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dŚĞ ŝƚLJ ŽĨ ůĂŵĞĚĂ ŚĂƐ ƉƌĞǀŝŽƵƐůLJ ĞdžƉƌĞƐƐĞĚ ŝŶƚĞƌĞƐƚ ŝŶ Ă ƐĞŶŝŽƌ ĂŶĚ ĚŝƐĂďůĞĚ ƚƌĂŶƐŝƚ ƉĂƐƐ ƉƌŽŐƌĂŵƚŽĂƐƐŝƐƚƚŚŽƐĞĚŝƐƉƌŽƉŽƌƚŝŽŶĂƚĞůLJůŽǁĞƌŝŶĐŽŵĞůĂŵĞĚĂ ƌĞƐŝĚĞŶƚƐǁŝƚŚĨƵŶĚŝŶŐƚŚĞŝƌ ƚƌĂŶƐƉŽƌƚĂƚŝŽŶŶĞĞĚƐ͘/ŶĐŽŽƌĚŝŶĂƚŝŽŶǁŝƚŚƚŚĞŝƚLJŽĨůĂŵĞĚĂ͕ ƐƚĂĨĨŝƐƐĞĞŬŝŶŐŽĂƌĚĂƉƉƌŽǀĂů ƚŽŽĨĨĞƌƐĞŶŝŽƌƐĂŶĚƉĞŽƉůĞǁŝƚŚĚŝƐĂďŝůŝƚŝĞƐǁŝƚŚĚŝƐƉƌŽƉŽƌƚŝŽŶĂƚĞůLJůŽǁĞƌŝŶĐŽŵĞŝŶůĂŵĞĚĂĂ ƉƌŽŐƌĂŵǁŝƚŚƵŶůŝŵŝƚĞĚĂĐĐĞƐƐƚŽůŽĐĂůƌŝĚĞƐŽŶdƌĂŶƐŝƚƐŝŵŝůĂƌƚŽƚŚĞ^dWW͘'ŝǀĞŶƚŚĞĨĂĐƚƚŚĂƚ ŵĂŶLJƐĞŶŝŽƌƐĂŶĚƉĞŽƉůĞǁŝƚŚĚŝƐĂďŝůŝƚŝĞƐĂƌĞŽŶĂĨŝdžĞĚŝŶĐŽŵĞ͕ƚŚŝƐƉƌŽŐƌĂŵǁŽƵůĚĂůůŽǁƚŚŽƐĞ ĞůŝŐŝďůĞƚŽƚƌĂǀĞůŽŶƚƌĂŶƐŝƚǁŝƚŚŽƵƚŚĂǀŝŶŐƚŽŵĂŬĞĚŝĨĨŝĐƵůƚĐŚŽŝĐĞƐĂŶĚƌƵŶŶŝŶŐƚŚĞƌŝƐŬŽĨďĞŝŶŐ ƵŶĂďůĞƚŽĐŽǀĞƌŶĞĐĞƐƐĂƌLJĞdžƉĞŶƐĞƐ͕ƐƵĐŚĂƐƌĞŶƚ͕ŵĞĚŝĐĂƚŝŽŶ͕ŽƌĚŽĐƚŽƌ͛ƐĨĞĞƐ͘
dŚĞƉŝůŽƚƉƌŽŐƌĂŵǁŝƚŚƚŚĞŝƚLJŽĨůĂŵĞĚĂǁŽƵůĚŽĨĨĞƌĂWĂLJͲƉĞƌͲZŝĚĞŵŽĚĞůƚŚĂƚǁŽƵůĚĞŶĂďůĞ ƐĞŶŝŽƌĂŶĚĚŝƐĂďůĞĚƉĂƌƚŝĐŝƉĂŶƚƐǁŝƚŚĂŶŝŶƐƚŝƚƵƚŝŽŶĂůƉĂƐƐĨŽƌƵŶůŝŵŝƚĞĚůŽĐĂůůŝŶĞƌŝĚĞƌƐŚŝƉ͘&ĂƌĞƐ ǁŽƵůĚ ďĞ ĂƐƐĞƐƐĞĚ ďLJ ďŽĂƌĚŝŶŐ Ăƚ Ă ƐĞŶŝŽƌ Žƌ ĚŝƐĂďůĞĚ ůŝƉƉĞƌ ƌĂƚĞ͘ dŚĞ ŝƚLJ ǁŝůů ďĞ ƐĞĞŬŝŶŐ
14 ĂƉƉƌŽǀĂůĨŽƌĂΨϭϳϱ͕ϬϬϬĂŶŶƵĂůĞdžƉĞŶĚŝƚƵƌĞĨƌŽŵƚŚĞŝƌŝƚLJŽƵŶ ĐŝůŽŶ&ĞďƌƵĂƌLJϭϱ͕ϮϬϮϮ͕ĨŽƌĂ ƚŚƌĞĞͲLJĞĂƌƉŝůŽƚƉƌŽŐƌĂŵ͘dŚĞΨϭϳϱ͕ϬϬϬǁŽƵůĚĂůůŽǁƵƉƚŽϯϭϱƉ ĂƌƚŝĐŝƉĂŶƚƐǁŝƚŚĂŶĞƐƚŝŵĂƚĞĚ ƌŝĚĞƌƐŚŝƉĂǀĞƌĂŐĞŽĨϯϯƌŝĚĞƐƉĞƌŵŽŶƚŚŝŶĂWĂLJͲƉĞƌͲZŝĚĞŵŽĚĞů͕ĂůƚŚŽƵŐŚŝŶǀŽŝĐŝŶŐǁŝůůďĞďĂƐĞĚ ŽŶĂĐƚƵĂůďŽĂƌĚŝŶŐƐĨƌŽŵůŝƉƉĞƌĐĂƌĚƐ͘&ĂƌĞƌĞǀĞŶƵĞĨŽƌƐƵďƐĞƋ ƵĞŶƚƉŝůŽƚLJĞĂƌƐǁŝůůĚĞƉĞŶĚŽŶ ƚŚĞŶƵŵďĞƌŽĨƐĞŶŝŽƌƐŝŶĐůƵĚĞĚŝŶƚŚĞƉŝůŽƚĂŶĚƚŚĞŶƵŵďĞƌŽĨďŽĂƌĚŝŶŐƐ͘
