SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS.
INSURER(S) AFFORDING COVERAGE
INSURER F :
INSURER E :
INSURER D :
INSURER C :
INSURER B :
INSURER A : NAIC #
NAME: CONTACT
(A/C, No): FAX
E-MAIL ADDRESS:
PRODUCER
(A/C, No, Ext): PHONE
INSURED
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed.
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
OTHER:
(Per accident)
(Ea accident)
$
$
N / A
SUBR WVDADDL
INSD
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. $
$
$
$ PROPERTY DAMAGE
BODILY INJURY (Per accident)
BODILY INJURY (Per person) COMBINED SINGLE LIMIT
AUTOS ONLY
AUTOS ONLY AUTOS NON-OWNED OWNED SCHEDULED
ANY AUTO
AUTOMOBILE LIABILITY
Y / N WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY OFFICER/MEMBER EXCLUDED?
(Mandatory in NH) DESCRIPTION OF OPERATIONS below
If yes, describe under
ANY PROPRIETOR/PARTNER/EXECUTIVE
$
$
$ E.L. DISEASE - POLICY LIMIT E.L. DISEASE - EA EMPLOYEEE.L. EACH ACCIDENT EROTH- STATUTE PER
(MM/DD/YYYY) LIMITS POLICY EXP(MM/DD/YYYY) POLICY EFFLTR TYPE OF INSURANCE POLICY NUMBER INSR
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
EXCESS LIAB
UMBRELLA LIAB EACH OCCURRENCE $ AGGREGATE $
$
OCCUR
CLAIMS-MADE DED RETENTION $
PRODUCTS - COMP/OP AGG $ GENERAL AGGREGATE $ PERSONAL & ADV INJURY $ MED EXP (Any one person) $
EACH OCCURRENCE $ DAMAGE TO RENTED
PREMISES (Ea occurrence) $ COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO- JECT LOC
CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY)
CANCELLATION
AUTHORIZED REPRESENTATIVE
ACORD 25 (2016/03)
© 1988-2015 ACORD CORPORATION. All rights reserved.
CERTIFICATE HOLDER
The ACORD name and logo are registered marks of ACORD
HIRED
AUTOS ONLY
8/5/2025
Newfront Insurance Services (Construction)
777 Mariner Island Blvd, Suite 250
San Mateo, CA 94404
415-754-3635
www.Newfront.com
Scott Gaddy
Construction Team
[email protected]
Argonaut Constructor's, Inc.
360 Sutton Place
Santa Rosa CA 95407
86602709
✓
✓
✓
The City of Cotati, their officers, officials, employees, agents, and volunteers are named additional insured as respects to general and auto by written contract. 30 day notice of cancellation - 10 days for non-payment of premium.
RE: Water Repair Project
City of Cotati
201 West Sierra Avenue
Cotati CA 94931
RE: Water Repair Project.
liability on a primary and non-contributory basis, as required by written contract. Waiver of subrogation applies to workers compensation, as required Endorsements attached.
✓
A 54303073 1/1/2025 1/1/2026 2,000,000
100,000
✓
5,000
✓
2,000,000
✓ $5,000 Deductible
4,000,000
✓ Cont. Liab & X,C,U
✓ 2,000,000
B 54303072 1/1/2025 1/1/2026 1,000,000
✓
✓
✓ ✓
B 54303074 1/1/2025 1/1/2026 ✓
1,000,000 Y
1,000,000
1,000,000
Executive Risk Indemnity Inc 35181
Federal Insurance Company 20281
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CG 20 10 12 19
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
CG 20 10 12 19 © Insurance Services Office, Inc., 2018 Page 1 of 2
ADDITIONAL INSURED OWNERS, LESSEES OR
CONTRACTORS SCHEDULED PERSON OR
ORGANIZATION
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
Name Of Additional Insured Person(s)
Or Organization(s) Location(s) Of Covered Operations
Information required to complete this Schedule, if not shown above, will be shown in the Declarations.
