SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS.
INSURER(S) AFFORDING COVERAGE
INSURER F :
INSURER E :
INSURER D :
INSURER C :
INSURER B :
INSURER A :
NAIC #
NAME:
CONTACT
A/C, No):
FAX
E- MAILADDRESS:
PRODUCER
A/C, No, Ext):
PHONE
INSURED
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed.
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
OTHER:
Per accident)
Ea accident)
N / A
SUBR
WVD
ADDL
INSD
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
PROPERTY DAMAGE
BODILY INJURY (Per accident)
BODILY INJURY (Per person)
COMBINED SINGLE LIMIT
AUTOS ONLY
AUTOSAUTOS ONLY
NON-OWNED
SCHEDULEDOWNED
ANY AUTO
AUTOMOBILELIABILITY
Y / N
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
OFFICER/MEMBEREXCLUDED?
Mandatory in NH)
DESCRIPTION OF OPERATIONS below
If yes, describe under
ANYPROPRIETOR/PARTNER/EXECUTIVE
E.L. DISEASE - POLICY LIMIT
E.L. DISEASE - EA EMPLOYEE
E.L. EACH ACCIDENT
STATUTEPER EROTHMM/DD/YYYY) LIMITS( POLICY EXP(
MM/DD/YYYY) NUMBERTYPE EFFPOLICY POLICY INSURANCELTRINSR OF DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
EXCESS LIAB
UMBRELLA LIAB $ EACH OCCURRENCE
AGGREGATE
OCCUR
CLAIMS-MADE
DED RETENTION $
PRODUCTS - COMP/OP AGG
GENERAL AGGREGATE
PERSONAL & ADV INJURY
MED EXP (Any one person)
EACH OCCURRENCE
DAMAGE TO RENTED $
PREMISES (Ea occurrence)
COMMERCIAL GENERAL LIABILITY
CLAIMS-MADE OCCUR
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY PROJECT LOC
CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY)
CANCELLATION
AUTHORIZED REPRESENTATIVE
ACORD 25 (2016/03)
1988-2015 ACORD CORPORATION. All rights reserved.
CERTIFICATE HOLDER
The ACORD name and logo are registered marks of ACORD
HIRED
AUTOS ONLY
1/5/2022
Risk Strategies Company
2040 Main Street, Suite 450
Irvine, CA 92614
949-242-9240
www.risk-strategies.com CA DOI License No. 0F06675 Sentinel Insurance Company Ltd 11000 Liberty Insurance Underwriters, Inc. 19917
Chubb National Insurance Company 10052
A $ 00072SBABB51268/ 31/2021 8/31/2022 2,000,
1,000,000
3 10,000
3 2,000,000
4,000,000
00034,000,
A 72SBABB5126 8/31/2021 8/31/2022 $ 2,000,000
3 3
C 2371785177 1/11/2022 1/11/2023 3
000N1,000,
1,000,000
1,000,000
B Professional Liability AEXNYABNA6M002 6/1/2020 6/1/2022 Per Claim: $2,000,000 Aggregate: $2,000,000
RSC Insurance Brokerage
Risk Strategies Company
[email protected]
Lisa Padilla, dba: Cityworks Design
2275 Huntington Dr., Ste #343
San Marino CA 91108
66118630
3 3
The City of Redondo Beach, its officers, elected and appointed officials, employees, and volunteers are named as non-owned and hired auto liability - see attached endorsements.
City of Redondo Beach
Community Development Department
415 Diamond St., Door 2
Redondo Beach CA 90277
Projects as on file with the insured including but not limited to Objective Resididential Design Guidelines. additional insureds and primary/non-contributory clause applies to the general liability policy, including the 66118630 | 22- 23 WC, 21- 22 GL- HNOA, 20- 22 PL | Sherry Young | 1/ 5/ 2022 9: 11: 54 AM ( PST) | Page 1 of 15
BUSINESS LIABILITY COVERAGE FORM
2. Applicable To Medical Expenses Coverage e. A trust, you are an insured. Your trustees We are also insureds, but only with respect to will not pay expenses for "bodily injury":
their duties as trustees.
a. Any Insured
2. Each of the following is also an insured: To any insured, except "volunteer workers".
Workersb. a. Employees And Volunteer Hired Person
whileTo Your " volunteer workers" only a person hired to do work for or on behalf performing duties related to the conduct of of any insured or a tenant of any insured. your business, or your "employees", other
c. Injury On Normally Occupied Premises than either your "executive officers" (if you To a person injured on that part of are an organization other than a premises you own or rent that the person partnership, joint venture or limited liability normally occupies. company) or your managers (if you are a d. Workers' Compensation And Similar limited liability company), but only for acts Laws within the scope of their employment by
you or while performing duties related to To a person, whether or not an the conduct of your business." employee" of any insured, if benefits for However, none of these " employees" or the "bodily injury" are payable or must be provided under a workers' compensation volunteer workers" are insureds for:
or disability benefits law or a similar law.( 1)" Bodily injury" or " personal and e. Athletics Activities advertising injury":
To a person a) To you, to your partners or injured while practicing, instructing or participating in any physical members (if you are a partnership exercises or games, sports or athletic or joint venture), to your members contests. if you are a limited liability
company), or to a co-"employee" f. Products-Completed Operations Hazard while in the course of his or her Included with the " products-completed employment or performing duties operations hazard". related to the conduct of your
g. Business Liability Exclusions business, or to your other volunteer workers" while Excluded under Business Liability Coverage. performing duties related to the
C. WHO IS AN INSURED conduct of your business;
1. If you are designated in the Declarations as:( b) To the spouse, child, parent, a. An brother or sister of that co- individual, you and your spouse are employee" or that " volunteer insureds, but only with respect to the conduct of a business of which you are worker" as a consequence of the ( sole owner. Paragraph 1)(a) above;
b. A partnership or joint venture, you are an c) For which there is any obligation insured. Your members, your partners, and to share damages with or repay their spouses are also insureds, but only with someone else who must pay respect to the conduct of your business.( damages because of the injury orc. described in Paragraphs 1)(a) A limited liability company, you are an ( orinsured. b) above; Your members are also insureds,(
but only with respect to the conduct of your d) Arising out of his or her providing business. Your managers are or failing to provide professional insureds, but only with health care services. respect to their duties as your managers. If you are not in the business of
cared. An organization other than a partnership,( providing professional health applyjoint services, Paragraph d) does not venture or limited liability company, you medicalare an to any nurse, emergency insured. Your "executive officers" and bydirectors are insureds, but only with respect technician or paramedic employed you to provide such services. to their duties as your officers or directors.
