Amendment No.4 to Professional Service Agreement No. 2020-020 with Paradigm Pictures for Video Production Services.

Agenda Item A.12

CPMS CONSENT CALENDAR
Meeting Date: June 18, 2024
TO: Mayor and Councilmembers
SUBMITTED BY: Kelly Hoover, Community Relations Manager/PIO PREPARED BY: Jaime Shaw, Management Assistant
SUBJECT: Amendment No. 4 to Professional Service Agreement No. 2020-020 with Paradigm Pictures for Video Production Services.

RECOMMENDATION:

Approve and authorize the City Manager to execute Amendment No. 4 to Agreement No. 2020-020 with Paradigm Pictures for Video Production Services increasing the contract amount by $35,000 for a new total not-to-exceed amount of $172,500, subject to approval of the FY 2024/25 mid-cycle budget.

BACKGROUND:

On February 14, 2020, the Ci ty Manager authorized an agreement with Paradigm Pictures for Video Production Services (Agreement No. 2020 -020, “Agreement”) in an amount not to exceed $29,500.

On March 22, 2021, the City Manager authorized Amendment No. 1 to the Agreement amending the contract amount by $12,000 with a total not to exceed amount of $41,500 and extending the term expiring June 30, 2022.

On June 7, 2022, the City Manager, with Council approval, authorized Amendment No. 2 to the Agreement amending th e contract amount by $43,000 with a total not -to-exceed amount of $84,500 and extending the term to June 30, 2023.

On June 20, 2023, the City Manager, with Council approval, authorized Amendment No. 3 to the Agreement amending the contract amount by $53,000 with a total not-to-exceed amount of $137,500, extending the term to June 30, 202 5, and increasing the fee schedule. Staff initially anticipated spending $26,500 in FY 2023/24 however, due to the high demand for videos and an increasing number of proje cts and programs the City is working on, staff has spent $42,000 as of June 11, 2024, still within contract authority.

Staff was able to move money within the division to cover the additional expenses for FY 2023/24.
1 Meeting Date: June 18, 2024

Page 2 of 2 ends

The original Agreement and subsequent Amendments are provided as Attachment 2.

DISCUSSION:

Paradigm Pictures has provided high-quality service to the City, producing approximately 120 videos (in English and Spanish) since February 2020. Videos continue to be a great way to reach the community. With the City’s ongoing effort to produce videos in Spanish as well , this creates an additional cost. Due to the high demand for videos and an increasing number of projects and programs the City is working on, staff is recommending the City Council authorize Amendment No. 4 to the Agreement to enable the Community relations Division to highlight City programs and projects.

FISCAL IMPACTS:

Amendment No. 4 is for an additional $ 35,000 for FY 2024/25 for a total new not -to- exceed amount of $172,500. Community Relations Division has budgeted $35,000 in FY 2024/25 under the line-item Professional Services (101 -10-1500-51200), subject to Council approval for the FY2024/25 mid-cycle budget.

ALTERNATIVES:

Alternatively, Council can choose not to approve Amendment No. 4, doing so would limit the number of videos the Community Relations Division produces in FY 2024/25 to four to six. As a comparison, in FY 2023/24, over 30 videos (English and Spanish) were produced and shared with the community.

LEGAL REVIEW BY: Megan Garibaldi, City Attorney
APPROVED BY: Robert Nisbet, City Manager
ATTACHMENTS:

1. Amendment No. 4 to the Professional Services Agreement No. 2020 -020 with Paradigm Pictures Video Production Services

2. Paradigm Pictures Video Production Services Agreement No. 2020 -020 and Amendments 1, 2, and 3
2 ATTACHMENT 1
Amendment No. 4 to the Professional Services Agreement No. 2020-020 with Paradigm Pictures Video Production Services
3 City of Goleta
Amendment No. 4 to Agreement No. 2020-020

Page 1 of 2 ends

AMENDMENT NO. 4

TO A PROFESSIONAL SERVICES AGREEMENT

BETWEEN THE CITY OF GOLETA
AND

PARADIGM PICTURES
This Amendment No. 4 to the Professional Services Agreement by and between the City of Goleta , a municipal corporation (“City”) and Paradigm Pictures (“Consultant”) dated February 14, 2020 (“Agreement,” Agreement No. 2020-020) is made on this _____ day of ___, 2024.

SECTION A. RECITALS

1. This Agreement is for professional services for video production services; and

2. This Agreement has been amended to increase the compensation and extend the term date (Amendment No. 1, 2, and 3); and

3. The Agreement currently provides in Section 3 Subsection (a) for the total compensation amount not to exceed $137,500; and

4. The parties desire to amend the Agreement so as to provide for additional compensation in the amount of $35,000 for continued tasks; and

5. The City Council approved this Amendment No. 4, on this _____ day of ____, 2024.

SECTION B. AMENDED TERMS
Now therefore City and Consultant agree as follows that the Agreement be, and hereby is, amended as follows:

1. Subsection (a) of Section 3. COMPENSATION AND PAYMENT of the Agreement is amended to add an additional authorized amount of $35,000 and to read in its entirety:
(a) Maximum and Rate . The total compensation payable to CONSULTANT by CITY for the services under this AGREEMENT SHALL NOT EXCEED the sum of $172,500 (herein "not-to-exceed amount") and shall be earned as the work progresses.

Hourly at the hourly rates and with reimbursement to
CONSULTANT for those expenses set forth in
CONSULTANT's Schedule of Fees marked Exhibit "B -1,"
DocuSign Envelope ID: BBA36BA9-9C21-4156-A815-7A727E9A2118 4 City of Goleta
Amendment No. 4 to Agreement No. 2020-020

Page 2 of 2 ends

attached and incorporated herein. The rates and expenses set forth in that exhibit shall be binding upon CONSULTANT until June 30, 2025, after which any change in said rates and expenses must be approved in writing by CITY's Project
Manager as described i n Section 5 (CITY is to be given 60 days notice of any rate increase request), provided the not to exceed amount is the total compensation due CONSULTANT
for all work described under this AGREEMENT.

2. Except as otherwise specifically provided herein, all other provisions of the Agreement shall remain in full force and effect.

In concurrence and witness whereof, this Amendment No. 4 has been executed by the parties effective on the date and year first above written.

CITY OF GOLETA CONSULTANT
____________________________ ______________________________ Robert Nisbet, City Manager Paul Westmacott, Owner/Producer ATTEST:
_____________________________
Deborah Lopez, City Clerk
APPROVED AS TO FORM:

MEGAN GARIBALDI, CITY ATTORNEY
_____________________________
Scott Shapses, Deputy City Attorney
DocuSign Envelope ID: BBA36BA9-9C21-4156-A815-7A727E9A2118 5 ATTACHMENT 2
Paradigm Pictures Video Production Services Agreement No. 2020-020 and Amendments 1, 2, and 3
6 DOCUMENT ROUTING AND APPROVAL FORM
Requires Council Approval:
☐NO
☐YES
Meeting Date:

Requires Vendor Set -up:
☐NO
☐YES
If no, Vendor Number:

Director Level Approval:
☐NO
☐YES
Site Authority:

Provide summary of agreement below:

Document Name and Type: Project Name :

Vendor Name:

Contact Person:

Address:

Phone Number:

Email Address:

Business License Number:

City Project Manager:

Contact Number:

Email Address:

AMOUNT NOT TO EXCEED : ON CALL SERVICES? : ☐NO ☐YES*
*On call s ervices require one spreadsheet to track multiple PO’s COUNCIL APPROPRIATION NEEDED : ☐NO ☐YES*
*May requ ire Purchasing Officer ’s override to input Requis ition

ROUTING PROCESS DESCRIPTION DATE INITIAL
Department Head
Initiation
Authority to initiate agreement
Risk Manager Staff to initiate review of insurance provision in agreement City Attorney Contract review/Approve as form
Finance Director,
Purchasing Officer
Funding Methods Approved/
Authorized, Purchase
Requisition reviewed.

Requisition Number:

Staff (DocuSign User) Staff routes agreement to vendor via DocuSign for electronic signature and requests Insurance documents.

Risk Manager Risk Management shall r ate Insurance.

City Manager City Manager will approve and sign the agreement.

City Clerk City Clerk will approve and sign the agreement.

FINALIZED ON: INITIAL RESOLUTION NO
(IF APPLICABLE)
Staff Routing Agreement:

Contact Number:

Email Address:

Vendor Staff will route a fully exec uted copy of the agreement to the vendor.

BELOW FOR CITY CLERK PROCESSING ONLY

FILE NUMBER
May 16, 2023
003177
City Manager
Extending agreement for video services and
updating fee schedule.

Amendment No. 3 to a Professional Services Agreement
Video Services
Paradigm Pictures
$137,500
Paul Westmacott
1173 Camino Andaluz, Santa Barbara, 93111
805-636-9026
[email protected]
2020-0022
Kelly Hoover
805-961-7507
[email protected]
Jaime Shaw
805-961-7508
[email protected]
DocuSign Envelope ID: 46D6A2EF-882A-4620-B74A-6EA557925A10 5/30/2023
5/31/2023
DocuSign Envelope ID: A95B4497-949A-4DF5-8017-24B92C08FD07 7/3/2023
7/3/2023
7/6/2023
7/6/2023
Moved to June 20, 2023
7/6/2023
7/14/2023
City of Goleta
Amendment No. 3 to Agreement No. 2020-020

Page 1 of 3 ends

AMENDMENT NO. 3

TO A PROFESSIONAL SERVICES AGREEMENT

BETWEEN THE CITY OF GOLETA
AND

PARADIGM PICTURES

This Amendment No. 3 to the Professional Services Agreement by and between the City of Goleta , a municipal corporation (“City”) and Paradigm Pictures (“Consultant”) dated February 14, 2020 (“Agreement,” Agreement No. 2020-020) is made on this _____ day of ___, 20______.

SECTION A. RECITALS

1. This Agreement is for professional services for video production services; and

2. This Agreement has been amended to increase the compensation and extend the term date (Amendment No. 1 and 2); and

3. The Agreement currently provides in Section 3 Subsection (a) for the total compensation amount not to exceed $84,500; and

4. The parties desire to amend the Agreement so as to provide for additional compensation in the amount of $53,000 for continued services ; and

5. The Agreement currently provides in Section 6 for the termination of the Agreement on June 30, 2023; and

6. The parties desire to amend the Agreement so as to extend the termination of the Agreement to June 30, 2025; and

7. The Agreement currently provides in Exhibit B entitled “Schedule of Fees” the hourly rates; and

8. The parties desire to amend Exhibit B of the Agreement to identify the new hourly rates, attached as “Exhibit B-1”; and

9. The City Council approved this Amendment No. 3, on this _____ day of ____, 20_____.

SECTION B. AMENDED TERMS

Now therefore City and Consultant agree as follows that the Agreement be, and hereby is, amended as follows:

DocuSign Envelope ID: 46D6A2EF-882A-4620-B74A-6EA557925A10 DocuSign Envelope ID: A95B4497-949A-4DF5-8017-24B92C08FD07 20th
23 June 23
2020-020.3
20th June
8 City of Goleta
Amendment No. 3 to Agreement No. 2020-020

Page 2 of 3 ends

1. Subsection (a) of Section 3. COMPENSATION AND PAYMENT of the Agreement is amended to add an additional authorized amount of $53,000 and to read in its entirety:
(a) Maximum and Rate . The total compensation payable to CONSULTANT by CITY for the services under this AGREEMENT SHALL NOT EXCEED the sum of $137,500 (herein "not-to-exceed amount") and shall be earned as the work progresses.

Hourly at the hourly rates and with reimbursement to
CONSULTANT for those expenses set forth in
CONSULTANT's Schedule of Fees marked Exhibit "B,"
attached and incorporated herein. The rates and expenses set forth in that exhibit shall be binding upon CONS ULTANT until June 30, 2025, after which any change in said rates and expenses must be approved in writing by CITY's Project
Manager as described in Section 5 (CITY is to be given 60 days notice of any rate increase request), provided the not to exceed amount is the total compensation due CONSULTANT
for all work described under this AGREEMENT.

2. Section 6. TERM, PROGRESS AND COMPLETION of the Agreement is amended to extend the term for an additional three years to read in its entirety.

The term of this Agr eement is from the date first written above to June 30, 2025, unless the term of this Agreement is extended or the Agreement is terminated as provided for herein.

CONSULTANT shall not commence work on the services to be performed until (i) CONSULTANT furnishes proof of insurance as required by Section 10 below, and (ii) CITY gives written authorization to proceed with the work provided by CITY’s Project Manager. All services shall be completed within the term of this Agreement following the notice to proceed.

3. This Agreement is amended to delete and replace in its entirety:

Exhibit B “ Schedule of Fees ” with Exhibit B-1 “Schedule of Fees ” attached hereto and incorporated herein.

4. Except as otherwise specifically provided herein, all other provisions of the Agreement shall remain in full force and effect.

In concurrence and witness whereof, this Amendment No. 3 has been executed by the parties effective on the date and year first above written.

DocuSign Envelope ID: 46D6A2EF-882A-4620-B74A-6EA557925A10 DocuSign Envelope ID: A95B4497-949A-4DF5-8017-24B92C08FD07 9 City of Goleta
Amendment No. 3 to Agreement No. 2020-020

Page 3 of 3 ends

MEGAN GARIBALDI, CITY ATTORNEY
_____________________________
Winnie Cai, Assistant City Attorney
DocuSign Envelope ID: 46D6A2EF-882A-4620-B74A-6EA557925A10 DocuSign Envelope ID: A95B4497-949A-4DF5-8017-24B92C08FD07 10 Exhibit B-1 – Schedule of Fees
$90 per hour for Public Service Announcement's (PSA’s) / commercials / or short impact videos. This includes all production and postproduction costs.

DocuSign Envelope ID: 46D6A2EF-882A-4620-B74A-6EA557925A10 DocuSign Envelope ID: A95B4497-949A-4DF5-8017-24B92C08FD07 11 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE

THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS.

INSURER(S) AFFORDING COVERAGE
INSURER F :

INSURER E :

INSURER D :

INSURER C :

INSURER B :

INSURER A :

NAIC #
NAME:

CONTACT
(A/C, No):

FAX
E-MAIL
ADDRESS:

PRODUCER
(A/C, No, Ext):

PHONE

INSURED
REVISION NUMBER:CERTIFICATE NUMBER:COVERAGES
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed.

If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).

THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS

CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.

OTHER:
(Per accident)
(Ea accident)
$
$
N / A
SUBR
WVD
ADDL
INSD

THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS

CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. $ $
$
$PROPERTY DAMAGE
BODILY INJURY (Per accident)
BODILY INJURY (Per person)

COMBINED SINGLE LIMIT

AUTOS ONLY

AUTOSAUTOS ONLY

NON-OWNED

SCHEDULEDOWNED

ANY AUTO

AUTOMOBILE LIABILITY
Y / N

WORKERS COMPENSATION

AND EMPLOYERS' LIABILITY
OFFICER/MEMBER EXCLUDED?
(Mandatory in NH)
DESCRIPTION OF OPERATIONS below
If yes, describe under

ANY PROPRIETOR/PARTNER/EXECUTIVE
$
$
$
E.L. DISEASE - POLICY LIMIT
E.L. DISEASE - EA EMPLOYEE
E.L. EACH ACCIDENT
ER
OTH-

STATUTE
PER

LIMITS(MM/DD/YYYY)

POLICY EXP
(MM/DD/YYYY)

POLICY EFF

POLICY NUMBERTYPE OF INSURANCELTR
INSR
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)

EXCESS LIAB
UMBRELLA LIAB $EACH OCCURRENCE
$AGGREGATE
$
OCCUR

CLAIMS-MADE

DED RETENTION
$
$PRODUCTS - COMP/OP AGG
$GENERAL AGGREGATE
$PERSONAL & ADV INJURY
$MED EXP (Any one person)
$EACH OCCURRENCE

DAMAGE TO RENTED
$PREMISES (Ea occurrence)

COMMERCIAL GENERAL LIABILITY

CLAIMS-MADE OCCUR
GEN'L AGGREGATE LIMIT APPLIES PER:

POLICY PRO-

JECT LOC

CERTIFICATE OF LIABILITY INSURANCE

DATE (MM/DD/YYYY)

CANCELLATION

AUTHORIZED REPRESENTATIVE
ACORD 25 (2016/03)
© 1988-2015 ACORD CORPORATION. All rights reserved.

CERTIFICATE HOLDER
The ACORD name and logo are registered marks of ACORD
HIRED

AUTOS ONLY
04/10/2023
Jo
hn McLaren Ins Inc
PO BOX 14136
TUCSON AZ 85732

DORIS SUTTON
(714)-968-4100 (714)-968-8304
john@ mclarenandassociates.com

PAUL WESTMACOTT
1173 Camino Andaluz
Santa Barbara CA 93111-1001
HISCOX Insurance Company Inc 10500
A X P100-062-248-4 01/13/2023 01/13/2024
1,000,000
100,000
5,000
S/T Ech. Agg.
2,000,000
S/T Gen. Agg.

A
✖ ✖
P100-062-248-4 01/13/2023 01/13/2024
A
Pr
ofessional Liability
P100-060-043-4 01/13/2023 01/13/2024
Each 1,000,000
Aggregate 2,000,000

THE CITY OF GOLETA IS ADDED AS ADDITIONALY INSURED
A 30 DAY WRITTEN NOTICE SHALL BE GIVEN OTHER THAN FOR NON PAYMENT OF PREMIUM WHICH IS 10 DAYS 130 Cremona Drive., Ste B
Goleta, Ca 93117

THE CITY OF GOLETA
By Sandra Rodriguez at 9:19 am, Apr 18, 2023
DocuSign Envelope ID: 46D6A2EF-882A-4620-B74A-6EA557925A10 DocuSign Envelope ID: A95B4497-949A-4DF5-8017-24B92C08FD07 12 Hiscox Insurance Company Inc.

Endorsement 30
NAMED INSURED: PAUL WESTMACOTT
Blanket Additional Insured - Clients and Lessors of Premises Page 1 of 1 BOP-GL E5025 CW (11/19)
Includes copyrighted material of Insurance
Services Office, Inc. with its permission
In consideration of the premium charged, and on the understanding this endorsement leaves all other terms, conditions, and exclusions unchanged, it is agreed the General Liability Coverage Part is amended as follows:

I. The following are added to the end of Section III. Who is an insured:

CL-A. Clients If you have agreed in a written contract or agreement to add them as an additional insured to a policy providing the type of coverage afforded by this Coverage Part, any person or organization for whom you are performing operations is an insured, but only with respect to liability arising out of:

1. your
acts or omissions or of those acting on your behalf; and

2. the performance of your ongoing operations for the additional insured.

A person or organization's status as an additional insured under this subsection CL-A ends when your operations for that additional insured are completed.

CL-B. Lessors of premises If you have agreed in a written contract or agreement to add them as an additional insured to a policy providing the type of coverage afforded by this Coverage Part, any person or organization from whom
you lease any premises is an insured, but only
with respect to liability arising out of the ownership, maintenance, or use of that part of the premises leased to
you.

