Docusign Envelope ID: F7084805-A656-4FAD-AEFD-6D63D002095B Docusign Envelope ID: 26D2CB7A-0DB5-4049-8955-D9022BC95F1C Docusign Envelope ID: F7084805-A656-4FAD-AEFD-6D63D002095B Docusign Envelope ID: 26D2CB7A-0DB5-4049-8955-D9022BC95F1C Docusign Envelope ID: F7084805-A656-4FAD-AEFD-6D63D002095B Docusign Envelope ID: 26D2CB7A-0DB5-4049-8955-D9022BC95F1C Docusign Envelope ID: F7084805-A656-4FAD-AEFD-6D63D002095B Docusign Envelope ID: 26D2CB7A-0DB5-4049-8955-D9022BC95F1C Docusign Envelope ID: F7084805-A656-4FAD-AEFD-6D63D002095B Docusign Envelope ID: 26D2CB7A-0DB5-4049-8955-D9022BC95F1C Docusign Envelope ID: F7084805-A656-4FAD-AEFD-6D63D002095B Docusign Envelope ID: 26D2CB7A-0DB5-4049-8955-D9022BC95F1C Docusign Envelope ID: F7084805-A656-4FAD-AEFD-6D63D002095B Docusign Envelope ID: 26D2CB7A-0DB5-4049-8955-D9022BC95F1C Docusign Envelope ID: F7084805-A656-4FAD-AEFD-6D63D002095B Docusign Envelope ID: 26D2CB7A-0DB5-4049-8955-D9022BC95F1C Docusign Envelope ID: F7084805-A656-4FAD-AEFD-6D63D002095B Docusign Envelope ID: 26D2CB7A-0DB5-4049-8955-D9022BC95F1C Docusign Envelope ID: F7084805-A656-4FAD-AEFD-6D63D002095B Docusign Envelope ID: 26D2CB7A-0DB5-4049-8955-D9022BC95F1C Docusign Envelope ID: F7084805-A656-4FAD-AEFD-6D63D002095B Docusign Envelope ID: 26D2CB7A-0DB5-4049-8955-D9022BC95F1C Docusign Envelope ID: F7084805-A656-4FAD-AEFD-6D63D002095B Docusign Envelope ID: 26D2CB7A-0DB5-4049-8955-D9022BC95F1C Docusign Envelope ID: F7084805-A656-4FAD-AEFD-6D63D002095B Docusign Envelope ID: 26D2CB7A-0DB5-4049-8955-D9022BC95F1C Docusign Envelope ID: F7084805-A656-4FAD-AEFD-6D63D002095B Docusign Envelope ID: 26D2CB7A-0DB5-4049-8955-D9022BC95F1C Docusign Envelope ID: F7084805-A656-4FAD-AEFD-6D63D002095B Docusign Envelope ID: 26D2CB7A-0DB5-4049-8955-D9022BC95F1C Docusign Envelope ID: F7084805-A656-4FAD-AEFD-6D63D002095B Docusign Envelope ID: 26D2CB7A-0DB5-4049-8955-D9022BC95F1C Docusign Envelope ID: F7084805-A656-4FAD-AEFD-6D63D002095B Docusign Envelope ID: 26D2CB7A-0DB5-4049-8955-D9022BC95F1C Docusign Envelope ID: F7084805-A656-4FAD-AEFD-6D63D002095B Docusign Envelope ID: 26D2CB7A-0DB5-4049-8955-D9022BC95F1C Docusign Envelope ID: F7084805-A656-4FAD-AEFD-6D63D002095B Docusign Envelope ID: 26D2CB7A-0DB5-4049-8955-D9022BC95F1C Docusign Envelope ID: F7084805-A656-4FAD-AEFD-6D63D002095B Docusign Envelope ID: 26D2CB7A-0DB5-4049-8955-D9022BC95F1C
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 endorsed.
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
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 PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. $ $
$
$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
10/23/2024
Arthur J. Gallagher Risk Management Services, LLC
2121 N. California Blvd., Suite 350
Walnut Creek CA 94596
Certificate Department
925-299-1112
925-299-0328
[email protected]
License#: 0D69293
The Travelers Indemnity Company of CT
25682
RANGPIP-01
Travelers Property Casualty Co of America
25674
Ranger Pipelines, Inc.
