Preferred Alliance, Inc. 1 Service Provider Agreement
Version 05-10-23
SERVICE PROVIDER AGREEMENT
This SERVICE PROVIDER AGREEMENT (“Agreement”) is entered into this ____ day of ___________ 2024 (“Effective Date”), by and between the CITY OF ALAMEDA, a municipal corporation (“the City”), and Preferred Alliance, Inc., a California corporation, whose address is 16960 S. Harlan Road, Building 2, Lathrop, CA 95330 (“Provider”), in reference to the following facts and circumstances:
RECITALS
A. The City is a municipal corporation duly organized and validly existing under the laws of the State of California with the power to carry on its business as it is now being conducted under the statutes of the State of California and the Charter of the City.
B. The City is in need of the following services: Third Party Administrator for Department of Transportation (DOT) compliance. The City has continued to use Preferred Alliance, Inc. since 2015 and the City has experience satisfactory services from the Provider at a reasonable cost.
C. Provider is specially trained, experienced and competent to perform the special services which will be required by this Agreement.
D. The City and Provider desire to enter into an agreement for Third Party Administration of Department of Transportation (DOT) Drug and Alcohol Testing Program , upon the terms and conditions herein.
AGREEMENT
NOW, THEREFORE, in consideration of the forgoing, which are incorporated herein by reference, and for good and valuable consideration, the receipt and adequacy of which are hereby acknowledged, the City and Provider agree as follows:
1. TERM:
The term of this Agreement shall commence on the 1st day of September 2024, and shall terminate on the 31st day of August 2027, unless terminated earlier as set forth herein.
The parties may agree to extend the term of this Agreement to add up to two additional three-year terms. Any extension shall be documented in a signed amendment. In the event that the parties agree to extend the Agreement, all provisions of the Agreement shall remain unchanged with the exception that t he compensation may be adjusted by the Consumer Price Index for the San Francisco Bay area as reported by the U.S. Department of Labor, Bureau of Labor Statistics for the previous calendar year.
2. SERVICES TO BE PERFORMED:
Provider agrees to do all necessary work at its own cost and expense, to furnish all labor, tools, equipment, materials, except as otherwise specified, and to do all necessary work included DocuSign Envelope ID: D7C5C45C-B994-4AAE-90ED-435965BDA727
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in Exhibit A as requested. Provider acknowledges that the work plan included in Exhibit A is tentative and does not commit the City to request Provider to perform all tasks included therein.
3. COMPENSATION TO PROVIDER:
a. By the 7th day of each month, Provider shall submit to the City an invoice for the total amount of work done the previous month. Pricing and accounting of charges are to be according to the fee schedule as set forth in Exhibit A and incorporated herein by this reference .
Extra work must be approved in writing by the City Manager or their designee prior to performance and shall be paid on a Time and Material basis as set forth in Exhibit A.
The total three-year compensation for this Agreement shall not exceed $40,000 with a total aggregate not to exceed the amount of $120,000. Use of contingency shall be for items of work outside the original scope and requires prior written authorization by the City. Use of contingency shall be for items of work outside the original scope and requires prior written authorization by the City.
4. TIME IS OF THE ESSENCE:
Provider and the City agree that time is of the essence regarding the performance of this Agreement.
5. STANDARD OF CARE:
Provider agrees to perform all services hereunder in a manner commensurate with the prevailing standards of like professionals or service providers, as applicable, in the San Francisco Bay Area and agrees that all services shall be performed by qualified and experienced personnel who are not employed by the City.
6. INDEPENDENT PARTIES:
Provider hereby declares that Provider is engaged as an independent business and Provider agrees to perform the services as an independent contractor. The manner and means of conducting the services and tasks are under the control of Provider except to the extent they are limited by statute, rule or regulation and the express terms of this Agreement. No civil service status or other right of employment will be acquired by virtue of Provider ’s services. None of the benefits provided by the City to its emp loyees, including but not limited to unemployment insurance, workers’ compensation plans, vacation and sick leave, are available from the City to Provider, its employees or agents. Deductions shall not be made for any state or federal taxes, FICA payments, PERS payments, or other purposes normally associated with an employer -employee relationship from any compensation due to Provider. Payments of the above items, if required, are the responsibility of Provider.
7. IMMIGRATION REFORM AND CONTROL ACT (IRCA):
Provider assumes any and all responsibility for verifying the identity and employment authorization of all of its employees performing work hereunder, pursuant to all applicable IRCA or other federal, or state rules and regulations. Provider shall indemnify, defend, and hold the City harmless from and against any loss, damage, liability, costs or expenses arising from any noncompliance of this provision by Provider.
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8. NON-DISCRIMINATION:
Consistent with the City’s policy and state and federal law that harassment and discrimination are unacceptable conduct, Provider and its employees, contractors, and agents shall not harass or discriminate against any job applicant, City employee, or any other person on the basis of any kind of any statutorily (federal, state or local) protected class, including but not limited to: race, religious creed, color, national origin, ancestry, disability (both mental and physical) including HIV and AIDS, medical condition (e.g. cancer), genetic information, marital status, sex, gender, gender identity, gender expression, age, sexual orientation, pregnancy, political affiliation, military and veteran status or legitimate union activities. Provider agrees that any violation of this provision shall constitute a material breach of this Agreement.
9. HOLD HARMLESS:
a. To the fullest extent permitted by law, Provider shall indemnify, defend (with counsel acceptable to the City) and hold harmless the City, its City Council, boards, commissions, officials, employees, agents and volunteers (“Indemnitees”) from and against any and all loss, damages, liability, obligations, claims, suits, judgments, costs and expenses whatsoever, including reasonable attorney ’s fees and costs of litigation (“Claims”), arising from or in any manner connected to Provider’s performance of its ob ligations under this Agreement or out of the operations conducted by Provider even if the City is found to have been negligent . If the Claims filed against Indemnitees alleg e negligence, recklessness or willful misconduct on the part of Provider, Provider shall have no right of reimbursement against Indemnitees for the costs of defense even if negligence, recklessness or willful misconduct is not found on the part of Provider.
Provider shall not have any obligations to indemnify Indemnitees if the loss or damage is found to have resulted solely from the negligence or the willful misconduct of the City. The defense and indemnification obligations of this Agreement are undertaken in addition to, and shall not in any way be limited by, the insurance obligations contained in this Agreement. b. As to Claims for professional liability only, Provider’s obligation to defend Indemnitees (as set forth above) is limited as provided in California Civil Code Section 2782.8. c. Provider’s obligation to indemnify, defend and hold harmless Indemnities shall expressly survive the expiration or early termination of this Agreement.
10. INSURANCE:
a. On or before the commencement of the terms of this Agreement, Provider shall furnish the City’s Risk Manager with certificates showing the type, amount, class of operations covered, effective dates and dates of expiration of insurance coverage in compliance with Sections
10.b. (1) through (4). The Certificate Holder should be The City of Alameda, 2263 Santa Clara, Ave., Alameda, CA 94501. Such certificates, which do not limit Provider’s indemnification, shall also contain substantially the following statement:
“Should any of the above insurance covered by this certificate be canceled or coverage reduced before the expiration date thereof, the insurer affording coverage shall provide thirty (30) days’ advance written notice to the City of Alameda. Attention: Risk Manager.” DocuSign Envelope ID: D7C5C45C-B994-4AAE-90ED-435965BDA727
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Provider shall maintain in force at all times during the performance of this Agreement all appropriate coverage of insurance required by this Agreement with an insurance company licensed to offer insurance business in the State of California with a current A.M. Best’s rating of no less than A:VII or Standard & Poor’s Rating (if rated) of at least BBB unless otherwise acceptable to the City. Provider shall deliver updated insurance certificates to the City at the address described in Section 17.f. prior to the expi ration of the existing insurance certificate for the duration of the term of Agreement. Endorsements naming the City, its City Council, boards, commissions, officials, employees, agents, and volunteers as additional insured shall be submitted with the insurance certificates.
_____________
Provider Initials
b. COVERAGE REQUIREMENTS:
Provider shall maintain insurance coverage and limits at least as broad as:
(1) Workers’ Compensation:
Statutory coverage as required by the State of California , as well as a Waiver of Subrogation (Rights of Recovery) endorsement. (2) Liability:
Commercial general liability coverage in the following minimum limits:
Bodily Injury: $1,000,000 each occurrence
$2,000,000 aggregate - all other
Property Damage: $1,000,000 each occurrence
$2,000,000 aggregate
If submitted, combined single limit policy with per occurrence limits in the amounts of $2,000,000 and aggregate limits in the amounts of $4 ,000,000 will be considered equivalent to the required minimum limits shown above. Provider shall also submit d eclarations and policy endorsements pages. Additional Insured Endorsement naming the City, its City Council, boards, commissions, officials, employees, agents, and volunteers is required . The Additional Insured Endorsement shall include primary and non-contributory coverage at least as broad as the CG 2010.
(3) Automotive:
Comprehensive automobile liability coverage (any auto) in the following minimum limits:
Bodily injury: $1,000,000 each occurrence
Property Damage: $1,000,000 each occurrence
or
Combined Single Limit: $2,000,000 each occurrence
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Additional Insured Endorsement naming the City, its City Council, boards, commissions, officials, employees, agents, and volunteers is required.
(4) Professional Liability:
Professional liability insurance which includes coverage appropriate for the professional acts, errors and omissions of Provider ’s profession and work hereunder, including, but not limited to, technology professional liability errors and omissions if the services being provided are technology -based, in the following minimum limits:
$2,000,000 each claim
Technology professional liability errors and omissions shall include, or be endorsed to include, property damage liability coverage for damage to, alteration of, loss of, or destruction of electronic data and/or information “property” of the City in the ca re, custody, or control of Provider. If not covered under Provider’s liability policy, such “property” coverage of the City may be endorsed onto Provider’s Cyber Liability Policy as covered property as follows: cyber liability coverage in an amount sufficient to cover the full replacement value of damage to, alteration of, loss of, or destruction of electronic data and/or information “property” of the City that will be in the care, custody, or control of Provider.
As to commercial general liability and automobile liability insurance, such insurance will provide that it constitutes primary insurance with respect to claims insured by such policy, and, except with respect to limits, that insurance applies separately to each insured against whom claim is made or suit is brought. Such insurance is not additional to or contributing with any other insurance carried by or for the benefit of the City.
c. SUBROGATION WAIVER:
Provider hereby agrees to waive rights of subrogation that any insurer of Provider may acquire from Provider by virtue of the payment of any loss. Provider agrees to obtain any endorsement that may be necessary to affect this waiver of subrogation, but this provision applies regardless of whether the City has received a waiver of subrogation endorse ment from the insurer. The Workers’ Compensation policy shall be endorsed with a waiver of subrogation in favor of the City for all work performed by Provider, its employees, agents and subcontractors. d. FAILURE TO SECURE:
If Provider at any time during the term hereof should fail to secure or maintain the foregoing insurance, the City shall be permitted to obtain such insurance in Provider’s name or as an agent of Provider and shall be compensated by Provider for the costs of the insurance premiums at the maximum rate permitted by law and computed from the date written notice is received that the premiums have not been paid.
e. ADDITIONAL INSUREDS:
The City, its City Council, boards, commissions, officials, employees, agents , and volunteers shall be named as additional insured(s) under all insurance coverages, except workers’ compensation and professional liability insurance. The naming of an additional insured shall not DocuSign Envelope ID: D7C5C45C-B994-4AAE-90ED-435965BDA727
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affect any recovery to which such additional insured would be entitled under this policy if not named as such additional insured. An additional insured named herein shall not be held liable for any premium, deductible portion of any loss, or expense of an y nature on this policy or any extension thereof. Any other insurance held by an additional insured shall not be required to contribute anything toward any loss or expense covered by the insurance provided by this policy.
Additional Insured covera ge under Provider’s policy shall be primary and non -contributory and will not seek contribution from the City’s insurance or self -insurance. Any available insurance proceeds broader than or in excess of the specified minimum insurance coverage requirements and/or limits shall be available to the additional insured(s). f. SUFFICIENCY OF INSURANCE:
The insurance limits required by the City are not represented as being sufficient to protect Provider. Provider is advised to consult Provider ’s insurance broker to determine adequate coverage for Provider. The coverage and limits shall be (1) the minimum coverage and limits specified in this Agreement; or (2) the broader coverage and maximum limits of the coverage carried by or available to Provider; whichever is greater. g. EXCESS OR UMBRELLA LIABILITY:
If any Excess or Umbrella Liability policies are used to meet the limits of liability required by this Agreement, then said policies shall be true “following form” of the underlying policy coverage, terms, conditions, and provisions and shall meet all of the insurance requirements stated in this Agreement, including but not limited to, the additional insured, SIR, and primary insurance requirements stated therein. No insurance policies maintained by the indemnified parties or Additional Insureds, whether primary or excess, and which also apply to a loss covered hereunder, shall be called upon to contribute to a loss until all the primary and excess liability policies carried by or available to the Provider are exhausted.
11. CONFLICT OF INTEREST:
Provider warrants that it is not a conflict of interest for Provider to perform the services required by this Agreement. Provider may be required to fill out a conflict of interest form if the services provided under this Agreement require Provider to make certain governmental decisions or serve in a staff capacity as defined in Title 2, Division 6, Section 18700 of the California Code of Regulations.
12. PROHIBITION AGAINST TRANSFERS:
a. Provider shall not assign, sublease, hypothecate, or transfer this Agreement, or any interest therein, directly or indirectly, by operation of law or otherwise, without prior written consent of the City Manager. Provider shall submit a written request for consent to transfer to the City Manager at least thirty (30) days in advance of the desired transfer. The City Manager or their designee may consent or reject such request in their sole and absolute discretion. Any attempt to do so without said consent shall be null and void, and any assignee, sublessee, hypothecate or transferee shall acquire no right or interest by reason of such attempted assignment, hypothecation or transfer. However, claims for money against the City under this Agreement may be assigned by Provider to a bank, trust company or other financial institution without prior written consent.
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b. The sale, assignment, transfer or other disposition of any of the issued and outstanding capital stock, membership interest, partnership interest, or the equivalent, which shall result in changing the control of Provider, shall be construed as an assignment of this Agreement.
Control means fifty percent or more of the voting power of Provider.
