Cities Index.
Insurance Certificate

Redondo Beach City Council
May 7, 2024

Document
Insurance Certificate
Meeting
May 7, 2024
Body
Redondo Beach City Council
Pages
4
Original file
420 KB
Text extracted from the city's file for reading and search. Open the original on redondo.legistar1.com. That file is the official record.

SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE

THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS.

INSURER(S) AFFORDING COVERAGE
INSURER F :

INSURER E :

INSURER D :

INSURER C :

INSURER B :

INSURER A : NAIC #
NAME: CONTACT
(A/C, No): FAX
E-MAIL ADDRESS:

PRODUCER
(A/C, No, Ext): PHONE

INSURED
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:

IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed.

If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).

THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS

CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.

OTHER:
(Per accident)
(Ea accident)
$
$
N / A

SUBR WVDADDL
INSD

THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS

CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. $
$
$
$ PROPERTY DAMAGE
BODILY INJURY (Per accident)
BODILY INJURY (Per person) COMBINED SINGLE LIMIT

AUTOS ONLY

AUTOS ONLY AUTOS NON-OWNED OWNED SCHEDULED

ANY AUTO

AUTOMOBILE LIABILITY

Y / N WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY OFFICER/MEMBER EXCLUDED?
(Mandatory in NH) DESCRIPTION OF OPERATIONS below
If yes, describe under

ANY PROPRIETOR/PARTNER/EXECUTIVE
$
$
$ E.L. DISEASE - POLICY LIMIT E.L. DISEASE - EA EMPLOYEEE.L. EACH ACCIDENT EROTH- STATUTE PER
(MM/DD/YYYY) LIMITS POLICY EXP(MM/DD/YYYY) POLICY EFFLTR TYPE OF INSURANCE POLICY NUMBER INSR
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)

EXCESS LIAB
UMBRELLA LIAB EACH OCCURRENCE $ AGGREGATE $
$
OCCUR
CLAIMS-MADE DED RETENTION $
PRODUCTS - COMP/OP AGG $ GENERAL AGGREGATE $ PERSONAL & ADV INJURY $ MED EXP (Any one person) $
EACH OCCURRENCE $ DAMAGE TO RENTED
PREMISES (Ea occurrence) $ COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO- JECT LOC

CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY)

CANCELLATION

AUTHORIZED REPRESENTATIVE
ACORD 25 (2016/03)
© 1988-2015 ACORD CORPORATION. All rights reserved.

CERTIFICATE HOLDER
The ACORD name and logo are registered marks of ACORD
HIRED

AUTOS ONLY
4/22/2024
Patriot Risk & Insurance Services
18952 MacArthur Blvd., Suite #300
Irvine, CA 92612
(949) 486-7910
www.patrisk.com 0K07568 Hartford Fire Insurance Company 19682 Hartford Casualty Insurance Company 29424
Sentinel Insurance Company, Ltd. 11000
Navigators Specialty Insurance Company 36056
Scottsdale Insurance Company 41297
A 72UEACI4418 10/1/2023 10/1/2024 1,000,000
300,000
✓
10,000
✓
1,000,000
✓ $5,000 Deductible
2,000,000
✓ 2,000,000
A 72UEACI4419 10/1/2023 10/1/2024 1,000,000
✓
B ✓ ✓ 72HHACI3468 10/1/2023 10/1/2024 15,000,000
15,000,000
✓ 10,000
C 72WEAAU0TGJ 10/1/2023 10/1/2024 ✓
1,000,000
1,000,000
1,000,000
D Pollution Liability SF23ECPZ0CBLVIC 10/1/2023 10/1/2024 $5,000,000 Each Incident/$10,000,000 Agg E Installation Floater RBS0255147 10/1/2023 10/1/2024 $250,000 Any one Job Site E Rented/Leased Equipment RBS0255147 10/1/2023 10/1/2024 $100,000 Any one item Dave Jacobson
Ashlyn Wooden
[email protected]
Sancon Technologies Inc.
5841 Engineer Dr.

