ACORD® DATE (MM/DD/AYY)
CERTIFICATE OF LIABILITY INSURANCE 02/11/2021
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 INSURERS), 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 endorsements).
NAMEACT Willis Towers Watson Certificate Center
Willis Towers Watson Northeast, Inc.
c/o 26 Century Bivd (A/C. No. Ext): 1-877-945-7378
E-MAIL
P.O. Box 305191 ADDRESS: [email protected]
Nashville, IN 372305191 USA
INSURERS) AFFORDING COVERAGE NAIC #
INSURER A: ARA Insurance Company 33022
INSURED INSURER B:
Quadient, Inc.
Attn: Heather Laskowski INSURER C:
478 Wheelers Farms Rd INSURER D:
Milford, CT 06461
INSURER E:
CERTIFICATE NUMBER: W20074474 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.
TYPE OF INSURANCE POLICY NUMBER
COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE 2,000,000
DAMAGE TO RENTED 50,000
_ CLAIMS-MADE X OCCUR PREMISES (Ea occurrence)
Contractual Liability MED EXP (Any one person) 10,000
PCS000488 (21) 02/01/2021/02/01/2022 2,000,000
PERSONAL & ADV INJURY
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE 2,000,000 X POLICY SECT I LOC PRODUCTS - COMP/OP AGG 2,000,000
OTHER:
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT
(Ea accident
ANY AUTO BODILY INJURY (Per person)
OWNED SCHEDULED
AUTOS ONLY AUTOS BODILY INJURY (Per accident) s
HIRED ON-OWNE
AUTOS ONLY UTOS ONL
UMBRELLA LIAB OCCUR EACH OCCURRENCE
EXCESS LIAB CLAIMS-MADE AGGREGATE
DED RETENTIONS
WORKERS COMPENSATION STATUTE I
AND EMPLOYERS' LIABILITY Y/N
ANYPROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT
OFFICER/MEMBEREXCLUDED? NIA
(Mandatory in NH) E.L DISEASE - EA EMPLOYEE S
SOFPERATIONS below E.L. DISEASE - POLICY LIMIT S
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additlonal Remarks Schedule, may be attached if more space is requred the City of Redondo Beach, it's officers, elected and appointed officials, employees and volunteers are Additiona Insured
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS.
ALTHORIZO REPRESENTATIVF
City of Redondo Beach
415 Diamond Street All they
Redondo Beach, CA 90277
© 1988-2016 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD SR ID: 20711887 BATCH: 1984991
ACORD® DATE (MM/DD/YYYY)
CERTIFICATE OF LIABILITY INSURANCE
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 INSURERS), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) 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 riahts to the certificate holder in lieu of such endorsements).
CANA Certificate Department
Pacific Diversified Insurance Services FAC, No): 925-686-6118 NExt: 925-686-2860
ADDRESS: [email protected]
Pleasant Hill CA 94523 INSURERS) AFFORDING COVERAGE NAIC # INSURER A : Liberty Mutual Fire Insurance Company 23035 INSURED INSURER B: Travelers Casualty and Surety Company of America 31194 Quadient, Inc. INSURER C: LM Insurance Corporation 33600 478 Wheelers Farms Road
Milford CT 06461 INSURER D: Liberty Insurance Underwriters, Inc. 19917 INSURER E:
INSURER F:
COVERAGES CERTIFICATE NUMBER: 1854115775 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 ADDL SUBR LIMITS
LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER
COMMERCIAL GENERAL LIABILITY 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 1 69 EA 6A
PRO PRODUCTS - COMP/OP AGG
POLICY LOC
OTHER:
A 2/1/2021 2/1/2022 COMBINED SINGLE LIMIT
AUTOMOBILE LIABILITY AS2661066867031 (Ea accident)
BODILY INJURY (Per person) 510000
X ANY AUTO
OWNED SCHEDULED
AUTOS ONLY AUTOS BODILY INJURY (Per accident) s
HIRED NON-OWNED
X AUTOS ONLY
AUTOS ONLY
$ 1,000
Comp/Coll Ded:
UMBRELLA LIAB X OCCUR 100046525601 2/1/2021 2/1/2022 EACH OCCURRENCE $5.000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $5.000.000
DED | X RETENTIONS n
WORKERS COMPENSATION WA566D066867021 2/1/2021 2/1/2022 TOTATUTE T
AND EMPLOYERS' LIABILITY Y/N
ANYPROPRIETOR/PARTNER/EXECUTIVE E.L EACH ACCIDENT $1,000.000 OFFICER/MEMBEREXCLUDED? N/ A
(Mandatory In NH) E.L DISEASE - EA EMPLOYEE $ 1.000,000 DESCRIPTION OF OPERATIONS below EL. DISEASE - POLICY LIMIT $1.000,000 105559991 2112021 2212022 5000000
As required by signed written contract, the too wing endorsements apply to the Ceray date Horder antior any other entity, named in this section: Auto Liabilit Naiver of Subregion WC000313 04- Liability Waiver of Subrogation CA0444 10-13, Auto Liability Primary Wording CA0001 10-13; Workers Compensatior Errors & Omissions/Cyber - Landmark American Insurance Co. - LCY842248 - Limit per claim/occurrence/Agg: $5,000,000 - Retention $50,000 Eff: 2/1/2021 - 2/1/202:
The City, its officers, elected and appointed officials, employees and volunteers
CERTIFICATE HOLDER CANCELLATION
NOTICE WILL BE DELIVERED IN
City of Redondo Beach ACCORDANCE WITH THE POLICY PROVISIONS.