A. Section II Who Is An Insured is amended to
include as an additional insured the person(s) or
organization(s) shown in the Schedule, but only
with respect to liability for "bodily injury", "property damage" or "personal and advertising injury"
caused, in whole or in part, by:
1. Your acts or omissions; or
2. The acts or omissions of those acting on your
behalf;
in the performance of your ongoing operations for
the additional insured(s) at the location(s)
designated above.
However:
1. The insurance afforded to such additional
insured only applies to the extent permitted by
law; and
2. If coverage provided to the additional insured is
required by a contract or agreement, the
insurance afforded to such additional insured
will not be broader than that which you are
required by the contract or agreement to
provide for such additional insured.
B. With respect to the insurance afforded to these
additional insureds, the following additional
exclusions apply:
This insurance does not apply to "bodily injury" or
"property damage" occurring after:
1. All work, including materials, parts or
equipment furnished in connection with such
work, on the project (other than service,
maintenance or repairs) to be performed by or
on behalf of the additional insured(s) at the
location of the covered operations has been
completed; or
2. That portion of "your work" out of which the
injury or damage arises has been put to its
intended use by any person or organization
other than another contractor or subcontractor
engaged in performing operations for a
principal as a part of the same project.
WHERE REQUIRED BY WRITTEN CONTRACT. ALL LOCATIONS WHERE REQUIRED BY WRITTEN CONTRACT.
54303073
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C. With respect to the insurance afforded to these
additional insureds, the following is added to
Section III Limits Of Insurance:
If coverage provided to the additional insured is
required by a contract or agreement, the most we
will pay on behalf of the additional insured is the
amount of insurance:
1. Required by the contract or agreement; or
2. Available under the applicable limits of
insurance;
whichever is less.
This endorsement shall not increase the
applicable limits of insurance.
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10-02-2461 (Ed. 7-15)
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. 10-02-2461 (Ed. 7-15) Includes copyrighted material of Insurance Services Office, Inc., with its permission.
PRIMARY INSURANCE FOR
SCHEDULED ADDITIONAL INSURED
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
Additional Insured: Location Of Covered Operations:
(If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.)
With respect only to the Additional Insured and at the
Location Of Covered Operations shown in the
Schedule, the following is added to SECTION IV –
COMMERCIAL GENERAL LIABILITY CONDITIONS,
Paragraph 4. Other Insurance and supersedes any
provision to the contrary:
Primary And Noncontributory Insurance
This insurance is primary to and will not seek
contribution from any other insurance available to
the Additional Insured with respect to the Location
Of Covered Operations shown in the Schedule
under this policy provided that:
(1) The Additional Insured is a named insured
under such other insurance; and
(2) You have agreed in writing in a contract or
agreement that this insurance would be
primary and would not seek contribution from
any other insurance available to the
Additional Insured.
54303073
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WHERE REQUIRED BY WRITTEN CONTRACT ALL LOCATIONS
POLICY NUMBER: COMMERCIAL GENERAL LIABILITY
CG 25 03 05 09
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
CG 25 03 05 09 © Insurance Services Office, Inc., 2008 Page 1 of 2
DESIGNATED CONSTRUCTION PROJECT(S)
GENERAL AGGREGATE LIMIT
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
Designated Construction Project(s):
Information required to complete this Schedule, if not shown above, will be shown in the Declarations.
A. For all sums which the insured becomes legally
obligated to pay as damages caused by "occurrences" under Section I – Coverage A, and for all medical expenses caused by accidents under
Section I – Coverage C, which can be attributed
only to ongoing operations at a single designated
construction project shown in the Schedule
above:
1. A separate Designated Construction Project
General Aggregate Limit applies to each designated construction project, and that limit is equal to the amount of the General Aggregate
Limit shown in the Declarations.
2. The Designated Construction Project General
Aggregate Limit is the most we will pay for the
sum of all damages under Coverage A, except damages because of "bodily injury" or "property damage" included in the "productscompleted operations hazard", and for medical expenses under Coverage C regardless of the number of:
a. Insureds;
b. Claims made or "suits" brought; or
c. Persons or organizations making claims or
bringing "suits".