Huntington Beach CA 92649
79635344
✓
✓
City of Redondo Beach, its officers, elected and appointed officials, employees and volunteers This insurance is primary and Non-contributory.

City of Redondo Beach
Public Works Department, Engineering Division
415 Diamond Street
Redondo Beach CA 90277
are named as additional insured as respects GL and Auto per attached endorsements. 30 days notice of cancellation (10 days for non-payment of premium.) to the certificate holder. 79635344 | 23-24 GL/Auto/Umb/WC/Poll/IM | Ashlyn Wooden | 4/22/2024 7:46:41 AM (PDT) | Page 1 of 29 This certificate cancels and supersedes ALL previously issued certificates.

POLICY NUMBER: ABCDEFGHIJ
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR

CONTRACTORS - OPTION I
This endorsement modifies insurance provided under the following:

COMMERCIAL GENERAL LIABILITY COVERAGE PART

SCHEDULE
Name Of Additional Insured Person(s) Designated Project(s) Or Location(s) Or Organization(s): Of Covered Operations:

Information required to complete this Schedule, if not shown above, will be shown in the Declarations.

A. With respect to those person(s) or organization(s) (3) In connection with "your work" for the shown in the Schedule above when you have additional insured at the project(s) or agreed in a written contract or written agreement location(s) designated in the Schedule to provide insurance such as is afforded under this and included within the "products- policy to them, Subparagraph f., Any Other completed operations hazard", but only if:

Party, under the Additional Insureds When (a) The written contract or written Required By Written Contract, Written agreement requires you to provide Agreement Or Permit Paragraph of Section II – such coverage to such additional Who Is An Insured is replaced with the following: insured at the project(s) or location(s) f. Any Other Party designated in the Schedule; and
Any other person or organization who is not (b) This Coverage Part provides an insured under Paragraphs a. through e. coverage for "bodily injury" or above, but only with respect to liability for "property damage" included within the "bodily injury", "property damage" or "personal "products-completed operations and advertising injury" caused, in whole or in hazard". part, by your acts or omissions or the acts or The insurance afforded to the additional omissions of those acting on your behalf:
insured shown in the Schedule applies:
(1) In the performance of your ongoing (1) Only if the "bodily injury" or "property operations for such additional insured at damage" occurs, or the "personal and the project(s) or location(s) designated in advertising injury" offense is committed:
the Schedule; (a) During the policy period; and
(2) In connection with your premises owned (b) Subsequent to the execution of such by or rented to you and shown in the written contract or written agreement; Schedule; or and Form HS 24 80 07 13 Page 1 of 2
© 2013, The Hartford
(Includes copyrighted material of Insurance Services Office, Inc., with its permission.) All, except Additional Insureds that are insured under a separate additional insured endorsement on this policy
Sancon Technologies Inc.
72UEACI4418
79635344 | 23-24 GL/Auto/Umb/WC/Poll/IM | Ashlyn Wooden | 4/22/2024 7:46:41 AM (PDT) | Page 2 of 29 This certificate cancels and supersedes ALL previously issued certificates. (c) Prior to the expiration of the period of When You Add Others As An Additional time that the written contract or written Insured To This Insurance agreement requires such insurance (a) Primary Insurance When Required By be provided to the additional insured. Contract
(2) Only to the extent permitted by law; and This insurance is primary if you have agreed (3) Will not be broader than that which you in a written contract or written agreement that are required by the written contract or this insurance be primary. If other insurance written agreement to provide for such is also primary, we will share with all that additional insured. other insurance by the method described in W Paragraph (c) below. This insurance does not ith respect to the insurance afforded to the person(s) or organization(s) that are additional apply to other insurance to which the additional insured in the Schedule has been insureds under this endorsement, the added as an additional insured. following additional exclusion applies:

T (b) Primary And Non-Contributory To Other his insurance does not apply to "bodily Insurance When Required By Contract injury", "property damage" or "personal and advertising injury" arising out of the rendering This insurance is primary to and will not seek of, or the failure to render, any professional contribution from any other insurance architectural, engineering or surveying available to an additional insured under your services, including: policy provided that:
(1) The preparing, approving, or failing to (i) The additional insured in the Schedule is prepare or approve maps, shop drawings, a Named Insured under such other opinions, reports, surveys, field orders, insurance; and change orders, designs or specifications; (ii) You have agreed in a written contract or or written agreement that this insurance
(2) Supervisory, inspection, architectural or would be primary and would not seek engineering activities. contribution from any other insurance The limits of insurance that apply to the additional available to the additional insured in the Schedule. insured shown in the Schedule are described in the Limits Of Insurance section. (c) Method Of Sharing
How this insurance applies when other insurance is If all of the other insurance permits available to the additional insured is described in the contribution by equal shares, we will follow Other Insurance Condition in Section IV – this method also. Under this approach, each Commercial General Liability Conditions, except as insurer contributes equal amounts until it has otherwise amended below. paid its applicable limit of insurance or none of B. W the loss remains, whichever comes first.
ith respect to insurance provided to the
person(s) or organization(s) that are additional If any of the other insurance does not permit insureds under this endorsement, the When You contribution by equal shares, we will Add Others As An Additional Insured To This contribute by limits. Under this method, each Insurance subparagraph, under the Other insurer's share is based on the ratio of its Insurance Condition of Section IV – Commercial applicable limit of insurance to the total General Liability Conditions is replaced with the applicable limits of insurance of all insurers. following: All other terms and conditions in the policy remain unchanged.

Page 2 of 2 ends

79635344 | 23-24 GL/Auto/Umb/WC/Poll/IM | Ashlyn Wooden | 4/22/2024 7:46:41 AM (PDT) | Page 3 of 29 This certificate cancels and supersedes ALL previously issued certificates.