Attn: Robert Shellabarger
415 Diamond Street AUTHORIZED REPRESENTATIVE
Redondo Beach CA 90277
USA чса.
© 1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: AS2661066867031 COMMERCIAL AUTO
CA 20 48 10 13
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 | - Covered Autos Coverages of the Auto
Dealers Coverage Form.
CA 20 48 10 13 © Insurance Services Office, Inc., 2011 Page 1 of 1 POLICY NUMBER: AS2661066867031
COMMERCIAL AUTO
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
BUSINESS AUTO COVERAGE FORM
Various provisions in this policy restrict coverage. SECTION I - COVERED AUTOS ead the entire policy carefully to determine righ
ties and what is and is not covere
roviding this insurance.
Other words and phrases that appear in quotation A. Description Of Covered Auto Designation marks have special meaning. Refer to Section V - Symbols Definitions.
Symbol Description Of Covered Auto Designation Symbols
1 Any "Auto"
2 Owned "Autos" Only those "autos" you own (and for Covered Autos Liability Coverage any Only
3 Owned Private pas enger vatos you acquire onership or Ther the poisy beginivate Passenger you acquire ownership of after the policy begins. "Autos" Only
4 Owned Only those "autos" you own that are not of the private passenger type (and for "Autos" Other Covered Autos Liability Coverage any "trailers" you don't own while attached to Than Private power units you own). This includes those "autos" not of the private passenger Passenger type you acquire ownership of after the policy begins. "Autos" Only
5 Only those "autos" you own that are required to have no-fault benefits in the state where they are licensed or principally garaged. This includes those "autos" you acquire ownership of after the policy begins provided they are required to have no. fault benefits in the state where they are licensed or principally garaged. 6 Owned "Autos"
Subject To A
Compulsory
Uninsured olicy begins provided they are subject to the same state uninsured motorist Motorists Law equirement
Specifically Only those "autos" described in Item Three of the Declarations for which a Autoribed® remium charge is shown (and for Covered Autos Liability Coverage any "trailers' you don't own while attached to any power unit described in Item Three) 8 Hired "Autos" vou lease. hire, rent or borrow. This does not include any "auto Only Onu lass, hire, vent or barrow from any of your"emplayees", parthers (if you are a palership, members (if you are a limited liabilly company or members of their Non-owned Only those "autos" you do not own, lease, hire, rent or borrow that are used in "Autos" Only connection with your business. This includes "autos" owned by your "employees", partners (if you are a partnership), members (if you are a limited liability company or members of their households but only while used in your business or your CA 00 01 10 13 © Insurance Services Office, Inc.., 2011 Page 1 of 12
COMMERCIAL AUTO
19 Only those "autos" that are land vehicles and that would qualify under the definitior nent Subject To of "mobile equipment" under this policy if they were not subject to a compulsory o Financiary or ficensed or princibity gaw grother motor vehicle insurance law where they are ance Law Only
B. Owned Autos You Acquire After The Policy SECTION I| - COVERED AUTOS LIABILITY COV- Begins ERAGE
1. If Symbols 1, 2, 3, 4, 5, 6 or 19 are entered A. Coverage next to a coverage in Item Two of the Decla- We will pay all sums an "insured" legally must pay rations, then you have coverage for "autos" as damages because of "bodily injury" or "prop- that you acquire of the type described for the erty damage" to which this insurance applies, remainder of the policy period caused by an "accident" and resulting from the But, if Symbol 7 is entered next to a coverage ownership, maintenance or use of a covered in Item Two of the Declarations, an "auto" you "auto".
acquire will be a covered "auto" for that cov- We will also pay all sums an "insured" legally erage only if: must pay as a "covered pollution cost or expense" to which this insurance applies, caused by an
a. We already cover all "autos" that you own "accident" and resulting from the ownership,
for that coverage or it replaces an "auto" maintenance or use of covered "autos". However, you previously owned that had that cov- we will only pay for the "covered pollution cost or erage; and expense" if there is either "bodily injury" or "prop- b. You tell us within 30 days after you ac- erty damage" to which this insurance applies that quire it that you want us to cover it for that is caused by the same "accident". coverage. We have the right and duty to defend any "in- C. Certain Trailers, Mobile Equipment And Tem- sured" against a "suit" asking for such damages porary Substitute Autos or a "covered pollution cost or expense". How- ever, we have no duty to defend any "insured"
If Covered Autos Liability Coverage is provided by against a "suit" seeking damages for "bodily in- this Coverage Form, the following types of vehi- jury" or "property damage" or a "covered pollution cles are also covered "autos" for Covered Autos cost or expense" to which this insurance does not Liability Coverage: apply. We may investigate and settle any claim or
1. "Trailers" with a load capacity of 2,000 "suit" as we consider appropriate. Our duty to de pounds or less designed primarily for travel fend or settle ends when the Covered Autos Li on public roads. ability Coverage Limit of Insurance has been ex- hausted by payment of judgments or settlements.