13. APPROVAL OF SUB-PROVIDERS:
a. Only those persons and/or businesses whose names and resumés are attached to this Agreement shall be used in the performance of this Agreement. However, if after the start of this Agreement, Provider wishes to use sub-providers, at no additional costs to the City, then Provider shall submit a written request for consent to add sub -providers including the names of the sub - providers and the reasons for the request to the City Manager at least five (5) days in advance. The City Manager may consent or reject such requests in their sole and absolute discretion. b. Each sub -provider shall be required to furnish proof of workers ’ compensation insurance and shall also be required to carry general, automobile and professional liability insurance (as applicable) in reasonable conformity to the insurance carried by Provider. c. In addition, any tasks or services performed by sub -providers shall be subject to each provision of this Agreement. Provider shall include the following language in their agreement with any sub-provider: “Sub-providers hired by Provider agree to be bound to Provider and the City in the same manner and to the same extent as Provider is bound to the City.” d. The requirements in this Section 13 shall not apply to persons who are merely providing materials, supplies, data or information that Provider then analyzes and incorporates into its work product.
14. PERMITS AND LICENSES:
Provider, at its sole expense, shall obtain and maintain during the term of this Agreement, all appropriate permits, certificates and licenses, including a City business license that may be required in connection with the performance of the services and tasks hereunder.
15. REPORTS:
a. Each and every report, draft, work product, map, record and other document produced, prepared or caused to be prepared by Provider pursuant to or in connection with this Agreement shall be the exclusive property of the City.
b. No report, information or other data given to or prepared or assembled by Provider pursuant to this Agreement shall be made available to any individual or organization by Provider without prior approval of the City Manager or their designee. c. Provider shall, at such time and in such form as City Manager or their designee may require, furnish reports concerning the status of services and tasks required under this Agreement.
16. RECORDS:
a. Provider shall maintain complete and accurate records with respect to the services, tasks, work, documents and data in sufficient detail to permit an evaluation of Provider’s DocuSign Envelope ID: D7C5C45C-B994-4AAE-90ED-435965BDA727
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performance under the Agreement , as well as maintain books and records related to sales, costs, expenses, receipts and other such information required by the City that relate to the performance of the services and tasks under this Agreement (collectively the “Records”). b. All Records shall be maintained in accordance with generally accepted accounting principles and shall be clearly identified and readily accessible. Provider shall provide free access to the Records to the representatives of the City or its designees during regular business hours upon reasonable prior notice. The City has the right to examine and audit the Records, and to make copies or transcripts therefrom as necessary, and to allow inspection of all proceedings and activities related to this Agreement. Such Records, together with supporting documents, shall be kept separate from other documents and records and shall be maintained by Provider for a period of three (3) years after receipt of final payment.
c. If supplemental examination or audit of the Records is necessary due to concerns raised by the City’s preliminary examination or audit of records, and the City ’s supplemental examination or audit of the records discloses a failure to adhere to appropriate internal financial controls, or other breach of this Agreement or failure to act in good faith, then Provider shall reimburse the City for all reasonable costs and expenses associated with the supplemental examination or audit.
17. NOTICES:
a. All notices shall be in writing and delivered: (i) by hand; or (ii) sent by registered, express, or certified mail, with return receipt requested or with delivery confirmation requested from the U.S. postal service ; or (iii) sent by overnight or same day courier service at the party’s respective address listed in this Section.
b. Each notice shall be deemed to have been received on the earlier to occur of : (x) actual delivery or the date on which delivery is refused ; or (y) three (3) days after notice is deposited in the U.S. mail or with a courier service in the manner described above (Sundays and City holidays excepted).
c. Either party may, at any time, change its notice address (other than to a post office box address) by giving the other party three (3) days prior written notice of the new address. d. All notices, demands, requests, or approvals from Provider to the City shall be addressed to the City at:
City of Alameda
Human Resources Department
2263 Santa Clara Ave, Room 290
Alameda, CA 94501
ATTENTION: Human Resources Department
Ph: (510) 747-4900
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e. All notices, demands, requests, or approvals from the City to Provider shall be addressed to Provider at:
Preferred Alliance, Inc.
16960 S. Harlan Road
Lathrop, CA 95330
ATTENTION: Nannette Mendez-Latalladi
Ph: 209-825-3425
f. All updated insurance certificates from Provider to the City shall be addressed to the City at:
City of Alameda
Human Resources Department
2263 Santa Clara Ave, Room 290
Alameda, CA 94501
ATTENTION: Human Resources
Ph: (510) 747-4900/ [email protected]
18. SAFETY:
a. Provider will be solely and completely responsible for conditions of all vehicles owned or operated by Provider, including the safety of all persons and property during performance of the services and tasks under this Agreement. This requirement will apply continuously and not be limited to normal working hours. In addition, Provider will comply with all s afety provisions in conformance with U.S. Department of Labor Occupational Safety and Health Act, any equivalent state law, and all other applicable federal, state, county and local laws, ordinances, codes, and any regulations that may be detailed in other parts of the Agreement. Where any of these are in conflict, the more stringent requirement s will be followed. Provider’s failure to thoroughly familiarize itself with the aforementioned safety provisions will not relieve it from compliance with the obligations and penalties set forth herein. b. Provider will immediately notify the City within 24 hours of any incident of death, serious personal injury or substantial property damage that occurs in connection with the performance of this Agreement. Provider will promptly submit to the City a writte n report of all incidents that occur in connection with this Agreement. This report must include the following information: (i) name and address of injured or deceased person(s); (ii) name and address of Provider’s employee(s) involved in the incident; (i ii) name and address of Provider’s liability insurance carrier; (iv) a detailed description of the incident; and (v) a police report.
19. TERMINATION:
a. In the event Provider fails or refuses to perform any of the provisions hereof at the time and in the manner required hereunder, Provider shall be deemed in default in the performance of this Agreement . If such default is not cured within two (2) business days after receipt by Provider from the City of written notice of default, specifying the nature of such default and the steps necessary to cure such default, the City may thereafter immediately terminate the Agreement forthwith by giving to Provider written notice thereof.
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b. The foregoing notwithstanding, the City shall have the option, at its sole discretion and without cause, of terminating this Agreement by giving seven (7) days’ prior written notice to Provider as provided herein.
c. Upon termination of this Agreement either for cause or for convenience, each party shall pay to the other party that portion of compensation specified in this Agreement that is earned and unpaid prior to the effective date of termination. The obligation of the parties under this Section 19.c. shall survive the expiration or early termination of this Agreement.
20. ATTORNEYS’ FEES:
In the event of any litigation, including administrative proceedings, relating to this Agreement, including but not limited to any action or suit by any party, assignee or beneficiary against any other party, beneficiary or assignee, to enforce, interpret or seek relief from any provision or obligation arising out of this Agreement, the parties and litigants shall bear their own attorney’s fees and costs. No party or litigant shall be entitled to recover any attorneys’ fees or costs from any other party or litigant, regardless of which party or litigant might prevail.
21. HEALTH AND SAFETY REQUIREMENTS.
Provider acknowledges that the City shall have the right to impose , at the City’s sole discretion, requirements that it deems are necessary to protect the health and safety of the City employees, residents, and visitors. Provider agrees to comply with all such requirements, including, but not limited to, mandatory vaccinations, the use of personal protective equipment (e.g. masks), physical distancing, and health screenings. Provider also agrees to make available to the City, at the City’s request, records to demonstrate Provider’s compliance with this Section.
22. COMPLIANCE WITH ALL APPLICABLE LAWS:
During the term of this Agreement, Provider shall keep fully informed of all existing and future state and federal laws and all municipal ordinances and regulations of the City of Alameda which affect the manner in which the services or tasks are to be performed by Provider, as well as all such orders and decrees of bodies or tribunals having any jurisdiction or authority over the same. Provider shall comply with all applicable laws, state and federal and all ordinances, rules and regulations enacted or issued by the City.
23. CONFLICT OF LAW:
This Agreement shall be interpreted under, and enforced by the laws of the State of California without regard to any choice of law rules which may direct the application of laws of another jurisdiction. The Agreement and obligations of the parties are subject to all valid laws, orders, rules, and regulations of the authorities having jurisdiction over this Agreemen t (or the successors of those authorities). Any suits brought pursuant to this Agreement shall be filed with the courts of the County of Alameda, State of California.
24. WAIVER:
A waiver by the City of any breach of any term, covenant, or condition contained herein shall not be deemed to be a waiver of any subsequent breach of the same or any other term, covenant, or condition contained herein, whether of the same or a different character.
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25. INTEGRATED CONTRACT:
Subject to the language of Section 29 the Recitals and exhibits are a material part of this Agreement and are expressly incorporated herein. This Agreement represents the full and complete understanding of every kind or nature whatsoever between the parties hereto, and all preliminary negotiations and agreements of whatsoever kind or nature are merged herein. No verbal agreement or implied cov enant shall be held to vary the provisions hereof. Any modification of this Agreement will be effective only by written execution signed by both the City and Provider.
26. CAPTIONS:
The captions in this Agreement are for convenience only, are not a part of the Agreement and in no way affect, limit or amplify the terms or provisions of this Agreement.
27. COUNTERPARTS:
This Agreement may be executed in any number of counterparts (including by fax, PDF , DocuSign, or other electronic means), each of which shall be deemed an original, but all of which shall constitute one and the same instrument.
28. SIGNATORY:
By signing this Agreement, signatory warrants and represents that they executed this Agreement in their authorized capacity and that by their signature on this Agreement, they or the entity upon behalf of which they acted, executed this Agreement.
29. CONTROLLING AGREEMENT:
In the event of a conflict between the terms and conditions of this Agreement (as amended, supplemented, restated or otherwise modified from time to time) and any other terms and conditions wherever contained, including, without limitation, terms and conditions included within exhibits, the terms and conditions of this Agreement shall control and be primary.
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EXHIBIT A
Fees for Services:
Employer shall pay Preferred Alliance, inc. according to the following schedule with rates affected by annual cost of living increase (+3.5% annually):
Preferred Alliance Random Fee Schedule
2024
ON SITE TESTING
Company Random Pool Size Per Driver/Per Month Rate Payment Terms 35-45 $9.01 Monthly
Non-random Tests (Pre-employment, Post-
accident, Reasonable Suspicion, Return to
Duty, and Follow-up)
$60 for drugs ($68 outside of Kaiser)
$45 for alcohol ($50 outside of Kaiser)
On-site Collection $175 per visit
After Hours (5:00 pm -8:00 am) for DOT or
Non-DOT Reasonable Suspicion or Post-
Accident test
$275 per visit + cost of test (Drug is $68.00
and Alcohol $50.00)
OTHER FEES
Reasonable Suspicion Training $1,200 + $16 per supervisor for materials they keep
Online Reasonable Suspicion Training $75 per license
Clearinghouse $3.00 per Limited Query and $4.00 per Full Query and reporting a Violation
DocuSign Envelope ID: D7C5C45C-B994-4AAE-90ED-435965BDA727 ANY PROPRIETOR/PARTNER/EXECUTIVEOFFICER/MEMBER EXCLUDED?
INSR ADDLSUBRLTR INSDWVD
PRODUCER CONTACTNAME: FAXPHONE(A/C, No):(A/C, No, Ext):E-MAILADDRESS:INSURER A :INSURED INSURER B :INSURER C :INSURER D :INSURER E :INSURER F :
POLICY NUMBERPOLICY EFFPOLICY EXPTYPE OF INSURANCELIMITS(MM/DD/YYYY)(MM/DD/YYYY)
AUTOMOBILE LIABILITY
UMBRELLA LIABEXCESS LIABWORKERS COMPENSATIONAND EMPLOYERS' LIABILITY DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
AUTHORIZED REPRESENTATIVE
EACH OCCURRENCE$DAMAGE TO RENTEDCLAIMS-MADEOCCUR $PREMISES (Ea occurrence)MED EXP (Any one person)$PERSONAL & ADV INJURY$GEN'L AGGREGATE LIMIT APPLIES PER:GENERAL AGGREGATE$PRO-POLICYLOC PRODUCTS - COMP/OP AGGJECT OTHER: $COMBINED SINGLE LIMIT$(Ea accident)ANY AUTO BODILY INJURY (Per person)$OWNEDSCHEDULEDBODILY INJURY (Per accident)$AUTOS ONLYAUTOSHIREDNON-OWNEDPROPERTY DAMAGE$AUTOS ONLYAUTOS ONLY(Per accident)$OCCUR EACH OCCURRENCECLAIMS-MADEAGGREGATE$DEDRETENTION$ PEROTH-STATUTEERE.L. EACH ACCIDENTE.L. DISEASE - EA EMPLOYEE$If yes, describe underE.L. DISEASE - POLICY LIMITDESCRIPTION OF OPERATIONS below INSURER(S) AFFORDING COVERAGENAIC #
COMMERCIAL GENERAL LIABILITY
Y / NN / A(Mandatory in NH)
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORETHE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED INACCORDANCE WITH THE POLICY PROVISIONS.
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIODINDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THISCERTIFICATE 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.
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THISCERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIESBELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZEDREPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.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 onthis certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
COVERAGESCERTIFICATE NUMBER:REVISION NUMBER:
CERTIFICATE HOLDERCANCELLATION
© 1988-2015 ACORD CORPORATION. All rights reserved.ACORD 25 (2016/03)
CERTIFICATE OF LIABILITY INSURANCEDATE (MM/DD/YYYY)
$
$$$$
The ACORD name and logo are registered marks of ACORD
4/16/2024
11000Health Services & Benefit Administrators, Inc.& Preferred Alliance, Inc.4160 Dublin Blvd Ste 400Dublin, CA 94568-7756294241669115792 A 2,000,000X57SBABF20661/1/20241/1/20251,000,000Contractual Liab10,000Employee Benefits2,000,0004,000,0004,000,000EBL2,000,0002,000,000A 57SBABF20661/1/20241/1/20254,000,000A 57SBABF20661/1/20241/1/20254,000,00010,000B 57WECGI69991/1/20241/1/20251,000,0001,000,0001,000,000CTPA E&O PrimaryMPL17510247/12/2023Limit3,000,000DExcess E&O Layer #1HMPL2301347/12/20237/12/2024Limit4,000,000If required by written contract or agreement City of Alameda is included as an Additional Insured respect General Liability in connection with services provided by the Named Insured for the Additional Insured per attached form.
City of Alameda Public Works DepartmentAlameda Point, Building 1950 West Mall Square, Room 110Alameda, CA 94501-7558 HEALSER-08SDECKER
Acrisure Partners West Coast Insurance Services, LLC1950 W Corporate Way #1Anaheim, CA 92801Shuai-Chun [email protected] Insurance Company, LtdHartford Casualty Insurance CompanyGreat American Insurance CompanyUnderwriters at Lloyd's, London (IL) X7/12/2024
X XXXXX XXXX
DocuSign Envelope ID: D7C5C45C-B994-4AAE-90ED-435965BDA727 FORM NUMBER:
EFFECTIVE DATE:
The ACORD name and logo are registered marks of ACORD
ADDITIONAL REMARKS
ADDITIONAL REMARKS SCHEDULE
FORM TITLE:
Page of
THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, ACORD 101 (2008/01)
AGENCY CUSTOMER ID:LOC #:
AGENCY NAMED INSUREDPOLICY NUMBERCARRIER NAIC CODE
© 2008 ACORD CORPORATION. All rights reserved.