Sancon Technologies Inc.
72UEACI4418
79635344 | 23-24 GL/Auto/Umb/WC/Poll/IM | Ashlyn Wooden | 4/22/2024 7:46:41 AM (PDT) | Page 4 of 29 This certificate cancels and supersedes ALL previously issued certificates. 79635344 | 23-24 GL/Auto/Umb/WC/Poll/IM | Ashlyn Wooden | 4/22/2024 7:46:41 AM (PDT) | Page 5 of 29 This certificate cancels and supersedes ALL previously issued certificates. 79635344 | 23-24 GL/Auto/Umb/WC/Poll/IM | Ashlyn Wooden | 4/22/2024 7:46:41 AM (PDT) | Page 6 of 29 This certificate cancels and supersedes ALL previously issued certificates. 79635344 | 23-24 GL/Auto/Umb/WC/Poll/IM | Ashlyn Wooden | 4/22/2024 7:46:41 AM (PDT) | Page 7 of 29 This certificate cancels and supersedes ALL previously issued certificates. 79635344 | 23-24 GL/Auto/Umb/WC/Poll/IM | Ashlyn Wooden | 4/22/2024 7:46:41 AM (PDT) | Page 8 of 29 This certificate cancels and supersedes ALL previously issued certificates. 79635344 | 23-24 GL/Auto/Umb/WC/Poll/IM | Ashlyn Wooden | 4/22/2024 7:46:41 AM (PDT) | Page 9 of 29 This certificate cancels and supersedes ALL previously issued certificates. 79635344 | 23-24 GL/Auto/Umb/WC/Poll/IM | Ashlyn Wooden | 4/22/2024 7:46:41 AM (PDT) | Page 10 of 29 This certificate cancels and supersedes ALL previously issued certificates. 79635344 | 23-24 GL/Auto/Umb/WC/Poll/IM | Ashlyn Wooden | 4/22/2024 7:46:41 AM (PDT) | Page 11 of 29 This certificate cancels and supersedes ALL previously issued certificates. 79635344 | 23-24 GL/Auto/Umb/WC/Poll/IM | Ashlyn Wooden | 4/22/2024 7:46:41 AM (PDT) | Page 12 of 29 This certificate cancels and supersedes ALL previously issued certificates. 79635344 | 23-24 GL/Auto/Umb/WC/Poll/IM | Ashlyn Wooden | 4/22/2024 7:46:41 AM (PDT) | Page 13 of 29 This certificate cancels and supersedes ALL previously issued certificates. 79635344 | 23-24 GL/Auto/Umb/WC/Poll/IM | Ashlyn Wooden | 4/22/2024 7:46:41 AM (PDT) | Page 14 of 29 This certificate cancels and supersedes ALL previously issued certificates. 79635344 | 23-24 GL/Auto/Umb/WC/Poll/IM | Ashlyn Wooden | 4/22/2024 7:46:41 AM (PDT) | Page 15 of 29 This certificate cancels and supersedes ALL previously issued certificates. 79635344 | 23-24 GL/Auto/Umb/WC/Poll/IM | Ashlyn Wooden | 4/22/2024 7:46:41 AM (PDT) | Page 16 of 29 This certificate cancels and supersedes ALL previously issued certificates. 79635344 | 23-24 GL/Auto/Umb/WC/Poll/IM | Ashlyn Wooden | 4/22/2024 7:46:41 AM (PDT) | Page 17 of 29 This certificate cancels and supersedes ALL previously issued certificates. 79635344 | 23-24 GL/Auto/Umb/WC/Poll/IM | Ashlyn Wooden | 4/22/2024 7:46:41 AM (PDT) | Page 18 of 29 This certificate cancels and supersedes ALL previously issued certificates. 79635344 | 23-24 GL/Auto/Umb/WC/Poll/IM | Ashlyn Wooden | 4/22/2024 7:46:41 AM (PDT) | Page 19 of 29 This certificate cancels and supersedes ALL previously issued certificates. 79635344 | 23-24 GL/Auto/Umb/WC/Poll/IM | Ashlyn Wooden | 4/22/2024 7:46:41 AM (PDT) | Page 20 of 29 This certificate cancels and supersedes ALL previously issued certificates. 79635344 | 23-24 GL/Auto/Umb/WC/Poll/IM | Ashlyn Wooden | 4/22/2024 7:46:41 AM (PDT) | Page 21 of 29 This certificate cancels and supersedes ALL previously issued certificates. 79635344 | 23-24 GL/Auto/Umb/WC/Poll/IM | Ashlyn Wooden | 4/22/2024 7:46:41 AM (PDT) | Page 22 of 29 This certificate cancels and supersedes ALL previously issued certificates. 79635344 | 23-24 GL/Auto/Umb/WC/Poll/IM | Ashlyn Wooden | 4/22/2024 7:46:41 AM (PDT) | Page 23 of 29 This certificate cancels and supersedes ALL previously issued certificates. 79635344 | 23-24 GL/Auto/Umb/WC/Poll/IM | Ashlyn Wooden | 4/22/2024 7:46:41 AM (PDT) | Page 24 of 29 This certificate cancels and supersedes ALL previously issued certificates.

COMMERCIAL AUTOMOBILE
HA 99 16 12 21
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

Form HA 99 16 12 21 Page 1 of 5
© 2021, The Hartford
(Includes copyrighted material of Insurance Services Office, Inc. with its permission.)

COMMERCIAL AUTOMOBILE BROAD FORM

ENDORSEMENT
This endorsement modifies insurance provided under the following:

BUSINESS AUTO COVERAGE FORM
To the extent that the provisions of this endorsement provide broader benefits to the "insured" than other provisions of the Coverage Form, the provisions of this endorsement apply.

1. BROAD FORM INSURED
Paragraph .1. - WHO IS AN INSURED - of
Section II - Liability Coverage is amended to
add the following:
d. Subsidiaries and Newly Acquired or
Formed Organizations
The Named Insured shown in the
Declarations is amended to include:
(1) Any legal business entity other than a
partnership or joint venture, formed as a
subsidiary in which you have an
ownership interest of more than 50% on
the effective date of the Coverage Form.

