15 Page
St. Francis Electric, LLC | Class A and C-10 Licensed Contractor 975 Carden Street, San Leandro, CA 94577 | Phone (510) 639-0639 www.sfe-inc.com | 24/7/365 Traffic Signal & Street Lighting Services 1-(844)-LIGHT88 Cost Proposal
Exhibit A
16 Page
St. Francis Electric, LLC | Class A and C-10 Licensed Contractor 975 Carden Street, San Leandro, CA 94577 | Phone (510) 639-0639 www.sfe-inc.com | 24/7/365 Traffic Signal & Street Lighting Services 1-(844)-LIGHT88
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS.
INSURER(S) AFFORDING COVERAGE
INSURER F :
INSURER E :
INSURER D :
INSURER C :
INSURER B :
INSURER A :
NAIC #
NAME:
CONTACT
(A/C, No):
FAX
E-MAIL
ADDRESS:
PRODUCER
(A/C, No, Ext):
PHONE
INSURED
REVISION NUMBER:CERTIFICATE NUMBER:COVERAGES
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be e ndorsed.
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A st atement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
OTHER:
(Per accident)
(Ea accident)
$
$
N / A
SUBR
WVD
ADDL
INSD
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIO D INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. $
$
$
$PROPERTY DAMAGE
BODILY INJURY (Per accident)
BODILY INJURY (Per person)
COMBINED SINGLE LIMIT
AUTOS ONLY
AUTOSAUTOS ONLY
NON-OWNED
SCHEDULEDOWNED
ANY AUTO
AUTOMOBILE LIABILITY
Y / N
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
OFFICER/MEMBER EXCLUDED?
(Mandatory in NH)
DESCRIPTION OF OPERATIONS below
If yes, describe under
ANY PROPRIETOR/PARTNER/EXECUTIVE
$
$
$
E.L. DISEASE - POLICY LIMIT
E.L. DISEASE - EA EMPLOYEE
E.L. EACH ACCIDENT
ER
OTH-
STATUTE
PER
LIMITS(MM/DD/YYYY)
POLICY EXP
(MM/DD/YYYY)
POLICY EFF
POLICY NUMBERTYPE OF INSURANCELTR
INSR
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
EXCESS LIAB
UMBRELLA LIAB $EACH OCCURRENCE
$AGGREGATE
$
OCCUR
CLAIMS-MADE
DED RETENTION $
$PRODUCTS - COMP/OP AGG
$GENERAL AGGREGATE
$PERSONAL & ADV INJURY
$MED EXP (Any one person)
$EACH OCCURRENCE
DAMAGE TO RENTED
$PREMISES (Ea occurrence)
COMMERCIAL GENERAL LIABILITY
CLAIMS-MADE OCCUR
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY PRO-
JECT LOC
CERTIFICATE OF LIABILITY INSURANCE
DATE (MM/DD/YYYY)
CANCELLATION
AUTHORIZED REPRESENTATIVE
ACORD 25 (2016/03)
© 1988-2015 ACORD CORPORATION. All rights reserved.
CERTIFICATE HOLDER
The ACORD name and logo are registered marks of ACORD
HIRED
AUTOS ONLY
X
Attn: Erin Smith
2,000,000
[email protected]
30 days notice of cancellation as per the attached endorsements. 4,000,000
X
Compensation, all as per the attached endorsements.
925-887-6815
General Liability and Auto Liability and Waiver of Subrogation applies to General Liability, Auto Liability and Workers 03092664
When required by written contract, Additional Insured status with Primary & Non-Contributory coverage applies to Additional Insured(s): City of Alameda, its City Council, boards, commissions, officers, employees and volunteers.
RE: SFE Job #17-728. Alameda SL Maintenance & Repair Services, City of Alameda, multiple locations.
USA
X
03102673
Y
A
1-925-798-3334
San Leandro, CA 94577
03/30/2023
GL5342018
04/01/24
X
1,000,000
DorriseyS
04/01/24
SFE #17-728
04/01/23
1,000,000
St. Francis Electric, LLC
B
1,000,000
NEW HAMPSHIRE INS CO
ALLIED WORLD NATL ASSUR CO
NATIONAL UNION FIRE INS CO OF PITTS
A 2,000,000
04/01/23
PO Box 2057
X
X
950 West Mall SAq
925-822-9009
500,000
68287709
68287709
X
P.O. Box 5668
Concord, CA 94524
10,000,00004/01/23
CA LIC 0B29370
5,000,000
CA4773676 2,000,000
X
04/01/24
X
04/01/2404/01/23
Almeda, CA 94501
25,000
Pollution Liability
X
X
WC022298334
Public Works Department
City of Alameda
B
10,000,000
CX
04/01/24
04/01/23X
X
23841
10690
Ea. Occ/Aggregate
19445
4,000,000
Sara Dorrisey
[Concord - Branch ID 15469]
Edgewood Partners Insurance Center (EPIC)
SUPP (05/04)
SUPPLEMENT TO CERTIFICATE OF INSURANCE
DATE
NAME OF INSURED:
Additional Description of Operations/Remarks from Page 1 :
Additional Information:
St. Francis Electric, LLC
Continued...