Acrisure Partners West Coast Insurance Services, LLC
HEALSER-08
SEE PAGE 1
1 SEE PAGE 1ACORD 25Certificate of Liability Insurance
1 SEE P 1Health Services & Benefit Administrators, Inc.& Preferred Alliance, Inc.4160 Dublin Blvd Ste 400Dublin, CA 94568-7756SEE PAGE 1 SDECKER1
Additional Insurance Information2023-2024 Excess E&O Layer #2Carrier: Scottsdale Insurance CompanyPolicy No.: EKS3485516Limit: $3,000,000 excess of $7,000,000Policy Period: 7/12/2023 - 7/12/2024 DocuSign Envelope ID: D7C5C45C-B994-4AAE-90ED-435965BDA727
ABCDEFGHIJ
BUSINESS 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. The words "we", "us" and "our" refer to the stock insurance company member of The Hartford providing this insurance.
CThe word "insured" means any person or organization qualifying as such under Section . - Who Is An Insured.
GOther words and phrases that appear in quotation marks have special meaning. Refer to Section . - Liability And Medical Expenses Definitions.
(a) The "bodily injury" or "property
A. COVERAGES
damage" is caused by an 1. BUSINESS LIABILITY COVERAGE (BODILY "occurrence" that takes place in the INJURY, PROPERTY DAMAGE, PERSONAL "coverage territory"; AND ADVERTISING INJURY) (b) The "bodily injury" or "propertyInsuring Agreement damage" occurs during the policy a. We will pay those sums that the insured period; and
becomes legally obligated to pay as (c) Prior to the policy period, no insureddamages because of "bodily injury", 1.listed under Paragraph of Section"property damage" or "personal and C. – Who Is An Insured and noadvertising injury" to which this insurance "employee" authorized by you to giveapplies. We will have the right and duty to or receive notice of an "occurrence" defend the insured against any "suit" or claim, knew that the "bodily injury" seeking those damages. However, we will or "property damage" had occurred,have no duty to defend the insured against in whole or in part. If such a listedany "suit" seeking damages for "bodily insured or authorized "employee"injury", "property damage" or "personal and knew, prior to the policy period, thatadvertising injury" to which this insurance the "bodily injury" or "propertydoes not apply. damage" occurred, then any We may, at our discretion, investigate any continuation, change or resumption "occurrence" or offense and settle any claim of such "bodily injury" or "property or "suit" that may result. But: damage" during or after the policy period will be deemed to have been (1) The amount we will pay for damages is known prior to the policy period.D. limited as described in Section - (2) To "personal and advertising injury" Liability And Medical Expenses Limits caused by an offense arising out of your Of Insurance; and business, but only if the offense was (2) Our right and duty to defend ends when committed in the "coverage territory" we have used up the applicable limit of during the policy period. insurance in the payment of judgments, c. "Bodily injury" or "property damage" will be settlements or medical expenses to which deemed to have been known to have this insurance applies. occurred at the earliest time when any No other obligation or liability to pay sums or
1. insured listed under Paragraph of Section perform acts or services is covered unless C. – Who Is An Insured or any "employee" explicitly provided for under Coverage authorized by you to give or receive notice Extension - Supplementary Payments. of an "occurrence" or claim:b. This insurance applies:
(1) Reports all, or any part, of the "bodily (1) To "bodily injury" and "property injury" or "property damage" to us or damage" only if: any other insurer; Form SS 00 08 04 05 Page 1 of 24
© 2005, The Hartford
Named Insured: Health Services& Benefit Administrators Inc. and Preferred Alliance
Policy No.: 57SBABF2066
DocuSign Envelope ID: D7C5C45C-B994-4AAE-90ED-435965BDA727 BUSINESS LIABILITYCOVERAGE FORM(2) b.Receivesawrittenorverbaldemandor Wewillmakethesepaymentsregardlessof claimfordamagesbecauseofthe"bodily fault.Thesepaymentswillnotexceedthe injury"or"propertydamage";or applicablelimitofinsurance.Wewillpay reasonable expensesfor:(3)Becomesawarebyanyothermeansthat (1)"bodilyinjury"or"propertydamage"has Firstaidadministeredatthetimeofan occurredorhasbeguntooccur. accident;d. (2)Damagesbecauseof"bodilyinjury"include Necessarymedical,surgical,x-rayanddamagesclaimedbyanypersonor dentalservices,includingprosthetic organizationforcare,lossofservicesor devices;anddeathresultingatanytimefromthe"bodily (3)Necessaryambulance,hospital, injury". professionalnursingandfuneral e.IncidentalMedical Malpractice services.(1)"Bodilyinjury"arisingoutofthe 3.COVERAGEEXTENSION-renderingoforfailuretorender SUPPLEMENTARY PAYMENTSprofessionalhealthcareservicesasa a.Wewillpay,withrespecttoanyclaimor physician,dentist,nurse,emergency "suit"weinvestigateorsettle,orany"suit" medicaltechnicianorparamedicshall againstan insured wedefend:bedeemedtobecausedbyan (1)Allexpenses weincur."occurrence", but only if: (2)Upto$1,000forthecostofbailbonds (a)Thephysician,dentist,nurse, requiredbecauseofaccidentsortraffic emergencymedicaltechnicianor lawviolationsarisingoutoftheuseof paramedicisemployedbyyouto anyvehicletowhichBusinessLiability provide suchservices; and Coveragefor"bodily injury"applies. We (b)Youarenotengagedinthe donothave to furnishthesebonds.businessoroccupationofproviding (3)Thecostofappealbondsorbondsto suchservices. releaseattachments,butonlyforbond (2)Forthepurposeofdeterminingthe amountswithintheapplicablelimitof limitsofinsurancefor incidentalmedical insurance.Wedonothavetofurnish malpractice,anyactoromission these bonds.togetherwithallrelatedactsor (4)All reasonable expenses incurred by the omissionsinthefurnishingofthese insuredatour request to assist us in the servicestoanyonepersonwillbe investigationordefenseoftheclaimor considered one"occurrence"."suit",includingactuallossofearnings 2.MEDICAL EXPENSES upto$500adaybecauseoftimeoff InsuringAgreement fromwork.a.Wewillpaymedicalexpensesasdescribed (5)Allcoststaxedagainsttheinsuredin belowfor"bodilyinjury"causedbyan the "suit".accident: (6)Prejudgmentinterestawardedagainst (1)On premisesyou ownor rent; theinsuredonthatpartofthejudgment wepay.Ifwemakeanoffertopaythe (2)Onwaysnexttopremisesyouownor applicablelimitofinsurance,wewillnot rent;or payanyprejudgmentinterestbasedon (3)Becauseofyour operations; that period of time aftertheoffer.provided that: (7)Allinterestonthefullamountofany (1)Theaccidenttakesplaceinthe judgmentthataccruesafterentryofthe "coverageterritory"andduringthe judgmentandbeforewehavepaid, policyperiod; offeredtopay,ordepositedincourtthe partofthejudgmentthatiswithinthe (2)The expenses are incurredand reported applicable limit of insurance.touswithinthreeyearsofthedateof the accident; and (1) (7)Anyamountspaidunderthroughabovewillnotreduce the limits of insurance.(3)Theinjuredpersonsubmitsto examination,atourexpense,byphysiciansofourchoiceasoftenaswe reasonably require.Page 2of24 FormSS 0008 0405 DocuSign Envelope ID: D7C5C45C-B994-4AAE-90ED-435965BDA727 BUSINESS LIABILITYCOVERAGE FORMb.Ifwedefendaninsuredagainsta"suit" Solongastheaboveconditionsaremet,andanindemniteeoftheinsuredisalso attorneys'feesincurredbyusinthenamedasapartytothe"suit",wewill defenseofthatindemnitee,necessarydefendthatindemniteeifallofthe litigationexpensesincurredbyusandfollowingconditionsare met: necessarylitigationexpensesincurredbytheindemniteeatourrequestwillbe(1)The"suit"againsttheindemnitee paidasSupplementaryPayments.seeksdamagesforwhichtheinsured hasassumedtheliabilityofthe Notwithstandingtheprovisionsof 1.b.(b) B.indemniteeinacontractoragreement ParagraphofSection–thatisan "insured contract"; Exclusions,suchpaymentswillnotbe deemedtobedamagesfor"bodily (2)Thisinsuranceappliestosuchliability injury"and"propertydamage"andwill assumed bytheinsured; not reducetheLimits of Insurance.(3)Theobligation to defend, or the cost of Ourobligationtodefendaninsured's thedefenseof,thatindemnitee,has indemniteeandtopayforattorneys'fees alsobeenassumedbytheinsuredin andnecessarylitigationexpensesas the same "insured contract"; Supplementary Paymentsends when:(4)Theallegationsinthe"suit"andthe (1)Wehaveuseduptheapplicablelimit informationweknowaboutthe ofinsuranceinthepaymentof "occurrence"aresuchthatnoconflict judgments orsettlements; orappearstoexistbetweentheinterests (2)oftheinsuredandtheinterestofthe Theconditionssetforthabove,ortheindemnitee; termsoftheagreementdescribedin(6)Paragraphabove,arenolongermet.(5)Theindemniteeandtheinsuredask ustoconductandcontrolthedefense B.EXCLUSIONSofthatindemniteeagainstsuch"suit" 1.ApplicableTo Business LiabilityCoverageandagreethatwecanassignthe Thisinsurancedoes not apply to:samecounseltodefendtheinsured andtheindemnitee;and a.ExpectedOrIntendedInjury(6)The indemnitee: (1)"Bodilyinjury"or"propertydamage" expectedorintendedfromthe (a)Agreesinwritingto: standpointoftheinsured.This (i)Cooperatewithusinthe exclusiondoesnotapplyto"bodily investigation,settlementor injury"or"propertydamage"resulting defense of the "suit"; fromtheuseofreasonableforceto (ii)Immediately sendus copies of protectpersons orproperty; oranydemands, notices, (2)"Personalandadvertisinginjury"arisingsummonsesorlegalpapers outofanoffensecommittedby,atthereceivedinconnectionwith directionoforwiththeconsentorthe "suit"; acquiescenceoftheinsuredwiththe(iii)Notify any otherinsurerwhose expectationofinflicting"personalandcoverageisavailabletothe advertisinginjury".indemnitee; and b.ContractualLiability(iv)Cooperatewithuswith (1)"Bodilyinjury"or"propertydamage";orrespecttocoordinatingother (2)"Personal andadvertisinginjury"applicableinsuranceavailable to the indemnitee; and forwhichtheinsuredisobligatedtopay damagesbyreasonoftheassumptionof(b)Providesuswithwritten liabilityina contractor agreement.authorizationto: Thisexclusiondoesnotapplytoliability (i)Obtainrecordsandother for damages becauseof:informationrelatedtothe "suit"; and (a)"Bodilyinjury","propertydamage"or"personalandadvertisinginjury"that(ii)Conductandcontrolthe theinsuredwouldhaveinthedefenseoftheindemniteein absenceofthecontractorsuch"suit". agreement;orFormSS 0008 0405 Page 3of24 DocuSign Envelope ID: D7C5C45C-B994-4AAE-90ED-435965BDA727 BUSINESS LIABILITYCOVERAGE FORM(b) (b)"Bodilyinjury"or"propertydamage" Performingdutiesrelatedtotheassumed in a contract oragreement conductoftheinsured’sbusiness,orthatisan"insuredcontract", (2)Thespouse,child,parent,brotheror providedthe"bodilyinjury"or sisterofthat"employee"asa "property damage" occurs (1)consequenceofabove.subsequenttotheexecutionofthe Thisexclusion applies:contractoragreement.Solelyfor (1)Whethertheinsuredmaybeliableas thepurposeofliabilityassumedin anemployerorinanyothercapacity; an"insuredcontract",reasonable andattorneys'feesandnecessarylitigation expenses incurred by or for (2)Toanyobligationtosharedamages apartyotherthananinsuredare withorrepaysomeoneelsewhomustdeemedtobedamagesbecauseof paydamagesbecause of the injury."bodilyinjury"or"propertydamage" Thisexclusiondoesnotapplytoliability provided: assumedbytheinsuredunderan"insured (i)Liabilitytosuchpartyfor,orfor contract".thecostof,thatparty’sdefense f.Pollutionhasalsobeenassumedinthe (1)"Bodilyinjury","propertydamage"or same"insuredcontract",and "personalandadvertisinginjury" (ii)Suchattorneys'feesand arisingoutoftheactual,allegedor litigationexpensesarefor threateneddischarge,dispersal, defenseofthat party against a seepage,migration,releaseorescape civiloralternativedispute of "pollutants":resolutionproceedinginwhich (a)Atorfromanypremises,siteor damagestowhichthis locationwhichisorwasatanyinsurance appliesare alleged. timeownedoroccupiedby,or c.Liquor Liability rentedorloanedtoanyinsured. "Bodilyinjury"or"propertydamage"for However,thissubparagraphdoes whichanyinsuredmaybeheldliableby not apply to:reasonof: (i)"Bodilyinjury"ifsustainedwithin(1)Causingorcontributingtothe abuildingandcausedbyintoxicationofany person; smoke,fumes,vapororsootproducedbyororiginatingfrom(2)Thefurnishingofalcoholicbeveragesto equipmentthatisusedtoheat,apersonunderthelegaldrinkingageor coolordehumidifythebuilding,undertheinfluenceofalcohol;or orequipmentthatisusedto(3)Anystatute,ordinanceorregulation heatwaterforpersonaluse,byrelatingtothesale,gift,distributionor thebuilding'soccupantsortheiruseofalcoholicbeverages. guests;Thisexclusionappliesonlyifyouareinthe (ii)"Bodilyinjury"or"propertybusinessofmanufacturing,distributing, damage"forwhichyoumaybeselling,servingorfurnishingalcoholic heldliable,ifyouareabeverages. contractorandtheownerord.Workers'CompensationAndSimilar lesseeofsuchpremises,site orLaws location hasbeenaddedtoyourAnyobligationoftheinsuredundera policyasanadditionalinsuredworkers'compensation,disabilitybenefits withrespecttoyourongoingorunemploymentcompensationlawor operationsperformedforthatanysimilar law. additional insuredatthatpremises,siteorlocationande.Employer’sLiability suchpremises,siteorlocation"Bodilyinjury" to: isnotandneverwasownedor(1)An"employee"oftheinsuredarising occupiedby,orrentedorout of andinthecourse of: loanedto,anyinsured,other(a)Employmentby the insured;or thanthatadditionalinsured;or
