ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED?
INSR ADDL SUBR
LTR INSD WVD
PRODUCER CONTACT NAME: PHONE FAX
(A/C, No, Ext): (A/C, No): E-MAIL ADDRESS:
INSURER A :
INSURED INSURER B :
INSURER C :
INSURER D :
INSURER E :
INSURER F :
POLICY NUMBER POLICY EFF POLICY EXP TYPE OF INSURANCE (MM/DD/YYYY) (MM/DD/YYYY) LIMITS
AUTOMOBILE LIABILITY
UMBRELLA LIAB
EXCESS LIAB WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
AUTHORIZED REPRESENTATIVE
EACH OCCURRENCE $ DAMAGE TO RENTED CLAIMS-MADE OCCUR PREMISES (Ea occurrence) $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ PRO- POLICY JECT LOC PRODUCTS - COMP/OP AGG OTHER: $ COMBINED SINGLE LIMIT
(Ea accident) $ ANY AUTO BODILY INJURY (Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ HIRED NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY (Per accident) $
$ OCCUR EACH OCCURRENCE CLAIMS-MADE AGGREGATE $ DED RETENTION $ PER OTH- STATUTE ER E.L. EACH ACCIDENT E.L. DISEASE - EA EMPLOYEE $
If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT INSURER(S) AFFORDING COVERAGE NAIC #
COMMERCIAL GENERAL LIABILITY
Y / N
N / A
(Mandatory in NH)
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS.
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed.
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
CERTIFICATE HOLDER CANCELLATION
ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved.
CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY)
$
$
$
$
$
The ACORD name and logo are registered marks of ACORD
10/18/2023
(323) 400-6705
31534
Auto-Graphics, Inc.
c/o Bryan Straight
15218 Summit Ave, #300-240
Fontana, CA 92336
41840
10200
A 2,000,000
OB3H750195-02 9/1/2023 9/1/2024 1,000,000
BUSINESS OWNERS 5,000
2,000,000
4,000,000
4,000,000
B 1,000,000
AW3H750128-02 9/1/2023 9/1/2024
A 2,000,000
OB3H750195-02 9/1/2023 9/1/2024 2,000,000
0 C
72WECAB3XRO 5/1/2023 5/1/2024 1,000,000 Y 1,000,000
1,000,000
D Media/Tech/Cyber* MPL1644550.23 5/1/2023 Ded: $5000, Limit 3,000,000 * Includes: Cyber & Incident Response, Network and Information Security & Privacy Liability, Third Party Privacy Breach Management Costs.
Certificate holder is named ADDITIONAL INSURED with respects to services & work performed and/or provided by the Named Insured.
Redondo Beach Public Library
303 N. Pacific Coast Highway
Redondo Beach, CA 90277
AUTOINC-01 AANAYA
PIASC Insurance Services, Inc.
5800 S. Eastern Avenue
Suite 400
Los Angeles, CA 90040
[email protected]
Citizens Insurance Co of Ameri
Allmerica Financial Benefit
Hartford Insurance Group
Hiscox Insurance Company, Inc.
X
5/1/2024
X
X
X
X
X
X
X
X
~
!&~Hanover
Insurance Group ..
OB3 H750195 1001328
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
BUSINESSOWNERS LIABILITY SPECIAL BROADENING ENDORSEMENT This endorsement modifies insurance provided under the following:
BUSINESSOWNERS COVERAGE FORM
SUMMARY OF COVERAGES Limits Page
1. Additional Insured by Contract, Agreement or Permit Included 1
2. Additional Insured - Broad Form Vendors Included 2
3. Alienated Premises Included 3
4. Broad Form Property Damage - Borrowed Equipment, Customers Included 3 Goods and Use of Elevators
5. Incidental Malpractice (Employed Nurses, EMT's and Paramedics) Included 3
6. Personal and Advertising Injury - Broad Form Included 4
7. Product Recall Expense Included 4
Product Recall Expense Each Occurrence Limit $25,000 5 Occurrence Product Recall Expense Aggregate Limit $50,000 5 Aggregate Product Recall Deductible $500 5
8. Unintentional Failure to Disclose Hazards Included 6
9. Unintentional Failure to Notify Included 6
This endorsement amends coverages provided under the Businessowners Coverage Form through new coverages and broader coverage grants. This coverage is subject to the provisions applicable to the Businessowners Coverage Form, except as provided below.
