SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS.
INSURER(S) AFFORDING COVERAGE
INSURER F :
INSURER E :
INSURER D :
INSURER C :
INSURER B :
INSURER A : NAIC #
NAME: CONTACT
(A/C, No): FAX
E-MAIL ADDRESS:
PRODUCER
(A/C, No, Ext): PHONE
INSURED
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed.
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
OTHER:
(Per accident)
(Ea accident)
$
$
N / A
SUBR WVDADDL
INSD
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. $
$
$
$ PROPERTY DAMAGE
BODILY INJURY (Per accident)
BODILY INJURY (Per person) COMBINED SINGLE LIMIT
AUTOS ONLY
AUTOS ONLY AUTOS NON-OWNED OWNED SCHEDULED
ANY AUTO
AUTOMOBILE LIABILITY
Y / N WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY OFFICER/MEMBER EXCLUDED?
(Mandatory in NH) DESCRIPTION OF OPERATIONS below
If yes, describe under
ANY PROPRIETOR/PARTNER/EXECUTIVE
$
$
$ E.L. DISEASE - POLICY LIMIT E.L. DISEASE - EA EMPLOYEEE.L. EACH ACCIDENT EROTH- STATUTE PER
(MM/DD/YYYY) LIMITS POLICY EXP(MM/DD/YYYY) POLICY EFFLTR TYPE OF INSURANCE POLICY NUMBER INSR
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
EXCESS LIAB
UMBRELLA LIAB EACH OCCURRENCE $ AGGREGATE $
$
OCCUR
CLAIMS-MADE DED RETENTION $
PRODUCTS - COMP/OP AGG $ GENERAL AGGREGATE $ PERSONAL & ADV INJURY $ MED EXP (Any one person) $
EACH OCCURRENCE $ DAMAGE TO RENTED
PREMISES (Ea occurrence) $ COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO- JECT LOC
CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY)
CANCELLATION
AUTHORIZED REPRESENTATIVE
ACORD 25 (2016/03)
© 1988-2015 ACORD CORPORATION. All rights reserved.
CERTIFICATE HOLDER
The ACORD name and logo are registered marks of ACORD
HIRED
AUTOS ONLY
6/18/2026
Inszone Insurance Services, LLC
2721 Citrus Road, Suite A
Rancho Cordova, CA 95742
Certificate Team 877-308-9663 916-400-2625 [email protected] License#: 0F82764 Everest Premier Insurance Company 16045 CASECON-07 Casey Construction, Inc.
619 Sylvan Way
Emerald Hills, CA 94062
187974462
A Y 7600009947251 10/1/2025 10/1/2026
X
1,000,000 1,000,000 1,000,000
RE: Project Name: Alta Vista Groundwater Project- RFP
Waiver of Subrogation on the Workers Compensation.
The aforementioned coverage is provided to the extent in the attached forms for: City of Pacifica City of Pacifica 170 Santa Maria Ave
Pacifica, CA 94044
POLICY NUMBER: 7600009947251
06/01/2026
Neilson & Phillips Insurance
5900 King Rd
Ste 204
Loomis CA 95650
(916) 380-5952
Financial Pacific Insurance CO
Palomar Excess & Surplus Insurance Company
Casey Construction Inc. Westchester Surplus Lines Insurance Company 619 Sylvan Way
Emerald Hills CA 94062-
31453
16754
10172
Cindy Hales
[email protected]
(000) 000-000-
X
X
X GL BI/PD Deductible
X $5,000 per occur
X
A X 60545307 12/19/2025 09/01/2026 1,000,000
100,000
5,000
1,000,000
2,000,000
2,000,000
Y
X
A X 60545307 09/01/2025 09/01/2026 1,000,000
Y
X
X
X X 0
B X PES-XS-01-7625 12/19/2025 09/01/2026 5,000,000
Y 5,000,000
C Contractors Pollution Liability G27984125010 09/01/2025 09/01/2026 Ea Pollution Cond Limit $1,000,000 Aggregate Limit $2,000,000
Deductible $5,000
Project Name: Alta Vista Groundwater Project- RFP
The certifixate holder is hereby named as additional insured per the attached endorsements. *A 30 day NOC will be given except for non-=pymt of premium a 10 day NOC will be given.
AI 142266
170 Santa Maria Ave
Pacifica CA 94044-
City of Pacifica
ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED?
INSR ADDL SUBR
LTR INSD WVD
DATE (MM/DD/YYYY) PRODUCER CONTACT NAME: PHONE FAX
(A/C, No, Ext): (A/C, No): E-MAIL ADDRESS:
INSURER A :
INSURED INSURER B :
INSURER C :
INSURER D :
INSURER E :
INSURER F : POLICY NUMBER
POLICY EFF POLICY EXP TYPE OF INSURANCE (MM/DD/YYYY) (MM/DD/YYYY) LIMITS AUTOMOBILE LIABILITY UMBRELLA LIAB
EXCESS LIAB WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
AUTHORIZED REPRESENTATIVE
EACH OCCURRENCE $ DAMAGE TO RENTED
CLAIMS-MADE OCCUR PREMISES (Ea occurrence) $
MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ PRO- POLICY JECT LOC PRODUCTS - COMP/OP AGG $ OTHER: $ COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO BODILY INJURY (Per person) $ OWNED SCHEDULED BODILY INJURY (Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY (Per accident) $ OCCUR EACH OCCURRENCE $ CLAIMS-MADE AGGREGATE $ DED RETENTION $ $ PER OTH- STATUTE ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $
If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ INSURER(S) AFFORDING COVERAGE NAIC #
COMMERCIAL GENERAL LIABILITY
Y / N
N / A
(Mandatory in NH)
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS.
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY 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.
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.
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).
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
CERTIFICATE HOLDER CANCELLATION
© 1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
CERTIFICATE OF LIABILITY INSURANCE
Policy #60545307
COMMERCIAL AUTO
CA 71 09 01 17
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
CA 71 09 01 17 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 7
BUSINESS AUTO ULTRA ENDORSEMENT
This endorsement modifies insurance provided under the following:
BUSINESS AUTO COVERAGE FORM
COMMON POLICY CONDITIONS
COVERAGE INDEX
DESCRIPTION PAGE
Temporary Substitute Auto Physical Damage 2
Broad Form Insured 2
Employee as Insureds 2
Additional Insured Status by Contract, Agreement or Permit 2 Bail Bond Coverage 3
Loss of Earnings Coverage 3
Amended Fellow Employee Coverage 3
Towing and Labor 3
Physical Damage Additional Transportation Expense Coverage 3 Extra Expense - Theft 3
Rental Reimbursement and Additional Transportation Expense 4 Personal Effects Coverage 4
Personal Property of Others 4
Locksmith Coverage 4
Vehicle Wrap Coverage 5
Airbag Accidental Discharge 5
Audio, Visual and Data Electronic Equipment Coverage 5
Auto Loan/Lease Total Loss Protection 5
Glass Repair – Deductible Amendment 5
Amended Duties in the Event of Accident, Claim, Suit or Loss 6 Waiver of Subrogation Required by Contract 6
Unintentional Failure to Disclose 6
Hired, Leased, Rented or Borrowed Auto Physical Damage 6 Mental Anguish 7
Extended Cancellation Condition 7
The COVERAGE INDEX set forth above is informational only and grants no coverage.