3. Any payments made under Coverage A for
damages or under Coverage C for medical
expenses shall reduce the Designated Construction Project General Aggregate Limit for that designated construction project. Such
payments shall not reduce the General Aggregate Limit shown in the Declarations nor shall they reduce any other Designated Construction Project General Aggregate Limit for any other designated construction project
shown in the Schedule above.
4. The limits shown in the Declarations for Each
Occurrence, Damage To Premises Rented To
You and Medical Expense continue to apply.
However, instead of being subject to the
General Aggregate Limit shown in the Declarations, such limits will be subject to the applicable Designated Construction Project General Aggregate Limit. 54303073
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B. For all sums which the insured becomes legally
obligated to pay as damages caused by "occurrences" under Section I – Coverage A, and for all medical expenses caused by accidents under
Section I – Coverage C, which cannot be attributed only to ongoing operations at a single designated construction project shown in the Schedule above:
1. Any payments made under Coverage A for
damages or under Coverage C for medical
expenses shall reduce the amount available
under the General Aggregate Limit or the
Products-completed Operations Aggregate
Limit, whichever is applicable; and
2. Such payments shall not reduce any Designated Construction Project General Aggregate Limit.
C. When coverage for liability arising out of the
"products-completed operations hazard" is provided, any payments for damages because of "bodily injury" or "property damage" included in
the "products-completed operations hazard" will
reduce the Products-completed Operations Aggregate Limit, and not reduce the General Aggregate Limit nor the Designated Construction Project General Aggregate Limit.
D. If the applicable designated construction project
has been abandoned, delayed, or abandoned
and then restarted, or if the authorized contracting parties deviate from plans, blueprints, designs, specifications or timetables, the project will still be deemed to be the same construction project.
E. The provisions of Section III – Limits Of Insurance not otherwise modified by this endorsement shall continue to apply as stipulated.
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COMMERCIAL AUTOMOBILE
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
COMMERCIAL AUTOMOBILE BROAD FORM ENDORSEMENT
This endorsement modifies insurance provided under the following:
BUSINESS AUTO COVERAGE FORM
This endorsement modifies the Business Auto Coverage Form.
1. EXTENDED CANCELLATION CONDITION
Paragraph A.2.b. – CANCELLATION - of the
COMMON POLICY CONDITIONS form IL 00 17 is
deleted and replaced with the following:
b. 60 days before the effective date of cancellation if we cancel for any other reason.
2. BROAD FORM INSURED
A. Subsidiaries and Newly Acquired or Formed
Organizations As Insureds
The Named Insured shown in the Declarations is
amended to include:
1. Any legally incorporated subsidiary in which
you own more than 50% of the voting stock on
the effective date of the Coverage Form.
However, the Named Insured does not include
any subsidiary that is an “insured” under any
other automobile policy or would be an
“insured” under such a policy but for its
termination or the exhaustion of its Limit of
Insurance.
2. Any organization that is acquired or formed by
you and over which you maintain majority
ownership. However, the Named Insured
does not include any newly formed or acquired
organization:
(a) That is an “insured” under any other
automobile policy;
(b) That has exhausted its Limit of Insurance
under any other policy; or
(c) 180 days or more after its acquisition or
formation by you, unless you have given
us written notice of the acquisition or
formation.
Coverage does not apply to “bodily injury” or
“property damage” that results from an “accident”
that occurred before you formed or acquired the
organization.
B. Employees as Insureds
Paragraph A.1. – WHO IS AN INSURED – of
SECTION II – LIABILITY COVERAGE is amended to
add the following:
d. Any “employee” of yours while using a
covered “auto” you don’t own, hire or
borrow in your business or your personal
affairs.
C. Lessors as Insureds
Paragraph A.1. – WHO IS AN INSURED – of
SECTION II – LIABILITY COVERAGE is
amended to add the following:
e. The lessor of a covered “auto” while the
“auto” is leased to you under a written
agreement if:
(1) The agreement requires you to
provide direct primary insurance for
the lessor; and
(2) The “auto” is leased without a driver.
