AMENDMENT NO. 5 TO
PROFESSIONAL SERVICES AGREEMENT
PROVISION OF ARCHITECTURAL AND ENGINEERING SERVICES WITH PBK
ARCHITECTS
This Amendment No. 5 ("Amendment") to Professional Services Agreement is made and entered into effective the 16'" day of April, 2024, by and between the CITY OF PLACENTIA, a Charter City and Municipal Corporation ("CITY"), and PBK Architects, a California corporation (hereinafter "CONSULTANT"). CITY and CONSULTANT are sometimes hereinafter individually referred to as "Party" and or collectively referred to as the "Parties." A. Recitals.
(i) CITY and CONSULTANT entered into a Professional Services Agreement ("Agreement") effective April 16, 2024 through which CONSULTANT has been providing professional services as more fully explained in the Scope of Services attached to the Agreement as Exhibit "A".
(ii) The Parties now seek to amend the Agreement to increase by $ 89,285, so the total amount shall not exceed $ 692,300.00, for additional architectural and engineering services in support of Public Safety Center.
(iii) All legal prerequisites to the making of this Amendment have occurred.
NOW, THEREFORE, in consideration of the mutual covenants and conditions set forth herein, the Parties agree as follows:
B. Amendment to Agreement.
1. Section 2.0, Paragraph 2.1. Compensation, of the Agreement is hereby amended to read as follows:
2.1 Consultant shall be paid hourly in accordance with the fee schedule set forth in Exhibit "C" (Fee Schedule"). Consultant's total compensation shall not exceed Six Hundred Ninety Two Thousand and Three Hundred Dollars ($692,300.00).
2. Except as specifically modified herein, all of the terms, conditions and provisions of the Agreement shall remain in full force and effect.
3. The Agreement, all amendments together with this Amendment No. 5 and all Exhibits attached thereto, constitutes the entire Agreement between the Parties and supersedes all prior negotiations, arrangements, representations, and understandings, if any, made by or between the Parties with respect to the subject matter hereof. No amendment or other modification of the Agreement, as modified by this Amendment No. 5 shall be binding unless executed in writing by both Parties hereto, or their respective successors, assigns, or grantees.
4. Each of the undersigned represents and warrants that he or she is duly authorized to execute and deliver this Amendment No. 5 and that such execution is binding upon the entity for which he or she is executing this document.
IN WITNESS WHEREOF, the Parties have caused Amendment No. 5 to the Consulting Services Agreement are to be executed as of the day and year first above written.
CONSULTANT CITY OF PLACENTIA
By: WW7
Kelley Needham
Principal
By:
Damien R. Arrula
City Administrator
ATTEST:
By:
Robert S. McKinnell, City Clerk
APPROVED AS TO FORM:
By:
Christian L. Bettenhausen, City Attorney
8163 Rochester Avenue
Rancho Cucamonga, CA 91730
P. +1 909-987-0909
PBK.com
March 27, 2024
Mr. Luis Estevez
Deputy City Administrator
City of Placentia
401 East Chapman Avenue
Placentia, CA 92870
Re: Request for Additional Services — Construction Completion Extension City of Placentia Public Safety Center
Project W2105300AR.06
Dear Mr. Estevez:
Attached is our Additional Services fee proposal to provide extended A/E construction support services through December of 2024 for the Public Safety Center.
Thank you for opportunity to submit this fee request to continue to provide the necessary construction support vital to the success of your project.
If you should have any questions, please do not hesitate to contact me.
Sincerely,
aFt..14"4,1
KELLEY NEEDHAM, AIA
Managing Partner
KN:hb/POW2105300ARx1-Itr
cc: Frank Cuomo, AIA, LEED AP BD -1-C, Associate Principal, Architect, PBK Stephanie Quintero, Director of Accounting, PBK
Encl: Add Services Fee Proposal
1 Add Services Proposal
A&E Contract Extention to December 2024
Placentia Public Safety Center W2105300AR
Design Services
Task Item/Description
PBK Project Team Members/Hours Participation
PBK Project PBK PDS A&F
Architect Team Mech/Plumb Electrical
Total Hours
CONSTRUCTION ADMINISTRATION SERVICES
A. Respond to Contractor's Requests for Information
B. Provide Clarifications / Requests for Changes"
C. Review Contractor Submittals and Shop Drawings
D. Attend Weekly Construction Meetings
E. Punch & Project Close-out
Subtotal Hours
Standard Hourly Rates
Subtotal Fees Site/Building Assessment
* Includes Permanent Electrical Power Design at Butler Building 50 0 15
65 40 8
40 35 18
25 0 0 0
12 12 10 10
192 87 51 140
$205.00 $175.00 $200.00 $175.00
$39,360 $15,225 $10,200 $24,500
40 65 *
25 Expenses Normally Included Within Overhead
The fallowing expenses shall he included as part of the Architect's overhead and shall not be billed to the project.
1. Meals and Lodging
2, Car Rental
3. Telephone Services
4. Standard Postal Services
5. Standard Insurance Coverage
Reimbursable Expenses
Reimbursable expenses shall be billed at direct cost without any mark-up.
These consist typically of the following expenditures:
1. Photography and Reprographic Services
2. Reprographic Construction Documents and Specifications
3. Express Mail Service
4. Engagement Meeting Materials
2 470
$89,285
ACORO®
CERTIFICATE OF LIABILITY INSURANCE
DATE (MM/DDIYYYY)
7/27/2023
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).
PRODUCER
Arthur J. Gallagher Risk Management Services, LLC
2618 E Broadway
Pearland TX 77581
INSURED
PBK Architects, Inc.
WLC Architects, Inc.
11 Greenway Plaza, Suite 2210
Houston TX 77046-1104
PBKARCH-01
CONTACT
NAME:
/AC. . Ern: 281-485-7500 FAX
No): 281-485-6933
1 ADDRESS:
INSURER(S) AFFORDING COVERAGE NAIC #
INSURER A: Continental Casualty Company 20443
INSURER B: Liberty Mutual Insurance Company 23043
INSURER C :
INSURER D :
INSURER E :
INSURER F :
COVERAGES CERTIFICATE NUMBER: 1193697042 REVISION NUMBER:
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.
INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP
LTR INSp WVD POLICY NUMBER (MM/DD/YYYY) IMM/DD/YYYY) LIMITS B X COMMERCIAL GENERAL LIABILITY TB5-Z91-472898-023 4/25/2023 4/25/2024 EACH OCCURRENCE
DAMAGE TO RENTED
CLAIMS -MADE OCCUR PREMISES (Ea occurrence)
X
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY
X
PRO-
JECT X LOC
OTHER:
B AUTOMOBILE LIABILITY
AS7-Z91-472898-033 4/25/2023 4/25/2024
$ 1,000,000
$ 1,000,000
MED EXP (Any one person) $ 10,000
PERSONAL & ADV INJURY $ 1,000,000
GENERAL AGGREGATE $ 2,000,000
PRODUCTS - COMP/OP AGG $ 2,000,000
COMBINED SINGLE LIMIT $ 1,000,000
(Ea accident)
X ANY AUTO BODILY INJURY (Per person) $
OWNED SCHEDULED
AUTOS ONLY AUTOS
HIRED NON -OWNED
AUTOS ONLY AUTOS ONLY
B X UMBRELLA LIAB X OCCUR TH7-Z91-472898-053 4/25/2023 4/25/2024
EXCESS LIAB CLAIMS -MADE
DED X RETENT ON $ 1 n nnn
g WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
ANYPROPRIETOR/PARTN ER/EXECUTIVE
OFFICER/MEMBEREXCLUDED?
(Mandatory In NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
A Professional Liability
Claims Made Form
YIN
N
NIA
WC5-Z91-472898-013 4/25/2023 4/25/2024
AEH591912035 8/1/2023 8/1/2024
BODILY INJURY (Per accident) $
PROPERTY DAMAGE $
(Per accident)
EACH OCCURRENCE
AGGREGATE
X
PER
STATUTE
OTH-
ER
$ 5,000,000
$ 5,000,000
E.L. EACH ACCIDENT $ 1,000,000
E,L, DISEASE - EA EMPLOYEE $ 1,000,000
E.L. DISEASE - POLICY LIMIT $ 1,000,000
Each Claim $5,000,000
Aggregate $10,000,000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required) See Attached...
CERTIFICATE HOLDER CANCELLATION
City of Placentia
Attn: Luis Estevez
401 E. Chapman
Placentia CA 92870
USA
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
© 1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
ACORO®
AGENCY CUSTOMER ID: PBKARCH-01
LOC #:
ADDITIONAL REMARKS SCHEDULE
AGENCY
Arthur J. Gallagher Risk Management Services, LLC
POLICY NUMBER
CARRIER
NAIC CODE
NAMED INSURED
PBK Architects, Inc.
WLC Architects, Inc.
11 Greenway Plaza, Suite 2210
Houston TX 77046-1104
EFFECTIVE DATE:
ADDITIONAL REMARKS
THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE
The General Liability and Auto policy includes a Blanket additional insured endorsement that provides additional insured status only when there is a written contract, agreement or permit between the named insured and the certificate holder that requires such status.
The General Liability, Auto, Professional Liability and Workers Compensation policy includes a Blanket waiver of subrogation endorsement that provides this feature only when there is a written contract, agreement or permit between the named insured and the certificate holder that requires such status.
General Liability is primary & non-contributory when required by written contract, agreement or permit.
Auto liability is primary & non-contributory as respects the insured's owned & covered vehicles.
The umbrella is follow form and does not include the professional liability.
Re: All Operations of the Named Insured The City of Placentia and its elected and appointed boards, officers, officials, agents, employees, and volunteer ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
, Policy no. : AS7-Z91-472898-033
COMMERCIAL AUTO
CA 04 49 11 16
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
PRIMARY AND NONCONTRIBUTORY -
OTHER INSURANCE CONDITION
This endorsement modifies insurance provided under the following:
AUTO DEALERS COVERAGE FORM
BUSINESS AUTO COVERAGE FORM
MOTOR CARRIER COVERAGE FORM
With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement.
A. The following is added to the Other Insurance
Condition in the Business Auto Coverage Form
and the Other Insurance — Primary And Excess
Insurance Provisions in the Motor Carrier
Coverage Form and supersedes any provision to
the contrary:
This Coverage Form's Covered Autos Liability
Coverage is primary to and will not seek
contribution from any other insurance available to
an "insured" under your policy provided that:
1. Such "insured" is a Named Insured under such
other insurance; and
2. You have agreed in writing in a contract or
agreement that this insurance would be
primary and would not seek contribution from
any other insurance available to such
"ins ured".
CA 04 49 11 16
B. The following is added to the Other Insurance
Condition in the Auto Dealers Coverage Form and
supersedes any provision to the contrary:
This Coverage Form's Covered Autos Liability
Coverage and General Liability Coverages are
primary to and will not seek contribution from any
other insurance available to an "insured" under
your policy provided that:
1. Such "insured" is a Named Insured under such
other insurance; and
2. You have agreed in writing in a contract or
agreement that this insurance would be
primary and would not seek contribution from
any other insurance available to such
"insured".
© Insurance Services Office, Inc., 2016 Page 1 of 1
NOTICE OF CANCELLATION TO THIRD PARTIES
A. If we cancel this policy for any reason other than nonpayment of premium, we will notify the persons or organizations shown in the Schedule below. We will send notice to the email or mailing address listed below at least 10 days, or the number of days listed below, if any, before cancellation becomes effective. In no event does the notice to the third party exceed the notice to the first named insured.
B. This advance notification of a pending cancellation of coverage is intended as a courtesy only. Our failure to provide such advance notification will not extend the policy cancellation date nor negate cancellation of the policy.
Name of Other Person(s) /
Organization(s):
Per schedule on file with
company
Schedule
Email Address or mailing address: Number Days Notice:
Per schedule on file with 30
company
All other terms and conditions of this policy remain unchanged.
Issued by LM Insurance Corporation 27243
For attachment to Policy No. WC5-Z91-472898-012
Issued to
Effective Date Premium $
PBK Architects, Inc. Endorsement No.
WC 99 20 75
Ed. 12/01/2016
© 2016 Liberty Mutual Insurance Page 1 of 1
WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT -
CALIFORNIA
We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule.
The additional premium for this endorsement shall be 2.0% of the California workers' compensation premium otherwise due on such remuneration.
Schedule
Additional premium is a percent of the California Manual Workers Compensation premium. Subject to a minimum premium charge of $250 per policy.
Person or Organization
Where required by contract or
written agreement prior to loss and
allowed by law.
Issued by LM Insurance Corporation 27243
For attachment to Policy No. WC5-Z91-472898-013
Issued to PBK Architects, Inc.
Job Description
Any
Effective Date Premium $
Endorsement No.
WC 04 03 06 R1 Page 1 of 1
Ed. 08/01/2013
COMPLETE NAMED INSURED:
PBK Architects, Inc.