Terms set forth in are likewise for information only and by themselves shall be deemed to grant no coverage.
3ROLF\45307
Waiver ofSubrogation Required byContract
Additional Insured Status byContract, Agreement or Permit
A. TEMPORARY SUBSTITUTE AUTO PHYSICAL DAMAGE
SECTION I – COVERED AUTOS, paragraph C. Certain Trailers, Mobile Equipment and Temporary Substitute Autos is amended by adding the following at the end of the existing language:
If Physical Damage Coverage is provided under this Coverage form for an "auto" you own, the Physical Damage coverages provided for that owned "auto" are extended to any "auto" you do not own while used with the permission of its owner as a temporary substitute for the covered "auto" you own that is out of service because of its breakdown, repair, servicing, "loss", or destruction
B. BROADENED LIABILITY COVERAGES
SECTION II – LIABILITY COVERAGE in Paragraph A. Coverage at 1. Who Is An Insured is amended to include the following:
d. Any legally incorporated subsidiary in which you own more than 50% of the voting stock on the effective date of the Coverage Form. However, the Named Insured does not include any subsidiary that is an "insured" under any other automobile policy or would be an "insured" under such a policy but for its termination or the exhaustion of its Limit of Insurance.
e. Any organization that is acquired or formed by you, during the term of this policy and over which you maintain majority ownership. However, the Named Insured does not include any newly formed or acquired organization:
(1) That is a joint venture or partnership,
(2) That is an "insured" under any other policy,
(3) That has exhausted its Limits of Insurance under any other policy, or (4) 180 days or more after its acquisition or formation by you, unless you have given us notice of the acquisition or formation
Coverage does not apply to "bodily injury" or "property damage" that results from an accident that occurred before you formed or acquired the organization.
f. Any employee of yours while acting in the course of your business or your personal affairs while using a covered "auto" you do not own, hire or borrow.
g. Any person or organization whom you are required to add as an additional insured on this policy under a written contract or agreement; but the written contract or agreement must be:
(1) Currently in effect or becoming effective during the term of this policy; and (2) Executed prior to the "bodily injury" or "property damage." The additional insured status will apply only with respect to your liability for "bodily injury" or "property damage" which may be imputed to that person(s) or organization(s) directly arising out of the ownership, maintenance or use of the covered "autos" at the location(s) designated, if any.
Coverage provided by this endorsement will not exceed the limits of liability required by the written contract or written agreement even if the limits of liability stated in the policy exceed those limits. This endorsement shall not increase the limits stated in Section II. C. Limits of Insurance.
For any covered "auto" you own this Coverage Form provides primary coverage.
CA 71 09 01 17 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 3 of 7 C. BROADENED SUPPLEMENTARY PAYMENTS
SECTION II. LIABILITY A. Coverage 2. Coverage Extensions a. Supplementary Payments (2) and (4) are replaced by the following:
(2) Up to $5,000 for cost of bail bonds (including bonds for related traffic violations) required because of an "accident" we cover. We do not have to furnish these bonds.
(4) All reasonable expenses incurred by the "insured" at our request, including actual loss of earning up to $500 a day because of time off from work.
D. AMENDED FELLOW EMPLOYEE EXCLUSION
Only with respect to your "employees" who occupy positions which are supervisory in nature, SECTION II. LIABILITY B.
Exclusion 5. Fellow Employee is replaced by:
5. Fellow Employee
"Bodily Injury":
a. To you, or your partners or members (if you are a partnership or joint venture), or to your members (if you are a limited liability company);
b. To your "executive officers" and directors (if you are an organization other than a partnership, joint venture, or limited liability company) but only with respect to performance of their duties as your officers or directors; c. For which there is an obligation to share damages with or repay someone else who must pay damages because of the injury described in paragraph a and b above; or d. Arising out of his or her providing or failing to provide professional health care services.
For purposes of this endorsement, a position is deemed to be supervisory in nature if that person performs principle work which is substantially different from that of his or her subordinates and has authority to hire, transfer, direct, discipline or discharge.
E. BROADENED PHYSICAL DAMAGE COVERAGES
SECTION III – PHYSICAL DAMAGE COVERAGE A. Coverage is amended as follows:
2. Towing is deleted and replaced with the following:
2. Towing and Labor
We will pay towing and labor costs incurred, up to the limits shown below, each time a covered "auto" is disabled:
a. For private passenger type vehicles we will pay up to $100 per disablement. b. For all other covered "auto's" we will pay up to $500 per disablement However, the labor must be performed at the place of disablement. !
"
""
4. Coverage Extensions
a. Transportation Expenses is amended to provide the following limits:
We will pay up to $60 per day to a maximum of $1,800. All other terms and provisions of this section remain applicable.
The following language is added to 4. Coverage Extensions:
"
#
"
c. Theft Recovery Expense
If you have purchased Comprehensive Coverage on an "auto" that is stolen, we will pay the expense of returning that stolen auto to you. The limit for this coverage extension is $5,000.
d. Rental Reimbursement
We will provide Rental Reimbursement and Additional Expense coverage only for those Physical Damage coverages for which a premium is shown in the Declarations or schedule pages. Coverage applies only to a covered "auto".
(1) We will pay for auto rental expense and the expense incurred by you because of "loss" to remove and transfer your materials and equipment from a covered "auto" to a covered "auto." Payment applies in addition to the otherwise applicable coverage you have on a covered "auto." No deductible applies to this coverage.
(2) We will pay only for expenses incurred during the policy period and beginning 24 hours after the "loss" and ending, regardless of the policy's expiration, with the lesser of the following number of days:
(a) The number of days reasonably required to repair or replace the covered "auto." If "loss" is caused by theft, this number of days is added to the number of days it takes to locate the covered "auto" and return it to you, or
(b) 30 days.
(3) Our payment is limited to the lesser of the following amounts:
(a) Necessary and actual expenses incurred; or
(b) $75 per day.
(c) This coverage does not apply while there are spare or reserve "autos" available to you for your operations.