03/30/2023
This endorsement, effective 12:01 A.M. forms a part of
policy No. issued to
by
ENDORSEMENT
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED - WHERE REQUIRED UNDER CONTRACT OR AGREEMENT This endorsement modifies insurance provided under the following:
BUSINESS AUTO COVERAGE FORM
SCHEDULE
ADDITIONAL INSURED:
87950 (10/05)
Authorized Representative or
Countersignature (in States Where
Applicable)
I. SECTION II - LIABILITY COVERAGE, A. Coverage, 1. - Who Is Insured, is amended to add:
d. Any person or organization, shown in the schedule above, to whom you become obligated to include as an additional insured under this policy, as a result of any contract or agreement you enter into which requires you to furnish insurance to that person or organization of the type provided by this policy, but only with respect to liability arising out of use of a covered "auto". However, the insurance provided will not ex ceed the lesser of:
(1) The coverage and/or limits of this policy, or
(2) The coverage and/or limits required by said contract or agreement.
ϬϰͬϬϭͬϮϬϮϯ
CA 477-36-76 ST. FRANCIS ELECTRIC, LLC
NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH, PA Any person or organization for whom you are contractually bound to provide Additional Insured status but only to the extent of such person's or organization's liability arising out of the use of a covered "auto".
This endorsement, effective 12:01 A.M. forms a part of
Policy No. issued to
By
LIMITED ADVICE OF CANCELLATION PROVIDED VIA E-MAIL
107414 (03/11)
Authorized Representative
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
All other terms, conditions and exclusions shall remain the same.
TO ENTITIES OTHER THAN THE FIRST NAMED INSURED
Insurer,
This policy is amended as follows:
In the event that the Insurer cancels this policy for any reason other than non-payment of premium, and
1. the cancellation effective date is prior to this policy's expiration date;
2. the First Named Insured is under an existing contractual obligation to notify a certificate holder when this policy is canceled (hereinafter, the "Certificate Holder(s)") and has provided to the Insurer, either directly or through its broker of record, the email address of a contact at each such entity; and
3. the Insurer received this information after the First Named Insured receives notice of cancellation of this policy and prior to this policy's cancellation effective date, via an electronic spreadsheet that is acceptable to the
the Insurer will provide advice of cancellation (the "Advice") via e-mail to each such Certificate Holders within
30 days after the First Named Insured provides such information to the Insurer; provided, however, that if a specific number of days is not stated above, then the Advice will be provided to such Certificate Holder(s) as soon as reasonably practicable after the First Named Insured provides such information to the Insurer.
Proof of the Insurer emailing the Advice, using the information provided by the First Named Insured, will serve as proof that the Insurer has fully satisfied its obligations under this endorsement.
This endorsement does not affect, in any way, coverage provided under this policy or the cancellation of this policy or the effective date thereof, nor shall this endorsement invest any rights in any entity not insured under this policy.
The following Definitions apply to this endorsement:
1. First Named Insured means the Named Insured shown on the Declarations Page of this policy.
2. Insurer means the insurance company shown in the header on the Declarations page of this policy.
ENDORSEMENT #
ϬϰͬϬϭͬϮϬϮϯ
CA 477-36-76 ST. FRANCIS ELECTRIC, LLC
NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH, PA
This endorsement,effective12:01A.M. forms a part of
policyNo. issued to
by
This endorsement modifies insurance provided under the following:
BUSINESS AUTO COVERAGE FORM
All other terms and conditions remain unchanged.
Authorized Representative or
74445 (10/99)
Countersignature (in States Where
Applicable)
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
INSURANCE PRIMARY AS TO CERTAIN ADDITIONAL INSUREDS
Section IV - Business Auto Conditions, B., General Conditions, 5., Other Insurance, c., is amended by the addition of the following sentence:
The insurance afforded under this policy to an additional insured will apply as primary insurance for such additional insured where so required under an agreement executed prior to the date of accident . We will not ask any insurer that has issued other insurance to such additional insured to contribute to the settlement of lo ss arising out of such accident.
ENDORSEMENT
ϬϰͬϬϭͬϮϬϮϯ
CA 477-36-76 ST. FRANCIS ELECTRIC, LLC
NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH, PA
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
BUSINESS AUTO COVERAGE FORM
62897 (6/95)
AUTHORIZED REPRESENTATIVE
ENDORSEMENT
This endorsement, effective 12:01 A.M.
policy No. issued to
by
This endorsement modifies insurance provided under the following:
WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (2)
(1)
The contract or agreement was entered into prior to any " accident" or " loss" .
No waiver of the right of recovery will directly or i ndirectly apply to your employees or employees of the person or organization, and we reserve our rights or lien to be reimbursed from any recovery funds obtained by any injured employee.
