursed or dis-
charged as a part of the judgment or settlement; or
b. Judgments or awards arising from acts deemed uninsurable bylaw.
4. "Error or omission" means any negligent act, error or omission while performing those services de-
scribed in the Schedule of this Coverage Part under the Description of Services.
5. "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, deficient, in-
adequate 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 removal of"your product" or "your work"; or
b. Your fulfilling the terms of the contract or agreement.
6. "Loading or unloading" means the handling of persons or property:
a. After being moved from the place where accepted for movement into or onto an aircraft, watercraft,
or "auto";
b. While in or on an aircraft, watercraft, or "auto"; or
c. While being moved from an aircraft, watercraft or "auto" to the place of final delivery; %)
but "loading or unloading" does not include the movement of property by means of a1$'i al �iet `y�
vice, other than a hand truck, that is not attached to the aircraft, watercraft or "auto" \ b I
clt`)\�
c a4�� \
GLS-172s (6-14) Page 9 of 10 )
7. "Suit" means a civil proceeding in which "damages" for injury to which this insurance applies are al-
leged. "Suit" includes:
a. An arbitration proceeding in which such "damages" are claimed and to which the insured must sub-
mit or does submit with our consent; or
b. Any other alternative dispute resolution proceeding in which such "damages" are claimed and to
which the insured submits with our consent.
8. "Volunteer worker" means a person who is not your employee, and who donates his or her work and
acts at the direction of and within the scope of duties determined by you, and is not paid a fee, salary or
other compensation by you or anyone else for their work performed for you.
9. "Your product" means:
a. Any goods or products, other than real property, manufactured, sold, handled, distributed or dis-
posed 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.
10. "Your work" means:
a. Work or operations performed by you or on your behalf; and
b. Materials, parts or equipment furnished in connection with such work or operations.
GLS-172s (6-14) Page 10 of 10
�D` I�\�
?I�`cj Z)
A SCOTTSDALE INSURANCE COMPANY"
ENDORSEMENT
NO.
ATTACHED TO AND
END ORSEM ENT EFFECTIVE DATE
FORMING APART OF
(12:01 A.M. STANDARD TIME)
NAMED INSURED
AGENTNO.
POLICYNUMBER
CPS2561230
11/26/2016
HIBA SHUBLAK DBA: ACTIVE LEARNING
0406E
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
KNOWN INJURY OR DAMAGE EXCLUSION -
PERSONAL AND ADVERTISING INJURY
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE FORM
The following exclusion is added to Paragraph 2. Exclu-
sions of SECTION I - COVERAGES, COVERAGE B PER-
SONAL AND ADVERTISING INJURY LIABILITY:
Known Injury Or Damage
This insurance does not apply to "personal and ad-
vertising injury" arising from an offense:
a. That occurs during the policy period and, prior
to the policy period, an insured listed under
Paragraph 1. of SECTION II - WHO IS AN IN-
SURED or an "employee" authorized by you to
give or receive notice of an offense or claim,
knew that the "personal and advertising injury"
had occurred prior to the policy period, in
whole or in part. If such a listed insured or au-
thorized "employee" knew, prior to the policy
period, that the "personal and advertising in-
jury" occurred, then any continuation, change
or resumption of such offense during or after
the policy period will be deemed to have been
known prior to the policy period; or
b. That occurs during the policy period and was,
prior to the policy period, known to have
occurred by any insured listed under Para-
graph 1. of SECTION II - WHO IS AN IN-
SURED or an "employee" authorized by you to
give or receive notice of an offense or claim, in-
cludes any continuation, change or resump-
tion of that "personal and advertising injury"
after the end of the policy period,
A "personal and advertising injury" arising from an of-
fense will be deemed to have been known to have oc-
curred at the earliest time when any insured listed
under Paragraph 1. of SECTION 11 - WHO IS AN IN-
SURED or an "employee" authorized by you to give or
receive notice of an offense or claim:
(1) Reports all, or any part, of the "personal
and advertising injury" to us or any other
insurer;
(2) Receives a written or verbal demand or
claim for damages because of the "person-
al and advertising injury"; or
(3) Becomes aware by any other means that
"personal and advertising injury" has oc-
curred or has begun to occur,
M
AUTHORIZED REPRESENTATIVE
Includes copyrighted material of ISO Properties, Inc., with its permission.
Copyright, ISO Properties, Inc., 2006
GLS-289s It1-07) Page 1 of i
INSURED
A� SCOTTSDALE INSURANCE COMPANY""
ENDORSEMENT
NO.
ATTACHED TO AND
ENDORSE M ENT EFFECTIVE DATE
FORM ING APART OF
(11;01 A.M. STANDARD TIME)
NAMED INSURED
AGENT NO.
POLICY NUMBER
CPS2561230
11/26/2016
HIEA SHUBLAK DBA: ACTIVE LEARNING
04068
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
MARIJUANA/ CANNABIS PRODUCTS EXCLUSION
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
This insurance does not apply to "bodily injury ... 'property damage" and/or "personal and advertising injury"
arising out of the sale, consumption, use or the exposure to the consumption or use of "marijuana, "edible
marijuana -infused product," "marijuana -infused product," "cannabis," or "cannabis containing product, or
any material, substance or item containing tetrahydrocannabinol (THC).
However, this exclusion shall not apply in the following state(s) [If left blank this exclusion applies in all
states]:
For purposes of this endorsement, the following definitions apply:
"Cannabis" means the following substances under whatever names they may be designated: The resin ex-
tracted from any part of a plant of the genus cannabis, and every compound, manufacture, salt, derivative,
mixture or preparation of such plant, its seeds or its resin.
"Cannabis containing product" means a product containing "cannabis" that is intended for use or consump-
tion, including but not limited to edible products, ointments, aerosols, oils, and tinctures.
"Edible marijuana -infused product" means a "Marijuana -Infused Product" that is to be consumed by eating
or drinking.
"Marijuana" means all parts of the plant Cannabis sativa L., whether growing or not; the seeds thereof; and
resin extracted from any part of the plant; and every compound, manufacture, salt, derivative, mixture, or
preparation of the plant and every compound, manufacture, salt, derivative, mixture, or preparation of the
plant, its seeds or resin. The term also includes "marijuana infused product(s)."
"Marijuana -Infused Product" means a product infused with marijuana that is intended for use or consump-
tion, including but not limited to edible products, ointments, aerosols, oils, and tinctures.
AUTHORIZED REPRESENTATIVE
GLS-455s (8-14) Page 1 of 1 Y ° "
INSURED g1545590814.fap
J0%,' SCOTTSDALE INSURANCE COMPANY"
ENDORSEMENT
NO.
ATTACHED TO AND
ENDORSEMENT EFFECTIVE DATE
FORMING A PART OF
Iy 2;D7 A.M. STANDARD TIME)
NAMED INSURED
AGENTNO,
POLICY NUMBER
CPS2561230
11/26/2016
HIBA SHUSLAK DSA: ACTIVE LEARNING
04068
THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ IT CAREFULLY.
OPTIONAL PROVISIONS ENDORSEMENT
The following special provisions (indicated by an "x") apply to this policy:
SCHEDULE
M Bodily Injury, Property Damage, Personal Injury and Advertising Injury Liability Deductible
Endorsement
Coverage
Amount and Basis of Deductible
Bodily Injury Liability
$ 500 per claimant
Property Damage Liability
$ 500 per claimant
Personal and Advertising Injury Liability
$ 500 per claimant
M Service of Suit Clause
Service of Process will be accepted by: COMMISSIONER_ OF INSURANCE_________________
45 FREMONT_STREET _239D_FL0ORy_SPSLFRANCISCO_CA94105_--- _----- _,and
Service of Process will be mailed to: C10 _UNITED STATES CORPORATION_ COMPANY____________—_
2210__OATEWAY OAKS DRIVE, --SUITE 150_MSACJ2AM,EMTOsATE},3__E505________________
M Minimum and Advance Premium Endorsement
Minimum Premium
IN Minimum Earned Cancellation Premium
Minimum Earned Cancellation Premium
of the advance premium.
ed
Includes copyrighted material of ISO Properties, Inc., with its permission. ��^^�,ei���
Copyright, 150 Properties, Inc., 2007 %
1.J.O G-D
e !AA
UTS-128s (8-15) Page 1 of
INSURED �m:9128s-o.fap
GLS-94s (6-15)
BODILY INJURY, PROPERTY DAMAGE, PERSONAL INJURY AND ADVERTISING
INJURY LIABILITY DEDUCTIBLE ENDORSEMENT
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
1. Our obligation under the Bodily Injury Liability, Property Damage Liability, Personal and Advertising In-
jury Liability coverages to pay damages on your behalf applies only to the amount of damages in ex-
cess of any deductible amounts stated in the Schedule above as applicable to such coverages, and the
Limits of Insurance applicable to Each Occurrence or offense for such coverages will be reduced by the
amount of such deductible. Aggregate Limits for such coverages shall not be reduced by the applica-
tion of such deductible amount.
2. The deductible amounts apply to damages and "loss adjustment expenses"
"Loss Adjustment Expenses" means the expenses which are incurred in conjunction with the defense,
adjustment or settlement of claims made under any one of the policies and which are allocable to such
claims according to generally accepted insurance industry practices; such expenses include, but are
not limited to, expenditures for legal costs, attorneys fees, investigations, experts, independent adjust-
ment services, and expenses incurred in obtaining recovery against any third party.
3. The deductible amounts stated in the Schedule above apply, respectively:
a. Under the Bodily Injury Liability Coverage to all damages because of "bodily injury' sustained by
one person;
b. Under the Property Damage Liability Coverage to all damages because of "property damage" sus-
tained by one person, organization or association; and
c. Under the Personal and Advertising Injury Liability coverage to all damages sustained by one per-
son, organization or association;
as the result of any one "occurrence" or offense.
4. The terms of this insurance, including those with respect to our right and duty to defend any "suits"
seeking those damages and your duties in the event of an "occurrence," offense, claim or "suit," apply ir-
respective of the application of the deductible amount.
S. We may pay any part or all of the deductible amount to effect settlement of any claim or "suit," and upon
notification of the action taken, you shall promptly reimburse us for such part of the deductible amount
as has been paid by us.
Includes copyrighted material of ISO Properties, Inc„ with its permission.
Copyright, ISO Properties, Inc„ 2007
UTS-128s (8-15) Page 2 of 4
UTS-9g (5-96)
SERVICE OF SUIT CLAUSE
It is agreed that in the event of the failure of the Company to pay any amount claimed to be due under this
policy, the Company at the request of the Insured (or reinsured), will submit to the jurisdiction of any court
of competent jurisdiction within the United States of America and will comply with all requirements neces-
sary to give the Court jurisdiction. All matters which arise will be determined in accordance with the law and
practice of the Court. In a suit instituted against any one of them under this contract, the Company agrees to
abide by the final decision of the Court or of any Appellate Court in the event of an appeal.
Pursuant to any statute of any state, territory or district of the United States of America which makes provi-
sion, the Company will designate the Superintendent, Commissioner or Director of Insurance or other offi-
cer specified for that purpose in the statute, or his successor or successors in office, as their true and lawful
attomey upon whom may be served any lawful process in any action, suit, or proceeding instituted by or on
behalf of the Insured (or reinsured) or any beneficiary arising out of this contract of insurance (or
reinsurance).
The officer named in the Schedule of this endorsement is authorized and directed to accept service of pro-
cess on behalf of the Company.
Having accepted service of process on behalf of the Company, the officer is authorized to mail the process
or a true copy to the individual named in the Schedule above.