P. O. Box 24109
San Francisco, CA 94124
SiriusPoint Specialty Insurance Corporation
16820
2050304876
A
X
1,000,000
X
300,000
10,000
1,000,000
2,000,000
X
Y
Y
DT22CO2N687429TCT24
4/1/2024
4/1/2025
2,000,000
A
1,000,000
X
X
X
Y
Y
8102N5769752426G
4/1/2024
4/1/2025
B
X
X
10,000,000
Y
CUP1T28488724NF
4/1/2024
Y
4/1/2025
10,000,000
B
Y
UB2N6998712426G
4/1/2024
4/1/2025
1,000,000
1,000,000
1,000,000
C
Pollution Liability
CPPLS000103006
4/1/2024
4/1/2025
Each Pollution/Agg
$2,000,000
NOTICE OF CANCELLATION: The Producer will endeavor to mail 30* days written notice to the Certificate Holder named on the certificate if any policy listed on the certificate is cancelled prior to the expiration date. Failure to do so shall impose no obligation or liability of any kind upon the Producer or otherwise alter the policy terms. *10 days for non-payment of premium
RE: Job #763 – Cyclic Sewer Replacement Project – Phase 21 ADDITIONAL INSURED(S): The City, its City Council, boards, commissions, officials, employees and volunteers City of Alameda – Department of Public Works
950 W. Mall Square Room 110
Alameda CA 94501
Docusign Envelope ID: 26D2CB7A-0DB5-4049-8955-D9022BC95F1C 10/23/2024
Policy No. DT22CO2N687429TCT24 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
BLANKET ADDITIONAL INSURED- AUTOMATIC STATUS
IF REQUIRED BY WRITTEN CONTRACT (CONTRACTORS)
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
The following is added to SECTION II - WHO IS AN
INSURED:
Any person or organization that:
a. You agree in a written contract or agreement to
include as an additional insured on this Coverage
Part;and
b. Has not been added as an additional insured for
the same project by attachment of an endorse-
ment under this Coverage Part which includes
such person or organization in the endorsement's
schedule;
is an insured, but:
a. Only with respect to liability for "bodily injury" or "property damage" that occurs, or for "personal
injury" caused by an offense that is committed,
subsequent to the signing of that contract or
agreement and while that part of the contract or
agreement is in effect; and
b. Only as described in Paragraph (1 ), (2) or (3) be-
low, whichever applies:
(1) If the written contract or agreement specifical-
ly requires you to provide additional insured
coverage to that person or organization by
the use of:
(a) The Additional Insured - Owners, Les-
sees or Contractors - (Form B) endorse-
ment CG 20 10 11 85; or
(b) Either or both of the following: the Addi-
tional Insured - Owners, Lessees or Con-
tractors - Scheduled Person Or Organi-
zation endorsement CG 20 1 O 1 O 01, or
the Additional Insured - Owners, Lessees
or Contractors - Completed Operations
endorsement CG 20 37 1 O 01;
the person or organization is an additional in-
sured only if the injury or damage arises out
of "your work" to which the written contract or
agreement applies;
(2) If the written contract or agreement specifical-
ly requires you to provide additional insured
coverage to that person or organization by
the use of:
(a) The Additional Insured - Owners, Les-
sees or Contractors - Scheduled Person
or Organization endorsement CG 20 1 O
07 04 or CG 20 10 04 13, the Additional
Insured - Owners, Lessees or Contrac-
tors - Completed Operations endorse-
ment CG 20 37 07 04 or CG 20 37 04 13,
or both of such endorsements with either
of those edition dates; or
(b) Either or both of the following: the Addi-
tional Insured - Owners, Lessees or Con-
tractors - Scheduled Person Or Organi-
zation endorsement CG 20 10, or the Ad-
ditional Insured - Owners, Lessees or
Contractors - Completed Operations en-
dorsement CG 20 37, without an edition
date of such endorsement specified;
the person or organization is an additional in-
sured only if the injury or damage is caused,
in whole or in part, by acts or omissions of
you or your subcontractor in the performance
of "your work" to which the written contract or
agreement applies; or
(3) If neither Paragraph (1) nor (2) above applies:
(a) The person or organization is an addi-
tional insured only if, and to the extent
that, the injury or damage is caused by
acts or omissions of you or your subcon-
tractor in the performance of "your work"
to which the written contract or agree-
ment applies; and
(b) Such person or organization does not
qualify as an additional insured with re-
spect to the independent acts or omis-
sions of such person or organization.
The insurance provided to such additional insured is
subject to the following provisions:
a. If the Limits of Insurance of this Coverage Part
shown in the Declarations exceed the minimum
limits required by the written contract or agree-
ment, the insurance provided to the additional in-
sured will be limited to such minimum required
limits. For the purposes of determining whether
CG D6 04 0219 © 2017 The Travelers Indemnity Company. All rights reserved. Page 1 of 2 Docusign Envelope ID: 26D2CB7A-0DB5-4049-8955-D9022BC95F1C
COMMERCIAL GENERAL LIABILITY
this limitation applies, the minimum limits required
by the written contract or agreement will be con-
sidered to include the minimum limits of any Um-
brella or Excess liability coverage required for the
additional insured by that written contract or
agreement. This provision will not increase the
limits of insurance described in Section Ill - Limits
Of Insurance.
b. The insurance provided to such additional insured
does not apply to:
(1) Any "bodily injury", "property damage" or
"personal injury" arising out of the providing,
or failure to provide, any professional archi-
tectural, engineering or surveying services,
including:
(a) The preparing, approving, or failing to
prepare or approve, maps, shop draw-
ings, opinions, reports, surveys, field or-
ders or change orders, or the preparing,
approving, or failing to prepare or ap-
prove, drawings and specifications; and
(b) Supervisory, inspection, architectural or
engineering activities.