DocuSign Envelope ID: D7C5C45C-B994-4AAE-90ED-435965BDA727 BUSINESS LIABILITYCOVERAGE FORM(iii)"Bodilyinjury"or"property releasedaspartofthe damage"arisingoutofheat, operationsbeingperformed smokeorfumesfroma bysuchinsured,contractoror "hostile fire"; subcontractor;(b) (ii)Atorfromanypremises,siteor "Bodilyinjury"or"propertylocationwhichisorwasatany damage"sustainedwithinatimeusedbyorforanyinsuredor buildingandcausedbytheothersforthehandling,storage, releaseofgases,fumesordisposal,processingortreatment vaporsfrommaterialsbroughtof waste; intothatbuildinginconnectionwithoperationsbeingperformed(c)Whichareorwereatanytime byyouoronyourbehalfbyatransported,handled,stored, contractororsubcontractor;ortreated,disposedof,orprocessed (iii)aswasteby orfor: "Bodilyinjury"or"property damage"arisingoutofheat, (i)Anyinsured; or smokeorfumesfroma (ii)Anypersonororganizationfor "hostile fire"; orwhomyoumaybelegally (e)Atorfromanypremises,siteorresponsible; locationonwhichanyinsuredorany(d)Atorfromanypremises,siteor contractorsor subcontractorslocationonwhichanyinsuredor workingdirectlyorindirectlyonanyanycontractorsorsubcontractors insured’sbehalfareperformingworkingdirectlyorindirectlyon operationsiftheoperationsaretoanyinsured'sbehalfare testfor,monitor,cleanup,remove,performingoperationsifthe contain,treat,detoxifyorneutralize,"pollutants"arebroughtonorto orinanywayrespondto,orassessthepremises,siteorlocationin theeffectsof,"pollutants".connectionwithsuchoperations (2)Anyloss,costorexpensearisingout bysuchinsured,contractoror of any:subcontractor.However,this (a)subparagraphdoes not apply to: Request, demand, order or statutoryorregulatoryrequirementthatany(i)"Bodilyinjury"or"property insuredorotherstestfor,monitor,damage"arisingoutofthe cleanup,remove,contain,treat,escapeoffuels,lubricantsor detoxifyorneutralize,orinanywayother operating fluidswhichare respondto,orassesstheeffectsof,neededtoperformthenormal "pollutants";orelectrical, hydraulic or (b)mechanical functions Claimorsuitbyoronbehalfofa necessaryfortheoperationof governmentalauthorityfor "mobile equipment" or itsparts, damagesbecauseoftestingfor,if such fuels, lubricants orother monitoring,cleaning up, removing, operatingfluidsescapefroma containing,treating,detoxifyingor vehiclepartdesignedtohold, neutralizing,orinanyway storeorreceivethem.This respondingto,orassessingthe exceptiondoesnotapplyifthe effects of,"pollutants"."bodilyinjury"or"property However,thisparagraphdoesnot damage"arisesoutofthe applytoliabilityfordamagesbecause intentionaldischarge,dispersal of"propertydamage"thattheinsured orreleaseofthefuels, wouldhaveintheabsenceofsuch lubricantsorotheroperating request,demand,orderorstatutoryor fluids,orifsuchfuels, regulatoryrequirement,orsuchclaim lubricantsorotheroperating or"suit"byoronbehalfofa fluidsarebroughtonortothe governmental authority.premises,siteorlocationwiththeintentthattheybedischarged, dispersedor FormSS 0008 0405 Page 5of24
DocuSign Envelope ID: D7C5C45C-B994-4AAE-90ED-435965BDA727 BUSINESS LIABILITYCOVERAGE FORMg.Aircraft,AutoOrWatercraft (2)Theuseof"mobileequipment"in,or whileinpracticeorpreparationfor,a"Bodilyinjury"or"propertydamage"arising prearrangedracing,speedor outoftheownership,maintenance,useor demolitioncontestorinanystunting entrustmenttoothersofanyaircraft,"auto" activity.or watercraft owned or operated by or rented i.Warorloanedtoanyinsured.Useincludesoperationand"loadingorunloading". "Bodilyinjury","propertydamage"orThisexclusionapplieseveniftheclaims "personalandadvertisinginjury",howeveragainstanyinsuredallegenegligenceor caused,arising,directlyorindirectly,outof:otherwrongdoinginthesupervision,hiring, (1)War,includingundeclaredor civil war;employment,trainingormonitoringofothers (2)Warlikeactionbyamilitaryforce, bythatinsured,ifthe"occurrence"which includingactioninhinderingor causedthe"bodilyinjury"or"property defendingagainstanactualordamage" involvedtheownership, expectedattack,byanygovernment, maintenance,use orentrustmenttoothersof sovereignorotherauthorityusinganyaircraft,"auto"orwatercraftthatis military personnel orotheragents; orownedoroperatedbyorrentedorloanedto (3)Insurrection,rebellion,revolution, anyinsured. usurpedpower,oractiontakenby Thisexclusion doesnotapplyto: governmentalauthorityinhinderingor (1)Awatercraftwhileashoreonpremises defendingagainst anyofthese.youown orrent; j.Professional Services(2)Awatercraftyou donotown thatis: "Bodilyinjury","propertydamage"or (a)Lessthan51 feetlong; and "personalandadvertisinginjury"arising outoftherenderingoforfailuretorender (b)Notbeingusedtocarrypersons anyprofessionalservice.Thisincludes for acharge; but is not limited to:(3)Parkingan"auto"on,orontheways (1)Legal, accountingoradvertisingnextto,premisesyouownorrent, services;providedthe"auto"isnotownedbyor rented orloanedtoyou ortheinsured; (2)Preparing,approving,orfailingtoprepareorapprovemaps,shop(4)Liabilityassumedunderany"insured drawings,opinions,reports,surveys,contract"fortheownership, fieldorders,changeorders,designsormaintenanceoruseofaircraftor drawingsandspecifications;watercraft; (3)Supervisory,inspection,architectural (5)"Bodilyinjury"or"propertydamage" orengineering activities;arisingoutoftheoperationofanyof f.(2)theequipmentlisted in Paragraph (4)Medical,surgical,dental,x-rayor f.(3)orofthedefinitionof"mobile nursingservicestreatment,adviceor equipment";or instruction;(6)Anaircraftthatisnotownedbyany (5)Anyhealthortherapeuticservice insured and is hired,charteredor loaned treatment, advice orinstruction;withapaidcrew.However,this (6)Anyservice,treatment,adviceor exceptiondoesnotapplyiftheinsured instructionforthepurposeof hasanyotherinsurancefor such"bodily appearance orskinenhancement,hair injury"or"propertydamage",whether removalorreplacementorpersonal theotherinsuranceisprimary,excess, grooming;contingentoronanyotherbasis. (7)Opticalorhearingaidservices h.Mobile Equipment includingtheprescribing,preparation, "Bodilyinjury"or"propertydamage" fitting,demonstrationordistributionof arisingoutof: ophthalmiclensesandsimilar products orhearingaiddevices;(1)Thetransportationof"mobileequipment"byan"auto"ownedoroperatedbyorrentedorloanedtoanyinsured;or
DocuSign Envelope ID: D7C5C45C-B994-4AAE-90ED-435965BDA727 BUSINESS LIABILITYCOVERAGE FORM(8) (1)(3)(4)Optometryoroptometricservices Paragraphs, andofthis includingbutnotlimitedtoexamination exclusiondonotapplyto"property oftheeyesandtheprescribing, damage"(otherthandamagebyfire)to preparation,fitting,demonstrationor premises,includingthecontentsofsuch distributionofophthalmiclensesand premises, rented to you for a period of 7orsimilarproducts; fewerconsecutivedays.AseparateLimitofInsuranceappliestoDamageTo (9)Any: PremisesRentedToYouasdescribedin (a)Bodypiercing(notincludingear D.Section-Limits OfInsurance.piercing); (2)Paragraphofthisexclusiondoesnot(b)Tattooing,includingbutnotlimited applyifthepremisesare"yourwork"and totheinsertionofpigmentsintoor wereneveroccupied,rentedorheldfor undertheskin; and rentalby you.(c)Similarservices; (3) (4)Paragraphs andofthis exclusiondo (10)Servicesinthepracticeofpharmacy; not apply to the useofelevators.and (3)(4)(5)(6)Paragraphs, , andofthis (11)Computerconsulting,designor exclusiondonotapplytoliabilityassumed programmingservices,includingweb undera sidetrackagreement.sitedesign. (3)(4)Paragraphs and ofthis exclusiondo(4)(5)Paragraphs and ofthis exclusiondo notapplyto"propertydamage"to notapplytotheIncidentalMedical borrowedequipmentwhilenotbeingused Malpracticecoverageaffordedunder to performoperations at ajobsite.1.e. A.ParagraphinSection -Coverages. (6)Paragraphofthisexclusiondoesnotk.Damage ToProperty applyto"propertydamage" includedinthe "products-completed operationshazard"."Property damage" to: l.Damage ToYour Product(1)Propertyyouown,rentoroccupy, includinganycostsorexpenses "Propertydamage"to"yourproduct" incurredbyyou,oranyotherperson, arisingoutofit orany part of it.organizationorentity,forrepair, m.Damage ToYour Workreplacement, enhancement, "Propertydamage"to"yourwork"arising restorationormaintenanceofsuch out of it or any part ofit andincluded in the propertyforanyreason,including "products-completed operationshazard".preventionofinjurytoapersonor damage to another's property; Thisexclusiondoesnotapplyifthedamagedworkortheworkoutofwhich (2)Premisesyousell,giveawayor thedamageariseswasperformedonyour abandon,ifthe"propertydamage"arises behalfby asubcontractor.outofanypartofthosepremises; n.DamageToImpairedPropertyOr (3)Property loaned to you; PropertyNotPhysically Injured(4)Personalpropertyinthecare,custody "Propertydamage"to"impairedproperty" orcontrol of the insured; orpropertythathasnotbeenphysically (5)Thatparticularpartofrealpropertyon injured, arisingoutof:whichyouoranycontractorsor (1)Adefect,deficiency,inadequacyor subcontractorsworkingdirectlyor dangerousconditionin"yourproduct" indirectlyonyourbehalfareperforming or"your work"; oroperations,ifthe"propertydamage" (2)arisesoutofthoseoperations;or Adelayorfailurebyyouoranyone actingonyourbehalftoperforma (6)Thatparticularpartofanyproperty contractoragreementinaccordance thatmustberestored,repairedor withits terms.replacedbecause"yourwork"wasincorrectly performedon it. Thisexclusiondoesnotapplytotheloss ofuseofotherpropertyarisingoutof suddenandaccidentalphysicalinjuryto "yourproduct"or"yourwork"afterithas beenputtoits intendeduse.
FormSS 0008 0405 Page 7of24
DocuSign Envelope ID: D7C5C45C-B994-4AAE-90ED-435965BDA727 BUSINESS LIABILITYCOVERAGE FORMo.RecallOfProducts,WorkOrImpaired (c)Titleofany literary orartistic work;Property (8)Arising out of anoffense committed by Damagesclaimedforanyloss,costor aninsuredwhose business is:(a)expenseincurredbyyouorothersforthe Advertising,broadcasting, lossofuse,withdrawal,recall,inspection, publishing ortelecasting;repair,replacement,adjustment,removal (b)Designingordeterminingcontent ordisposal of: of websites for others;or(1)"Yourproduct"; (c)AnInternetsearch,access, (2)"Yourwork";or contentor service provider.(3)"Impaired property"; However,thisexclusiondoesnot ifsuchproduct,workorpropertyis a.b. c.applytoParagraphs, andwithdrawnorrecalledfromthemarketor underthedefinitionof"personaland fromusebyanypersonororganization G.advertisinginjury"inSection–becauseofaknownorsuspecteddefect, LiabilityAndMedicalExpenses deficiency,inadequacyordangerous Definitions.condition in it. Forthepurposesofthisexclusion, p.Personal AndAdvertisingInjury placingan"advertisement"foror linkingtoothersonyourwebsite,by "Personal andadvertisinginjury": itself,isnotconsideredthebusiness(1)Arising out of oral, written or electronic ofadvertising,broadcasting, publicationofmaterial,ifdonebyorat publishing ortelecasting;thedirectionoftheinsuredwith (9)Arisingoutofanelectronicchatroom knowledge of itsfalsity; orbulletinboardtheinsuredhosts, (2)Arising out of oral, written or electronic owns,oroverwhichtheinsured publicationofmaterialwhosefirst exercises control;publicationtookplacebeforethe (10)Arisingoutoftheunauthorizeduseofbeginningofthepolicy period; another's name or product in youre-mail(3)Arisingoutofacriminalactcommitted address,domainnameormetatags,orbyor at the direction of the insured; anyothersimilartacticstomislead(4)Arisingoutofanybreachofcontract, another'spotentialcustomers;exceptanimpliedcontracttouse (11)Arisingoutoftheviolationofa another’s"advertisingidea"inyour person'srightofprivacycreatedby "advertisement"; anystate orfederal act.(5)Arisingoutofthefailureofgoods, However,thisexclusiondoesnot productsorservicestoconformwith applytoliabilityfordamagesthatthe anystatementofqualityor insuredwouldhaveintheabsenceof performancemadeinyour suchstate orfederal act;"advertisement"; (12)Arisingoutof:(6)Arisingoutofthewrongdescriptionof (a)An"advertisement"forotherson thepriceofgoods,productsorservices; yourweb site;(7)Arisingoutofanyviolationofany (b)Placingalinktoawebsiteof intellectualpropertyrightssuchas others onyour website;copyright,patent,trademark,trade name,tradesecret,servicemarkor (c)Contentfromawebsiteofothersotherdesignationoforiginor displayedwithinaframeorborderauthenticity. onyourwebsite.Contentincludesinformation,code,sounds,text,However,thisexclusiondoesnot graphicsorimages;orapplytoinfringement,inyour "advertisement",of (d)Computercode,softwareor programming usedtoenable:(a)Copyright; (i)Yourweb site; or(b)Slogan,unlessthesloganisalso atrademark,tradename,service (ii)The presentation or functionalitymarkorotherdesignationof origin ofan"advertisement"orotherorauthenticity; or contentonyourwebsite;
DocuSign Envelope ID: D7C5C45C-B994-4AAE-90ED-435965BDA727 BUSINESS LIABILITYCOVERAGE FORM(13) (a)Arisingoutofaviolationofanyanti- Maybeawardedorincurredby trustlaw; reasonofanyclaimorsuit alleging actual or threatened injury (14)Arising out of the fluctuation in price or or damage of any nature or kind to valueofanystocks,bondsorother personsorpropertywhichwould securities; or nothaveoccurredinwholeorin (15)Arisingoutofdiscriminationor part but for the "asbestos hazard";humiliationcommittedbyoratthe (b)Ariseoutofanyrequest,demand, directionofany"executiveofficer", orderorstatutoryorregulatory director,stockholder,partneror requirementthatanyinsuredor memberoftheinsured. otherstestfor,monitor,cleanup, q.ElectronicData remove,encapsulate,contain,Damagesarisingoutofthelossof,lossof treat,detoxifyorneutralizeorin useof,damageto,corruptionof,inability anywayrespondtoorassessthe toaccess,orinabilitytomanipulate effects of an"asbestos hazard"; or"electronicdata". (c)Ariseoutofanyclaimorsuitforr.Employment-RelatedPractices damagesbecauseoftestingfor,monitoring,cleaningup,removing,"Bodily injury"or "personal and advertising encapsulating,containing,treating,injury"to: detoxifyingorneutralizingorinany(1)Aperson arisingoutofany: wayrespondingtoorassessingthe(a)Refusaltoemploy thatperson; effectsofan"asbestoshazard".(b)Terminationofthatperson's t.ViolationOfStatutesThatGovernE-employment; or Mails,Fax,PhoneCallsOrOther MethodsOfSendingMaterialOr (c)Employment-related practices, Informationpolicies,actsoromissions,suchascoercion,demotion,evaluation, "Bodilyinjury","propertydamage",or reassignment, discipline, "personalandadvertisinginjury"arising defamation,harassment,humiliation directlyorindirectlyoutofanyactionor ordiscriminationdirectedatthat omissionthatviolatesorisallegedto person;or violate:(2)Thespouse,child,parent,brotheror (1)TheTelephoneConsumerProtection sisterofthatpersonasa Act(TCPA),including anyamendment consequenceof"bodilyinjury"or of oradditiontosuch law;"personaland advertising injury" to the (2)TheCAN-SPAM Act of 2003, including personatwhomanyofthe anyamendmentoforadditiontosuch employment-relatedpractices law;or(a)(b)(c)described in Paragraphs, ,or (3)Anystatute,ordinanceorregulation,aboveisdirected. otherthantheTCPAorCAN-SPAMActThisexclusion applies: of2003,thatprohibitsorlimitsthe(1)Whethertheinsuredmaybeliableas sending,transmitting,communicatingoranemployerorinanyothercapacity; distributionofmaterialorinformation.and DamageToPremisesRentedToYou–(2)Toanyobligationtosharedamages ExceptionForDamageByFire,Lightning withorrepaysomeoneelsewhomust or Explosionpaydamagesbecause of the injury. c. h.k. o.Exclusionsthroughandthroughdos.Asbestos notapplytodamagebyfire,lightningor explosiontopremisesrentedtoyouor (1)"Bodilyinjury","propertydamage"or temporarilyoccupiedby youwith permission of "personalandadvertisinginjury"theowner.AseparateLimitofInsurance arisingoutofthe"asbestoshazard".appliestothiscoverageasdescribedin (2)Anydamages,judgments,settlements, D.Section-LiabilityAndMedicalExpensesloss,costsorexpensesthat: LimitsOf Insurance.