Your stockholders are also insureds, but only ( 2)" Property damage" to property:
with respect to their liability as stockholders.( a) Owned, occupied or used by,
72SBABB5126
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BUSINESS LIABILITY COVERAGE FORM
b) Rented to, in the care, custody or b. Coverage under this provision does not control of, or over which physical apply to:
control is being exercised for any ( 1)" Bodily injury" or " property damage" purpose by you, any of your that occurred; or"
employees", " volunteer workers", (
2)" Personal and advertising injury" any partner or member (if you are committeda arising out of an offense partnership or joint venture), or any member ( if you are a limited before you acquired or formed the liability company). organization.
Equipmentb. Real Estate Manager 4. Operator Of Mobile
inAny person (other than your "employee" or With respect to "mobile equipment" registered volunteer worker"), or any organization your name under any motor vehicle registration" suchwhile acting as your real estate manager. law, any person is an insured while driving yourc. equipment along a public highway with Temporary Custodians Of Your permission. Any other person or organizationPropertyresponsible isAnyfor the conduct of such person person or organization having proper also an insured, but only with respect to liabilitytemporary custody of your property if you anddie, arising out of the operation of the equipment, but only: only if no other insurance of any kind is available 1) With respect to liability arising out of the to that person or organization for this liability. maintenance or use of that property; and However, no person or organization is an insured with respect to:( 2) Until your legal representative has been appointed. a." Bodily injury" to a co-"employee" of the ord. person driving the equipment; Legal Representative If You Die Your b." Property damage" to property owned by, legal representative if you die, but byonly with rented to, in the charge of or occupied respect to duties as such. That you or the employer of any person who is representative will have all your rights and an insured under this provision. duties under this insurance.
Watercrafte. Unnamed Subsidiary 5. Operator of Nonowned Any With respect to watercraft you do not own that subsidiary and subsidiary thereof, of is less than 51 feet long and is not being used yours which is a legally incorporated entity to carry persons for a charge, any person is an of which you own a financial interest of more insured while operating such watercraft with than 50% of the voting stock on the your permission. Any other person or effective date of this Coverage Part. organization responsible for the conduct of
The insurance afforded herein for any such person is also an insured, but only with subsidiary not shown in the Declarations respect to liability arising out of the operation as a named insured does not apply to
otherinjury of the watercraft, and only if noor damage with respect to which an insurance of any kind is available to that insured under this insurance is also an
person or organization for this liability.
insured under another policy or would be
However, no person or organization is an an insured under such policy but for its insured with respect to: termination or upon the exhaustion of its limits of insurance. a." Bodily injury" to a co-"employee" of the or3. Newly Acquired Or Formed Organization person operating the watercraft; Any b." Property damage" to property owned by, organization you newly acquire or form, rented to, in the charge of or occupied by other than a partnership, joint venture or you or the employer of any person who is limited liability company, and over which you maintain an insured under this provision. financial interest of more than 50% of the voting stock, will qualify as a Named 6. Additional Insureds When Required By Insured if there is no other similar insurance Written Contract, Written Agreement Or available to that organization. However: Permit
a. Coverage under this provision is afforded The person(s) or organization(s) identified in only until the 180th day after you acquire Paragraphs a. through f. below are additional or form the organization or the end of the insureds when you have agreed, in a written policy period, whichever is earlier; and
Form SS 00 08 04 05 Page 11 of 24
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BUSINESS LIABILITY COVERAGE FORM
contract, written agreement or because of a e) Any failure to make such permit issued by a state or political inspections, adjustments, tests or subdivision, that such person or organization servicing as the vendor has be added as an additional insured on your agreed to make or normally policy, provided the injury or damage occurs undertakes to make in the usual subsequent to the execution of the contract or course of business, in connection agreement, or the issuance of the permit. with the distribution or sale of the products; A person or organization is an additional (
f) Demonstration, installation, insured under this provision only for that servicing or repair operations, period of time required by the contract, except such operations performed agreement or permit.