Such leased “auto” will be considered a
covered “auto” you own and not a covered
“auto” you hire.
However, the lessor is an “insured” only
for “bodily injury” or “property damage”
resulting from the acts or omissions by:
1. You;
2. Any of your “employees” or agents;
or
3. Any person, except the lessor or
any “employee” or agent of the
lessor, operating an “auto” with the
permission of any of 1. and/or 2.
above.
D. Persons And Organizations As Insureds
Under A Written Insured Contract
Paragraph A.1 – WHO IS AN INSURED – of
SECTION II – LIABILITY COVERAGE is
amended to add the following:
f. Any person or organization with respect to
the operation, maintenance or use of a
covered “auto”, provided that you and
such person or organization have agreed
under an express provision in a written
“insured contract”, written agreement or a
written permit issued to you by a
governmental or public authority to add
such person or organization to this policy
as an “insured”.
However, such person or organization is
an “insured” only:
Form: 16-02-0292 (Rev. 4-11) Page 1 of 3
"Includes copyrighted material of Insurance Services Office, Inc. with its permission" 54303072
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maintenance or use of a covered
“auto”; and
(2) for “bodily injury” or “property damage”
caused by an “accident” which takes
place after:
(a) You executed the “insured
contract” or written agreement; or
(b) The permit has been issued to
you.
3. FELLOW EMPLOYEE COVERAGE
EXCLUSION B.5. - FELLOW EMPLOYEE – of
SECTION II – LIABILITY COVERAGE does not apply.
4. PHYSICAL DAMAGE – ADDITIONAL TEMPORARY
TRANSPORTATION EXPENSE COVERAGE
Paragraph A.4.a. – TRANSPORTATION EXPENSES
– of SECTION III – PHYSICAL DAMAGE
COVERAGE is amended to provide a limit of $50 per
day for temporary transportation expense, subject to a
maximum limit of $1,000.
5. AUTO LOAN/LEASE GAP COVERAGE
Paragraph A. 4. – COVERAGE EXTENSIONS - of
SECTION III – PHYSICAL DAMAGE COVERAGE is
amended to add the following:
c. Unpaid Loan or Lease Amounts
In the event of a total “loss” to a covered “auto”, we will pay any unpaid amount due on the loan or lease for a
covered “auto” minus:
1. The amount paid under the Physical Damage
Coverage Section of the policy; and
2. Any:
a. Overdue loan/lease payments at the time of
the “loss”;
b. Financial penalties imposed under a lease for
excessive use, abnormal wear and tear or
high mileage;
c. Security deposits not returned by the lessor:
d. Costs for extended warranties, Credit Life
Insurance, Health, Accident or Disability
Insurance purchased with the loan or lease;
and
e. Carry-over balances from previous loans or
leases.
We will pay for any unpaid amount due on the loan or
lease if caused by:
1. Other than Collision Coverage only if the
Declarations indicate that Comprehensive
Coverage is provided for any covered “auto”;
2. Specified Causes of Loss Coverage only if the
Declarations indicate that Specified Causes of
Loss Coverage is provided for any covered “auto”;
or
3. Collision Coverage only if the Declarations indicate that Collision Coverage is provided for any
covered “auto.
6. RENTAL AGENCY EXPENSE
Paragraph A. 4. – COVERAGE EXTENSIONS – of
SECTION III – PHYSICAL DAMAGE COVERAGE
is amended to add the following:
d. Rental Expense
We will pay the following expenses that you or
any of your “employees” are legally obligated
to pay because of a written contract or
agreement entered into for use of a rental
vehicle in the conduct of your business:
MAXIMUM WE WILL PAY FOR ANY ONE
CONTRACT OR AGREEMENT:
1. $2,500 for loss of income incurred by the
rental agency during the period of time that
vehicle is out of use because of actual
damage to, or “loss” of, that vehicle, including
income lost due to absence of that vehicle for
use as a replacement;
2. $2,500 for decrease in trade-in value of the
rental vehicle because of actual damage to
that vehicle arising out of a covered “loss”; and
3. $2,500 for administrative expenses incurred
by the rental agency, as stated in the contract
or agreement.