(2) Any "bodily injury" or "property damage"
caused by "your work" and included in the
"products-completed operations hazard" un-
less the written contract or agreement specifi-
cally requires you to provide such coverage
for that additional insured during the policy
period.
c. The additional insured must comply with the fol-
lowing duties:
(1) Give us written notice as soon as practicable
of an "occurrence" or an offense which may
Policy No. DT22CO2N687429TCT24
result in a claim. To the extent possible, such
notice should include:
(a) How, when and where the "occurrence"
or offense took place;
(b) The names and addresses of any injured
persons and witnesses; and
(c) The nature and location of any injury or
damage arising out of the "occurrence" or
offense.
(2) If a claim is made or "suit" is brought against
the additional insured:
(a) Immediately record the specifics of the
claim or "suit" and the date received; and
(b) Notify us as soon as practicable and see
to it that we receive written notice of the
claim or "suit" as soon as practicable.
(3) Immediately send us copies of all legal pa-
pers received in connection with the claim or
"suit", cooperate with us in the investigation
or settlement of the claim or defense against
the "suit", and otherwise comply with all policy
conditions.
(4) Tender the defense and indemnity of any
claim or "suit" to any provider of other insur-
ance which would cover such additional in-
sured for a loss we cover. However, this con-
dition does not affect whether the insurance
provided to such additional insured is primary
to other insurance available to such additional
insured which covers that person or organiza-
tion as a named insured as described in Par-
agraph 4., Other Insurance, of Section IV -
Commercial General Liability Conditions.
Docusign Envelope ID: 26D2CB7A-0DB5-4049-8955-D9022BC95F1C Docusign Envelope ID: 26D2CB7A-0DB5-4049-8955-D9022BC95F1C Docusign Envelope ID: 26D2CB7A-0DB5-4049-8955-D9022BC95F1C Docusign Envelope ID: 26D2CB7A-0DB5-4049-8955-D9022BC95F1C POLICY NUMBER: DT22CO2N687429TCT24 ISSUE DATE : 04-01-24 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
DESIGNATED PERSON OR ORGANIZATION - NOTICE OF
CANCELLATION PROVIDED BY US
This endorsement modifies insurance provided under the following:
ALL COVERAGE PARTS INCLUDED IN THIS PO LICY
CANCELLATION:
SCHEDULE
Number of Days Notice: 30
PERSON OR
ORGANIZATION:
City of Alamdeda
ADDRESS:
950 W. Mall Square Room 110
Alameda CA 94501
PROVISIONS
If we cancel this policy for any legally permitted reason other than nonpayment of premium, and a number of days is shown for Cancellation i1 the Schedule above, we will mail notice of cancellation to the person or organization shown i1 such Schedule. We will mail such notice to the address shown i1 the Schedule above at least the number of days shown for Cancellation i1 such Schedule before the effective date of cancellation. n. T4 a; a; l9 © 2019 The Travelers Indemnity Company. All rights reserved. Page 1 of 1 Docusign Envelope ID: 26D2CB7A-0DB5-4049-8955-D9022BC95F1C
COMMERCIAL AUTO
This endorsement modifies insurance provided under the following:
BUSINESS AUTO COVERAGE FORM
CA T3 53 02 15
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
BUSINESS AUTO EXTENSION ENDORSEMENT
Includes copyrighted material of Insurance Services Office, Inc. with its permission.
GENERAL DESCRIPTION OF COVERAGE – This endorsement broadens coverage. However, coverage for any injury, damage or medical expenses described in any of the provisions of this endorsement may be excluded or limited by another endorsement to the Coverage Part, and these coverage broadening provisions do not apply to the extent that coverage is excluded or limited by such an endorsement. The following listing is a general cover- age description only. Limitations and exclusions may apply to these coverages. Read all the provisions of this en- dorsement and the rest of your policy carefully to determine rights, duties, and what is and is not covered.
A. BROAD FORM NAMED INSURED
B. BLANKET ADDITIONAL INSURED
C. EMPLOYEE HIRED AUTO
D. EMPLOYEES AS INSURED
E. SUPPLEMENTARY PAYMENTS – INCREASED
LIMITS
F. HIRED AUTO – LIMITED WORLDWIDE COV-
ERAGE – INDEMNITY BASIS
G. WAIVER OF DEDUCTIBLE – GLASS
PROVISIONS
A. BROAD FORM NAMED INSURED
The following is added to Paragraph A.1., Who Is
An Insured, of SECTION II – COVERED AUTOS
LIABILITY COVERAGE:
Any organization you newly acquire or form dur-
ing the policy period over which you maintain
50% or more ownership interest and that is not
separately insured for Business Auto Coverage.
Coverage under this provision is afforded only un-
til the 180th day after you acquire or form the or-
ganization or the end of the policy period, which-
ever is earlier.