The following changes are made to SECTION II -
LIABILITY:
1. Additional Insured by Contract, Agreement or
Permit
The following is added to SECTION II -
LIABILITY, C. Who Is An Insured:
Additional Insured by Contract, Agreement or
Permit
a. Any person or organization with whom you
agreed in a written contract, written
agreement or permit to add such person or
organization as an additional insured on
your policy is an additional insured only with
respect to liability for "bodily injury",
"property damage", or "personal and
advertising injury" caused, in whole or in
part, by your acts or omissions, or the acts
or omissions of those acting on your behalf,
but only with respect to:
(1) "Your work" for the additional insured(s)
designated in the contract, agreement or
permit;
(2) Premises you own, rent, lease or
occupy; or
(3) Your maintenance, operation or use of
equipment leased to you.
b. The insurance afforded to such additional
insured described above:
(1) Only applies to the extent permitted by
law; and
(2) Will not be broader than the insurance
which you are required by the contract,
agreement or permit to provide for such
additional insured.
(3) Applies on a primary basis if that is
required by the written contract, written
agreement or permit.
(4) Will not be broader than coverage
provided to any other insured.
(5) Does not apply if the "bodily injury",
"property damage" or "personal and
advertising injury" is otherwise excluded
from coverage under this Coverage Part,
including any endorsements thereto.
391-1006 08 16 Includes copyrighted materials of Insurance Services Offices, Inc., with its permission. Page 1 of 6 c. This provision does not apply:
(1) Unless the written contract or written
agreement was executed or permit was
issued prior to the "bodily injury",
"property damage", or "personal injury
and advertising injury".
(2) To any person or organization included
as an insured by another endorsement
issued by us and made part of this
Coverage Part.
(3) To any lessor of equipment:
(a) After the equipment lease expires; or
(b) If the "bodily injury", "property
damage", "personal and advertising
injury" arises out of sole negligence
of the lessor.
(4) To any:
(a) Owners or other interests from whom
land has been leased if the
"occurrence" takes place or the
offense is committed after the lease
for the land expires; or
(b) Managers or lessors of premises if:
(i) The "occurrence" takes place or
the offense is committed after
you cease to be a tenant in that
premises; or
(ii) The "bodily injury", "property
damage", "personal injury" or
"advertising injury" arises out of
structural alterations, new
construction or demolition
operations performed by or on
behalf of the manager or lessor.
(5) To "bodily injury", "property damage" or
"personal and advertising injury" arising
out of the rendering of or the failure to
render any professional services.
This exclusion applies even if the claims
against any insured allege negligence or
other wrongdoing in the supervision,
hiring, employment, training or
monitoring of others by that insured, if
the "occurrence" which caused the
"bodily injury" or "property damage" or
the offense which caused the "personal
and advertising injury" involved the
rendering of or failure to render any
professional services by or for you.
d. With respect to the insurance afforded to
these additional insureds, the following is
added to SECTION II - LIABILITY, D. Liability
and Medical Expense Limits of Insurance:
The most we will pay on behalf of the
additional insured for a covered claim is the
lesser of the amount of insurance:
1. Required by the contract, agreement or
permit described in Paragraph a.; or
2. Available under the applicable Limits of
Insurance shown in the Declarations.
This endorsement shall not increase the
applicable Limits of Insurance shown in the
Declarations
e. All other insuring agreements, exclusions,
and conditions of the policy apply.
2. Additional Insured - Broad Form Vendors
The following is added to SECTION II -
LIABILITY, C. Who Is An Insured:
Additional Insured - Broad Form Vendors
a. Any person or organization that is a vendor
with whom you agreed in a written contract
or written agreement to include as an
additional insured under this Coverage Part
is an insured, but only with respect to liability
for "bodily injury" or "property damage"
arising out of "your products" which are
distributed or sold in the regular course of
the vendor's business.
b. The insurance afforded to such vendor
described above:
(1) Only applies to the extent permitted by
law;
(2) Will not be broader than the insurance
which you are required by the contract or
agreement to provide for such vendor;
(3) Will not be broader than coverage
provided to any other insured; and
(4) Does not apply if the "bodily injury",
"property damage" or "personal and
advertising injury" is otherwise excluded
from coverage under this Coverage Part,
including any endorsements thereto
c. With respect to insurance afforded to such
vendors, the following additional exclusions
apply:
The insurance afforded to the vendor does
not apply to:
(1) "Bodily injury" or "property damage" for
which the vendor is obligated to pay
damages by reasons of the assumption of
liability in a contract or agreement. This
exclusion does not apply to liability for
damages that the insured would have in
the absence of the contract or
agreement;
(2) Any express warranty unauthorized by
you;
391-1006 0816 Includes copyrighted materials of Insurance Services Offices, Inc., with its permission. Page 2 of 6 (3) Any physical or chemical change in the
product made intentionally by the
vendor;
(4) Repackaging, unless unpacked solely for
the purpose of inspection,
demonstration, testing, or the
substitution of parts under instruction
from the manufacturer, and then
repackaged in the original container;
~
!&~Hanover
Insurance Group ..