2. "Mobile equipment" while being carried or
towed by a covered "auto". 1. Who Is An Insured
Any "auto" you do not own while used with The following are "insureds":
the permission of its owner as a temporary a. You for any covered "auto". substitute for a covered "auto" you own that is • Anyone else while using with your pe out of service because of its: hission a covered "auto" you own, hire c a. Breakdown; borrow except:
b. Repair; (1) The owner or anyone else from
whom you hire or borrow a covered
c. Servicing;
d. "Loss"; or his exception does not apply if th
e. Destruction. overed "auto" is a "trailer" connecte
to a covered "auto" you own.
COMMERCIAL AUTO
(2) Your "employee" if the covered "auto" pay interest ends when we have paid, owned by that "employee" or offered to pay or deposited in court ember of his or her househol ne part of the judgment that is withi (3) Someone using a covered "auto" ur Limit of Insurance while he or she is working in a busi- These payments will not reduce the Limit of Insurance.
b. Out-of-state Coverage Extensions
business is yours.
While a covered "auto" is away from the
(4) Anyone other than your "employees", state where it is licensed, we will:
partners (if you are a partnership), (1) Increase the Limit of Insurance for nembers (if you are a limited liability
company) or a lessee or borrower or Covered Autos Liability Coverage to any of their "employees", while mov- meet the limits specified by a com- ing property to or from a covered pulsory or financial responsibility law of the jurisdiction where the covered
"auto" is being used. This extension
(5) A partner (if you are a partnership) or does not apply to the limit or limits a member (if you are a limited liability specified by any law governing motor company) for a covered "auto" owned carriers of passengers or property. by him or her or a member of his or
her household (2) Provide the minimum amounts and
types of other coverages, such as no-
c. Anyone liable for the conduct of an "in- fault, required of out-of-state vehicles sured" described above but only to the by the jurisdiction where the covered extent of that liability. "auto" is being used.
2. Coverage Extensions We will not pay anyone more than once a. Supplementary Payments for the same elements of loss because of We will pay for the "insured": these extensions.
(1) All expenses we incur. B. Exclusions
(2) Up to $2,000 for cost of bail bonds This insurance does not apply to any of the fol- (including bonds for related traffic law lowing:
violations) required because of an 1. Expected Or Intended Injury "accident" we cover. We do not have
"Bodily injury" or "property damage" expected
to furnish these bonds. or intended from the standpoint of the "in- (3) The cost of bonds to release attach- sured".
ments in any "suit" against the "in-
sured" we defend, but only for bond 2. Contractual
amounts within our Limit of Insur- Liability assumed under any contract or agreement.
4) All reasonable expenses incurred b But this exclusion does not apply to liability he "insured" at our request, includin for damages:
ctual loss of earnings up to $250 a. Assumed in a contract or agreement that ay because of time off from worl is an "insured contract", provided the bodily injury" or "property damage" oc-
curs subsequent to the execution of the
contract or agreement; or
b. That the "insured" would have in the ab-
sence of the contract or agreement.
3. Workers' Compensation
Any obligation for which the "insured" or the
"insured's" insurer may be held liable under
any workers' compensation, disability benefits
CA 00 01 10 13 © Insurance Services Office, Inc., 2011 Page 3 of 12
COMMERCIAL AUTO
or unemployment compensation law or any 7. Handling Of Property similar law. "Bodily injury" or "property damage" resulting
4. Employee Indemnification And Employer's from the handling of property:
Liability a. Before it is moved from the place where it "Bodily injury" to: is accepted by the "insured" for move- ment into or onto the covered "auto"; or
a. An "employee" of the "insured" arising out
of and in the course of: b. After it is moved from the covered "auto" to the place where it is finally delivered by
(1) Employment by the "insured"; or the "insured".
(2) Performing the duties related to the 8. Movement Of Property By Mechanical De- conduct of the "insured's" business;
"Bodily injury" or "property damage" resulting
b. The spouse, child, parent, brother or sis- from the movement of property by a me. ter of that "employee" as a consequence chanical device (other than a hand truck) of Paragraph a. above. unless the device is attached to the covered This exclusion applies: "auto".
(1) Whether the "insured" may be liable 9. Operations
as an employer or in any other ca- "Bodily injury" or "property damage" arising pacity; and out of the operation of:
(2) To any obligation to share damages a. Any equipment listed in Paragraphs 6.b. with or repay someone else who and 6.c. of the definition of "mobile must pay damages because of the in- equipment"; or
jury. b. Machinery or equipment that is on, at-
But this exclusion does not apply to "bodily in- tached to or part of a land vehicle that jury" to domestic "employees" not entitled to would qualify under the definition of "mo- workers' compensation benefits or to liability bile equipment" if it were not subject to a assumed by the "insured" under an "insured compulsory or financial responsibility law or other motor vehicle insurance law
contract". For the purposes of the Coverage
Form, a domestic "employee" is a person en- where it is licensed or principally garaged gaged in household or domestic work per- 10. Completed Operations "Bodily injury" or "property damage" arising
dence premises. out of your work after that work has been
5. Fellow Employee completed or abandoned.
"Bodily injury" to: In this exclusion, your work means:
a. Any fellow "employee" of the "insured" a. Work or operations performed by you or arising out of and in the course of the fel- on your behalf; and low "employee's" employment or while b. Materials, parts or equipment furnished in performing duties related to the conduct connection with such work or operations. of your business; or Your work includes warranties or representa- b. The spouse, child, parent, brother or sis- tions made at any time with respect to the fit- ter of that fellow "employee" as a conse- ess, quality, durability or performance of an quence of Paragraph a. above. of the items included in Paragraph a. or 1 above.