ƐƚŚŝƐŝƐŶŽƚĂƉƌŽŐƌĂŵŝĚĞŶƚŝĨŝĞĚŝŶŽĂƌĚWŽůŝĐŝĞƐϯϯϯŽƌϯϯϰ͕ŽĂƌĚŽĨŝƌĞĐƚŽƌƐĂƉƉƌŽǀĂůŝƐ ƌĞƋƵŝƌĞĚƉƌŝŽƌƚŽƉƌŽŐƌĂŵĚĞǀĞůŽƉŵĞŶƚ͘dŚŝƐƉƌŽŐƌĂŵǁŝůůďĞĂƚƌĞŵĞŶĚŽƵƐďĞŶĞĨŝƚĨŽƌ ĂƐƚĂLJ
ĚŝƐĂďůĞĚĂŶĚƐĞŶŝŽƌƌĞƐŝĚĞŶƚƐ͘dŚĞŝŶŝƚŝĂůƉƌŽŐƌĂŵǁŝůůƐƚĂƌƚǁ ŝƚŚϲϱƐĞŶŝŽƌƐĞŶƌŽůůĞĚŝŶDĂƐƚŝĐŬ ^ĞŶŝŽƌĞŶƚĞƌ͘dŚĞŝƚLJŽĨůĂŵĞĚĂǁŝůůďĞƐĞĞŬŝŶŐŝƚLJŽƵŶĐŝůĂƉƉƌŽǀĂůƐƵďƐĞƋƵĞŶƚůLJĂĨƚĞƌƚŚĞ dƌĂŶƐŝƚŽĂƌĚŽĨŝƌĞĐƚŽƌƐ͛ǀŽƚĞ͘
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dƌĂŶƐŝƚ͛Ɛ ͞WĂLJͲƉĞƌͲZŝĚĞ͟ ŵŽĚĞů ĐĂŶ ƉƌŽǀŝĚĞ ĂĚƵůƚ Žƌ LJŽƵƚŚ ůŝƉƉĞƌ ĐĂƌĚƐ ůŽĂĚĞĚ ǁŝƚŚ ĂŶ ŝŶƐƚŝƚƵƚŝŽŶĂůƉĂƐƐĂůůŽǁŝŶŐĨŽƌĂĐĐĞƐƐƚŽƵŶůŝŵŝƚĞĚƌŝĚĞƐŽŶdƌĂŶƐŝƚ͘/ŶƐƚŝƚƵƚŝŽŶĂůƉĂƐƐĞƐĂƌĞŶŽƚ ĂǀĂŝůĂďůĞ ŽŶ ƐĞŶŝŽƌ Žƌ ĚŝƐĂďůĞĚ ĐĂƌĚƐ ŝŶ ƚŚĞ ĐƵƌƌĞŶƚ ůŝƉƉĞƌ ƐLJƐƚĞŵ͕ ƐŽ ƚŚĞ ĞůŝŐŝďůĞ ƉŽƉƵůĂƚŝŽŶ ŶĞĞĚƐƚŽďĞĚĞĨŝŶĞĚƵƉĨƌŽŶƚƚŽĂůůŽǁĨŽƌƚŚĞƉƌŽƉĞƌƌŝĚĞƉƌŝĐŝ ŶŐ͘dŚŝƐŵŽĚĞůĐŽƵůĚďĞĞdžƚĞŶĚĞĚ ƚŽŽƚŚĞƌĐŝƚŝĞƐƚŚĂƚĂƌĞǁŝůůŝŶŐƚŽƉƌŽǀŝĚĞĨƵŶĚŝŶŐ͘ƵƌƌĞŶƚůLJƐƚĂĨĨŝƐĂǁĂƌĞƚŚĂƚƚŚĞtĞƐƚŽŶƚƌĂ ŽƐƚĂdƌĂŶƐƉŽƌƚĂƚŝŽŶĚǀŝƐŽƌLJŽŵŵŝƚƚĞĞ;tdͿŝƐĂůƐŽŝŶƚĞƌĞƐƚĞĚŝŶƐƵĐŚĂƉƌŽŐƌĂŵĂŶĚǁŝůů ďĞƐƚĂƌƚŝŶŐĚŝƐĐƵƐƐŝŽŶƐǁŝƚŚƚŚĞŝƚLJŽĨ^ĂŶWĂďůŽ͘
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ƐƚŝŵĂƚĞĚWŝůŽƚWƌŽŐƌĂŵWƌŝĐŝŶŐ
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ƐƚŝŵĂƚĞƐ WĂLJͲƉĞƌͲZŝĚĞDŽĚĞů
ƐƚŝŵĂƚĞĚEƵŵďĞƌŽĨWĂƌƚŝĐŝƉĂŶƚƐ ϯϭϱ
ƐƚŝŵĂƚĞĚEƵŵďĞƌŽĨZŝĚĞƐƉĞƌWĞƌƐŽŶͬDŽŶƚŚ ϯϯΎ
ŶŶƵĂů
ƐƚŝŵĂƚĞĚWŝůŽƚ&ĂƌĞZĞǀĞŶƵĞ Ψϭϱϳ͕ϰϴϮ
ĚƵůƚůŝƉƉĞƌĂƌĚ
EĞǁĂƌĚƐ;Ψϯ͘ϬϬͬĐĂƌĚͿ Ψϵϰϱ
ƐƚŝŵĂƚĞĚZĞƉůĂĐĞŵĞŶƚĂƌĚƐ
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^ƚĂĨĨŝŶŐ
ƐƚŝŵĂƚĞ
ĚŵŝŶŝƐƚƌĂƚŝǀĞŽŽƌĚ;ϱϮŚŽƵƌƐͿ͕dĞŵƉŽƌĂƌLJ
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DĂƌŬĞƚŝŶŐ