GI.547s(1 M7)
MINIMUM AND ADVANCE PREMIUM ENDORSEMENT
This endorsement modifies Conditions provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
LIQUOR LIABILITY COVERAGE PART
PRODUCTS/ COMPLETED OPERATIONS LIABILITY COVERAGE PART
Item 5.b. of the Premium Audit Condition (under SECTION IV . COMMERCIAL GENERAL LIABILITY CON-
DITIONS, LIQUOR LIABILITY CONDITIONS AND PRODUCTStCOMPLETED OPERATIONS LIABILITY
CONDITIONS) is amended to read:
b. The advance premium for this Coverage Part is a deposit premium only. The final premium shall be
subject to audit. At the close of each audit period we will compute the earned premium for that pe-
riod. Any audit premiums are due and payable to us on notice to the first Named Insured, If the sum
of the advance and audit premiums paid for the policy term is greater than the earned premium, we
will return the excess to the first Named Insured, subject to the minimum premium as defined be-
low. In the event the first Named Insured fails or refuses to allow our representative to audit your
books and records, we may unilaterally charge a final premium for the policy period at double the
minimum or advance premium, whichever is greater, and such final premium shall be immediately
due and payable on notice to the first Named Insured. For purposes of this endorsement, the terms
advance premium, earned premium, and minimum premium are defined as follows:
Was
Includes copyrighted rnaterfa! of ISO Properties, Inc., with its permission.
Copyright, ISO Properties, Inc., 2447�`,1a
UTS-128s (8-15) Page 3 of 4� �"'
Advance Premium - The premium that is stated in the applicable initial policy Declarations or
Renewal Certificate and payable in full by the first Named Insured at the inception of each Pol-
icy Period.
Earned Premium - The premium that is developed by applying the rate(s) scheduled in the pol-
icy to the actual premium basis for the audit period,
Minimum Premium - The lowest premium for which this insurance will be written for the Policy
Period stated in Item 2. of the Declarations of the applicable initial policy or subsequent Re-
newal Certificate. This minimum premium is equal to one hundred percent (100%) (unless a dif-
ferent percentage [%] is shown in the SCHEDULE above) of the advance premium including
any premium adjustments made by endorsement to this policy during the Policy Period, Pre-
mium adjustments do not include the audit premium developed for the Policy Period stated in
Item 2. of the Declarations.
UTS-1199 (6-14)
MINIMUM EARNED CANCELLATION PREMIUM
The following provision is added to the Cancellation Condition:
If You request cancellation of this policy, We will retain not less than the portion of the advance premium as
stated in the Schedule.
AUTHORIZED REPRESENTATIVE
Includes copyrighted material of ISO Properties, Inc., with its perm
Copyright, 150 Properties, Inc., 2007
UTS-128s (8-15) Page 4 of 4
A SCOTTSDALE INSURANCE COMPANY"
ENDORSEMENT
NO.
ATTACHED TO AND
ENDORSEMENT EFFECTIVE DATE
FORMING APART OF
POLICY NUMBER
(12;01 A.M. STANDARD TIM E)
NAMED INSURED
AGENTNO.
CPS2561230
11/26/2016
HIBA SHUSLAK DBA: ACTIVE LEARNING
04068
THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ IT CAREFULLY.
COMMUNICABLE DISEASE EXCLUSION
This insurance does not apply to "bodily injury," "property damage," "personal and advertising injury," error
or omission, or other damages arising out of the actual or alleged transmission of or exposure to a "commu-
nicable disease," illness or condition related to any "communicable disease"
This exclusion applies even if claims against any insured allege negligence or other wrongdoing in the:
a. Actor failure to act by any insured;
b. Supervising, hiring, employing, training or monitoring of others or care of animals that may be infected
with and spread a "communicable disease";
c. Testing for a "communicable disease";
d. Failure to prevent the spread of the disease; or
e. Failure to report the disease to authorities as required by local, state or federal law, statute or regulation.
For purposes of this endorsement, the following definition applies:
"Communicable disease" means any infectious and/or contagious disease, including but not limited to, dis-
eases caused by bacteria, fungi, protozoa, viruses, or any combination of the foregoing.
AUTHORIZED REPRESENTATIVE
Includes copyrighted material of ISO Properties, Inc., with its permission.
Copyright, ISO Properties, Inc., 2008
UTS-180g (10-08) Page 1 of 1
INSURED
Pa
CP
SCOTTSDALE INSURANCE COMPANY"'
ENDORSEMENT
NO.
ATTACHED TO AND
ENDORSEMENT EFFECTIVE DATE
FORMING APART OF
(12;01 A.M. STANDARD TIME)
NAMED INSURED
AGENT NO.
POLICY NUMBER
CPS2561230
11/26/2016
HIBA SHUBLAK DBA: ACTIVE LEARNING
04068
THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ IT CAREFULLY.
AMENDATORY ENDORSEMENTS
(Without Medical Payments Exclusion)
This endorsement lists several endorsements that modify your policy as follows:
IL 001711 98
COMMON POLICY CONDITIONS
All Coverage Pans included in this policy are subject to the foIlowing conditions:
A Cancellation
1. The first Named Insured shown in the Declarations may cancel this policy by mailing or delivering to
us advance written notice of cancellation.
2. We may cancel this policy by mailing or delivering to the first Named Insured written notice of can-
cellation at least:
a. Ten (10) days before the effective date of cancellation if we cancel for nonpayment of premium;
or
b. Thirty (30) days before the effective date of cancellation it we cancel for any other reason.
3. We will mail or deliver our notice to the first Named Insured's last mailing address known to us.
A. Notice of cancellation will state the effective date of cancellation. The policy period will end on that
date.
5. If this policy is canceled, we will send the first Named Insured any premium refund due. If we
cancel, the refund will be pro rata. If the first Named Insured cancels, the refund may be less than
pro rata. The cancellation will be effective even if we have not made or offered a refund.
6. If notice is mailed, proof of mailing will be sufficient proof of notice.
B. Changes
This policy contains all the agreements between you and us concerning the insurance afforded. The first
Named Insured shown in the Declarations is authorized to make changes in the terms of this policy with
our consent. This policy's terms can be amended or waived only by endorsement issued by us and
made a part of this policy.
C. Examination of Your Books and Records
We may examine and audit your books and records as they relate to this policy at any time during the
policy period and up to threeyears afterward.
D. Inspections and Surveys
1. We have the right to:
Includes copyrighted material of 150 Properties, Inc., with its permission.
Copyright, ISO Properties, Inc., 2012
UTS-246s (2-15) Page 1 of 11
INSURED
0;0�G\ w
`� am
1{ 1
a. Make inspections and surveys at anytime;
b. Give you reports on the conditions we find; and
c. Recommend changes.
2. We are not obligated to make any inspections, surveys, reports or recommendations and any such
actions we do undertake relate only to insurability and the premiums to be charged. We do not
make safety inspections. We do not undertake to perform the duty of any person or organization to
provide for the health or safety of workers or the public. And we do not warrant that conditions:
a. Are safe or healthful; or
b. Comply with laws, regulations, codes or standards,
3. Paragraphs 1. and 2. of this condition apply not only to us, but also to any rating, advisory,
rate service or similar organization which makes insurance inspections, surveys, reports or
recommendations.
4. Paragraph 2. of this condition does not apply to any inspections, surveys, reports or recommenda-
tions we may make relative to certification, under state or municipal statutes, ordinances or regula-
tions, of boilers, pressure vessels or elevators.
E. Premiums
Thefirst Named Insured shown in the Declarations:
1. Is responsible for the payment of all premiums; and
2. Will be the payee for any return premiums we pay.
P. Transfer of Your Rights and Duties Under This Policy
Your rights and duties under this policy may not be transferred without our written consent except in the
case of death of an individual Named Insured.
If you die, your rights and duties will be transferred to your legal representative but only while acting
within the scope of duties as your legal representative. Until your legal representative is appointed, any-
one having proper temporary custody of your property will have your rights and duties but only with re-
spect to that property.
UTS-4289 (11-12)
PREMIUM AUDIT
The following is added to the Premium Audit provision:
If the first Named Insured fails or refuses to provide documentation adequate to determine the appor-
tionment of exposures by class code, we may unilaterally apply all exposures to the class code with the
highest rate stated in the policy including any class code adjustments made by endorsement.
UTS-2679 (5-98)
LEAD CONTAMINATION EXCLUSION
This policy does not apply to:
1. Any damages arising out of the ingestion, inhalation or absorption of lead in any form.
2. Any loss, cost or expense arising out of any:
a. Request, demand or order that any "insured" or others test for, monitor, clean up, remove��dfjt�in,
treat, detoxify or neutralize, or in any way respond to, or assess the effects of lead; or.N
Includes copyrighted material of ISO Properties, Inc., with its permission. Gu'('--
Copyright, ISO Properties, Inc., 2012\��\7AS\�
UTS-246s (2-15) Page 2 of 11
b. Claim or suit by or on behalf of a governmental authority for damages because of testing for, moni-
toring, cleaning up, removing, containing, treating, detoxifying or neutralizing, or in any way re-
sponding to, or assessing the effects of lead.
Cc 21 4712 07
EMPLOYMENT -RELATED PRACTICES EXCLUSION
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
A. The following exclusion is added to paragraph 2. Exclusions of Section I - Coverage A - Bodily Injury
and Property Damage Liability:
This insurance does not apply to:
"Bodily injury" to:
(1) A person arising out of any:
(a) Refusal to employ that person;
(b) Termination of that person's employment; or
(c) Employment -related practices, policies, acts or omissions, such as coercion, demotion,
evaluation, reassignment, discipline, defamation, harassment, humiliation, discrimination or
malicious prosecution directed atthat person; or
(2) The spouse, child, parent, brother or sister of that person as a consequence of "bodily injury" to
that person at whom any of the employment -related practices described in paragraphs (a), (b)
or (c) above is directed.
This exclusion applies:
(1) Whether the injury -causing event described in paragraphs (a), (b) or (c) above occurs before
employment, during employment or after employment of that person;
(2) Whether the insured may be liable as an employer or in any other capacity; and
(3) To any obligation to share damages with or repay someone else who must pay damages be-
cause of the injury.
B. The following exclusion is added to paragraph 2. Exclusions of Section I -Coverage B -Personal and
Advertising Injury Liability:
This insurance does not apply to:
"Personal and advertising injury"to:
(1) A person arising out of any:
(a) Refusal to employ that person;
(b) Termination of that person's employment; or
(c) Employment -related practices, policies, acts or omissions, such as coercion, demotion,
evaluation, reassignment, discipline, defamation, harassment, humiliation, discrimination or
malicious prosecution directed at that person; or
(2) The spouse, child, parent, brother or sister of that person as a consequence of "personal and
advertising injury"to that person at whom any of the employment -related practices described in
paragraphs (a), (b) or (c) above is directed.
i3°(
This exclusion applies: -1 �p ��� �
A
Includes copyrighted material of 150 Properties, Inc., with its permission. �e�,�l0.
Copyright, ISO Properties, Inc., 2012\1�J\C� i
Page 3 of 11
UTS-246s (2-15) '"���� �`
(1) Whether the injury -causing event described in paragraphs (a), (b) or (c) above occurs before
employment, during employment or after employment of that person;
(2) Whether the insured maybe liable as an employer or in any other capacity; and
(3) To any obligation to share damages with or repay someone else who must pay damages be-
cause of the injury.
GLS-74s (9-05)
AMENDMENT OF CONDITIONS
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
LIQUOR LIABILITY COVERAGE PART
RAILROAD PROTECTIVE LIABILITY COVERAGE PART
OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE PART
PRODUCTS COMPLETED OPERATIONS COVERAGE PART
The Condition entitled When We Do Not Renew is deleted in its entirety.
IL 00 21 09 08
NUCLEAR ENERGY LIABILITY EXCLUSION (BROAD FORM)
This endorsement modifies insurance provided under the following:
COMMERCIAL AUTOMOBILE COVERAGE PART
COMMERCIAL GENERAL LIABILITY COVERAGE PART
LIQUOR LIABILITY COVERAGE PART
FARM COVERAGE PART
MEDICAL PROFESSIONAL LIABILITY COVERAGE PART
OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE PART
POLLUTION LIABILITY COVERAGE PART
PRODUCTS/ COMPLETED OPERATIONS LIABILITY COVERAGE PART
RAILROAD PROTECTIVE LIABILITY COVERAGE PART
UNDERGROUND STORAGE TANK POLICY
1. The insurance does not apply:
A. Under any Liability Coverage, to 'bodily injury" or "property damage":
(1) With respect to which an "insured" under the policy is also an insured under a nuclear energy li-
ability policy issued by Nuclear Energy Liability Insurance Association, Mutual Atomic Energy
Liability Underwriters, Nuclear Insurance Association of Canada or any of their successors, or
would be an insured under any such policy but for its termination upon exhaustion of its limit of
liability; or
(2) Resulting from the "hazardous properties" of "nuclear material" and with respect to which
(a) any person or organization is required to maintain financial protection pursuant to the
Atomic Energy Act of 1954, or any law amendatory thereof, or (b) the "insured" is, or had this
policy not been issued would be, entitled to indemnity from the United States of America, or any
agency thereof, under any agreement entered into by the United States of America, or any
agency thereof, with any person or organization,
B. Under any Medical Payments coverage, to expenses incurred with respect to "bodily injury" result-
ing from the "hazardous properties" of "nuclear material" and arising out of the operation ovo.
clear facility" by any person or organization. �C I( P
Includes copyrighted material of 150 Properties, Inc., with its permission. .�°d,�
Copyright, 150 Properties, Inc., 2012 00,
e a?, .