PBR Architects, Inc. Suite 2210
PBK Architects, Inc. d/b/a PBK Engineers Houston, TX 77046 PBK Architects, Inc. d/b/a PBK Roof Consultants
PBK Architects, Inc. d/b/a PBK Facility Consulting
PBK Architects, Inc. d/b/a PBK Architects
PBK, Inc.
PBK Architects, Inc. d/b/a PBK Healthcare
PBK Architects, Inc. d/b/a Campaign Communications
PBK Architects, Inc. d/b/a PBK Engineering
PBK Architects, Inc. d/b/a Cunico Consulting
PBK Architects, Inc. d/b/a PBK Sports
PBK Architects, Inc. d/b/a PBK University
PBK Architects, Inc. d/b/a PBK Higher Education
PBK Architects, Inc. d/b/a PBK Higher Ed
PBK Architects, Inc. d/b/a PBK Interiors
PBK Architects, Inc. dba PBK
PBK Architects, Inc. dba DIG Engineers
PBK Architects, Inc. dba LEAF Engineers
PBK Architects, Inc. dba The Educated Vote
PBK Architects, Inc. dba Building Envelope & Asset Management Professionals (BEAM) Smith Iwanaga Milhous PryceArchitects, Inc. (legal)
S.I.M Architects, Inc. (DBA)
SIM+PBK (DBA)
PBK Architects, Inc. dba Edgeland Design Group 11/2/2021 PBK Architects, Inc. dba Kuba la Engineers 9/30/2021
Wolff/Lang/Christopher Architects, Incorporated 2/1/2022
WLC Architects, Inc. 2/1/2022
WLC Architects 2/1/2022
PBK-WLC 2/1/2022
PBK-WLC Architects 2/1/202
PBK Holdco LLC (added 6/21/22)
PBK IntermediateCo, Inc. (added 6/21/22)
Manley Spangler Smith Architects, P.C. (added 9/15/22)
Manley Spangler Smith Architects, a Professional Corporation Spangler & Manley Architects, P.C.
MSSA-PBK
MSSA-PBK Architects
PBK Architects, Inc. dba Blue Ring Creative (9/28/22)
POLICY NUMBER: TBS -Z91-472898-023 COMMERCIAL GENERAL LIABILITY CG 20 10 04 13
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED - OWNERS, LESSEES OR
CONTRACTORS - SCHEDULED PERSON OR
ORGANIZATION
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
A. Section II — Who Is An Insured is amended to
include as an additional insured the person(s) or
organization(s) shown in the Schedule, but only
with respect to liability for "bodily injury", "property damage" or "personal and advertising injury"
caused, in whole or in part, by:
1. Your acts or omissions; or
2. The acts or omissions of those acting on your
behalf;
in the performance of your ongoing operations for
the additional insured(s) at the location(s)
designated above.
However:
1. The insurance afforded to such additional
insured only applies to the extent permitted by
law; and
2. If coverage provided to the additional insured is
required by a contract or agreement, the
insurance afforded to such additional insured
will not be broader than that which you are
required by the contract or agreement to provide
for such additional insured.
B. With respect to the insurance afforded to these
additional insureds, the following additional
exclusions apply:
This insurance does not apply to "bodily injury" or
"property damage" occurring after:
CG 20 10 04 13
1. All work, including materials, parts or equipment
furnished in connection with such work, on the
project (other than service, maintenance or
repairs) to be performed by or on behalf of the
additional insured(s) at the location of the
covered operations has been completed; or
2. That portion of "your work" out of which the
injury or damage arises has been put to its
intended use by any person or organization
other than another contractor or subcontractor
engaged in performing operations for a principal
as a part of the same project.
C. With respect to the insurance afforded to these
additional insureds, the following is added to
Section III — Limits Of Insurance:
If coverage provided to the additional insured is
required by a contract or agreement, the most we
will pay on behalf of the additional insured is the
amount of insurance:
1. Required by the contract or agreement; or
2. Available under the applicable Limits of
Insurance shown in the Declarations;
whichever is less.
This endorsement shall not increase the applicable
Limits of Insurance shown in the Declarations.
© ISO Properties, Inc., 2012 Page 1 of 2 ❑
SCHEDULE
Name Of Additional Insured Person(s)
Or Organization(s)
All persons or organizations with whom you have entered into a written contract or agreement, prior to an 'occurrence" or offense, to provide additional insured status.
Location: All locations as required by a written contract or agreement entered into prior to an "occurrence" or offense.
Location(s) Of Covered Operations
All locations as required by a written contract or agreement entered into prior to an 'occurrence" or offense.
Information required to complete this Schedule, if not shown above, will be shown in the Declarations.
CG 20 10 04 13
© Insurance Services Office, Inc., 2012 Page 2 of 2
POLICY NUMBER: TB5-Z91-472898-023 COMMERCIAL GENERAL LIABILITY CG 20 37 04 13
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED - OWNERS, LESSEES OR
CONTRACTORS - COMPLETED OPERATIONS
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART
Name Of Additional Insured Person(s)
Or Organization(s)
SCHEDULE
Location And Description Of Completed Operations
All persons or organizations with whom you have entered Into All locations as required by a written contract or agreement a written contract or agreement, prior to an "occurrence" or entered into prior to an "occurrence" or offense. offense, to provide additional insured status,
Information required to complete this Schedule, if not shown above, will be shown in the Declarations.
A. Section II — Who Is An Insured is amended to
include as an additional insured the person(s) or
organization(s) shown in the Schedule, but only
with respect to liability for "bodily injury" or
'property damage" caused, in whole or in part, by
"your work" at the location designated and
described in the Schedule of this endorsement
performed for that additional insured and
included in the "products -completed operations
hazard".
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.
CG 20 37 04 13
B. With respect to the insurance afforded to these
additional insureds, the following is added to
Section III — Limits Of Insurance:
If coverage provided to the additional insured is
required by a contract or agreement, the most we
will pay on behalf of the additional insured is the
amount of insurance:
1. Required by the contract or agreement; or
2. Available under the applicable Limits of
Insurance shown in the Declarations;
whichever is less.
This endorsement shall not increase the applicable
Limits of Insurance shown in the Declarations.