6. Care, Custody Or Control
"Property damage" to or "covered pollution Your work will be deemed completed at the earliest of the following times:
ost or expense" involving property owned ol
ransported by the "insured" or in the "in (1) When all of the work called for in your sured's" care, custody or control. But this ex- contract has been completed; clusion does not apply to liability assumed (2) When all of the work to be done at under a sidetrack agreement. the site has been completed if your
COMMERCIAL AUTO
contract calls for work at more than (2) The "bodily injury", "property dam- one site; or age" or "covered pollution cost or ex
pense" does not arise out of the op.
(3) When that part of the work done at a eration of any equipment listed in job site has been put to its intended
use by any person or organization Paragraphs 6.b. and 6.c. of the defi- other than another contractor or sub- nition of "mobile equipment". contractor working on the same pro- Paragraphs b. and c. above of this exclusion ject. do not apply to "accidents" that occur away
Work that may need service, maintenance, sure reis respected or anted to r correction, repair or replacement, but which is upon a covered "auto" if:
otherwise complete, will be treated as com
pleted. a) The "pollutants" or any proper
n which the "pollutants" are cor
11. Pollution tained are upset, overturned or
"Bodily injury" or "property damage" arising damaged as a result of the main- out of the actual, alleged or threatened dis- tenance or use of a covered charge, dispersal, seepage, migration, re- "auto"; and
lease or escape of "pollutants": (b) The discharge, dispersal, seep- a. That are, or that are contained in any age, migration, release or escape property that is: of the "pollutants" is caused di-
rectly by such upset, overturn or
(1) Being transported or towed by, han- damage.
ded or handled for movement into.
onto or from the covered "auto". 12. War
(2) Otherwise in the course of transit by "Bodily injury" or "property damage" arising or on behalf of the "insured"; or directly or indirectly out of:
(3) Being stored, disposed of, treated or a. War, including undeclared or civil war; processed in or upon the covered b. Warlike action by a military force, includ- "auto": ing action in hindering or defending
against an actual or expected attack, by
b. Before the "pollutants" or any property in any government, sovereign or other au- which the "pollutants" are contained are thority using military personnel or other moved from the place where they are ac- agents; or
cepted by the "insured" for movement into c. Insurrection, rebellion, revolution, or onto the covered "auto"; or
usurped power or action taken by gov-
c. After the "pollutants" or any property in ernmental authority in hindering or de- which the "pollutants" are contained are fending against any of these. moved from the covered "auto" to the 13. Racing
place where they are finally delivered,
disposed of or abandoned by the "in- Covered "autos" while used in any profes- sional or organized racing or demolition con-
sured". test or stunting activity, or while practicing for Paragraph a. above does not apply to fuels, such contest or activity. This insurance also lubricants, fluids, exhaust gases or other simi- does not apply while that covered "auto" is lar "pollutants" that are needed for or result being prepared for such a contest or activity. from the normal electrical, hydraulic or me- C. Limit Of Insurance chanical functioning of the covered "auto" or
its parts if: Regardless of the number of covered "autos", "insureds", premiums paid, claims made or vehi-
(1) The "pollutants" escape, seep, mi- cles involved in the "accident", the most we will grate or are discharged, dispersed oi pay for the total of all damages and "covered pol- released directly from an "auto" par lution cost or expense" combined resulting from designed by its manufacturer to hold, any one "accident" is the Limit Of Insurance for store, receive or dispose of such "pol- Covered Autos Liability Coverage shown in the lutants", and Declarations.
CA 00 01 10 13 © Insurance Services Office, Inc., 2011 Page 5 of 12
COMMERCIAL AUTO
All "bodily injury", "property damage" and "cov- a. Glass breakage; ered pollution cost or expense" resulting from
continuous or repeated exposure to substantially ". "Loss" caused by hitting a bird or animal; the same conditions will be considered as result-
ing from one "accident". c. "Loss" caused by falling objects or mis- siles.
No one will be entitled to receive duplicate pay-
ments for the same elements of "loss under this However, you have the option of having glass Coverage Form and any Medical Payments Cov- breakage caused by a covered "auto's" colli- sion or overturn considered a "loss" under
erage endorsement, Uninsured Motorists Cover- Collision Coverage. age endorsement or Underinsured Motorists
Coverage endorsement attached to this Coverage 4. Coverage Extensions Part. a. Transportation Expenses
SECTION III - PHYSICAL DAMAGE COVERAGE We will pay up to $20 per day, to a maxi- A. Coverage mum of $600, for temporary transporta-
1. We will pay for "loss" to a covered "auto" or tion expense incurred by you because of the total theft of a covered "auto" of the
its equipment under:
private passenger type. We will pay only
a. Comprehensive Coverage for those covered "autos" for which you From any cause except: carry either Comprehensive or Specified (1) The covered "auto's" collision with Causes Of Loss Coverage. We will pay another object; or for temporary transportation expenses in- curred during the period beginning 48
(2) The covered "auto's" overturn. hours after the theft and ending, regard- b. Specified Causes Of Loss Coverage less of the policy's expiration, when the covered "auto" is returned to use or we
Caused by: pay for its "loss".