(d) If "loss" results from the total theft of a covered "auto" of the private passenger or light truck type, we will pay under this coverage only that amount of your rental reimbursement expense which is not already provided for under the SECTION III – PHYSICAL DAMAGE COVERAGE, A. Coverage, 4.
Coverage Extensions, a. Transportation Expenses.
e. Personal Effects
If you have purchased Comprehensive Coverage on this policy for an "auto" you own and that "auto" is stolen, we will pay, without application of a deductible, up to $500 for Personal Effects stolen with the "auto".
The insurance provided under this provision is excess over any other collectible insurance. For this coverage extension, Personal Effects means tangible property that is worn or carried by an "insured".
f. Personal Property of Others
We will pay up to $500 for loss to personal property of others in or on your covered "auto." This coverage applies only in the event of "loss" to your covered "auto" caused by fire, lightning, explosion, theft, mischief or vandalism, the covered "auto's" collision with another object, or the covered "auto's" overturn. No deductibles apply to this coverage.
!
g. Locksmith Coverage
We will pay up to $250 per occurrence for necessary locksmith services for keys locked inside a covered private passenger "auto". The deductible is waived for these services.
CA 71 09 01 17 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 5 of 7
h. Vehicle Wrap Coverage
If you have Comprehensive or Collision coverage on an "auto" that is a total loss, in addition to the actual cash value of the "auto", we will pay up to $1,000 for vinyl vehicle wraps which are displayed on the covered "auto" at the time of total loss. Regardless of the number of autos deemed a total loss, the most we will pay under this Vehicle Wrap Coverage for any one "loss" is $5,000. For purposes of this coverage provision, signs or other graphics painted or magnetically affixed to the vehicle are not considered vehicle wraps.
F. SECTION III – PHYSICAL DAMAGE COVERAGE, B. Exclusions is amended at 3. to include the following language:
If you have purchased Comprehensive or Collision Coverage under this policy, this exclusion does not apply to mechanical breakdown relating to the accidental discharge of an air bag. This coverage applies only to a covered auto you own and is excess of any other collectible insurance or warranty. No deductible applies to this coverage.
G. BROADENED LIMITS OF INSURANCE
SECTION III – PHYSICAL DAMAGE COVERAGE – C. Limit of Insurance at 1.b. is amended to provide the following limits:
b. Limits of $1,000 per "loss" is increased to $5,000 per "loss". All other terms and provisions of this section remain applicable.
!
SECTION III – PHYSICAL DAMAGE COVERAGE – C. Limit of Insurance is amended by adding the following language:
4. In the event of a total "loss" to a covered "auto" shown in the Schedule pages, subject at the time of the "loss" to a loan or lease, we will pay any unpaid amount due including up to a maximum of $500 for early termination fees or penalties on the lease or loan for a covered"auto" less:
a. The amount paid under the Physical Damage Coverage Section of the policy; and b. Any:
(1) Overdue lease / loan payments at the time of the "loss''; (2) Financial penalties imposed under a lease for excessive use, abnormal wear and tear or high mileage; (3) Security deposits not returned by the lessor;
(4) Costs for extended warranties, Credit Life Insurance, Health, Accident or Disability Insurance purchased with the loan or lease; and
(5) Carry-over balances from previous loans or leases.
"
#
$
H. GLASS REPAIR – DEDUCTIBLE
SECTION III – PHYSICAL DAMAGE COVERAGE – D. Deductible is amended by adding the following:
Any deductible shown in the Declarations as applicable to the covered "auto" will not apply to glass breakage if the damaged glass is repaired, rather than replaced.
I. AMENDED DUTIES IN THE EVENT OF ACCIDENT, CLAIM, SUIT OR LOSS Under SECTION IV – BUSINESS AUTO CONDITIONS, A. Loss Conditions , the following is added to paragraph 2.
Duties In The Event of Accident, Suit or Loss:
d. Knowledge of any "accident", "claim", "suit" or "loss" will be deemed knowledge by you when notice of such "accident", "claim", "suit" or "loss" has been received by:
(1) You, if you are an individual;
(2) Any partner or insurance manager if you are a partnership; (3) An executive officer or insurance manager, if you are a corporation; (4) Your members, managers or insurance manager, if you are a limited liability company; or (5) Your officials, trustees, board members or insurance manager, if you are a not-for-profit organization.
J. WAIVER OF SUBROGATION REQUIRED BY CONTRACT
Under SECTION IV, BUSINESS AUTO CONDITIONS, A. Loss Conditions 5. Transfer of Rights of Recovery Against Others to Us the following language is added:
However, we waive any rights of recovery we may have against the person or organization with whom you have agreed in writing in a contract, agreement or permit, to provide insurance such as is afforded under the policy to which this endorsement is attached. This provision does not apply unless the written contract or written agreement has been executed, or permit has been issued, prior to the "bodily injury" or "property damage."
K. UNINTENTIONAL FAILURE TO DISCLOSE
Under SECTION IV – BUSINESS AUTO CONDITIONS, B. General Conditions , the following is added to 2.
Concealment, Misrepresentation Or Fraud:
Your unintentional error in disclosing, or failing to disclose, any material fact existing at the effective date of this Coverage Form, or during the policy period in connection with any additional hazards, will not prejudice your rights under this Coverage Form.
!
"
#$
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L. HIRED, LEASED, RENTED OR BORROWED AUTO PHYSICAL DAMAGE Under SECTION IV – BUSINESS AUTO CONDITIONS B. General Conditions 5. Other Insurance Paragraph 5.b. is replaced by the following:
b. (1) For "Comprehensive" and "Collision" Auto Physical Damage coverage provided by this endorsement, the following are deemed to be covered "autos" you own:
(a) Any Covered "auto" you lease, hire, rent or borrow; and (b) Any Covered "auto" hired or rented by your "employee" under a contract in that individual "employee's" name, with your permission, while performing duties related to the conduct of your business.
However, any "auto" that is leased, hired, rented or borrowed with a driver is not a covered "auto" (2) Limit of Insurance For This Section
The most we will pay for any one "loss" is the lesser of the following:
(a) $75,000 per accident, or
(b) actual cash value at the time of loss, or
(c) cost of repair.
CA 71 09 01 17 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 7 of 7 Minus a $500 deductible. An adjustment for depreciation and physical condition will be made in determining actual cash value in the event of a total loss. No deductible applies to "loss" caused by fire or lightning.
(3) This Hired Auto Physical Damage coverage is excess over any other collectible insurance. (4) Definitions For This Section
(a) Comprehensive Coverage: from any cause except the covered "auto's" collision with another object or the covered "auto's" overturn. We will pay glass breakage, "loss" caused by hitting a bird or animal and, "loss" caused by falling objects or missiles.