© Insurance Services Office, Inc., 2012 Page 1 of 1
POLICY NUMBER:TB5-Z91-472898-023 COMMERCIAL GENERAL LIABILITY CG 24 0412 19
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
WAIVER OF TRANSFER OF RIGHTS OF RECOVERY
AGAINST OTHERS TO US (WAIVER OF SUBROGATION)
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
ELECTRONIC DATA LIABILITY COVERAGE PART
LIQUOR LIABILITY COVERAGE PART
POLLUTION LIABILITY COVERAGE PART DESIGNATED SITES
POLLUTION LIABILITY LIMITED COVERAGE PART DESIGNATED SITES
PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART
RAILROAD PROTECTIVE LIABILITY COVERAGE PART
UNDERGROUND STORAGE TANK POLICY DESIGNATED TANKS
The following is added to Paragraph 8. Transfer Of
Rights Of Recovery Against Others To Us of
Section IV — Conditions:
We waive any right of recovery against the person(s)
or organization(s) shown in the Schedule above
because of payments we make under this Coverage
Part. Such waiver by us applies only to the extent that the insured has waived its right of recovery against
such person(s) or organization(s) prior to loss. This
endorsement applies only to the person(s) or
organization(s) shown in the Schedule above.
SCHEDULE
Name Of Person(s) Or Organization(s):
As required by written contract or agreement entered into prior to loss.
Information required to complete this Schedule, if not shown above, will be shown in the Declarations.
CG 24 04 12 19
© Insurance Services Office, Inc., 2018 Page 1 of 1
Policy #TB5-Z91-472898-023
4/25/2023-4/25/2024
COMMERCIAL GENERAL LIABILITY
CG 20 01 12 19
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
PRIMARY AND NONCONTRIBUTORY -
OTHER INSURANCE CONDITION
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
LIQUOR LIABILITY COVERAGE PART
PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART
The following is added to the Other Insurance
Condition and supersedes any provision to the
contrary:
Primary And Noncontributory Insurance
This insurance is primary to and will not seek
contribution from any other insurance available to
an additional insured under your policy provided
that:
(1) The additional insured is a Named Insured
under such other insurance; and
CG 20 01 12 19
(2) You have agreed in writing in a contract or
agreement that this insurance would be
primary and would not seek contribution
from any other insurance available to the
additional insured.
© Insurance Services Office, Inc., 2018 Page 1 of 1
Policy Number TB5-Z91-472898-023
Issued by LM Insurance Corporation
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
DESIGNATED CONSTRUCTION PROJECT OR DESIGNATED LOCATION
COMBINED AGGREGATE LIMITS — WITH TOTAL AGGREGATE LIMIT
FOR ALL PROJECTS AND LOCATIONS
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
A. For all sums which the insured becomes legally obligated to pay as damages caused by "occurrences" under Section I — Coverage A, and for all medical expenses caused by accidents under Section I - Coverage C, which can be attributed only to ongoing operations at a single designated construction project or a single designated "location":
1. A separate Designated General Aggregate Limit applies to each designated construction project and to each designated "location", and that limit is equal to the amount of the General Aggregate Limit shown in the Declarations.
2. The Designated General Aggregate Limit is the most we will pay for the sum of all damages under Section I - Coverage A, except damages because of "bodily injury' or "property damage" included in the "products -completed operations hazard", and for medical expenses under Section I - Coverage C regardless of the number of:
a. Insureds;
b. Claims made or "suits" brought; or
c. Persons or organizations making claims or bringing "suits".
3. Any payments made under Coverage A for damages or under Coverage C for medical expenses shall reduce the Designated General Aggregate Limit for that designated construction project or designated "location". Such payments shall not reduce the General Aggregate Limit shown in the Declarations nor shall they reduce any other Designated General Aggregate Limit for any other designated construction project or designated "location".
4. The limits shown in the Declarations for Each Occurrence, Damage to Premises Rented to You and Medical Expense continue to apply. However, instead of being subject to the General Aggregate Limit shown in the Declarations, such limits will be subject to the applicable Designated General Aggregate Limit and the Total Aggregate Limit for all Projects and Locations.
5. The Total Aggregate Limit for all Projects and Locations shown in the Schedule of this endorsement is the most we will pay for the sum of all damages caused by "occurrences" under Section I — Coverage A and all medical expenses caused by accidents under Section I — Coverage C which can be attributed only to ongoing operations at a designated construction project or designated "location" shown in the Schedule of this endorsement, regardless of the number of construction projects, "locations", "occurrences" or accidents.
6. Each Designated General Aggregate Limit is subject to the Total Aggregate Limit for all Projects and Locations shown in the Schedule of this endorsement.
B. For all sums which the insured becomes legally obligated to pay as damages caused by "occurrences" under Section I — Coverage A, and for all medical expenses caused by accidents under Section I - Coverage C, which cannot be attributed only to ongoing operations at a single designated construction project or single designated "location":
LC 25 19 01 15
2014 Liberty Mutual Insurance Page 1 of 2
Includes copyrighted material of Insurance Services Office, Inc., with its permission.
1. Any payments made under Coverage A for damages or under Coverage C for medical expenses shall reduce the amount available under the General Aggregate Limit or the Products -Completed Operations Aggregate Limit, whichever is applicable; and
2. Such payments shall not reduce any Designated General Aggregate Limit.
C. When coverage for liability arising out of the "products -completed operations hazard" is provided, any payments for damages because of "bodily injury' or "property damage" included in the "products -completed operations hazard" will reduce the Products -Completed Operations Aggregate Limit, and not reduce the General Aggregate Limit nor the Designated General Aggregate Limit.
D. If the applicable construction project has been abandoned, delayed, or abandoned and then restarted, or if the authorized contracting parties deviate from plans, blueprints, designs, specifications or timetables, the project will still be deemed to be the same construction project.
E. For the purposes of this endorsement, the Definitions Section is amended by the addition of the following definition:
"Location" means any premise that you occupy for permanent operations as part of your business, but does not include any premises at which you are performing operations as part of a construction project. All 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 shall be considered a single "location".
F. The provisions of Section III - Limits Of Insurance not otherwise modified by this endorsement shall continue to apply as stipulated.
Schedule
Designated Construction Project(s) or Designated Location(s):
All "locations" and all construction projects at which you are performing ongoing operations.
Total Aggregate Limit for all Projects and Locations: $ 20,000,000 LC 25 19 01 15
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POLICY NUMBER: AS2-Z91-472898-033 COMMERCIAL AUTO
CA20481013
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
DESIGNATED INSURED FOR
COVERED AUTOS LIABILITY COVERAGE
This endorsement modifies insurance provided under the following:
AUTO DEALERS COVERAGE FORM
BUSINESS AUTO COVERAGE FORM
MOTOR CARRIER COVERAGE FORM
With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement.