at the vendor's premises in
However, no such person or organization is an connection with the sale of the additional insured under this provision if such product; person or organization is included as an (
g) Products which, after distribution additional insured by an endorsement issued or sale by you, have been labeled by us and made a part of this Coverage Part, or relabeled or used as a including all persons or organizations added container, part or ingredient of any as additional insureds under the specific other thing or substance by or for additional insured coverage grants in Section orF.– Optional the vendor; Additional Insured Coverages. h)" Bodily injury" or " property a. Vendors
damage" arising out of the sole
Any person(s) or organization(s) (referred to negligence of the vendor for its below as vendor), but only with respect to own acts or omissions or those of" bodily injury" or " property damage" arising its employees or anyone else out of "your products" which are distributed
thisor acting on its behalf. However, sold in the regular course of the vendor's exclusion does not apply to:
business and only if this Coverage Part (
i) The exceptions contained in provides coverage for " bodily injury" or ( Subparagraphs d) (or ; f) or" property damage" included within the products-completed operations hazard". ii)"Such inspections, adjustments, tests or servicing as the vendor( 1) The insurance afforded to the vendor normallyis has agreed to make or subject to the following additional usualexclusions: undertakes to make in the
inThiscourse of business, insurance does not apply to: connection with the distribution a)" Bodily injury" or " property or sale of the products. damage" for which the vendor is (
anyobligated 2) This insurance does not apply toto pay damages by insured person or organization fromreason of the assumption of whom you have acquired such products, liability in a contract or agreement. or any ingredient, part or container, This exclusion does not apply to
orliability entering into, accompanyingfor damages that the containing such products. vendor would have in the absence
Equipmentof b. Lessors Of the contract or agreement;
1) Any person or organization from ( b) Any express warranty whom you lease equipment; but only unauthorized by you; with respect to their liability for "bodily (
c) Any physical or chemical change
orininjury", " property damage" the product made intentionally " personal and advertising injury" by the vendor; caused, in whole or in part, by your
d) Repackaging, except when maintenance, operation or use of unpacked solely for the purpose of equipment leased to you by such inspection, demonstration, testing, person or organization. or the substitution of parts under
instructions from the manufacturer,
and then repackaged in the
original container;
66118630 | 22- 23 WC, 21- 22 GL- HNOA, 20- 22 PL | Sherry Young | 1/ 5/ 2022 9: 11: 54 AM ( PST) | Page 4 of 15
BUSINESS LIABILITY COVERAGE FORM
2) With respect to the insurance afforded e. Permits Issued By State Or Political Subdivisionsto these additional insureds, this
insurance does not apply to any ( 1) Any state or political subdivision, but " occurrence" which takes place after operationsyou only with respect to cease to lease that equipment. performed by you or on your behalf for c. Lessors Of Land Or Premises which the state or political subdivision has issued a permit.( 1) Any person or organization from whom you lease land or premises, but 2) With respect to the insurance afforded only with respect to liability arising out to these additional insureds, this of the ownership, maintenance or use insurance does not apply to:
of that part of the land or premises ( a)" Bodily injury", "property damage" leased to you. or " personal and advertising
2) With respect to the insurance afforded injury" arising out of operations to these additional insureds, this performed for the state or insurance does not apply to: municipality; or
a) (Any " occurrence" which takes " b) Bodily injury" or "property damage" place after you cease to lease that included within the " productsland or be a tenant in that completed operations hazard". premises; or f. Any Other Party
b) Structural alterations, new ( 1) Any other person or organization who construction or demolition Paragraphsoperations is not an insured under a. performed by or on withbehalf ethrough . above, but only of such person or respect to liability for " bodily injury", organization." property damage" or " personal and
d. Architects, Engineers Or Surveyors advertising injury" caused, in whole or in part, by your acts or omissions or( 1) Any architect, engineer, or surveyor, but the acts or omissions of those acting only with respect to liability for " bodily on your behalf: injury", " property damage" or " personal and advertising injury" caused, in whole a) In the performance of your or in part, by your acts or omissions or ongoing operations; the acts or omissions of those acting on ( b) In connection with your premises your behalf: owned by or rented to you; or
a) In connection with your premises; ( c) In connection with "your work" and or included within the " productsb) In the performance of your completed operations hazard", but ongoing operations performed by only if
you or on your behalf.( i) The written contract or written 2) With respect to the insurance afforded agreement requires you to to these additional insureds, the provide such coverage to following additional exclusion applies: such additional insured; and This insurance does not apply to ii) This Coverage Part provides bodily injury", " property damage" or coverage for "bodily injury" or personal and advertising injury" " property damage" included arising out of the rendering of or the within the " productsfailure to render any professional completed operations hazard". services by or for you, including:( 2) With respect to the insurance afforded a) The preparing, approving, or to these additional insureds, this failure to prepare or approve, insurance does not apply to:
maps, shop drawings, opinions, " Bodily injury", " property damage" or reports, surveys, field orders, " personal and advertising injury" change orders, designs or arising out of the rendering of, or the drawings and specifications; or failure to render, any professional b) Supervisory, inspection, architectural, engineering or surveying architectural or engineering services, including:
activities.
Form SS 00 08 04 05 Page 13 of 24
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BUSINESS LIABILITY COVERAGE FORM
a) The preparing, approving, or This General Aggregate limit does not failure to prepare or approve, apply to " property damage" to premises maps, shop drawings, opinions, while rented to you or temporarily reports, surveys, field orders, occupied by you with permission of the change orders, designs or owner, arising out of fire, lightning or drawings and specifications; or explosion.
b) LimitSupervisory, inspection, 3. Each Occurrence
architectural or engineering whicheveractivities. bSubject to 2.a. or 2. above, applies, the most we will pay for the sum of all
The limits of insurance that apply to additional damages because of all " bodily injury", insureds are described in Section – D. Limits " property damage" and medical expenses Of Insurance. arising out of any one " occurrence" is the Liability and Medical Expenses Limit shown in How this insurance applies when other the Declarations. insurance is available to an additional insured is described in the Other Insurance Condition The most we will pay for all medical expenses in Section – E. Liability And Medical Expenses because of " bodily injury" sustained by any General Conditions. one person is the Medical Expenses Limit shown in the Declarations. No person or organization is an insured with Limitrespect to the conduct of any current or past 4. Personal And Advertising Injury partnership, joint venture or limited liability Subject to 2.b. above, the most we will pay for company that is not shown as a Named Insured in the sum of all damages because of all the Declarations." personal and advertising injury" sustained by D. LIABILITY AND MEDICAL EXPENSES any one person or organization is the Personal and Advertising Injury Limit shown in the LIMITS OF INSURANCE Declarations.