B. BLANKET ADDITIONAL INSURED
The following is added to Paragraph c. in A.1.,
Who Is An Insured , of SECTION II – COVERED
AUTOS LIABILITY COVERAGE:
Any person or organization who is required under
a written contract or agreement between you and
that person or organization, that is signed and
executed by you before the "bodily injury" or
"property damage" occurs and that is in effect
during the policy period, to be named as an addi-
tional insured is an "insured" for Covered Autos
Liability Coverage, but only for damages to which
H. HIRED AUTO PHYSICAL DAMAGE – LOSS OF
USE – INCREASED LIMIT
I. PHYSICAL DAMAGE – TRANSPORTATION
EXPENSES – INCREASED LIMIT
J. PERSONAL PROPERTY
K. AIRBAGS
L. NOTICE AND KNOWLEDGE OF ACCIDENT OR
LOSS
M. BLANKET WAIVER OF SUBROGATION
N. UNINTENTIONAL ERRORS OR OMISSIONS
this insurance applies and only to the extent that
person or organization qualifies as an "insured"
under the Who Is An Insured provision contained
in Section II.
C. EMPLOYEE HIRED AUTO
1. The following is added to Paragraph A.1.,
Who Is An Insured , of SECTION II – COV-
ERED AUTOS LIABILITY COVERAGE:
An "employee" of yours is an "insured" while
operating an "auto" hired or rented under a
contract or agreement in an "employee's"
name, with your permission, while performing
duties related to the conduct of your busi-
ness.
2. The following replaces Paragraph b. in B.5.,
Other Insurance, of SECTION IV – BUSI-
NESS AUTO CONDITIONS:
b. For Hired Auto Physical Damage Cover-
age, the following are deemed to be cov-
ered "autos" you own:
(1) Any covered "auto" you lease, hire,
rent or borrow; and
(2) Any covered "auto" hired or rented by
your "employee" under a contract in
an "employee's" name, with your
Policy No. 8102N5769752426G
Docusign Envelope ID: 26D2CB7A-0DB5-4049-8955-D9022BC95F1C
COMMERCIAL AUTO
CA T3 53 02 15Page 2 of 4 © 2015 The Travelers Indemnity Company. All rights reserved.
Includes copyrighted material of Insurance Services Office, Inc. with its permission. permission, while performing duties
related to the conduct of your busi-
ness.
However, any "auto" that is leased, hired,
rented or borrowed with a driver is not a
covered "auto".
D. EMPLOYEES AS INSURED
The following is added to Paragraph A.1., Who Is
An Insured, of SECTION II – COVERED AUTOS
LIABILITY COVERAGE:
Any "employee" of yours is an "insured" while us-
ing a covered "auto" you don't own, hire or borrow
in your business or your personal affairs.
E. SUPPLEMENTARY PAYMENTS – INCREASED
LIMITS
1. The following replaces Paragraph A.2.a.(2),
of SECTION II – COVERED AUTOS LIABIL-
ITY COVERAGE:
(2) Up to $3,000 for cost of bail bonds (in-
cluding bonds for related traffic law viola-
tions) required because of an "accident"
we cover. We do not have to furnish
these bonds.
2. The following replaces Paragraph A.2.a.(4),
of SECTION II – COVERED AUTOS LIABIL-
ITY COVERAGE:
(4) All reasonable expenses incurred by the
"insured" at our request, including actual
loss of earnings up to $500 a day be-
cause of time off from work.
F. HIRED AUTO – LIMITED WORLDWIDE COV-
ERAGE – INDEMNITY BASIS
The following replaces Subparagraph (5) in Para-
graph B.7., Policy Period, Coverage Territory,
of SECTION IV – BUSINESS AUTO CONDI-
TIONS:
(5) Anywhere in the world, except any country or
jurisdiction while any trade sanction, em-
bargo, or similar regulation imposed by the
United States of America applies to and pro-
hibits the transaction of business with or
within such country or jurisdiction, for Cov-
ered Autos Liability Coverage for any covered
"auto" that you lease, hire, rent or borrow
without a driver for a period of 30 days or less
and that is not an "auto" you lease, hire, rent
or borrow from any of your "employees",
partners (if you are a partnership), members
(if you are a limited liability company) or
members of their households.
(a) With respect to any claim made or "suit"
brought outside the United States of
America, the territories and possessions
of the United States of America, Puerto
Rico and Canada:
(i) You must arrange to defend the "in-
sured" against, and investigate or set-
tle any such claim or "suit" and keep
us advised of all proceedings and ac-
tions.
(ii) Neither you nor any other involved
"insured" will make any settlement
without our consent.
(iii) We may, at our discretion, participate
in defending the "insured" against, or
in the settlement of, any claim or
"suit".
(iv) We will reimburse the "insured" for
sums that the "insured" legally must
pay as damages because of "bodily
injury" or "property damage" to which
this insurance applies, that the "in-
sured" pays with our consent, but
only up to the limit described in Para-
graph C., Limits Of Insurance, of
SECTION II – COVERED AUTOS
LIABILITY COVERAGE.
(v) We will reimburse
the "insured" for
the reasonable expenses incurred
with our consent for your investiga-
tion of such claims and your defense
of the "insured" against any such
"suit", but only up to and included
within the limit described in Para-
graph C., Limits Of Insurance, of
SECTION II – COVERED AUTOS
LIABILITY COVERAGE, and not in
addition to such limit. Our duty to
make such payments ends when we
have used up the applicable limit of
insurance in payments for damages,
settlements or defense expenses.