(1) Fire, lightning or explosion;
b. Loss Of Use Expenses
(2) Theft;
For Hired Auto Physical Damage, we will
(3) Windstorm, hail or earthquake; pay expenses for which an "insured" be- (4) Flood; comes legally responsible to pay for loss
of use of a vehicle rented or hired without
(5) Mischief or vandalism; or
a driver under a written rental contract or
(6) The sinking, burning, collision or de- agreement. We will pay for loss of use railment of any conveyance transport- expenses if caused by:
ing the covered "auto"
(1) Other than collision only if the Decla-
c. Collision Coverage rations indicates that Comprehensive Caused by: Coverage is provided for any covered
(1) The covered "auto's" collision with
another object; or (2) Specified Causes Of Loss only if the Declarations indicates that Specified
(2) The covered "auto's" overturn. auses Of Loss Coverage is pro
2. Towing ided for any covered "auto"; o
We will pay up to the limit shown in the Decla- (3) Collision only if the Declarations indi- rations for towing and labor costs incurred cates that Collision Coverage is pro- each time a covered "auto" of the private vided for any covered "auto". passenger type is disabled. However, the la- However, the most we will pay for any bor must be performed at the place of dis- expenses for loss of use is $20 per day, ablement. to a maximum of $600.
3. Glass Breakage - Hitting A Bird Or Animal B. Exclusions - Falling Objects Or Missiles
1. We will not pay for "loss" caused by or result-
If you carry Comprehensive Coverage for the ing from any of the following. Such "loss" is damaged covered "auto", we will pay for the axoluded regardlece of any other cause or following under Comprehensive Coverage:
COMMERCIAL AUTO
event that contributes concurrently or in any installed, that reproduces, receives or sequence to the "loss". transmits audio, visual or data signals. a. Nuclear Hazard d. Any accessories used with the electronic equipment described in Paragraph c.
(1) The explosion of any weapon em-
ploying atomic fission or fusion; or
(2) Nuclear reaction or radiation, or ra- 5. Exclusions 4.c. and 4.d. do not apply to dioactive contamination, however
caused.
b. War Or Military Action
a. Permanently installed in or upon the cov-
(1) War, including undeclared or civil ered "auto";
war;
b. Removable from a housing unit which is
(2) Warlike action by a military force, in- permanently installed in or upon the cov- 12) Youth action stil tapedera.
ing against an actual or expected at- ered "auto";
tack, by any government, sovereign c. An integral part of the same unit housing any electronic equipment described in
sonnel or other agents; or Paragraphs a. and b. above; or (3) Insurrection, rebellion, revolution, d. Necessary for the normal operation of the usurped power or action taken by covered "auto" or the monitoring of the governmental authority in hindering covered "auto's" operating system. or defending against any of these.
6. We will not pay for "loss" to a covered "auto"
2. We will not pay for "loss" to any covered due to "diminution in value" "auto" while used in any professional or or-
ganized racing or demolition contest or stunt- C. Limits Of Insurance ing activity, or while practicing for such con- 1. The most we will pay for:
test or activity. We will also not pay for "loss" a. "Loss" to any one covered "auto" is the to any covered "auto" while that covered
lesser of:
"auto" is being prepared for such a contest or
activity. (1) The actual cash value of the dam-
3. We will not pay for "loss" due and confined to: aged or stolen property as of the time of the "loss"; or
a. Wear and tear, freezing, mechanical or
electrical breakdown. (2) The cost of repairing or replacing the damaged or stolen property with
b. Blowouts, punctures or other road dam-
other property of like kind and quality.
age to tires.
This exclusion does not apply to such "loss" b. All electronic equipment that reproduces, receives or transmits audio, visual or data
Pasting from the total theft of a covered signals in any one "loss" is $1,000, if, at the time of "loss", such electronic equip-
4. We will not pay for "loss" to any of the follow-
ing:
(1) Permanently installed in or upon the
a. Tapes, records, discs or other similar au- covered "auto" in a housing, opening dio, visual or data electronic devices de- or other location that is not normally signed for use with audio, visual or data used by the "auto" manufacturer for electronic equipment. the installation of such equipment; speed-measuring equipment, such as ra- (2) Removable from a permanently in- stalled housing unit as described in
apparatus intended to elude or disrupt Paragraph b. (1) above; or speed-measuring equipment. (3) An integral part of such equipment as c. Any electronic equipment, without regard described in Paragraphs b.(1) and to whether this equipment is permanently b.(2) above.
CA 00 01 10 13 © Insurance Services Office, Inc., 2011 Page 7 of 12
COMMERCIAL AUTO
2. An adjustment for depreciation and physical b. Additionally, you and any other involved condition will be made in determining actua "insured" must:
cash value in the event of a total "loss"
(1) Assume no obligation, make no pay-
3. If a repair or replacement results in better ment or incur no expense without our than like kind or quality, we will not pay for the consent, except at the "insured's" amount of the betterment. own cost.