1. The Most We Will Pay
LimitThe 5. Damage To Premises Rented To YouLimits of Insurance shown in the The Damage To Premises Rented To You Declarations and the rules below fix the most Limit is the most we will pay under Business we will pay regardless of the number of:
Liability Coverage for damages because of
a. Insureds;" property damage" to any one premises, while b. Claims made or "suits" brought; or rented to you, or in the case of damage by fire, c. Persons or organizations making claims or lightning or explosion, while rented to you or bringing "suits". temporarily occupied by you with permission of the owner. 2. Aggregate Limits
In the case of damage by fire, lightning or The most we will pay for:
explosion, the Damage to Premises Rented To
a. Damages because of " bodily injury" and You Limit applies to all damage proximately " property damage" included in the caused by the same event, whether such" products-completed operations hazard" is explosionthe damage results from fire, lightning or Products-Completed Operations or any combination of these.
Aggregate Limit shown in the 6. How Limits Apply To Additional InsuredsDeclarations.
The most we will pay on behalf of a person or b. Damages because of all other " bodily organization who is an additional insured injury", " property damage" or " personal under this Coverage Part is the lesser of: and advertising injury", including medical expenses, is the General Aggregate Limit a. The limits of insurance specified in a shown written contract, written agreement or in the Declarations. permit issued by a state or political This General Aggregate Limit applies orseparatelysubdivision; to each of your " locations"
owned by or rented to you. b. The Limits of Insurance shown in the Declarations." Location" means premises involving the
same or connecting lots, or premises Such amount shall be a part of and not in whose connection is interrupted only by a addition to the Limits of Insurance shown in street, the Declarations and described in this Section. roadway or right-of-way of a railroad.
66118630 | 22- 23 WC, 21- 22 GL- HNOA, 20- 22 PL | Sherry Young | 1/ 5/ 2022 9: 11: 54 AM ( PST) | Page 6 of 15
BUSINESS LIABILITY COVERAGE FORM
If more than one limit of insurance under this 1) Immediately send us copies of any policy and any endorsements attached thereto demands, notices, summonses or applies to any claim or "suit", the most we will pay legal papers received in connection under this policy and the endorsements is the with the claim or "suit"; single highest limit of liability of all coverages ( 2) Authorize us to obtain records and applicable to such claim or " suit". However, this other information; paragraph does not apply to the Medical Expenses ( 3) Cooperate with us in the investigation, limit set forth in Paragraph 3. above. settlement of the claim or defense The andseparately Limits of Insurance of this Coverage Part apply against the "suit"; to each consecutive annual period and to ( 4) Assist us, upon our request, in the any remaining period of less than 12 months, starting enforcement of any right against any with the beginning of the policy period shown in the
person or organization that may be
Declarations, unless the policy period is extended liable to the insured because of injury after issuance for an additional period of less than 12 or damage to which this insurance
months. In that case, the additional period will be may also apply. deemed part of the last preceding period for purposes
Costof d. Obligations At The Insured's Own determining the Limits of Insurance. ownE. No insured will, except at that insured'sLIABILITY AND MEDICAL EXPENSES assumeGENERAL cost, voluntarily make a payment, CONDITIONS any obligation, or incur any expense, other
1. Bankruptcy than for first aid, without our consent.
InsuranceBankruptcy or e. Additional Insured's Other insolvency of the insured or of the insured's estate will not relieve us of our If we cover a claim or " suit" under this obligations under this Coverage Part. Coverage Part that may also be covered
2. Duties In The Event Of Occurrence, by other insurance available to an Offense, Claim Or Suit additional insured, such additional insured must submit such claim or " suit" to the a. Notice Of Occurrence Or Offense other insurer for defense and indemnity.
You or any additional insured must see to
However, this provision does not apply to it that we are notified as soon as the extent that you have agreed in a
practicable of an " occurrence" or an
written contract, written agreement or offense which may result in a claim. To permit that this insurance is primary and the extent possible, notice should include:
non-contributory with the additional (
1) How, when and where the "occurrence" insured's own insurance. or offense took place; f. Knowledge Of An Occurrence, Offense,( 2) TheSuitinjured names and addresses of any Claim Or
persons and witnesses; and
Paragraphs a. and b. apply to you or to(
3) The nature and location of any injury any additional insured only when such or damage arising out of the " occurrence", offense, claim or " suit" is " occurrence" or offense. known to:
b. Notice Of Claim ( 1) You or any additional insured that is If a claim is made or " suit" is brought an individual; against any insured, you or any additional ( 2) Any partner, if you or an additional insured must: insured is a partnership;
1) Immediately record the specifics of the ( 3) Any manager, if you or an additional claim or "suit" and the date received; insured is a limited liability company; and ( 4) Any " executive officer" or insurance (
2) Notify us as soon as practicable. manager, if you or an additional You or any additional insured must see to insured is a corporation; it that we receive a written notice of the ( 5) Any trustee, if you or an additional claim or "suit" as soon as practicable. insured is a trust; or c. Assistance And Cooperation Of The ( 6) Any elected or appointed official, if you Insured or an additional insured is a political
You and any other involved insured must: subdivision or public entity.
Form SS 00 08 04 05 Page 15 of 24
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BUSINESS LIABILITY COVERAGE FORM
This Paragraph f. (applies separately to 3) We have issued this policy in reliance you and any additional insured. upon your representations.