4. $7,500 maximum total amount for paragraphs
1., 2. and 3. combined.
7. EXTRA EXPENSE – BROADENED COVERAGE
Paragraph A.4. – COVERAGE EXTENSIONS – of
SECTION III – PHYSICAL DAMAGE COVERAGE
is amended to add the following:
e. Recovery Expense
We will pay for the expense of returning a
stolen covered “auto” to you.
8. AIRBAG COVERAGE
Paragraph B.3.a. - EXCLUSIONS – of SECTION
III – PHYSICAL DAMAGE COVERAGE does not
apply to the accidental or unintended discharge of
an airbag. Coverage is excess over any other
collectible insurance or warranty specifically
designed to provide this coverage.
9. AUDIO, VISUAL AND DATA ELECTRONIC
EQUIPMENT - BROADENED COVERAGE
Paragraph C.2. – LIMIT OF INSURACE - of
SECTION III - PHYSICAL DAMAGE is deleted
and replaced with the following:
2. $2,000 is the most we will pay for "loss" in any
one "accident" to all electronic equipment that
reproduces, receives or transmits audio, visual
or data signals which, at the time of "loss", is:
a. Permanently installed in or upon the
covered "auto" in a housing, opening or
other location that is not normally used by
the "auto" manufacturer for the installation
of such equipment;
b. Removable from a permanently installed
housing unit as described in Paragraph
2.a. above or is an integral part of that
equipment; or
c. An integral part of such equipment.
Form: 16-02-0292 (Rev. 4-11) Page 2 of 3
"Includes copyrighted material of Insurance Services Office, Inc. with its permission" 54303072
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"Includes copyrighted material of Insurance Services Office, Inc. with its permission"
10. GLASS REPAIR – WAIVER OF DEDUCTIBLE
Under Paragraph D. - DEDUCTIBLE – of
SECTION III – PHYSICAL DAMAGE COVERAGE
the following is added:
No deductible applies to glass damage if the glass
is repaired rather than replaced.
11. TWO OR MORE DEDUCTIBLES
Paragraph D.- DEDUCTIBLE – of SECTION III –
PHYSICAL DAMAGE COVERAGE is amended to
add the following:
If this Coverage Form and any other Coverage
Form or policy issued to you by us that is not an
automobile policy or Coverage Form applies to the
same “accident”, the following applies:
1. If the deductible under this Business Auto
Coverage Form is the smaller (or smallest)
deductible, it will be waived; or
2. If the deductible under this Business Auto
Coverage Form is not the smaller (or smallest)
deductible, it will be reduced by the amount of
the smaller (or smallest) deductible.
12. AMENDED DUTIES IN THE EVENT OF
ACCIDENT, CLAIM, SUIT OR LOSS
Paragraph A.2.a. - DUTIES IN THE EVENT OF
AN ACCIDENT, CLAIM, SUIT OR LOSS of
SECTION IV - BUSINESS AUTO CONDITIONS is
deleted and replaced with the following:
a. In the event of “accident”, claim, “suit” or
“loss”, you must promptly notify us when the
“accident” is known to:
(1) You or your authorized representative, if
you are an individual;
(2) A partner, or any authorized
representative, if you are a partnership;
(3) A member, if you are a limited liability
company; or
(4) An executive officer, insurance manager,
or authorized representative, if you are an
organization other than a partnership or
limited liability company.
Knowledge of an “accident”, claim, “suit” or
“loss” by other persons does not imply that the
persons listed above have such knowledge.
Notice to us should include:
(1) How, when and where the “accident” or
“loss” occurred;
(2) The “insured’s” name and address; and
(3) To the extent possible, the names and
addresses of any injured persons or
witnesses.