This endorsement identifies person(s) or organization(s) who are "insureds" for Covered Autos Liability Coverage under the Who Is An Insured provision of the Coverage Form. This endorsement does not alter coverage provided in the Coverage Form.
SCHEDULE
Name Of Person(s) Or Organization(s):
Any person or organization whom you have agreed in writing to add as an additional insured, but only to coverage and minimum limits of insurance required by the written agreement, and in no event to exceed either the scope of coverage or the limits of insurance provided in this policy.
Information required to complete this Schedule, if not shown above, will be shown in the Declarations.
Each person or organization shown in the Schedule is
an "insured" for Covered Autos Liability Coverage, but
only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured provision
contained in Paragraph A.1. of Section II - Covered
Autos Liability Coverage in the Business Auto and
Motor Carrier Coverage Forms and Paragraph D.2. of
Section I - Covered Autos Coverages of the Auto
Dealers Coverage Form.
CA 20481013
© Insurance Services Office, Inc., 2011 Page 1 of 1
Policy Number AS2-Z91-472898-033
Issued by Liberty Insurance Corp.
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
AUTO ENHANCEMENT ENDORSEMENT
This endorsement modifies insurance provided under the following:
BUSINESS AUTO COVERAGE FORM
Newly Acquired or Formed Organizations
II. Employees as Insureds
III. Lessor - Additional Insured and Loss Payee
IV. Supplementary Payments - Increased Limits
V. Fellow Employee Coverage
VI. Personal Property of Others
VII. Additional Transportation Expense and Cost to Recover Stolen Auto VIII. Airbag Coverage
IX. Tapes, Records and Discs Coverage
X. Physical Damage Deductible - Single Deductible
XI. Physical Damage Deductible - Glass
XII. Physical Damage Deductible - Vehicle Tracking System XIII. Duties in Event of Accident, Claim, Suit or Loss
XIV. Unintentional Failure to Disclose Hazards
XV. Worldwide Liability Coverage - Hired and Nonowned Autos XVI. Hired Auto Physical Damage
XVII. Auto Medical Payments Coverage Increased Limits
XVIII. Drive Other Car Coverage - Broadened Coverage for Designated Individuals XIX. Rental Reimbursement Coverage
XX. Notice of Cancellation or Nonrenewal
XXI. Loan/Lease Payoff Coverage
XXII. Limited Mexico Coverage
XXIII. Waiver of Subrogation
I. NEWLY ACQUIRED OR FORMED ORGANIZATIONS
Throughout this policy, the words "you" and "your" also refer to any organization you newly acquire or form, other than a partnership or joint venture, and over which you maintain ownership of more than 50 percent interest, provided:
A. There is no similar insurance available to that organization; B. Unless you notify us to add coverage to your policy, the coverage under this provision is afforded only until:
1. The 90th day after you acquire or form the organization; or
2. The end of the policy period,
whichever is earlier; and
C. The coverage does not apply to an "accident" which occurred before you acquired or formed the organization.
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II. EMPLOYEES AS INSUREDS
Paragraph A.1. Who Is An Insured of SECTION II - COVERED AUTOS LIABILITY COVERAGE is amended to add the following:
Your "employee" is an "insured" while using with your permission a covered "auto" you do not own, hire or borrow in your business or your personal affairs.
III. LESSOR - ADDITIONAL INSURED AND LOSS PAYEE
A. Any "leased auto" will be considered an "auto" you own and not an "auto" you hire or borrow. The coverages provided under this section apply to any "leased auto" until the expiration date of this policy or until the lessor or his or her agent takes possession of the "leased auto" whichever occurs first.
B. For any "leased auto" that is a covered "auto" under SECTION 11 - COVERED AUTOS LIABILITY COVERAGE, Paragraph A.1. Who Is An Insured provision is changed to include as an "insured" the lessor of the "leased auto". However, the lessor is an "insured" only for "bodily injury" or "property damage" resulting from the acts or omissions by:
1. You.
2. Any of your "employees" or agents; or
3. Any person, except the lessor or any "employee" or agent of the lessor, operating a "leased auto" with the permission of any of the above.
C. Loss Payee Clause
1. We will pay, as interests may appear, you and the lessor of the "leased auto" for "loss" to the covered "leased auto".
2. The insurance covers the interest of the lessor of the "leased auto" unless the "loss" results from fraudulent acts or omissions on your part.
3. If we make any payment to the lessor of a "leased auto", we will obtain his or her rights against any other party.
D. Cancellation
1. If we cancel the policy, we will mail notice to the lessor in accordance with the Cancellation Common Policy Condition.
2. If you cancel the policy, we will mail notice to the lessor.
3. Cancellation ends this agreement.
E. The lessor is not liable for payment of your premiums.
F. For purposes of this endorsement, the following definitions apply:
"Leased auto" means an "auto" which you lease for a period of six months or longer for use in your business, including any "temporary substitute" of such "leased auto". "Temporary substitute" means an "auto" that is furnished as a substitute for a covered "auto" when the covered "auto" is out of service because of its breakdown, repair, servicing, "loss" or destruction.
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IV. SUPPLEMENTARY PAYMENTS - INCREASED LIMITS
Subparagraphs A.2.a.(2) and A.2.a.(4) of SECTION II - COVERED AUTOS LIABILITY COVERAGE are deleted and replaced by the following:
(2) Up to $3,000 for cost of bail bonds (including bonds for related traffic law 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 earnings up to $500 a day because of time off from work.
V. FELLOW EMPLOYEE COVERAGE
A. Exclusion B.5. of SECTION II - COVERED AUTOS LIABILITY COVERAGE does not apply.
B. For the purpose of Fellow Employee Coverage only, Paragraph B.5. of SECTION IV - BUSINESS AUTO CONDITIONS is changed as follows:
This Fellow Employee Coverage is excess over any other collectible insurance.
VI. PERSONAL PROPERTY OF OTHERS
Exclusion 6. in SECTION II - COVERED AUTOS LIABILITY COVERAGE for a covered "auto" is amended to add the following:
This exclusion does not apply to "property damage" or "covered pollution cost or expense" involving "personal property" of your "employees" or others while such property is carried by the covered "auto". The Limit of Insurance for this coverage is $5,000 per "accident". Payment under this coverage does not increase the Limit of Insurance.
For the purpose of this section of this endorsement, "personal property" is defined as any property that is not used in the individual's trade or business or held for the production or collection of income.
VII. ADDITIONAL TRANSPORTATION EXPENSE AND COST TO RECOVER STOLEN AUTO A. Paragraph A.4.a. of SECTION III - PHYSICAL DAMAGE COVERAGE is amended as follows:
The amount we will pay is increased to $50 per day and to a maximum limit of $1,000.