FormSS 0008 0405 Page 9of24
DocuSign Envelope ID: D7C5C45C-B994-4AAE-90ED-435965BDA727 BUSINESS LIABILITYCOVERAGE FORM2.ApplicableTo MedicalExpenses Coveragee.Atrust,youareaninsured.Yourtrustees arealsoinsureds,butonlywithrespectto We will not payexpenses for "bodilyinjury": theirduties astrustees.a.Any Insured 2.Eachofthefollowing is also aninsured:Toanyinsured,except"volunteerworkers". a.Employees AndVolunteer Workersb.HiredPerson Your"volunteerworkers"onlywhileTo a person hired to do work foror onbehalf performingdutiesrelatedtotheconductof ofanyinsuredoratenantofanyinsured. yourbusiness,oryour"employees",other c.InjuryOn Normally Occupied Premises thaneitheryour"executiveofficers"(ifyou Toapersoninjuredonthatpartof areanorganizationotherthana premisesyouownorrentthattheperson partnership,jointventureorlimitedliability normally occupies. company)oryourmanagers(ifyouarea limitedliabilitycompany),butonlyforacts d.Workers'CompensationAndSimilar withinthescopeoftheiremploymentby Laws youorwhileperformingdutiesrelatedto Toaperson,whetherornotan the conduct of yourbusiness."employee"ofanyinsured,ifbenefitsfor However,noneofthese"employees"or the"bodilyinjury"arepayableormustbe "volunteerworkers" areinsuredsfor:providedunderaworkers'compensation ordisability benefits law ora similarlaw. (1)"Bodilyinjury"or"personaland advertising injury":e.Athletics Activities (a)Toyou,toyourpartnersor Toapersoninjuredwhilepracticing, members(ifyouareapartnership instructingorparticipatinginanyphysical orjointventure),toyourmembers exercisesorgames,sportsorathletic (ifyouarealimitedliability contests. company),ortoaco-"employee"f.Products-CompletedOperationsHazard whileinthecourseofhisorher Includedwiththe"products-completed employmentorperformingdutiesoperationshazard". relatedtotheconductofyour business,ortoyourother g.Business LiabilityExclusions "volunteerworkers" while ExcludedunderBusinessLiabilityCoverage. performingdutiesrelatedtothe C.WHO IS AN INSURED conduct of yourbusiness;1.Ifyou aredesignated in the Declarations as: (b)Tothespouse,child,parent, brotherorsisterofthatco-a.Anindividual,youandyourspouseare "employee"orthat"volunteer insureds,butonlywithrespecttothe worker"asaconsequenceof conduct of a business of which youare the (1)(a)Paragraphabove;sole owner. (c)Forwhichthereisanyobligation b.Apartnershiporjointventure,youarean tosharedamageswithorrepay insured.Yourmembers,yourpartners,and someoneelsewhomustpay theirspousesarealsoinsureds,butonlywith damagesbecauseoftheinjury respecttotheconductofyourbusiness. (1)(a)describedinParagraphsorc.Alimitedliabilitycompany,youarean (b) above; orinsured.Yourmembersarealsoinsureds, (d)Arisingoutofhisorherproviding butonlywithrespecttotheconductofyour orfailingtoprovideprofessional business.Yourmanagersareinsureds,but healthcare services.onlywithrespecttotheirdutiesasyourmanagers. Ifyouarenotinthebusinessofprovidingprofessionalhealthcared.Anorganizationotherthanapartnership, (d)services,Paragraphdoesnotapplyjointventureorlimitedliabilitycompany,you toanynurse,emergencymedicalareaninsured.Your"executiveofficers"and technicianorparamedicemployedbydirectorsareinsureds,butonlywithrespect youtoprovidesuchservices.totheirdutiesasyourofficersordirectors.Yourstockholdersarealsoinsureds,butonly (2)"Property damage" to property:withrespecttotheirliabilityasstockholders. (a)Owned,occupiedor usedby,
DocuSign Envelope ID: D7C5C45C-B994-4AAE-90ED-435965BDA727 BUSINESS LIABILITYCOVERAGE FORM(b) b.Rentedto,inthecare,custodyor Coverageunderthisprovisiondoesnot controlof,oroverwhichphysical apply to:controlisbeingexercisedforany (1)"Bodilyinjury"or"propertydamage" purposebyyou,anyofyour thatoccurred;or"employees","volunteerworkers", (2)"Personalandadvertisinginjury" anypartnerormember(ifyouare arisingoutofan offensecommittedapartnershiporjointventure),or beforeyouacquiredorformedthe anymember(ifyouarealimited organization.liabilitycompany). 4.Operator Of Mobile Equipmentb.Real EstateManager Withrespectto"mobileequipment"registeredinAny person (other than your "employee"or yournameunderanymotorvehicleregistration"volunteerworker"),oranyorganization law,anypersonisaninsuredwhiledrivingsuchwhileacting asyour real estatemanager.equipmentalongapublichighwaywithyourc.TemporaryCustodiansOf Your permission.AnyotherpersonororganizationProperty responsiblefortheconductofsuchpersonisAnypersonororganizationhavingproper alsoaninsured,butonlywithrespecttoliabilitytemporarycustodyofyourpropertyifyou arising out oftheoperation of the equipment,anddie,butonly: onlyifno other insurance of anykindisavailable(1)Withrespecttoliabilityarisingoutofthe tothatpersonororganizationforthisliability.maintenanceoruseofthatproperty;and However, noperson ororganizationisaninsuredwithrespectto:(2)Untilyourlegalrepresentativehas beenappointed. a."Bodilyinjury"toaco-"employee"ofthepersondriving the equipment;ord.Legal Representative If YouDie b."Propertydamage"topropertyownedby, Yourlegalrepresentativeifyoudie,but rentedto,inthechargeoforoccupiedbyonlywithrespecttodutiesassuch.That youortheemployerofanypersonwhois representativewillhaveallyourrightsand aninsuredunder thisprovision.dutiesunder thisinsurance. 5.Operator of NonownedWatercrafte.Unnamed Subsidiary Withrespecttowatercraftyoudonotownthat Anysubsidiaryandsubsidiarythereof,of islessthan51feetlongandisnotbeingused yourswhichisa legally incorporatedentity to carry persons for a charge, any personisan ofwhichyouownafinancialinterestof insuredwhileoperatingsuchwatercraftwith morethan50%ofthevotingstockonthe yourpermission.Anyotherpersonor effectivedateofthis CoveragePart. organizationresponsiblefortheconductof Theinsuranceaffordedhereinforany suchpersonisalsoaninsured,butonlywith subsidiarynotshownintheDeclarations respecttoliabilityarisingoutoftheoperation asanamedinsureddoesnotapplyto ofthewatercraft,andonlyifnootherinjuryordamagewithrespecttowhichan insuranceofanykindisavailabletothat insuredunderthisinsuranceisalsoan personor organization for thisliability.insuredunderanotherpolicyorwouldbe However,nopersonororganizationisan aninsuredundersuchpolicybutforits insured withrespect to:terminationorupontheexhaustionofits limits of insurance. a."Bodilyinjury"toaco-"employee"ofthepersonoperating the watercraft;or3.NewlyAcquired Or Formed Organization b."Propertydamage"topropertyownedby,Anyorganizationyounewlyacquireorform, rentedto,inthechargeoforoccupiedby otherthanapartnership,jointventureor youortheemployerofanypersonwhois limitedliabilitycompany,andoverwhichyou aninsuredunder thisprovision.maintainfinancialinterestof more than 50%of thevotingstock,willqualifyasaNamed 6.AdditionalInsuredsWhenRequiredBy Insuredifthereisnoothersimilarinsurance WrittenContract,WrittenAgreementOr available to thatorganization. However: Permita.Coverageunderthisprovisionisafforded Theperson(s)ororganization(s)identifiedin onlyuntilthe180thdayafteryouacquire a. f.Paragraphsthroughbelowareadditionalorformtheorganizationortheendofthe insuredswhenyouhaveagreed,inawrittenpolicyperiod, whichever is earlier; andFormSS 0008 0405 Page 11of24 DocuSign Envelope ID: D7C5C45C-B994-4AAE-90ED-435965BDA727 BUSINESS LIABILITYCOVERAGE FORM (e)contract,writtenagreementorbecauseofa Anyfailuretomakesuch permitissuedbyastateorpolitical inspections,adjustments,testsor subdivision,thatsuchpersonororganization servicingasthevendorhas beaddedasanadditionalinsuredonyour agreedtomakeornormally policy,providedtheinjuryordamageoccurs undertakestomakeintheusual subsequenttotheexecutionofthecontractor courseofbusiness,inconnectionagreement, ortheissuanceofthepermit. withthedistributionorsaleofthe products;Apersonororganizationisanadditional (f)Demonstration,installation, insuredunderthisprovisiononlyforthat servicingorrepairoperations, periodoftimerequiredbythecontract, exceptsuchoperationsperformed agreementor permit. atthevendor'spremisesin However,no suchperson or organization is an connectionwiththesaleofthe additionalinsuredunderthisprovisionifsuch product;personororganizationisincludedasan (g)Productswhich,afterdistribution additionalinsuredbyanendorsementissued orsalebyyou,havebeenlabeled byusandmadeapartofthisCoveragePart, orrelabeledorusedasa includingallpersonsororganizationsadded container,partor ingredient of any asadditionalinsuredsunderthespecific otherthingorsubstancebyorfor additionalinsuredcoveragegrantsinSection the vendor; orF.–Optional AdditionalInsuredCoverages. (h)"Bodilyinjury"or"property a.Vendors damage"arisingoutofthesole Anyperson(s)ororganization(s)(referredto negligenceofthevendorforits belowasvendor),butonlywithrespectto ownactsoromissionsorthoseof"bodilyinjury"or"propertydamage"arising itsemployeesoranyoneelse outof"yourproducts"whicharedistributed acting onits behalf. However, thisorsoldintheregularcourseofthevendor's exclusiondoes not apply to:businessandonlyifthisCoveragePart (i)Theexceptionscontainedin providescoveragefor"bodilyinjury"or (d)(f)Subparagraphsor ;or"propertydamage"includedwithinthe (ii)"products-completedoperationshazard". Suchinspections,adjustments,testsorservicingasthevendor(1)Theinsuranceaffordedtothevendor has agreed to make or normallyissubjecttothefollowingadditional undertakes to make in the usualexclusions: courseof business,inThisinsurancedoes not apply to: connectionwiththedistribution(a)"Bodilyinjury"or"property orsaleoftheproducts.damage"forwhichthevendoris (2)Thisinsurancedoesnotapplytoanyobligatedtopaydamagesby insuredpersonororganizationfromreasonoftheassumptionof whom you have acquired suchproducts,liability in acontract or agreement. oranyingredient,partorcontainer,Thisexclusiondoesnotapplyto enteringinto, accompanyingorliabilityfordamagesthatthe containingsuchproducts.vendorwouldhaveintheabsence b.LessorsOfEquipmentof the contractor agreement; (1)Anypersonororganizationfrom (b)Anyexpress warranty whomyouleaseequipment;butonly unauthorizedby you; withrespecttotheirliabilityfor"bodily (c)Anyphysicalorchemicalchange injury","propertydamage"orintheproductmadeintentionally "personalandadvertisinginjury"bythevendor; caused,inwholeorinpart,byyour (d)Repackaging, except when maintenance,operationoruseof unpackedsolelyforthepurposeof equipmentleasedtoyoubysuch inspection,demonstration,testing, personor organization.orthesubstitutionofpartsunderinstructionsfromthemanufacturer,andthenrepackagedinthe original container;Page 12of24 FormSS 0008 0405 DocuSign Envelope ID: D7C5C45C-B994-4AAE-90ED-435965BDA727 BUSINESS LIABILITYCOVERAGE FORM(2) e.PermitsIssuedByStateOrPolitical Withrespecttotheinsuranceafforded Subdivisionstotheseadditionalinsureds,thisinsurancedoesnotapplytoany (1)Anystateorpoliticalsubdivision,but "occurrence"whichtakesplaceafter onlywithrespecttooperationsyoucease to lease thatequipment. performed byyou oron yourbehalf for c.LessorsOfLandOrPremises whichthestateorpoliticalsubdivision hasissueda permit.