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ƐƚŝŵĂƚĞƐ WĂLJͲƉĞƌͲZŝĚĞDŽĚĞů
ƐƚŝŵĂƚĞĚEƵŵďĞƌŽĨWĂƌƚŝĐŝƉĂŶƚƐ ϯϲϱ
ƐƚŝŵĂƚĞĚEƵŵďĞƌŽĨZŝĚĞƐƉĞƌWĞƌƐŽŶͬDŽŶƚŚ ϯϯΎ
ŶŶƵĂů
ƐƚŝŵĂƚĞĚWŝůŽƚ&ĂƌĞZĞǀĞŶƵĞ ΨϮϬϬ͕ϬϬϬ
ĚƵůƚůŝƉƉĞƌĂƌĚ
EĞǁĂƌĚƐ;Ψϯ͘ϬϬͬĐĂƌĚͿ ΨϭϱϬ
ƐƚŝŵĂƚĞĚZĞƉůĂĐĞŵĞŶƚĂƌĚƐ
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ZĞƉ;ϮϱŚŽƵƌƐͿ Ψϳ͕ϭϭϬ
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ƌŽĐŚƵƌĞƐ͕ĞƐƚ͘ĨŽƌϱϬϬƉŝĞĐĞƐΛĂǀŐ͘ΨϬ͘ϲϬĞĂ͘ ΨϲϬϬ
WƌŝŶƚĂŶĚKŶůŝŶĞĚƐ Ψϯ͕ϮϬϯ
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dŚŝƌĚzĞĂƌWŝůŽƚWƌŽŐƌĂŵWƌŝĐŝŶŐ;ĨŽƌϰϭϱ>Žǁ/ŶĐŽŵĞ^ĞŶŝŽƌWĂƌƚŝĐŝƉĂŶƚƐͿ dƌĂŶƐŝƚWĂƐƐ
ƐƚŝŵĂƚĞƐ WĂLJͲƉĞƌͲZŝĚĞDŽĚĞů
ƐƚŝŵĂƚĞĚEƵŵďĞƌŽĨWĂƌƚŝĐŝƉĂŶƚƐ ϰϭϱ
ƐƚŝŵĂƚĞĚEƵŵďĞƌŽĨZŝĚĞƐƉĞƌWĞƌƐŽŶͬDŽŶƚŚ ϯϯΎ
ŶŶƵĂů
ƐƚŝŵĂƚĞĚWŝůŽƚ&ĂƌĞZĞǀĞŶƵĞ ΨϮϰϳ͕ϯϭϱ
ĚƵůƚůŝƉƉĞƌĂƌĚ
EĞǁĂƌĚƐ;Ψϯ͘ϬϬͬĐĂƌĚͿ ΨϭϱϬ
ƐƚŝŵĂƚĞĚZĞƉůĂĐĞŵĞŶƚĂƌĚƐ
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^ŚŝƉƉŝŶŐŽƐƚƐ;h^W^Ϳ ΨϵϬ
^ƚĂĨĨŝŶŐ
ƐƚŝŵĂƚĞ
ĚŵŝŶŝƐƚƌĂƚŝǀĞŽŽƌĚ;ϰϮŚŽƵƌƐͿ͕dĞŵƉŽƌĂƌLJ
ĚŵŝŶŝƐƚƌĂƚŝǀĞŽŽƌĚ;ϭϱ͘ϱϬŚŽƵƌƐͿ͕^ĞŶŝŽƌ
DĂƌŬĞƚŝŶŐZĞƉ;ϮϱŚŽƵƌƐͿ Ψϳ͕ϭϭϬ
DĂƌŬĞƚŝŶŐ
ƌŽĐŚƵƌĞƐ͕ĞƐƚ͘ĨŽƌϬϬƉŝĞĐĞƐΛĂǀŐ͘ΨϬ͘ϲϬĞĂ͘ ΨϲϬϬ
WƌŝŶƚĂŶĚKŶůŝŶĞĚƐ Ψϯ͕ϮϬϯ
&ŽƌŵƐƚĂĐŬ;ŽŶůŝŶĞĂƉƉůŝĐĂƚŝŽŶͿ ΨϭϬϬ
dŽƚĂůdŚŝƌĚzĞĂƌWŝůŽƚWƌŽŐƌĂŵWƌŝĐŝŶŐ
;ǁŝƚŚϱϬŶĞǁƉĂƌƚŝĐŝƉĂŶƚƐʹdŽƚĂůϰϭϱƉĂƌƚŝĐŝƉĂŶƚƐͿ ΨϮϱϴ͕ϴϲϵ
18 džŚŝďŝƚ
ϮϬϮϬ͕ϮϬϮϭĂŶĚĞĂƌůLJϮϬϮϮ&ƌĞĞƵƐWĂƐƐZĞŝŵďƵƌƐĞŵĞŶƚ