Section IV - Business Auto Conditions, A. - Loss Conditions, 5. - Transfer of Rights of Recovery Against Others to Us, is amended to add:
The " accident" or " loss" is due to operations undertaken in accordance with the contract existing between you and such person or organization; and
However, we will waive any right of recover we have against any person or organization with whom you have entered into a contract or agreement because of payments we make under this Coverage Form arising out of an " accident" or " loss" if:
ϬϰͬϬϭͬϮϬϮϯ forms a part of
CA 477-36-76 ST. FRANCIS ELECTRIC, LLC
NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH, PA
POLICY NUMBER:
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
State Or Governmental Agency Or Subdivision Or Political Subdivision:
COMMERCIAL GENERAL LIABILITY
CG 20 12 12 19
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED - STATE OR GOVERNMENTAL
AGENCY OR SUBDIVISION OR POLITICAL
SUBDIVISION - PERMITS OR AUTHORIZATIONS
(-
ANY AND ALL STATE OR POLITICAL SUBDIVISIONS CONTRACTUALLY REQUIRING ADDITIONAL
INSURED STATUS IN CONNECTION WITH ISSUANCE OF PERMITS TO YOU, RELATING TO PREMISES.
Information required to complete this Schedule, if not shown above, will be shown in the Declarations.
A. Section II – Who Is An Insured is amended to
include as an additional insured any state or
governmental agency or subdivision or political
subdivision shown in the Schedule, subject to
the following provisions:
1. This insurance applies only with respect to
operations performed by you or on your
behalf for which the state or governmental
agency or subdivision or political subdivision
has issued a permit or authorization.
However:
a. The insurance afforded to such additional
insured only applies to the extent
permitted by law; and
b. If coverage provided to the additional
insured is required by a contract or
agreement, the insurance afforded to
such additional insured will not be
broader than that which you are required
by the contract or agreement to provide
for such additional insured.
2. This insurance does not apply to:
a. "Bodily injury", "property damage" or
"personal and advertising injury" arising
out of operations performed for the
federal government, state or municipality;
or
b. "Bodily injury" or "property damage"
included within the "products-completed
operations hazard".
B. With respect to the insurance afforded to these
additional insureds, the following is added to
Section III – Limits Of Insurance:
If coverage provided to the additional insured is
required by a contract or agreement, the most
we will pay on behalf of the additional insured
is the amount of insurance:
1. Required by the contract or agreement; or
2. Available under the applicable limits of
insurance;
whichever is less.
This endorsement shall not increase the
applicable limits of insurance.
CG 20 12 12 19 Page ofInsurance Services Office, Inc., 2018 11
POLICY NUMBER:
ADDITIONAL INSURED - OWNERS, LESSEES OR
CONTRACTORS - SCHEDULED PERSON OR
ORGANIZATION
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
Name Of Additional Insured Person(s)
Or Organization(s) Location(s) Of Covered Operations
COMMERCIAL GENERAL LIABILITY
CG 20 10 12 19
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
Information required to complete this Schedule, if not shown above, will be shown in the Declarations.
Insurance Services Office, Inc., 2018CG 20 10 12 19 Page 1 of 2 A. Section II – Who Is An Insured is amended to
include as an additional insured the person(s) or
organization(s) shown in the Schedule, but only
with respect to liability for "bodily injury",
"property damage" or "personal and advertising
injury" caused, in whole or in part, by:
1. Your acts or omissions; or
2. The acts or omissions of those acting on
your behalf;
in the performance of your ongoing operations
for the additional insured(s) at the location(s)
designated above.
However:
1. The insurance afforded to such additional
insured only applies to the extent permitted
by law; and
2. If coverage provided to the additional
insured is required by a contract or
agreement, the insurance afforded to such
additional insured will not be broader than
that which you are required by the contract
or agreement to provide for such additional
insured.
B. With respect to the insurance afforded to these
additional insureds, the following additional
exclusions apply:
This insurance does not apply to "bodily injury"
or "property damage" occurring after:
1. All work, including materials, parts or
equipment furnished in connection with such
work, on the project (other than service,
maintenance or repairs) to be performed by
or on behalf of the additional insured(s) at
the location of the covered operations has
been completed; or
2. That portion of "your work" out of which
the injury or damage arises has been put to
its intended use by any person or
organization other than another contractor or
subcontractor engaged in performing
operations for a principal as a part of the
same project.
GL 534-20-18
ANY PERSON OR ORGANIZATION WHOM YOU
BECOME OBLIGATED TO INCLUDE AS AN
ADDITIONAL INSURED AS A RESULT OF ANY
CONTRACT OR AGREEMENT YOU HAVE
ENTERED INTO.
PER THE CONTRACT OR AGREEMENT.
Insurance Services Office, Inc., 2018Page 2 of 2 CG 20 10 12 19 C. With respect to the insurance afforded to these
additional insureds, the following is added to
Section III – Limits Of Insurance:
If coverage provided to the additional insured is
required by a contract or agreement, the most
we will pay on behalf of the additional insured
is the amount of insurance:
1. Required by the contract or agreement; or
2. Available under the applicable limits of
insurance;
whichever is less.