However, the coverage afforded to such additional insured(s) does not apply to any liability arising out of structural alterations, new construction, or demolition operations performed by or for such additional insured(s).

A person or organization’s status as an additional insured under this subsection CL-B ends when
you cease to be a tenant in the premises.

Endorsement Effective: January 13, 2023 Policy No.: P100.062.248.4 By: Kevin Kerridge
(Appointed Representative)
DocuSign Envelope ID: 46D6A2EF-882A-4620-B74A-6EA557925A10 DocuSign Envelope ID: A95B4497-949A-4DF5-8017-24B92C08FD07 13 16-1593

MISSION SANTA BARBARA INS SERV
1114 STATE ST STE 254
SANTA BARBARA CA 93101-2798

PAUL WESTMACOTT
1173 CAMINO ANDALUZ
SANTA BARBARA CA 93111-1001
OC-464/EP 4/99
G2
**** REPRINTED FROM THE ARCHIVE. THE ORIGINAL TRANSACTION MAY INCLUDE ADDITIONAL FORMS **** DocuSign Envelope ID: 46D6A2EF-882A-4620-B74A-6EA557925A10 DocuSign Envelope ID: A95B4497-949A-4DF5-8017-24B92C08FD07 14 MISSION SANTA BARBARA INS SERV
1114 STATE ST STE 254
SANTA BARBARA CA 93101-2798
June 23, 2022
Policy Number: A3543348
24-Hour Claims: 1-866-472-3326
Policy Service: 1-866-472-3326
Online Account Services: www.safeco.com
THIS IS NOT A BILL.

IDENTIFICATION CARDS ENCLOSEDPAUL WESTMACOTT
1173 CAMINO ANDALUZ
SANTA BARBARA CA 93111-1001
Welcome to Safeco]
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DRIVING RECORD
Your driving record affects the rate you pay for your insurance coverage. We will charge a lower rate if all named operators of the insured vehicle have had no accidents and no convictions during the last three years. We will charge a higher rate if during the last three years, any of the named operators of the vehicle have been convicted of traffic violations or have been involved in one or more at-fault accidents. The more violations and at-fault accidents the operators accumulate, the more the premium is increased. If your premium has been adjusted due to convictions or accidents, your rating information disclosure page will indicate convictions or accidents for each rated driver.

RATING INFORMATION
The premiums on your policy are also based on the kind of car you drive, where the car is located, use of the car, the annual miles driven, the marital status of the operator, and the years of driving experience of the named operators. In addition, you may be eligible for a variety of discounts which are listed below:
· Air Bag Ð The insured vehicle is equipped with a factory-installed air bag system on both the driver and passenger sides.
· Account Ð The named insured has additional, select lines of business with Safeco. Examples include home, condominium, renters, landlord protection and umbrella policies. · Distant Student Ð The youthful operator is less than 25 years of age, resides in your household but is a resident student at an education institution over 100 road miles from the principal garaging address and the youthful operator does not have a car at school. · Good Driver Ð The principal operator has been continuously licensed for the previous 36 months, the most recent 18 months in the U.S. or Canada, has no more than one DMV violation point during the most recent 36 months, has not been a driver of a motor vehicle involved in an accident that resulted in bodily injury or in the death of any person and was principally at fault, and has no DUI convictions in the last 10 years.
· Good Student Ð A youthful operator (less than 25 years of age) is a full-time student in high school or college. They must either be ranked in the top 20% of their class, maintain a ªBº average or its equivalent (High School), ªB-º or its equivalent (College), an average of 3 grade points for all subjects combined or its equivalent, or be included in a dean's list, honor roll or comparable listing for scholastic achievement.
· Longevity Ð The insured's policy has been enforce with Safeco for three to six or more years without interruption.
· Mature Driver Improvement Course Ð The principal operator is aged 55 years or older and has successfully completed the California state approved mature driver improvement course during the last three years. The operator must not have any at-fault accidents or violations within the last three years. · Multi-Car Ð Two or more vehicles are insured with Safeco and all are owned or leased by named insureds residing in the same household.
· Superior Good Driver Ð The principal operator qualifies for the Good Driver Discount, has five years of driving experience, has no chargeable violations in the past three years, has no major violations in the past 5 years, has no more than 1 DMV violations point during the past five years and no principally at fault accidents resulting in bodily injury or death in the last five years. · Anti-Theft Devices (available for Antique Auto, Classic Cars and Motorhomes with Comprehensive Coverage only) Ð The insured vehicle is equipped with anti-theft devices such as an alarm only, active disabling device or a passive disabling device. **** REPRINTED FROM THE ARCHIVE. THE ORIGINAL TRANSACTION MAY INCLUDE ADDITIONAL FORMS **** DocuSign Envelope ID: 46D6A2EF-882A-4620-B74A-6EA557925A10 DocuSign Envelope ID: A95B4497-949A-4DF5-8017-24B92C08FD07 17 SA-2219/CAEP 10/19 Page 2 of 2
Group rates are also available for individuals that qualify as Highly Skilled Workers. Supporting documentation must be provided to qualify.

All discounts and savings are subject to eligibility requirements. The descriptions are necessarily brief and do not include all terms, conditions, or exclusions.

Safeco offers two automobile programs in California. If you are a good driver, you qualify for the good driver program and the standard program. Each program offers different coverages and different rating plans. For your convenience below we've included the coverage and rating differences between the two programs. Please contact your agent if you would like to compare coverages and rates to see which plan is best suited to your needs.

Coverage Options: Safeco Safeco Standard
Policy Term 6 or 12 months 6 months only
Emergency Roadside Assistance Available Not Available
Auto Loan/Lease Coverage Available Not Available
Audio, Video and Customized Equipment Coverage Up to $5,000 per vehicle Up to $4,000 per vehicle Optimum Package Plus Available Not Available
Permissive Drivers Covered at selected limits Limited to minimum CA limit Recreational Vehicles Accepted Not Accepted
Antique/Classic Vehicles Accepted Not Accepted
Mexico Coverage Available Not Available
Bodily Injury Liability Limits:
- $300,000/$300,000 Split Limit Available Not Available - $500,000/$500,000 Split Limit Available Not Available - $100,000 Combined Single Limit Available Not Available - $300,000 Combined Single Limit Available Not Available Property Damage Liability Limits:
- $300,000 Per Accident Available Not Available
- $500,000 Per Accident Available Not Available
Medical Payment Limit of $25,000 Available Not Available Uninsured Motorist Bodily Injury Limits:
- $300,000/$300,000 Split Limit Available Not Available - $500,000/$500,000 Split Limit Available Not Available Loss of Use Limit $75/$4,500 Available Not Available
Auto Death Indemnity and Total Disability Available Not Available Extended Non-Owned Auto Coverage Available Not Available Vendors Single Interest Available Not Available
Thank you for entrusting us with your insurance needs. We appreciate having you as a customer. **** REPRINTED FROM THE ARCHIVE. THE ORIGINAL TRANSACTION MAY INCLUDE ADDITIONAL FORMS **** DocuSign Envelope ID: 46D6A2EF-882A-4620-B74A-6EA557925A10 DocuSign Envelope ID: A95B4497-949A-4DF5-8017-24B92C08FD07 18 P-4537/CAEP 1/16 Page 1 of 2
G1
IMPORTANT NOTICE Ð ADD A PARTY TO RECEIVE NOTICE
California law gives you the right to identify an additional person to receive a duplicate copy of any notice of lapse, termination, expiration, nonrenewal or cancellation we send to you due to non-payment of premium.

To assign a designee, simply complete the form below and mail the form to:

Safeco Insurance Companies
Personal Lines Underwriting
PO Box 704000
Salt Lake City, UT 84170-4000
Email: [email protected]
Fax: 877-344-5107
You may also deliver the form to your independent Safeco agent. Agent contact information is shown on your policy Declarations.

Please keep a copy of the completed form for your records. You may also change or terminate the third party designee by sending us written notification or completing the relevant section below.

Request to Designate a Third Party to Receive a Copy of Policy Termination Notices for Non-Payment of Premium.

Insured
Name
Policy
Number(s)*
Address
*List all applicable policy numbers.

I designate the following person to receive a duplicate copy of any notice of lapse, termination, expiration, nonrenewal or cancellation that you send me due to non-payment of premium for the policy number shown above.

I understand the third party designee does not have any right, whether as an additional insured or otherwise, to any benefits under the policy other than the right to receive the notice of lapse, termination, expiration, nonrenewal, or cancellation for nonpayment of premium.

Insured
Name
Policy
Number(s)*
Address
*List all applicable policy numbers.

I would like to replace my prior third party designee with the following person to receive a duplicate copy of any notice of lapse, termination, expiration, nonrenewal or cancellation that you send me due to non-payment of premium for the policy number shown above.

Designee Name
Street City State Zip
Signature of Insured Date
Request to Delete a Third Party from Receiving a Copy of Policy Termination Notices for Non-Payment of Premium.

Insured
Name
Policy
Number(s)*
Address
*List all applicable policy numbers.

I would like to delete my previously selected third party designee from receiving a duplicate copy of any notice of lapse, termination, expiration, nonrenewal or cancellation that you send me due to nonpayment of premium for the policy number shown above.

Designee Name
Street City State Zip
Signature of Insured Date
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1 CN-2/CAEP 12/20
Safeco Insurance Privacy Notice Ð California
Effective December 11, 2020
Safeco Insurance, its affiliates and subsidiaries (collectively ªSafecoº or ªweº, ªusº and ªourº ) provide insurance to individuals. We strive to protect your privacy. This notice applies to you if you are a California resident and are contacting us to learn about our products, to buy insurance for yourself (for example, auto insurance), or if you are filing a claim against a policy. In this notice, we explain how we gather, use, share, and protect your data.

What Personal Data Do We Collect?
The types of personal data we gather and share depends on both the product and your relationship to us. For example, we may gather different data if you are a claimant reporting an injury than if you want a quote for auto insurance. The data we gather can include your social security number, income, transaction data such as account balances and payment history, and data from consumer reports. It may also include data gathered in connection with our provision of insurance services, when you apply for such services, or resulting from other contacts with you. It may also include:
· Identifiers, including a real name, alias, postal address, unique personal identifier, online identifier, Internet Protocol address, email address, account name, Social Security number, driver's license number, or other similar identifiers;
· Personal data , such as your name, signature, Social Security number, physical characteristics or description, address, telephone number, driver's license or state identification card number, insurance policy number, education, employment, employment history, bank account number, financial data, medical data, or health insurance data;
· Protected classification characteristics described in California Civil Code § 1798.80(e) , including age, race, color, national origin, citizenship, religion or creed, marital status, medical condition, physical or mental disability, sex (including gender, gender identity, gender expression, pregnancy or childbirth and related medical conditions), sexual orientation, veteran or military status; · Commercial data, including records of personal property, products or services purchased, obtained, or considered, or other purchasing or consuming histories and tendencies; · Internet or other similar network activity , including browsing history, search history, data on a consumer's interaction with a website, application, or advertisement; · Professional or employment related data , including current or past job history or performance evaluations;
· Inferences drawn from other personal data , such as a profile reflecting a person's preferences, characteristics, psychological trends, predispositions, behavior, attitudes, intelligence, abilities, and aptitudes;
· Risk data , including data about your driving and/or accident history; this may include data from consumer reporting agencies, such as your motor vehicle records and loss history data, health data, or criminal convictions;
· Claims data, including data about your previous and current claims, which may include data regarding your health, criminal convictions, third party reports, or other personal data.

For information about the types of personal data we have gathered in the past twelve months, please go to libertymutual.com/privacy and click on the link for the California Supplemental Privacy Policy.

How Do You Gather my Data?
We gather your personal data directly from you.

For example, you provide us with data when you:

We also gather your personal data from other people .

For example:
· ask about, buy insurance or file a claim · your insurance agent or broker · pay your policy · your employer, association or business (if you are insured through them)
· visit our websites, call us, or visit our office · our affiliates or other insurance companies about your transactions with them
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2 CN-2/CAEP 12/20
· consumer reporting agencies, Motor Vehicle
Departments, and inspection services, to gather your
credit history, driving record, claims history, or value and condition of your property
· other public directories and sources
· third parties, including other insurers, brokers and
insurance support organizations who you have
communicated with about your policy or claim, anti-
fraud databases, sanctions lists, court judgments and
other databases, government entities, open electoral
register, advertising networks, data analytics
providers, social networks, data brokers, or in the
event of a claim, third parties including other parties to the claim, witnesses, experts, loss adjustors, and
claim handlers
· other third parties who take out a policy with us and are required to provide your data such as when you
are named as a beneficiary or where a family
member has taken out a policy which requires your
personal data
Organizations that share data with us may keep it and share it to others as permitted by law. For data about how we have gathered personal data in the past twelve months, please go to libertymutual.com/privacy and click on the link for the California Supplemental Privacy Policy.

How Do We Use Your Personal Data?
Safeco uses your data to provide you our products and services and as otherwise provided in this notice. We may use your data and the data of our former customers for our business purposes. Our business purposes include:

Business Purpose Data Categories
Market, sell and provide insurance.

This includes for example:
· calculating your premium;
· determining your eligibility for a quote;
· confirming your identity and service your policy;
· Identifiers
· Personal Information
· Protected Classification Characteristics
· Commercial Information
· Internet or other similar network activity
· Professional or employment related
information
· Inferences drawn from other personal
information
· Risk data
· Claims data
Manage your claim.

This includes for example:
· managing your claim, if any;
· conducting claims investigations;
· conducting medical examinations;
· conducting inspections, appraisals;
· providing roadside assistance;
· providing rental car replacement, or repairs;
· Identifiers
· Personal Information
· Protected Classification Characteristics
· Commercial Information
· Internet or other similar network activity
· Professional or employment related
information
· Inferences drawn from other personal
information
· Risk data
· Claims data
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Day to Day Business and Insurance Operations.

This includes, for example:
· creating, maintaining, customizing and securing
accounts;
· supporting day-to-day business and insurance
related functions;
· doing internal research for technology development;
· marketing and creating products and services;
· conducting audits related to a current contact with a consumer and other transactions;
· as described at or before the point of gathering
personal data or with your authorization;
· Identifiers
· Personal Information
· Protected Classification Characteristics
· Commercial Information
· Internet or other similar network activity
· Professional or employment related
information
· Inferences drawn from other personal
information
· Risk data
· Claims data
Security and Fraud Detection.

This includes for example:
· detecting security issues;
· protecting against fraud or illegal activity, and to
comply with regulatory and law enforcement
authorities;
· managing risk and securing our systems, assets,
infrastructure and premises; roadside assistance,
rental car replacement, or repairs
· help to ensure the safety and security of Safeco staff, assets and resources, which may include physical
and virtual access controls and access rights
management;
· supervisory controls and other monitoring and
reviews, as permitted by law; and emergency and
business continuity management;
· Identifiers
· Personal Information
· Protected Classification Characteristics
· Commercial Information
· Internet or other similar network activity
· Professional or employment related
information
· Inferences drawn from other personal
information
· Risk data
· Claims data
Regulatory and Legal Requirements.

This includes for example:
· controls and access rights management;
· to evaluate or conduct a merger, divestiture,
restructuring, reorganization, dissolution, or other
sale or transfer of some or all of Safeco's assets,
whether as a going concern or as part of bankruptcy,
liquidation, or similar proceeding, in which personal
data held by Safeco is among the assets transferred;
· exercising and defending our legal rights and
positions;
· to meet Safeco contract obligations;
· to respond to law enforcement requests and as
required by applicable law, court order, or
governmental regulations;
· as otherwise permitted by law
· Identifiers
· Personal Information
· Protected Classification Characteristics
· Commercial Information
· Internet or other similar network activity
· Professional or employment related
information
· Inferences drawn from other personal
information
· Risk data
· Claims data
Improve Your Customer Experience and Our Products.

This includes for example:
· improve your customer experience, our products and
service;
· to provide, support, personalize and develop our
website, products and services;
· create and offer new products and services;
· Identifiers
· Personal Information
· Commercial Information
· Internet or other similar network activity
· Professional or employment related
information
· Inferences drawn from other personal
information
· Risk data
· Claims data
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Analytics to identify, understand and manage our risks
and products.

This includes for example:
· conducting analytics to better identify, understand
and manage risk and our products;
· Identifiers
· Personal Information
· Protected Classification Characteristics
· Commercial Information
· Internet or other similar network activity
· Professional or employment related
information
· Inferences drawn from other personal
information
· Risk data
· Claims data
Customer service and technical support:
· answer questions and provide notifications;
· provide customer and technical support.
· Identifiers
· Personal Information
· Commercial Information
· Internet or other similar network activity
· Professional or employment related
information
· Inferences drawn from other personal
information
· Risk data
· Claims data
Do We Share Your Personal Data?
Safeco does not sell your personal data as defined by California law.

Safeco may share personal data with affiliated and non-affiliated third parties, including:
· Liberty Mutual affiliates;
· Service Providers (such as auto repair facilities, towing companies, property inspectors, and independent adjusters);
· Insurance support organizations;
· Brokers and agents;
· Government entities (e.g. regulatory, quasi-regulatory, tax or other authorities, law enforcement agencies, courts, arbitrational bodies, and fraud prevention agencies); · Consumer reporting agencies;
· Advisors including law firms, accountants, auditors, and tax advisors; · Insurers, re-insurers, policy holders, and claimants; · Group policyholders (for reporting claims data or an audit); · Advertising networks, data analytics providers, and social networks; · Service providers and affiliates for actuarial or research studies; and · As permitted by law.

We may also share data with other companies that provide marketing services on our behalf or as part of a joint marketing agreement for products offered by Safeco. We will not share your personal data with others for their own marketing purposes.

We may also share data about our transactions (such as payment history) and experiences (such as claims made) with you to our affiliates.

Safeco may share the following categories of personal data as needed for business purposes:

Identifiers Personal Data
Protected Classification Characteristics Commercial Data Internet of other similar network activity Professional, employment and education data Inferences drawn from personal data Risk Data
Claims Data
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For information about how we have shared personal data in the past twelve months, please go to libertymutual.com/privacy and click on the link for the California Supplemental Privacy Policy.

Your Agent or Broker
Your agent or broker is not a Safeco employee and is not subject to our privacy policy. Because your agent or broker works with you directly, he or she may have data about you that Safeco does not have. Your agent or broker may use this data differently than Safeco. Contact your agent or broker to learn more about their privacy practices.

How Do We Keep your Personal Data Safe?
We maintain physical, electronic, and administrative safeguards created to protect your data from unauthorized access. Our employees are authorized to access your data only for legitimate business purposes.

What Rights Do I Have to Learn More About My Personal Data? You may have rights under California laws to learn more about our privacy practices.

For example, under the California Insurance Code you may request a copy of certain information about you to review its completeness and accuracy. You must make this request in writing by contacting us as indicated below.

We have 30 business days after receiving your request to send the data to you.

To the extent required by law, we will also tell you of any persons to whom we have shared the data in the last two years. We will also share the name and address of any consumer reporting agency from which we have received information about you. Some data we are not required to share.