3. Financial
Hazardsa.
Responsibility Laws b. Unintentional Failure To Disclose When this policy is certified as proof of
financial responsibility for the future under If unintentionally you should fail to disclose the provisions of any motor vehicle all hazards relating to the conduct of your financial responsibility law, the insurance business at the inception date of this provided by the policy for " bodily injury" Coverage Part, we shall not deny any liability and "property damage" liability will coverage under this Coverage Part comply with the provisions of the law to because of such failure. the extent of the coverage and limits of 7. Other Insuranceinsurance required by that law.
If other valid and collectible insurance is
b. With respect to " mobile equipment" to available for a loss we cover under this which this insurance applies, we will Coverage Part, our obligations are limited as provide any liability, uninsured motorists, follows:
underinsured motorists, no-fault or other
Insurancecoverage a. Primary required by any motor vehicle law. We will provide the required limits for This insurance is primary except when b. those coverages. below applies. If other insurance is also primary, we will share with all that other 4. Legal Action Against Us inNoinsurance by the method described c.person or organization has a right under below. this Coverage Form:
Insurancea. b. Excess To join us as a party or otherwise bring us into a "suit" asking for damages from an This insurance is excess over any of the other insurance, whether primary, excess, insured; or
contingent or on any other basis: b. To sue us on this Coverage Form unless Workall of its terms have been fully complied 1) Your
with. That is Fire, Extended Coverage,
A person or organization may sue us to recover Builder's Risk, Installation Risk or on an agreed settlement or on a final judgment similar coverage for "your work"; against an insured; but we will not be liable for ( 2) Premises Rented To You damages that are not payable under the terms of That is fire, lightning or explosion this insurance or that are in excess of the insurance for premises rented to you applicable limit of insurance. An agreed or temporarily occupied by you with settlement means a settlement and release of permission of the owner; liability signed by us, the insured and the Liabilityclaimant or 3) Tenant the claimant's legal representative.
5. Separation Of Insureds That is insurance purchased by you to cover your liability as a tenant for Except with respect to the Limits of Insurance, " property damage" to premises rented and any rights or duties specifically assigned to you or temporarily occupied by you in this policy to the first Named Insured, this with permission of the owner; insurance applies:
Watercrafta. 4) Aircraft, Auto Or As if each Named Insured were the only maintenanceNamed Insured; and If the loss arises out of the tob. or use of aircraft, "autos" or watercraft Separately to each insured against whom ofathe extent not subject to Exclusion g. claim is made or "suit" is brought. Section – A. Coverages.
6. Representations ( 5) Property Damage To Borrowed
a. When You Accept This Policy Equipment Or Use Of Elevators By accepting this policy, you agree: If the loss arises out of " property 1) The statements in the Declarations damage" to borrowed equipment or ( are accurate and complete; the use of elevators to the extent not subject to Exclusion k. of Section –(A. 2) Those statements are based upon Coverages. representations you made to us; and
66118630 | 22- 23 WC, 21- 22 GL- HNOA, 20- 22 PL | Sherry Young | 1/ 5/ 2022 9: 11: 54 AM ( PST) | Page 8 of 15
BUSINESS LIABILITY COVERAGE FORM
6) When You Are Added As An When this insurance is excess over other Additional Insured To Other insurance, we will pay only our share of Insurance the amount of the loss, if any, that
exceeds the sum of: That is other insurance available to you covering liability for damages 1) The total amount that all such other arising out of the premises or insurance would pay for the loss in the operations, or products and completed absence of this insurance; and operations, for which you have been ( 2) The total of all deductible and selfadded as an additional insured by that insured amounts under all that other insurance; or insurance.
7) When withAdditional You Add Others As An We will share the remaining loss, if any, Insured To This any other insurance that is not described inInsurancethis Excess Insurance provision and was not That is other insurance available to an bought specifically to apply in excess of the additional insured. Limits of Insurance shown in the
Declarations of this Coverage Part. However, the following provisions Sharingapply to other insurance available to c. Method Of any person or organization who is an If all the other insurance permits additional insured under this Coverage contribution by equal shares, we will follow Part: this method also. Under this approach,
a) Primary Insurance When each insurer contributes equal amounts Required By Contract until it has paid its applicable limit of insurance or none of the loss remains, This insurance is primary if you whichever comes first. have agreed in a written contract, written agreement or permit that If any of the other insurance does not permit this insurance be primary. If other contribution by equal shares, we will insurance is also primary, we will contribute by limits. Under this method, each share with all that other insurance insurer’s share is based on the ratio of its by the method described in c. applicable limit of insurance to the total below. applicable limits of insurance of all insurers.
b) Primary And Non-Contributory 8. Transfer Of Rights Of Recovery Against To Other Insurance When Others To Us
Required By Contract a. Transfer Of Rights Of Recovery
If you have agreed in a written If the insured has rights to recover all or contract, written agreement or part of any payment, including permit that this insurance is Supplementary Payments, we have made primary and non-contributory with aretheunder this Coverage Part, those rights additional insured's own transferred to us. The insured must do insurance, this insurance is nothing after loss to impair them. At our primary and we will not seek request, the insured will bring " suit" or contribution from that other transfer those rights to us and help us insurance. enforce them. This condition does not
Paragraphs a) (and b) do not apply to apply to Medical Expenses Coverage. other insurance to which the additional b. Waiver Of Rights Of Recovery (Waiver insured has been added as an Of Subrogation)
additional insured.