This endorsement shall not increase the
applicable limits of insurance.
POLICY NUMBER:
ADDITIONAL INSURED - OWNERS, LESSEES OR
CONTRACTORS - COMPLETED OPERATIONS
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
Name Of Additional Insured Person(s)
Or Organization(s) Location And Description Of Completed Operations
COMMERCIAL GENERAL LIABILITY
CG 20 37 12 19
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART
Information required to complete this Schedule, if not shown above, will be shown in the Declarations.
A. Section II – Who Is An Insured is amended to
include as an additional insured the person(s) or
organization(s) shown in the Schedule, but only
with respect to liability for "bodily injury" or
"property damage" caused, in whole or in part,
by "your work" at the location designated and
described in the Schedule of this endorsement
performed for that additional insured and
included in the "products-completed operations
hazard".
However:
1. The insurance afforded to such additional
insured only applies to the extent permitted
by law; and
2. If coverage provided to the additional
insured is required by a contract or
agreement, the insurance afforded to such
additional insured will not be broader than
that which you are required by the contract
or agreement to provide for such additional
insured.
B. With respect to the insurance afforded to these
additional insureds, the following is added to
Section III – Limits Of Insurance:
If coverage provided to the additional insured is
required by a contract or agreement, the most
we will pay on behalf of the additional insured
is the amount of insurance:
1. Required by the contract or agreement; or
2. Available under the applicable limits of
insurance;
whichever is less.
This endorsement shall not increase the
applicable limits of insurance.
CG 20 37 12 19 Insurance Services Office, Inc., 2018 Page 1 of 1 GL 534-20-18
ANY PERSON OR ORGANIZATION
WHOM YOU BECOME OBLIGATED
TO INCLUDE AS AN ADDITIONAL INSURED
AS A RESULT OF ANY CONTRACT OR
AGREEMENT YOU HAVE ENTERED INTO.
PER THE CONTRACT OR AGREEMENT.
This endorsement, effective 12:01 A.M. forms a part of
Policy No. issued to
By
LIMITED ADVICE OF CANCELLATION PROVIDED VIA E-MAIL
107414 (03/11)
Authorized Representative
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
All other terms, conditions and exclusions shall remain the same.
TO ENTITIES OTHER THAN THE FIRST NAMED INSURED
Insurer,
This policy is amended as follows:
In the event that the Insurer cancels this policy for any reason other than non-payment of premium, and
1. the cancellation effective date is prior to this policy's expiration date;
2. the First Named Insured is under an existing contractual obligation to notify a certificate holder when this policy is canceled (hereinafter, the "Certificate Holder(s)") and has provided to the Insurer, either directly or through its broker of record, the email address of a contact at each such entity; and
3. the Insurer received this information after the First Named Insured receives notice of cancellation of this policy and prior to this policy's cancellation effective date, via an electronic spreadsheet that is acceptable to the
the Insurer will provide advice of cancellation (the "Advice") via e-mail to each such Certificate Holders within
30 days after the First Named Insured provides such information to the Insurer; provided, however, that if a specific number of days is not stated above, then the Advice will be provided to such Certificate Holder(s) as soon as reasonably practicable after the First Named Insured provides such information to the Insurer.
Proof of the Insurer emailing the Advice, using the information provided by the First Named Insured, will serve as proof that the Insurer has fully satisfied its obligations under this endorsement.
This endorsement does not affect, in any way, coverage provided under this policy or the cancellation of this policy or the effective date thereof, nor shall this endorsement invest any rights in any entity not insured under this policy.
The following Definitions apply to this endorsement:
1. First Named Insured means the Named Insured shown on the Declarations Page of this policy.
2. Insurer means the insurance company shown in the header on the Declarations page of this policy.
ENDORSEMENT#
ϬϰͬϬϭͬϮϬϮϯ
GL 534-20-18 ST. FRANCIS ELECTRIC, LLC
NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH, PA
This endorsement, effective 12:01 A.M. forms a part of
policy No. issued to
by
ENDORSEMENT
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
AMENDMENT OF LIMITS OF INSURANCE
(Per Project or Per Location Aggregate Limit)
86681 (9/04) Page 1 of 2
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE FORM
I. Your policy is amended to include either a Per Project General Aggregate Limit, a Per Location General Aggregate Limit or a Per Project and Per Location General Aggregate Limit. Please select only one of the following:
[ ] Per Project General Aggregate Limit $
[ ] Per Location General Aggregate Limit $
[ ] Per Project and Per Location General Aggregate Limit $ IF NEITHER OF THESE BOXES ARE CHECKED, THIS ENDORSEMENT IS VOID. IF MORE THAN ONE OF THE THESE BOXES ARE CHECKED, THIS ENDORSEMENT IS VOID.
II. SECTION III - LIMITS OF INSURANCE , is amended to include the following:
1. The Limits of Insurance and the rules below fix 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 General Aggregate Limit is the most we will pay for the sum of:
a. Medical expenses under Coverage C;
b. Damages under Coverage A, except damages because of "bodily injury" or "property damage" included in the products-completed operations hazard"; and c. Damages under Coverage B.