If you believe the data we have about you is incorrect, you may notify us in writing of what you would like to correct and why. We will respond within 30 business days.

If we agree, we will change our records. We will send the change to any organization that has received the inaccurate information from us. It will also be included in any later disclosures to others.

If we disagree, we will tell you why. You can write us with a short statement explaining why you believe that the data is incorrect. This will become part of the file. We will also send it to any persons that have received the disputed information from us. It will also be included in any later disclosures to others.

You may have additional rights under other California laws. For more information about these rights, please go to libertymutual.com/privacy and click on the link California Supplemental Privacy Notice. If you cannot access the link, please contact us.

How to Contact Us:

You can submit requests, seek additional information, or obtain a copy of our privacy notice in an alternative format by either:

Calling: 800-344-0197
Email: [email protected]
Online: libertymutualgroup.com/privacy-policy/data-request Mail: Liberty Mutual Insurance Company
175 Berkeley St., 6
th Floor
Boston, MA 02116
Attn: Privacy Office
Who is Providing this Notice?
This Privacy Notice is provided on behalf of the following Safeco companies and affiliates:

American Economy Insurance Company, American States Insurance Company, American States Insurance Company of Texas, American States Lloyds Insurance Company, American States Preferred Insurance Company, First National Insurance Company of America, General Insurance Company of America, Insurance Company of Illinois, Safeco Insurance Company of America, Safeco Insurance Company of Illinois, Safeco Insurance Company of Indiana, Safeco Insurance Company of Oregon, Safeco Lloyds Insurance Company, Safeco National Insurance Company, Safeco Surplus Lines Insurance Company. **** REPRINTED FROM THE ARCHIVE. THE ORIGINAL TRANSACTION MAY INCLUDE ADDITIONAL FORMS **** DocuSign Envelope ID: 46D6A2EF-882A-4620-B74A-6EA557925A10 DocuSign Envelope ID: A95B4497-949A-4DF5-8017-24B92C08FD07 25 SAFECO INSURANCE COMPANY OF AMERICA
Auto
CN-0009/CAEP 12/19 Page 1 of 2

CALIFORNIA DEPARTMENT OF INSURANCE

COMMUNITY SERVICES STATEMENT
NOTICE TO POLICYHOLDER(S):

California Department of Insurance Regulations Section 2646.6 requires all Insurance Companies to request information as to the race or national origin and gender of each policyholder. The Regulation calls for this information to be provided voluntarily by each policyholder. This information will be reported to the California Department of Insurance.

The California Department of Insurance requests that you provide this following information in order to monitor the Company's compliance with the law. You are not required to provide this information, but are encouraged to do so. The Company will not use this information you provide here for underwriting or rating purposes. If you have any questions about this request, you may call the California Department of Insurance Consumer Hotline at (800) 927-HELP.

Policy Type:

Policy Number:

Policyholder Name(s):

Policyholder Address:

FOLD
. . . . . .

Please check the Race or National Origin as it applies to you, the policyholder(s). For the purpose of completing this form, the policyholder is defined as: An individual, spouse, domestic partner, or business partner(s) named on the policy.

Race / National Origin Policyholder Co-Policyholder
Male / Female / Non-Binary Male / Female / Non-Binary
African-American ÐÐ ÐÐ ÐÐ ÐÐ ÐÐ ÐÐ
American Indian or Alaskan Native ÐÐ ÐÐ ÐÐ ÐÐ ÐÐ ÐÐ
Asian / Pacific Islander ÐÐ ÐÐ ÐÐ ÐÐ ÐÐ ÐÐ
Latino ÐÐ ÐÐ ÐÐ ÐÐ ÐÐ ÐÐ
White ÐÐ ÐÐ ÐÐ ÐÐ ÐÐ ÐÐ
Other ÐÐ ÐÐ ÐÐ ÐÐ ÐÐ ÐÐ
MAILING INSTRUCTIONS: Please fold this form in half as indicated, tape top and bottom edges together.

Affix proper U.S. postage and place in mail. DO NOT SEND THIS FORM WITH YOUR PAYMENT OR WITH ANY OTHER CORRESPONDENCE REGARDING YOUR POLICY.
**** REPRINTED FROM THE ARCHIVE. THE ORIGINAL TRANSACTION MAY INCLUDE ADDITIONAL FORMS **** DocuSign Envelope ID: 46D6A2EF-882A-4620-B74A-6EA557925A10 DocuSign Envelope ID: A95B4497-949A-4DF5-8017-24B92C08FD07 26 CN-0009/CAEP 12/19 Page 2 of 2

COMMUNITY SERVICE STATEMENT

COLLECTION POINT
PO Box 958416
Lake Mary, FL 32795

THE POST

OFFICE WILL

NOT DELIVER

MAIL WITHOUT

POSTAGE
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

FOLD
I9 00519 79 I

COMMUNITY SERVICE STATEMENT COLLECTION POINT
PO Box 958416
Lake Mary, FL 32795
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The premium on your policy has been increased, at least in part, due to information provided by:

Verisk Analytics
Loss History Report
1000 Bishops Gate Blvd,suite 300
P.O Box 5404
Mt.Laurel, NJ 08054-5404
1-800-709-8842
https://fcra.verisk.com/
The decision to take action was made by SAFECO INSURANCE COMPANY OF AMERICA. The company shown above will be unable to provide you the specific reasons why the decision was made.

The Fair Credit Reporting Act gives you certain rights regarding information about you. You have the right, under Section 612, to obtain a free copy of the report from the company shown above, as long as you request it within 60 days of receipt of this notice. You also have the right, under Section 611, to dispute with them any information contained in the report.

If you have any questions about this change, please contact your agent.

CN-7046/EP 7/02
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SAFECO INSURANCE COMPANY OF AMERICA

RATING INFORMATION DISCLOSURE

THE FOLLOWING INFORMATION IS USED IN DETERMINING THE PREMIUM THAT IS CHARGED FOR YOUR POLICY. PLEASE CALL YOUR AGENT IF YOUR DRIVING PATTERNS HAVE CHANGED AND

YOU WISH TO UPDATE YOUR ESTIMATED ANNUAL MILEAGE, OR FOR QUESTIONS REGARDING YOUR POLICY.

BRIANA WESTMACOTT
31 Years and 9 Months
No Rated Items
No Rated Items
Good Driver, Superior Good Driver
2019 AUDI A3 PREMIUM PLUS 7000 93111
Both Side Air Bag
Account-Umbrella/Home/Landlord Protect, Multi-Car
* For New Business: This is the estimated annual mileage for the current policy term.

EXCESS VEHICLE
2018 TOYOTA PRIUS C 5000 93111
Both Side Air Bag
Account-Umbrella/Home/Landlord Protect, Multi-Car
* For New Business: This is the estimated annual mileage for the current policy term.

PRIMARY RATED DRIVER

DRIVING EXPERIENCE

TRAFFIC CONVICTIONS

AT FAULT ACCIDENTS

DRIVER DISCOUNTS

VEHICLE RATED ON EXPIRING RENEWAL ESTIMATED GARAGING ZIP MILEAGE ANNUAL MILEAGE *

VEHICLE DISCOUNTS AND SURCHARGES

POLICY DISCOUNTS AND AFFINITY PLANS

PRIMARY RATED DRIVER

DRIVING EXPERIENCE

TRAFFIC CONVICTIONS

AT FAULT ACCIDENTS

DRIVER DISCOUNTS

VEHICLE RATED ON EXPIRING RENEWAL ESTIMATED GARAGING ZIP MILEAGE ANNUAL MILEAGE *

VEHICLE DISCOUNTS AND SURCHARGES

POLICY DISCOUNTS AND AFFINITY PLANS
SA-1696/EP 1/04
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SAFECO INSURANCE COMPANY OF AMERICA

RATING INFORMATION DISCLOSURE

PAUL WESTMACOTT
33 Years and 11 Months
No Rated Items
No Rated Items
Good Driver, Superior Good Driver
2018 AUDI Q7 PREMIUM PLUS 6500 93111
Both Side Air Bag
Account-Umbrella/Home/Landlord Protect, Multi-Car
* For New Business: This is the estimated annual mileage for the current policy term.

PRIMARY RATED DRIVER

DRIVING EXPERIENCE

TRAFFIC CONVICTIONS

AT FAULT ACCIDENTS

DRIVER DISCOUNTS

VEHICLE RATED ON EXPIRING RENEWAL ESTIMATED GARAGING ZIP MILEAGE ANNUAL MILEAGE *

VEHICLE DISCOUNTS AND SURCHARGES

POLICY DISCOUNTS AND AFFINITY PLANS
SA-1696/EP 1/04
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AUTOMOBILE POLICY DECLARATIONS
NAMED INSURED:

PAUL WESTMACOTT
1173 CAMINO ANDALUZ
SANTA BARBARA CA 93111-1001
POLICY PERIOD FROM: JUNE 22 2022
TO: JUNE 22 2023
at 12:01 A.M. standard time at
the address of the insured as
stated herein.

AGENT TELEPHONE:
1-866-472-3326
AGENT:

MISSION SANTA BARBARA INS SERV
1114 STATE ST STE 254
SANTA BARBARA CA 93101-2798

PAUL WESTMACOTT, BRIANA R WESTMACOTT
A3 PREMIUM PLUS 4 DOOR SEDAN ID# WAUGUGFF4K1009138
PRIUS C 4 DOOR ID# JTDKDTB35J1605763
BODILY INJURY $500,000 $ 240.50 $500,000 $ 203.30
Each Person Each Person
$500,000 $500,000
Each Occurrence Each Occurrence
PROPERTY DAMAGE $100,000 224.90 $100,000 167.00
Each Occurrence Each Occurrence
BODILY INJURY $500,000 122.90 $500,000 108.10
Each Person Each Person
$500,000 $500,000
Each Accident Each Accident
Actual Cash Value 130.00 Actual Cash Value 87.60
Less $250 Deductible Less $250 Deductible
Full Safety Glass Full Safety Glass
Actual Cash Value 603.80 Actual Cash Value 400.30
Less $500 Deductible Less $500 Deductible

40.50 26.30
ANTI FRAUD FEE 1.74 1.74
---------- ----------
$ 1,364.34 $ 994.34
You may pay your premium in full or in installments. There is no installment fee for the following billing plans: Full Pay, Annual 2-Pay. Installment fees for all other billing plans are listed below. If more than one policy is billed on the installment bill, only the highest fee is charged. The fee is:
$0.00 per installment for recurring automatic deduction (EFT) $0.00 per installment for recurring credit card or debit card $4.00 per installment for all other payment methods

RATED DRIVERS
2019 AUDI
2018 TOYOTA
Insurance is afforded only for the coverages for which limits of liability or premium charges are indicated.

COVERAGES 2019 AUDI LIMITS PREMIUMS 2018 TOYT LIMITS PREMIUMS LIABILITY:

UNINSURED AND UNDERINSURED MOTORISTS:

COMPREHENSIVE

COLLISION

WAIVER OF COLLISION DEDUCTIBLE
ADDITIONAL COVERAGES:

TOTAL TOTAL
-CONTINUED-
DATE PREPARED: JUNE 23 2022SA-1697/EP 6/20 Page 1 of 3
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AUTOMOBILE POLICY DECLARATIONS
(CONTINUED)
NAMED INSURED:

PAUL WESTMACOTT
1173 CAMINO ANDALUZ
SANTA BARBARA CA 93111-1001
POLICY PERIOD FROM: JUNE 22 2022
TO: JUNE 22 2023
at 12:01 A.M. standard time at
the address of the insured as
stated herein.

AGENT TELEPHONE:
1-866-472-3326
AGENT:

MISSION SANTA BARBARA INS SERV
1114 STATE ST STE 254
SANTA BARBARA CA 93101-2798

PAUL WESTMACOTT, BRIANA R WESTMACOTT
Q7 PREMIUM PLUS 4 DOOR ID# WA1LHAF79JD013222
BODILY INJURY $500,000 $ 234.90
Each Person
$500,000
Each Occurrence
PROPERTY DAMAGE $100,000 219.90
Each Occurrence
BODILY INJURY $500,000 121.00
Each Person
$500,000
Each Accident
Actual Cash Value 125.50
Less $250 Deductible
Full Safety Glass
Actual Cash Value 586.30
Less $500 Deductible

39.30 ANTI FRAUD FEE 1.74
----------
$ 1,328.64
2019 AUDI $ 1,364.34
2018 TOYT 994.34
2018 AUDI 1,328.64
VEHICLE COVERAGES $ 3,687.32
----------
$ 3,687.32

RATED DRIVERS
2018 AUDI
Insurance is afforded only for the coverages for which limits of liability or premium charges are indicated.

COVERAGES 2018 AUDI LIMITS PREMIUMS
LIABILITY:

UNINSURED AND UNDERINSURED MOTORISTS:

COMPREHENSIVE

COLLISION

WAIVER OF COLLISION DEDUCTIBLE
ADDITIONAL COVERAGES:

TOTAL
TOTAL EACH VEHICLE:

PREMIUM SUMMARY PREMIUM
TOTAL 12 MONTH PREMIUM FOR ALL VEHICLES ................................. -CONTINUED-
DATE PREPARED: JUNE 23 2022SA-1697/EP 6/20 Page 2 of 3
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AUTOMOBILE POLICY DECLARATIONS
(CONTINUED)
You may pay your premium in full or in installments. There is no installment fee for the following billing plans: Full Pay, Annual 2-Pay. Installment fees for all other billing plans are listed below. If more than one policy is billed on the installment bill, only the highest fee is charged. The fee is:
$0.00 per installment for recurring automatic deduction (EFT) $0.00 per installment for recurring credit card or debit card $4.00 per installment for all other payment methods
CONGRATULATIONS! YOUR PREMIUM INCLUDES DISCOUNTS AND ADJUSTMENTS FOR:

Account-Umbrella/Home/Landlord Protect, Good Driver, Superior Good Driver, Multi-Car, Both Side Air Bag
SA-1852/CAEP 2/21, SA-1701/EP 9/90, SA-1696/EP 1/04, SA-2482/CAEP 9/15 Policy underwritten by SAFECO INSURANCE COMPANY OF AMERICA (a stock insurance company).

Administrative office: 175 Berkeley St., Boston, MA 02116 Mailing Address: PO Box 704000, Salt Lake City, UT 84170-4000 POLICY FORMS APPLICABLE TO THIS POLICY:

SA-1698/EP 6/20 Page 3 of 3
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1114 STATE ST STE 254
SANTA BARBARA CA 93101-2798
TELEPHONE: 1-866-472-3326

IF YOU HAVE A PROBLEM
The California Department of Insurance maintains a Consumer Affairs Division to investigate consumer complaints at:

California Department of Insurance
Consumer Affairs Division
300 South Spring Street
Los Angeles, California 90013
www.insurance.ca.gov
Telephone (Toll Free): 1-(800)-927-HELP
(4357)
The Department requests that you should only contact the Department of Insurance after contacts with the insurance company or its agent or other representative have failed to produce a satisfactory solution to your problem.

P-3221/CAEP 7/20
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CALIFORNIA PERSONAL AUTO POLICY

READY REFERENCE TO YOUR AUTO POLICY
Beginning
On Page
AGREEMENT 1
DEFINITIONS 1
PART A Ð LIABILITY COVERAGE 3
Insuring Agreement
Supplementary Payments
Exclusions
Limit of Liability
Out of State Coverage
Financial Responsibility
Other Insurance
PART B Ð MEDICAL PAYMENTS COVERAGE 7
Insuring Agreement
Exclusions
Limit of Liability
Other Insurance
PART C Ð UNINSURED MOTORISTS COVERAGE 9
Insuring Agreement
Exclusions
Limit of Liability
Other Insurance
Arbitration
PART D Ð COVERAGE FOR DAMAGE TO YOUR AUTO 13
Insuring Agreement
Deductible
Transportation Expenses
Loss to Wearing Apparel and Luggage
Exclusions
Limit of Liability
Payment of Loss
No Benefit to Bailee
Other Sources of Recovery
Appraisal
PART E Ð DUTIES AFTER AN ACCIDENT OR LOSS 18
PART F Ð GENERAL PROVISIONS 19
Policy Period and Territory
Bankruptcy
Changes
Payment of Premium
Legal Action Against Us
Legal Action Against Us Ð Uninsured Motorists Coverage
Our Right to Recover Payment
Termination
Transfer of Your Interest in This Policy
Two or More Autos Insured; Two or More Auto Policies
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Beginning
On Page
Loss Payable Clause
Storage Costs
Named Driver Exclusion
Warning
ADDITIONAL COVERAGES 22
Roadside Assistance Coverage
Loss of Use Coverage
Full Safety Glass Coverage
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AGREEMENT
In return for your payment of all premiums, and in reliance upon the statements in the application we agree to insure you subject to the terms, conditions and limitations of this policy. We will insure you for the coverages and limits shown on the Declarations. Your policy consists of the policy contract, Declara- tions and endorsements applicable to the policy.

DEFINITIONS
A. Throughout this policy, ªyouº and ªyourº refer
to:

1. The ªnamed insuredº shown in the Dec-
larations;

2. The spouse if a resident of the same
household; and

3. The registered domestic partner as de-
fined by California Family Code, if a
resident of the same household.

B. ªWe,º ªusº and ªourº refer to the Company, as
shown in the Declarations providing this insur-
ance.

C. For purposes of this policy, a private passen-
ger type auto shall be deemed to be owned by
a person if leased:

1. Under a written agreement to that per-
son; and

2. For a continuous period of at least six
months.

D. Throughout the policy, ªminimum limitsº re-
fers to the following limits of liability required
by California law to be provided under a policy
of automobile liability insurance:

1. $15,000 for each person, subject to
$30,000 for each accident, with respect
to bodily injury;

2. $5,000 for each accident with respect to
property damage.

Other words and phrases are defined. They are in
bold type when used.

E. ªBodily injuryº means bodily harm, sickness
or disease, including death that results.

F. ªBusinessº includes trade, profession or oc-
cupation.

G. ªFamily memberº means a person related to
you by blood, marriage, registered domestic
partnership or adoption who is a resident of
your household. This includes a ward or foster
child who is a resident of your household.

H. ªFungiº means any type or form of fungus,
including yeast, mold or mildew, blight or
mushroom and any mycotoxins, spore, scents
or other substances, products or byproducts
produced, released by or arising out of fungi,
including growth, proliferation or spread of
fungi or the current or past presence offungi.

However, this definition does not include any
fungi intended by the insured for consump-
tion.

I. ªOccupyingº means in; upon; or getting in,
on, out or off.

J. ªPersonal vehicle sharing program º means
a legal entity qualified to do business in the
state of California engaged in the business of
facilitating the sharing of private passenger
vehicles for noncommercial use by individuals
within the state. Personal vehicle sharing
means the use of private passenger motor
vehicles by persons other than the vehicle's
owner, in connection with a personal vehicle
sharing program.
ªPrivate passenger motor vehicleºas it re-
lates to a personal vehicle sharing
program means a vehicle that is insured, or
is subject to being insured, under a personal
automobile liability insurance policy insuring
a single individual or individuals residing in
the same household, as the named insured,
or meets the requirements of Section 16058
of the Vehicle Code, but does not include a
vehicle with fewer than four wheels.