(b) Collision Coverage: caused by the covered "auto's" collision with another object or by the covered "auto's" overturn.
M. MENTAL ANGUISH
Under SECTION V – DEFINITIONS, C. is replaced by the following:
C. "Bodily injury" means bodily injury, sickness or disease sustained by a person including mental anguish or death resulting from bodily injury, sickness, or disease.
N. EXTENDED CANCELLATION CONDITION
Under CANCELLATION, of the COMMON POLICY CONDITIONS form, item 2.b. is replaced by the following:
b. 60 days before the effective date of cancellation if we cancel for any other reason.
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CG 71 03 07 17
ULTRA LIABILITY PLUS ENDORSEMENT
COMMERCIAL GENERAL LIABILITY EXTENSION ENDORSEMENT SUMMARY OF COVERAGES This is a summary of the various additional coverages and coverage modifications provided by this endorsement. No coverage is provided by this summary.
* Extended Property Damage
* Expanded Fire Legal Liability to include Explosion, Lightning and Sprinkler Leakage * Coverage for non-owned watercraft is extended to 51 feet in length * Property Damage - Borrowed Equipment
* Property Damage Liability - Elevators
*
*
* Coverage F - Electronic Data Liability Coverage - $50,000 * Coverage G - Product Recall Expense
* Coverage H - Water Damage Legal Liability - $25,000
* Increase in Supplementary Payments: Bail Bonds to $1,000 * Increase in Supplementary Payments: Loss of Earnings to $500 * For newly formed or acquired organizations - extend the reporting requirement to 180 days * Broadened Named Insured
* Automatic Additional Insured - Vendors
* Automatic Additional Insured - Lessor of Leased Equipment Automatic Status When Required in Lease Agreement With * Automatic Additional Insured - Managers or Lessor of Premises * Additional Insured - Engineers, Architects or Surveyors Not Engaged by the Named Insured * Additional Insured - Employee Injury to Another Employee * Automatically included - Aggregate Limits of Insurance (per location) * Automatically included - Aggregate Limits of Insurance (per project) * Knowledge of occurrence - Knowledge of an “occurrence”, “claim or suit” by your agent, servant or employee shall not in * Blanket Waiver of Subrogation
* Liberalization Condition
* Unintentional failure to disclose all hazards. If you unintentionally fail to disclose any hazards existing at the inception * Mobile equipment to include snow removal, road maintenance and street cleaning equipment less than 1,000 lbs GVW REFER TO THE ACTUAL ENDORSEMENT FOLLOWING ON PAGES 2 THROUGH 12 FOR CHANGES AFFECTING
YOUR INSURANCE PROTECTION
CG 71 03 07 17 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 12 $25,000 Each Recall Limit with a $50,000 Aggregate - $1,000 Deductible Automatic Additional Insured - Owners, Lessees or Contractors - Automatic Status When Required in Construction Agreement With You – Including Upstream Parties
*
Coverage D - Voluntary Property Damage Coverage
$5,000 Occurrence with a $10,000 Aggregate
Coverage E - Care, Custody and Control Property Damage Coverage $25,000 Occurrence with a $100,000 Aggregate - $500 Deductible date of your policy, we will not deny coverage under this Coverage Form because of such failure. However, this provision does not affect our right to collect additional premium or exercise our right of cancellation or non-renewal. itself constitute knowledge of the named insured unless an officer of the named insured has received such notice from the agent, servant or employee
You
* Bodily Injury Redefined
Policy #60545307
* Blanket Waiver ofSubrogation
* Automatically included - Aggregate Limits of Insurance (per project) CG 71 03 07 17
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ULTRA LIABILITY PLUS ENDORSEMENT
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SECTION I - COVERAGES
A. The following changes are made at COVERAGE A - BODILY INJURY AND PROPERTY DAMAGE LIABILITY
1. Extended Property Damage
At 2. Exclusions exclusion a. Expected or Intended Injury is replaced with the following:
“Bodily injury” or “property damage” expected or intended from the standpoint of the insured. This exclusion does not apply to “bodily injury” or “property damage” resulting from the use of reasonable force to protect persons or property.
Expanded Fire Legal Liability
At 2. Exclusions the last paragraph is deleted and replaced by the following:
Exclusions c. through n. do not apply to damage by fire, explosion, lightning, smoke resulting from such fire, explosion, or lightning or sprinkler leakage to premises while rented to you or temporarily occupied by you with permission of the owner. A separate limit of insurance applies to this coverage as described in SECTION III - LIMITS OF INSURANCE .
3. Non-Owned Watercraft
At 2. Exclusions exclusion g. Aircraft, Auto Or Watercraft (2) (a) is deleted and replaced by the following:
(a) Less than 51 feet long;
4. Property Damage – Borrowed Equipment
At 2. Exclusions the following is added to paragraph (4) of exclusion j. Damage To Property :
This exclusion does not apply to “property damage” to borrowed equipment while at a jobsite and while not being used to perform operations. The most we will pay for “property damage” to any one piece of borrowed equipment under this coverage is $25,000 per occurrence. The insurance afforded under this provision is excess over any valid and collectible property insurance (including deductible) available to the insured, whether primary, excess, contingent or on any other basis.
5. Property Damage Liability – Elevators
At 2. Exclusions the following is added to paragraphs (3), (4) and (6) of exclusion j. Damage To Property :
B. The following coverages are added:
1. COVERAGE D - VOLUNTARY PROPERTY DAMAGE COVERAGE
“Property damage” to property of others caused by the insured:
a. While in your possession; or
b. Arising out of “your work”.
Coverage applies at the request of the insured, whether or not the insured is legally obligated to pay.
For the purposes of this Voluntary Property Damage Coverage only:
Exclusion j. Damage to Property is deleted and replaced by the following:
CG 71 03 07 17 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 2 of 12
2. This exclusion does not apply to “property damage” resulting from the use of elevators. However, any insurance provided for such “property damage” is excess over any valid and collectible property insurance (including deductible) available to the insured, whether primary, excess, contingent or on any other basis.
CG 71 03 07 17
j. Damage to Property
“Property damage” to:
(1) Property held by the insured for servicing, repair, storage or sale at premises you own, rent, lease, operate or use;
(2) Property transported by or damage caused by any “automobile”, “watercraft” or “aircraft” you own, hire or lease;
(3) Property you own, rent, lease, borrow or use.
The amount we will pay is limited as described below in SECTION III - LIMITS OF INSURANCE For the purposes of this Voluntary Property Damage Coverage, our right and duty to defend ends when we have paid the Limit of Liability or the Aggregate Limit for each coverage, and we are granted discretion in making payments under this coverage.