13. WAIVER OF SUBROGATION
Paragraph A.5. - TRANSFER OF RIGHTS OF
RECOVERY AGAINST OTHERS TO US of
SECTION IV – BUSINESS AUTO CONDITIONS is
deleted and replaced with the following:
5. We will waive the right of recovery we would
otherwise have against another person or
organization for “loss” to which this insurance
applies, provided the “insured” has waived
their rights of recovery against such person or
organization under a contract or agreement
that is entered into before such “loss”.
To the extent that the “insured’s” rights to
recover damages for all or part of any
payment made under this insurance has not
been waived, those rights are transferred to
us. That person or organization must do
everything necessary to secure our rights and
must do nothing after “accident” or “loss” to
impair them. At our request, the insured will
bring suit or transfer those rights to us and
help us enforce them.
14. UNINTENTIONAL FAILURE TO DISCLOSE
HAZARDS
Paragraph B.2. – CONCEALMENT,
MISREPRESENTATION or FRAUD of SECTION
IV – BUSINESS AUTO CONDITIONS - is deleted
and replaced with the following:
If you unintentionally fail to disclose any hazards
existing at the inception date of your policy, we will
not void coverage under this Coverage Form
because of such failure.
15. AUTOS RENTED BY EMPLOYEES
Paragraph B.5. - OTHER INSURANCE of
SECTION IV – BUSINESS AUTO CONDITIONS -
is amended to add the following:
e. Any “auto” hired or rented by your “employee”
on your behalf and at your direction will be
considered an “auto” you hire. If an
“employee’s” personal insurance also applies
on an excess basis to a covered “auto” hired
or rented by your “employee” on your behalf
and at your direction, this insurance will be
primary to the “employee’s” personal
insurance.
16. HIRED AUTO – COVERAGE TERRITORY
Paragraph B.7.b.(5).(a) - POLICY PERIOD,
COVERAGE TERRITORY of SECTION IV –
BUSINESS AUTO CONDITIONS is deleted and
replaced with the following:
(a) A covered “auto” of the private passenger
type is leased, hired, rented or borrowed
without a driver for a period of 45 days or
less; and
17. RESULTANT MENTAL ANGUISH COVERAGE
Paragraph C. of - SECTION V – DEFINITIONS is
deleted and replaced by the following:
“Bodily injury” means bodily injury, sickness or
disease sustained by any person, including
mental anguish or death as a result of the “bodily
injury” sustained by that person.
54303072
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16-02-0316 Ed. 10 14
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. 16-02-0316 Ed. 10 14 Page 1 of 1
PRIMARY AND NON-CONTRIBUTORY LIABILITY
INSURANCE
This endorsement modifies insurance provided under the following:
BUSINESS AUTO COVERAGE FORM
With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement.
This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below.
Named Insured:
Endorsement Effective Date:
SCHEDULE
Name(s) Of Person(s) Or Organization(s):
Information required to complete this Schedule, if not shown above, will be shown in the Declarations.
The following is added to Item 5. – “Other
Insurance” of Item B. – “General Conditions” under
Section IV – “Business Auto Conditions”:
e. Regardless of the provisions of Paragraph 5.a.
through d. above, for any liability arising out of the
ownership, maintenance, use, rental, lease, loan, hire
or borrowing by an ”insured” of a covered “auto” for
which an “insured” is contractually obligated to
provide primary insurance coverage to a client, this
Coverage Form will be primary and non-contributory
with respect to the Persons or Organizations in the
schedule, regardless of the availability or existence of other collectible insurance under any other Coverage
Form or policy that applies on a primary basis.
54303072
Argonaut Constructor's, Inc.
01/01/2025
86602709 | 00015967 | 25-26 GL,AL,WC,XS,POLL, 2nd/3rd Layer Excess | Excl:XS OT1 OT2 OT3 OT4 | Jessica Flores | 8/5/2025 2:52:48 PM (PDT) | Page 12 of 17 As required by written contract.
POLICY NUMBER: COMMERCIAL AUTO
16-02-0322 (Ed. 11-15)
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. 16-02-0322 (Ed. 11-15) Includes copyrighted material of Insurance Services Office, Inc., with its permission.