K. ªProperty damageº means physical injury or
destruction of tangible property including loss
of use.

L. ªPunitive or exemplary damagesº include
damages which are awarded to punish or de-
ter wrongful conduct, to set an example, to
fine, penalize or impose a statutory penalty,
and damages which are awarded for any pur-
pose other than as compensatory damages
for bodily injury or property damage.

M. ªTrailerº means a vehicle designed to be
pulled by a:

1. Private passenger auto; or

2. Pickup, van or motorhome.

It also means a recreational camping vehicle,
a farm wagon or farm implement while towed
by a vehicle listed in M.1. or M.2. above.
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N. ªUninsured motor vehicleº means a land
motor vehicle or trailer of any type:

1. To which no bodily injury liability bond or
policy applies at the time of the acci-
dent.

2. Which, with respect to damages for
bodily injury only, is an underinsured
motor vehicle. An underinsured motor
vehicle is one to which a liability bond or
policy applies at the time of the accident
but its limit for liability is less than the
limit of liability for this coverage.

3. Which, with respect to damages for
bodily injury only, is a hit-and-run vehi-
cle whose owner or operator cannot be
identified and which makes physical
contact with:
a. you, any family member or any
other rated driver shown on the
Declarations;
b. a vehicle which you, any family
member or any other rated driver
shown on the Declarations are oc-
cupying; or
c. your covered auto.

4. To which a bodily injury liability bond or
policy applies at the time of the
accident, but the bonding or insuring
company:
a. denies coverage;
b. refuses to admit coverage except
conditionally or with reservation; or
c. is or becomes insolvent.

However, ªuninsured motor vehicleº does
not include any vehicle or equipment:

1. Furnished or available for the regular
use of you, any family member or any
other rated driver shown on the Declara-
tions.

2. Owned or operated by a self-insurer un-
der any applicable motor vehicle law,
except a self-insurer which is or be-
comes insolvent.

3. Owned by any governmental unit or
agency.

4. Designed or modified for use primarily
off public roads while not on public
roads.

5. While located for use as a residence or
premises.

6. Owned by you, any family member or
any other rated driver shown on the
Declarations unless the vehicle is being
operated, or caused to be operated, by
a person without the consent of the
owner of such vehicle in connection with
criminal activity that has been docu-
mented in a police report.

O. ªYour covered autoº means:

1. Any vehicle or trailer shown in the Dec-
larations.

2. a. any newly acquired vehicle, wheth-
er operational or not, on the date
you become the owner, subject to
conditions for Newly Acquired
Replacement Vehicle and Newly
Acquired Additional Vehicle un-
der O.2.b. below. Any newly
acquired vehicle must be of the fol-
lowing types:
(1) a private passenger auto;
(2) a pickup or van that:
(a) has a Gross Vehicle
Weight Rating of 12,000
lbs or less; and
(b) is not used for the deliv-
ery or transportation of
goods and materials un-
less such use is:
i. incidental to your
business of in-
stalling, maintaining
or repairing furnish-
ings or equipment; or
ii. for farming or ranch-
ing; or
(3) a motorhome or trailer.
b. a newly acquired vehicle is subject
to the following conditions:
(1) Newly Acquired Replacement
Vehicle. If the vehicle you ac-
quire replaces one shown in
the Declarations, the replace-
ment vehicle will have the
same coverage as the vehicle
it replaced, other than Part D
Ð Coverage for Damage to
Your Auto. This provision ap-
plies only if there is no other
insurance policy that provides
coverage for that replacement
vehicle.

Part D Ð Coverage for Dam-
age to Your Auto shall apply
for the first thirty (30) days af-
ter you acquire the vehicle,
including the date of acquisi-
tion, only to the extent Part D
Ð Coverage for Damage to
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Your Auto applied to the vehi-
cle being replaced. You must
notify us within thirty (30) days
after you acquire the replace-
ment vehicle for Part D Ð
Coverage for Damage to Your
Auto to continue.
(2) Newly Acquired Additional
Vehicle. For any newly ac-
quired vehicle that is in
addition to any shown in the
Declarations coverage shall
apply for the first thirty (30)
days after you acquire the ve-
hicle, including the date of
acquisition. Coverage shall be
the broadest coverage we
provide for any vehicle shown
in the Declarations. This cov-
erage applies only if:
(a) you acquire the additional
vehicle during the policy
period shown on the Dec-
larations; and
(b) there is no other insur-
ance policy that provides
coverage for the addi-
tional vehicle.

If you wish to add or continue
coverage you must ask us to
insure the additional vehicle
within thirty (30) days after you
acquire the additional vehicle.

This thirty (30) days of cover-
age includes the day you
acquire the vehicle.
(3) Collision Coverage for a newly
acquired vehicle begins on the
date that you acquire the
vehicle. However, if the
Declarations does not indicate
that Collision Coverage applies
to at least one vehicle, you
must ask us to insure the newly
acquired vehicle within four (4)
days after you acquire it. If a
loss occurs during the four (4)
days after you acquire the
vehicle but before you asked
us to insure the newly acquired
vehicle, a $500 collision
deductible will apply.
(4) Comprehensive Coverage for
a newly acquired vehicle be-
gins on the date that you
acquire the vehicle. However,
if the Declarations does not
indicate that Comprehensive
Coverage applies to at least
one vehicle, you must ask us
to insure the newly acquired
vehicle within four (4) days af-
ter you acquire it. If a loss
occurs during the four (4) days
after you acquire the vehicle
but before you asked us to in-
sure the newly acquired
vehicle, a $500 comprehen-
sive deductible will apply.

3. Any auto or trailer you do not own while
used as a temporary substitute for any
other vehicle described in this definition
which is out of normal use because of
its:
a. breakdown;
b. repair;
c. servicing;
d. loss; or
e. destruction.

This provision (O.3.) does not apply to
Coverage for Damage to Your Auto.

PART A Ð LIABILITY COVERAGE

INSURING AGREEMENT
A. We will pay damages for bodily injury or
property damage for which any insured be-
comes legally responsible because of an auto
accident. We will settle or defend, as we con-
sider appropriate, any claim or suit asking for
these damages. In addition to our limit of liabil-
ity, we will pay all defense costs we incur. Our
duty to settle or defend ends when our limit of
liability for this coverage has been exhausted.

We have no duty to defend any suit or settle
any claim for bodily injury or property dam-
age not covered under this policy.

B. ªInsuredº as used in this Part means:

1. You or any family member for the
ownership, maintenance or use of any
auto or trailer.

2. Any person using your covered auto
with your express or implied permission.

The actual use must be within the scope
of that permission.

3. For your covered auto, any person or
organization but only with respect to le-
gal responsibility for acts or omissions of
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a person for whom coverage is afforded
under B.1. and B.2. above.

4. For any auto or trailer, other than your
covered auto, any other person or or-
ganization but only with respect to legal
responsibility for acts or omissions of
you or any family member for whom
coverage is afforded under this Part.

This provision (B.4.) applies only if the
person or organization does not own or
hire the auto or trailer.

However, for the purposes of this coverage,
ªinsuredº does not mean any person who is
using your covered auto under a personal
vehicle sharing program.

INTEREST ON JUDGMENTS
We will pay interest on judgments subject to all of
the following:

1. Any notice, demand, summons, judg-
ment, or any process has been promptly
forwarded to us as required by the poli-
cy conditions.

2. We accept the defense or agree to the
judgment.

3. We will pay the interest on that part of
the judgment that is covered and that
does not exceed our applicable limit of
liability.

4. We will pay interest that accrues after
entry of judgment and before we pay,
tender, or deposit in court.

5. If we appeal the judgment, we will pay
interest on the entire judgment.

6. Post-judgment interest is in addition to
the applicable limit of liability.

7. Where we are required to cover pre-
judgment interest, it shall be included in
the limit of liability and is not an addi-
tional amount of insurance.

SUPPLEMENTARY PAYMENTS
We will pay on behalf of an insured:

1. Up to $1,000 for the cost of bail bonds
required because of an accident,
including related traffic law violations.

The accident must result in bodily
injury or property damage covered
under this policy. We are not obligated
to apply for or furnish such bonds.

2. Premiums on appeal bonds and bonds
to release attachments in any suit we
defend.

3. Up to $250 a day for loss of earnings,
but not other income, because of at-
tendance at hearings or trials at our
request.

4. Other reasonable expenses incurred at
our request.

5. All expenses incurred by an insured for
first aid to others at the time of the acci-
dent, not to exceed $10,000.

EXCLUSIONS
A. We do not provide Liability Coverage for:

1. Any insured who intentionally causes
bodily injury or property damage
even if such bodily injury or property
damage is of a different kind or degree
than expected or intended, or such bod-
ily injury or property damage is
sustained by a different person or per-
sons than expected or intended.

2. Property damage to property owned or
being transported by any insured.

3. Property damage to property:
a. rented to;
b. used by; or
c. in the care of;
any insured.

This exclusion (A.3.) does not apply to
property damage to a residence or pri-
vate garage.

4. Bodily injury to an employee of any in-
sured during the course of employment.

This exclusion (A.4.) does not apply to
bodily injury to a domestic employee
unless workers compensation benefits
are required or available for that domes-
tic employee.

5. Bodily injury to any fellow employee of
the insured injured in the course of em-
ployment if the bodily injury arises out
of the use of an auto in the business of
the employer. This exclusion (A.5.) does
not apply to you with respect to bodily
injury sustained by any fellow employ-
ee.

6. Any insured's liability arising out of the
ownership or operation of a vehicle
while it is being used as a public or liv-
ery conveyance. This exclusion (A.6.)
does not apply to a share-the-expense
car pool.

7. Any insured using any vehicle while
employed in the pickup or delivery of
newspapers or magazines, food or any
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products for the purpose of compensa-
tion. This exclusion does not apply to:
a. delivery that is incidental to an in-
sured's business; or
b. you or any family member eligible
for the Good Driver discount.

8. a. any insured while employed or
otherwise engaged in the business
or occupation of:
(1) selling;
(2) repairing;
(3) servicing;
(4) storing; or
(5) parking;
vehicles designed for use mainly on
public highways. This includes road
testing and delivery.
b. this exclusion (A.8.) does not apply
to the ownership, maintenance or
use of your covered auto by:
(1) you;
(2) any family member; or
(3) any partner, agent or employ-
ee of you or any family
member.

9. Any insured maintaining or using any
vehicle while that insured is employed
or otherwise engaged in any business
(other than farming or ranching) not de-
scribed in Exclusion A.7. and A.8.

This exclusion (A.9.) does not apply to
the maintenance or use of a:
a. private passenger auto;
b. pickup, motorhome or van that:
(1) you own; or
(2) you do not own while used as
a temporary substitute for
your covered auto which is
out of normal use because of
its:
(a) breakdown;
(b) repair;
(c) servicing;
(d) loss; or
(e) destruction; or
c. trailer used with a vehicle de-
scribed in A.9.a. or A.9.b. above.

10. Any insured using a vehicle without the
express or implied permission of the
owner or other person having lawful
possession, or using a vehicle beyond
the scope of the permission granted.

However, this exclusion does not apply
to a family member using your cov-
ered auto.

11. Bodily injury or property damage for
which that insured:
a. is an insured under a nuclear en-
ergy liability policy; or
b. would be an insured under a nu-
clear energy liability policy but for
its termination upon exhaustion of
its limit of liability.

A nuclear energy liability policy is a poli-
cy issued by any of the following or their
successors:
a. American Nuclear Insurers;
b. Mutual Atomic Energy Liability Un-
derwriters; or
c. Nuclear Insurance Association of
Canada.

12. Punitive or exemplary damages
awarded against any insured.

13. Bodily injury to you or any family
member whenever the ultimate benefits
of that indemnification accrue directly or
indirectly to you or any family member.

14. Bodily injury or property damage aris-
ing out of the use of your covered auto
while leased or rented to others. How-
ever, this exclusion does not apply to
the operation of your covered auto by
you or a family member.

15. Bodily injury or property damage aris-
ing out of a criminal act or omission of
the insured. This exclusion applies re-
gardless of whether that insured is
actually charged with, or convicted of, a
crime. However, this exclusion (15.)
does not apply to traffic violations.

B. We do not provide Liability Coverage for the
ownership, maintenance or use of:

1. a. Any vehicle which:
(1) has fewer than four wheels;
(2) is designed mainly for use off
public roads.
b. This exclusion (B.1.) does not ap-
ply:
(1) while such vehicle is being
used by an insured in a medi-
cal emergency; or
(2) to any trailer.
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2. Any vehicle, other than your covered
auto, which is:
(1) owned by you; or
(2) furnished or available for your
regular use.

3. a. Any vehicle, other than your cov-
ered auto, which is:
(1) owned by any family member
or other person who resides
with you; or
(2) furnished or available for the
regular use of any family
member or other person who
resides with you.
b. However, this exclusion (B.3.) does
not apply to you while you are
maintaining, occupying or operat-
ing any vehicle which is:
(1) owned by a family member or
other person who resides with
you; or
(2) furnished or available for the
regular use of a family mem-
ber or other person who
resides with you.

4. Any vehicle while it is:
a. operating on a surface designed or
used for racing, except for an orga-
nized and controlled event that is
not a speed, performance, stunt or
demolition event;
b. participating in a high performance
driving or racing instruction course
or school; or
c. preparing for, practicing for, used
in, or competing in any prearranged
or organized:
(1) race activity; or
(2) speed, performance, stunt, or
demolition contest or exhibition.

LIMIT OF LIABILITY
A. If the Declarations indicate ªper personº/p er
accident coverage applies:

The limit of liability as shown in the Declara-
tions for ªeach personºfor Bodily Injury
Liability is our maximum limit of liability for all
damages, including damages for care and
loss of services (including loss of consortium
and wrongful death), arising out of bodily in-
jury sustained by any one person in any one
auto accident.

Subject to this limit for each person, the limit
of liability shown in the Declarations for each
accident for Bodily Injury Liability is our max-
imum limit of liability for all damages for
bodily injury resulting from any one auto
accident.

The limit of liability shown in the Declarations
for each accident for Property Damage Liabil-
ity is our maximum limit of liability for all
property damage resulting from any one au-
to accident.

This is the most we will pay regardless of the
number of:

1. Insureds;

2. Claims made;

3. Vehicles or premiums shown in the Dec-
larations; or

4. Vehicles involved in the auto accident.

B. If the Declarations indicate Combined Single
Limit applies, paragraph A. above is replaced
by the following:

The limit of liability shown in the Declarations
for this coverage is our maximum limit of lia-
bility for all damages resulting from any one
auto accident. This is the most we will pay
regardless of the number of:

1. Insureds;

2. Claims made;

3. Vehicles or premiums shown in the Dec-
larations; or

4. Vehicles involved in the auto accident.

We will apply the limit of liability to provide
any minimum limits required by law for
bodily injury and property damage liability.

However, this provision will not change our
total limit of liability.

C. No one will be entitled to receive duplicate
payments for the same elements of loss under
this coverage and Part B Ð Medical Pay-
ments Coverage or Part C Ð Uninsured
Motorists Coverage of this policy.

D. A vehicle and attached trailer are considered
one vehicle. Therefore, the limits of liability will
not be increased for an accident involving a
vehicle which has an attachedtrailer.

OUT OF STATE COVERAGE
If an auto accident to which this policy applies oc-
curs in any state or province other than the one in
which your covered auto is principally garaged,
we will interpret your policy for that accident as
follows:

A. If the state or province has:

1. A financial responsibility or similar law
specifying limits of liability for bodily
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injury or property damage higher than
the limit shown in the Declarations, your
policy will provide the higher specified
limit.

2. A compulsory insurance or similar law
requiring a nonresident to maintain in-
surance whenever the nonresident uses
a vehicle in that state or province, your
policy will provide at least the required
minimum limits and types of coverage.

B. No one will be entitled to duplicate payments
for the same elements of loss.

FINANCIAL RESPONSIBILITY
When this policy is certified as future proof of fi-
nancial responsibility, this policy shall comply with
the law to the extent required.

OTHER INSURANCE
If there is other applicable liability insurance or ev- idence of financial responsibility:

1. Any insurance we provide for a vehicle
you do not own shall be excess over
any other collectible insurance or evi-
dence of financial responsibility.

However, any insurance we provide for
a vehicle you do not own will be primary
insurance if the vehicle is insured under
a policy affording coverage to a named
insured engaged in the business of:
a. selling;
b. repairing;
c. servicing;
d. delivering;
e. testing;
f. road testing;
g. parking; or
h. storing;
motor vehicles. This applies only if an
insured:
a. is operating the vehicle; and
b. is neither the person engaged in
such business nor that person's
employee or agent.

2. Any insurance we provide for a vehicle
you own shall be excess to that of:
a. a person engaged in the business
of:
(1) selling;
(2) repairing;
(3) servicing;
(4) delivering;
(5) testing;
(6) road testing;
(7) parking; or
(8) storing;
motor vehicles, if the accident oc-
curs while the vehicle is being
operated by that person or that
person' s employee or agent; or
b. an owner, tenant or lessee of prem-
ises on which loss arising out of the
loading or unloading of the vehicle
occurs.

3. We will pay only our share of:
a. the loss. Our share of the loss is the
proportion that our limit of liability
bears to the total of all applicable
limits.
b. defense costs if both primary and
excess policies of liability insurance
or evidence of financial responsibil-
ity apply to the loss. Our share of
defense costs is the proportion that
the amount of damages paid by us
bears to the total amount of dam-
ages paid under all applicable
policies of liability insurance or evi-
dence of financial responsibility.

PART B Ð MEDICAL PAYMENTS COVERAGE

INSURING AGREEMENT
A. We will pay the usual and customary charg-
es incurred for reasonable and necessary
medical and funeral expenses because of
bodily injury:

1. Caused by accident; and

2. Sustained by an insured.

We will pay only those expenses incurred for
services rendered within 3 years from the
date of the accident.

We have a right to review medical expenses
and services to determine if they are reason-
able and necessary for the bodily injury
sustained.
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B. ªInsuredº as used in this Part B Ð Medical
Payments Coverage means:

1. You or any family member:
a. while occupying; or
b. as a pedestrian or bicyclist when
struck by;
a motor vehicle designed for use mainly
on public roads or a trailer of any type.

2. Any other person while occupying your
covered auto with your express or im-
plied permission. The actual use must
be within the scope of that permission.

3. Any other person while occupying, as a
guest, an automobile not owned by you
or a family member, while being oper-
ated by you or a family member.

However, for the purposes of this coverage,
ªinsuredº does not mean any person who is
using your covered auto under a personal
vehicle sharing program.

C. ªUsual and customary chargesº as used in
this Part means:

The lowest of the following:

1. The charge billed by the medical provid-
er for covered treatment;

2. The eightieth percentile charge for that
covered treatment in the geozip area
where the provider is located, as deter-
mined through the use of a FAIRHealth
or similar database;

3. The amount authorized by a state man-
dated fee schedule or by another law or
regulation; or

4. The amount authorized by a written PPN
or PPO agreement to which the medical
provider is a party.

The insured shall not be responsible for
payment of any reduction applied by us. If a
medical provider disputes an amount paid by
us, we will be responsible for resolving such
disputes.