UTS-246s (2-15) Page 4 of 11
C. Under any Liability Coverage, to "bodily injury" or "property damage" resulting from "hazardous
properties" of "nuclear material" if:
(1) The "nuclear material" (a) is at any "nuclear facility" owned by, or operated by or on behalf of, an
"insured" or (b) has been discharged or dispersed therefrom;
(2) The "nuclear material" is contained in "spent fuel" or "waste" at any time possessed, handled,
used, processed, stored, transported or disposed of, by or on behalf of an "insured"; or
(3) The "bodily injury" or "property damage" arises out of the furnishing by an "insured" of services,
materials, parts or equipment in connection with the planning, construction, maintenance, op-
eration or use of any "nuclear facility," but if such facility is located within the United States of
America, its territories or possessions or Canada, this exclusion (3) applies only to "property
damage" to such "nuclear facility" and any property thereat.
2. As used in this endorsement:
"Hazardous properties" includes radioactive, toxic or explosive properties.
"Nuclear material" means "source material, "special nuclear material" or "by-product material."
"Source material, "special nuclear material," and "by-product material" have the meanings given them in
the Atomic Energy Act of 1954 or in any law amendatory thereof.
"Spent fuel" means any fuel element or fuel component, solid or liquid, which has been used or exposed
to radiation in a "nuclear reactor."
"Waste" means any waste material (a) containing "by-product material" other than the tailings or wastes
produced by the extraction or concentration of uranium or thorium from any ore processed primarily for
its "source material" content, and (b) resulting from the operation by any person or organization of any
"nuclear facility" included under the first two paragraphs of the definition of "nuclear facility."
"Nuclear facility" means:
(a) Any "nuclear reactor";
(b) Any equipment or device designed or used for (1) separating the isotopes of uranium or pluto-
nium, (2) processing or utilizing "spent fuel," or (3) handling, processing or packaging "waste";
(c) Any equipment or device used for the processing, fabricating or alloying of "special nuclear
material" if at any time the total amount of such material in the custody of the "insured" at the
premises where such equipment or device is located consists of or contains more than
twenty-five (25) grams of plutonium or uranium 233 or any combination thereof, or more than
two hundred fifty (250) grams of uranium 235; or
(d) Any structure, basin, excavation, premises or place prepared or used for the storage or dis-
posal of "waste";
and includes the site on which any of the foregoing is located, all operations conducted on such
site and all premises used for such operations.
"Nuclear reactor" means any apparatus designed or used to sustain nuclear fission in a self-supporting
chain reaction or to contain a critical mass of fissionable material.
"Property damage" includes all forms of radioactive contamination of property.
Includes copyrighted materi al of ISO Properties, Inc., with itsp arm ission.
Copyright, ISO Properties, Inc., 2012�+��9 r
UTS-246s (2-15) Page 5 of 11 "C`
Gt-5-30s (1-15)
The following has been added to the policy:
CONTRACTORS SPECIAL CONDITIONS
The following is added to SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS:
Contractors Special Conditions
You will obtain current certificates of insurance from all independent contractors providing evidence of:
1, 'Bodily injury" and "property damage" liability Limits of Insurance equal to or greater than the limits
provided by this policy;
2. Coverage equal to or greater than the coverage provided by this policy; and
3. Effective dates of coverage that "coincide" with the effective dates of coverage on this policy.
Failure to comply with this condition does not alter the coverage provided by this policy, but will result in
an additional premium charge.
The following is added to SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS, para-
graph 5. Premium Audit:
Should you fail to provide current certificates of insurance from all independent contractors at such
times as we request to complete a premium audit, a premium charge will be made. The premium charge
will be computed by multiplying the "total cost' of all work sublet that fails to meet the above condition,
by the rate per $1,000 payroll for the applicable classification of the work performed. The pre-
mium charge will be computed by multiplying our usual and customary rate per $1,000 payroll for that
classification.
For purposes of this endorsementthe following definitions apply:
"Total cost" means the cost of all labor, materials and equipment furnished, used or delivered for use in
the execution of the work and all fees, bonuses or commissions paid.
"Coincide" means that the effective dates of coverage for all policies of all independent contractors cov-
ers that period of time during which work was performed for you within the effective dates covered by
this policy.
UTS-749 (8-95)
This policy does not apply to a claim of or indemnification for punitive or exemplary damages
Punitive or exemplary damages also include any damages awarded pursuant to statute in the form of
double, treble or other multiple damages in excess of compensatory damages.
If suit is brought against any insured for a claim failing within coverage provided under the policy, seeking
both compensatory and punitive or exemplary damages, then the Company will afford a defense to such ac-
tion. However, the Company will have no obligation to pay for any costs, interest or damages attributable to
punitive or exemplary damages.
a �y� e6
+f-o. �l
Includes copyrighted material of ISO Properties, Inc., with its permission.
Copyright, ISO Properties, Inc., 2012 t^Cyy 1
P
UT5-246s (2-15) Page 6 of 11`
UTS•266g (5-98)
This policy does not apply to:
1. Damages in any way or to any extent arising out of or involving asbestos, asbestos fibers, or any prod-
uct containing asbestos or asbestos fibers.
2. Any economic loss, diminution of property value, abatement costs, or any other loss, cost or expense
including equitable relief, in any way or to any extent arising out of or involving asbestos, asbestos fi-
bers or any product containing asbestos or asbestos fibers,
3. Any fees, fines, costs, or expenses of any nature whatsoever in the investigation or defense of any claim
or suit arising out of or involving asbestos, asbestos fibers, or any product containing asbestos or as-
bestos fibers.
CC 21 67 12 04
This endorsement modifies insurance provided under the following:
M U i
A. The following exclusion is added to paragraph 2. Exclusions of Section I - Coverage A- Bodily Injury
And Property Damage Liability:
2, Exclusions
This insurance does not apply to:
Fungi Or Bacteria
a 'Bodily injury" or "property damage" which would not have occurred, in whole or in part, but for
the actual, alleged or threatened inhalation of, ingestion of, contact with, exposure to, existence
of, or presence of, any "fungi" or bacteria on or within a building or structure, including its con-
tents, regardless of whether any other cause, event, material or product contributed concur-
rently or in any sequence to such injury or damage.
b. Any loss, cost or expenses arising out of the abating, testing for, monitoring, cleaning up, re-
moving, containing, treating, detoxifying, neutralizing, remediating or disposing of, or in any
way responding to, or assessing the effects of, "fungi" or bacteria, by any insured or by any
other person or entity.
This exclusion does not apply to any "fungi" or bacteria that are, are on, or are contained in, a good
or product intended for bodily consumption.
B. The following exclusion is added to paragraph 2. Exclusions of section I -Coverage B -Personal And
Advertising Injury Liability:
2. Exclusions
This insurance does not apply to:
Fungi Or Bacteria
a. "Personal and advertising injury" which would not have taken place, in whole or in part, but for
the actual, alleged or threatened inhalation of, ingestion of, contact with, exposure to, existence
of, or presence of any "fungi" or bacteria on or within a building or structure, including it ,t:
tents, regardless of whether any other cause, event, material or product contrib tet ncur� W 1r
rently or in any sequence to such injury.t j\
,I
Includes copyrighted material of ISO Properties, Inc., with its permission.
Copyright. ISO Properties, Inc., 2012`rr`��p
UTS-246s (2-15) Page 7 of 11
b. Any loss, cost or expense arising out of the abating, testing for, monitoring, cleaning up, remov-
ing, containing, treating, detoxifying, neutralizing, remediating or disposing of, or in any way
responding to, or assessing the effects of, "fungi" or bacteria, by any insured or by any other
person or entity.
C. The following definition is added to the Definitions Section:
"Fungi" means any type or form of fungus, including mold or mildew and any mycotoxins, spores,
scents or byproducts produced or released by fungi.
cLs-152s (4-14)
AMENDMENT TO OTHER INSURANCE CONDITION
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
Condition 4. Other Insurance of Section IV • Commercial General Liability Conditions is deleted in its en-
tirety and is replaced by the following:
4. Other Insurance
a. Primary Insurance
This insurance is primary except when b, below applies.
b. Excess Insurance
(1) This insurance is excess over any other insurance, whether primary, 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 to you to cover your liability as a tenant for "property dam-
age" to premises rented to you or temporarily occupied by you with permission of the
owner;
(d) If the loss arises out of the maintenance or use of aircraft, "auto" or watercraft to the ex-
tent not subject to Exclusion g. of CoverageA(Section 1); or
(e) That is valid and collectible insurance available to you under any other policy.
(2) When this insurance is excess, we will have no duty under Coverages Aar B to defend the
insured against any "suit" if any other insurer has a duty to defend the insured against that
"suit." If no other insurer defends, we will undertake to do so, but we will be entitled to the
insured's rights against all those other insurers.
(3) When this insurance is excess over other insurance, we will pay only the amount of the
loss, if any, that exceeds the sum of:
(a) The total amount that all such other insurance would pay for the loss In the absence of
this insurance; and
(b) The total of all deductible and self -insured amounts under all other insurance.
If a loss occurs involving two or more policies, each of which states that its insurance will be ex-
cess, then our policy will contribute on a pro rata basis,
Includes copyrighted material of ISO Properties, Inc., with its permission
Copyright, ISO Properties, Inc., 2012
U75-246s (2-15) Page 8 of 11
G LS-341 s (8-12)
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
ERRORS AND OMISSIONS COVERAGE PART
A The following is added to paragraph 2. Exclusions of Section I - Coverage A- Bodily Injury And Prop-
erty Damage Liability of the Commercial General Liability Coverage Part and paragraph 2. Exclusions
of Section I - Coverage of the Errors And Omissions Coverage Part:
This insurance does not apply to:
Hydraulic Fracturing
1. "Bodily injury," "property damage" or "error or omission":
a. Arising, in whole or in part, out of any operation involving substances under pressure being
pumped underground with the objective of creating fractures in geologic formations to facilitate
the release and extraction of hydrocarbons, including, but not limited to, oil or natural gas.
Such operations include, but are not limited to, "hydraulic fracturing," "gas fracking" and/ or the
actual, alleged, threatened or suspected contact with, exposure to, existence of or presence of
any "flowback" or the handling, transporting, storage, release or disposal of any "flowback" by
any insured or by any other person or entity; or
b. Caused, directly or indirectly or in whole or in part, by the movement, in any direction, of earth
or land arising, in whole or in part, out of any operation involving substances under pressure
being pumped underground with the objective of creating fractures in underground geologic
formations to facilitate the release and extraction of hydrocarbons, including, but not limited to,
oil or natural gas. Such operations include, but are not limited to, "hydraulic fracturing' or "gas
fracking."
2. Any loss, cost or expense arising, in whole or in part, out of the abating, testing for, monitoring,
cleaning up, removing, containing, treating, remediating or disposing of, or in any way responding
to or assessing the effects of "hydraulic fracturing," "gas fracking" or "flowback," by any insured or
by any other person or entity.
We will have no duty to settle any claim or defend any "suit" against the insured arising out of or in any
way related to items 1. or 2. above.