However, the Named Insured does not
include any subsidiary that is an
"insured" under any other automobile
policy or would be an "insured" under
such a policy but for its termination or
the exhaustion of its Limit of Insurance.
(2) Any organization that is acquired or
formed by you and over which you
maintain majority ownership. However,
the Named Insured does not include any
newly formed or acquired organization:
(a) That is a partnership or joint
venture,
(b) That is an "insured" under any other
policy,
(c) That has exhausted its Limit of
Insurance under any other policy, or
(d) 180 days or more after its
acquisition or formation by you,
unless you have given us notice of
the acquisition or formation.

Coverage does not apply to "bodily
injury" or "property damage" that results
from an "accident" that occurred before
you formed or acquired the organization.
e. Employees as Insureds
(1). Any "employee" of yours while using a
covered "auto" you don't own, hire or
borrow in your business or your
personal affairs.
f. Lessors as Insureds
(1). The lessor of a covered "auto" while the
"auto" is leased to you under a written
agreement if:
(a) The agreement requires you to
provide direct primary insurance for
the lessor and
(b) The "auto" is leased without a
driver.

Such a leased "auto" will be considered a
covered "auto" you own and not a covered
"auto" you hire.
g. Additional Insured if Required by Contract
(1) When you have agreed, in a written
contract or written agreement, that a
person or organization be added as an
additional insured on your business auto
policy, such person or organization is an
"insured", but only to the extent such
person or organization is liable for
"bodily injury" or "property damage"
caused by the conduct of an "insured"
under paragraphs a. or b. of Who Is An
Insured with regard to the ownership,
maintenance or use of a covered "auto."
The insurance afforded to any such
additional insured applies only if the
"bodily injury" or "property damage"
occurs:
(a) During the policy period, and
(b) Subsequent to the execution of such
written contract, and
Sancon Technologies Inc.
72UEACI4419
79635344 | 23-24 GL/Auto/Umb/WC/Poll/IM | Ashlyn Wooden | 4/22/2024 7:46:41 AM (PDT) | Page 25 of 29 This certificate cancels and supersedes ALL previously issued certificates.

Page 2 of 5 ends

(c) Prior to the expiration of the period
of time that the written contract
requires such insurance be provided
to the additional insured.
(2) How Limits Apply
If you have agreed in a written contract
or written agreement that another
person or organization be added as an
additional insured on your policy, the
most we will pay on behalf of such
additional insured is the lesser of:
(a) The limits of insurance specified in
the written contract or written
agreement; or
(b) The Limits of Insurance shown in
the Declarations.

Such amount shall be a part of and not
in addition to Limits of Insurance shown
in the Declarations and described in this
Section.
(3) Additional Insureds Other Insurance
If we cover a claim or "suit" under this
Coverage Part that may also be covered
by other insurance available to an
additional insured, such additional
insured must submit such claim or "suit"
to the other insurer for defense and
indemnity.

However, this provision does not apply
to the extent that you have agreed in a
written contract or written agreement
that this insurance is primary and noncontributory with the additional insured's own insurance.
(4) Duties in The Event Of Accident, Claim,
Suit or Loss
If you have agreed in a written contract
or written agreement that another
person or organization be added as an
additional insured on your policy, the
additional insured shall be required to
comply with the provisions in LOSS
CONDITIONS 2. - DUTIES IN THE

EVENT OF ACCIDENT, CLAIM , SUIT
OR LOSS – OF SECTION IV –
BUSINESS AUTO CONDITIONS, in the
same manner as the Named Insured.

2. Primary and Non-Contributory if
Required by Contract
Only with respect to insurance provided to
an additional insured in A.1.g. - Additional
Insured If Required by Contract, the
following provisions apply:
(1) Primary Insurance When Required By
Contract
This insurance is primary if you have
agreed in a written contract or written
agreement that this insurance be
primary. If other insurance is also
primary, we will share with all that other
insurance by the method described in
Other Insurance 5.d.
(2} Primary And Non-Contributory To Other
Insurance When Required By Contract
If you have agreed in a written contract
or written agreement that this insurance
is primary and non-contributory with the
additional insured's own insurance, this
insurance is primary and we will not
seek contribution from that other
insurance.