OB3 H750195 1001328
The most we will pay on behalf of the vendor
for a covered claim is the lesser of the
amount of insurance:
1. Required by the contract or agreement
described in Paragraph a.; or
2. Available under the applicable Limits of
Insurance shown in the Declarations;
This endorsement shall not increase the
applicable Limits of Insurance shown in the
Declarations. (5) Any failure to make such inspection,
adjustments, tests or servicing as the
vendor has agreed to make or normally
undertakes to make in the usual course
3. Alienated Premises
of business in connection with the sale
of the product;
(6) Demonstration, installation, servicing or
repair operations, except such
operations performed at the vendor's
premises in connection with the sale of
the product;
(7) Products which, after distribution or sale
SECTION II - LIABILITY, B. Exclusions, 1.
Applicable To Business Liability Coverage k.
Damage to Property, paragraph (2) is replaced by
the following :
(2) Premises you sell, give away or abandon, if
the "property damage" arises out of any part
of those premises and occurred from hazards
that were known by you, or should have
reasonably been known by you, at the time
by you, have been the property was transferred or abandoned. labeled or relabeled or used as a container, part or
ingredient of any other thing or
substance by or for the vendor;
4. Broad Form Property Damage - Borrowed
Equipment, Customers Goods, Use of Elevators
(8) "Bodily injury" or "property damage"
arising out of the sole negligence of the
vendor for its own acts or omissions or
those of its employees or anyone else
acting on its behalf. However, this
exclusion does not apply to:
(a) The exceptions contained within the
exclusion in subparagraphs (4) or (6)
above; or
(b) Such inspections, adjustments, tests
or servicing as the vendor has
agreed to make or normally
undertakes to make in the usual
course of business, in connection
with the distribution or sale of the
products.
(9) "Bodily injury" or "property damage"
arising out of an "occurrence" that took
place before you have signed the
contract or agreement with the vendor.
(10)To any person or organization included
as an insured by another endorsement
issued by us and made part of this
Coverage Part.
(11)Any insured person or organization,
from whom you have acquired such
products, or any ingredient, part or
container, entering into, accompanying 5.
or containing such products.
d. With respect to the insurance afforded to
these vendors, the following is added to
SECTION II - LIABILITY, D. Liability and
Medical Expense Limits of Insurance :
a. The following is added to SECTION II - LIABILITY, B. Exclusions, 1. Applicable To Business Liability Coverage, k. Damage to
Property:
Paragraph (4) does not apply to "property
damage" to borrowed equipment while at a
jobsite and not being used to perform
operations.
Paragraph (3), (4) and (6) do not apply to
"property damage" to "customers goods"
while on your premises nor to the use of
elevators.
b. For the purposes of this endorsement, the
following definition is added to SECTION II - LIABILITY, F. Liability and Medical Expenses Definitions:
1. "Customers goods" means property of
your customer on your premises for the
purpose of being:
a. Worked on; or
b. Used in your manufacturing process.
c. The insurance afforded under this provision is
excess over any other valid and collectible
property insurance (including deductible)
available to the insured whether primary,
excess, contingent or on any other basis.
Incidental Malpractice - Employed Nurses, EMT's
and Paramedics
SECTION II - LIABILITY, C. Who Is An Insured ,
paragraph 2.a.(1)(d) does not apply to a nurse,
391-1006 08 16 Includes copyrighted materials of Insurance Services Offices, Inc., with its permission. Page 3 of 6 emergency medical technician or paramedic
employed by you if you are not engaged in the
business or occupation of providing medical,
paramedical, surgical, dental, x-ray or nursing
services.
6. Personal Injury - Broad Form
a. SECTION II - LIABILITY, B. Exclusions, 2.