3. The Products-Completed Operations Aggreg ate Limit is the mo st we w ill pay under Coverage A for damages because of "bodily injury" and "property damage" included in the "products-completed operations hazard".
4. Subject to 2. above, the Personal and Advertising Injury Limit is the most we will pay under Coverage B for the sum of all damages because of all "personal and advertising injury" sustained by any one person or organization.
5. Subject to 2. or 3. above, whichever applies, the Each Occurrence Limit is the most we will pay for the sum of:
a. Damages under Coverage A; and
b. Medical expenses under Coverage C
ϬϰͬϬϭͬϮϬϮϯ
GL 534-20-18 ST. FRANCIS ELECTRIC, LLC
NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH, PA X 2,000,000
86681 (9/04) Page 2 of 2
Authorized Representative or
Countersignature (in States Where
Applicable)
because of all "bodily injury" and "property damage" arising out of any one "occurrence".
6. Subject to 5. above, the Damage to Premises Rented To You Limit is the most we will pay under Coverage A because of "property damage" to any one premises, while rented to you, or in the case of damage by fire, while rented to you or temporarily occupied by you with permission of the owner.
7. Subject to 5. above, the Medical Expense Limit is the most we will pay under Coverage C for all medical expenses because of "bod ily injury" sustained by any one person.
8. Subject to 2., 4., 5., 6., and/or 7. above, the Per Project Aggregate Limit is the most we will pay under Coverages A, B, and C combined for the sum of:
a. Damages under Coverage A;
b. Damages under Coverage B; and
c. Medical Expenses under Coverage C
arising out of any single Project described above.
9. Subject to 2., 4., 5., 6., and/or 7. above, the Per Location Aggregate Limit is the most we will pay under Coverages A, B, and C combined for the sum of:
a. Damages under Coverage A;
b. Damages under Coverage B; and
c. Medical expenses under Coverage C
arising out of the any single Location described above.
The Limits of Insurance of this Coverage Pa rt 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.
III. The Limits of Insurance shown in the Declarati ons are deleted in their entirety and replaced by the Limits of Insurance set forth below.
Limits of Insurance
General Aggregate Limit $
Each Occurrence Limit $
Products-Completed Operations Aggregate Limit $
Personal & Advertising Injury Limit $
Damage to Premises Rented to You $
Medical Expense Limit $
Per Project General Aggregate Limit, Per Location $
General Aggregate Limit or Per
Project and Per Location General Aggregate Limit
IV. SECTION V - DEFINITIONS, is amended to include the following:
23. "Location" means premises involving the same or connecting lots, or premises whose connection is interrupted only by a street, roadway, waterway, or right-of-way railroad.
All other terms and conditions of this policy remain the same. 10,000,000
500,000
25,000
/FXABBB84 /FXABBB72 /FXABBB73 /FXABBB83 /FXABBB32 /FXABBB69 /FXABBB78 /FXABBB68 /FXABBB79 /FXABBB82 /FXABBB83 /FXABBB69 /FXABBB77 /FXABBB69 /FXABBB78 /FXABBB84 /FXABBB32 /FXABBB67 /FXABBB72 /FXABBB65 /FXABBB78 /FXABBB71 /FXABBB69 /FXABBB83 /FXABBB32 /FXABBB84 /FXABBB72 /FXABBB69 /FXABBB32 /FXABBB80 /FXABBB79 /FXABBB76 /FXABBB73 /FXABBB67 /FXABBB89 /FXABBB46 /FXABBB32 /FXABBB80 /FXABBB76 /FXABBB69 /FXABBB65 /FXABBB83 /FXABBB69 /FXABBB32 /FXABBB82 /FXABBB69 /FXABBB65 /FXABBB68 /FXABBB32 /FXABBB73 /FXABBB84 /FXABBB32 /FXABBB67 /FXABBB65 /FXABBB82 /FXABBB69 /FXABBB70 /FXABBB85 /FXABBB76 /FXABBB76 /FXABBB89 /FXABBB46 PRIMARY AND NONCONTRIBUTORY –
OTHER INSURANCE CONDITION