B. The following is added to paragraph 2. Exclusions of Section I -Coverage B -Personal And Advertis-
ing Injury Liability of the Commercial General Liability Coverage Pan:
This insurance does not apply to:
Hydraulic Fracturing
1. 'Personal and advertising injury",
a. Arising, in whole or in part, out of any operation involving substances under pressure being
pumped underground with the objective of creating fractures in underground geologic forma-
tions to facilitate the release and extraction of hydrocarbons, including, but not limited to, oil or
natural gas. Such operations include, but are not limited to, "hydraulic fracturing, "gas fracking'
and/ or the actual, alleged, threatened or suspected contact with, exposure to, existence of or
presence of any "flowback' or the handling, transporting, storage, release or disposal of any
"flowback" by any "insured" or by any other person or entity; or
b. Caused, directly or indirectly or in whole or in part, by the movement, in any direction, of earth
or land arising, in whole or in pan, out of any operation involving substances under ppravie �
AA
htcludes copyrighted material of 150 Properties, Inc., with its permission.
Copyright, 150 Properties, Inc., 2912
U7S-246s (2-15) Page 9 of 11�p�^
being pumped underground with the objective of creating fractures in underground geologic
formations to facilitate the release and extraction of hydrocarbons, including, but not limited to,
oil or natural gas. Such operations include, but are not limited to, "hydraulic fracturing" or "gas
fracking."
2. Any loss, cost or expense arising, in whole or in part, out of the abating, testing for, monitoring,
cleaning up, removing, containing, treating, remediating or disposing of, or in any way responding
to or assessing the effects of "hydraulic fracturing; "'gas fracking" or "flowback;' by any insured or
by any other person or entity.
We will have no duty to settle any claim or defend any "suit" against the insured arising out of or in any
way related to items 1. or 2. above.
For purposes of this endorsement, the following definitions apply:
1. "Hydraulic fracturing," or hydrofracking means the process by which water, "proppants," chemicals
and/ or other fluid additives are injected at high pressure into underground geologic formations to
create fractures, to facilitate the extraction of any hydrocarbons including but not limited to natural
gas and/ or oil.
2. "Flowback" means any substance containing returned "hydraulic fracturing" fluid, including but not
limited to water, "proppants," "hydraulic fracturing" fluid additives; and, any hydrocarbon com-
pounds, salts, conventional pollutants, organics, metals, and naturally occurring radioactive mate-
rial broughtto the surface with the water.
3. "Gas fracking" or liquefied propane/ butane gas fracturing means the waterless process by which
propane gel and "proppants" are injected at high pressure into underground geologic formations to
create fractures, to facilitate the release and extraction of natural gas.
4. "Proppant" means particles that are used to keep fractures open after a hydraulic fracturing
treatment.
CG 2106 D514
EXCLUSION - ACCESS OR DISCLOSURE OF CONFIDENTIAL OR
PERSONAL INFORMATION AND DATA -RELATED LIABILITY -
WITH LIMITED BODILY INJURY EXCEPTION
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
A. Exclusion 2.p. of Section I -Coverage A- Bodily Injury And Property Damage Liability is replaced by
the following:
2. Exclusions
This insurance does not apply to:
p. Access Or Disclosure Of Confidential Or Personal Information And Data -related Liability
Damages arising out of:
(1) Any access to or disclosure of any person's or organization's confidential or personal in-
formation, including patents, trade secrets, processing methods, customer lists, financial
information, credit card information, health information or any other type of nonpublic infor-
mation; or
(2) The loss of, loss of use of, damage to, corruption of, inability to access, or inability to ma-
nipulate electronic data.
Includes co pyrighted material of I50 Properties, Inc., with its permission.
Copyright, 150 Properties, Inc., 2012q,\��i�w,
JTS-246s (2-15) Page 10 of 11
This exclusion applies even if damages are claimed for notification costs, credit monitoring ex-
penses, forensic expenses, public relations expenses or any other loss, cost or expense in-
curred by you or others arising out cf that which is described in paragraph (1) or (2) above.
However, unless paragraph (1) above applies, this exclusion does not apply to damages be-
cause of "bodily injury."
As used in this exclusion, electronic data means information, facts or programs stored as or on,
created or used on, or transmitted to or from computer software, including systems and appli-
cations software, hard or floppy disks, CD-ROMs, tapes, drives, cells, data processing devices
or any other media which are used with electronically controlled equipment.
B. The following is added to paragraph 2. Exclusions of Section I -Coverage B -Personal And Advertis-
ing Injury Liability:
2. Exclusions
This insurance does not apply to:
Access Or Disclosure Of Confidential Or Personal Information
"Personal and advertising injury" arising out of any access to or disclosure of any person's or orga-
nization's confidential or personal information, including patents, trade secrets, processing meth-
ods, customer lists, financial information, credit card information, health information or any other
type of nonpublic information.
This exclusion applies even if damages are claimed for notification costs, credit monitoring ex-
penses, forensic expenses, public relations expenses or any other loss, cost or expense incurred
by you or others arising out of any access to or disclosure of any person's or organization's confi-
dential or personal information.
GLS-457s (10-14)
AIRCRAFT EXCLUSION
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
The following is added to paragraph 2. Exclusions of Section I - Coverages, Coverage B - Personal And
Advertising Injury Liability:
This insurance does not apply to:
"Personal and advertising injury" arising out of the ownership, maintenance, use or entrustment to
others of any aircraft. Use includes operation and "loading and unloading"
This exclusion applies even if claims against any insured allege negligence or other wrongdoing in the
supervision, hiring, employment, training or monitoring of others by any insured.
AUTHORIZED REPRESENTATIVE DATE
Includes copyrighted material of ISO Properties, Inc., with its permission.
Copyright, ISO Properties, Inc., 2012
UTS-246s (2-15) Page 11 of 11
A SCOTTSDALE INSURANCE COMPANY"
ENDORSEMENT
NO.
ATTACHED TO AND
ENDORSEMENT EFFECTIVE DATE
FORMING APART
(t 2:01 A.M. STANDARD TIM E)
NAMED INSURED
AGENTNO.
POLICY NUMBER
CPS25GI230
11/26/2016
HIBA SHUBLAK DEA: ACTIVE LEARNING
04068
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
FUNGI OR BACTERIA EXCLUSION
This endorsement modifies insurance provided under the following:
PROFESSIONAL LIABILITY INSURANCE COVERAGE PART
DIRECTORS AND OFFICERS LIABILITY INCLUDING ENTITY REIMBURSEMENT AND
ENTITY LIABILITY COVERAGE PART
ERRORS AND OMISSIONS COVERAGE PART
A. The following exclusion is added to the coverage parts This exclusion does not apply to any "fungi" or bac-
as indicated below. For those coverage parts only, this teria that are, are on, or are contained in, a good or
exclusion supercedes and replaces any conflicting pol- product intended for consumption.
icy provisions: 2. The following applies to the DIRECTORS AND OF-
1. The following applies to the PROFESSIONAL Lk FICERS LIABILITY INCLUDING ENTITY REIM-
ABILITY INSURANCE COVERAGE PART: BU RSEM ENT AND ENTITY LIABILITY COVERAGE
SECTION III - EXCLUSIONS
This insurance does not apply to:
"Damages" due to any claim or loss based upon or
arising out of any negligent act, error or omission
in rendering or failing to render professional ser-
vices which would not have occurred, in whole or
in part, but for the actual, alleged or threatened in-
halation of, ingestion of, contact with, exposure to,
existence of, or presence of, any "fungi" or bacteria
on or within a building or structure, including its
contents, regardless of whether any other cause,
event, material or product contributed concurrently
or in any sequence to such injury or damage; or
Any loss, cost or expenses arising out of the abat-
ing, testing for, monitoring, cleaning up, removing,
containing, treating, detoxifying, neutralizing, re -
mediating or disposing of, or in any way respond-
ing to, or assessing the effects of, "fungi" or
bacteria, by any insured or by any other person or
entity.
PART:
IV. EXCLUSIONS
This insurance does not apply to:
DAMAGES due to any CLAIM or loss based
upon or arising out of any WRONGFUL ACT
which would not have occurred, in whole or in
part, but for the actual, alleged or threatened
inhalation of, ingestion of, contact with, expo-
sure to, existence of, or presence of, any
"fungi" or bacteria on or within a building or
structure, including its contents, regardless of
whether any other cause, event, material or
product contributed concurrently or in any se-
quence to such injury or damage; or
Any loss, cost or expenses arising out of the
abating, testing for, monitoring, cleaning up,
removing, containing, treating, detoxifying,
neutralizing, remediating or disposing of, or in
any way responding to, or assessing the ef-
fects of, "fungi" or bacteria, 1
11any insured or
by any other person or e
t`IS"
Includes copyrighted material of ISO Properties, Inc., with its permission.
Copyright, ISO Properties, Inc., 2003
UTS-303g (1-09) Page 1 of 2
INSURED
as
G\y 'N�`
This exclusion does not apply to any "fungi" or bac-
teria that are, are on, or are contained in, a good or
product intended for consumption.
3. The following applies to the ERRORS AND OMIS-
SIONS COVERAGE PART:
2. Exclusions
This insurance does not apply to:
"Damages" due to any "claim" or loss based
upon or arising out of an "error or omission"
which would not have occurred, in whole or in
part, but for the actual, alleged or threatened
inhalation of, ingestion of, contact with, expo-
sure to, existence of, or presence of, any
"fungi" or bacteria on or within a building or
structure, including its contents, regardless of
whether any other cause, event, material or
product contributed concurrently or in any se-
quence to such injury or damage; or
Any loss, cost or expenses arising out of the
abating, testing for, monitoring, cleaning up,
removing, containing, treating, detoxifying,
neutralizing, remediating or disposing of, or in
any way responding to, or assessing the ef-
fects of, "fungi" or bacteria, by any insured or
by any other person or entity.
This exclusion does not apply to any "fungi" or
bacteria that are, are on, or are contained in, a
good or product intended for consumption.
B. For the purposes of this endorsement, the following
definition is added to the DEFINITIONS Section of
each Coverage Part:
"Fungi" means any type or form of fungus, including
mold or mildew and any mycotoxins, spores, scents or
byproducts produced or released by fungi.
AUTHORIZED REPRESENTATIVE
Includes copyrighted material of ISO Properties, Inc., with its permission.
Copyright, ISO Properties, Inc., 2003
DATE
UTS-303g (1-09) Page 2 of 2
A SCOTTSDALE INSURANCE COMPANY"
ENDORSEMENT
NO.
ATTACHED TO AND
ENDORSEMENT EFFECTIVE DATE
FORM ING APART OF
(y 2;01 A.M. STANDARD TIME)
NAMED INSURED
AGENTNO.
POLICY NUMBER
CPS2561230
11/2G/201G
HIBA SHUBLAK DBA: ACTIVE LEARNING
04068
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
AMENDMENT OF NONPAYMENT CANCELLATION CONDITION
Wherever a Cancellation Condition for nonpayment of premium is found in the policy, the following is
added:
If the insured failed to pay premium charged on a prior policy we issued and payment was due during
the current renewal policy term, we may cancel this policy by mailing or delivering to the first Named In-
sured and mortgagee, if any, written notice of cancellation at least ten (10) days before the effective date of
cancellation.
AUTHORIZED REPRESENTATIVE
UTS-365s (2-09) Page 1 of 1
INSURED
DATE
COMMERCIAL GENERAL LIABILITY
CG 32 34 0105
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
CALIFORNIA CHANGES
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
ELECTRONIC DATA LIABILITY COVERAGE PART
LIQUOR LIABILITY COVERAGE PART
OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE PART
POLLUTION LIABILITY COVERAGE PART
PRODUCT WITHDRAWAL COVERAGE PART
PRODUCTS/ COMPLETED OPERATIONS LIABILITY COVERAGE PART
UNDERGROUND STORAGE TANK POLICY
The term "spouse" is replaced by the following:
Spouse or registered domestic partner under California
law.
CG 32 34 0105 Copyright, ISO Properties, Inc., 2004 Page 1 of 1
INSURED
SCOTTSDALE INSURANCE COMPANY"'
ENDORSEMENT
NO.
ATTACHED TO AND
ENDORSEMENT EFFECTIVE DATE
FORMING APART OF
(12:01 A.M. STANDARD TIME)
NAMED INSURED
AGENT NO.