EXCLUSIONS
We do not provide Medical Payments Coverage
for any insured for bodily injury:

1. Sustained while occupying any motor-
ized vehicle having fewer than four
wheels.

2. Sustained while occupying your cov-
ered auto when it is being used as a
public or livery conveyance. This exclu-
sion (2.) does not apply to a share-the-
expense car pool.

3. Sustained while occupying any vehicle
while employed in the pickup or delivery
of newspapers or magazines, food or
any products for the purpose of com-
pensation. This exclusion does not
apply to:
a. delivery that is incidental to an in-
sured's business; or
b. any insured eligible for the Good
Driver discount.

4. Sustained while occupying any vehicle
located for use as a residence or prem-
ises.

5. Occurring during the course of employ-
ment if workers compensation benefits
are required or available for the bodily
injury.

6. Sustained while occupying, or when
struck by, any vehicle (other than your
covered auto) which is:
a. owned by you; or
b. furnished or available for your regu-
lar use.

7. Sustained while occupying, or when
struck by, any vehicle (other than your
covered auto) which is:
a. owned by any family member; or
b. furnished or available for the regu-
lar use of any family member.

However, this exclusion (7.) does not
apply to you.

8. Sustained while occupying a vehicle
without the express or implied permis-
sion of the owner or other person having
lawful possession, or using a vehicle
beyond the scope of the permission
granted. However this exclusion does
not apply to a family member using
your covered auto.

9. Sustained while occupying a vehicle
when it is being used in the business or
occupation of an insured. This exclu-
sion (9.) does not apply to bodily injury
sustained while occupying a:
a. private passenger auto;
b. pickup, van or motorhome that you
own; or
c. trailer used with a vehicle de-
scribed in 9.a. or 9.b. above.

10. Caused by or as a consequence of:
a. discharge of a nuclear weapon
(even if accidental);
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b. war (declared or undeclared);
c. civil war;
d. insurrection; or
e. rebellion or revolution.

11. From or as a consequence of the follow-
ing, whether controlled or uncontrolled
or however caused:
a. nuclear reaction;
b. radiation; or
c. radioactive contamination.

12. Sustained while occupying any vehicle
while it is:
a. operating on a surface designed or
used for racing except for an orga-
nized and controlled event that is
not a speed, performance, stunt or
demolition event;
b. participating in a high performance
driving or racing instruction course
or school; or
c. preparing for, practicing for, used
in, or competing in any prearranged
or organized:
(1) race activity; or
(2) speed, performance, stunt, or
demolition contest or exhibition.

13. Caused by the actual, alleged or threat-
ened presence, growth, proliferation or
spread of fungi or bacteria.

LIMIT OF LIABILITY
A. The limit of liability shown in the Declarations
for this coverage is our maximum limit of liabil-
ity for each person injured in any one
accident. This is the most we will pay regard-
less of the number of:

1. Insureds;

2. Claims made;

3. Vehicles or premiums shown in the Dec-
larations; or

4. Vehicles involved in the accident.

B. No one will be entitled to receive duplicate
payments for the same elements of loss under
this coverage and PartA Ð Liability Coverage
or Part C Ð Uninsured Motorists Coverage of
this policy.

OTHER INSURANCE
If there is other applicable auto medical payments
insurance available any insurance we provide
shall be excess over any other applicable auto
medical payments insurance. If more than one
policy applies on an excess basis, we will bear our
proportionate share with other collectible auto
medical payments insurance.

PART C Ð UNINSURED MOTORISTS COVERAGE

INSURING AGREEMENT
A. We will pay damages which an insured is le-
gally entitled to recover from the owner or
operator of an uninsured motor vehicle be-
cause of:

1. Bodily injury sustained by that insured
and caused by an accident;

2. Property damage caused by an acci-
dent if the Declarations indicates that
property damage Uninsured Motorists
Coverage applies to that auto. Only
items 1. and 4. under the definition of
uninsured motor vehicle apply to
property damage.

With respect to coverage for property
damage, the accident must involve di-
rect physical contact between your
covered auto and the uninsured mo-
tor vehicle, and:
a. The owner or operator of the unin-
sured motor vehicle must be
identified; or
b. The uninsured motor vehicle
must be identified by its license
number.

The owner's or operator's liability for these
damages must arise out of the ownership,
maintenance or use of the uninsured motor
vehicle. With respect to coverage under item

2. of the definition of uninsured motor vehi-
cle, we will pay damages under this
coverage only after the limits of liability under
any applicable liability bonds or policies have
been exhausted by payment of judgments or
settlements.

Any judgment for damages arising out of suit
brought without our written consent is not
binding on us.

B. ªInsuredº as used in this Part C Ð Uninsured
Motorists Coverage means:

1. The ªnamed insuredºas shown in the
Declarations, spouse or registered do-
mestic partner.
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2. Family member if a resident of your
household;

3. Any Rated Driver shown on the Declara-
tions other than you or a family
member.

4. Any other person occupying your cov-
ered auto with your express or implied
permission. The actual use must be
within the scope of that permission.

5. Any person entitled to recover for dam-
ages because of bodily injury to which
this coverage applies sustained by a
person described in 1., 2. or 3. above.

However, for the purposes of this coverage,
ªinsuredº does not mean any person who is
using your covered auto under a personal
vehicle sharing program.

C. ªProperty damageº as used in this Part C Ð
Uninsured Motorists Coverage means
physical injury to or destruction of your
covered auto. However, property damage
does not include:

1. Loss of use of your covered auto; or

2. Damage to personal property contained
in your covered auto other than a child
passenger restraint system that:
a. meets the applicable federal motor
vehicle safety standards; and
b. was in use by a child at the time of
the accident for which this cover-
age applies.

EXCLUSIONS
A. 1. We do not provide Uninsured Motorists
Coverage forbodily injury sustained:
a. by an insured while occupying, or
when struck by:
(1) any motor vehicle; or
(2) a trailer of any type used with
a motor vehicle;
owned by that insured which is not
insured for this coverage under this
policy.
b. by any family member or any oth-
er rated driver shown on the
Declarations while occupying, or
when struck by, any motor vehicle
you own which is insured for this
coverage on a primary basis under
any other policy.

2. However, this Exclusion (A.) shall not
apply to bodily injury sustained by an
insured when struck by any motor vehi-
cle or trailer:
a. owned by that insured; and
b. being operated, or caused to be
operated, by a person without that
insured's consent in connection
with criminal activity that has been
documented in a police report and
that insured is not a party to the
criminal activity.

B. We do not provide Uninsured Motorists Cov-
erage for bodily injury sustained by any
insured:

1. If that insured or the legal representa-
tive settles the bodily injury claim
without our consent.

This exclusion (B.1.) does not apply to a
settlement made with the insurer of a
vehicle described under item 2. of the
definition of uninsured motor vehicle.

2. While occupying your covered auto
when it is being used as a public or liv-
ery conveyance. This exclusion (B.2.)
does not apply to a share-the-expense
car pool.

3. While using any vehicle while employed
in the pickup or delivery of newspapers
or magazines, food or any products for
the purpose of compensation. This ex-
clusion does not apply to:
a. delivery that is incidental to an in-
sured's business; or
b. any insured eligible for the Good
Driver discount.

4. While using a vehicle without the ex-
press or implied permission of the owner
or other person having lawful posses-
sion or using a vehicle beyond the
scope of the permission granted. How-
ever, this exclusion does not apply to
you, any family member or any other
rated driver shown on the Declarations
using your covered auto.

5. While occupying or operating an
owned motorcycle or moped;

6. While using any vehicle while it is:
a. operating on a surface designed or
used for racing except for an orga-
nized and controlled event that is
not a speed, performance, stunt or
demolition event;
b. participating in a high performance
driving or racing instruction course
or school; or
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c. preparing for, practicing for, used
in, or competing in any prearranged
or organized:
(1) race activity; or
(2) speed, performance, stunt, or
demolition contest or exhibi-
tion.

C. We do not provide Uninsured Motorists Cov-
erage for property damage sustained by any
insured while occupying or when struck by
any motor vehicle owned by you, any family
member or any other rated driver shown on
the Declarations which is not insured for this
coverage under this policy.

D. This coverage shall not apply:

1. To property damage to:
a. a trailer of any type;
b. any motor vehicle owned by you to
which Collision Coverage applies
under this policy; or
c. any other motor vehicle to the ex-
tent that there is valid and
collectible Collision Coverage ap-
plicable to that damage under any
other policy.

2. Directly or indirectly to benefit:
a. any insurer or self-insurer under
any of the following or similar law:
(1) workers compensation law; or
(2) disability benefits law.
b. any insurer of property.

3. Directly to the benefit of the United
States or any state or political subdivi-
sion thereof.

E. We do not provide Uninsured Motorists Cov-
erage forpunitive or exemplary damages.

F. We do not provide Uninsured Motorists Cov-
erage for bodily injury resulting from an
accident for which you, anyfamily member or
any other rated driver shown on the Declara-
tions are legally responsible.

LIMIT OF LIABILITY
A. The limit of Bodily Injury Liability shown in the
Declarations for ªeach personº for Uninsured
Motorists Coverage is our maximum limit of li-
ability for all damages, including damages for
care and loss of services (including loss of
consortium and wrongful death), arising out of
bodily injury sustained by any one person in
any one accident.

Subject to this limit for ªeach personº, the lim-
it of Bodily Injury Liability shown in the
Declarations for ªeach accidentºfor Unin-
sured Motorists Coverage is our maximum
limit of liability for all damages for bodily in-
jury resulting from any one accident.

Our maximum limit of liability for all damages
for property damage resulting from any one
accident will be the lesser of:

1. The limit of Property Damage Liability
shown in the Declarations;

2. The actual cash value of your covered
auto; or

3. The amount of any deductible if there is
valid and collectible Collision Coverage
under any other policy.

An adjustment for depreciation and physical
condition will be made in determining actual
cash value at the time of the loss.

The limit of Bodily Injury or Property Dam-
age Liability shown in the Declarations is the
most we will pay regardless of the number
of:

1. Insureds;

2. Claims made;

3. Vehicles or premiums shown in the Dec-
larations; or

4. Vehicles involved in the accident.

In no event shall the limit of liability for two or
more policies be added together, combined
or stacked to determine the limit of insurance
coverage available to injured persons.

B. If the Declarations indicate Combined Single
Limit Coverage applies, paragraph (A.) above
is replaced by the following:

The limit of liability shown in the Declarations
for Uninsured Motorists Coverage is our maxi-
mum limit of liability for all damages resulting
from any one auto accident. This is the most
we will pay regardless of the number of:

1. Insureds;

2. Claims made;

3. Vehicles or premiums shown in the Dec-
larations; or

4. Vehicles involved in the auto accident.

We will apply the limit of liability to provide
any separate minimum limits required by
law for bodily injury and property damage
liability. However, this provision will not
change our total limit of liability.
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C. With respect to coverage under item 2. of the
definition of uninsured motor vehicle, the
limit of liability shall be reduced by all sums:

1. Paid because of the bodily injury by or
on behalf of persons or organizations
who may be legally responsible. This in-
cludes all sums paid under Part A Ð
Liability Coverage of the policy; and

2. The amount paid and the present value of
all amounts payable to theinsured under
any workers compensation law, exclusive
of nonoccupational disability benefits.

D. No one will be entitled to receive duplicate
payments for the same elements of loss under
this coverage and PartA Ð Liability Coverage
or Part B Ð Medical Payment Coverage of
this policy.

E. We will not make a duplicate payment under
this coverage for any element of loss for which
payment has been made by or on behalf of
persons or organizations who may be legally
responsible.

F. A vehicle and attached trailer are considered
one vehicle. Therefore the limits of liability will
not be increased for an accident involving a
vehicle which has an attachedtrailer.

G. We will not pay for any element of loss if a
person is entitled to receive payment for the
same element of loss under any workers
compensation law exclusive of nonoccupa-
tional disability benefits.

OTHER INSURANCE
If there is other applicable insurance available un-
der more than one policy or provisions of
coverage that is similar to the insurance provided
under this Part of the policy:

1. Any recovery for damages under all
such policies or provisions of coverage
may equal but not exceed the highest
applicable limit for any one vehicle un-
der any insurance providing coverage
on either a primary or excess basis.

2. Any insurance we provide with respect
to a vehicle you do not own, including
any vehicle while used as a temporary
substitute for your covered auto shall
be excess over any collectible insurance
providing coverage on a primary basis.

3. If the coverage under this policy is
provided:
a. on a primary basis, we will pay only
our share of the loss that must be
paid under insurance providing
coverage on a primary basis. Our
share is the proportion that our limit
of liability bears to the total of all
applicable limits of liability for cov-
erage provided on a primary basis.
b. on an excess basis, we will pay on-
ly our share of the loss that must be
paid under insurance providing
coverage on an excess basis. Our
share is the proportion that our limit
of liability bears to the total of all
applicable limits of liability for cov-
erage provided on an excess basis.

ARBITRATION
A. If we and aninsured do not agree:

1. Whether that insured is legally entitled
to recover damages; or

2. As to the amount of damages which are
recoverable by that insured;
from the owner or operator of an uninsured
motor vehicle then the matter will be settled
by arbitration. Such arbitration may be initiat-
ed by a written demand for arbitration made
by either party.

The arbitration shall be conducted by a single
neutral arbitrator. With respect to property
damage arbitration proceedings must be
formally instituted by the insured within 1
year from the date of the accident. Disputes
concerning coverage under this part may not
be arbitrated.

B. Each party will:

1. Pay the expenses it incurs; and

2. Bear the expenses of the arbitrator
equally.

C. Any decision of the arbitrator will be binding as
to:

1. Whether the insured is legally entitled
to recover damages; and

2. The amount of damages.

ADDITIONAL DUTY
A person seeking Uninsured Motorists Coverage
must also promptly notify us in writing of a tentative
settlement between the insured and the insurer of
the underinsured motor vehicle and allow us 30
days to advance payment to that insured in an
amount equal to the tentative settlement to preserve
our rights against the insurer, owner or operator of
such underinsured motor vehicle.
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PART D Ð COVERAGE FOR DAMAGE TO YOUR AUTO

INSURING AGREEMENT
A. We will pay for direct and accidental loss to
your covered auto or any non-owned auto,
including its equipment, any child safety seat
in use in your covered auto or non-owned
auto, minus any applicable deductible shown
in the Declarations. We will pay for loss to
your covered autocaused by:

1. Other than collision only if the Declara-
tions indicate that Comprehensive
Coverage is provided for that auto.

2. Collision only if the Declarations indi-
cate that Collision Coverage is provided
for that auto.

If there is a loss to a non-owned auto, we
will provide the broadest coverage applicable
to any vehicle shown in the Declarations.

Deductible
Unless stated otherwise, the applicable de-
ductible shown in the Declarations shall be
applied to each accidental loss covered un-
der this Part D Ð Coverage for Damage to
Your Auto.

1. If loss to more than one of your cov-
ered autos or a non-owned auto
results from the same loss, only the
highest applicable deductible will apply.

2. When there is a loss to your covered
auto that is insured for Collision Cover-
age under this policy, we will waive the
collision deductible if:
a. the loss involves an uninsured mo-
tor vehicle as the term is defined in
the Definitions section under items1.
and 4. of the definition;
b. the accident must involve direct
physical contact between your
covered auto and the uninsured
motor vehicle, and:
(1) the owner or operator of the
uninsured motor vehicle
must be identified; or
(2) the uninsured motor vehicle
must be identified by its li-
cense number.
c. you are legally entitled to recover
the full amount of the loss from the
owner or operator of the uninsured
motor vehicle; and
d. the Declarations indicates that the
Waiver of Collision Deductible ap-
plies to that vehicle.

If you are legally entitled to recover only
a percentage of the loss, we will waive
that percentage of your deductible.

However, if the amount of the loss is
less than your deductible, we will pay
the percentage of the loss you are legal-
ly entitled to recover. In no event will we
pay more than the amount of the loss.

3. In the event of a collision with another
vehicle insured by:
(a) a Safeco insurance company; or
(b) another Liberty Mutual Agency
Corporation company;
no deductible will apply.

This does not include a vehicle de-
scribed as your covered auto or non-
owned auto.

4. No deductible will apply to your cov-
ered auto or a non-owned auto if the
loss to your covered auto or a non-
owned auto results from the same
event as a loss covered under your
Safeco Homeowners, Condominium or
Renters policy and we issue a payment
under your Homeowners, Condominium
or Renters policy for the loss.

B. ªCollisionº means the upset ofyour covered
auto or a non-owned auto or its impact with
another vehicle or object.
ªComprehensiveº means loss, other than
collision, to your covered auto or a non-
owned auto. Loss caused by the following
are not collision losses but are compre-
hensive losses:

Loss caused by missiles or falling objects;
fire; theft or larceny; explosion or earthquake;
windstorm; hail, water or flood; malicious
mischief or vandalism; riot or civil commotion;
contact with a bird or animal; or breakage of
glass.

If breakage of glass is caused by a collision,
you may elect to have it considered a loss
caused by collision.

C. 1. ªNon-owned autoº means:
a. any private passenger auto, pickup,
van (other than cargo van) or trail-
er with a Gross Vehicle Weight
Rating of 12,000 pounds or less or
any cargo van or moving van with a
Gross Vehicle Weight Rating of
18,000 pounds or less, not owned
by or furnished or available for the
regular use of you or any family
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member while in the custody of or
being operated by you or any fami-
ly member; or
b. any auto or trailer you do not own
while used as a temporary
substitute for your covered auto
which is out of normal use because
of its:
(1) breakdown;
(2) repair;
(3) servicing;
(4) loss; or
(5) destruction.

2. ªNon-owned autoº does not include
any vehicle which has been operated or
rented by or in the possession of you or
any family member for 30 or more con-
secutive days. This does not apply to a
temporary substitute vehicle authorized
by us.

D. ªCamper bodyº means a body equipped as
sleeping or living quarters which is designed
to be mounted on a pickup.

E. ªDiminution in valueº means the actual or
perceived loss in market or resale value which
results from a direct and accidental loss.

TRANSPORTATION EXPENSES
A. Subject to the limitations described in para-
graphs B. and C, below, we will pay:

1. Temporary transportation expenses in-
curred by you in the event of the total theft
of your covered auto or a non-owned
auto. We will pay for such expenses only
if the Declarations indicate that Compre-
hensive Coverage is provided for that
auto. We will pay only expenses incurred
during the period:
a. beginning 48 hours after the theft;
and
b. ending when your covered auto or
the non-owned auto is returned to
use or we pay for its loss.

2. Indirect loss expenses for which you
become legally responsible in the event
of a loss to a non-owned auto. We will
pay only expenses beginning when the
non-owned auto is withdrawn from use
for more than 24 hours. We will pay for
indirect loss expenses if the loss is
caused by:
a. a comprehensive loss only if the
Declarations indicate that Compre-
hensive Coverage is provided for
any your covered auto.
b. collision only if the Declarations in-
dicate that Collision Coverage is
provided for anyyour covered auto.