NOTICE OF CANCELLATION OR NON-RENEWAL TO
SPECIFIED PERSONS OR ORGANIZATIONS
This endorsement modifies the following:
COMMON POLICY CONDITIONS
SCHEDULE
Name(s) and Address(es):
The following Condition is added:
Notice Of Cancellation Or Non-Renewal To Specified Persons Or Organizations
1. If we cancel or non-renew this policy for any reason other than non-payment, we will deliver notice of the cancellation or non-renewal to any Person(s) or Organization(s) shown in the Schedule __ days prior to the effective date of cancellation or non-renewal.
2. If we cancel this policy for non-payment, we will deliver notice of the cancellation to any Person(s) or Organization(s) shown in the Schedule __ days prior to the effective date of cancellation.
3. If notice is mailed, proof of mailing will be sufficient proof of notice.
4. Any failure by us to notify such person(s) or organization(s) will not invalidate such cancellation or non-renewal with respect to any other person(s) or organization(s). 54303072
86602709 | 00015967 | 25-26 GL,AL,WC,XS,POLL, 2nd/3rd Layer Excess | Excl:XS OT1 OT2 OT3 OT4 | Jessica Flores | 8/5/2025 2:52:48 PM (PDT) | Page 13 of 17 30 10 ALL PERSONS OR ORGANIZATIONS AS ON FILE WITH US.
WC 90 03 75 (05/18)
Workers' Compensation and Employers' Liability Policy
Named Insured Endorsement Number
Policy Number
Symbol: Number:
Policy Period
TO
Effective Date of Endorsement
Issued By (Name of Insurance Company)
Insert the policy number. The remainder of the information is to be completed only when this endorsement is issued subsequent to the preparation of the policy.
CALIFORNIA WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT This endorsement applies only to the insurance provided by the policy because California is shown in Item 3.A. of the Information Page.
We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule, but this waiver applies only with respect to bodily injury arising out of the operations described in the Schedule, where you are required by a written contract to obtain this waiver from us.
You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule.
Schedule
1. ( ) Specific Waiver
Name of person or organization:
( ) Blanket Waiver
Any person or organization for whom the Named Insured has agreed by written contract to furnish this waiver.
2. Operations:
3. Premium:
The premium charge for this endorsement shall be percent of the California premium developed on payroll in connection with work performed for the above person(s) or organization(s) arising out of the operations described.
4. Minimum Premium:
Authorized Representative
Argonaut Constructor's, Inc.
54303074
01/01/2026 01/01/2025
Federal Insurance Company
86602709 | 00015967 | 25-26 GL,AL,WC,XS,POLL, 2nd/3rd Layer Excess | Excl:XS OT1 OT2 OT3 OT4 | Jessica Flores | 8/5/2025 2:52:48 PM (PDT) | Page 14 of 17 X
WHERE REQUIRED BY WRITTEN CONTRACT n/a Jennifer Knight n/a 54303074
01/01/2025
Argonaut Constructor's, Inc.
Federal Insurance Company
86602709 | 00015967 | 25-26 GL,AL,WC,XS,POLL, 2nd/3rd Layer Excess | Excl:XS OT1 OT2 OT3 OT4 | Jessica Flores | 8/5/2025 2:52:48 PM (PDT) | Page 15 of 17
ALL PERSONS OR ORGANIZATIONS AS ON FILE
WITH US.
PCM Manus (06 18)
(Page 5 of 23)
P. GREEN BUILDING MATERIALS mean any building products or construction materials that are recognized by The Leadership in Energy and Environmental Design (LEED®) or Energy Star as: (i) being environmentally preferable or sustainable; or (ii) providing enhanced energy efficiency.