POLICY NUMBER
CPS2561230
11/26/2016
HIBA SHUBLAK DBA: ACTIVE LEARNING
04068
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
AMENDATORY ENDORSEMENT - CALIFORNIA
Wherever the term AUTHORIZED REPRESENTATIVE appears beneath a signature line in this policy, it is
removed and replaced by the term COUNTERSIGNATURE.
For example:
is replaced by:
DATE
DATE
AUTHORIZED REPRESENTATIVE
COUNTERSIGNATURE
COUNTERSIGNATURE
DATE
UTs-253-CA (1-97) INSURED
A SCOTTSDALE INSURANCE COMPANY
National Casualty Company
Scottsdale Indemnity Company
SCOTTSDALE
SIiAVLV51JYE1 INSNIITN([ CI]N1V9Ati
CLAIM REPORTING
INFORMATION
Your insurance policy has been placed with the Scottsdale Insurance Group, a subsidiary of the Nationwide
Insurance Company. The Scottsdale Insurance Group is a reliable, service -oriented group of companies
that will help protect you against certain losses.
Our commitmentto you is to provide fast, fair claim service. Promptly reporting an event that could lead to a
claim, as required by your policy, helps us fulfill this commitment to you. Please refer to your policy for this
and all other terms and conditions.
To report a claim, you may contact the Scottsdale Insurance Group 24 hours a day, 7 days a week, by call-
ing 1-800-423-7675 or via our Web site at www,scottsdaleins.com.
Thank you for your business and as always, we appreciate the opportunity to serve you.
HOW TO REPORTA CLAIM
Call 1.800.423-7675 or visit our Web site at www.scottsdaleins.com
In order to expedite this process, please be prepared to furnish as much of the following information
as possible:
Your policy number
Date, time and location of the loss/ accident
• Details of the loss/accident
Name, address and phone number of any invelved parties
• If applicable, name of law enforcement agency or fire department along with the incident number
Please referto your policy for speck claim reporting requirements.
G\P .
E)x
NOTX0178CW (2-06) INSURED
COMMERCIAL GENERAL LIABILITY
CG 00 01 0413
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
insurance.
The word "insured" means any person or organization
qualifying as such under Section II - Who Is An Insured.
Other words and phrases that appear in quota-
tion marks have special meaning. Refer to Section V -
Definitions,
SECTION I - COVERAGES
COVERAGE A- BODILY INJURY AND PROPERTY
DAMAGE LIABILITY
1. Insuring Agreement
a. We will pay those sums that the insured be-
comes legally obligated to pay as damages
because of "bodily injury" or "property dam-
age" 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 in-
sured against any "suit" seeking damages for
"bodily injury" or "property damage" to which
this insurance does not apply. We may, at our
discretion, investigate any "occurrence" 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 ends when
we have used up the applicable limit of in-
surance in the payment of judgments or
settlements under Coverages A or B or
medical 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 "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";
(2) The "bodily injury" or "property damage"
occurs during the policy period; and
(3) Prior to the policy period, no insured listed
under Paragraph 1. of Section II - Who Is
An Insured and no "employee" authorized
by you to give or receive notice of an "oc-
currence" or claim, knew that the "bodily
injury" or "property damage" had oc-
curred, in whole or in part. If such a listed
insured or authorized "employee" knew,
prior to the policy period, that the "bodily
injury" or "property damage" occurred,
then any continuation, change or resump-
tion of such "bodily injury" or "property
damage" during or after the policy period
will be deemed to have been known prior
to the policy period.
c. "Bodily injury" or "property damage" which
occurs during the policy period and was not,
prior to the policy period, known to have
occurred by any insured listed under Para-
graph 1. of Section II - Who Is An Insured or
any "employee" authorized by you to give or
receive notice of an "occurrence" or claim, in-
cludes any continuation, change or resump-
tion of that "bodily injury" or "property damage"
after the end of the policy period.
d. "Bodily injury" or "property damage" will be
deemed to have been known to have occurred
at the earliest time when any insured listed
under Paragraph 1. of Section II - Who Is An
Insured or any "employee" authorized by you
to give or receive notice of an "occurrence" or
claim:
(1) Reports all, or any part, of the "bodily in-
jury" or "property damage" to us or any
other insurer;
(2) Receives a written or verbal demand or
claim for damages because of the "bodily
injury" or "property damage"; or
(3) Becomes aware by any other means that
"bodily injury" or "property damage" has
occurred or has begun to occur.
e. 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".
CG 00 010413 Copyright, Insurance Services Office, Inc., 2012
INSURED
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.
b. Contractual Liability
"Bodily injury" or "property damage" for which
the insured is obligated to pay damages by
reason of the assumption of liability in a con-
tract or agreement. This exclusion does not
apply to liability for damages:
(1) That the insured would have in the ab-
sence of the contract or agreement; or
(2) Assumed in a contract or agreement that
is an "insured contract", provided the
"bodily injury" or "property damage" oc-
curs subsequent to the execution of the
contract or agreement. Solely for the pur-
poses of liability assumed in an "insured
contract", reasonable attorneys' fees and
necessary litigation expenses incurred by
or for a party other than an insured are
deemed to be damages because of "bodily
injury" or "property damage", provided:
(a) Liability to such party for, or for the
cost of, that party's defense has also
been assumed in the same "insured
contract"; and
(b) Such attorneys' fees and litigation ex-
penses are for defense of that party
against a civil or alternative dispute
resolution proceeding in which dam-
ages 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
under the influence of alcohol; or
(3) Any statute, ordinance or regulation relat-
ing to the sale, gift, distribution or use of
alcoholic beverages.
This exclusion applies even if the claims
against any insured allege negligence or other
wrongdoing in:
(a) The supervision, hiring, employment,
training or monitoring of others by that
insured; or
(b) Providing or failing to provide trans-
portation with respect to any person
that may be under the influence of
alcohol;
if the "occurrence" which caused the "bodily in-
jury" or "property damage", involved that which
is described in Paragraph (1), (2) or above.
However, this exclusion applies only if you are
in the business of manufacturing, distributing,
selling, serving or furnishing alcoholic bever-
ages. For the purposes of this exclusion, per-
mitting a person to bring alcoholic beverages
on your premises, for consumption on your
premises, whether or not a fee is charged or a
license is required for such activity, is not by it-
self considered the business of 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 con-
duct 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 whether the insured
may be liable as an employer or in any other
capacity and to any obligation to share dam-
ages with or repay someone else who must
pay damages because of the injury.
This exclusion does not apply to liability as-
sumed by the insured under an "insured
contract".
Page 2 of 16 Copyright, Insurance Services Office, Inc., 2012
�A ,
� &0 010413
f. Pollution
(d) At or from any premises, site or loca-
(1) "Bodily injury" or "property damage" aris-
tion on which any insured or any con-
ing out of the actual, alleged or threatened
tractors or subcontractors working
discharge, dispersal, seepage, migration,
directly or indirectly on any insured's
release or escape of "pollutants":
behalf are performing operations if the
"pollutants" are brought on or to the
(a) At or from any premises, site or Iota-
premises, site or location in
tion which is or was at an time owned
lion with such operations by such in -
suchconnin-
or
or occupied by, or rented or loaned to,
sured, contractor or subcontractor,
any insured. However, this subpara-
However, this subparagraph does not
graph does not apply to:
apply to:
(i) "Bodily injury" if sustained within a
(1) "Bodily injury" or "property dam -
building and caused by smoke,
age" arising out of the escape of
fumes, vapor or soot produced by
fuels, lubricants or other operating
or originating from equipment that
fluids which are needed to per -
is used to heat, cool or dehumidify
form the normal electrical, hy-
the building, or equipment that is
draulic or mechanical functions
used to heat water for personal
necessary for the operation of
use, by the building's occupants
"mobile equipment" or its parts, if
or their guests;
such fuels, lubricants or other
(ii) "Bodily injury" or "property dam-
operating fluids escape from a ve-
age" for which you may be held
hicle part designed to hold, store
liable, if you are a contractor and
or receive them. This exception
the owner or lessee of such prem-
does not apply if the "bodily injury"
ises, site or location has been
or "property damage" arises out of
added to your policy as an addi-
the intentional discharge, disper-
tional insured with respect to your
sal or release of the fuels, lubri-
ongoing operations performed for
cants or other operating
fluids, or
that additional insured at that
if such fuels, lubricants
or other
premises, site or location and
operating fluids are brought on or
such premises, site or location is
to the premises, site or location
not and never was owned or oc-
with the intent that they be dis-
cupied by, or rented or loaned to,
charged, dispersed or released as
any insured, other than that addi-
part of the operations being per-
tional insured; or
formed by such insured, contrac-
(iii) "Bodily injury" or "property dam-
for or subcontractor;
age" arising out of heat, smoke or
(i) "Bodily injury" or "property dam -
fumes from a "hostile fire",
age" sustained within a building
(b) At or from any premises, site or loca-
and caused by the release of
gases, fumes or vapors from ma -
tion which is or was at any time used
by or for any insured or others for the
terials brought into that building in
handling, storage, disposal, process-
connection with operations being
performed by you or on your be-
ing or treatment of waste;
half by a contractor or subcon-
(c) Which are or were at any time trans-
tractor; or
ported, handled, stored, treated, dis-
posed of, or processed as waste by or
(Ili) "Bodily injury" or "property dam -
for:
age" arising out of heat, smoke or
fumes from a "hostile fire".
(i) Any insured; or
(e) At or from any premises, site loca-
(ii) An organization for
Y person or 9
lion on which any insured or any con -
whom you may be legally respon-
tractors or subcontractors working
sible; or
directly or indirectly on any insured's
behalf are performing operations if the
operations are to test for, monitor,
clean up, remove, contain, treat, de-
toxify or neutralize, or in 1p }Jay re-
spond to, orassekfeff�tct� of,
"pollutants".
A,4 »Q��
CG 00 01 0413 Copyright, Insurance Services Office, Inc., 2012 (J ge 3 of 16
(2) Any loss, cost or expense arising out of
(5) "Bodily injury" or "property damage" aris-
any;
ing out of:
(a) Request, demand, order or statutory
(a) The operation of machinery or equip -
or regulatory requirement that any in-
ment that is attached to, or part of, a
sured or others testfor, monitor, clean
land vehicle that would qualify under
up, remove, contain, treat, detoxify or
the definition of "mobile equipment" if
neutralize, or in any way respond to,
it were not subject to a compulsory or
or assess the effects of, "pollutants"; or
financial responsibility law or other
(b) Claim or suit by or on behalf of a
motor vehicle insurance law where it is
governmental authority for damages
licensed or principally garaged; or
because of testing for, monitoring,
(b) The operation of any of the machinery
cleaning up, removing, containing,
or equipment listed in Paragraph f.(2)
treating, detoxifying or neutralizing, or
or f.(3) of the definition of "mobile
in any way responding to, or assess-
equipment".
ing the effects of, "pollutants".
h. Mobile Equipment
However, this paragraph does not apply to
"Bodily injury" or "property damage" arising out
liability for damages because of "property
of:
damage" that the insured would have in
the absence of such request, demand,
(1) The transportation of "mobile equipment"
order or statutory or regulatory require-
by an "auto" owned or operated by or
ment, or such claim or "suit" by or on be-
rented or loaned to any insured; or
half of a governmental authority.
(2) The use of "mobile equipment" in, or while
g. Aircraft, Auto Or Watercraft
in practice for, or while being prepared for,
"Bodily injury" or "property damage" arising out
any prearranged racing, speed, demoli-
or stunting activity.
tion,of
the ownership, maintenance, use or entrust-
ment to others of any aircraft,"auto" or water-
t. War
craft owned or operated by or rented or loaned
"Bodily injury" or "property damage", however
to any insured. Use includes operation and
caused, arising, directly or indirectly, out of
"loading or unloading".
(1) War, including undeclared or civil war;
This exclusion applies even if the claims
(2) warlike action by a military force, including
against any insured allege negligence or other
action in hindering or defending against an
wrongdoing in the supervision, hiring, employ-
ment, training or monitoring of others by that
actual or expected attack, by any govern -
insured, if the "occurrence" which caused the
ment, sovereign or other authority using
"bodily injury" or "property damage" involved
military personnel or other agents; or
the ownership, maintenance, use or entrust-
(3) Insurrection, rebellion, revolution, usurped
ment to others of any aircraft, "auto" or water-
power, or action taken by governmental
craft that is owned or operated by or rented or
authority in hindering or defending against
loaned to any insured,
any of these.