If the insured has waived any rights of
When this insurance is excess, we will recovery against any person or have no duty under this Coverage Part to organization for all or part of any payment, defend the insured against any "suit" if any including Supplementary Payments, we other insurer has a duty to defend the have made under this Coverage Part, we insured against that " suit". If no other also waive that right, provided the insured insurer defends, we will undertake to do againstso, waived their rights of recovery but we will be entitled to the insured's
such person or organization in a contract,
rights against all those other insurers. agreement or permit that was executed prior to the injury or damage.
Form SS 00 08 04 05 Page 17 of 24
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BUSINESS LIABILITY COVERAGE FORM
FranchiseF. OPTIONAL ADDITIONAL 3. Additional Insured - Grantor Of INSURED isCOVERAGES WHO IS AN INSURED under Section C.
amended to include as an additional insured If listed or shown as applicable in the Declarations, the person(s) or organization(s) shown in the one or more of the following Optional Additional Declarations as an Additional Insured - Insured Coverages also apply. When any of these Grantor Of Franchise, but only with respect to Optional Additional Insured Coverages apply, their liability as grantor of franchise to you. Paragraph (6. Additional Insureds When Required Leasedby Written Contract, Written Agreement or Permit) 4. Additional Insured - Lessor Of of Section , EquipmentC. Who Is An Insured, does not apply to the person or organization shown in the a. WHO IS AN INSURED under Section C. is Declarations. These coverages are subject to the amended to include as an additional terms and conditions applicable to Business insured the person(s) or organization(s) Liability Coverage in this policy, except as shown in the Declarations as an Additional provided below: Insured – Lessor of Leased Equipment,
1. Additional Insured - Designated Person Or but only with respect to liability for "bodily Organization injury", " property damage" or " personal
and advertising injury" caused, in whole or WHO IS AN INSURED under Section C. is oramended in part, by your maintenance, operation to include as an additional insured use of equipment leased to you by such the person(s) or organization(s) shown in the person(s) or organization(s). Declarations, but only with respect to liability for " bodily injury", " property damage" or b. With respect to the insurance afforded to personal and advertising injury" caused, in these additional insureds, this insurance " whole or in part, by your acts or omissions or does not apply to any "occurrence" which the acts or omissions of those acting on your takes place after you cease to lease that behalf: equipment.
a. In the performance of your ongoing 5. Additional Insured - Owners Or Other operations; or Interests From Whom Land Has Been
Leasedb. In connection with your premises owned
by or rented to you. a. WHO IS AN INSURED under Section C. is amended to include as an additional 2. Additional Insured - Managers Or Lessors insured the person(s) or organization(s) Of Premises
shown in the Declarations as an Additional
a. WHO IS AN INSURED under Section C. is Fromamended Insured – Owners Or Other Interests to include as an additional insured Whom Land Has Been Leased, but only the person(s) or organization(s) shown in the with respect to liability arising out of the Declarations as an Additional Insured - ownership, maintenance or use of that part Designated Person Or Organization; but only of the land leased to you and shown in the with respect to liability arising out of the Declarations. ownership, maintenance or use of that part of
b. With respect to the insurance afforded to the premises leased to you and shown in the these additional insureds, the following Declarations.
additional exclusions apply:
b. With respect to the insurance afforded to
This insurance does not apply to: these additional insureds, the following additional exclusions apply: 1) Any " occurrence" that takes place orThisafter you cease to lease that land; insurance does not apply to:
2) Structural alterations, new ( 1) Any " occurrence" which takes place construction or demolition operations after you cease to be a tenant in that performed by or on behalf of such premises; or
person or organization.(
2) Structural alterations, new
Politicalconstruction 6. Additional Insured - State Oror demolition operations Permitsperformed Subdivision – by or on behalf of such
isperson or organization. a. WHO IS AN INSURED under Section C. amended to include as an additional
insured the state or political subdivision
shown in the Declarations as an Additional
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BUSINESS LIABILITY COVERAGE FORM
Insured – State Or Political Subdivision - e) Any failure to make such Permits, but only with respect to inspections, adjustments, tests or operations performed by you or on your servicing as the vendor has agreed behalf for which the state or political to make or normally undertakes to subdivision has issued a permit. make in the usual course of theb. With business, in connection with respect to the insurance afforded to distribution or sale of the products; these additional insureds, the following additional exclusions apply: f) Demonstration, installation, servicing or repair operations, This insurance does not apply to:
except such operations performed (
1)" Bodily injury", " property damage" or at the vendor's premises in " personal and advertising injury" thearising connection with the sale of out of operations performed for product;
the state or municipality; or (
g) Products which, after distribution (
2)" Bodily injury" or " property damage" or sale by you, have been labeled included in the " product-completed or relabeled or used as a operations" hazard. container, part or ingredient of any
7. Additional Insured – Vendors other thing or substance by or for ora. WHO C. the vendor; IS AN INSURED under Section is
amended to include as an additional ( h)" Bodily injury" or " property insured the person(s) or organization(s) damage" arising out of the sole referred to below as vendor) shown in the negligence of the vendor for its Declarations as an Additional Insured - own acts or omissions or those of Vendor, but only with respect to " bodily its employees or anyone else injury" or "property damage" arising out of acting on its behalf. However, this your products" which are distributed or exclusion does not apply to:
sold in the regular course of the vendor's ( i) The exceptions contained in business and only if this Coverage Part ( orprovides Subparagraphs d) (or ; f) coverage for " bodily injury" or (
ii) Such inspections, " property damage" included within the adjustments, tests or servicing " products-completed operations hazard". as the vendor has agreed to
b. The insurance afforded to the vendor is make or normally undertakes subject to the following additional exclusions: to make in the usual course of 1) This insurance does not apply to: business, in connection with a)" Bodily the distribution or sale of the ( injury" or " property products. damage" for which the vendor is
obligated to pay damages by ( 2) This insurance does not apply to any reason of the assumption of insured person or organization from liability in a contract or agreement. whom you have acquired such This exclusion does not apply to products, or any ingredient, part or liability for damages that the container, entering into, vendor would have in the absence accompanying or containing such of the contract or agreement; products.