D. Deductible (2) Immediately send us copies of any
For each covered "auto", our obligation to pay for, request, demand, order, notice, summons or legal paper received
concerning the claim or "suit".
(3) Cooperate with us in the investigation
Coverage deductible shown in the Declarations or settlement of the claim or defense does not apply to "loss" caused by fire or light- against the "suit". ning.
SECTION IV - BUSINESS AUTO CONDITIONS (4) Authorize us to obtain medical re- cords or other pertinent information.
The following conditions apply in addition to the
Common Policy Conditions: (5) Submit to examination, at our ex- pense, by physicians of our choice,
A. Loss Conditions as often as we reasonably require.
1. Appraisal For Physical Damage Loss
c. If there is "loss" to a covered "auto" or its
If you and we disagree on the amount of equipment, you must also do the follow- "loss", either may demand an appraisal of the ing:
"loss" In this event, each party will select a
competent appraiser. The two appraisers will (1) Promptly notify the police if the cov- ered "auto" or any of its equipment is
and anou gras: they stolen.
(2) Take all reasonable steps to protect
agree, they will submit their differences to the the covered "auto" from further dam- umpire. A decision agreed to by any two will age. Also keep a record of your ex- be binding. Each party will: penses for consideration in the set- a. Pay its chosen appraiser; and tlement of the claim.
b. Bear the other expenses of the appraisal (3) Permit us to inspect the covered and umpire equally. "auto" and records proving the "loss" If we submit to an appraisal, we will still retain before its repair or disposition. our right to deny the claim. (4) Agree to examinations under oath at
2. Duties In The Event Of Accident, Claim, our request and give us a signed Suit Or Loss statement of your answers.
We have no duty to provide coverage under 3. Legal Action Against Us this policy unless there has been full compli- No one may bring a legal action against us ance with the following duties: under this Coverage Form until:
a. In the event of "accident", claim, "suit" or a. There has been full compliance with all "loss", you must give us or our authorized the terms of this Coverage Form; and representative prompt notice of the "acci-
dent" or "loss". Include: b. Under Covered Autos Liability Coverage, we agree in writing that the "insured" has
(1) How, when and where the "accident" an obligation to pay or until the amount of or "loss" occurred; that obligation has finally been deter- (2) The "insured's" name and address; mined by judgment after trial. No one has the right under this policy to bring us into
(3) To the extent possible, the names an action to determine the "insured's" li- and addresses of any injured persons ability.
and witnesses.
COMMERCIAL AUTO
4. Loss Payment - Physical Damage Cover- son or organization holding, storing or trans- ages porting property for a fee regardless of any
other provision of this Coverage Form.
At our option, we may:
a. Pay for, repair or replace damaged or sto- 5. Other Insurance len property; a. For any covered "auto" you own, this
b. Return the stolen property, at our ex- Coverage Form provides primary insur ance. For any covered "auto" you don't
pense. We will pay for any damage that own, the insurance provided by this Cov- results to the "auto" from the theft; or
erage Form is excess over any other col-
c. Take all or any part of the damaged or lectible insurance. However, while a cov stolen property at an agreed or appraisec ered "auto" which is a "trailer" is con value. nected to another vehicle, the Covered
If we pay for the "loss", our payment will in- Autos Liability Coverage this Coverage clude the applicable sales tax for the dam- Form provides for the "trailer" is:
aged or stolen property. (1) Excess while it is connected to a mo-
5. Transfer Of Rights Of Recovery Against tor vehicle you do not own; or Others To Us (2) Primary while it is connected to a
If any person or organization to or for whom covered "auto" you own. we make payment under this Coverage Form b. For Hired Auto Physical Damage Cover- has rights to recover damages from another, age, any covered "auto" you lease, hire, those rights are transferred to us. That person rent or borrow is deemed to be a covered or organization must do everything necessary "auto" you own. However, any "auto" that to secure our rights and must do nothing after is leased, hired, rented or borrowed with "accident" or "loss" to impair them. a driver is not a covered "auto".
B. General Conditions c. Regardless of the provisions of Para-
1. Bankruptcy graph a. above, this Coverage Form's
Covered Autos Liability Coverage is pri-
Bankruptcy or insolvency of the "insured" or
the "insured's" estate will not relieve us of any mary for any liability assumed under an "insured contract".
obligations under this Coverage Form.
d. When this Coverage Form and any other
2. Concealment, Misrepresentation Or Fraud
Coverage Form or policy covers on the
This Coverage Form is void in any case of same basis, either excess or primary, we fraud by you at any time as it relates to this will pay only our share. Our share is the Coverage Form. It is also void if you or any proportion that the Limit of Insurance of other "insured", at any time, intentionally con- our Coverage Form bears to the total of ceals or misrepresents a material fact con- the limits of all the Coverage Forms and cerning: policies covering on the same basis.