This exclusion does not apply to:
j. Damage To Property
(1) A watercraft while ashore on premises you
"Property damage" to:
own or rent;
(1) Property you own, rent, or occupy, includ-
(2) A watercraft you do not own that is:
ing any costs or expenses incurred by
(a) Less than 26 feet long; and
you, or any other person, organization or
entity, for repair, replacement, enhance-
(b) Not being used to carry persons or
ment, restoration or maintenance of such
property for a charge;
property for any reason, including preven-
(3) Parking an "auto" on, or on the ways next
tion of injury to a person or damage to
to, premises you own or rent, provided the
another's property;
"auto" is not owned by or rented or loaned
(2) Premises you sell, give away or abandon,
to you or the insured;
if the "property damage" arises out of any
(4) Liability assumed under any "insured con-
tract" for the ownership, maintenance or
part of those premises; t•
Property loaned to
use of aircraft or watercraft; or��\gam,��
(3) you;
10�w\�
Page 4 of 16 Copyright, Insurance Services Office, Inc., 2012�� G 00 01 0413
(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 subcon-
tractors 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
contents of such premises, rented to you for a
period of seven or fewer consecutive days. A
separate limit of insurance applies to Damage
To Premises 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 exclu-
sion do not apply to liability assumed under a
sidetrack agreement.
Paragraph (6) of this exclusion does not apply
to "property damage" included in the "prod-
ucts -completed operations hazard".
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 "prod-
ucts -completed operations hazard".
This exclusion does not apply if the damaged
work or the work out of which the dam-
age arises was performed on your behalf by a
subcontractor.
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 dan-
gerous 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
accidental 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 ex-
pense incurred by you or others for the loss of
use, withdrawal, recall, inspection, repair, re-
placement, 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".
p. Electronic Data
Damages arising out of the loss of, loss of use
of, damage to, corruption of, inability to ac-
cess, or inability to manipulate electronic data.
However, this exclusion does not apply to lia-
bility for damages because of "bodily injury".
As used in this exclusion, electronic data
means information, facts or programs stored
as or on, created or used on, or transmitted
to or from computer software, including sys-
tems and applications software, hard or floppy
disks, CD-ROMs, tapes, drives, cells, data
processing devices or any other media
which are used with electronically controlled
equipment.
q. Recording And Distribution Of Material Or
Information In Violation Of Law
"Bodily injury" or "property damage" arising di-
rectly or indirectly out of any action or omis-
sion that violates or is alleged to violate:
(1) The Telephone Consumer Protection Act
(TCPA), including any amendment of or
addition to such law;
(2) The CAN-SPAM Act of 2003, including any
amendment of or addition to such law;
(3) The Fair Credit Reporting Act (FCRA), and
any amendment of or addition to such law,
including the Fair and Accurate Credit
Transactions Act (FACTA); or
CG 00 01 0413 Copyright, Insurance Services Office, Inc., 2012
\ee
S\��a� �I (SIP
(4) Any federal, state or local statute, ordi-
nance or regulation, other than the TCPA,
CAN-SPAM Act of 2003 or FCRA and
their amendments and additions, that
addresses, prohibits, or limits the print-
ing, dissemination, disposal, collecting,
recording sending, transmitting, com-
municating or distribution of material or
information.
Exclusions c. through n. do not apply to damage
by fire to premises while rented to you or tempo-
rarily occupied by you with permission of the
owner. A separate limit of insurance applies to this
coverage as described in Section III - Limits Of
Insurance.
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
because 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 "per-
sonal and advertising injury" to which this
insurance does not apply. We may, at our dis-
cretion, investigate 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 in-
surance in the payment of judgments or
settlements under Coverages A or B or
medical expenses under Coverage C.
No other obligation or liability to pay sums or
perform ads 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
committed in the "coverage territory" during
the policy period.
2. Exclusions
This insurance does not apply to:
a. Knowing Violation Of Rights Of Another
"Personal and advertising injury" caused by or
at the direction of the insured with the knowl-
edge that the act would violate the rights of
another and would inflict "personal and adver-
tising injury".
b. Material Published With Knowledge Of
Falsity
"Personal and advertising injury" arising out of
oral or written publication, in any manner, of
material, if done by or at the direction of the in-
sured with knowledge of its falsity.
c. Material Published Prior To Policy Period
"Personal and advertising injury" arising out of
oral or written publication, in any manner, of
material whose first publication took place be-
fore the beginning of the policy period.
d. Criminal Acts
"Personal and advertising injury" arising out of
a criminal act committed by or at the direction
of the insured.
e. Contractual Liability
"Personal and advertising injury" for which
the insured has assumed liability in a contract
or agreement. This exclusion does not apply
to liability for damages that the insured
would have in the absence of the contract or
agreement.
f. Breach Of Contract
"Personal and advertising injury" arising out of
a breach of contract, except an implied con-
tract to use another's advertising idea in your
"advertisement".
g. Quality Or Performance Of Goods -Failure
To Conform To Statements
"Personal and advertising injury" arising out of
the failure of goods, products or services to
conform with any statement of quality or per-
formance made in your "advertisement".
h. Wrong Description Of Prices
"Personal and advertising injury" arising out
of the wrong description of the price of
goods, products or services stated in your
"advertisement".
Page 6 of 16 Copyright, Insurance Services Office, Inc., 2012
� �®ev� ik
CG 00 01 0413
i. Infringement Of Copyright, Patent,
Trademark Or Trade Secret
"Personal and advertising injury" arising out of
the infringement of copyright, patent, trade-
mark, trade secret or other intellectual prop-
erty rights. Under this exclusion, such other
intellectual property rights do not include
the use of another's advertising idea in your
"advertisement".
However, this exclusion does not apply to in-
fringement, in your "advertisement", of copy-
right, trade dress or slogan.
j. Insureds In Media And Internet Type
Businesses
"Personal and advertising injury" committed by
an insured whose business is:
(1) Advertising, broadcasting, publishing or
telecasting;
(2) Designing or determining content of web
sites for others; or
(3) An Internet search, access, content or
service provider.
However, this exclusion does not apply to
Paragraphs 14.a., b. and c. of "personal
and advertising injury" under the Definitions
section.
For the purposes of this exclusion, the placing
of frames, borders or links, or advertising, for
you or others anywhere on the Internet, is not
by itself, considered the business of advertis-
ing, broadcasting, publishing ortelecasting.
k. Electronic Chatrooms Or Bulletin Boards
"Personal and advertising injury" arising out of
an electronic chatroom or bulletin board the in-
sured hosts, owns, or over which the insured
exercises control.
I. Unauthorized Use OfAnother's Name Or
Product
"Personal and advertising injury" arising out of
the unauthorized use of another's name or
product in your e-mail address, domain name
or metatag, or any other similar tactics to mis-
lead another's potential customers.
m. Pollution
"Personal and advertising injury" arising out of
the actual, alleged or threatened discharge,
dispersal, seepage, migration, release or es-
cape of "pollutants" at any time.
n. Pollution -related
Any loss, cost or expense arising out of any:
(1) Request, demand, order or statutory or
regulatory requirement that any insured or
others test for, monitor, clean up, remove,
contain, treat, detoxify or neutralize, or in
any way respond to, or assess the effects
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, re-
moving, containing, treating, detoxifying or
neutralizing, or in any way responding to,
or assessing the effects of, "pollutants".
o. War
"Personal and advertising injury", however
caused, arising, directly or indirectly, out of.
(1) War, including undeclared or civil war;
(2) Warlike action by a military force, including
action in hindering or defending against an
actual or expected attack, by any govern-
ment, sovereign or other authority using
military personnel or other agents; or
(3) Insurrection, rebellion, revolution, usurped
power, or action taken by governmental
authority in hindering or defending against
any of these.
p. Recording And Distribution Of Material Or
Information In Violation Of Law
"Personal and advertising injury" arising di-
rectly or indirectly out of any action or omis-
sion that violates or is alleged to violate:
(1) The Telephone Consumer Protection Act
(TCPA), including any amendment of or
addition to such law;
(2) The CAN-SPAM Act of 2003, including any
amendment of or addition to such law;
(3) The Fair Credit Reporting Act (FCRA), and
any amendment of or addition to such law,
including the Fair and Accurate Credit
Transactions Act (FACTA); or
(4) Any federal, state or local statute, ordi-
nance or regulation, other than the TCPA,
CAN-SPAM Act of 2003 or FCRA and
their amendments and additions, that
addresses, prohibits, or limits the print-
ing, dissemination, disposal, collecting,
recording, sending, transmitting, com-
municating or distribution of material or
information.
CG 00 01 0413 Copyright, Insurance Services Office, Inc., 2012
�� Page 7 of 16
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 premisesyou own or rent;
(2) On ways next to premises you own or rent;
or
(3) Because of your operations;
provided that:
(a) The accident takes place in the "cov-
erage territory" and during the policy
period;
(b) The expenses are incurred and re-
ported to us within one year of the
date of the accident; and
(c) The injured person submits to exami-
nation, at our expense, by physicians
of our choice as often as we reason-
ably require.
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. Any Insured
To any insured, except"volunteer workers".
b. Hired Person
To a person hired to do work for or on behalf
of any insured or a tenant of any insured.
c. Injury On Normally Occupied Premises
To a person injured on that part of prem-
ises you own or rent that the person normally
occupies.
d. Workers' Compensation And Similar Laws
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. Athletics Activities
To a person injured while practicing, instruct-
ing or participating in any physical exercises or
games, sports, or athletic contests.
f. Products -Completed Operations Hazard
Included within the "products -completed oper-
ations hazard".
g. Coverage A Exclusions
Excluded under Coverage A.
SUPPLEMENTARY PAYMENTS - COVERAGES A
Al
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.
I 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 in-
vestigation or defense of the claim or "suit", in
cluding actual loss of earnings up to $250 a
day because of time off from work.
e. All court costs taxed against the insured in the
"suit". However, these payments do not in-
clude attorneys' fees or attorneys' expenses
taxed against the insured.
f. Prejudgment interest awarded against the in-
sured 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
interest based on that period of time after the
offer.
ea�e�'.
A .
Page 8 of 16 Copyright, Insurance Services Office, Inc., 2012 CG 00 01 0413
g. All interest on the full amount of any judgment
that accrues after entry of the judgment and
before we have paid, offered to pay, or depos-
ited in court the part of the judgment that is
within the applicable limit of insurance.
These payments will not reduce the limits of
insurance.
2. If we defend an insured against a "suit" and an in-
demnitee 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
liability of the indemnitee in a contract or
agreement that is an "insured contract";
b. This insurance applies to such liability as-
sumed by the insured;
c. The obligation to defend, or the cost of the de-
fense 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
indemnitee;
e. The indemnitee and the insured ask us to
conduct and control the defense of that indem-
nitee against such "suit" and agree that we can
assign the same counsel to defend the insured
and the indemnitee; and
f. The indemnitee:
(1) Agrees in writing to:
(a) Cooperate with us in the 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 cover-
age is available to the indemnitee; and
(d) Cooperate with us with respect to co-
ordinating other applicable insurance
available to the indemnitee; and ,
(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 we have used up the applicable limit of insur-
ance in the payment of judgments or settlements
or 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
duties as your officers or directors. Your stock-
holders are also insureds, but only with re-
spect to their liability as stockholders.
e. A trust, you are an insured. Your trustees are
also insureds, but only with respect to their du-
ties as trustees.