2. COVERAGE E - CARE, CUSTODY AND CONTROL PROPERTY DAMAGE COVERAGE For the purpose of this Care, Custody and Control Property Damage Coverage only:
a. Item (4) of exclusion j. does not apply.
The amount we will pay is limited as described below in SECTION III - LIMITS OF INSURANCE For the purposes of this Care, Custody and Control Property Damage Coverage, our right and duty to defend ends when we have paid the Limit of Liability or the Aggregate Limit for each coverage, and we are granted discretion in making payments under this coverage.
3. COVERAGE F - ELECTRONIC DATA LIABILITY COVERAGE
For the purposes of this Electronic Data Liability Coverage only:
a. Exclusion p. of Coverage A – Bodily Injury And Property Damage Liability in Section I – Coverages is replaced by the following:
2. Exclusions
This insurance does not apply to:
p. Electronic data
Damages arising out of the loss of, loss of use of, damage to, corruption of, inability to access, or inability to manipulate “electronic data” that does not result from physical injury to tangible property.
However, this exclusion does not apply to liability for damages because of “bodily injury” b. “Property damage” means:
(1) Physical injury to tangible property, including all resulting loss of use of that property. All such loss of use shall be deemed to occur at the time of the physical injury that caused it; or (2) Loss of use of tangible property that is not physically injured. All such loss of use shall be deemed to occur at the time of the “occurrence” that caused it; or (3) Loss of, loss of use of, damage to, corruption of, inability to access or inability to properly manipulate “electronic data”, resulting from physical injury to tangible property. All such loss of “electronic data” shall be deemed to occur at the time of the “occurrence” that caused it.
For the purposes of this Electronic Data Liability Coverage , “electronic data” is not tangible property.
The amount we will pay is limited as described below in SECTION III - LIMITS OF INSURANCE
4. COVERAGE G - PRODUCT RECALL EXPENSE
a. Insuring Agreement
(1) We will pay 90% of "product recall expense" you incur as a result of a "product recall" you initiate during the coverage period.
(2) We will only pay for "product recall expense" arising out of "your products" which have been physically relinquished to others.
The amount we will pay is limited as described below in SECTION III - LIMITS OF INSURANCE CG 71 03 07 17 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 3 of 12 CG 71 03 07 17
b. Exclusions
This insurance does not apply to "product recall expense" arising out of:
(1) Any fact, circumstance or situation which existed at the inception date of the policy and which you were aware of, or could reasonably have foreseen that would have resulted in a "product recall". (2) Deterioration, decomposition or transformation of a chemical nature, except if caused by an error in the manufacture, design, processing, storage, or transportation of "your product". (3) The withdrawal of similar products or batches that are not defective, when a defect in another product or batch has been found.
(4) Acts, errors or omissions of any of your employees, done with prior knowledge of any of your officers or directors.
(5) Inherent vice, meaning a natural condition of property that causes it to deteriorate or become damaged. (6) “Bodily injury” or “property damage”.
(7) Failure of “your product” to accomplish its intended purpose, including any breach of warranty of fitness, quality, efficacy or efficiency, whether written or implied. (8) Loss of reputation, customer faith or approval, or any costs incurred to regain customer market, or any other consequential damages.
(9) Legal fees or expenses.
(10) Damages claimed for any loss, cost or expense incurred by you or others for the loss of use of “your product”.
(11) “Product recall expense” arising from the “product recall” of any of “your products” for which coverage is excluded by endorsement.
(12) Any “product recall” initiated due to the expiration of the designated shelf life of “your product”.
5. COVERAGE H - WATER DAMAGE LEGAL LIABILITY
The Insurance provided under Coverage H (Section I) applies to “property damage” arising out of water damage to premises that are both rented to and occupied by you.
The Limit under this coverage shall not be in addition to the Damage To Premises Rented To You Limit.
The amount we will pay is limited as described below in SECTION III - LIMITS OF INSURANCE C. SUPPLEMENTARY PAYMENTS - COVERAGES A AND B is amended:
1. To read SUPPLEMENTARY PAYMENTS
2. Bail Bonds
Item 1.b. is amended as follows:
b. Up to $1,000 for cost of bail bonds required because of accidents or traffic law violations arising out of the use of any vehicle to which the Bodily Injury Liability Coverage applies. We do not have to furnish these bonds.
3. Loss of Earnings
Item 1.d. is amended as follows:
d. All reasonable expenses incurred by the insured at our request to assist us in the investigation or defense of the claim or “suit”, including actual loss of earnings up to $500 a day because of time off from work.
4.. The following language is added to Item 1.
However, we shall have none of the duties set forth above when this insurance applies only for Voluntary Property Damage Coverage and/or Care, Custody or Control Property Damage Coverage and we have paid the Limit of Liability or the Aggregate Limit for these coverages.
CG 71 03 07 17 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 4 of 12 CG 71 03 07 17
SECTION II - WHO IS AN INSURED
A. The following change is made:
Extended Reporting Requirements
Item 3.a. is deleted and replaced by the following :
a. Coverage under this provision is afforded only until the 180th day after you acquire or form the organization or the end of the policy period, whichever is earlier.
B. The following provisions are added:
4. Item 1.f. is added as follows:
f. Any legally incorporated entity of which you own more than 50 percent of the voting stock during the policy period only if there is no other similar insurance available to that entity. However:
(1) Coverage A does not apply to “bodily injury” or “property damage” that occurred before you acquired more than 50 percent of the voting stock; and
(2) Coverage B does not apply to “personal and advertising injury” arising out of an offense committed before you acquired more than 50 percent of the voting stock.
5. Additional Insured - Owners, Lessees or Contractors-Automatic Status When Required in Construction or Service Agreement With You – Including Upstream Parties a.
b. Any other person or organization you are required to add as an additional insured under the contract or agreement described in Paragraph a. above.
Such person(s) or organization(s) is an additional insured only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" which may be imputed to that person or organization directly arising out of:
1. Your acts or omissions; or
2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured.
However, the insurance afforded to such additional insured:
1. Only applies to the extent permitted by law; and
2. Will not be broader than that which you are required by the contract or agreement to provide for such additional insured.
c. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply:
This insurance does not apply to:
1. "Bodily injury", "property damage" or "personal and advertising injury" arising out of the rendering of, or the failure to render, any professional architectural, engineering or surveying services, including:
a. The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or b. Supervisory, inspection, architectural or engineering activities.
This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by that insured, if the "occurrence" which caused the "bodily injury" or "property damage", or the offense which caused the "personal and advertising injury", involved the rendering of or the failure to render any professional architectural, engineering or surveying services.