(b) This insurance is excess over any valid
and collectible other insurance available
to the "insured" whether primary, excess,
contingent or on any other basis.
(c) This insurance is not a substitute for re-
quired or compulsory insurance in any
country outside the United States, its ter-
ritories and possessions, Puerto Rico and
Canada.
Policy No. 8102N5769752426G
Docusign Envelope ID: 26D2CB7A-0DB5-4049-8955-D9022BC95F1C
COMMERCIAL AUTO
CA T3 53 02 15 Page 3 of 4
Includes copyrighted material of Insurance Services Office, Inc. with its permission. © 2015 The Travelers Indemnity Company. All rights reserved.
You agree to maintain all required or
compulsory insurance in any such coun-
try up to the minimum limits required by
local law. Your failure to comply with
compulsory insurance requirements will
not invalidate the coverage afforded by
this policy, but we will only be liable to the
same extent we would have been liable
had you complied with the compulsory in-
surance requirements.
(d) It is understood that we are not an admit-
ted or authorized insurer outside the
United States of America, its territories
and possessions, Puerto Rico and Can-
ada. We assume no responsibility for the
furnishing of certificates of insurance, or
for compliance in any way with the laws
of other countries relating to insurance.
G. WAIVER OF DEDUCTIBLE – GLASS
The following is added to Paragraph D., Deducti-
ble, of SECTION III – PHYSICAL DAMAGE
COVERAGE:
No deductible for a covered "auto" will apply to
glass damage if the glass is repaired rather than
replaced.
H. HIRED AUTO PHYSICAL DAMAGE – LOSS OF
USE – INCREASED LIMIT
The following replaces the last sentence of Para-
graph A.4.b., Loss Of Use Expenses , of SEC-
TION III – PHYSICAL DAMAGE COVERAGE:
However, the most we will pay for any expenses
for loss of use is $65 per day, to a maximum of
$750 for any one "accident".
I. PHYSICAL DAMAGE – TRANSPORTATION
EXPENSES – INCREASED LIMIT
The following replaces the first sentence in Para-
graph A.4.a., Transportation Expenses , of
SECTION III – PHYSICAL DAMAGE COVER-
AGE:
We will pay up to $50 per day to a maximum of
$1,500 for temporary transportation expense in-
curred by you because of the total theft of a cov-
ered "auto" of the private passenger type.
J. PERSONAL PROPERTY
The following is added to Paragraph A.4., Cover-
age Extensions , of SECTION III – PHYSICAL
DAMAGE COVERAGE:
Personal Property
We will pay up to $400 for "loss" to wearing ap-
parel and other personal property which is:
(1) Owned by an "insured"; and
(2) In or on your covered "auto".
This coverage applies only in the event of a total
theft of your covered "auto".
No deductibles apply to this Personal Property
coverage.
K. AIRBAGS
The following is added to Paragraph B.3., Exclu-
sions, of SECTION III – PHYSICAL DAMAGE
COVERAGE:
Exclusion 3.a. does not apply to "loss" to one or
more airbags in a covered "auto" you own that in-
flate due to a cause other than a cause of "loss"
set forth in Paragraphs A.1.b. and A.1.c., but
only:
a. If that "auto" is a covered "auto" for Compre-
hensive Coverage under this policy;
b. The airbags are not covered under any war-
ranty; and
c. The airbags were not intentionally inflated.
We will pay up to
a maximum of $1,000 for any
one "loss".
L. NOTICE AND KNOWLEDGE OF ACCIDENT OR
LOSS
The following is added to Paragraph A.2.a., of
SECTION IV – BUSINESS AUTO CONDITIONS:
Your duty to give us or our authorized representa-
tive prompt notice of the "accident" or "loss" ap-
plies only when the "accident" or "loss" is known
to:
(a) You (if you are an individual);
(b) A partner (if you are a partnership);
(c) A member (if you are a limited liability com-
pany);
(d) An executive officer, director or insurance
manager (if you are a corporation or other or-
ganization); or
(e) Any "employee" authorized by you to give no-
tice of the "accident" or "loss".
M. BLANKET WAIVER OF SUBROGATION
The following replaces Paragraph A.5., Transfer
Of Rights Of Recovery Against Others To Us ,
of SECTION IV – BUSINESS AUTO CONDI-
TIONS :
5. Transfer Of Rights Of Recovery Against
Others To Us
We waive any right of recovery we may have
against any person or organization to the ex-
tent required of you by a written contract
signed and executed prior to any "accident"
or "loss", provided that the "accident" or "loss"
arises out of operations contemplated by
Policy No. 8102N5769752426G
Docusign Envelope ID: 26D2CB7A-0DB5-4049-8955-D9022BC95F1C
COMMERCIAL AUTO
CA T3 53 02 15Page 4 of 4 © 2015 The Travelers Indemnity Compa ny. All rights reserved .
Includes copyrighted material of Insurance Services Office, Inc. with its permission. such contract. The waiver applies only to the
person or organization designated in such
contract.