B. For the expenses described in paragraphs
A.1. and A.2. we will pay the greater of the fol-
lowing, without application of a deductible:

1. Up to $25 per day, to a maximum of
$750; or

2. The limit for Loss of Use, if any, shown
in the Declarations.

C. Our payment for the expenses described in
paragraphs A.1. and A.2. will be limited to that
period of time reasonably required to repair or
replace the your covered auto or the non-
owned auto.

LOSS TO WEARING APPAREL AND LUGGAGE
In addition to the applicable limit of liability, we will pay up to $200 for each accident, for loss to you
or any family member for direct and accidental
loss of or damage to wearing apparel and lug-
gage. The loss must be caused by:

1. A collision to which Collision Coverage
under this policy applies.

2. Fire, lightning, flood or total theft of your
covered auto and the loss coincides
with other loss to which Comprehensive
Coverage applies.

EXCLUSIONS
We will not pay for:

1. Loss to your covered auto or any non-
owned auto which occurs while it is be-
ing used as a public or livery
conveyance. This exclusion (1.) does
not apply to a share-the-expense car
pool.

2. Loss to your covered auto or any non-
owned auto while employed in the
pickup or delivery of newspapers or
magazines, food or any products for the
purpose of compensation. This exclu-
sion does not apply to:
a. delivery that is incidental to an in-
sured's business; or
b. any insured eligible for the Good
Driver discount.

3. Damage or loss due and confined to:
a. wear and tear;
b. freezing;
c. mechanical or electrical breakdown
or failure; or
d. road damage to tires.
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This exclusion (3.) does not apply if the
damage results from the total theft of
your covered auto or any non-owned
auto.

4. Damage or loss arising out of neglect.

Neglect means your failure to adequate-
ly maintain your covered auto or non-
owned auto after the loss.

With respect to water under Compre-
hensive Coverage, there is no coverage
for:
a. moisture, condensation, humidity,
or vapor;
b. water intrusion around or through
panels, surfaces and seals; or
c. water that collects in spaces or
ventilation systems; or
d. fungi, dry rot or bacteria;
resulting from neglect.

5. Loss due to or as a consequence of:
a. discharge of any nuclear weapon
(even if accidental);
b. war (declared or undeclared);
c. civil war;
d. insurrection; or
e. rebellion or revolution.

6. Loss from or as a consequence of the
following, whether controlled or uncon-
trolled or however caused:
a. nuclear reaction;
b. radiation; or
c. radioactive contamination.

7. Loss to:
a. any electronic equipment designed
for the production or reproduction
of sound, pictures, audio, visual or
data or that receives or transmits
sound, pictures or data signals.
b. this exclusion (7.) does not apply
to:
(1) equipment designed for the
reproduction of sound or
transmission of sound, pic-
tures, audio, visual or data
signals and accessories used
with such equipment, provid-
ed:
(a) the electronic equipment
is permanently installed
by the original vehicle
manufacturer or manufac-
turer's dealership in your
covered auto or any
non-owned auto; or
(b) the electronic equipment
is:
i. removable from a
housing unit which is
permanently installed
by the original vehi-
cle manufacturer or
manufacturer's deal-
ership in the auto;
ii. designed to be solely
operated by use of
the power from the
auto's electrical sys-
tem; and
iii. in or upon your
covered auto or any
non-owned auto;
at the time of loss; or
(c) any equipment installed
through our Teen Safe
Driver
TM program.

However, we will pay only up
to a total of $1,000 or the ac-
tual cash value of your
covered auto or any non-
owned auto, whichever is
less, for all such equipment
that is not installed by the orig-
inal vehicle manufacturer or
manufacturer's dealership.
(2) any other electronic equipment
that is:
(a) necessary for the normal
operation of the auto or
the monitoring of the au-
to's operating systems;
(b) an integral part of the
same unit housing any
electronic equipment de-
scribed in 7.a. and
permanently installed by
the original vehicle manu-
facturer or manufacturer's
dealership in your cov-
ered auto or any non-
owned auto.

8. Loss to:
a. tapes, records, discs, or other me-
dia used with such equipment
described in exclusion (7.); or
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b. any other accessories, not perma-
nently installed used with such
equipment described in exclusion
(7.).

9. Loss to your covered auto or any non-
owned auto due to destruction or con-
fiscation by governmental or civil
authorities because you or any family
member:
a. engaged in illegal activities; or
b. failed to comply with Environmental
Protection Agency or Department
of Transportation standards.

This exclusion (9.) does not apply to the
interests of Loss Payees in your cov-
ered auto.

10. Loss to a camper body, motorhome or
trailer you own which is not shown in
the Declarations. This exclusion (10.)
does not apply to a camper body, mo-
torhome or trailer you:
a. acquire during the policy period;
and
b. ask us to insure within 30 days af-
ter you become the owner.

11. Loss to any non-owned auto when
used by you or any family member
without the express or implied permis-
sion of the owner or other person having
lawful possession, or using a vehicle
beyond the scope of the permission
granted.

12. Loss to equipment, whether operational
or not, whose design may be used for
the detection or location of law enforce-
ment equipment.

13. Loss to any non-owned auto being
maintained or used by any person while
employed or otherwise engaged in the
business of:
a. selling;
b. repairing;
c. servicing;
d. storing; or
e. parking;
vehicles designed for use on public
highways. This includes road testing and
delivery.

14. Loss to any non-owned auto being
maintained or used by any person while
employed or otherwise engaged in any
business not described in exclusion 2.
and 13. This exclusion (14.) does not
apply to the maintenance or use by you
or any family member of a non-owned
auto which is a private passenger auto
or trailer.

15. Loss to your covered auto or any non-
owned auto while it is:
a. operating on a surface designed or
used for racing. This does not apply
to an organized and controlled
event that is not a speed, perfor-
mance, stunt or demolition event;
b. participating in a high performance
driving or racing instruction course
or school; or
c. preparing for, practicing for, used
in, or competing in any prearranged
or organized:
(1) race activity; or
(2) speed, performance, stunt, or
demolition contest or exhibition.

16. Loss to, or loss of use of, a non-owned
auto rented by:
a. you; or
b. any family member;
if a rental vehicle company is precluded
from recovering such loss or loss of use,
from you or that family member, pursu-
ant to the provisions of any applicable
rental agreement or state law.

17. Loss to your covered auto or any non-
owned auto, arising out of the actual,
alleged or threatened presence, growth,
proliferation or spread of fungi, dry rot
or bacteria.

18. Loss to your covered auto, non-
owned auto, or trailer, for diminution
in value.

19. Loss in excess of $1,000 per claim or the
actual cash value of your covered auto
or any non-owned auto, whichever is
less, for any furnishings or equipment that
were not installed by the original vehicle
manufacturer or manufacturer's dealer-
ship which mechanically or structurally
changes your vehicle and results in in-
crease in performance or change in
appearance, including but not limited to:
a. custom murals, paintings or other
decals or graphics;
b. custom wheels, tachometers, pres-
sure and temperature gauges;
**** REPRINTED FROM THE ARCHIVE. THE ORIGINAL TRANSACTION MAY INCLUDE ADDITIONAL FORMS **** DocuSign Envelope ID: 46D6A2EF-882A-4620-B74A-6EA557925A10 DocuSign Envelope ID: A95B4497-949A-4DF5-8017-24B92C08FD07 53 SA-1852/CAEP 2/21 - 17 -
c. modified or custom engines and
fuel systems, light bars, racing
slicks and/or oversized tires, roll
bars and lift kits, winches, utility
boxes, and tool boxes; or
d. non-standard paint.

This exclusion does not apply to equip-
ment installed to make a vehicle
handicap accessible.

20. Loss arising out of the use of your cov-
ered auto while leased or rented to
others.

21. Loss to your covered auto or a non-
owned auto caused by an intentional act
by you or a family member, or at the di-
rection of you or afamily member.

22. Loss to your covered auto or any non-
owned auto while being used in a per-
sonal vehicle sharing program.

LIMIT OF LIABILITY
A. At our option, our limit of liability for loss will be the lowest of:

1. The actual cash value of the stolen or
damaged property;

2. a. the amount necessary to repair or
replace the property;
b. determination of the cost of repair
or replacement will be based upon
one of the following:
(1) the cost of repair or replace-
ment agreed upon by you and
us;
(2) a competitive bid approved by
us; or
(3) an estimate written based upon
the prevailing competitive price.

You agree with us that we may
include in the estimate parts
furnished by the original vehicle
manufacturer or parts from
other sources including non-
original equipment manufac-
turers. The prevailing
competitive price means prices
charged by a majority of the
repair market in the area where
the vehicle is to be repaired as
determined by us; or

3. The limit of liability shown in the Decla-
rations.

However, the most we will pay for loss to any
non-owned auto, which is a trailer, is
$1,500.

B. An adjustment for depreciation and physical
condition may be made based upon the phys-
ical condition and wear and tear of the
property or damaged part of the property at
the time of the loss. This adjustment for physi-
cal condition includes but is not limited to,
broken, cracked or missing parts, rust, dents,
scrapes, gouges and paint condition. When
replacing parts normally subject to repair or
replacement during the useful life of the vehi-
cle, we will not pay for the amount of any
betterment.

PAYMENT OF LOSS
We may pay for loss in money or repair or replace
the damaged or stolen property. We may, at our
expense, return any stolen property to:

1. You; or

2. The address shown in this policy.

If we return stolen property we will pay for any
damage resulting from the theft. We may keep all
or part of the property at an agreed or appraised
value.

If we pay for loss in money, our payment will in-
clude the applicable sales tax for the damaged or
stolen property.

NO BENEFIT TO BAILEE
This insurance shall not directly or indirectly bene-
fit any carrier or other bailee for hire.

OTHER SOURCES OF RECOVERY
If other sources of recovery also cover the loss,
we will pay only our share of the loss. Our share is
the proportion that our limit of liability bears to the total of all applicable limits. However, any insur-
ance we provide with respect to a non-owned
auto shall be excess over any other collectible
source of recovery including, but not limited to:

1. Any coverage provided by the owner of
the non-owned auto;

2. Any other applicable physical damage
insurance;

3. Any other source of recovery applicable
to the loss.

If more than one policy applies on an excess ba-
sis, we will bear our proportionate share with other
collectible sources of recovery.

APPRAISAL
A. If we and you do not agree on the amount of
loss, either may demand an appraisal of the
loss. In this event, each party will select a
competent appraiser. The two appraisers will
select an umpire. The appraisers will state
separately the actual cash value and the
amount of loss. If they fail to agree, they will
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submit their differences to the umpire. A deci-
sion agreed to by any two will be binding.

Each party will:

1. Pay its chosen appraiser; and

2. Bear the expenses of the appraisal and
umpire equally.

B. We do not waive any of our rights under this
policy by agreeing to an appraisal.

PART E Ð DUTIES AFTER AN ACCIDENT OR LOSS
We have no duty to provide coverage under this
policy unless there has been full compliance with
the following duties:

A. We must be notified promptly of how, when
and where the accident or loss happened. No-
tice should also include the names and
addresses of any injured persons and of any
witnesses.

B. A person seeking any coverage must:

1. Cooperate with us in the investigation,
settlement or defense of any claim or
suit.

2. Promptly send us copies of any notices
or legal papers received in connection
with the accident or loss.

3. Submit, as often as we reasonably re-
quire:
a. to physical examinations by physi-
cians we select. We will pay for
these exams.
b. to examination under oath and
subscribe the same. We may ex-
amine any insured separately and
apart from the presence of any oth-
er insured.

4. Authorize us to obtain:
a. medical reports; and
b. other pertinent records.

5. Submit a proof of loss, under oath if re-
quested, when required by us.

6. Must not, except at the insured's own
cost:
a. voluntarily make any payment;
b. assume any obligation; or
c. incur any expense other than for
immediate medical or surgical relief
to others imperative at the time of
the accident.

C. A person seeking Uninsured Motorists Cover-
age must also:

1. Promptly notify the police or other
proper authority, within 24 hours if a
hit-and-run driver is involved. The
insured must provide us within 30 days
of the accident, a statement under oath:
a. that the insured has a cause of ac-
tion for damages arising out of an
accident with a hit-and-run vehicle
whose owner or operator cannot be
identified; and
b. setting forth the facts in support
thereof.

At our request, the insured must make
your covered auto available for inspec-
tion.

2. Promptly send us copies of the legal
papers if a suit is brought.

A person seeking coverage for bodily injury
sustained in an accident involving a vehicle
described in item 2. of the definition of unin-
sured motor vehicle must:

1. Provide us with a copy of the complaint
by personal service or certified mail, if
the insured brings action against the
owner or operator of the uninsured mo-
tor vehicle.

2. Within a reasonable time, make availa-
ble all pleadings and depositions for
copying by us or furnish us copies at our
expense.

3. Provide us with proof that the limits of li-
ability under any applicable liability bonds
or policies have been exhausted by
payment of judgments or settlements.

A person seeking Uninsured Motorists Cov-
erage for property damage must also notify
us or our agent within 10 business days of
the accident.

D. A person seeking Coverage for Damage to
Your Auto must also:

1. Take reasonable steps after loss to
protect your covered auto or any non-
owned auto and its equipment from
further loss. We will pay reasonable
expenses incurred to do this.

2. Promptly notify the police if your cov-
ered auto or any non-owned auto is
stolen.
**** REPRINTED FROM THE ARCHIVE. THE ORIGINAL TRANSACTION MAY INCLUDE ADDITIONAL FORMS **** DocuSign Envelope ID: 46D6A2EF-882A-4620-B74A-6EA557925A10 DocuSign Envelope ID: A95B4497-949A-4DF5-8017-24B92C08FD07 55 SA-1852/CAEP 2/21 - 19 -

3. Permit us to inspect and appraise the
damaged property before its repair or
disposal.

4. Submit a proof of loss, under oath if re-
quested, within 91 days after date of the
loss, and upon the company's request,
exhibit the damaged property.

PART F Ð GENERAL PROVISIONS

POLICY PERIOD AND TERRITORY
A. This policy applies only to accidents and loss-
es which occur:

1. During the policy period as shown in the
Declarations; and

2. Within the policy territory.

B. The policy period is the period stated in the
Declarations. The policy may be renewed for
successive policy periods if the required pre-
mium is paid and accepted by us on or before
the expiration of the current policy period. The
premium will be computed at our then current
rate for coverage then offered.

C. The policy territory is:

1. The United States of America, its territo-
ries or possessions;

2. Puerto Rico;

3. Canada; or

4. Mexico, within 100 miles of the United
States boundary line.

This policy also applies to loss to, or acci-
dents involving, your covered auto while
being transported between their ports.

BANKRUPTCY
Bankruptcy or insolvency of the insured shall not
relieve us of any obligations under this policy.

CHANGES
A. This policy, your Declarations page and en-
dorsements issued by us to this policy contain
all the agreements between you and us. Its
terms may not be changed or waived except
by endorsement issued by us.

B. The premium for your policy is based on in-
formation we have received from you or other
sources. You agree to cooperate with us in
determining if this information is correct and
complete and you will notify us if it changes. If
this information is incorrect, incomplete, or
changes, we will adjust your premium during
the policy term or take other appropriate ac-
tion based upon the corrected, completed or
changed information. Changes during the pol-
icy term that will result in a premium increase
or decrease during the policy term include, but
are not limited to, changes in:

1. The number, type or use classification
of insured vehicles.

2. Operators using insured vehicles, in-
cluding newly licensed family member
drivers and any household members
that have licenses.

3. The location where your vehicle is prin-
cipally garaged.

4. Customized equipment or parts.

You also agree to disclose all licensed driv-
ers residing in your household.

C. If we make a change which broadens cover-
age under this edition of your policy without
additional premium charge, that change will
automatically apply to your policy as of the
date we implement the change in your state.

This paragraph (C.) does not apply to chang-
es implemented with a general program
revision that includes both broadenings and
restrictions in coverage, whether that general
program revision is implemented through in-
troduction of:

1. A subsequent edition of your policy; or

2. An Amendatory Endorsement.

PAYMENT OF PREMIUM
If your initial premium payment is by check, draft
or any remittance other than cash, coverage un-
der this policy is conditioned upon the check, draft
or remittance being honored upon presentment to
the bank or other financial institution. If the check,
draft or remittance is not honored upon present-
ment, this policy may, at our option, be deemed
void from its inception. This means that we will not
be liable under this policy for any claims or dam-
ages which would otherwise be covered if the
check, draft, or remittance had been honored up-
on presentment.

FRAUD
This policy was issued in reliance upon the
information provided on your application. We may
void this policy if you or an insured have
concealed or misrepresented any material fact or
circumstance, or engaged in fraudulent conduct,
at the time application was made or any time
during the policy period.
**** REPRINTED FROM THE ARCHIVE. THE ORIGINAL TRANSACTION MAY INCLUDE ADDITIONAL FORMS **** DocuSign Envelope ID: 46D6A2EF-882A-4620-B74A-6EA557925A10 DocuSign Envelope ID: A95B4497-949A-4DF5-8017-24B92C08FD07 56 SA-1852/CAEP 2/21 - 20 -
We may void this policy or deny coverage for an
accident or loss if you or an insured have con-
cealed or misrepresented any material fact or
circumstance, or engaged in fraudulent conduct,
in connection with the presentation or settlement
of a claim.

We may void this policy or deny coverage for
fraud or material misrepresentation even after the
occurrence of an accident or loss. This means we
will not be liable for any claims or damages which
would otherwise be covered. If we make a pay-
ment, we may request that you reimburse us. If so
requested, you must reimburse us for any pay-
ments we may have already made.

LEGAL ACTION AGAINST US
A. No legal action may be brought against us un-
til there has been full compliance with all the
terms of this policy. In addition, under Part A,
no legal action may be brought against us un-
til:

1. We agree in writing that the insured
has an obligation to pay; or

2. The amount of that obligation has been
finally determined by judgment after trial.

B. No person or organization has any right under
this policy to bring us into any action to deter-
mine the legal liability of aninsured.

This provision does not apply to Uninsured Motor-
ists Coverage.

LEGAL ACTION AGAINST US Ð UNINSURED

MOTORISTS COVERAGE
No legal action may be brought against us until:

1. There has been full compliance with all
the terms of the policy; and

2. With respect to an accident involving a
vehicle described in items 1., 3. and 4.
of the definition of ªuninsured motor
vehicleº, one of the following actions is
taken within two years from the date of
the accident:
a. agreement as to the amount of
damages for bodily injury due
under this coverage has been
concluded;
b. the insured or the insured's legal
representative has formally institut-
ed arbitration proceedings by
notifying us in writing. With respect
to bodily injury, such notification
must be sent by certified mail, re-
turn receipt requested; or
c. suit for bodily injury has been
filed against the uninsured
motorist in a court of competent
jurisdiction. Written notice of the
suit must be provided to us within
a reasonable time after the
insured knew or should have
known of the uninsured status of
the other motorist. In no event will
such notice be required before
one year from the date of the
accident. Failure of the insured
or the insured's representative to
provide such notice will not be a
basis for a denial of coverage
unless such failure prejudices our
rights.