��a
CG 00 01 0413 Copyright, Insurance Services Office, Inc., 2012
Mfe 9 of 16
2. Each of the following is also an insured:
a. Your "volunteer workers" only while performing
duties related to the conduct of your business,
or your "employees", other than either your
"executive officers" (if you are an organization
other than a partnership, joint venture orlim-
ited liability company) cryour 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 "employees" or "volunteer workers" 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 ven-
ture), to your members (if you are a
limited liability company), to a co"em-
ployee" while in the course of his or
her employment or performing duties
related to the conduct of your busi-
ness, or to your other "volunteer
workers" while performing duties re-
lated to the conduct of your business;
(b) To the spouse, child, parent, brother
or sister of that co -"employee" or "vol-
unteer worker" as a consequence of
Paragraph (1)(a) above;
(c) For which there is any obligation to
share damages with or repay some-
one else who must pay damages
because of the injury described in
Paragraph (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 con-
trol of, or over which physical control
is being exercised for any purpose by;
you, any of your "employees", "volunteer
workers", any partner or member (if
you are a partnership or joint venture), or
any member (if you are a limited liability
company).
b. Any person (other than your "employee" or
"volunteer worker"), or any organization while
acting as your real estate 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 representative has been
appointed.
d. Your legal representative if you die, but only
with respect to duties as such. That represen-
tative will have all your rights and duties under
this Coverage Part.
3. 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 Adoes 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
1. The Limits of Insurance shown in the Declarations
and the rules below fix the most we will pay regard-
less 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 dam-
age" included in the "products -completed op-
erations hazard"; and
c. Damages under Coverage B.
Page 10 of 16 Copyright, Insurance Services Office, Inc., 2012
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CG 00 01 0413
3. The Products -Completed Operations Aggregate
Limit is the most we will pay under Coverage Afor
damages because of "bodily injury" and "property
damage" included in the "products -completed op-
erations hazard".
4. Subject to Paragraph 2. above, the Personal And
Advertising Injury Limit is the most we will pay
under Coverage B for the sum of all damages be-
cause of all "personal and advertising injury" sus-
tained by any one person or organization.
5. Subject to Paragraph 2. or 3. above, whichever ap-
plies, 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 Paragraph S. 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 Paragraph S. above, the Medical Ex-
pense Limit is the most we will pay under Cover-
age C for all medical expenses because of "bodily
injury" sustained 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.
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
notice of the claim or "suit" as soon as
practicable.
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 enforce-
ment 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; 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 ap-
plicable limit of insurance. An agreed settlement
means a settlement and release of liability signed
by us, the insured and the claimant or the
claimant's legal representative.
CG 00 01 0413 Copyright, Insurance Services Office, Inc., 2012 Pagel 1 of 16
4. Otherinsurance (3) When this insurance is excess over other
If other valid and collectible insurance is available insurance, we will pay only our share of
to the insured for a loss we cover under Cover- the amount of the loss, if any, that exceeds
ages A or B of this Coverage Part, our obligations the sum of:
are limited as follows: (a) The total amount that all such other in -
a. Primary Insurance surance would pay for the loss in the
This insurance is primary except when Para- absence of this insurance; and
graph b, below applies. If this insurance is pri- (b) The total of all deductible and self-
mary, our obligations are not affected unless insured amounts under all that other
any of the other insurance is also primary. insurance.
Then, we will share with all that other insurance (4) We will share the remaining loss, if any,
by the method described in Paragraph c. with any other insurance that is not de -
below. scribed in this Excess Insurance provision
b. Excess Insurance and was not bought specifically to apply in
excess of the Limits of Insurance shown in
(1) This insurance is excess over: the Declarations of this Coverage Part.
(a) Any of the other insurance, whether c. Method Of Sharing
primary, excess, contingent or on any
other basis: If all of the other insurance permits contribu-
tion by equal shares, we will follow this method
(i) That is Fire, Extended Coverage, also. Under this approach each insurer con -
Builder's Risk, Installation Risk or tributes equal amounts until it has paid its ap-
similar coverage for "your work"; plicable limit of insurance or none of the loss
(il) That is Fire insurance for premises remains, whichever comes first.
rented to you or temporarily occu- If any of the other insurance does not permit
pied by you with permission of the contribution by equal shares, we will contribute
owner; by limits. Under this method, each insurer's
(iii) That is insurance purchased by share is based on the ratio of its applicable
you to cover your liability as a ten- limit of insurance to the total applicable limits
ant for "property damage" to of insurance of all insurers.
premises rented to you or tempo- 5. Premium Audit
rarily occupied by you with per-
mission of the owner; or a. We will compute all premiums for this Cover -
( age Part in accordance with our rules and
(iv) If the loss arises out of the main-
rates.
tenance or use of aircraft, "autos" b. Premium shown in this Coverage Part as od-
jeci to Exclusion g. of Section 1 -
or watercraft to the extent not sub- vance premium is a deposit premium only. At
Coverage A - Bodily Injury And the close of each audit period we will compute
Property Damage Liability. the earned premium for that period and send
notice to the frst Named Insured. The due date
(b) Any other primary insurance available for audit and retrospective premiums is the
to you covering liability for damages date shown as the due date on the bill. If the
arising out of the premises or opera- sum of the advance and audit premiums paid
tions, or the products and completed for the policy period is greater than the earned
operations, for which you have been premium, we will return the excess to the first
added as an additional insured. Named Insured.
(2) When this insurance is excess, we will c. The first Named Insured must keep records of
have no duty under Coverages A or B to the information we need for premium compu-
defend the insured against any "suit" if any tation, and send us copies at such times as we
other insurer has a duty to defend the in- may request.
sured against that "suit". If no other insurer
defends, we will undertake to do so, but 6. Representations
we will be entitled to the insured's rights By accepting this policy, you agree:
against all those other insurers. a. The statements in the Declarations are accu-
rate and complete;
Page 12 of 16 Copyright, Insurance Services Office, Inc., 2012 on,C 00 01 0413
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 re-
quest, 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. For the purposes of this definition:
a. Notices that are published include material
placed on the Internet or on similar electronic
means of communication; and
b. Regarding web sites, only that part of a web
site that is about your goods, products or ser-
vices for the purposes of attracting customers
or supporters is considered an advertisement.
2. "Auto" means:
a. A land motor vehicle, trailer or semitrailer de-
signed for travel on public roads, including any
attached machinery or equipment; or
b. Any other land vehicle that is subject to a com-
pulsory or financial responsibility law or other
motor vehicle insurance law where it is li-
censed or principally garaged.
However, "auto" does not include "mobile
equipment".
3. "Bodily injury" means bodily injury, sickness or dis-
ease sustained by a person, including death result-
ing from any of these at any time.
4. "Coverage territory" means:
a. The United States of America (including its ter-
ritories and possessions), Puerto Rico and
Canada;
b. International waters or airspace, but only if the
injury or damage occurs in the course of travel
or transportation between any places included
in Paragraph a. above; or
c. All other parts of the world if the injury or dam-
age arises out of:
(1) Goods or products made or sold by you in
the territory described in Paragraph a.
above;
(2) The activities of a person whose home is in
the territory described in Paragraph a.
above, but is away for a short time on your
business; or
(3) "Personal and advertising injury" offenses
thattake place through the Internet or sim-
ilar electronic means of communication;
provided the insured's responsibility to pay
damages is determined in a "suit" on the mer-
its, in the territory described in Paragraph a.
above or in a settlement 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, bylaws 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" meanstangible 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 the re-
pair, replacement, adjustment or removal of "your
product" or "your work" or your fulfilling the terms
of the contract or agreement.
Vl
CCIS00 01 0413 Copyright, Insurance Services office, Inc., 2012
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
contract";
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 in-
demnify 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
damage" to a third person or organization.
Tort liability means a liability that would be im-
posed 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 in-
jury" or "property damage" arising out of
construction or demolition operations,
within 50 feet of any railroad property and
affecting any railroad bridge or trestle,
tracks, road -beds, tunnel, underpass or
crossing;
(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 draw-
ings, opinions, reports, surveys, field
orders, change orders or drawings
and specifications; or
(b) Giving directions or instructions, or
failing to give them, if that is the pri-
mary 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,
architectural 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 re-
lated to the conduct of your business. "Leased
worker" does not include a "temporary worker".
11. "Loading or unloading" means the handling of
property:
a. After it is moved from the place where it is ac-
cepted for movement into or onto an aircraft,
watercraft or "auto";
b. While it is in or on an aircraft, watercraft or
"auto"; or
c. While it is being moved from an aircraft, water-
craft or "auto" to the place where it is finally
delivered;
but "loading or unloading" does not include the
movement of property by means of a mechanical
device, other than a hand truck, that is not at-
tached to the aircraft, watercraft or "auto".
12. "Mobile equipment" means any of the following
types of land vehicles, including any attached ma-
chinery or equipment:
a. Bulldozers, farm machinery, forklifts and other
vehicles designed for use principally off public
roads;
b. Vehicles maintained for use solely on or next
to premises you own or rent;
c. Vehicles that travel on crawler treads;
d. Vehicles, whether self-propelled or not, main-
tained primarily to provide mobility to perma-
nently mounted:
(1) Power cranes, shovels, loaders, diggers or
drills; or
(2) Road construction or resurfacing equip-
ment such as graders, scrapers or rollers;
e. Vehicles not described in Paragraph a., b., c.
or d. above that are not self-propelled and are
maintained primarily to provide mobility to per-
manently attached equipment of the following
types:
(1) Air compressors, pumps and generators,
including spraying, welding, building
cleaning, geophysical exploration, lighting
and well servicing equipment; or
(2) Cherry pickers and similar devices used to
raise or lower workers;
f. Vehicles not described in Paragraph a., b., c.
or d. above maintained primarily for purposes
other than the transportation of persons or
cargo.
Page 14 of 16 Copyright, Insurance Services Office, Inc., 2012 0 i 010104 13
However, self-propelled vehicles with the fol- 16.
lowing types of permanently attached equip-
ment are not "mobile equipment" but will be
considered "autos":
(1) Equipment designed primarily for:
(a) Snowremoval;
(b) Road maintenance, but not construc-
tion or resurfacing; or
(c) Street cleaning;
(2) Cherry pickers and similar devices
mounted on automobile or truck chassis
and used to raise or lower workers; and
(3) Air compressors, pumps and generators,
including spraying, welding, building
cleaning, geophysical exploration, lighting
and well servicing equipment.
However, "mobile equipment" does not include any
land vehicles that are subject to a compulsory or
financial responsibility law or other motor vehicle
insurance law where it is licensed or principally ga-
raged. Land vehicles subject to a compulsory or
financial responsibility law or other motor vehicle
insurance law are considered "autos".
13. "Occurrence" means an accident, including contin-
uous or repeated exposure to substantially the
same general harmful conditions.
14. "Personal and advertising injury" means injury, in-
cluding consequential "bodily injury", arising out of
one or more of the following offenses:
a. False arrest, detention or imprisonment;
b. Malicious prosecution;
c. The wrongful eviction from, wrongful entry
into, or invasion of the right of private occu-
pancy of a room, dwelling or premises that a
person occupies, committed by or on behalf of
its owner, landlord or lessor;
d. Oral or written publication, in any manner, of
material that slanders or libels a person or or-
ganization or disparages a person's or organi-
zation's goods, products or services;
e. Oral or written publication, in any manner, of
material that violates a person's right of
privacy;
f. The use of another's advertising idea in your
"advertisement"; or
g. Infringing upon another's copyright, trade
dress or slogan in your "advertisement".
15. "Pollutants" mean any solid, liquid, gaseous or
thermal irritant or contaminant, including smoke,
vapor, soot, fumes, acids, alkalis, chemicals and
waste. Waste includes materials to be recycled, re-
conditioned or reclaimed.
"Products -completed operations hazard":
a. Includes all "bodily injury" and "property dam-
age" occurring away from premises you own
or rent and arising out of "your product" or
"your work" except:
(1) Products that are still in your physical pos-
session; or
(2) Work that has not yet been completed or
abandoned. However, "your work" will be
deemed completed at the earliest of the
following times:
(a) When all of the work called for in your
contract has been completed.
(b) When all of the work to be done at the
job site has been completed if your
contract calls for work at more than
one job site.
(c) When that part of the work done at a
job site has been put to its intended
use by any person or organization
other than another contractor or
subcontractor working on the same
project.
Work that may need service, maintenance,
correction, repair or replacement, but
which is otherwise complete, will be
treated as completed.
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
classification, listed in the Declarations or
in a policy 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.