B. Paragraph A.4.a. of SECTION III - PHYSICAL DAMAGE COVERAGE is amended to add the following:
If your business is shown in the Declarations as something other than an auto dealership, we will also pay up to $1,000 for reasonable and necessary costs incurred by you to return a stolen covered "auto" from the place where it is recovered to its usual garaging location.
VIII. AIRBAG COVERAGE
Exclusion B.3.a. in SECTION III - PHYSICAL DAMAGE COVERAGE is amended to add the following:
This exclusion does not apply to the accidental discharge of an airbag.
IX. TAPES, RECORDS AND DISCS COVERAGE
Exclusion B.4.a. of SECTION III - PHYSICAL DAMAGE COVERAGE is deleted and replaced by the following:
a. Tapes, records, discs or other similar audio, visual or data electronic devices designed for use with audio, visual or data electronic equipment except when the tapes, records, discs or other similar audio, visual or data electronic devices:
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(1) Are your property or that of a family member; and
(2) Are in a covered "auto" at the time of "loss".
The most we will pay for "loss" is $200. No Physical Damage Coverage deductible applies to this coverage.
X. PHYSICAL DAMAGE DEDUCTIBLE - SINGLE DEDUCTIBLE
Paragraph D. in SECTION III - PHYSICAL DAMAGE COVERAGE is deleted and replaced by the following:
D. Deductible
For each covered "auto", our obligation to pay for, repair, return or replace damaged or stolen property will be reduced by the applicable deductible shown in the Declarations. Any Comprehensive Coverage deductible shown in the Declarations does not apply to "loss" caused by fire or lightning.
When two or more covered "autos" sustain "loss" in the same collision, the total of all the "loss" for all the involved covered "autos" will be reduced by a single deductible, which will be the largest of all the deductibles applying to all such covered "autos".
XI. PHYSICAL DAMAGE DEDUCTIBLE — GLASS
Paragraph D. in SECTION III - PHYSICAL DAMAGE COVERAGE is amended to add the following:
No deductible applies to "loss" to glass if you elect to patch or repair it rather than replace it.
XII. PHYSICAL DAMAGE DEDUCTIBLE - VEHICLE TRACKING SYSTEM Paragraph D. in SECTION III - PHYSICAL DAMAGE COVERAGE is amended to add:
Any Comprehensive Coverage Deductible shown in the Declarations will be reduced by 50% for any "loss" caused by theft if the vehicle is equipped with a vehicle tracking device such as a radio tracking device or a global positioning device and that device was the method of recovery of the vehicle.
XIII. DUTIES IN EVENT OF ACCIDENT, CLAIM, SUIT OR LOSS
Subparagraphs A.2.a. and A.2.b. of SECTION IV- BUSINESS AUTO CONDITIONS are changed to:
a. In the event of "accident", claim, "suit" or "loss", your insurance manager or any other person you designate must notify us as soon as reasonably possible of such "accident", claim, "suit" or "loss". Such notice must include:
(1) How, when and where the "accident" or "loss" occurred; (2) The "insured's" name and address; and
(3) To the extent possible, the names and addresses of any injured persons and witnesses.
Knowledge of an "accident", claim, "suit" or "loss" by your agent, servant or "employee" shall not be considered knowledge by you unless you, your insurance manager or any other person you designate has received notice of the "accident", claim, "suit" or "loss" from your agent, servant or "employee". b. Additionally, you and any other involved "insured" must:
(1) Assume no obligation, make no payment or incur no expense without our consent, except at the "insured's" own cost.
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(2) Immediately send us copies of any request, demand, order, notice, summons or legal paper received concerning the claim or "suit".
(3) Cooperate with us in the investigation or settlement of the claim or defense against the "suit". (4) Authorize us to obtain medical records or other pertinent information. (5) Submit to examination, at our expense, by physicians of our choice, as often as we reasonably require.
XIV. UNINTENTIONAL FAILURE TO DISCLOSE HAZARDS
Paragraph B.2. in SECTION IV - BUSINESS AUTO CONDITIONS is amended to add the following:
Any unintentional failure to disclose all exposures or hazards existing as of the effective date of the Business Auto Coverage Form or at any time during the policy period will not invalidate or adversely affect the coverage for such exposure or hazard. However, you must report the undisclosed exposure or hazard to us as soon as reasonably possible after its discovery.
XV. WORLDWIDE LIABILITY COVERAGE - HIRED AND NONOWNED AUTOS Condition B.7. in SECTION IV - BUSINESS AUTO CONDITIONS is amended to add the following:
For "accidents" resulting from the use or operation of covered "autos" you do not own, the coverage territory means all parts of the world subject to the following provisions:
a. If claim is made or "suit" is brought against an "insured" outside of the United States of America, its territories and possessions, Puerto Rico and Canada, we shall have the right, but not the duty to investigate, negotiate, and settle or defend such claim or "suit".
If we do not exercise that right, the "insured" shall have the duty to investigate, negotiate, and settle or defend the claim or "suit" and we will reimburse the "insured" for the expenses reasonably incurred in connection with the investigation, settlement or defense. Reimbursement will be paid in the currency of the United States of America at the rate of exchange prevailing on the date of reimbursement.
The "insured" shall provide us with such information we shall reasonably request regarding such claim or "suit" and its investigation, negotiation, and settlement or defense.
The "insured" shall not agree to any settlement of the claim or "suit" without our consent. We shall not unreasonably withhold consent.
b. We are not licensed to write insurance outside of the United States of America, its territories or possessions, Puerto Rico and Canada.
We will not furnish certificates of insurance or other evidence of insurance you may need for the purpose of complying with the laws of other countries relating to auto insurance.
Failure to comply with the auto insurance laws of other countries may result in fines or penalties. This insurance does not apply to such fines or penalties.
XVI. HIRED AUTO PHYSICAL DAMAGE
If no deductibles are shown in the Declarations for Physical Damage Coverage for Hired or Borrowed Autos, the following will apply:
A. We will pay for "loss" under Comprehensive and Collision coverages to a covered "auto" of the private passenger type hired without an operator for use in your business:
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1. The most we will pay for coverage afforded by this endorsement is the lesser of:
a. The actual cost to repair or replace such covered "auto" with other property of like kind and quality; or
b. The actual cash value of such covered "auto" at the time of the "loss".
2. An adjustment for depreciation and physical condition will be made in determining actual cash value in the event of a total "loss".