Paragraphs (1) and (2) do not apply to other
insurance to which the additional insured
has been added as an additional insured.

When this insurance is excess, we will have
no duty to defend the insured against any
"suit" if any other insurer has a duty to
defend the insured against that "suit". If no
other insurer defends, we will undertake to
do so, but we will be entitled to the insured's
rights against all those other insurers.

When this insurance is excess over other
insurance, we will pay only our share of the
amount of the loss, if any, that exceeds the
sum of:
(1) The total amount that all such other
insurance would pay for the loss in the
absence of this insurance; and
(2) The total of all deductible and selfinsured amounts under all that other insurance.

We will share the remaining loss, if any, by
the method described in SECTION IVBusiness Auto Conditions, B. General Conditions, Other Insurance 5.d.

3. AUTOS RENTED BY EMPLOYEES
Any "auto" hired or rented by your "employee"
on your behalf and at your direction will be
considered an "auto" you hire.

The SECTION IV- Business Auto Conditions, B.

General Conditions, 5. OTHER INSURANCE
Condition is amended by adding the following:
e. If an "employee’s" personal insurance also
applies on an excess basis to a covered
"auto" hired or rented by your "employee" on
your behalf and at your direction, this
insurance will be primary to the
"employee’s" personal insurance.
79635344 | 23-24 GL/Auto/Umb/WC/Poll/IM | Ashlyn Wooden | 4/22/2024 7:46:41 AM (PDT) | Page 26 of 29 This certificate cancels and supersedes ALL previously issued certificates.

Form HA 99 16 12 21 Page 3 of 5

4. AMENDED FELLOW EMPLOYEE EXCLUSION
EXCLUSION 5. - FELLOW EMPLOYEE - of
SECTION II - LIABILITY COVERAGE does not
apply if you have workers' compensation
insurance in-force covering all of your
"employees".

Coverage is excess over any other collectible
insurance.

5. HIRED AUTO PHYSICAL DAMAGE COVERAGE
If hired "autos" are covered "autos" for Liability
Coverage and if Comprehensive, Specified
Causes of Loss, or Collision coverages are
provided under this Coverage Form for any
"auto" you own, then the Physical Damage
Coverages provided are extended to "autos" you
hire or borrow, subject to the following limit.

The most we will pay for "loss" to any hired
"auto" is:
(1) $100,000;
(2) The actual cash value of the damaged or
stolen property at the time of the "loss"; or
(3) The cost of repairing or replacing the
damaged or stolen property,
whichever is smallest, minus a deductible. The
deductible will be equal to the largest deductible
applicable to any owned "auto" for that
coverage. No deductible applies to "loss"
caused by fire or lightning. Hired Auto Physical
Damage coverage is excess over any other
collectible insurance. Subject to the above limit,
deductible and excess provisions, we will
provide coverage equal to the broadest
coverage applicable to any covered "auto" you
own.

We will also cover loss of use of the hired "auto"
if it results from an "accident", you are legally
liable and the lessor incurs an actual financial
loss, subject to a maximum of $1000 per
"accident".

This extension of coverage does not apply to
any "auto" you hire or borrow from any of your
"employees", partners (if you are a partnership),
members (if you are a limited liability company),
or members of their households.

6. PHYSICAL DAMAGE - ADDITIONAL

TEMPORARY TRANSPORTATION EXPENSE

COVERAGE
Paragraph A.4.a. of SECTION III - PHYSICAL
DAMAGE COVERAGE is amended to provide a
limit of $50 per day and a maximum limit of
$1,000.

7. LOAN/LEASE GAP COVERAGE
Under SECTION III - PHYSICAL DAMAGE
COVERAGE, in the event of a total "loss" to a
covered "auto", we will pay your additional legal
obligation for any difference between the actual
cash value of the "auto" at the time of the "loss"
and the "outstanding balance" of the loan/lease.
"Outstanding balance" means the amount you
owe on the loan/lease at the time of "loss" less
any amounts representing taxes; overdue
payments; penalties, interest or charges
resulting from overdue payments; additional
mileage charges; excess wear and tear charges;
lease termination fees; security deposits not
returned by the lessor; costs for extended
warranties, credit life Insurance, health, accident
or disability insurance purchased with the loan
or lease; and carry-over balances from previous
loans or leases.