CG 71 03 07 17 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 5 of 12
BROAD FORM NAMED INSURED
Any person or organization for whom you are performing operations when you and such person or organization have agreed in writing in a contract or agreement that such person or organization be added as an additional insured on your policy;
CG 71 03 07 17
2. "Bodily injury" or "property damage" occurring after:
a. All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or b. That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project.
6. a. Any person(s) or organization(s) (referred to throughout this additional coverage as vendor), but only with respect to "bodily injury" or "property damage", which may be imputed to that person(s) or organization(s) arising out of “your products” shown with the Schedule which are distributed or sold in the regular course of the vendor's business is an insured.
However:
(1) The insurance afforded to such vendor only applies to the extent permitted by law; and (2) If coverage provided to the vendor is required by a contract or agreement, the insurance afforded to such vendor will not be broader than that which you are required by the contract or agreement to provide for such vendor.
b. With respect to the insurance afforded to these vendors, the following additional exclusions apply:
(1) This insurance afforded the vendor does not apply to:
(a) “Bodily injury” or “property damage” for which the vendor is obligated to pay damages by reason of the assumption of liability in a contract or agreement. This exclusion does not apply to liability for damages that the vendor would have in the absence of the contract or agreement; (b) Any express warranty unauthorized by you;
(c) Any physical or chemical change in the product made intentionally by the vendor; (d) Repackaging, except when unpacked solely for the purpose of inspection, demonstration, testing, or the substitution of parts under instructions from the manufacturer, and then repackaged in the original container.
(e) Any failure to make such inspections, adjustments, tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business, in connection with the distribution or sale of products.
(f) Demonstration, installation, servicing or repair operations, except such operations performed at the vendor's premises in connection with the sale of the product. (g) Products which, after distribution or sale by you, have been labeled or relabeled or used as a container, part or ingredient of any other thing or substance by or for the vendor. (h) "Bodily injury" or "property damage" arising out of the sole negligence of the vendor for its own acts or omissions or those of its employees or anyone else acting on its behalf. However, this exclusion does not apply to:
i. The exceptions contained in Sub-paragraphs d. or f.; or ii. Such inspections, adjustments, tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business, in connection with the distribution or sale of the products.
(2) This insurance does not apply to any insured person or organization, from whom you have acquired such products, or any ingredient, part or container, entering into, accompanying or containing such products.
CG 71 03 07 17 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 6 of 12 Additional Insured - Vendors
CG 71 03 07 17
7. a. Any person(s) or organization(s) from whom you lease equipment when you and such person(s) or organization(s) have agreed in writing in a contract or agreement that such person(s) or organization(s) be added as an additional insured on your policy. Such person(s) or organization(s) is an insured only with respect to your liability for "bodily injury", "property damage" or "personal and advertising injury" directly arising out of the maintenance, operation or use of equipment leased to you, which may be imputed to such person or organization as the lessor of equipment.
However, the insurance afforded to such additional insured:
(1) Only applies to the extent permitted by law; and
(2) Will not be broader than that which you are required by the contract or agreement to provide for such additional insured.
A person's or organization's status as an additional insured under this endorsement ends when their contract or agreement with you for such leased equipment ends.
b. With respect to the insurance afforded to these additional insureds, this insurance does not apply to any "occurrence" which takes place after the equipment lease expires.
8. a. Any person(s) or organization(s), but only with respect to liability arising out of the ownership, maintenance or use of that part of the premises leased to you and subject to the following additional exclusions:
This insurance does not apply to:
(1) Any "occurrence" which takes place after you cease to be a tenant in that premises. (2) Structural alterations, new construction or demolition operations performed by or on behalf of the person(s) or organization(s) shown in the Schedule.
However:
(1) The insurance afforded to such additional insured only applies to the extent permitted by law; and (2) If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured.
9. Additional Insured - Engineers, Architects or Surveyors Not Engaged by the Named Insured a. Any architects, engineers or surveyors who are not engaged by you are insureds, but only with respect to liability for "bodily injury" or "property damage" or “personal and advertising injury" which may be imputed to that architect, engineer or surveyor arising out of:
(1) Your acts or omissions; or
(2) Your acts or omissions of those acting on your behalf; in the performance of your ongoing operations performed by you or on your behalf.
However, the insurance afforded to such additional insured:
(1) Only applies to the extent permitted by law; and
(2) Will not be broader than that which you are required by the contract or agreement to provide for such additional insured.
b. With respect to the insurance afforded to these additional insureds, the following additional exclusion applies:
This insurance does not apply to "bodily injury", "property damage" or "personal and advertising injury" arising out of the rendering of or failure to render any professional services, including:
CG 71 03 07 17 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 7 of 12 Additional Insured – Lessor of Leased Equipment – Automatic Status When Required in Lease Agreement With You
Additional Insured – Managers or Lessors of Premises
But only if such architects, engineers or surveyors, while not engaged by you, are contractually required to be added as an additional insured to your policy.
CG 71 03 07 17
(1) The preparing, approving, or failing to prepare or approve, maps, drawings, opinions, reports, surveys, change orders, designs or specifications; or
(2) Supervisory, inspection or engineering services.
This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by that insured, if the "occurrence" which caused the “bodily injury" or "property damage", or the offense which caused the "personal and advertising injury", involved the rendering of or the failure to render any professional services.
10. Additional Insured- Employee Injury to Another Employee With respect to your “employees” who occupy positions which are supervisory in nature:
Paragraph 2.a.(1) of SECTION II – WHO IS AN INSURED is amended to read:
a. “Bodily injury” or “personal and advertising injury” (1) To you, to your partners or members (if you are a partnership or joint venture), or to your members (if you are a limited liability company);
(2) For which there is any obligation to share damages with or repay someone else who must pay damages because of the injury described in paragraph (1)(a) above; or (3) Arising out of his or her providing or failing to provide professional healthcare services. Paragraph 3.a. is deleted.
For the purpose of this Item 10 only, a position is deemed to be supervisory in nature if that person performs principle work which is substantially different from that of his or her subordinates and has authority to hire, direct, discipline or discharge.
SECTION III - LIMITS OF INSURANCE
A. The following Items are deleted and replaced by the following:
2. The General Aggregate Limit is the most we will pay for the sum of:
a. Medical expenses under Coverage C;
b. Damages under Coverage A, except damages because of "bodily injury" or "property damage" included in the "products-completed operations hazard"; and
c. Damages under Coverage B; and
d. Damages under Coverage H.
3. The Products-Completed Operations Aggregate Limit is the most we will pay under Coverage A for damages because of "bodily injury" and "property damage" included in the "products-completed operations hazard" and Coverage G.