3. If a repair or replacement results in better than like kind or quality, we will not pay for the amount of the betterment.
B. For each covered "auto", our obligation to pay for, repair, return or replace the covered "auto" will be reduced by any deductible shown in the Declarations that applies to private passenger "autos" that you own. If no applicable deductible is shown in the Declarations, the deductible will be $250.
If the Declarations show other deductibles for Physical Damage Coverages for Hired or Borrowed Autos, this Section XVI of this endorsement does not apply.
C. Paragraph A.4.b. of SECTION III - PHYSICAL DAMAGE COVERAGE is replaced by the following:
b. Loss of Use Expenses
For Hired Auto Physical Damage provided by this endorsement, we will pay expenses for which an "insured" becomes legally responsible to pay for loss of use of a private passenger vehicle rented or hired without a driver, under a written rental contract or agreement. We will pay for loss of use expenses caused by:
(1) Other than collision only if the Declarations indicate that Comprehensive Coverage is provided for any covered "auto";
(2) Specified Causes of Loss only if the Declarations indicate that Specified Causes of Loss Coverage is provided for any covered "auto"; or
(3) Collision only if the Declarations indicate that Collision Coverage is provided for any covered "auto".
However, the most we will pay under this coverage is $30 per day, subject to a maximum of $900.
XVII. AUTO MEDICAL PAYMENTS COVERAGE - INCREASED LIMITS For any covered "loss", the Limit of Insurance for Auto Medical Payments will be double the limit shown in the Declarations if the "insured" was wearing a seat belt at the time of the "accident". This is the maximum amount we will pay for all covered medical expenses, regardless of the number of covered "autos", "insureds", premiums paid, claims made, or vehicles involved in the "accident".
If no limit of insurance for Auto Medical Payments is shown on the Declarations, this paragraph Section XVII of this endorsement does not apply.
XVIII. DRIVE OTHER CAR COVERAGE - BROADENED COVERAGE FOR DESIGNATED INDIVIDUALS A. This endorsement amends only those coverages indicated with an "X" in the Drive Other Car section of the Schedule to this endorsement.
B. SECTION II - COVERED AUTOS LIABILITY COVERAGE is amended as follows:
1. Any "auto" you don't own, hire or borrow is a covered "auto" for Liability Coverage while being used by any individual named in the Drive Other Car section of the Schedule to this endorsement or by his or her spouse while a resident of the same household except:
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a. Any "auto" owned by that individual or by any member of his or her household; or b. Any "auto" used by that individual or his or her spouse while working in a business of selling, servicing, repairing or parking "autos".
2. The following is added to Who Is An Insured:
Any individual named in the Drive Other Car section of the Schedule to this endorsement and his or her spouse, while a resident of the same household, are "insureds" while using any covered "auto" described in Paragraph B.1. of this endorsement.
C. Auto Medical Payments, Uninsured Motorist, and Underinsured Motorist Coverages are amended as follows:
The following is added to Who Is An Insured:
Any individual named in the Drive Other Car section of the Schedule to this endorsement and his or her "family members" are "insured" while "occupying" or while a pedestrian when struck by any "auto" you don't own except:
Any "auto" owned by that individual or by any "family member".
D. SECTION 111 - PHYSICAL DAMAGE COVERAGE is changed as follows:
Any private passenger type "auto" you don't own, hire or borrow is a covered "auto" while in the care, custody or control of any individual named in the Drive Other Car section of the Schedule to this endorsement or his or her spouse while a resident of the same household except:
1. Any "auto" owned by that individual or by any member of his or her household; or
2. Any "auto" used by that individual or his or her spouse while working in a business of selling, servicing, repairing or parking "autos".
E. For purposes of this endorsement, SECTION V - DEFINITIONS is amended to add the following:
"Family member" means a person related to the individual named in the Drive Other Car section of the Schedule to this endorsement by blood, marriage or adoption who is a resident of the individual's household, including a ward or foster child.
XIX. RENTAL REIMBURSEMENT COVERAGE
A. For any owned covered "auto" for which Collision and Comprehensive Coverages are provided, we will pay for rental reimbursement expenses incurred by you for the rental of an "auto" because of a covered physical damage "loss" to an owned covered "auto". Such payment applies in addition to the otherwise applicable amount of physical damage coverage you have on a covered "auto". No deductibles apply to this coverage.
B. We will pay only for those expenses incurred during the policy period beginning 24 hours after the "loss" and ending with the earlier of the return or repair of the covered "auto", or the exhaustion of the coverage limit.
C. Our payment is limited to the lesser of the following amounts:
1. Necessary and actual expenses incurred; or
2. $30 per day with a maximum of $900 in any one period.
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D. This coverage does not apply:
1. While there are spare or reserve "autos" available to you for your operations; or
2. If coverage is provided by another endorsement attached to this policy.
E. If a covered "loss" results from the total theft of a covered "auto" of the private passenger type, we will pay under this coverage only that amount of your rental reimbursement expenses which is not already provided for under Paragraph A.4. Coverage Extensions of SECTION III — PHYSICAL DAMAGE COVERAGE of the Business Auto Coverage Form or Section VII of this endorsement.
XX. NOTICE OF CANCELLATION OR NONRENEWAL
A. Paragraph A.2. of the COMMON POLICY CONDITIONS is changed to:
2. We may cancel or non -renew this policy by mailing written notice of cancellation or non -renewal to the Named Insured, and to any name(s) and address(es) shown in the Cancellation and Non -renewal Schedule:
a. For reasons of non-payment, the greater of:
(1) 10 days; or
(2) The number of days specified in any other Cancellation Condition attached to this policy; or b. For reasons other than non-payment, the greater of:
(1) 60 days;
(2) The number of days shown in the Cancellation and Non -renewal Schedule; or (3) The number of days specified in any other Cancellation Condition attached to this policy, prior to the effective date of the cancellation or non -renewal.
B. All other terms of Paragraph A. of the COMMON POLICY CONDITIONS, and any amendments thereto, remain in full force and effect.
XXI. LOAN/LEASE PAYOFF COVERAGE
The following is added to Paragraph C. Limits Of Insurance of SECTION III - PHYSICAL DAMAGE COVERAGE:
In the event of a total "loss" to a covered "auto" of the private passenger type shown in the schedule or declarations for which Collision and Comprehensive Coverage apply, we will pay any unpaid amount due on the lease or loan for that covered "auto", less:
1. The amount paid under the PHYSICAL DAMAGE COVERAGE SECTION of the policy; and
2. Any:
a. Overdue lease/loan payments at the time of the "loss"; b. Financial penalties imposed under a lease for excessive use, abnormal wear and tear or high mileage;
c. Security deposits not returned by the lessor;
d. Costs for extended warranties, Credit Life Insurance, Health, Accident or Disability Insurance purchased with the loan or lease; and
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e. Carry-over balances from previous loans or leases.