N. UNINTENTIONAL ERRORS OR OMISSIONS
The following is added to Paragraph B.2., Con-
cealment, Misrepresentation, Or Fraud , of
SECTION IV – BUSINESS AUTO CONDITIONS:
Policy No. 8102N5769752426G
The unintentional omission of, or unintentional
error in, any information given by you shall not
prejudice your rights under this insurance. How-
ever this provision does not affect our right to col-
lect additional premium or exercise our right of
cancellation or non-renewal.
Docusign Envelope ID: 26D2CB7A-0DB5-4049-8955-D9022BC95F1C Policy No. 8102N5769752426G COMMERCIAL AUTO
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
BLANKET ADDITIONAL INSURED- PRIMARY AND
NON-CONTRIBUTORY WITH OTHER INSURANCE -
CONTRACTORS
This endorsement modifies insurance provided under the following:
BUSINESS AUTO COVERAGE FORM
PROVISIONS
1. The following is added to Paragraph c. in A.1.,
Who Is An Insured, of SECTION II - COVERED
AUTOS LIABILITY COVERAGE:
This includes any person or organization who you
are required under a written contract or
agreement, that is signed by you before the
"bodily injury" or "property damage" occurs and
that is in effect during the policy period, to name
as an additional insured for Covered Autos
Liability Coverage, but only for damages to which
this insurance applies and only to the extent of
that person's or organization's liability for the
conduct of another "insured".
2. The following is added to Paragraph B.5., Other
Insurance of SECTION IV - BUSINESS AUTO
CONDITIONS:
Regardless of the provisions of paragraph a. and
paragraph d. of this part 5. other Insurance, this
insurance is primary to and non-contributory with
applicable other insurance under which an
additional insured person or organization is a
named insured when a written contract or
agreement with you, that is signed by you before
the "bodily injury" or "property damage" occurs
and that is in effect during the policy period,
requires this insurance to be primary and non-
contributory.
CA T4 99 0216 u 2016 The Travelers Indemnity Company. All rights reserved. Page 1 of 1 Includes copyrighted material of Insurance Services Office, Inc. with its permission.
Docusign Envelope ID: 26D2CB7A-0DB5-4049-8955-D9022BC95F1C Policy No. CPPLS000103006
Docusign Envelope ID: 26D2CB7A-0DB5-4049-8955-D9022BC95F1C Policy No. CPPLS000103006
Docusign Envelope ID: 26D2CB7A-0DB5-4049-8955-D9022BC95F1C H. CHOICE OF LAW - In the event that the INSURED and the Company have any dispute concerning, relating to, or arising out of this Policy, including without limitation its formation, coverage provided hereunder, or the meaning, interpretation or operation of any term, condition, definition or provision of this Policy resulting in litigation, arbitration or other form of dispute resolution, the INSURED agrees with the Company that the laws of the State of New York apply without giving effect to any conflicts or choice of law principles.
I. CONSENT - Where consent of the Company or the INSURED is required under this Policy, such consent will not be unreasonably withheld, conditioned, or denied.
J. DESIGN ENTITY'S INSURANCE - The INSURED must require that each DESIGN ENTITY it utilizes provide written evidence of professional liability insurance. Furthermore, the INSURED must not agree to any limitation of liability from a DESIGN ENTITY with the exception of insurance proceeds without the prior written consent of the Company.
K. ENFORCEABILITY- If any part of this Policy is deemed invalid or unenforceable, it does not affect the validity or enforceability of any other part of this Policy.
L. INSPECTION - To the extent an INSURED has such rights, the Company is permitted, but not obligated, upon reasonable prior notice to the INSURED, to inspect, audit, review records, sample and/or monitor any JOB SITE, operations, or COVERED LOCATION at any time. Neither this right, nor the actual undertaking thereof, constitute an undertaking on behalf of the INSURED or others to determine or warrant that a JOB SITE, operations, or COVERED LOCATION is legal, safe, or conforms to any applicable standard or requirement, or is in compliance with any environmental law or other law. The Company has the right to interview persons employed by or affiliated with the INSURED. To the extent reasonably practicable, access for the inspection and interviews will be coordinated through the agent or broker of the FIRST NAMED INSURED. The INSURED agrees to provide appropriate personnel and access to its record to assist the Company's representatives during any action taken pursuant to this provision.
M. JURISDICTION AND VENUE- In the event that the INSURED and the Company have any dispute concerning, relating to, or arising out of this Policy, including without limitation its formation, coverage provided hereunder, or the meaning, interpretation or operation of any term, condition, definition or provision of this Policy resulting in litigation or other form of dispute resolution, the INSURED agrees with the Company to submit to the jurisdiction of the state and federal courts in the State of New York, and that any litigation or other form of dispute resolution may take place in the state and federal courts in the State of New York.
Nothing in this Condition constitutes or should be understood to constitute a waiver of the Company's right to remove an action to any United States District Court.