b) Any express warranty 8. Additional Insured – Controlling Interest unauthorized by you; WHO IS AN INSURED under Section C. is c) Any physical or chemical change amended to include as an additional insured in the product made intentionally the person(s) or organization(s) shown in the by the vendor; Declarations as an Additional Insured –
d) Repackaging, Controlling Interest, but only with respect to ( unless unpacked their liability arising out of: solely for the purpose of inspection, demonstration, testing, or the a. Their financial control of you; or substitution of parts under b. Premises they own, maintain or control instructions from the manufacturer, while you lease or occupy these premises. and then repackaged in the original
container;
Form SS 00 08 04 05 Page 19 of 24
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BUSINESS LIABILITY COVERAGE FORM
This insurance does not apply to structural The limits of insurance that apply to additional alterations, new construction and demolition insureds are described in Section – D. Limits Of operations performed by or for that person or Insurance. organization. How this insurance applies when other insurance
9. Additional Insured – Owners, Lessees Or is available to an additional insured is described in Contractors – Scheduled Person Or the Other Insurance Condition in Section –E.
Organization Liability And Medical Expenses General
a. WHO C. Conditions. IS AN INSURED under Section is
amended to include as an additional G. LIABILITY AND MEDICAL EXPENSES insured the person(s) or organization(s) DEFINITIONSshown in the Declarations as an Additional
1." Advertisement" means the widespread public Insured – Owner, Lessees Or Contractors, but only with dissemination of information or images that respect to liability for "bodily has the purpose of inducing the sale of goods, injury", " property damage" or " personal and advertising products or services through: injury" caused, in whole or in part, by your acts or omissions or the a. ( 1) Radio; acts or omissions of those acting on your ( 2) Television; behalf:( 3) Billboard;(
1) In the performance of your ongoing ( 4) Magazine;
operations for the additional (
5) Newspaper; insured(s); or
b. The Internet, but only that part of a web ( 2) In connection with " your work" site that is about goods, products or performed for that additional insured services for the purposes of inducing the and included within the " productsorcompleted sale of goods, products or services; operations hazard", but only if this Coverage Part provides c. Any other publication that is given coverage for " bodily injury" or widespread public distribution. property damage" included within the However, "advertisement" does not include:" products-completed operations
a. The design, printed material, information hazard".
or images contained in, on or upon the
b. With respect to the insurance afforded to packaging or labeling of any goods or these additional insureds, this insurance ordoesproducts; not apply to "bodily injury", "property
ordamage" b. An interactive conversation between or " personal an advertising among persons through a computer network. injury" arising out of the rendering of, or the failure to render, any professional 2." Advertising idea" means any idea for an architectural, engineering or surveying advertisement". services, including: 3." Asbestos hazard" means an exposure or 1) The preparing, approving, or threat of exposure to the actual or alleged( failure to prepare or approve, maps, shop properties of asbestos and includes the mere drawings, opinions, presence of asbestos in any form. reports, surveys, field orders, change orders, designs or 4." Auto" means a land motor vehicle, trailer or drawings and specifications; or semi-trailer designed for travel on public 2) Supervisory, roads, including any attached machinery or ( inspection, architectural or engineering activities. equipment. But " auto" does not include mobile equipment". 10. Additional Insured – Co-Owner Of Insured Premises 5." Bodily injury" means physical:
WHO C. a. Injury; IS AN INSURED under Section is
amended to include as an additional insured b. Sickness; or the person(s) or Organization(s) shown in the
DiseaseDeclarations c.as an Additional Insured – CoOwner Of sustained by a person and, if arising out of the Insured Premises, but only with above, mental anguish or death at any time. respect to their liability as co-owner of the premises shown in the Declarations. 6." Coverage territory" means:
66118630 | 22- 23 WC, 21- 22 GL- HNOA, 20- 22 PL | Sherry Young | 1/ 5/ 2022 9: 11: 54 AM ( PST) | Page 12 of 15 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
Form SS 04 38 09 09 Page 1 of 3
2009, The Hartford
Includes copyrighted material of ISO Properties, Inc., with its permission)
HIRED AUTO AND NON-OWNED AUTO
This endorsement modifies insurance provided under the following:
BUSINESS LIABILITY COVERAGE FORM
This coverage is subject to all provisions in the
BUSINESS LIABILITY COVERAGE FORM not
expressly modified herein:
A. Amended Coverage:
Coverage is extended to " bodily injury" and
property damage" arising out of the use of a "hired
auto" and "non-owned auto".
B. Paragraph B. EXCLUSIONS is amended as
follows:
1. Exclusion g. Aircraft, Auto or Watercraft does
not apply to a " hired auto" or a " non-owned
auto".
2. Exclusion e. Employers Liability does not
apply to "bodily injury" to domestic "employees"
not entitled to workers’ compensation benefits
or to liability assumed by the "insured" under an
insured contract".
3. Exclusion f. Pollution is replaced by the
following:
Bodily injury" or "property damage" arising out
of the actual, alleged or threatened discharge,
dispersal, seepage, migration, release or
escape of "pollutants":
a. That are, or that are contained in any
property that is:
1) Being transported or towed by, handled,
or handled for movement into, onto or
from, the covered "auto";
2) Otherwise in the course of transit by or
on behalf of the "insured"; or
3) Being stored, disposed of, treated or
processed in or upon the covered
auto".
b. Before the " pollutants" or any property in
which the " pollutants" are contained are
moved from the place where they are
accepted by the "insured" for movement into
or onto the covered "auto"; or
c. After the " pollutants" or any property in
which the " pollutants" are contained are
moved from the covered "auto" to the place
where they are finally delivered, disposed of
or abandoned by the "insured".