6. Subject to 5. above, the Damage to Premises Rented to You Limit is the most we will pay under Coverage A for damages because of "property damage" to any one premises, while rented to you, or in the case of damage by fire, explosion, lightning, smoke resulting from such fire, explosion, or lightning or sprinkler leakage while rented to you or temporarily occupied by you with permission of the owner.
B. The following are added:
8. Subject to Paragraph 5. of SECTION III – LIMITS OF INSURANCE $25,000 is the most we will pay under Coverage H for Water Damage Legal Liability.
Aggregate Limit $50,000
Each Product Recall Limit $25,000
a. The Aggregate Limit shown above is the most we will pay for the sum of all "product recall expense" you incur as a result of all "product recalls" you initiate during the endorsement period.
CG 71 03 07 17 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 8 of 12 Coverage G - Product Recall Expense
9. CG 71 03 07 17
b. The Each Product Recall Limit shown above is the most we will pay, subject to the Aggregate and $1,000 deductible, for "product recall expense" you incur for any one "product recall” you initiate during the endorsement period.
We will only pay for the amount of "product recall expenses" which are in excess of the deductible amount. The deductible applies separately to each "product recall". The limits of insurance will not be reduced by the amount of this deductible.
We may, or will if required by law, pay all or any part of any deductible amount. Upon notice of our payment of a deductible amount, you shall promptly reimburse us for the part of the deductible amount we paid.
10. The General Aggregate Limit applies separately to each of your "locations" owned by or rented to you or temporarily occupied by you with the permission of the owner. "Location" means premises involving the same or connecting lots, or premises whose connection is interrupted only by a street, roadway, waterway or right-of-way of a railroad.
11. The General Aggregate Limit applies separately to each of your projects away from premises owned by or rented to you.
12. With respects to the insurance afforded to additional insureds afforded coverage by items 5 through 10 of SECTION II – WHO IS AN INSURED above, the following is added:
The most we will pay on behalf of the additional insured is the amount of insurance:
a. Required by the contract or agreement;
b. Available under the applicable Limits of Insurance shown in the Declarations; Whichever is less.
This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. 13 . Subject to 5. of SECTION III – LIMITS OF INSURANCE , a $5,000 "occurrence" limit and a $10,000 "aggregate" limit is the most we will pay under Coverage A for damages because of "property damage" covered under Coverage D - Voluntary Property Damage Coverage .
For the purposes of this Voluntary Property Damage Coverage, our right and duty to defend ends when we have paid the Limit of Liability or the Aggregate Limit for each coverage, and we are granted discretion in making payments under this coverage.
14. Subject to 5. of SECTION III – LIMITS OF INSURANCE , a $25,000 "occurrence" limit and a $100,000 "aggregate" limit is the most we will pay under Coverage E - Care, Custody and Control Coverage regardless of the number of:
a. Insureds;
b. Claims made or "suits" brought; or
c. Persons or organizations making claims or bringing "suits".
Deductible - Our obligation to pay damages on your behalf applies only to the amount of damages in excess of $500.
This deductible applies to all damages because of "property damage" as the result of any one "occurrence" regardless of the number of persons or organizations who sustain damages because of that "occurrence".
We may pay any part or all of the deductible amount to effect settlement of any claim or "suit" and upon notification of the action taken, you shall promptly reimburse us for such part of the deductible amount as has been paid by us.
As respects this coverage "aggregate" is the maximum amount we will pay for all covered "occurrences" during one policy period.
For the purposes of this Care, Custody and Control Property Damage Coverage, our right and duty to defend ends when we have paid the Limit of Liability or the Aggregate Limit for each coverage, and we are granted discretion in making payments under this coverage.
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Aggregate Limits of Insurance (Per Project)
CG 71 03 07 17
15. Subject to 5. of SECTION III – LIMITS OF INSURANCE , the most we will pay for “property damage” under Coverage F - Electronic Data Liability Coverage for loss of “electronic data” is $50,000 without regard to the number of “occurrences”.
SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS
A. The following conditions are amended:
1. Knowledge of Occurrence
Condition 2., Items a. and b. are deleted and replaced by the following:
(1) Duties In The Event Of Occurrence, Offense, Claim Or Suit (a) You must see to it that we are notified as soon as practicable of an "occurrence" or an offense which may result in a claim. Knowledge of an "occurrence" by your agent, servant or employee shall not in itself constitute knowledge of the named insured unless an officer of the named insured has received such notice from the agent, servant or employee. To the extent possible, notice should include:
i. How, when and where the "occurrence" took place;
ii. The names and addresses of any injured persons and witnesses, and iii. The nature and location of any injury or damage arising out of the "occurrence" or offense. (b)
i.
2. Where Broad Form Named Insured is added in SECTION II – WHO IS AN INSURED of this endorsement, Condition 4. Other Insurance b. Excess Insurance (1).(a) is replaced by the following:
(a) Any of the other insurance, whether primary, excess, contingent or on any other basis, that is available to an insured solely by reason of ownership by you of more than 50 percent of the voting stock, and not withstanding any other language in any other policy. This provision does not apply to a policy written to apply specifically in excess of this policy.
B. The following are added:
10. Condition (5) of 2. "Duties in the event Occurrence, Offense, Claim or Suit" c. You or any other involved insured must:
(5) Upon our request, replace or repair the property covered under Voluntary Property Damage Coverage at your actual cost, excluding profit or overhead.
11. Blanket Waiver Of Subrogation
We waive any right of recovery we may have against any person or organization because of payments we make for injury or damage arising out of: premises owned or occupied by or rented or loaned to you, ongoing operations performed by you or on your behalf, done under a contract with that person or organization, “your work”, or “your products”. We waive this right where you have agreed to do so as part of a written contract, executed by you before the “bodily injury” or “property damage” occurs or the “personal and advertising injury” offense is committed.
12. Liberalization
If a revision to this Coverage Part, which would provide more coverage with no additional premium becomes effective during the policy period in the state designated for the first Named Insured shown in the Declarations, your policy will automatically provide this additional coverage on the effective date of the revision.
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Immediately record the specifics of the claim or "suit" and the date received; and If a claim is made or "suit" is brought against any insured, you must:
ii. Notify us as soon as practicable.
You must see to it that we receive written notice of the claim or "suit" as soon as practicable. Knowledge of a claim or "suit" by your agent, servant or employee shall not in itself constitute knowledge of the named insured unless an officer of the named insured has received such notice from the agent, servant or employee.
CG 71 03 07 17
13. Unintentional Failure to Disclose All Hazards
Based on our reliance on your representations as to existing hazards, if you unintentionally should fail to disclose all such hazards at the inception date of your policy, we will not deny coverage under this Coverage Part because of such failure. However, this provision does not affect our right to collect additional premium or exercise our right of cancellation or non-renewal.