OUR RIGHT TO RECOVER PAYMENT
A. If we make a payment under this policy and
the person to or for whom payment was made
has a right to recover damages from another
person, entity or organization we shall be sub-
rogated to that right. That person shall:

1. Do whatever is necessary to enable us
to exercise our rights; and

2. Do nothing after loss to prejudice them.

However, our rights in this paragraph (A.) do
not apply under Part D Ð Coverage for Dam-
age to Your Auto , against any person using
your covered auto with a reasonable belief
that that person has permission to do so.

This paragraph (A.) does not apply to cover-
age under item 2. of the definition of
uninsured motor vehicle or Part B Ð Medi-
cal Payments Coverage of the policy.

B. If we make a payment under this policy and
the person to or for whom payment is made
recovers damages from another, that person
shall:

1. Hold in trust for us the proceeds of the
recovery; and

2. Reimburse us to the extent of our pay-
ment.

This paragraph does not apply to coverage
under items 1., 3. or 4. of the definition of un-
insured motor vehicle.

C. With respect to Part B Ð Medical Payments,
we shall be entitled to the payment and
reimbursement as provided in paragraphB. of
this provision regardless of whether the total
amount of the recovery of the person to or for
whom payment was made (or his or her
estate, parent or legal guardian) is less than
the actual loss suffered by that person (or his
or her estate, parent or legal guardian). The
proceeds of any judgment or settlement
obtained by us or the person to or for whom
payment was made (or his or her estate,
parent or legal guardian) shall first be applied
to satisfy our claims, liens, and other rights
under paragraphB. of this provision.
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TERMINATION
A. Cancellation. This policy may be canceled
during the policy period as follows:

1. The named insured shown in the Decla-
rations may cancel by:
a. returning this policy to us; or
b. giving us advance written or verbal
notice of the date cancellation is to
take effect. We may waive the
requirement that the notice be in
writing by confirming the date and
time of cancellation to you in
writing.

2. We may cancel by mailing to the named
insured shown in the Declarations at the
address shown in this policy:
a. at least 10 days notice if cancella-
tion is for non-payment of premium;
or
b. at least 20 days notice in all other
cases.

3. We will cancel only:
a. for nonpayment of premium; or
b. if your driver's license or that of:
(1) any driver who lives with you;
or
(2) any driver who customarily
uses your covered auto;
has been suspended or revoked.

This must have occurred:
(1) during the policy period; or
(2) 180 days prior to the most re-
cent renewal or effective date
of the policy.

However, with respect to a suspend-
ed driver's license, such cancellation
will not become effective if the sus-
pension is removed prior to the time
that the cancellation of the policy is to
become effective; or
c. discovery of fraud by the named in-
sured in pursuing a claim under the
policy, if the policy is not recinded;
or
d. if the policy was obtained through
material misrepresentation of any
of the following information, and the
correct information is not furnished
to us within 20 days of receipt of
notice of cancellation:
(1) safety record;
(2) annual miles driven in prior
years;
(3) number of years of driving ex-
perience;
(4) record of prior automobile in-
surance claims, if any; or
(5) any other factor found by the
Commissioner of Insurance to
have a substantial relationship
to the risk of loss; or
e. a substantial increase in the hazard
insured against.

B. Nonrenewal. If we decide not to renew or
continue this policy, we will mail notice to the
named insured shown in the Declarations at
the address shown in this policy. Notice will be
mailed at least 30 days before the end of the
policy period.

C. Automatic Termination. If we offer to renew
and you or your representative do not accept,
this policy will automatically terminate at the
end of the current policy period. Failure to pay
the required renewal premium when due shall
mean that you have not accepted our offer.

Coverage for your covered auto shall auto-
matically terminate on the effective date of
any other motor vehicle insurance policy
covering that vehicle.

D. Other Termination Provisions.

1. We may deliver any notice instead of
mailing it. Proof of mailing of any notice
shall be sufficient proof of notice.

2. If this policy is canceled, you may be
entitled to a premium refund. If so, we
will send you the refund. The premium
refund, if any, will be computed on a pro
rata basis. However, making or offering
to make the refund is not a condition of
cancellation.

3. The effective date of cancellation stated
in the notice shall become the end of the
policy period.

TRANSFER OF YOUR INTEREST IN THIS
POLICY
A. Your rights and duties under this policy may
not be assigned without our written consent.

However, if a named insured shown in the
Declarations dies, coverage will be provided
for:

1. The surviving spouse or registered do-
mestic partner if resident in the same
household at the time of death. Cover-
age applies to the spouse or registered
domestic partner as if a named insured
shown in the Declarations; and
**** REPRINTED FROM THE ARCHIVE. THE ORIGINAL TRANSACTION MAY INCLUDE ADDITIONAL FORMS **** DocuSign Envelope ID: 46D6A2EF-882A-4620-B74A-6EA557925A10 DocuSign Envelope ID: A95B4497-949A-4DF5-8017-24B92C08FD07 58 SA-1852/CAEP 2/21 - 22 -

2. The legal representative of the de-
ceased person as if a named insured
shown in the Declarations. This applies
only with respect to the representative's
legal responsibility to maintain or use
your covered auto.

B. Coverage will only be provided until the end of
the policy period.

TWO OR MORE AUTOS INSURED; TWO OR

MORE AUTO POLICIES
If this policy insures two or more autos or if any
other auto insurance policy issued to you by us
applies to the same accident, the maximum limit
of our liability shall not exceed the highest limit
applicable to any one auto. In no event shall the
limit of liability of two or more motor vehicles or
two or more policies be added together,
combined, or stacked to determine the limit of
insurance coverage available to you or any
insured.

LOSS PAYABLE CLAUSE
As to the interest of the loss payee, this policy will
remain in effect from the inception date and until
ten days after proof of mailing that the
cancellation notice has been mailed to the loss
payee. When we pay the loss payee we shall, to
the extent of payment, have the loss payee's
rights of recovery.

Where fraud, misrepresentation, material omis-
sion, or intentional damage has been committed
by or at the direction of any insured, or where the
loss is otherwise not covered under the terms of
the policy, the Loss Payee or lienholder's interest
will not be protected.

STORAGE COSTS
If you give us your consent, we may move the
damaged property, at our expense, to reduce
storage costs during the claims process. If you do
not give us your consent, we will pay only the
storage costs which would have resulted if we had
moved the damaged property.

NAMED DRIVER EXCLUSION
If there is an excluded driver under this policy,
then we will not provide coverage for any claim
arising from an accident or loss involving a motor
vehicle being operated by that excluded person.

This includes any claim for damages made
against you or any family member or any other
person or organization that is vicariously liable for
an accident arising out of the operation of a motor
vehicle by the excluded driver.

WARNING
Unless you have automobile insurance written by
a Mexican insurance company, you may spend
many hours or days in jail, if you have an accident
in Mexico. Insurance coverage should be secured
from a company licensed under the laws of
Mexico to write insurance in order to avoid
complications and some other penalties possible
under the laws of Mexico, including the possible
impoundment of your automobile.

ADDITIONAL COVERAGES
AGREEMENT: WE WILL PROVIDE THE INSURANCE DESCRIBED IN EACH OF THE FOLLOWING ADDITIONAL COVERAGES ONLY IF INDICATED IN THE DECLARATIONS.

ROADSIDE ASSISTANCE COVERAGE CALL
1-877-ROAD 101 (1-877-762-3101)
ªYour covered autoº as used in this endorse-
ment means a private passenger vehicle,
motorhome or trailer owned by you and for which
a specific premium is shown on the Declarations
for this coverage.

The following coverages apply to each vehicle for
which this coverage is shown on the Policy Decla-
rations:

1. Each time your covered auto or any
non-owned auto is disabled due to me-
chanical or electrical breakdown we will
pay reasonable and necessary expens-
es for the use of an authorized service
provider to tow or flatbed your covered
auto or non-owned auto up to 15 miles
or to the nearest qualified place where
necessary repairs can be made during
regular business hours.

2. Each time your covered auto or any
non-owned auto is disabled requiring:
a. towing to dislodge the vehicle from
its place of disablement within 100
feet of a public street or highway; or
b. labor, including change of tire, at
the place of its breakdown; or
c. delivery of fuel, oil, water or other
fluids (we do not pay the costs of
these items); or
d. key lock-out services;
we will cover up to one (1) hour of labor
for the use of an authorized service
provider for service at the place of dis-
ablement.
**** REPRINTED FROM THE ARCHIVE. THE ORIGINAL TRANSACTION MAY INCLUDE ADDITIONAL FORMS **** DocuSign Envelope ID: 46D6A2EF-882A-4620-B74A-6EA557925A10 DocuSign Envelope ID: A95B4497-949A-4DF5-8017-24B92C08FD07 59 SA-1852/CAEP 2/21 - 23 -

3. For policies with a 6 month policy term,
coverage is limited to no more than two
occurrences per vehicle plus an addi-
tional two occurrences per policy in a 6
month policy period for both coverages

1. and 2., above.

4. For policies with an annual policy term,
coverage is limited to no more than four
occurrences per vehicle plus an addi-
tional four occurrences per policy in a 12
month policy period for both coverages

1. and 2.

Authorized service providermeans a service pro-
vider contracted by us providing, at no charge to
you, roadside assistance as described and limited
above.

When service is provided by other than an author-
ized service provider, we will reimburse you only
for reasonable charges as determined by us.

No deductible applies to this coverage.

SA-2736/EP 7/09

LOSS OF USE COVERAGE
The provisions and exclusions that apply to Part D
Ð Coverage for Damage to Your Auto also apply
to this coverage except as changed below:

When there is a loss to any vehicle described in
the Declarations for which a specific premium
charge indicates that Loss of Use is afforded, we
will reimburse you for expenses you incur to rent a
substitute vehicle.

This coverage applies only if:

1. The vehicle is withdrawn from use for
more than 24 hours;

2. The loss is caused by collision, or is
covered by the Comprehensive Cover-
age of this policy; and

3. The loss exceeds the appropriate colli-
sion or comprehensive deductible
applying to the vehicle.

However, this coverage does not apply to losses
caused by collision if Collision Coverage does
not apply to the vehicle.

Our payment will be limited to that period of time
reasonably required to repair or replace the auto.

We will pay up to the amount per day and the maxi-
mum shown for Loss of Use in the Declarations.

FULL SAFETY GLASS COVERAGE
We will pay under Comprehensive Coverage for
the cost of repairing or replacing damaged safety
equipment on your covered auto without a de-
ductible. We will pay only if:

1. The Declarations indicates that Com-
prehensive Coverage applies; and

2. A specific premium charge for Full Safe-
ty Glass Coverage is shown in the
Declarations for your covered auto.
ªSafety equipmentº, as used in this coverage
means the:

1. Glass used in the windshield, doors and
windows of your covered auto; and

2. Glass, plastic or other material used in
the lights of your covered auto.
**** REPRINTED FROM THE ARCHIVE. THE ORIGINAL TRANSACTION MAY INCLUDE ADDITIONAL FORMS **** DocuSign Envelope ID: 46D6A2EF-882A-4620-B74A-6EA557925A10 DocuSign Envelope ID: A95B4497-949A-4DF5-8017-24B92C08FD07 60 This policy has been signed by our President and Secretary.

James MacPhee Mark C. Touhey
President Vice President and Secretary
This policy includes copyrighted material of Insurance Services Office, Inc. with its permission.

SA-1701/EP 9/90
G19
**** REPRINTED FROM THE ARCHIVE. THE ORIGINAL TRANSACTION MAY INCLUDE ADDITIONAL FORMS **** DocuSign Envelope ID: 46D6A2EF-882A-4620-B74A-6EA557925A10 DocuSign Envelope ID: A95B4497-949A-4DF5-8017-24B92C08FD07 61 SA-2482/CAEP 9/15
Auto Body Repair Consumer Bill of Rights
A CONSUMER IS ENTITLED TO:

1. SELECT THE AUTO BODY REPAIR SHOP TO REPAIR AUTO BODY DAMAGE COVERED BY THE INSURANCE COMPANY. AN INSURANCE COMPANY MAY NOT REQUIRE THE REPAIRS TO BE DONE AT A SPECIFIC AUTO BODY REPAIR SHOP.

2. AN ITEMIZED WRITTEN ESTIMATE FOR AUTO BODY REPAIRS AND, UPON COMPLETION OF REPAIRS, A DETAILED INVOICE. THE ESTIMATE AND THE INVOICE MUST INCLUDE AN ITEMIZED LIST OF PARTS AND LABOR ALONG WITH THE TOTAL PRICE FOR THE WORK PERFORMED. THE

ESTIMATE AND INVOICE MUST ALSO IDENTIFY ALL PARTS AS NEW, USED, AFTERMARKET, RECONDITIONED, OR REBUILT.

3. BE INFORMED ABOUT COVERAGE FOR TOWING AND STORAGE SERVICES.

4. BE INFORMED ABOUT THE EXTENT OF COVERAGE, IF ANY, FOR A REPLACEMENT RENTAL VEHICLE WHILE A DAMAGED VEHICLE IS BEING REPAIRED.

5. BE INFORMED OF WHERE TO REPORT SUSPECTED FRAUD OR OTHER COMPLAINTS AND CONCERNS ABOUT AUTO BODY REPAIRS.

6. SEEK AND OBTAIN AN INDEPENDENT REPAIR ESTIMATE DIRECTLY FROM A REGISTERED AUTO

BODY REPAIR SHOP FOR REPAIR OF A DAMAGED VEHICLE, EVEN WHEN PURSUING AN INSURANCE CLAIM FOR REPAIR OF THE VEHICLE.

COMPLAINTS WITHIN THE JURISDICTION OF THE BUREAU OF AUTOMOTIVE REPAIR Complaints concerning the repair of a vehicle by an auto body repair shop should be directed to:

Toll Free (866) 799-3811
Bureau of Automotive Repair 10949
North Mather Blvd.

Rancho Cordova, CA 95670
The Bureau of Automotive Repair can also accept complaints over its web site at:
www.autorepair.ca.gov

COMPLAINTS WITHIN THE JURISDICTION OF THE CALIFORNIA INSURANCE COMMISSIONER Any concerns regarding how an auto insurance claim is being handled should be submitted to the California Department of Insurance at:
(800) 927-4357 or (213) 897-8921
California Department of Insurance
Consumer Services Division
300 South Spring Street
Los Angeles, CA 90013
The California Department of Insurance can also accept complaints over its web site at:
www.insurance.ca.gov
Last Revised Ð January 20, 2015
Copyright
California Department of Insurance
Disclaimer
**** REPRINTED FROM THE ARCHIVE. THE ORIGINAL TRANSACTION MAY INCLUDE ADDITIONAL FORMS **** DocuSign Envelope ID: 46D6A2EF-882A-4620-B74A-6EA557925A10 DocuSign Envelope ID: A95B4497-949A-4DF5-8017-24B92C08FD07 62 CALIFORNIA INSURANCE IDENTIFICATION CARDCALIFORNIA INSURANCE IDENTIFICATION CARD

COMPANYCOMPANY

SAFECO INSURANCE COMPANY OF AMERICASAFECO INSURANCE COMPANY OF AMERICA 62 MAPLE AVENUE
KEENE NH 03431
62 MAPLE AVENUE
KEENE NH 03431

POLICY NUMBER EFFECTIVE DATE EXPIRATION DATEPOLICY NUMBER EFFECTIVE DATE EXPIRATION DATE A3543348 JUNE 22 2022 JUNE 22 2023A3543348 JUNE 22 2022 JUNE 22 2023

YEARMAKE/MODELVEHICLE IDENTIFICATION NUMBERYEARMAKE/MODELVEHICLE IDENTIFICATION NUMBER 2019AUDIWAUGUGFF4K10091382019AUDIWAUGUGFF4K1009138
NAIC24740NAIC24740 AGENCY/COMPANY ISSUING CARDAGENCY/COMPANY ISSUING CARD

MISSION SANTA BARBARA INS SERVMISSION SANTA BARBARA INS SERV 1-866-472-33261-866-472-3326 1114 STATE ST STE 254SANTA BARBARA CA 93101-27981114 STATE ST STE 254 SANTA BARBARA CA 93101-2798

INSUREDPAUL WESTMACOTTINSUREDPAUL WESTMACOTT
1173 CAMINO ANDALUZ
SANTA BARBARA CA 93111-10011173 CAMINO ANDALUZ
SANTA BARBARA CA 93111-1001
SEE IMPORTANT NOTICE ON REVERSE SIDEVEHICLE REGISTRATION COPY CN-7042/CAEP 6/13CN-7042/CAEP 6/13

CALIFORNIA INSURANCE IDENTIFICATION CARDCALIFORNIA INSURANCE IDENTIFICATION CARD

COMPANYCOMPANY

SAFECO INSURANCE COMPANY OF AMERICASAFECO INSURANCE COMPANY OF AMERICA 62 MAPLE AVENUE
KEENE NH 03431
62 MAPLE AVENUE
KEENE NH 03431

POLICY NUMBER EFFECTIVE DATE EXPIRATION DATEPOLICY NUMBER EFFECTIVE DATE EXPIRATION DATE A3543348 JUNE 22 2022 JUNE 22 2023A3543348 JUNE 22 2022 JUNE 22 2023

YEARMAKE/MODELVEHICLE IDENTIFICATION NUMBERYEARMAKE/MODELVEHICLE IDENTIFICATION NUMBER 2018TOYOTAJTDKDTB35J16057632018TOYOTAJTDKDTB35J1605763
NAIC24740NAIC24740 AGENCY/COMPANY ISSUING CARDAGENCY/COMPANY ISSUING CARD

MISSION SANTA BARBARA INS SERVMISSION SANTA BARBARA INS SERV 1-866-472-33261-866-472-3326 1114 STATE ST STE 254SANTA BARBARA CA 93101-27981114 STATE ST STE 254 SANTA BARBARA CA 93101-2798

INSUREDPAUL WESTMACOTTINSUREDPAUL WESTMACOTT
1173 CAMINO ANDALUZ
SANTA BARBARA CA 93111-1001
1173 CAMINO ANDALUZ
SANTA BARBARA CA 93111-1001
SEE IMPORTANT NOTICE ON REVERSE SIDEVEHICLE REGISTRATION COPY CN-7042/CAEP 6/13CN-7042/CAEP 6/13 SEPARATE ID CARD(S) ON THE PERFORATIONS.

ONE COPY MUST BE KEPT IN THE INSURED VEHICLE
AND PRESENTED UPON DEMAND. THE OTHER COPY SHOULD BE PRESENTED

TO THE MOTOR VEHICLE DEPARTMENT
WHEN RENEWING YOUR VEHICLE REGISTRATION. CN-7042/CAEPC 6/13 **** REPRINTED FROM THE ARCHIVE. THE ORIGINAL TRANSACTION MAY INCLUDE ADDITIONAL FORMS **** DocuSign Envelope ID: 46D6A2EF-882A-4620-B74A-6EA557925A10 DocuSign Envelope ID: A95B4497-949A-4DF5-8017-24B92C08FD07 63 PRESENT THIS COPY WHEN RENEWING

YOUR VEHICLE REGISTRATION
The insurance policy meets the requirements of Section 16056.