(1)Anypersonororganizationfrom (2)whomyouleaselandorpremises,but Withrespecttotheinsuranceafforded onlywithrespecttoliabilityarisingout totheseadditionalinsureds,this oftheownership,maintenanceoruse insurance doesnotapplyto:ofthatpartofthelandorpremises (a)"Bodilyinjury","propertydamage" leased to you. or"personalandadvertising (2)Withrespecttotheinsuranceafforded injury"arisingoutofoperations totheseadditionalinsureds,this performedforthestateor insurance doesnotapplyto: municipality; or(a) (b)Any"occurrence"whichtakes "Bodilyinjury"or"propertydamage"placeafter youcease to lease that includedwithinthe"products-landorbeatenantinthat completedoperationshazard".premises; or f.Any OtherParty(b)Structuralalterations, new (1)Anyotherpersonororganizationwho constructionordemolition a.isnotaninsuredunderParagraphsoperationsperformedbyoron ethrough.above,butonlywithbehalfofsuchpersonor respecttoliabilityfor"bodilyinjury", organization. "propertydamage"or"personaland d.Architects, EngineersOrSurveyors advertisinginjury"caused,inwholeor inpart,byyouractsoromissionsor(1)Anyarchitect,engineer,orsurveyor,but theactsoromissionsofthoseacting onlywithrespecttoliabilityfor"bodily onyour behalf:injury","propertydamage"or"personal (a)andadvertisinginjury"caused,inwhole Intheperformanceofyour orinpart,byyouractsoromissionsor ongoing operations;theactsoromissionsofthoseactingon (b)Inconnectionwithyourpremises yourbehalf: ownedby orrentedtoyou;or(a)Inconnectionwithyourpremises; (c)In connection with "your work" and or includedwithinthe"products-(b)Intheperformanceofyour completedoperationshazard",butongoingoperationsperformedby only ifyouor onyour behalf. (i)Thewrittencontractorwritten (2)Withrespecttotheinsuranceafforded agreementrequiresyouto totheseadditionalinsureds,the providesuchcoverageto followingadditional exclusionapplies: suchadditional insured;and(ii)Thisinsurancedoesnotapplyto ThisCoveragePartprovides "bodilyinjury","propertydamage"or coveragefor"bodilyinjury"or "personalandadvertisinginjury" "propertydamage"included arisingoutoftherenderingoforthe within the"products-failuretorenderanyprofessional completed operationshazard".services byor for you, including: (2)Withrespecttotheinsuranceafforded (a)Thepreparing,approving,or totheseadditionalinsureds,this failuretoprepareorapprove, insurance doesnotapplyto:maps,shopdrawings,opinions, "Bodilyinjury","propertydamage"or reports,surveys,fieldorders, "personalandadvertisinginjury" changeorders, designsor arisingoutoftherenderingof,orthe drawings andspecifications; or failuretorender,anyprofessional(b)Supervisory,inspection, architectural,engineeringorsurveying architecturalorengineering services,including:activities.FormSS 0008 0405 Page 13of24 DocuSign Envelope ID: D7C5C45C-B994-4AAE-90ED-435965BDA727 BUSINESS LIABILITYCOVERAGE FORM(a)Thepreparing,approving,or ThisGeneralAggregatelimitdoesnot failuretoprepareorapprove, applyto"propertydamage"topremises maps,shopdrawings,opinions, whilerentedtoyouortemporarily reports,surveys,fieldorders, occupiedbyyouwithpermissionofthe changeorders, designsor owner,arisingoutoffire,lightningordrawings andspecifications; or explosion.(b) 3.Each Occurrence LimitSupervisory,inspection, architecturalorengineering 2.a.2.bSubjectto orabove,whicheveractivities. applies,themostwewillpayforthesumofall Thelimitsofinsurancethatapplytoadditional damagesbecauseofall"bodilyinjury", D.insuredsaredescribedinSection–Limits "propertydamage"andmedicalexpenses OfInsurance. arisingoutofanyone"occurrence"istheLiabilityandMedicalExpensesLimitshownin Howthisinsuranceapplieswhenother the Declarations.insuranceisavailabletoanadditionalinsuredisdescribedintheOtherInsuranceCondition Themostwewillpayforallmedicalexpenses E.inSection– Liability AndMedicalExpenses becauseof"bodilyinjury"sustainedbyany GeneralConditions. onepersonistheMedicalExpensesLimit shownintheDeclarations.Nopersonororganizationisaninsuredwith 4.Personal AndAdvertisingInjury Limitrespecttotheconductofanycurrentorpast partnership,jointventureorlimitedliability 2.b.Subjecttoabove,themostwewillpayfor companythatisnotshownasaNamedInsuredin thesumofalldamagesbecauseofall the Declarations. "personalandadvertisinginjury"sustainedby any one person or organization is the Personal D.LIABILITYANDMEDICALEXPENSES andAdvertisingInjuryLimitshowninthe LIMITS OF INSURANCE Declarations.1.TheMost We WillPay 5.Damage ToPremisesRented ToYou LimitTheLimitsofInsuranceshowninthe TheDamageToPremisesRentedToYou Declarationsandtherulesbelowfixthemost LimitisthemostwewillpayunderBusiness wewillpay regardless of the number of: LiabilityCoveragefordamagesbecauseof a.Insureds; "propertydamage"toanyonepremises,while b.Claims made or"suits" brought;or rented to you, or in the case of damage byfire,lightningorexplosion,whilerentedtoyouor c.Persons or organizations making claims or temporarilyoccupiedby youwith permission of bringing"suits". the owner. 2.Aggregate Limits Inthecaseofdamagebyfire,lightningor The mostwe will payfor: explosion, the Damage toPremises Rented To a.Damagesbecauseof"bodilyinjury"and YouLimitappliestoalldamageproximately "propertydamage"includedinthe causedbythesameevent,whethersuch"products-completedoperationshazard"is damage results fromfire,lightning orexplosiontheProducts-CompletedOperations orany combinationofthese.AggregateLimit showninthe 6.HowLimitsApplyTo Additional InsuredsDeclarations. Themostwewillpayonbehalfofapersonor b.Damagesbecauseofallother"bodily organizationwhoisanadditionalinsured injury","propertydamage"or"personal underthis CoveragePart is the lesser of:andadvertisinginjury",includingmedical a.Thelimitsofinsurancespecifiedina expenses,istheGeneralAggregateLimit writtencontract,writtenagreementor shownintheDeclarations. permitissuedbyastateorpolitical ThisGeneralAggregateLimitapplies subdivision;orseparatelytoeachofyour"locations" b.TheLimitsofInsuranceshowninthe ownedby orrentedtoyou. Declarations."Location"meanspremisesinvolvingthe Suchamountshallbeapartofandnotin sameorconnectinglots,orpremises additiontotheLimitsofInsuranceshownin whoseconnectionisinterruptedonlybya the Declarations anddescribedinthis Section.street,roadwayorright-of-wayofa railroad.Page 14of24 FormSS 0008 0405 DocuSign Envelope ID: D7C5C45C-B994-4AAE-90ED-435965BDA727 BUSINESS LIABILITYCOVERAGE FORM(1)Ifmorethanonelimitofinsuranceunderthis Immediatelysenduscopiesofany policyandanyendorsementsattachedthereto demands,notices,summonsesor appliestoanyclaimor"suit",themostwewillpay legalpapersreceivedinconnection underthispolicyandtheendorsementsisthe withtheclaimor "suit";singlehighestlimitofliabilityofallcoverages (2)Authorizeustoobtainrecordsand applicabletosuchclaimor"suit".However,this other information;paragraph does not apply to theMedicalExpenses (3)Cooperatewithusintheinvestigation, 3.limit set forthinParagraph above. settlementoftheclaimordefense TheLimitsofInsuranceofthisCoveragePartapply againstthe"suit";andseparatelytoeachconsecutiveannualperiodandto (4)Assistus,uponourrequest,inthe any remaining period of less than 12 months, starting enforcementofanyrightagainstany withthebeginningofthepolicyperiodshowninthe personororganizationthatmaybe Declarations,unlessthepolicyperiodisextended liabletotheinsuredbecauseofinjury after issuance for anadditional periodoflessthan12 ordamagetowhichthisinsurance months.Inthatcase,theadditionalperiodwillbe may also apply.deemedpartofthelastprecedingperiodforpurposes d.ObligationsAt TheInsured's Own CostofdeterminingtheLimitsofInsurance. Noinsuredwill,exceptatthatinsured'sownE.LIABILITYANDMEDICALEXPENSES cost,voluntarilymakeapayment,assumeGENERAL CONDITIONS anyobligation,orincuranyexpense,otherthanforfirstaid,withoutourconsent.1.Bankruptcy e.Additional Insured'sOther InsuranceBankruptcyorinsolvencyoftheinsuredoroftheinsured'sestatewillnotrelieveusofour Ifwecoveraclaimor"suit"underthis obligationsunder thisCoverage Part. CoveragePartthatmayalsobecovered byotherinsuranceavailabletoan 2.DutiesInTheEventOfOccurrence, additionalinsured,suchadditionalinsured Offense, ClaimOrSuit mustsubmitsuchclaimor"suit"tothe a.NoticeOfOccurrenceOrOffense other insurerfordefenseand indemnity.Youoranyadditionalinsuredmustseeto However,thisprovisiondoesnotapplyto itthatwearenotifiedassoonas theextentthatyouhaveagreedina practicableofan"occurrence"oran writtencontract,writtenagreementor offensewhichmayresultinaclaim.To permitthatthisinsuranceisprimaryand the extentpossible,notice should include:non-contributorywiththeadditional (1)How,whenandwherethe"occurrence" insured's owninsurance.oroffensetookplace; f.KnowledgeOfAnOccurrence,Offense,(2)Thenamesandaddressesofany ClaimOrSuitinjuredpersons andwitnesses;and a.b.Paragraphsandapplytoyouorto(3)Thenatureandlocationofanyinjury anyadditionalinsuredonlywhensuch ordamagearisingoutofthe "occurrence",offense,claimor"suit"is "occurrence"or offense. knownto:b.NoticeOfClaim (1)Youoranyadditionalinsuredthatis anindividual;Ifaclaimismadeor"suit"isbrought againstanyinsured,youoranyadditional (2)Anypartner,ifyouoranadditional insured must: insured is apartnership;(1)Immediately record the specifics of the (3)Anymanager,ifyouoranadditional claimor"suit"andthedatereceived; insured is alimitedliability company;and (4)Any"executiveofficer"orinsurance (2)Notify usas soonas practicable. manager,ifyouoranadditional insured is acorporation;Youoranyadditionalinsuredmustseeto itthatwereceiveawrittennoticeofthe (5)Anytrustee,ifyouoranadditional claim or"suit" assoon aspracticable. insured is atrust;orc.AssistanceAndCooperationOfThe (6)Any electedor appointedofficial, ifyou Insured oranadditionalinsuredisapolitical subdivision orpublic entity.Youand anyotherinvolved insured must:
FormSS 0008 0405 Page 15of24
DocuSign Envelope ID: D7C5C45C-B994-4AAE-90ED-435965BDA727 BUSINESS LIABILITYCOVERAGE FORMf. (3)ThisParagraphappliesseparatelyto Wehaveissuedthispolicyinreliance youand anyadditional insured. uponyour representations.3.FinancialResponsibility Laws b.UnintentionalFailureToDisclose Hazardsa.Whenthispolicyiscertifiedasproofof financialresponsibilityforthefutureunder If unintentionally youshouldfailtodisclose theprovisionsofanymotorvehicle allhazardsrelatingtotheconductofyour financialresponsibilitylaw,theinsurance businessattheinceptiondateofthis providedbythepolicyfor"bodilyinjury" CoveragePart,weshallnotdenyany liabilityand"propertydamage"liabilitywill coverageunderthisCoveragePart complywiththeprovisionsofthelawto becauseofsuch failure.theextentofthecoverageandlimitsof 7.OtherInsuranceinsurance required bythat law. Ifothervalidandcollectibleinsuranceis b.Withrespectto"mobileequipment"to availableforalosswecoverunderthis whichthisinsuranceapplies,wewill CoveragePart,ourobligationsarelimitedas provideanyliability,uninsuredmotorists, follows:underinsuredmotorists,no-faultorothera.Primary Insurancecoveragerequiredbyanymotorvehicle b.law.Wewillprovidetherequiredlimitsfor Thisinsuranceisprimaryexceptwhenthose coverages. belowapplies.Ifotherinsuranceisalso primary,wewillsharewithallthatother 4.Legal Action Against Us c.insurancebythemethoddescribedinNopersonororganizationhasarightunder below.thisCoverage Form: b.ExcessInsurancea.Tojoinusasapartyorotherwisebringus Thisinsuranceisexcessoveranyofthe intoa"suit"askingfordamagesfroman otherinsurance,whetherprimary,excess, insured;or contingent oron anyotherbasis:b.TosueusonthisCoverageFormunless (1)YourWorkallofitstermshavebeenfullycomplied with. ThatisFire,ExtendedCoverage, Builder'sRisk,InstallationRiskor Apersonororganizationmaysueustorecover similarcoverage for "yourwork";onanagreedsettlementoronafinaljudgmentagainstaninsured;butwewillnotbeliablefor (2)Premises RentedTo Youdamagesthat are not payable under the terms of Thatisfire,lightningorexplosion thisinsuranceorthatareinexcessofthe insuranceforpremisesrentedtoyou applicablelimitofinsurance. Anagreed ortemporarilyoccupiedbyyouwith settlementmeansasettlementandreleaseof permission of the owner;liabilitysignedbyus,theinsuredandthe (3)Tenant Liabilityclaimantortheclaimant'slegalrepresentative. Thatisinsurancepurchasedbyyouto 5.SeparationOfInsureds coveryourliabilityasatenantfor ExceptwithrespecttotheLimitsofInsurance, "propertydamage"topremisesrented andanyrightsordutiesspecificallyassigned toyouortemporarilyoccupiedbyyou inthispolicytothefirstNamedInsured,this withpermissionoftheowner;insurance applies: (4)Aircraft,Auto Or Watercrafta.AsifeachNamedInsuredweretheonly IfthelossarisesoutofthemaintenanceNamed Insured;and or useofaircraft, "autos" or watercraft tob.Separatelytoeachinsuredagainstwhom g.theextentnotsubjecttoExclusionofaclaimismadeor "suit"isbrought. A.Section–Coverages.6.Representations (5)PropertyDamageToBorrowed a.When YouAcceptThisPolicy Equipment Or UseOfElevatorsByaccepting thispolicy,you agree:Ifthelossarisesoutof"property damage"toborrowedequipmentor (1)ThestatementsintheDeclarations theuseofelevatorstotheextentnot areaccurateand complete; k. A.subjecttoExclusionofSection–(2)Thosestatementsarebasedupon Coverages.representationsyou made to us; and