Paragraph a. above does not apply to fuels,
lubricants, fluids, exhaust gases or other
similar " pollutants" that are needed for or
result from the normal electrical, hydraulic
or mechanical functioning of the covered
auto" or its parts, if:
1) The "pollutants" escape, seep, migrate,
or are discharged or released directly
from an " auto" part designed by its
manufacturer to hold, store, receive, or
dispose of such "pollutants"; and
2) The " bodily injury" and " property
damage" does not arise out of the
operation of any equipment listed in
paragraphs 15.b. and 15.c. of the
definition of "mobile equipment".
Paragraphs b. and c. above do not apply to
accidents" that occur away from premises
owned by or rented to an " insured" with
respect to " pollutants" not in or upon a
covered "auto" if:
1) The " pollutants" or any property in
which the "pollutants" are contained are
upset, overturned or damaged as a
result of the maintenance or use of a
covered "auto"; and
72SBABB5126
66118630 | 22- 23 WC, 21- 22 GL- HNOA, 20- 22 PL | Sherry Young | 1/ 5/ 2022 9: 11: 54 AM ( PST) | Page 13 of 15 Policy Number: 72SBAAP6869
2) The discharge, dispersal, seepage,
migration, release or escape of the
pollutants" is caused directly by such
upset, overturn or damage as a result of
the maintenance or use of a covered
auto".
4. With respect to this coverage, the following
additional exclusions apply:
a. Fellow employee
Coverage does not apply to "bodily injury" to
any fellow " employee" of the " insured"
arising out of the operation of an " auto"
owned by the "insured" in the course of the
fellow "employee’s" employment.
b. Care, custody or control
Coverage does not apply to " property
damage" involving property owned or
transported by the " insured" or in the
insured’s" care, custody or control.
C. With respect to "hired auto" and "non-owned auto"
coverage, Paragraph C. WHO IS AN INSURED is
deleted and replaced by the following:
The following are "insureds":
a. You.
b. Your " employee" while using with your
permission:
1) An "auto" you hire or borrow; or
2) An " auto" you don’t own, hire or borrow in
your business or personal affairs; or
3) An " auto" hired or rented by your
employee" on your behalf and at your
direction.
c. Anyone else while using a "hired auto" or "nonowned auto" with your permission except:
1) The owner or anyone else from whom you
hire or borrow an "auto".
2) Someone using an auto while he or she is
working in a business of selling, servicing,
repairing, parking or storing "autos" unless
that business is yours.
3) Anyone other than your " employees",
partners (if you are a partnership), members
if you are a limited liability company), or a
lessee or borrower or any of their
employees", while moving property to or
from an "auto".
4) A partner ( if you are a partnership), or a
member ( if you are a limited liability
company) for an "auto" owned by him or her
or a member of his or her household.
d. Anyone liable for the conduct of an " insured"
described above but only to the extent of that
liability.
D. With respect to the operation of a "hired auto" and
non-owned auto", the following additional
conditions apply:
1. OTHER INSURANCE
a. Except for any liability assumed under an
insured contract" the insurance provided by
this Coverage Form is excess over any
other collectible insurance.
However, if your business is the selling,
servicing, repairing, parking or storage of
autos", the insurance provided by this
endorsement is primary when covered
bodily injury" or " property damage" arises
out of the operation of a customer’s "auto"
by you or your "employee".
b. When this Coverage Form and any other
Coverage Form or policy covers on the
same basis, either excess or primary, we
will pay only our share. Our share is the
proportion that the Limit of Insurance of our
Coverage Form bears to the total of the
limits of all the Coverage Forms and policies
covering on the same basis.
2. TWO OR MORE COVERAGE FORMS OR
POLICIES ISSUED BY US
If the Coverage Form and any other Coverage
Form or policy issued to you by us or any
company affiliated with us apply to the same
accident", the aggregate maximum Limit of
Insurance under all the Coverage Forms or
policies shall not exceed the highest applicable
Limit of Insurance under any one Coverage
Form or policy. This condition does not apply to
any Coverage Form or policy issued by us or an
affiliated company specifically to apply as
excess insurance over this Coverage Form.
E. The following definitions are added:
G. LIABILITY AND MEDICAL EXPENSES
DEFINITIONS:
1." Hired auto" means any " auto" you lease,
hire, rent or borrow. This does not include
any auto you lease, hire, rent or borrow
from any of your "employees", your partners
if you are a partnership), members (if you
are a limited liability company),
66118630 | 22- 23 WC, 21- 22 GL- HNOA, 20- 22 PL | Sherry Young | 1/ 5/ 2022 9: 11: 54 AM ( PST) | Page 14 of 15 Form SS 04 38 09 09 Page 3 of 3
or your "executive officers" or members of
their households.
This does not include a long-term leased
auto" that you insure as an owned " auto"
under any other auto liability insurance
policy or a temporary substitute for an
auto" you own that is out of service
because of its breakdown, repair, servicing
or destruction.
2." Non-owned auto " means any " auto" you
do not own, lease, hire, rent or borrow
which is used in connection with your
business. This includes:
a." Autos" owned by your "employees" your
partners ( if you are a partnership),
members ( if you are a limited liability
company), or your " executive officers",
or members of their households, but
only while used in your business or your
personal affairs.
b. Customer’s " auto" that is in your care,
custody or control for service.
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