N. OTHER INSURANCE - This insurance applies in excess of:
1. any applicable Self-Insured Retention or DEDUCTIBLE PERIOD; and
2. the applicable limits of any other valid and collectible insurance available to the INSURED, whether such insurance was issued to the INSURED or another entity, and whether such other insurance is stated to be primary, pro rata, contributory, excess, contingent, or on any other basis, unless such other insurance is specifically written as providing excess Limits of Liability above those provided under this Policy; and
3. with regards to Coverage C, valid and collectible SUBCONTRACTOR'S INSURANCE whether such insurance is stated to be primary, pro rata, contributory, excess, contingent, or on any other basis; and © 2022 SiriusPoint Specialty Insurance Corporation. All Rights Reserved.
May not be copied without permission.
24 Policy No,.CPPLS000103006
Docusign Envelope ID: 26D2CB7A-0DB5-4049-8955-D9022BC95F1C
4. with regards to Coverage F, valid and collectible DESIGN ENTITY'S INSURANCE whether such insurance is stated to be primary, pro rata, contributory, excess, contingent, or on any other basis.
The Company will only pay its share of any coverage afforded under this Policy that exceeds the total amount of such other insurance.
However, solely with regard to an ADDITIONAL INSURED pursuant to SECTION VII.B.2. and Coverages A, I and J, when required by written contract that is signed by the FIRST NAMED INSURED or an ADDITIONAL NAMED INSURED prior to the date the applicable POLLUTION CONDITION or INDOOR CONTAMINANT CONDITION first commences, this insurance applies in excess of any applicable Self-Insured Retention, and primary to, and non- contributory with, any other insurance available to that ADDITIONAL INSURED. The scope and limits of coverage under this Policy will not exceed what is required by the written contract.
Upon request of the Company, the INSURED must promptly provide the Company with copies of all such other insurance policies.
0. REPRESENTATIONS - By accepting this Policy, the INSURED agrees that the statements contained in the application and any supplemental materials and other information furnished in connection therewith, or in connection with any amendments to the Policy, are the INSURED's representations, that they are deemed material, that this Policy is issued in reliance upon the truth of such representations, and that this Policy embodies all agreements existing between the INSURED and the Company relating to this insurance.
This entire Policy is void if, whether before or after coverage is afforded under this Policy, the INSURED has willfully concealed or misrepresented any fact or circumstance material to the granting of coverage under this Policy, or the terms of or premium for such coverage.
As a courtesy to the INSURED, the Company, in its sole discretion, may accept an application that the INSURED completed for another insurance carrier in lieu of completing the Company's application. In that event, the INSURED understands and acknowledges that, by accepting this Policy, the Company has relied upon the INSURED's truth and correctness of such statements, representations and information contained within that application, including any warranty statement, as if made to the Company on the same date.
P. SANCTION LIMITATIONS - The Company will not provide any coverage hereunder to the extent that the provision of such coverage would expose the Company to any sanction, prohibition or restriction under United Nations resolutions or the trade or economic sanctions, laws or regulations of the European Union or the United States of America, including but not limited to sanctions, laws and regulations administered and enforced by the U.S. Treasury Department's Office of Foreign Assets Control ("OFAC").
Q. SEPARATION OF INSUREDS - Except with regard to the Limits of Liability, Self-Insured Retention, exclusions or limitations that refer to "any'' INSURED, and any rights and duties assigned to the FIRST NAMED INSURED, this Policy applies as if each INSURED were the only INSURED, and separately to each INSURED against whom a CLAIM is made. Except as otherwise provided herein, misrepresentation, concealment, breach of a term or condition, or violation of any duty under this Policy by one (1) INSURED does not, by itself, affect coverage for another INSURED under this Policy. Provided, however, this Condition does not apply to any entity who is a parent, subsidiary, affiliate, director, officer, partner, member or employee of the INSURED that misrepresented, concealed or breached a term or condition, or violated a duty under this Policy.
R. SUBCONTRACTOR'S INSURANCE -The FIRST NAMED INSURED or ADDITIONAL NAMED INSURED must not agree to any limitation of liability from a SUBCONTRACTOR with the exception of insurance proceeds without the prior written consent of the Company.
25 © 2022 SiriusPoint Specialty Insurance Corporation. All Rights Reserved.
May not be copied without permission.
Policy No. CPPLS000103006
Docusign Envelope ID: 26D2CB7A-0DB5-4049-8955-D9022BC95F1C S. SUBROGATION - In the event of payment under this Policy, the Company will be subrogated to all of the INSURED's rights of recovery. The INSURED must do whatever is necessary to secure such rights and must not do anything intentional to prejudice such rights. The Company has priority in any recovery. Any monies recovered as a result of subrogation proceedings accrue first to the Company in excess of the Company's total payment and the costs to the Company of recovery, then to the INSURED.
Notwithstanding the foregoing, the Company hereby expressly waives such rights of subrogation against an entity where such rights have been waived, in writing, by the INSURED prior to the applicable CLAIM, POLLUTION CONDITION, INDOOR CONTAMINANT CONDITION, or PROFESSIONAL LOSS.