Additional Exclusions Applicable only to
"Personal and Advertising Injury", paragraph
e. is deleted.
b. SECTION II - LIABILITY, F. Liability and
Medical Expenses Definitions, 14. "Personal
and advertising injury", paragraph b. is
replaced by the following:
b. Malicious prosecution or abuse of
process.
c. The following is added to SECTION II - LIABILITY, F. Liability and Medical Expenses Definitions, Definition 14. "Personal and
advertising injury":
"Discrimination" (unless insurance thereof is
prohibited by law) that results in injury to the
feelings or reputation of a natural person,
but only if such "discrimination" is:
(1) Not done intentionally by or at the
direction of:
(a) The insured;
(b) Any officer of the corporation,
director, stockholder, partner or
member of the insured; and
(2) Not directly or indirectly related to an
"employee", not to the employment,
prospective employment or termination
of any person or persons by an insured.
d. For purposes of this endorsement, the
following definition is added to SECTION II -
LIABILITY, F. Liability and Medical Expenses
Definitions:
1. "Discrimination" means the unlawful
treatment of individuals based upon race,
color, ethnic origin, gender, religion, age,
or sexual preference. "Discrimination"
does not include the unlawful treatment
of individuals based upon developmental,
physical, cognitive, mental, sensory or
emotional impairment or any
combination of these.
e. This coverage does not apply if liability
coverage for "personal and advertising
injury" is excluded either by the provisions of
the Coverage Form or any endorsement
thereto.
7. Product Recall Expense
a. SECTION II - LIABILITY, B. Exclusions, 1.
Applicable To Business Liability Coverage,
o. Recall of Products, Work or Impaired
Property is replaced by the following:
o. Recall of Products, Work or Impaired
Property
Damages claimed for any loss, cost or
expense incurred by you or others for
the loss of use, withdrawal, recall,
inspection, repair, replacement,
adjustment, removal or disposal of:
(1) "Your product";
(2) "Your work"; or
(3) "Impaired property";
If such product, work or property is
withdrawn or recalled from the market or
from use by any person or organization
because of a known or suspected defect,
deficiency, inadequacy or dangerous
condition in it, but this exclusion does
not apply to "product recall expenses"
that you incur for the "covered recall" of
"your product".
However, the exception to the exclusion
does not apply to "product recall
expenses" resulting from:
(4) Failure of any products to accomplish
their intended purpose;
(5) Breach of warranties of fitness,
quality, durability or performance;
(6) Loss of customer approval, or any
cost incurred to regain customer
approval;
(7) Redistribution or replacement of
"your product" which has been
recalled by like products or
substitutes;
(8) Caprice or whim of the insured;
(9) A condition likely to cause loss of
which any insured knew or had
reason to know at the inception of
this insurance;
(10)Asbestos, including loss, damage or
clean up resulting from asbestos or
asbestos containing materials; or
(11) Recall of "your products" that have
no known or suspected defect solely
because a known or suspected
defect in another of "your products"
has been found.
b. The following is added to SECTION II - LIABILITY, C. Who Is An Insured, paragraph
3.b.:
"Product recall expense" arising out of any
withdrawal or recall that occurred before you
acquired or formed the organization.
391-1006 08 16 Includes copyrighted materials of Insurance Services Offices, Inc., with its permission. Page 4 of 6 c. The following is added to SECTION II -
LIABILITY, D. Liability and Medical Expenses
Limits of Insurance:
Product Recall Expense Limits of Insurance
a. The Limits of Insurance shown in the
SUMMARY OF COVERAGES of this
endorsement and the rules stated below
fix the most that we will pay under this
Product Recall Expense Coverage
regardless of the number of:
(1) Insureds;
(2) "Covered Recalls" initiated; or
(3) Number of "your products"
withdrawn.
b. The Product Recall Expense Aggregate
Limit is the most that we will reimburse
you for the sum of all "product recall
expenses" incurred for all "covered
recalls" initiated during the policy period.
c. The Product Recall Each Occurrence
Limit is the most we will pay in
connection with any one defect or
deficiency.
d. All "product recall expenses" in
connection with substantially the same
general harmful condition will be
deemed to arise out of the same defect
or deficiency and considered one
"occurrence".
e. Any amount reimbursed for "product
recall expenses" in connection with any
one "occurrence" will reduce the amount
of the Product Recall Expense Aggregate
Limit available for reimbursement of
"product recall expenses" in connection
with any other defect or deficiency.
f. If the Product Recall Expense Aggregate
Limit has been reduced by
reimbursement of "product recall
expenses" to an amount that is less than
the Product Recall Expense Each
Occurrence Limit, the remaining
Aggregate Limit is the most that will be
available for reimbursement of "product
recall expenses" in connection with any
other defect or deficiency.
g. Product Recall Deductible
We will only pay for the amount of
"product recall expenses" which are in
excess of the $500 Product Recall
Deductible. The Product Recall
Deductible applies separately to each
"covered recall". The limits of insurance
will not be reduced by the amount of this
deductible.