This coverage is limited to a maximum of $1,500 for each covered "auto".
XXII.LIMITED MEXICO COVERAGE
WARNING
AUTO ACCIDENTS IN MEXICO ARE SUBJECT TO THE LAWS OF MEXICO ONLY - NOT THE LAWS OF THE UNITED STATES OF AMERICA. THE REPUBLIC OF MEXICO CONSIDERS ANY AUTO ACCIDENT A CRIMINAL OFFENSE AS WELL AS A CIVIL MATTER.
IN SOME CASES THE COVERAGE PROVIDED UNDER THIS ENDORSEMENT MAY NOT BE RECOGNIZED
BY THE MEXICAN AUTHORITIES AND WE MAY NOT BE ALLOWED TO IMPLEMENT THIS COVERAGE AT ALL IN MEXICO. YOU SHOULD CONSIDER PURCHASING AUTO COVERAGE FROM A LICENSED MEXICAN INSURANCE COMPANY BEFORE DRIVING INTO MEXICO.
THIS ENDORSEMENT DOES NOT APPLY TO ACCIDENTS OR LOSSES WHICH OCCUR BEYOND 25 MILES FROM THE BOUNDARY OF THE UNITED STATES OF AMERICA.
A. Coverage
1. Paragraph B.7. of SECTION IV - BUSINESS AUTO CONDITIONS is amended by the addition of the following:
The coverage territory is extended to include Mexico but only if all of the following criteria are met:
a. The "accidents" or "loss" occurs within 25 miles of the United States border; and b. While on a trip into Mexico for 10 days or less.
2. For coverage provided by this section of the endorsement, Paragraph B.5. Other Insurance in SECTION IV - BUSINESS AUTO CONDITIONS is replaced by the following:
The insurance provided by this endorsement will be excess over any other collectible insurance.
B. Physical Damage Coverage is amended by the addition of the following:
If a "loss" to a covered "auto" occurs in Mexico, we will pay for such "loss" in the United States. If the covered "auto" must be repaired in Mexico in order to be driven, we will not pay more than the actual cash value of such "loss" at the nearest United States point where the repairs can be made.
C. Additional Exclusions
The following additional exclusions are added:
This insurance does not apply:
1. If the covered "auto" is not principally garaged and principally used in the United States.
2. To any "insured" who is not a resident of the United States.
XXIII. WAIVER OF SUBROGATION
Paragraph A.5. in SECTION IV - BUSINESS AUTO CONDITIONS does not apply to any person or organization where the Named Insured has agreed, by written contract executed prior to the date of "accident", to waive rights of recovery against such person or organization.
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Policy Number TB5-Z91-472898-023
Issued by LM Insurance Corporation
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
NOTICE OF CANCELLATION TO THIRD PARTIES
This endorsement modifies insurance provided under the following:
BUSINESS AUTO COVERAGE PART
MOTOR CARRIER COVERAGE PART
GARAGE COVERAGE PART
TRUCKERS COVERAGE PART
EXCESS AUTOMOBILE LIABILITY INDEMNITY COVERAGE PART
SELF-INSURED TRUCKER EXCESS LIABILITY COVERAGE PART
COMMERCIAL GENERAL LIABILITY COVERAGE PART
EXCESS COMMERCIAL GENERAL LIABILITY COVERAGE PART
PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART
LIQUOR LIABILITY COVERAGE PART
COMMERCIAL LIABILITY - UMBRELLA COVERAGE FORM
A. If we cancel this policy for any reason other than nonpayment of premium, we will notify the persons or organizations shown in the Schedule of this endorsement . We will send notice to the email or mailing address listed above at least 10 days, or the number of days listed above, if any, before the cancellation becomes effective. In no event does the notice to the third party exceed the notice to the first named insured.
B. This advance notification of a pending cancellation of coverage is intended as a courtesy only. Our failure to provide such advance notification will not extend the policy cancellation date nor negate cancellation of the policy.
All other terms and conditions of this policy remain unchanged.
Schedule
Name of Other Person(s) / Email Address or mailing address: Number Days Notice:
Organization(s):
Per Schedule On File With The Company
LIM 99 01 05 11
Per Schedule On File With The Company Per Schedule On File With The Company © 2011, Liberty Mutual Group of Companies. All rights reserved, Includes copyrighted material of Insurance Services Office, Inc., with its permission.
TEXAS WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT This endorsement applies only to the insurance provided by the policy because Texas is shown in Item 3.A. of the Information Page.
We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule, but this waiver applies only with respect to bodily injury arising out of the operations described in the Schedule where you are required by a written contract to obtain this waiver from us.
This endorsement shall not operate directly or indirectly to benefit anyone not named in the Schedule.
The premium for this endorsement is shown in the Schedule.
Schedule
1. () Specific Waiver
Name of person or organization
(X) Blanket Waiver
Any person or organization for whom the Named Insured has agreed by written contract to furnish this waiver.
2. Operations:
All Texas Operations
3, Premium:
The premium charge for this endorsement shall be 2.0 percent of the premium developed on payroll in connection with work performed for the above person(s) or organization(s) arising out of the operations described.
4. Advance Premium:
Issued by LM Insurance Corporation 27243 For
attachment to Policy No,WC5-Z91-472898-013
Issued to
Effective Date Premium $
PBK Architects, Inc. Endorsement No,
WC 42 03 04 B © Copyright 2014 National Council on Compensation Insurance, Inc, Page 1 of 1 Ed. 06/01/2014 All Rights Reserved.
TEXAS NOTICE OF MATERIAL CHANGE ENDORSEMENT
This endorsement applies only to the insurance provided by the policy because Texas is shown in item 3.A. of the Information Page.
In the event of cancelation or other material change of the policy, we will mail advance notice to the person or organization named in the Schedule. The number of days advance notice is shown in the Schedule.
This endorsement shall not operate directly or indirectly to benefit anyone not named in the Schedule.
Schedule
1. Number of days advance notice: 60
2. Notice will be mailed to: Per schedule on file with company Issued by LM Insurance Corporation 27243
For attachment to Policy No.WC5-Z91-472898-013
Issued to PBK Architects, Inc.
WC 42 06 01
Ed. 07/01/1984
Effective Date Premium $
Endorsement No.