a. This Coverage Form; 6. Premium Audit
b. The covered "auto"; a. The estimated premium for this Coverage c. Your interest in the covered "auto"; or Form is based on the exposures you told d. A claim under this Coverage Form. us you would have when this policy be- gan. We will compute the final premium
3. Liberalization due when we determine your actual ex- If we revise this Coverage Form to provide posures. The estimated total premium will more coverage without additional premium be credited against the final premium due charge, your policy will automatically provide and the first Named Insured will be billed the additional coverage as of the day the re- for the balance, if any. The due date for vision is effective in your state. the final premium or retrospective pre- mium is the date shown as the due date
4. No Benefit To Bailee - Physical Damage on the bill. If the estimated total premium Coverages exceeds the final premium due, the first
We will not recognize any assignment or Named Insured will get a refund. yrant any coverage for the benefit of any per-
CA 00 01 10 13 © Insurance Services Office, Inc., 2011 Page 9 of 12
COMMERCIAL AUTO
b. If this policy is issued for more than one 1. A land motor vehicle, "trailer" or semitrailer year, the premium for this Coverage Form designed for travel on public roads; or will be computed annually based on our 2. Any other land vehicle that is subject to a rates or premiums in effect at the begin- compulsory or financial responsibility law or ning of each year of the policy. other motor vehicle insurance law where it is
7. Policy Period, Coverage Territory licensed or principally garaged.
Under this Coverage Form, we cover "acci- However, "auto" does not include "mobile equip- dents" and "losses" occurring: ment".
a. During the policy period shown in the C. "Bodily injury" means bodily injury, sickness or Declarations; and disease sustained by a person, including death b. Within the coverage territory. resulting from any of these.
D. "Covered pollution cost or expense" means any
The coverage territory is:
cost or expense arising out of:
(1) The United States of America;
1. Any request, demand, order or statutory or
(2) The territories and possessions of the regulatory requirement that any "insured" or United States of America; others test for, monitor, clean up, remove, (3) Puerto Rico; contain, treat, detoxify or neutralize, or in any (4) Canada; and way respond to, or assess the effects of, "pol- lutants"; or
(5) Anywhere in the world if a covered
"auto" of the private passenger type 2. Any claim or "suit" by or on behalf of a gov- ernmental authority for damages because of
is leased, hired, rented or borrowed
without a driver for a period of 30 testing for, monitoring, cleaning up, removing, days or less, containing, treating, detoxifying or neutraliz- ing, or in any way responding to, or assessing
provided that the "insured's" responsibility to the effects of, "pollutants". pay damages is determined in a "suit" on the
merits, in the United States of America, the "Covered pollution cost or expense" does not in- clude any cost or expense arising out of the ac-
territories and possessions of the United
States of America, Puerto Rico or Canada, or tual, alleged or threatened discharge, dispersal, in a settlement we agree to. seepage, migration, release or escape of "pollut- ants":
We also cover "loss" to, or "accidents" involv-
ing, a covered "auto" while being transported a. That are, or that are contained in any between any of these places. property that is:
8. Two Or More Coverage Forms Or Policies (1) Being transported or towed by, han- Issued By Us dled or handled for movement into,
onto or from the covered "auto";
If this Coverage Form and any other Cover-
age Form or policy issued to you by us or any (2) Otherwise in the course of transit by company affiliated with us applies to the or on behalf of the "insured"; or same "accident", the aggregate maximum (3) Being stored, disposed of, treated or Limit of Insurance under all the Coverage processed in or upon the covered Forms or policies shall not exceed the highest "auto";
applicable Limit of Insurance under any one b. Before the "pollutants" or any property in Coverage Form or policy. This condition does which the "pollutants" are contained are not apply to any Coverage Form or policy is- moved from the place where they are ac- sued by us or an affiliated company specifi. cepted by the "insured" for movement into cally to apply as excess insurance over this or onto the covered "auto"; or Coverage Form.
c. After the "pollutants" or any property in
SECTION V - DEFINITIONS which the "pollutants" are contained are A. "Accident" includes continuous or repeated expo- moved from the covered "auto" to the sure to the same conditions resulting in "bodily in- place where they are finally delivered, jury" or "property damage". disposed of or abandoned by the "in- B. "Auto" means: sured".
COMMERCIAL AUTO
Paragraph a. above does not apply to fuels, 4. An obligation, as required by ordinance, to in- lubricants, fluids, exhaust gases or other simi- demnify a municipality, except in connection lar "pollutants" that are needed for or result with work for a municipality; from the normal electrical, hydraulic or me- 5. That part of any other contract or agreement chanical functioning of the covered "auto" or pertaining to your business (including an in- its parts, if: demnification of a municipality in connection (1) The "pollutants" escape, seep, mi- with work performed for a municipality under grate or are discharged, dispersed or which you assume the tort liability of another released directly from an "auto" part to pay for "bodily injury" or "property damage" designed by its manufacturer to hold, to a third party or organization. Tort liability store, receive or dispose of such "pol- means a liability that would be imposed by lutants"; and law in the absence of any contract or agree- (2) The ment; or
6. That part of any contract or agreement en-
tered into, as part of your business, pertaining
eration of any equipment listed in to the rental or lease, by you or any of your Paragraph 6.b. or 6.c. of the defini- "employees", of any "auto". However, such tion of "mobile equipment". contract or agreement shall not be considered an "insured contract" to the extent that it obli-
Paragraphs b. and c. above do not apply to
"accidents" that occur away from premises gates you or any of your "employees" to pay owned by or rented to an "insured" with re- for "property damage" to any "auto" rented or leased by you or any of your "employees".