We may, or will if required by law, pay all
or any part of any deductible amount, if
applicable. Upon notice of our payment
~
!&~Hanover
Insurance Group ..
OB3 H750195 1001328
of a deductible amount, you shall
promptly reimburse us for the part of the
deductible amount we paid.
The Product Recall Expense Limits of
Insurance apply separately to each
consecutive annual period and to any
remaining period of less than 12 months, starting with the beginning of the policy period shown in the Declarations, unless the
policy period is extended after issuance for
an additional period of less than 12 months. In that case, the additional period will be deemed part of the last preceding period for
the purposes of determining the Limits of
Insurance.
d. The following is added to SECTION II - LIABILITY, E. Liability and Medical Expense General Conditions, 2. Duties in the Event of
Occurrence, Offense, Claim or Suit:
You must see to it that the following are
done in the event of an actual or anticipated
"covered recall" that may result in "product
recall expense":
(1) Give us prompt notice of any discovery
or notification that "your product" must
be withdrawn or recalled. Include a
description of "your product" and the
reason for the withdrawal or recall;
(2) Cease any further release, shipment,
consignment or any other method of
distribution of like or similar products
until it has been determined that all
such products are free from defects that
could be a cause of loss under this
insurance.
e. For the purposs of this endorsement, the
following definitions are added to SECTION
II - LIABILITY, F. Liability and Medical
Expenses Definitions:
1. "Covered recall" means a recall made
necessary because you or a government
body has determined that a known or
suspected defect, deficiency,
inadequacy, or dangerous condition in
"your product" has resulted or will result
in "bodily injury" or "property damage".
2. "Product recall expense(s)" means:
a. Necessary and reasonable expenses
for:
(1) Communications, including radio
or television announcements or
printed advertisements including
stationary, envelopes and
postage;
391-1006 08 16 Includes copyrighted materials of Insurance Services Offices, Inc., with its permission. Page 5 of 6 f.
(2) Shipping the recalled products
from any purchaser, distributor or
user to the place or places
designated by you;
(3) Remuneration paid to your
regular "employees" for
necessary overtime;
(4) Hiring additional persons, other
than your regular "employees";
(5) Expenses incurred by "employees" 8·
including transportation and
accommodations;
(6) Expenses to rent additional
warehouse or storage space;
(7) Disposal of "your product", but
only to the extent that specific
methods of destruction other than
those employed for trash
discarding or disposal are 9.
required to avoid "bodily injury"
or "property damage" as a result
of such disposal,
you incur exclusively for the purpose
of recalling "your product"; and
b. Your lost profit resulting from such
"covered recall".
This Product Recall Expense Coverage does
not apply:
(1) If the "products - completed operations
hazard" is excluded from coverage under
this Coverage Part including any
endorsement thereto; or
(2) To "product recall expense" arising out of
any of "your products" that are otherwise
excluded from coverage under this
Coverage Part including endorsements
thereto.
Unintentional Failure to Disclose Hazards
The following is added to SECTION II - LIABILITY, E. Liability and Medical Expenses General Conditions:
Representations
We will not disclaim coverage under this
Coverage Part if you fail to disclose all hazards
existing as of the inception date of the policy
provided such failure is not intentional.
Unintentional Failure to Notify
The following is added to SECTION II -
LIABILITY, E. Liability and Medical Expenses
General Conditions, 2. Duties in the Event of
Occurrence, Offense, Claim or Suit:
Your rights afforded under this Coverage Part
shall not be prejudiced if you fail to give us
notice of an "occurrence", offense, claim or "suit",
solely due to your reasonable and documented
belief that the "bodily injury", "property damage"
or "personal and advertising injury" is not
covered under this Policy.
ALL OTHER TERMS, CONDITIONS, AND EXCLUSIONS REMAIN UNCHANGED. 391-1006 0816 Includes copyrighted materials of Insurance Services Offices, Inc., with its permission. Page 6 of 6