DocuSign Envelope ID: D7C5C45C-B994-4AAE-90ED-435965BDA727 BUSINESS LIABILITYCOVERAGE FORM(6)WhenYouAreAddedAsAn Whenthisinsuranceisexcessoverother AdditionalInsuredToOther insurance,wewillpayonlyourshareof Insurance theamountoftheloss,ifany,that exceedsthesumof:Thatisotherinsuranceavailableto (1)youcoveringliabilityfordamages Thetotalamountthatallsuchother arisingoutofthepremisesor insurancewouldpay for the loss in the operations,or products andcompleted absenceofthis insurance;andoperations,forwhichyouhavebeen (2)Thetotalofalldeductibleandself-addedasanadditionalinsuredbythat insuredamountsunderallthatother insurance;or insurance.(7)WhenYouAddOthersAsAn Wewillshare the remaining loss,if any, withAdditionalInsuredToThis anyotherinsurancethatisnotdescribedinInsurance this ExcessInsuranceprovision andwas notThatisotherinsuranceavailabletoan boughtspecificallytoapplyinexcessoftheadditionalinsured. LimitsofInsuranceshownintheDeclarationsofthisCoveragePart.However,thefollowingprovisions c.MethodOfSharingapplytootherinsuranceavailableto anypersonororganizationwhoisan Ifalltheotherinsurancepermits additional insured under thisCoverage contribution by equal shares, we will follow Part: thismethodalso.Underthisapproach, (a)PrimaryInsuranceWhen eachinsurercontributesequalamounts RequiredBy Contract untilithaspaiditsapplicablelimitof insuranceornoneofthelossremains, Thisinsuranceisprimaryifyou whichevercomesfirst.haveagreedinawrittencontract, writtenagreementorpermitthat Ifanyoftheotherinsurancedoesnotpermitthisinsurancebeprimary.Ifother contributionbyequalshares,wewillinsuranceisalsoprimary,wewill contributebylimits.Underthismethod,eachsharewithallthatotherinsurance insurer’sshareisbasedontheratioofitsc.bythemethoddescribedin applicablelimitofinsurancetothetotalbelow. applicablelimitsofinsuranceofallinsurers.(b)PrimaryAndNon-Contributory8.TransferOfRightsOfRecoveryAgainst ToOtherInsuranceWhen OthersTo UsRequiredBy Contract a.TransferOfRightsOfRecoveryIfyouhaveagreedinawritten Iftheinsuredhasrightstorecoverallor contract,writtenagreementor partofanypayment,including permitthatthisinsuranceis SupplementaryPayments,wehavemade primaryandnon-contributorywith underthisCoveragePart,thoserightsaretheadditionalinsured'sown transferredtous.Theinsuredmustdo insurance,thisinsuranceis nothingafterlosstoimpairthem.Atour primaryandwewillnotseek request,theinsuredwillbring"suit"or contributionfromthatother transferthoserightstousandhelpus insurance. enforcethem.Thisconditiondoesnot (a)(b)Paragraphs and donot apply to apply to Medical ExpensesCoverage.other insurance to which the additional b.WaiverOfRightsOfRecovery(Waiver insuredhasbeenaddedasan Of Subrogation)additionalinsured. Iftheinsuredhaswaivedanyrightsof Whenthisinsuranceisexcess,wewill recoveryagainst anypersonor havenodutyunderthisCoveragePartto organizationforallorpartof anypayment, defend the insured against any "suit" ifany includingSupplementaryPayments,we otherinsurerhasadutytodefendthe havemadeunderthisCoveragePart,we insuredagainstthat"suit".Ifnoother alsowaivethatright,providedtheinsured insurerdefends,wewillundertaketodo waivedtheirrightsofrecoveryagainstso,butwewillbeentitledtotheinsured's suchpersonororganizationinacontract, rightsagainst allthoseotherinsurers. agreementorpermitthatwasexecuted prior to the injuryor damage.FormSS 0008 0405 Page 17of24 DocuSign Envelope ID: D7C5C45C-B994-4AAE-90ED-435965BDA727 BUSINESS LIABILITYCOVERAGE FORM 3.Additional Insured-GrantorOfFranchiseF.OPTIONALADDITIONALINSURED C.WHOISANINSUREDunderSectionisCOVERAGES amendedtoincludeasanadditionalinsured If listed or shown as applicable in the Declarations, theperson(s)ororganization(s)showninthe oneormoreofthefollowingOptionalAdditional DeclarationsasanAdditionalInsured-InsuredCoverages also apply. When any of these GrantorOfFranchise,butonlywithrespectto OptionalAdditionalInsuredCoveragesapply, theirliability asgrantoroffranchise to you.6.Paragraph(AdditionalInsuredsWhenRequired 4.AdditionalInsured-LessorOfLeasedbyWrittenContract,WrittenAgreementorPermit) EquipmentC.ofSection,WhoIsAnInsured,doesnotapply tothepersonororganizationshowninthe a. C.WHO IS AN INSURED under Section isDeclarations.Thesecoveragesaresubjecttothe amendedtoincludeasanadditional termsandconditionsapplicabletoBusiness insuredtheperson(s)ororganization(s) LiabilityCoverageinthispolicy,exceptas shown in the Declarations as an Additional provided below: Insured–LessorofLeasedEquipment, butonlywithrespecttoliabilityfor"bodily 1.AdditionalInsured-DesignatedPersonOr injury","propertydamage"or"personal Organization andadvertisinginjury"caused,inwholeor C.WHOISANINSUREDunderSectionis inpart,byyourmaintenance,operationoramendedtoincludeasanadditionalinsured useofequipmentleasedtoyoubysuch theperson(s)ororganization(s)showninthe person(s)or organization(s).Declarations,butonlywithrespecttoliability b.Withrespecttotheinsuranceaffordedto for"bodilyinjury","propertydamage"or theseadditionalinsureds,thisinsurance "personalandadvertisinginjury"caused,in doesnotapplytoany"occurrence"which wholeorinpart,byyouractsoromissionsor takesplaceafteryouceasetoleasethat theactsoromissionsofthoseactingonyour equipment.behalf: 5.AdditionalInsured-OwnersOrOther a.Intheperformanceofyourongoing InterestsFromWhomLandHasBeen operations; or Leasedb.Inconnectionwithyourpremisesowned a. C. WHO IS AN INSURED under Section is byor rented to you. amendedtoincludeasanadditional 2.AdditionalInsured-ManagersOrLessorsinsuredtheperson(s)ororganization(s) Of Premises shown in the Declarations as an Additional a. C.WHOISANINSUREDunderSectionis Insured– Owners Or OtherInterestsFromamendedtoincludeasanadditionalinsured WhomLandHasBeenLeased,butonly the person(s) or organization(s)shown in the withrespecttoliabilityarisingoutofthe DeclarationsasanAdditionalInsured- ownership, maintenance or useofthat part DesignatedPersonOrOrganization;butonly ofthelandleased to youand showninthe withrespecttoliabilityarisingoutofthe Declarations.ownership,maintenanceoruseofthatpartof b.Withrespecttotheinsuranceaffordedto the premises leasedtoyou andshown in the theseadditionalinsureds,thefollowing Declarations. additionalexclusions apply:b.Withrespecttotheinsuranceaffordedto Thisinsurancedoes not apply to:theseadditionalinsureds,thefollowing (1)Any"occurrence"thattakesplace additionalexclusions apply: afteryou ceasetoleasethat land;orThisinsurancedoes not apply to: (2)Structuralalterations, new (1)Any"occurrence"whichtakesplace constructionordemolitionoperations afteryouceasetobeatenantinthat performedbyoronbehalfofsuch premises; or personor organization.(2)Structuralalterations, new 6.AdditionalInsured-StateOrPoliticalconstructionordemolitionoperations Subdivision–Permitsperformedbyoronbehalfofsuch a. C.WHO IS AN INSURED under Section ispersonor organization. amendedtoincludeasanadditional insuredthestateorpoliticalsubdivision shown in the Declarations as an Additional
DocuSign Envelope ID: D7C5C45C-B994-4AAE-90ED-435965BDA727 BUSINESS LIABILITYCOVERAGE FORM(e)Insured–StateOrPoliticalSubdivision- AnyfailuretomakesuchPermits,butonlywithrespectto inspections,adjustments,testsoroperationsperformedbyyouoronyour servicingasthevendorhasagreedbehalfforwhichthestateorpolitical tomakeornormallyundertakestosubdivision hasissueda permit. makeintheusualcourseofbusiness,inconnectionwiththeb.Withrespecttotheinsuranceaffordedto distributionorsaleoftheproducts;theseadditionalinsureds,thefollowing (f)Demonstration,installation, additionalexclusions apply: servicingorrepairoperations, Thisinsurancedoes not apply to: exceptsuchoperationsperformed (1)"Bodilyinjury","propertydamage"or atthevendor'spremisesin "personalandadvertisinginjury" connectionwiththesaleofthearisingoutofoperationsperformedfor product;the stateor municipality;or (g)Productswhich,afterdistribution (2)"Bodilyinjury"or"propertydamage" orsalebyyou,havebeenlabeled includedinthe"product-completed orrelabeledorusedasa operations"hazard. container,partor ingredient of any 7.Additional Insured–Vendors otherthingorsubstancebyorfor the vendor; ora. C.WHO IS AN INSURED under Section isamendedtoincludeasanadditional (h)"Bodilyinjury"or"property insuredtheperson(s)ororganization(s) damage"arisingoutofthesole(referredtobelowasvendor)shown in the negligenceofthevendorforits DeclarationsasanAdditionalInsured- ownactsoromissionsorthoseof Vendor,butonlywithrespectto"bodily itsemployeesoranyoneelse injury"or"propertydamage"arisingoutof acting onits behalf. However, this"yourproducts"whicharedistributedor exclusiondoes not apply to:soldintheregularcourseofthevendor's (i)Theexceptionscontainedin businessandonlyifthisCoveragePart (d)(f)Subparagraphsor ;orprovidescoveragefor"bodilyinjury"or (ii)Suchinspections, "propertydamage"includedwithinthe adjustments,tests or servicing "products-completed operationshazard". asthevendorhasagreedto b.Theinsuranceaffordedtothevendoris makeornormallyundertakes subjecttothefollowingadditionalexclusions: tomakeintheusualcourseof (1)Thisinsurancedoes not apply to: business,inconnectionwiththedistributionorsaleofthe (a)"Bodilyinjury"or"property products.damage"forwhichthevendoris obligatedtopaydamagesby (2)Thisinsurancedoesnotapplytoany reasonoftheassumptionof insuredpersonororganizationfromliability in acontract or agreement. whomyouhaveacquiredsuch Thisexclusiondoesnotapplyto products,oranyingredient,partor liabilityfordamagesthatthe container,enteringinto, vendorwouldhaveintheabsence accompanyingorcontainingsuch of the contractor agreement; products.(b)Anyexpress warranty 8.Additional Insured–Controlling Interestunauthorizedby you; C.WHOISANINSUREDunderSectionis (c)Anyphysicalorchemicalchange amendedtoincludeasanadditionalinsured intheproductmadeintentionally theperson(s)ororganization(s)showninthe bythevendor; DeclarationsasanAdditionalInsured–ControllingInterest,butonlywithrespectto (d)Repackaging,unlessunpacked theirliability arisingoutof:solelyforthepurposeofinspection,demonstration,testing,orthe a.Theirfinancial controlofyou;or substitutionof partsunder b.Premisestheyown,maintainorcontrol instructionsfromthemanufacturer, whileyou lease oroccupy these premises.andthenrepackagedintheoriginalcontainer; FormSS 0008 0405 Page 19of24
DocuSign Envelope ID: D7C5C45C-B994-4AAE-90ED-435965BDA727 BUSINESS LIABILITYCOVERAGE FORMThisinsurancedoesnotapplytostructural ThelimitsofinsurancethatapplytoadditionalD.alterations,newconstructionanddemolition insuredsaredescribedinSection–LimitsOfoperationsperformedbyorforthatpersonor Insurance.organization. Howthisinsuranceapplieswhenotherinsurance 9.AdditionalInsured–Owners,LesseesOr isavailabletoanadditionalinsuredisdescribedin Contractors–ScheduledPersonOr E.theOtherInsuranceConditioninSection–Organization LiabilityAndMedicalExpensesGeneral Conditions.a. C. WHO IS AN INSURED under Section is amendedtoincludeasanadditional G.LIABILITYANDMEDICALEXPENSES insuredtheperson(s)ororganization(s) DEFINITIONSshown in the Declarations as an Additional 1."Advertisement"meansthewidespreadpublic Insured–Owner,Lessees Or Contractors, disseminationofinformationorimagesthat butonlywithrespecttoliabilityfor"bodily hasthepurposeofinducingthesaleofgoods, injury","propertydamage"or"personal products orservicesthrough:andadvertisinginjury"caused,inwholeor inpart,byyouractsoromissionsorthe a. (1)Radio;actsoromissionsofthoseactingonyour (2)Television;behalf: (3)Billboard;(1)Intheperformanceofyourongoing (4)Magazine;operationsfortheadditional (5)Newspaper;insured(s);or b.TheInternet,butonlythatpartofaweb (2)Inconnectionwith"yourwork" sitethatisaboutgoods,productsor performedforthatadditionalinsured servicesforthepurposesofinducingthe andincludedwithinthe"products- sale of goods, products orservices; orcompletedoperationshazard",but c.Anyotherpublicationthatisgiven onlyifthisCoveragePartprovides widespread publicdistribution.coveragefor"bodilyinjury"or "propertydamage"includedwithinthe However, "advertisement"does not include:"products-completedoperations a.Thedesign,printedmaterial,information hazard". orimagescontainedin,onoruponthe b.Withrespecttotheinsuranceaffordedto packagingorlabelingofanygoodsor theseadditionalinsureds,thisinsurance products;ordoesnotapplyto"bodilyinjury","property b.Aninteractiveconversationbetweenordamage"or"personalanadvertising amongpersonsthroughacomputernetwork.injury"arisingoutoftherenderingof,or 2."Advertisingidea"meansanyideaforan thefailuretorender,anyprofessional "advertisement".architectural,engineeringorsurveying services,including: 3."Asbestoshazard"meansanexposureor threatofexposuretotheactualoralleged(1)Thepreparing,approving,orfailureto propertiesofasbestosandincludesthemere prepareorapprove,maps,shop presenceofasbestosinanyform.drawings,opinions,reports,surveys, fieldorders, change orders, designs or 4."Auto"meansalandmotorvehicle,traileror drawings andspecifications; or semi-trailerdesignedfortravelonpublic roads,includinganyattachedmachineryor (2)Supervisory,inspection,architectural equipment. But"auto"doesnotinclude orengineering activities. "mobile equipment".10.AdditionalInsured–Co-OwnerOfInsured5."Bodilyinjury" means physical:Premises a.Injury;C.WHOISANINSUREDunderSectionis amendedtoincludeasanadditionalinsured b.Sickness; ortheperson(s)orOrganization(s)showninthe c.DiseaseDeclarationsasanAdditionalInsured–Co- sustainedbyapersonand,ifarisingoutofthe OwnerOfInsuredPremises,butonlywith above, mental anguish ordeathatany time.respecttotheirliabilityasco-ownerofthepremisesshown in the Declarations. 6."Coverageterritory"means:
DocuSign Envelope ID: D7C5C45C-B994-4AAE-90ED-435965BDA727 BUSINESS LIABILITYCOVERAGE FORMa. b.The United States of America(includingits Youhavefailedtofulfillthetermsofa territoriesandpossessions),PuertoRico contractor agreement;andCanada; ifsuch property canbe restored to useby:b.Internationalwaters orairspace, but only if a.Therepair,replacement,adjustmentor theinjuryordamageoccursinthecourse removalof"yourproduct"or"yourwork"; oftravelortransportationbetweenany ora.places includedinabove; b.Yourfulfillingthetermsofthecontractor c.Allotherpartsoftheworldiftheinjuryor agreement.damage arises out of: 12."Insured contract"means:(1)Goodsorproductsmadeorsoldbyyou a.Acontractforaleaseofpremises. a.intheterritorydescribedinabove; However,thatportionofthecontractfora (2)Theactivities of a person whose home leaseofpremisesthatindemnifiesany aisintheterritorydescribedin. personororganizationfordamagebyfire, above,butisawayforashorttimeon lightningorexplosiontopremiseswhileyourbusiness; or rentedtoyouortemporarilyoccupiedby (3)"Personalandadvertisinginjury" youwithpermissionoftheowneris offensesthattakeplacethroughthe subjecttotheDamageToPremises Internetorsimilarelectronicmeansof RentedToYoulimitdescribedinSection D.communication –LiabilityandMedicalExpensesLimits of Insurance.providedtheinsured'sresponsibilitytopay b.damagesisdeterminedintheUnitedStatesof Asidetrack agreement;America(includingitsterritoriesand c.Anyeasementorlicenseagreement,possessions),PuertoRicoorCanada,ina includinganeasementorlicense "suit"onthemeritsaccordingtothe agreementinconnectionwithconstruction substantivelawinsuchterritory,orina ordemolitionoperationsonorwithin50settlement weagree to. feetofa railroad;7."Electronicdata"meansinformation,factsor d.Anyobligation,asrequiredbyordinance, programs: toindemnifyamunicipality,exceptin a.Stored asor on; connectionwith workfora municipality;b.Created orused on; or e.Anelevator maintenance agreement; orc.Transmitted to orfrom f.Thatpartofanyothercontractor agreementpertainingtoyourbusiness computersoftware,includingsystemsand (includinganindemnificationofa applicationssoftware,hardorfloppydisks, municipalityinconnectionwithwork CD-ROMS,tapes,drives,cells,data performedforamunicipality)underwhichprocessingdevicesoranyothermediawhich youassumethetortliabilityofanother areusedwithelectronicallycontrolled partytopayfor"bodilyinjury"or"property equipment. damage"toathirdpersonororganization, 8."Employee"includesa"leasedworker". providedthe"bodilyinjury"or"property "Employee"doesnotincludea"temporary damage"iscaused,inwholeorinpart,by worker". youorbythoseactingonyourbehalf. 9."Executiveofficer"meansapersonholding Tortliabilitymeansaliabilitythatwould be anyoftheofficerpositionscreatedbyyour imposedbylawintheabsenceofany charter,constitution,by-lawsoranyother contractor agreement.similargoverningdocument. f.Paragraphincludesthatpartofany10."Hostilefire"meansonewhichbecomes contractoragreementthatindemnifiesa uncontrollableorbreaksoutfromwhereitwas railroadfor"bodilyinjury"or"propertyintendedtobe. damage"arisingoutofconstructionordemolitionoperationswithin50feetofany 11."Impairedproperty"meanstangibleproperty, railroadpropertyandaffectingany railroad otherthan"yourproduct"or"yourwork",that bridgeortrestle,tracks,road-beds,tunnel, cannot beused orislessuseful because: underpassor crossing.a.Itincorporates"yourproduct"or"yourwork" f.However,Paragraphdoesnotinclude thatisknownorthoughttobedefective, thatpartofany contractor agreement:deficient,inadequateordangerous;or FormSS 0008 0405 Page 21of24
DocuSign Envelope ID: D7C5C45C-B994-4AAE-90ED-435965BDA727 BUSINESS LIABILITYCOVERAGE FORM(1) (1)Thatindemnifiesanarchitect, Powercranes,shovels,loaders, engineerorsurveyorforinjuryor diggers ordrills; ordamage arisingoutof: (2)Roadconstructionorresurfacing (a)Preparing,approvingorfailingto equipmentsuchasgraders,scrapers prepareorapprovemaps,shop orrollers;drawings, opinions, reports, e. a.b.c.d.Vehiclesnotdescribedin,,,orsurveys,fieldorders,change abovethatarenotself-propelledandareorders,designsordrawingsand maintainedprimarilytoprovidemobilityto specifications;or permanentlyattachedequipmentofthe (b)Givingdirectionsorinstructions, followingtypes:or failingtogivethem,if that is the (1)Air compressors, pumpsand primarycauseoftheinjuryor generators, includingspraying, damage;or welding,buildingcleaning,(2)Underwhichtheinsured,ifan geophysicalexploration,lightingand architect,engineerorsurveyor, wellservicing equipment;orassumesliabilityforaninjuryor (2)Cherrypickersandsimilardevices damagearisingoutoftheinsured's usedtoraiseor lower workers;renderingorfailuretorender f. a.b.c.d.Vehiclesnotdescribedin,,,orprofessionalservices,includingthose abovemaintainedprimarilyforpurposes (1)listedinaboveandsupervisory, otherthanthetransportationofpersonsorinspection,architecturalor cargo.engineeringactivities. However,self-propelledvehicleswiththe13."Leasedworker"meansapersonleasedto followingtypesofpermanentlyattached youbyalaborleasingfirmunderan equipmentarenot"mobileequipment"but agreementbetweenyouandthelaborleasing will beconsidered"autos":firm, to perform duties related to the conduct of (1)Equipment,ofatleast1,000pounds yourbusiness."Leasedworker"doesnot grossvehicleweight,designedincludea "temporaryworker". primarilyfor:14."Loadingorunloading"meansthehandlingof (a)Snowremoval;property: (b)Roadmaintenance,butnot a.Afteritismovedfromtheplacewhereitis construction orresurfacing;oracceptedformovementintoorontoan aircraft,watercraftor "auto"; (c)Streetcleaning;b.Whileit is in oron anaircraft, watercraft or (2)Cherrypickersandsimilardevices "auto";or mountedonautomobileortruck chassisandusedtoraiseorlower c.Whileitisbeingmovedfromanaircraft, workers; andwatercraftor"auto"totheplacewhere itis finallydelivered; (3)Air compressors, pumpsandgenerators, includingspraying, but"loadingorunloading"doesnotincludethe welding,buildingcleaning, movement of property by means of a mechanical geophysicalexploration,lightingand device,otherthanahandtruck,thatisnot wellservicing equipment.attachedtotheaircraft,watercraftor"auto". 16."Occurrence"meansanaccident,including15."Mobile equipment" means any ofthefollowing continuousorrepeatedexposuretosubstantiallytypesoflandvehicles,includinganyattached thesamegeneralharmfulconditions.machineryor equipment: 17."Personaland advertising injury" means injury, a.Bulldozers,farmmachinery,forkliftsand includingconsequential"bodilyinjury",arising othervehiclesdesignedforuseprincipally out of oneor more of the followingoffenses:offpublic roads; a.Falsearrest, detention orimprisonment;b.Vehiclesmaintainedforusesolelyonor next to premisesyou ownor rent; b.Maliciousprosecution;c.Vehicles thattravel oncrawlertreads;d.Vehicles,whetherself-propelledornot,on which arepermanentlymounted:
DocuSign Envelope ID: D7C5C45C-B994-4AAE-90ED-435965BDA727 BUSINESS LIABILITYCOVERAGE FORMc.Thewrongfulevictionfrom,wrongfulentry Work thatmayneed service,maintenance, into,orinvasionoftherightofprivate correction,repairorreplacement,but occupancyofaroom,dwellingor whichisotherwisecomplete,willbe premisesthatthepersonoccupies, treatedas completed.committedbyoronbehalfofitsowner, The"bodilyinjury"or"propertydamage" landlordor lessor; mustoccurawayfrompremisesyouownd.Oral,writtenorelectronicpublicationof orrent,unlessyourbusinessincludesthe materialthatslandersorlibelsapersonor selling,handlingordistributionof"your organizationordisparagesaperson'sor product"forconsumptiononpremisesyou organization's goods, products orservices; ownor rent.e. b.Oral,writtenorelectronicpublicationof Doesnotinclude"bodilyinjury"or materialthatviolatesaperson'srightof "property damage" arisingoutof:privacy; (1)Thetransportationofproperty,unlessf.Copying,inyour"advertisement",a theinjuryordamagearisesoutofa person’sororganization’s"advertising conditioninoronavehiclenotowned idea" orstyle of "advertisement"; oroperatedbyyou,andthatcondition wascreatedbythe"loadingorg.Infringement of copyright, slogan, or title of unloading"ofthatvehiclebyany anyliteraryorartisticwork,inyour insured;or"advertisement"; or (2)Theexistenceoftools,uninstalled h.Discriminationorhumiliationthatresultsin equipmentorabandonedorunusedinjurytothefeelingsorreputationofa materials.naturalperson. 20."Property damage" means:18."Pollutants"meansanysolid,liquid,gaseousorthermalirritantorcontaminant,includingsmoke, a.Physicalinjurytotangibleproperty, vapor,soot,fumes,acids,alkalis,chemicalsand includingallresultinglossofuseofthat waste.Wasteincludesmaterialstoberecycled, property.Allsuchlossofuseshallbe reconditionedorreclaimed. deemedtooccuratthetimeofthe physicalinjury thatcaused it; or19."Products-completed operationshazard";b.Lossofuseoftangiblepropertythatisnot a.Includesall"bodilyinjury"and"property physicallyinjured.Allsuchlossofuse damage"occurringawayfrompremises shallbedeemedtooccuratthetimeof youownorrentandarisingoutof"your "occurrence"that causedit.product" or"your work"except: Asusedinthisdefinition,"electronicdata"is (1)Productsthatarestillinyourphysical not tangible property.possession;or 21."Suit"meansacivilproceedinginwhich(2)Workthathasnotyetbeencompleted damagesbecauseof"bodilyinjury","property orabandoned.However,"yourwork" damage"or"personalandadvertisinginjury" willbedeemedtobecompletedatthe towhichthisinsuranceappliesarealleged. earliest of the followingtimes: "Suit"includes:(a)Whenalloftheworkcalledforin a.Anarbitrationproceedinginwhichsuch yourcontract hasbeen completed. damagesareclaimedandtowhichthe (b)Whenall of the work to bedone atinsuredmustsubmitordoessubmitwiththejobsitehasbeencompletedif ourconsent; oryourcontractcallsforworkat b.Anyotheralternativedisputeresolution more than onejobsite. proceedinginwhichsuchdamagesare (c)When that part of the workdone at claimedandtowhichtheinsuredsubmits ajobsitehasbeenputtoits withour consent.intendedusebyanypersonor 22."Temporaryworker"meansapersonwhois organizationotherthananother furnishedtoyoutosubstituteforapermanentcontractororsubcontractor"employee"onleaveortomeetseasonalor working onthesameproject. short-termworkloadconditions.23."Volunteerworker" means aperson who:a.Is not your"employee"; FormSS 0008 0405 Page 23of24
DocuSign Envelope ID: D7C5C45C-B994-4AAE-90ED-435965BDA727 BUSINESS LIABILITYCOVERAGE FORMb. (2)Donates his orher work; Theprovidingoforfailuretoprovide warnings orinstructions.c.Actsatthedirectionofandwithinthe c.scopeofduties determined byyou;and Doesnotincludevendingmachinesor d.Isnotpaidafee,salaryorother otherpropertyrentedtoorlocatedforthe compensationbyyouoranyoneelsefor useofothersbutnotsold.theirwork performedforyou. 25."Yourwork":24."Yourproduct": a.Means:a.Means: (1)Workoroperationsperformedbyyou (1)Any goodsor products,otherthanreal oron yourbehalf;andproperty, manufactured, sold, handled, (2)Materials, partsorequipment distributedor disposed of by: furnished in connectionwith suchwork (a)You; oroperations.(b) b.Otherstradingunderyourname; Includes:or (1)Warrantiesor representations made at (c)Apersonororganizationwhose anytimewithrespecttothefitness, businessorassetsyouhave quality,durability,performanceoruse acquired;and of "yourwork";and(2) (2)Containers(otherthanvehicles), Theprovidingoforfailuretoprovide materials, partsorequipment warnings orinstructions.furnishedinconnectionwithsuch goodsor products.b.Includes:(1)Warrantiesor representations made at anytimewithrespecttothefitness, quality,durability,performanceoruse of "yourproduct"; and
DocuSign Envelope ID: D7C5C45C-B994-4AAE-90ED-435965BDA727