Q. INSURED means:
1. the FIRST NAMED INSURED;
2. any ADDITIONAL NAMED INSURED; and
3. any present or former director, officer, partner, member, employee, leased or temporary worker of the FIRST NAMED INSURED or any ADDITIONAL NAMED INSURED, while acting within the scope of his/her duties as such; and
4. any organization or entity, in existence at any time prior to the POLICY PERIOD, in which the FIRST NAMED INSURED has: (i) an ownership interest of fifty percent (50%) or more; or (ii) control over the management thereof; and
5. any joint venture in which the FIRST NAMED INSURED or any ADDITIONAL NAMED INSURED is named as a coventurer, but solely to the extent such FIRST NAMED INSURED or ADDITIONAL NAMED INSURED is liable because of its performance CONTRACTING SERVICES provided under such joint venture; and
6. solely with regard to Coverage B under this Policy and only when required by written contract, INSURED also includes:
(a) the client for whom the INSURED performs CONTRACTING SERVICES provided that such contract was signed by the INSURED and such client prior to the date the POLLUTION CONDITION first commenced.
However, the client is included as an INSURED under this Policy solely to the extent that the client is found liable based upon CONTRACTING SERVICES negligently performed by an INSURED other than the client.
No coverage will be provided for such entity’s own negligence or strict liability; and (b) any entity unrelated to the FIRST NAMED INSURED or any ADDITIONAL NAMED INSURED, provided that such contract was signed by the INSURED and the client for whom the INSURED performs CONTRACTING SERVICES prior to the date the POLLUTION CONDITION first commenced. However, such entity is included as an INSURED under this Policy solely to the extent that it is found liable based upon CONTRACTING SERVICES negligently performed by an INSURED other than such entity. No coverage will be provided for such entity’s own negligence or strict liability.
Coverage for such client or entity under this Policy shall not exceed the lesser of the following amounts:
(i) the Limit of Liability required under such written contract; or (ii) the applicable Coverage B Limit of Liability of this Policy.
However, INSURED does not include and DESIGN PROFESSIONAL Notwithstanding Section IX. CONDITIONS, Item N. OTHER INSURANCE, and only when required by such written contract, the coverage afforded under this Policy for any person or entity who is an INSURED solely by reason of subparagraph 6. of the Definition of INSURED will apply as primary as to any other valid and collectible insurance available to such INSURED.
R. JOB SITE means a location at which CONTRACTING SERVICES are performed. JOB SITE also includes real property rented or leased by the INSURED during the course of performing CONTRACTING SERVICES, but only if such real property is utilized in direct support of such CONTRACTING SERVICES. However, JOB SITE does not include any:
1. COVERED LOCATION; or
PCM E164754 08
86602709 | 00015967 | 25-26 GL,AL,WC,XS,POLL, 2nd/3rd Layer Excess | Excl:XS OT1 OT2 OT3 OT4 | Jessica Flores | 8/5/2025 2:52:48 PM (PDT) | Page 16 of 17 ENDORSEMENT # 8
This endorsement, effective 12:01 a.m., , forms a part of Policy No. issued to By Great American E & S Insurance Company
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
PRIMARY AND NON-CONTRIBUTORY COVERAGE FOR THE INSURED’S CLIENT AND UNRELATED ENTITIES WHEN REQUIRED BY CONTRACT – COVERAGE B ONLY This endorsement modifies insurance provided under the following:
PROFESSIONAL AND CONTRACTING SERVICES ENVIRONMENTAL LIABILITY INSURANCE POLICY The INSURED and the Company agree to the following Policy change(s):
The last paragraph of Section II. DEFINITIONS, Item Q. INSURED, is deleted in its entirety and replaced with the following:
Notwithstanding Section IX. CONDITIONS, Item N. OTHER INSURANCE, and only when required by such written contract, the coverage afforded under this Policy for any person or entity who is an INSURED solely by reason of subparagraph 6. of the Definition of INSURED will apply as primary and non-contributory as to any other valid and collectible insurance available to such INSURED.
All other terms and conditions remain the same.
PCM MANUS (09 19)
Argonaut Constructor's, Inc.
01/01/2025 PCM E164754 08
86602709 | 00015967 | 25-26 GL,AL,WC,XS,POLL, 2nd/3rd Layer Excess | Excl:XS OT1 OT2 OT3 OT4 | Jessica Flores | 8/5/2025 2:52:48 PM (PDT) | Page 17 of 17