For the purposes of this insurance, elecq&%3 data
is not tangible property. o je 1 in
A I
CG 00 01 0413 Copyright, Insurance Services Office, Inc., 2012
As used in this definition, electronic data means
information, facts or programs stored as or on,
created or used on, or transmitted to or from com-
puter software, including systems and applications
software, hard or floppy disks, CD-ROMs. tapes,
drives, cells, data processing devices or any other
media which are used with electronically controlled
equipment.
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
consent.
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. "volunteer worker" means a person who is notyour
"employee", and who donates his or her work and
acts at the direction of and within the scope of
duties determined by you, and is not paid a fee,
salary or other compensation by you or anyone
else for their work performed for you.
21. "Your product":
a. Means:
(1) Any goods or products, other than real
property, manufactured, sold, handled,
distributed or disposed of by:
(a) You;
(b) Others trading under your name; or
(c) A person or organization whose busi-
ness or assets you have acquired; and
(2) Containers (other than vehicles), materials,
parts or equipment furnished in connec-
tion with such goods or products.
b. Includes:
(1) Warranties or representations made at any
time with respect to the fitness, quality,
durability, performance or use of "your
product"; and
(2) The providing of or failure to provide warn-
ings or instructions.
c. Does not include vending machines or other
property rented to or located for the use of
others but not sold.
22. "Your work":
a. Means:
(1) Work or operations performed by you or
on your behalf; and
(2) Materials, parts or equipment furnished in
connection with such work or operations.
b. Includes:
(1) Warranties or representations made at
any time with respect to the fitness, qual-
ity, durability, performance or use of "your
work"; and
(2) The providing of or failure to provide warn-
ings or instructions.
Page 16 of 16 Copyright, Insurance Services Office, Inc., 2012
a w
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�a5
2 0,Ob 01 0413
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
CG 20 02 11 85
ADDITIONAL INSURED - CLUB MEMBERS
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
WHO IS AN INSURED (Section II) is amended to include as an insured any of your members, but only with respect to
their liability for your activities or activities they perform on your behalf.
G
CC 20 02 1185 @Y,J^�"
Copyright, Insurance services Office, Inc., 1984 Page 1 of 1
INSURED
COMMERCIAL GENERAL LIABILITY
CG21730115
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
EXCLUSION OF CERTIFIED ACTS OF TERRORISM
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
LIQUOR LIABILITY COVERAGE PART
OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE PART
POLLUTION LIABILITY COVERAGE PART
PRODUCTS/ COMPLETED OPERATIONS LIABILITY COVERAGE PART
RAILROAD PROTECTIVE LIABILITY COVERAGE PART
UNDERGROUND STORAGE TANK POLICY
A. The following exclusion is added:
This insurance does not apply to:
TERRORISM
"Any injury or damage" arising, directly or indi-
rectly, out of a "certified act of terrorism".
B. The following definitions are added:
1. For the purposes of this endorsement, "any in-
jury or damage" means any injury or damage
covered under any Coverage Part to which this
endorsement is applicable, and includes but is
not limited to 'bodily injury""property dam-
age", "personal and advertisin,g injury", "injury"
or "environmental damage" as may be defined
in any applicable Coverage Part.
2. "Certified act of terrorism" means an act that
is certified by the Secretary of the Treasury, in
accordance with the provisions of the federal
Terrorism Risk Insurance Act, to be an act
of terrorism pursuant to such Act. The crite-
ria contained in the Terrorism Risk Insurance
Act for a "certified act of terrorism" include the
following:
a. The act resulted in insured losses in ex-
cess of $5 million in the aggregate, attrib-
utable to all types of insurance subject to
the Terrorism Risk Insurance Act; and
b. The act is a violent act or an act that is
dangerous to human life, property or infra-
structure and is committed by an individ-
ual 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 Govern-
ment by coercion.
C. The terms and limitations of any terrorism eXCILI-
sion, or the inapplicability or omission of a terror-
ism exclusion, do not serve to create coverage for
injury or damage that is otherwise excluded under
this Coverage Part.
t �,,j,a
G
15
CG 2173 01 15 Copyright, Insurance Services Office, Inc., 2014 Page 1 of 1
INSURED
COMMERCIAL GENERAL LIABILITY
CG 24 26 0413
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
AMENDMENT OF INSURED CONTRACT DEFINITION
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART
The definition of "insured contract" in the Definitions
section is replaced by the following:
"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 organi-
zation for damage by fire to premises while
rented to you or temporarily occupied by you
with permission of the owner is not an "insured
contract";
b. A sidetrack agreement;
c. Any easement or license agreement, except
in connection with construction or demolition
operations on or within 50 feet of a railroad;
d. An obligation, as required by ordinance, to in-
demnify 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
damage"to a third person or organization, pro-
vided the "bodily injury" or "property damage"
is caused, in whole or in part, by you or by
those acting on your behalf. However, such
part of a contract or agreement shall only be
considered an "insured contract" to the extent
your assumption of the tort liability is permitted
by law, Tort liability means a liability that would
be imposed by law in the absence of any con-
tract or agreement.
Paragraph f. does not include that part of any con-
tract or agreement:
(1) That indemnifies a railroad for "bodily injury"
or "property damage" arising out of construc-
tion 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 sur-
veyor for injury or damage arising out of:
(a) Preparing, approving, or failing to prepare
or approve, maps, shop drawings, opin-
ions, reports, surveys, field orders, change
orders or drawings and specifications; or
(b) Giving directions or instructions, or failing
to give them, if that is the primary cause of
the injury or damage; or
(3) Under which the insured, if an architect, engi-
neer or surveyor, assumes liability for an injury
or damage arising out of the insured's render-
ing or failure to render professional services,
including those listed in (2) above and supervi-
sory, inspection, architectural or engineering
activities.
CG 24 26 0413 Copyright, Insurance Services Office, Inc., 2012
INSURED
� S
Page 1 of 1
A SCOTTSDALE INSURANCE COMPANY
ENDORSEMENT
NO.
ATTACHED TO AND
ENDORSE M ENT EFFECTIVE DATE
FORMING APART OF
(�2;D1 A.M. STANDARD TIME)
NAMED INSURED
AGENT NO.
POLICY NUMBER
CPS2561230
11/26/2016
HIBA SHUSLAK DBA: ACTIVE LEARNING
04066
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
SEXUAL AND/ OR PHYSICAL ABUSE LIABILITY COVERAGE FORM
INSURING AGREEMENT
Sexual and/ or Physical Abuse Liability is covered up to the limits of liability shown below. Coverage is subject to this cover-
age form and the exclusions, conditions and other terms of this policy.
LIMITS OF LIABILITY
COVERAGE
each claim
Sexual and/ or Physical Abuse Liability
300 oo_o____ aggregate
Advance Premium
Premium Bases
Rates
Description of Hazards
$ INCLUDED TOTAL ADVANCE PREMIUM
COVERAGES - SEXUAL AND/OR PHYSICAL
ABUSE LIABILITY
(a) We will pay on your behalf all sums which you
shall become legally obligated to pay as DAM-
AGES because of injury manifesting during the
policy period to any person, and arising out of
SEXUAL AND/ OR PHYSICAL ABUSE, caused
by one of your EMPLOYEES, or arising out of
your failure to properly supervise. We shall have
the right and duty to defend any suit against you
seeking such DAMAGES, even if any of the alle-
gations of the suit are groundless, false orfraudu-
lent, and may make such investigation and such
settlement of any claim or suit as we deem expe-
dient, but we shall not be obligated to pay any
claim or judgment or to defend any suit after
the applicable limit of our liability has been
exhausted.
(b) This insurance applies to DAMAGES from
SEXUAL AND/ OR PHYSICAL ABUSE only if the
SEXUAL AND/OR PHYSICAL ABUSE takes
place in the "coverage territory."
It. EXCLUSIONS
This policy does not apply:
(a) to any actual or alleged SEXUAL AND/OR
PHYSICAL ABUSE by you or PERSONS IN-
SURED (see Section III below);
(b) to liability of others assumed by you under any
contract or agreement, either oral or in writing,
unless specifically endorsed hereon;
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G LS44s (9-10) Page 1 of 2 _�p�^ C..�1��
INSURED 990 490910d.
(c) to any obligation for which you or any carrier as
your insurer may be held liable under any work-
ers' compensation, unemployment compensation
or disability benefits law, or under any similar law;
(d) to bodily injury to, or SEXUAL AND/ OR PHYSI-
CAL ABUSE, sickness, disease, or death sus-
tained by any of your EMPLOYEES arising out of,
and in the course of employment by you;
(e) to any loss or claim either directly or indirectly
arising from your activities as an officer or di-
rector of any corporation, company or business
other than that of the Named Insured;
(f) to any claim for punitive or exemplary damages;
or
(g) to any loss or claim arising from corporal
punishment.
III. PERSONS INSURED
Each of the following is an insured under this insur-
ance to the extent set forth below:
(a) if the Named Insured is designated in the DECLA-
RATIONS as an individual, the person so desig-
nated, but only with respect to the conduct of a
business of which he is the sole proprietor, and
the spouse of the Named Insured with respect to
the conduct of such a business;
(b) if the Named Insured is designated in the DECLA-
RATIONS as a partnership or joint venture, the
partnership or joint venture so designated and
any partner or member thereof but only with re-
spect to his liability as such; or
(c) if the Named Insured is designated in the DECLA-
RATIONS as other than an individual, partnership
or joint venture, the organization so designated
and any executive officer, director or stockholder
thereof while acting within the scope of his duties
as such.
IV. LIMITSOF LIABILITY
Regardless of the number of insureds under this pol-
icy, our liability is limited as follows:
The limit of liability stated in the schedule as applica-
ble to each claim is the limit of our liability for all
DAMAGES because of each claim or suit covered
hereby. The limit of liability stated in the schedule as
aggregate, subject to the above provision regarding
each claim, is the total limit of our liability under this
Coverage for all DAMAGES.
V. SUPPLEMENTARY PAYMENTS
We will pay, in addition to the applicable limit of
liability for DAMAGES, all interest on that amount of
any judgment payable by us that accrues after entry
of the judgment and before we have paid, offered to
pay or deposited in court the amount available for the
judgment.
VI. DEFINITIONS
(a) SEXUAL AND/OR PHYSICAL ABUSE means
sexual or physical injury or abuse, including as-
sault and battery, negligent or deliberate touch-
ing. Any multiple, continuous, or related acts of
SEXUAL AND/ OR PHYSICAL ABUSE against a
single claimant or victim shall be treated as a
single SEXUAL AND/OR PHYSICAL ABUSE
claim for determining the Each Claim limits of
insurance available under this coverage form re-
gardless of the number of acts, events, condi-
tions, injuries, perpetrators, claims, causes of
action, theories of liability, lawsuits, or insurance
policies in effect at any point during exposure to
the SEXUAL AND/ OR PHYSICAL ABUSE.
The SEXUAL AND/ OR PHYSICAL ABUSE must
have been manifested within the policy period.
The SEXUAL AND/ OR PHYSICAL ABUSE shall
be deemed to have been manifested as of the
earliest date that any element of the SEXUAL
AND/ OR PHYSICAL ABUSE took place, regard-
less of whether such SEXUAL AND/ OR PHYSI-
CALABUSE was continuous or progressive.
(b) EMPLOYEE means any person, other than a
PERSON INSURED, in your employment, includ-
ing but not limited to persons with child caring re-
sponsibilities, attendants, janitors, bus drivers
and volunteer workers.
(c) DAMAGES means all damages, including dam-
ages for death, which are payable because of in-
jury to which this insurance applies.(
lk-
AUTHORIZED REPRESENTATIVE
DATE
A�y,
G LS44s (9-10) Page 2 of 2
Nationwide
Underwritten by: Scottsdale Insurance Company
Home Office: One Nationwide Plaza • Columbus, Ohio 43215
Administrative Office: 8877 North Gainey Center Drive • Scottsdale, Arizona 853258
1-800-423-7675 • A Stock Company
?,ev`eve
In Witness Whereof, the Company has caused this policy to be executed and attested.
; e,4-�4, '? 4
Secretary
President
The information contained herein replaces any similar information contained elsewhere in the policy,
UiS-COVPG (1-16) INSURED