spect to "pollutants" not in or upon a covered
"auto" if: An "insured contract" does not include that part of (a) The "pollutants" or any property any contract or agreement:
in which the "pollutants" are con- a. That indemnifies a railroad for "bodily in- tained are upset, overturned or jury" or "property damage" arising out of damaged as a result of the main- construction or demolition operations, tenance or use of a covered within 50 feet of any railroad property and "auto"; and affecting any railroad bridge or trestle,
(b) The discharge, dispersal, seep- tracks, roadbeds, tunnel, underpass or crossing;
age, migration, release or escape
of the "pollutants" is caused di- b. That pertains to the loan, lease or rental rectly by such upset, overturn or of an "auto" to you or any of your "em- damage. ployees", if the "auto" is loaned, leased or
rented with a driver; or
E. "Diminution in value" means the actual or per-
ceived loss in market value or resale value which c. That holds a person or organization en- results from a direct and accidental "loss". gaged in the business of transporting F. "Employee" includes a "leased worker". "Em-
ployee" does not include a "temporary worker".
or territory that person or organization is
G. "Insured" means any person or organization quali- authorized to serve by public authority. in as an insured in the Who Is An Insured pro
ision of the applicable coverage. Except with re I. "Leased worker" means a person leased to you spect to the Limit of Insurance, the coverage af by a labor leasing firm under an agreement be- forded applies separately to each insured who is tween you and the labor leasing firm to perform seeking coverage or against whom a claim or duties related to the conduct of your business. "suit" is brought. "Leased worker" does not include a "temporary worker".
H. "Insured contract" means:
J. . "Loss" means direct and accidental loss or dam-
1. A lease of premises; age.
2. A sidetrack agreement; K. "Mobile equipment" means any of the following
3. Any easement or license agreement, except types of land vehicles, including any attached in connection with construction or demolition machinery or equipment:
operations on or within 50 feet of a railroad;
CA 00 01 10 13 © Insurance Services Office, Inc., 2011 Page 11 of 12
COMMERCIAL AUTO
1. Bulldozers, farm machinery, forklifts and other c. Air compressors, pumps and generators, vehicles designed for use principally off public including spraying, welding, building roads; cleaning, geophysical exploration, lighting
2. Vehicles maintained for use solely on or next or well-servicing equipment. to premises you own or rent; However, "mobile equipment" does not include
3. Vehicles that travel on crawler treads; land vehicles that are subject to a compulsory or financial responsibility law or other motor vehicle
4. Vehicles, whether self-propelled or not, main- insurance law where it is licensed or principally tained primarily to provide mobility to perma- garaged. Land vehicles subject to a compulsory nently mounted: or financial responsibility law or other motor vehi- a. Power cranes, shovels, loaders, diggers cle insurance law are considered "autos". or drills; or L. "Pollutants" means any solid, liquid, gaseous or b. Road construction or resurfacing equip- thermal irritant or contaminant, including smoke, ment such as graders, scrapers or rollers; vapor, soot, fumes, acids, alkalis, chemicals and
5. Vehicles not described in Paragraph 1., 2., 3. waste. Waste includes materials to be recycled, reconditioned or reclaimed.
or 4. above that are not self-propelled and are
maintained primarily to provide mobility to M. "Property damage" means damage to or loss of permanently attached equipment of the fol- use of tangible property. lowing types: N. "Suit" means a civil proceeding in which:
a. Air compressors, pumps and generators, 1. Damages because of "bodily injury" or "prop- including spraying, welding, building erty damage"; or
cleaning, geophysical exploration, lighting
and well-servicing equipment; or 2. A "covered pollution cost or expense"; b. Cherry pickers and similar devices used to which this insurance applies, are alleged to raise or lower workers; or "Suit" includes:
6. Vehicles not described in Paragraph 1., 2., 3. a. An arbitration proceeding in which such or 4. above maintained primarily for purposes damages or "covered pollution costs or other than the transportation of persons or expenses" are claimed and to which the cargo. However, self-propelled vehicles with "insured" must submit or does submit with the following types of permanently attached our consent; or equipment are not "mobile equipment" but will b. Any other alternative dispute resolution be considered "autos":
proceeding in which such damages or
a. Equipment designed primarily for: "covered pollution costs or expenses" are claimed and to which the insured submits
(1) Snow removal;
(2) Road maintenance, but not construc-
tion or resurfacing; or O. "Temporary worker" means a person who is fur- nished to you to substitute for a permanent "em-
(3) Street cleaning; ployee" on leave or to meet seasonal or short- b. Cherry pickers and similar devices term workload conditions. mounted on automobile or truck chassis P. "Trailer" includes semitrailer. and used to raise or lower workers; and
POLICY NUMBER: AS2661066867031 COMMERCIAL AUTO
CA 04 44 10 13
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:
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.
SCHEDULE
Name(s) Of Person(s) Or Organzation(s):
Premium: $ INCL
Information required to complete this Schedule, if not shown above, will be shown in the Declarations. that person or organization.
CA 04 44 10 13 © Insurance Services Office, Inc., 2011 Page 1 of 1
WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT
This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule.
Schedule
Where required by contract or written agreement prior to loss.
This endorsement is executed by the
Premium $
Effective Date 2/1/2021 Expiration Date 2/1/2022
For attachment to Policy No. WA566D066867021
WC 00 03 13 © 1983 National Council on Compensation Insurance. Page 1 of 1 Ed. 4/1/1984