ϮϬϮϬʹϭƐƚƐŝdžŵŽŶƚŚƐ͗ϮϬƉĂƐƐĞƐdžϭϱƚƌŝƉƐͬŵŽŶƚŚΎϲŵŽŶƚŚƐсϭ͕ϴϬϬƚƌŝƉƐΎΨϭ͘ϭϮͬƌŝĚĞсΨϮ͕Ϭϭϲ ϮϬϮϬʹϮŶĚƐŝdžŵŽŶƚŚƐ͗ϯϬƉĂƐƐĞƐdžϭϱƚƌŝƉƐͬŵŽŶƚŚΎϲŵŽŶƚŚƐсϮ͕ϳϬϬƚƌŝƉƐΎΨϭ͘ϭϮͬƌŝĚĞсΨϯ͕ϬϮϰ ϮϬϮϭʹϭƐƚƐŝdžŵŽŶƚŚƐ͗ϱϬƉĂƐƐĞƐdžϭϱƚƌŝƉƐͬŵŽŶƚŚΎϲŵŽŶƚŚƐсϰ͕ϱϬϬΎΨϭ͘ϭϮͬƌŝĚĞсΨϱ͕ϬϰϬ ϮϬϮϭʹϮŶĚƐŝdžŵŽŶƚŚƐ͗ϲϮƉĂƐƐĞƐdžϭϱƚƌŝƉƐͬŵŽŶƚŚΎϲŵŽŶƚŚƐсϱ͕ϱϴϬΎΨϭ͘ϭϮͬƌŝĚĞсΨϲ͕ϮϱϬ ϮϬϮϮʹϭƐƚĨŽƵƌŵŽŶƚŚƐ͗ϲϮƉĂƐƐĞƐdžϭϱͬƚƌŝƉƐͬŵŽŶƚŚΎϰŵŽŶƚŚƐсϯ͕ϳϮϬΎΨϭ͘ϭϮсΨϰ͕ϭϲϲ ^ƵďͲƚŽƚĂůсΨϮϬ͕ϰϵϲ
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21 ACORD 101 (2008/01)
The ACORD name and logo are registered marks of ACORD
© 2008 ACORD CORPORATION. All rights reserved.
THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: FORM TITLE:
ADDITIONAL REMARKS
ADDITIONAL REMARKS SCHEDULE Page of
AGENCY CUSTOMER ID:
LOC #:
AGENCY
CARRIER NAIC CODE
POLICY NUMBER
NAMED INSURED
EFFECTIVE DATE:
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22 Includes copyrighted material of the Insurance Services Office, Inc. with its permission.
RL 2032E 01/02 Page 1 of 1
THE PRINCETON EXCESS AND SURPLUS LINES
INSURANCE COMPANY
RETAINED LIMIT POLICY CHANGES
Named Insured
Alameda Contra Costa Transit District
Endorsement Number
Policy Number
N1-A3-RL-0000100-06
Endorsement Effective
04/26/2021
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
This endorsement modifies insurance provided under the following:
AUTOMOBILE LIABILITY COVERAGE PART
GENERAL LIABILITY COVERAGE PART
This endorsement changes the policy effective on the inception date of the policy unless another date is indicated above.
The following is added to the definition of Insured in the Liability Conditions, Definitions And Exclusions section of the policy:
g. With respect to Bodily Injury and/or Property Damage under both the Automobile Liability Coverage Part and the General Liability Coverage Part, any person or organization with whom you have agreed in a writte n contract or written agreement to assume the Tort Liability for a specified activity or operation is an Insured with regards to such specified activity or operation. However, this insurance only applies with respect to liability for Bodily Injury or Property Damage caused, in whole or in part, by your acts or omissions or th e acts or omissions of those acting on your behalf.
The following provisions also apply:
(1) The written contract or written agreement must be in effect at the inception of the Policy Period or become effective during the Policy Period; and
(2) The written contract or written agreement must be executed prior to the Bodily Injury or Property Damage.
Subject to the paragraphs above, any such person's or organization's status as an Insured ends when any of the following first occurs: this policy terminates; the written contract or written agreement terminates; or the specified activity or operation terminates.
Tort Liability means liability that would be imposed by law in the absence of any contract or agreement.
All other terms and conditions remain unchanged.
23