/FXABN084 /FXABN0104 /FXABN0105 /FXABN0115 /FXABN032 /FXABN0101 /FXABN0110 /FXABN0100 /FXABN0111 /FXABN0114 /FXABN0115 /FXABN0101 /FXABN0109 /FXABN0101 /FXABN0110 /FXABN0116 /FXABN032 /FXABN0109 /FXABN0111 /FXABN0100 /FXABN0105 /FXABN0102 /FXABN0105 /FXABN0101 /FXABN0115 /FXABN032 /FXABN0105 /FXABN0110 /FXABN0115 /FXABN0117 /FXABN0114 /FXABN097 /FXABN0110 /FXABN099 /FXABN0101 /FXABN032 /FXABN0112 /FXABN0114 /FXABN0111 /FXABN0118 /FXABN0105 /FXABN0100 /FXABN0101 /FXABN0100 /FXABN032 /FXABN0117 /FXABN0110 /FXABN0100 /FXABN0101 /FXABN0114 /FXABN032 /FXABN0116 /FXABN0104 /FXABN0101 /FXABN032 /FXABN0102 /FXABN0111 /FXABN0108 /FXABN0108 /FXABN0111 /FXABN0119 /FXABN0105 /FXABN0110 /FXABN0103 /FXABN058 /FXABN032 /FXABN067 /FXABN079/FXABN077 /FXABN077 /FXABN069 /FXABN082 /FXABN067 /FXABN073 /FXABN065 /FXABN076 /FXABN032 /FXABN071/FXABN069 /FXABN078 /FXABN069 /FXABN082 /FXABN065 /FXABN076 /FXABN032 /FXABN076 /FXABN073 /FXABN065 /FXABN066 /FXABN073 /FXABN076 /FXABN073 /FXABN084 /FXABN089 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/FXABN032 /FXABN0116 /FXABN0104 /FXABN097 /FXABN0116 /FXABN058 /FXABB040 /FXABB049 /FXABB041
/FXABN084 /FXABN0104 /FXABN0101 /FXABN032/FXABN097 /FXABN0100 /FXABN0100 /FXABN0105 /FXABN0116 /FXABN0105 /FXABN0111 /FXABN0110 /FXABN097 /FXABN0108 /FXABN032/FXABN0105 /FXABN0110 /FXABN0115 /FXABN0117 /FXABN0114 /FXABN0101 /FXABN0100 /FXABN032/FXABN0105 /FXABN0115 /FXABN032/FXABN097 /FXABN032/FXABN078 /FXABN097 /FXABN0109 /FXABN0101 /FXABN0100 /FXABN032 /FXABN073 /FXABN0110 /FXABN0115 /FXABN0117 /FXABN0114 /FXABN0101 /FXABN0100 /FXABN032 /FXABN0117 /FXABN0110 /FXABN0100 /FXABN0101 /FXABN0114 /FXABN032 /FXABN0115 /FXABN0117 /FXABN099 /FXABN0104 /FXABN032 /FXABN0111 /FXABN0116 /FXABN0104 /FXABN0101 /FXABN0114 /FXABN032 /FXABN0105 /FXABN0110 /FXABN0115 /FXABN0117 /FXABN0114 /FXABN097 /FXABN0110 /FXABN099 /FXABN0101 /FXABN059 /FXABN032 /FXABN097 /FXABN0110 /FXABN0100 /FXABN032 /FXABB040 /FXABB050 /FXABB041
/FXABN089 /FXABN0111 /FXABN0117 /FXABN032 /FXABN0104 /FXABN097 /FXABN0118 /FXABN0101 /FXABN032/FXABN097 /FXABN0103 /FXABN0114 /FXABN0101 /FXABN0101 /FXABN0100 /FXABN032 /FXABN0105 /FXABN0110 /FXABN032/FXABN0119 /FXABN0114 /FXABN0105 /FXABN0116 /FXABN0105 /FXABN0110 /FXABN0103 /FXABN032 /FXABN0105 /FXABN0110 /FXABN032 /FXABN097 /FXABN032/FXABN099 /FXABN0111 /FXABN0110 /FXABN0116 /FXABN0114 /FXABN097 /FXABN099 /FXABN0116 /FXABN032 /FXABN0111 /FXABN0114 /FXABN032/FXABN097 /FXABN0103 /FXABN0114 /FXABN0101 /FXABN0101 /FXABN0109 /FXABN0101 /FXABN0110 /FXABN0116 /FXABN032/FXABN0116 /FXABN0104 /FXABN097 /FXABN0116 /FXABN032/FXABN0116 /FXABN0104 /FXABN0105 /FXABN0115 /FXABN032/FXABN0105 /FXABN0110 /FXABN0115 /FXABN0117 /FXABN0114 /FXABN097 /FXABN0110 /FXABN099 /FXABN0101 /FXABN032/FXABN0119 /FXABN0111 /FXABN0117 /FXABN0108 /FXABN0100 /FXABN032 /FXABN098 /FXABN0101 /FXABN032 /FXABN0112 /FXABN0114 /FXABN0105 /FXABN0109 /FXABN097 /FXABN0114 /FXABN0121 /FXABN032 /FXABN097 /FXABN0110 /FXABN0100 /FXABN032 /FXABN0119 /FXABN0111 /FXABN0117 /FXABN0108 /FXABN0100 /FXABN032 /FXABN0110 /FXABN0111 /FXABN0116 /FXABN032 /FXABN0115 /FXABN0101 /FXABN0101 /FXABN0107 /FXABN032 /FXABN099 /FXABN0111 /FXABN0110 /FXABN0116 /FXABN0114 /FXABN0105 /FXABN098 /FXABN0117 /FXABN0116 /FXABN0105 /FXABN0111 /FXABN0110 /FXABN032/FXABN0102 /FXABN0114 /FXABN0111 /FXABN0109 /FXABN032/FXABN097 /FXABN0110 /FXABN0121 /FXABN032/FXABN0111 /FXABN0116 /FXABN0104 /FXABN0101 /FXABN0114 /FXABN032/FXABN0105 /FXABN0110 /FXABN0115 /FXABN0117 /FXABN0114 /FXABN097 /FXABN0110 /FXABN099 /FXABN0101 /FXABN032 /FXABN097 /FXABN0118 /FXABN097 /FXABN0105 /FXABN0108 /FXABN097 /FXABN098 /FXABN0108 /FXABN0101 /FXABN032 /FXABN0116 /FXABN0111 /FXABN032 /FXABN0116 /FXABN0104 /FXABN0101 /FXABN032 /FXABN097 /FXABN0100 /FXABN0100 /FXABN0105 /FXABN0116 /FXABN0105 /FXABN0111 /FXABN0110 /FXABN097 /FXABN0108 /FXABN032 /FXABN0105 /FXABN0110 /FXABN0115 /FXABN0117 /FXABN0114 /FXABN0101 /FXABN0100 /FXABN046 /FXABN067 /FXABN079/FXABN077 /FXABN077 /FXABN069 /FXABN082 /FXABN067 /FXABN073 /FXABN065 /FXABN076 /FXABN032 /FXABN071/FXABN069 /FXABN078 /FXABN069 /FXABN082 /FXABN065 /FXABN076 /FXABN032 /FXABN076 /FXABN073 /FXABN065 /FXABN066 /FXABN073 /FXABN076 /FXABN073 /FXABN084 /FXABN089 /FXABB067 /FXABB071/FXABB032 /FXABB050 /FXABB048 /FXABB032 /FXABB048 /FXABB049 /FXABB032 /FXABB049 /FXABB050 /FXABB032 /FXABB049 /FXABB057 /FXABN0169 /FXABN032 /FXABN073 /FXABN0110 /FXABN0115 /FXABN0117 /FXABN0114 /FXABN097 /FXABN0110 /FXABN099 /FXABN0101 /FXABN032 /FXABN083 /FXABN0101 /FXABN0114 /FXABN0118 /FXABN0105 /FXABN099 /FXABN0101 /FXABN0115 /FXABN032 /FXABN079/FXABN0102 /FXABN0102 /FXABN0105 /FXABN099 /FXABN0101 /FXABN044 /FXABN032 /FXABN073 /FXABN0110 /FXABN099 /FXABN046 /FXABN044 /FXABN032 /FXABN050 /FXABN048 /FXABN049 /FXABN056 /FXABN032 /FXABN032 /FXABN032 /FXABN032 /FXABN032 /FXABN032 /FXABN032 /FXABN032 /FXABN032 /FXABN032 /FXABN032 /FXABN032 /FXABN032 /FXABN032 /FXABN032 /FXABN032 /FXABN032 /FXABN032 /FXABN032 /FXABN032 /FXABN032 /FXABN032 /FXABN032 /FXABN032 /FXABN032 /FXABN032 /FXABN032 /FXABN032 /FXABN032 /FXABN032 /FXABN032 /FXABN032 /FXABN032 /FXABN032 /FXABN032 /FXABN032 /FXABN032 /FXABN080 /FXABN097 /FXABN0103 /FXABN0101 /FXABN032 /FXABN049 /FXABN032 /FXABN0111 /FXABN0102 /FXABN032 /FXABN049 Policy # GL 534-20-18
POLICY NUMBER:
CONTRACTUAL LIABILITY - RAILROADS
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
Scheduled Railroad: Designated Job Site:
COMMERCIAL GENERAL LIABILITY
CG 24 17 10 01
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
CG 24 17 10 01 ISO Properties, Inc., 2000 Page 1 of 1
(If no entry appears above, information required to complete this endorsement will be s hown in the Declarations as applicable to this endorsement.)
With respect to operations performed for, or
affecting, a Scheduled Railroad at a Designated
Job Site, the definition of "insured contract" in the
Definitions section is replaced by the following:
9. "Insured Contract" means:
a. A contract for a lease of premises. However,
that portion of the contract for a lease of
premises that indemnifies any person or
organization 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;
d. An obligation, as required by ordinance, to
indemnify a municipality, except in
connection with work for a municipality;
e. An elevator maintenance agreement;
f. That part of any other contract or agreement
pertaining to your business (including an in-
demnification of a municipality in connection
with work performed for a municipality)
under which you assume the tort liability of
another party to pay for "bodily injury" or
"property damage" to a third person or
organization. Tort liability means a liability
that would be imposed by law in the
absence of any contract or agreement.
Paragraph f. does not include that part of any
contract or agreement:
(1) 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, opinions, re-
ports, 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;
(2) Under which the insured, if an architect,
engineer or surveyor, assumes liability for an in-
jury or damage arising out of the insured's
rendering or failure to render professional
services, including those listed in Paragraph (1)
above and supervisory, inspection, architectural
or engineering activities.