14. The following conditions are added in regard to Coverage G - Product Recall Expense In event of a "product recall", you must
a. See to it that we are notified as soon as practicable of a "product recall". To the extent possible, notice should include how, when and where the "product recall" took place and estimated "product recall expense". b. Take all reasonable steps to minimize "product recall expense". This will not increase the limits of insurance. c. If requested, permit us to question you under oath at such times as may be reasonably required about any matter relating to this insurance or your claim, including your books and records. Your answers must be signed.
d. Permit us to inspect and obtain other information proving the loss. You must send us a signed, sworn statement of loss containing the information we request to investigate the claim. You must do this within 60 days after our request.
e. Cooperate with us in the investigation or settlement of any claim. f. Assist us upon our request, in the enforcement of any rights against any person or organization which may be liable to you because of loss to which this insurance applies.
SECTION V – DEFINITIONS
A. At item 12. "Mobile equipment" the wording at f.(1) is deleted and replaced by the following:
(a) Snow removal;
(b) Road maintenance, but not construction or resurfacing; or (c) Street cleaning;
except for such vehicles that have a gross vehicle weight less than 1,000 lbs which are not designed for highway use.
B. Item 3. “bodily injury” is deleted and replaced with the following:
3. “Bodily injury” means physical injury, sickness or disease sustained by a person. This includes mental anguish, mental injury, shock, fright or death that results from such physical injury, sickness or disease.
C. The following definitions are added for this endorsement only:
23. “Electronic data" means information, facts or programs stored as or on, created or used on, or transmitted to or from computer software, including systems and applications software, hard or floppy disks, CD-ROMS, tape drives, cells, data processing devices or any other media which are used with electronically controlled equipment.
24. "Product recall" means a withdrawal or removal from the market of "your product" based on the determination by you or any regulatory or governmental agency that:
a. The use or consumption of "your product" has caused or will cause actual or alleged "bodily injury" or "property damage"; and
b. Such determination requires you to recover possession or control of "your product" from any distributor, purchaser or user, to repair or replace "your product", but only if "your product" is unfit for use or consumption, or is hazardous as a result of:
(1) An error or omission by an insured in the design, manufacturing, processing, labeling, storage, or transportation of "your product"; or
(2) Actual or alleged intentional, malicious or wrongful alteration or contamination of "your product" by someone other than you.
CG 71 03 07 17 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 11 of 12 f.(1) Equipment designed primarily for:
CG 71 03 07 17
25. "Product recall expense" means reasonable and necessary expenses for:
a. Telephone, radio and television communication and printed advertisements, including stationery, envelopes and postage.
b. Transporting recalled products from any purchaser, distributor or user, to locations designated by you. c. Remuneration paid to your employees for overtime, as well as remuneration paid to additional employees or independent contractors you hire.
d. Transportation and accommodation expense incurred by your employees. e. Rental expense incurred for temporary locations used to store recalled products. f. Expense incurred to properly dispose of recalled products, including packaging that cannot be reused. g. Transportation expenses incurred to replace recalled products. h. Repairing, redistributing or replacing covered recalled products with like products or substitutes, not to exceed your original cost of manufacturing, processing, acquisition and/or distribution.
These expenses must be incurred as a result of a "product recall".
CG 71 03 07 17 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 12 of 12 60545307
All persons or organizations as required by
written contrat
All operations of the named insured
60545307
All operations as required by written contract All operations of the named insured POLICY NUMBER:
COMMERCIAL GENERAL LIABILITY
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
DEDUCTIBLE LIABILITY INSURANCE
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART
SCHEDULE Amount and Basis of Deductible
Coverage PER CLAIM OR PER OCCURRENCE
Bodily Injury Liability $ $
or
Property Damage Liability $ $
or
Bodily Injury Liability and/or Property $ $
Damage Liability Combined
(If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.)
APPLICATION OF ENDORSEMENT (Enter below any limitations on the application of this endorsement. If no limitation is entered, the deductibles apply to damages for all "bodily injury" and "property damage", however caused):- "Bodily injury" and "property damage"
combined;
Our obligation under the Bodily Injury Liability and
Property Damage Liability Coverages to pay
damages on your behalf applies only to the amount
of damages in excess of any deductible amounts
stated in the Schedule above as applicable to such
coverages.
(3)
A.
as the result of any one "occurrence".
If damages are claimed for care, loss of
services or death resulting at any time from
"bodily injury", a separate deductible amount will
be applied to each person making a claim for
such damages. With respect to "property
damage", person includes an organization.
B. You may select a deductible amount on either a per
claim or a per "occurrence" basis. Your selected
deductible applies to the coverage option and to the
basis of the deductible indicated by the placement
of the deductible amount in the Schedule above.
The deductible amount stated in the Schedule
above applies as follows:
2. PER OCCURRENCE BASIS. If the deductible
amount indicated in the Schedule above is on a
"per occurrence" basis, that deductible amount
applies as follows:
1. PER CLAIM BASIS. If the deductible amount
indicated in the Schedule above is on a per
claim basis, that deductible applies as follows:
a. Under Bodily Injury Liability Coverage, to all
damages because of "bodily injury";
Under Bodily Injury Liability Coverage, to all
damages sustained by any one person
because of "bodily injury";
a.
Under Property Damage Liability Coverage,
to all damages sustained by any one person
because of "property damage"; or
b.
Under Bodily Injury Liability and/or Property
Damage Liability Coverage Combined, to all
damages sustained by any one person
because of:
c.
(1) "Bodily injury";
(2) "Property damage"; or
CG 03 00 01 96 Copyright, Insurance Services Office, Inc., 1994 Page 1 of 2 60545307 CG 03 00 01 96
5,000
CG 03 00 01 96
b. The terms of this insurance, including those with
respect to:
Under Property Damage Liability Coverage,
to all damages because of "property
damage"; or
C.
Our right and duty to defend the insured against
any "suits" seeking those damages: and
1. c. Under Bodily Injury Liability and/or Property
Damage Liability Coverage Combined, to all
damages because of: Your duties in the event of an "occurrence", claim, or "suit".
2. (1) "Bodily injury";
"Property damage"; or (2)
apply irrespective of the application of the
deductible amount.
(3) "Bodily injury" and "property damage"
combined We may pay any part or all of the deductible
amount to effect settlement of any claim or "suit"
and, upon notification of the action taken, you shall
promptly reimburse us for such part of the
deductible amount as has been paid by us.
D.
as the result of any one "occurrence", regardless
of the number of persons or organizations who
sustain damages because of that "occurrence".
CG 03 00 01 96 Copyright, Insurance Services Office, Inc., 1994 Page 2 of 2 Policy #60545307