THIS CARD MUST BE KEPT IN THE INSURED

VEHICLE AND PRESENTED UPON DEMAND
The insurance policy meets the requirements of Section 16056.

IN CASE OF AN ACCIDENT

1.STOP.Get help for injured people.

2.RECORD PERTINENT FACTS.
·Date, time, location of accident.
·Names, addresses and telephone numbers of registered owners, occupants of all vehicles, injured people and witnesses. ·Insurance company name and policy number for each vehicle involved.

3.DO NOT ADMIT FAULT.Discuss the accident only with the police or your Safeco representative.

4.CALL THE POLICE(when required by law).

Call Safeco from the Accident scene or as soon as possible for 24 hour claims assistance, including windshield repair or replacement.

Please call
1-866-472-3326
If your policy includesRoadside Assistancecall 1-877-ROAD 101 (1-877-762-3101) for 24 hour service

PRESENT THIS COPY WHEN RENEWING

YOUR VEHICLE REGISTRATION
The insurance policy meets the requirements of Section 16056.

THIS CARD MUST BE KEPT IN THE INSURED

VEHICLE AND PRESENTED UPON DEMAND
The insurance policy meets the requirements of Section 16056.

IN CASE OF AN ACCIDENT

1.STOP.Get help for injured people.

3.DO NOT ADMIT FAULT.Discuss the accident only with the police or your Safeco representative.

4.CALL THE POLICE(when required by law).

Call Safeco from the Accident scene or as soon as possible for 24 hour claims assistance, including windshield repair or replacement.

Please call
1-866-472-3326
If your policy includesRoadside Assistancecall 1-877-ROAD 101 (1-877-762-3101) for 24 hour service
**** REPRINTED FROM THE ARCHIVE. THE ORIGINAL TRANSACTION MAY INCLUDE ADDITIONAL FORMS **** DocuSign Envelope ID: 46D6A2EF-882A-4620-B74A-6EA557925A10 DocuSign Envelope ID: A95B4497-949A-4DF5-8017-24B92C08FD07 64 CALIFORNIA INSURANCE IDENTIFICATION CARDCALIFORNIA INSURANCE IDENTIFICATION CARD

COMPANYCOMPANY

SAFECO INSURANCE COMPANY OF AMERICASAFECO INSURANCE COMPANY OF AMERICA 62 MAPLE AVENUE
KEENE NH 03431
62 MAPLE AVENUE
KEENE NH 03431

POLICY NUMBER EFFECTIVE DATE EXPIRATION DATEPOLICY NUMBER EFFECTIVE DATE EXPIRATION DATE A3543348 JUNE 22 2022 JUNE 22 2023A3543348 JUNE 22 2022 JUNE 22 2023

YEARMAKE/MODELVEHICLE IDENTIFICATION NUMBERYEARMAKE/MODELVEHICLE IDENTIFICATION NUMBER 2018AUDIWA1LHAF79JD0132222018AUDIWA1LHAF79JD013222
NAIC24740NAIC24740. AGENCY/COMPANY ISSUING CARDAGENCY/COMPANY ISSUING CARD

MISSION SANTA BARBARA INS SERVMISSION SANTA BARBARA INS SERV 1-866-472-33261-866-472-3326 1114 STATE ST STE 254SANTA BARBARA CA 93101-27981114 STATE ST STE 254 SANTA BARBARA CA 93101-2798

ONE COPY MUST BE KEPT IN THE INSURED VEHICLE
AND PRESENTED UPON DEMAND. THE OTHER SHOULD BE PRESENTED

YOUR VEHICLE REGISTRATION
The insurance policy meets the requirements of Section 16056.

THIS CARD MUST BE KEPT IN THE INSURED

VEHICLE AND PRESENTED UPON DEMAND
The insurance policy meets the requirements of Section 16056.

IN CASE OF AN ACCIDENT

1.STOP.Get help for injured people.

3.DO NOT ADMIT FAULT.Discuss the accident only with the police or your Safeco representative.

4.CALL THE POLICE(when required by law).

Call Safeco from the Accident scene or as soon as possible for 24 hour claims assistance, including windshield repair or replacement.

Please call
1-866-472-3326
If your policy includesRoadside Assistancecall 1-877-ROAD 101 (1-877-762-3101) for 24 hour service
**** REPRINTED FROM THE ARCHIVE. THE ORIGINAL TRANSACTION MAY INCLUDE ADDITIONAL FORMS **** DocuSign Envelope ID: 46D6A2EF-882A-4620-B74A-6EA557925A10 DocuSign Envelope ID: A95B4497-949A-4DF5-8017-24B92C08FD07 66 DOCUMENT ROUTING AND APPROVAL FORM
Requires Council Approval:
☐NO
☐YES
Meeting Date:

Requires Vendor Set -up:
☐NO
☐YES
If no, Vendor Number:

Director Level Approval:
☐NO
☐YES
Site Authority:

Provide summary of agreement below:

Document Name and Type: Project Name :

Vendor Name:

Contact Person:

Address:

Phone Number:

Email Address:

Business License Number:

City Project Manager:

Contact Number:

Email Address:

Requisition Number:

Staff (DocuSign User) Staff routes agreement to vendor via DocuSign for electronic signature and requests Insurance documents.

Risk Manager Risk Management shall r ate Insurance.

City Manager City Manager will approve and sign the agreement.

City Clerk City Clerk will approve and sign the agreement.

FINALIZED ON: INITIAL RESOLUTION NO
(IF APPLICABLE)
Staff Routing Agreement:

Contact Number:

Email Address:

Vendor Staff will route a fully exec uted copy of the agreement to the vendor.

BELOW FOR CITY CLERK PROCESSING ONLY

FILE NUMBER
June 7, 2022
003177
City Manager
Videographer services
Professional Services Amendment between City of Goleta and Paradigm Pictures N/A
Paul Westmacott DBA: Paradigm Pictures
$84,500
Paul Westmacott
1173 Camino Andaluz, Santa Barbara, 93111
805-636-9026
[email protected]
2020-0022
Kelly Hoover
(805) 961-7507
[email protected]
Jaime Shaw
(805) 961-7508
[email protected]
On-call services (Professional Services)
DocuSign Envelope ID: FACDFA61-1315-4CF3-9787-DF3CD1AD4230 6/14/2022
6/14/2022
6/14/2022
6/20/2022
6/20/2022
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DocuSign Envelope ID: FACDFA61-1315-4CF3-9787-DF3CD1AD4230 69 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE

THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS.

INSURER(S) AFFORDING COVERAGE
INSURER F :

INSURER E :

INSURER D :

INSURER C :

INSURER B :

INSURER A :

NAIC #
NAME:

CONTACT
(A/C, No):

FAX
E-MAIL
ADDRESS:

PRODUCER
(A/C, No, Ext):

PHONE

INSURED
REVISION NUMBER:CERTIFICATE NUMBER:COVERAGES
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed.

THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS

OTHER:
(Per accident)
(Ea accident)
$
$
N / A
SUBR
WVD
ADDL
INSD

COMBINED SINGLE LIMIT

AUTOS ONLY

AUTOSAUTOS ONLY

NON-OWNED

SCHEDULEDOWNED

ANY AUTO

AUTOMOBILE LIABILITY
Y / N

WORKERS COMPENSATION

AND EMPLOYERS' LIABILITY
OFFICER/MEMBER EXCLUDED?
(Mandatory in NH)
DESCRIPTION OF OPERATIONS below
If yes, describe under

ANY PROPRIETOR/PARTNER/EXECUTIVE
$
$
$
E.L. DISEASE - POLICY LIMIT
E.L. DISEASE - EA EMPLOYEE
E.L. EACH ACCIDENT
ER
OTH-

STATUTE
PER

LIMITS(MM/DD/YYYY)

POLICY EXP
(MM/DD/YYYY)

POLICY EFF

POLICY NUMBERTYPE OF INSURANCELTR
INSR
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)

EXCESS LIAB
UMBRELLA LIAB $EACH OCCURRENCE
$AGGREGATE
$
OCCUR

CLAIMS-MADE
DED
RETENTION $
$PRODUCTS - COMP/OP AGG
$GENERAL AGGREGATE
$PERSONAL & ADV INJURY
$MED EXP (Any one person)
$EACH OCCURRENCE

DAMAGE TO RENTED
$PREMISES (Ea occurrence)

COMMERCIAL GENERAL LIABILITY

CLAIMS-MADE
OCCUR
GEN'L AGGREGATE LIMIT APPLIES PER:

POLICY PRO-

JECT LOC

CERTIFICATE OF LIABILITY INSURANCE

DATE (MM/DD/YYYY)

CANCELLATION

CERTIFICATE HOLDER
The ACORD name and logo are registered marks of ACORD
HIRED

AUTOS ONLY
06/09/2022
J
ohn McLaren Ins Inc
PO BOX 14136
TUCSON AZ 85732

DORIS SUTTON
(714)-968-4100 (714)-968-8304
john@ mclarenandassociates.com

PAUL WESTMACOTT
1173 Camino Andaluz
Santa Barbara CA 93111-1001
HISCOX Insurance Company Inc 10500
A X UDC-4374980-BOP-21 01/13/2022 01/13/2023
1,000,000
100,000
5,000
S/T Ech. Agg.
2,000,000
S/T Gen. Agg.

A
✖ ✖
UDC-4374980-BOP-21 01/13/2022 01/13/2023
A
P
rofessional Liability
UDC-4374980-EO-21 01/13/2022 01/13/2023
Each 1,000,000
Aggregate 2,000,000

THE CITY OF GOLETA IS ADDED AS ADDITIONALY INSURED
A 30 DAY WRITTEN NOTICE SHALL BE GIVEN OTHER THAN FOR NON PAYMENT OF PREMIUM WHICH IS 10 DAYS 130 Cremona Drive., Ste B
Goleta, Ca 93117

THE CITY OF GOLETA
DocuSign Envelope ID: FACDFA61-1315-4CF3-9787-DF3CD1AD4230 70 DOCUMENT ROUTING AND APPROVAL FORM
Requires Council Approval:
☐NO
☐YES
Meeting Date:

Requires Vendor Set -up:
☐NO
☐YES
If no, Vendor Number:

Director Level Approval:
☐NO
☐YES
Site Authority:

Provide summary of agreement below:

Document Name and Type: Project Name :

Vendor Name:

Contact Person:

Address:

Phone Number:

Email Address:

Business License Number:

City Project Manager:

Contact Number:

Email Address:

ROUTING PROCESS DESCRIPTION DATE INITIAL
Department Head
Initiation
Authority to initiate agreement
Risk Manager Staff to initiate review of insurance provision in agreement City Attorney Contract review/A pprove as form
Finance Director,
Purchasing Officer
Funding Methods Approved/
Authorized, Purchase
Requisition reviewed.

Requisition N umber:

Vendor Staff sends agreement to vendor via DocuSign for electronic signature and requests Insurance documents.

Staff (DocuSign User) Staff receives electronically signed agreement and insurance documents from vendor.

Risk Manager Risk Management shall rate Insurance and provide documents to Project Manager upon approval
City Manager City Manager will approve and sign the agreement.

City Clerk City Clerk will approve and sign the agreement.

FINALIZED ON: INITIAL RESOLUTION NO
(IF APPLICABLE)
Staff Routing Agreement:

Contact Number:

Email Address:

Vendor Staff will assign the vendor to receive a fully executed copy of the agreement via DocuSign.

PLEASE RETURN SIGNED DOCUMENTS TO THE CITY CLERK’S OFFICE

BELOW FOR CITY CLERK PROCESSING ONLY

FILE NUMBER
003177
City Manager
Video Production Services
Professional Services Amendment
Paradigm Pictures
$41,500.00
Paul Westcott
3525 San Jose Ln. Santa Barbara, CA 93105
805-636-9026
[email protected]
2020-0022
Kelly Hoover
805.961.7507
[email protected]
Sandra Rodriguez
805-961-7576
[email protected]
N/A but budgeted for in FY21/22 Budget
DocuSign Envelope ID: AC466182-9F0F-4F29-86DA-660982AF28CC 3/8/2021
3/10/2021
3/10/2021
3/11/2021
3/12/2021
3/12/2021
3/15/2021
3/15/2021
3/22/2021

City of Goleta
Amendment No. 1 to Agreement No. 2020-020

Page 1 of 2 ends

AMENDMENT NO. 1

TO A PROFESSIONAL SERVICES AGREEMENT

BETWEEN THE CITY OF GOLETA
AND

PARADIGM PICTURES

This Amendment No. 1 to the Professional Services Agreement by and between the CITY OF GOLETA , a municipal corporation (“City”) and PARADIGM PICTURES (“Consultant”) dated February 14, 2020 (“Agreement,” Agreement No. 2020-020) is made on this _____ day of March, 2021.

RECITALS
WHEREAS, this Agreement is for professional services for video production services; and
WHEREAS, the Agreement currently provides in Section 3 Subsection (a) for th e total compensation amount not to exceed twenty-nine thousand five hundred ($29,500); and
WHEREAS, the parties desire to amend the Agreement so as to provide for additional compensation in the amount of $12,000.00 for continued tasks; and WHEREAS, the Agreement currently provides in Section 6 for the termination of the Agreement on June 30, 2021; and

WHEREAS, the parties desire to amend the Agreement so as to extend the termination of the Agreement to June 30, 2022 and

WHEREAS, the City Manager approved this Amendment No.1 on this _____ day of March, 2021.

AMENDED TERMS

Now therefore City and Consultant agree as follows that the Agreement be, and hereby is, amended as follows:

1. Subsection (a) of Section 3. COMPENSATION AND PAYMENT of the Agreement is amended to add an additional authorized amount of $12,000.00 and to read in its entirety:
(a) Maximum and Rate . The total compensation payable to CONSULTANT by CITY for the services under this AGREEMENT SHALL NOT EXCEED the sum of $41,500.00 (herein "not-to-exceed amount") and shall be earned as the work progresses.

DocuSign Envelope ID: AC466182-9F0F-4F29-86DA-660982AF28CC 22 22
72 City of Goleta
Amendment No. 1 to Agreement No. 2020-020

Page 2 of 2 ends

2. Section 6. TERM, PROGRESS AND COMPLETION of the Agreement is amended to extend the term for an additional 1 year to read in its entirety.

The term of this Agreement is from the date first written a bove to June 30, 2022, unless the term of this Agreement is extended or the Agreement is terminated as provided for herein.

3. Except as otherwise specifically provided herein, all other provisions of the Agreement shall remain in full force and effect

In concurrence and witness whereof, this Amendment No. 1 has been executed by the parties effective on the date and year first above written.

CITY OF GOLETA CONSULTANT

____________________________ ______________________________ Michelle Greene, City Manager Paul Westcott, Owner/Producer

ATTEST:

_____________________________
Deborah Lopez, City Clerk

APPROVED AS TO FORM:

MICHAEL JENKINS, CITY ATTORNEY
_____________________________
Winnie Cai, Assistant City Attorney

DocuSign Envelope ID: AC466182-9F0F-4F29-86DA-660982AF28CC 73 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE

THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS.

INSURER(S) AFFORDING COVERAGE
INSURER F :

INSURER E :

INSURER D :

INSURER C :

INSURER B :

INSURER A :

NAIC #
NAME:

CONTACT
(A/C, No):

FAX
E-MAIL
ADDRESS:

PRODUCER
(A/C, No, Ext):

PHONE

INSURED
REVISION NUMBER:CERTIFICATE NUMBER:COVERAGES
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed.

THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS

OTHER:
(Per accident)
(Ea accident)
$
$
N / A
SUBR
WVD
ADDL
INSD

COMBINED SINGLE LIMIT

AUTOS ONLY

AUTOSAUTOS ONLY

NON-OWNED

SCHEDULEDOWNED

ANY AUTO

AUTOMOBILE LIABILITY
Y / N

WORKERS COMPENSATION

AND EMPLOYERS' LIABILITY
OFFICER/MEMBER EXCLUDED?
(Mandatory in NH)
DESCRIPTION OF OPERATIONS below
If yes, describe under

ANY PROPRIETOR/PARTNER/EXECUTIVE
$
$
$
E.L. DISEASE - POLICY LIMIT
E.L. DISEASE - EA EMPLOYEE
E.L. EACH ACCIDENT
ER
OTH-

STATUTE
PER

LIMITS(MM/DD/YYYY)

POLICY EXP
(MM/DD/YYYY)

POLICY EFF

POLICY NUMBERTYPE OF INSURANCELTR
INSR
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)

EXCESS LIAB
UMBRELLA LIAB $EACH OCCURRENCE
$AGGREGATE
$
OCCUR

CLAIMS-MADE
DED
RETENTION $
$PRODUCTS - COMP/OP AGG
$GENERAL AGGREGATE
$PERSONAL & ADV INJURY
$MED EXP (Any one person)
$EACH OCCURRENCE

DAMAGE TO RENTED
$PREMISES (Ea occurrence)

COMMERCIAL GENERAL LIABILITY

CLAIMS-MADE
OCCUR
GEN'L AGGREGATE LIMIT APPLIES PER:

POLICY PRO-

JECT LOC

CERTIFICATE OF LIABILITY INSURANCE

DATE (MM/DD/YYYY)

CANCELLATION

CERTIFICATE HOLDER
The ACORD name and logo are registered marks of ACORD
HIRED

AUTOS ONLY
03/15/2021
J
ohn McLaren Ins Inc
PO BOX 7049
HUNTINGTON BEACH CA 92615-7049

DORIS SUTTON
(714)-968-4100 (714)-968-8304
john@ mclarenandassociates.com

PAUL WESTMACOTT
1173 Camino Andaluz
Santa Barbara CA 93111-1001
HISCOX Insurance Company Inc 10500
A X UDC-4374980-BOP-21 01/13/2021 01/13/2022
1,000,000
100,000
5,000
S/T Ech. Agg.
2,000,000
S/T Gen. Agg.

A
✖ ✖
UDC-4374980-BOP-21 01/13/2021 01/13/2022
A
P
rofessional Liability
UDC-4374980-EO-21 01/13/2021 01/13/2022
Each 1,000,000
Aggregate 2,000,000

THE CITY OF GOLETA IS ADDED AS ADDITIONALY INSURED
A 30 DAY WRITTEN NOTICE SHALL BE GIVEN OTHER THAN FOR NON PAYMENT OF PREMIUM WHICH IS 10 DAYS 130 Cremona Drive., Ste B
Goleta, Ca 93117

THE CITY OF GOLETA

APPROVED
3/15/21
DocuSign Envelope ID: AC466182-9F0F-4F29-86DA-660982AF28CC 74 75
76 77
78 79
80 81
82 83
84 85
86 87

Goleta City CouncilJune 18, 2024

Goleta City Council
June 18, 2024