GL 534-20-18
ANY RAILROAD ORGANIZATION WHOM HAS
GRANTED YOU AN EASEMENT FOR ANY JOB
SITE TO PERMIT YOU TO PERFORM WORK AS
A RESULT OF ANY CONTRACT OR AGREEMENT
YOU HAVE ENTERED INTO.
POLICY NUMBER:
Insurance Services Office, Inc., 2018 Page 1 of 1
WAIVER OF TRANSFER OF RIGHTS OF RECOVERY
AGAINST OTHERS TO US (WAIVER OF SUBROGATION)
COMMERCIAL GENERAL LIABILITY
CG 24 04 12 19
This endorsement modifies insurance provided under the following:
SCHEDULE
Name Of Person(s) Or Organization(s):
Information required to complete this Schedule, if not shown above, will be shown in the Declarations.
CG 24 04 12 19
The following is added to Paragraph 8. Transfer Of
Rights Of Recovery Against Others To Us of
Section IV – Conditions:
We waive any right of recovery against the
person(s) or organization(s) shown in the Schedule
above because of payments we make under this
Coverage Part. Such waiver by us applies only to
the extent that the insured has waived its right of
recovery against such person(s) or organization(s)
prior to loss. This endorsement applies only to the
person(s) or organization(s) shown in the Schedule
above.
COMMERCIAL GENERAL LIABILITY COVERAGE PART
ELECTRONIC DATA LIABILITY COVERAGE PART
LIQUOR LIABILITY COVERAGE PART
POLLUTION LIABILITY COVERAGE PART DESIGNATED SITES
POLLUTION LIABILITY LIMITED COVERAGE PART DESIGNATED SITES
PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART
RAILROAD PROTECTIVE LIABILITY COVERAGE PART
UNDERGROUND STORAGE TANK POLICY DESIGNATED TANKS
GL 534-20-18
PURSUANT TO APPLICABLE WRITTEN CONTRACT OR AGREEMENT YOU ENTER INTO.
This endorsement, effective 12:01 AM forms a part of Policy No.
Issued to
By
LIMITED ADVICE OF CANCELLATION PROVIDED VIA E-MAIL
TO ENTITIES OTHER THAN THE NAMED INSURED
WC 99 00 56
(Ed. 04/11)
(WORKERS' COMPENSATION ONLY)
All other terms, conditions and exclusions shall remain the same.
AUTHORIZED REPRESENTATIVE
This endorsement changes the policy to which it is attached effective on the inception date of the policy unless a different date is indicated below.
(The following " attaching clause" need be completed only when this endorsement is issued subsequent to preparation of the policy).
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
This policy is amended as follows:
In the event that the Insurer cancels this policy for any reason other than non-payment of premium, and
1. the cancellation effective date is prior to this policy's expiration date;
2. the Named Insured or, if applicable, any other employers named in Item 1 of the Information Page is under an existing contractual obligation to notify a certificate holder when this policy is canceled (hereinafter, the " Certificate Holder(s)" ) and the Named Insured has provided to the Insurer, either directly or through its broker of record, the email address of a contact at each such entity; and
3. the Insurer received this information after the Named Insured receives notice of cancellation of this policy and prior to this policy's cancellation effective date, via an electronic spreadsheet that is acceptable to the Insurer, the Insurer will provide advice of cancellation (the " Advice" ) via e-mail to each such Certificate Holders within 30 days after the Named Insured provides such information to the Insurer; provided, however, that if a specific number of days is not stated above, then the Advice will be provided to such Certificate Holder(s) as soon as reasonably practicable after the Named Insured provides such information to the Insurer.
Proof of the Insurer emailing the Advice, using the information provided by the First Named Insured , will serve as proof that the Insurer has fully satisfied its obligations under this endorsement.
This endorsement does not affect, in any way, coverage provided under this policy or the cancellation of this policy or the effective date thereof, nor shall this endorsement invest any rights in any entity not insured under this policy.
The following definitions apply to this endorsement:
1. Named Insured means the insured first named employer in Item 1 of the Information Page of this policy.
2. Insurer means the insurance company shown in the header on the Information Page of this policy.
ϬϰͬϬϭͬϮϬϮϯ WC 022-29-8334
ST. FRANCIS ELECTRIC, LLC
NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH, PA.
BLANKET WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT This endorsement changes the policy to which it is attached effective on the inception date of the policy unless a different date is indicated below.
(The following " attaching clause" need be completed only when this endorsement is issued subsequent to preparation of the policy).
This endorsement, effective 12:01 AM forms a part of Policy No.
Issued to
By
We have a right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against any person or organization with whom you have a written contract that requires you to obtain this agreement from us, as regards any work you perform for such person or organization.
The additional premium for this endorsement shall be % of the total estimated workers compensation premium for this policy.
WC 04 03 61 Countersigned by ______________________________ (Ed. 11/90)
Authorized Representative
ϬϰͬϬϭͬϮϬϮϯ WC 022-29-8334
ST. FRANCIS ELECTRIC, LLC
NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH, PA.
2.00