T. TERRITORY - This Policy will only apply to a POLLUTION CONDITION or INDOOR CONTAMINANT CONDITION located, CONTRACTING SERVICES or PROFESSIONAL SERVICES rendered, a CLAIM, POLLUTION PROTECTIVE CLAIM, or DESIGN CLAIM made and at all times solely maintained, and ADA AND FHA EXPENSE, BANKRUPTCY LITIGATION EXPENSE, BUILDING INFORMATION MODELING EXPENSE, DISASTER MANAGEMENT COSTS or SUBPOENA EXPENSE for services performed, within the United States, its territories or possessions, Puerto Rico, or Canada.
SECTION VII. DEFINITIONS
A. ADA AND FHA EXPENSE means reasonable and necessary fees and expenses incurred by counsel, chosen and retained by the Company, to assist the INSURED with their response to a regulatory or administrative action first brought against the INSURED during the POLICY PERIOD by a government agency under the Americans with Disabilities Act of 1990, 42 U.S.C. § 12101 et. seq. or the Fair Housing Act, 42 U.S.C. § 3601 et. seq., and alleging an act, error, or omission with respect to the rendering of or failure to render PROFESSIONAL SERVICES on or after the Retroactive Date stated in Item 9. of the Declarations and before the end of the POLICY PERIOD.
B. ADDITIONAL INSURED means:
1. any person or entity identified as an ADDITIONAL INSURED in an endorsement attached to this Policy; and
2. solely with regard to Coverage A, I and J, when required by a written contract that is signed by the FIRST NAMED INSURED or an ADDITIONAL NAMED INSURED prior to the date the applicable POLLUTION CONDITION or INDOOR CONTAMINANT CONDITION first commences, ADDITIONAL INSURED also includes:
a. the client person or entity for whom the INSURED performs CONTRACTING SERVICES pursuant to such written contract; and
b. any other person or entity, unrelated to the FIRST NAMED INSURED or any ADDITIONAL NAMED INSURED pursuant to such written contract;
The scope and limits of coverage for such person or entity under this Policy will not exceed what is required by the written contract.
Coverage is provided solely for the person's or entity's liability arising out of the FIRST NAMED INSURED's or any ADDITIONAL NAMED INSURED's ownership, maintenance, use, or operation of a COVERED LOCATION, vicarious liability for CONTRACTING SERVICES, or a POLLUTION CONDITION or INDOOR CONTAMINANT CONDITION as applicable. Coverage will only be afforded for such person or entity if that person or entity is named in a lawsuit, petition or regulatory action as a co-defendant with the FIRST NAMED INSURED or any ADDITIONAL NAMED INSURED alleging that it is liable as a result of either the FIRST NAMED INSURED's or any ADDITIONAL NAMED INSURED's ownership, maintenance, use, or operation of a COVERED LOCATION, such person's or entity's vicarious liability for CONTRACTING SERVICES, or a POLLUTION CONDITION or INDOOR 26 © 2022 SiriusPoint Specialty Insurance Corporation. All Rights Reserved.
May not be copied without permission.
Policy No. CPPLS000103006
Docusign Envelope ID: 26D2CB7A-0DB5-4049-8955-D9022BC95F1C
COMMERCIAL GENERAL LIABILITY
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 insurance to the total applicable limits of
insurance of all insurers.
d. Primary And Non-Contributory Insurance If
Required By Written Contract
If you specifically agree in a written contract or
agreement that the insurance afforded to an
insured under this Coverage Part must apply on
a primary basis, or a primary and non
contributory basis, this insurance is primary to
other insurance that is available to such insured
which covers such insured as a named insured,
and we will not share with that other insurance,
provided that:
(1) The "bodily injury'' or "property damage" for
which coverage is sought occurs; and
(2) The "personal and advertising injury'' for
which coverage is sought is caused by an
offense that is committed;
subsequent to the signing of that contract or
agreement by you.
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 and send
notice to the first Named Insured. The due date
for audit and retrospective premiums is the date
shown as the due date on the bill. 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.
The unintentional omission of, or unintentional error
in, any information provided by you which we relied
upon in issuing this policy will not prejudice your
rights under this insurance. However, this provision
does not affect our right to collect additional
premium or to exercise our rights of cancellation or
nonrenewal in accordance with applicable insurance
laws or regulations.
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
insurance applies:
a. As if each Named Insured were the only
Named Insured; and
b. Separately to each insured against whom claim
is made or "suit" is brought.
8. Transfer Of Rights Of Recovery Against Others
To Us
If the insured has rights to recover all or part of any payment we have made under this Coverage Part,
those rights are transferred to us. The insured must
do nothing after loss to impair them. At our request,
the insured will bring "suit" or transfer those rights
to us and help us enforce them.
9. When We Do Not Renew
If we decide not to renew this Coverage Part, we will
mail or deliver to the first Named Insured shown in
the Declarations written notice of the nonrenewal
not less than 30 days before the expiration 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 market
segments about your goods, products or services
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 websites, only that part of a website
that is about your goods, products or services
for the purposes of attracting customers or
supporters is considered an advertisement.
Includes copyrighted material of Insurance Services Office, Inc. with its permission.
Policy No. DT22C02N687429TCT24
Docusign Envelope ID: 26D2CB7A-0DB5-4049-8955-D9022BC95F1C