8. AIRBAG COVERAGE
Under Paragraph B. EXCLUSIONS - of

SECTION III - PHYSICAL DAMAGE
COVERAGE, the following is added:

The exclusion relating to mechanical breakdown
does not apply to the accidental discharge of an
airbag.

9. ELECTRONIC EQUIPMENT - BROADENED

COVERAGE
a. The exceptions to Paragraphs B.4 -
EXCLUSIONS - of SECTION III - PHYSICAL
DAMAGE COVERAGE are replaced by the
following:

Exclusions 4.c. and 4.d. do not apply to
equipment designed to be operated solely by
use of the power from the "auto's" electrical
system that, at the time of "loss", is:
(1) Permanently installed in or upon the
covered "auto";
(2) Removable from a housing unit which is
permanently installed in or upon the
covered "auto";
(3) An integral part of the same unit housing
any electronic equipment described in
Paragraphs (1) and (2) above; or
(4) Necessary for the normal operation of the
covered "auto" or the monitoring of the
covered "auto's" operating system.
b. Section III, Physical Damage Coverage,
Limit of Insurance, Paragraph C.2. is
amended to add the following:
$1,500 is the most we will pay for "loss" in
any one "accident" to all electronic
equipment (other than equipment designed
solely for the reproduction of sound, and
accessories used with such equipment) that
reproduces, receives or transmits audio,
visual or data signals which, at the time of
"loss", is:
79635344 | 23-24 GL/Auto/Umb/WC/Poll/IM | Ashlyn Wooden | 4/22/2024 7:46:41 AM (PDT) | Page 27 of 29 This certificate cancels and supersedes ALL previously issued certificates.

Page 4 of 5 ends

(1) Permanently installed in or upon the
covered "auto" in a housing, opening or
other location that is not normally used
by the "auto" manufacturer for the
installation of such equipment;
(2) Removable from a permanently installed
housing unit as described in Paragraph

2.a. above or is an integral part of that
equipment; or
(3) An integral part of such equipment.
c. For each covered "auto", should loss be
limited to electronic equipment only, our
obligation to pay for, repair, return or replace
damaged or stolen electronic equipment will
be reduced by the applicable deductible
shown in the Declarations, or $250,
whichever deductible is less.

10. EXTRA EXPENSE - BROADENED

COVERAGE
Under Paragraph A. - COVERAGE - of SECTION
III - PHYSICAL DAMAGE COVERAGE, we will
pay for the expense of returning a stolen covered
"auto" to you.

11. GLASS REPAIR - WAIVER OF DEDUCTIBLE
Under Paragraph D. - DEDUCTIBLE - of

SECTION III - PHYSICAL DAMAGE COVERAGE,
the following is added:

No deductible applies to glass damage if the
glass is repaired rather than replaced.

12. TWO OR MORE DEDUCTIBLES
Under Paragraph D. - DEDUCTIBLE - of

SECTION III - PHYSICAL DAMAGE COVERAGE,
the following is added:

If another Hartford Financial Services Group,
Inc. company policy or coverage form that is not
an automobile policy or coverage form applies to
the same "accident", the following applies:
(1) If the deductible under this Business Auto
Coverage Form is the smaller (or smallest)
deductible, it will be waived;
(2) If the deductible under this Business Auto
Coverage Form is not the smaller (or
smallest) deductible, it will be reduced by
the amount of the smaller (or smallest)
deductible.

13. AMENDED DUTIES IN THE EVENT OF

ACCIDENT, CLAIM, SUIT OR LOSS
The requirement in LOSS CONDITIONS 2.a. -

DUTIES IN THE EVENT OF ACCIDENT,
CLAIM, SUIT OR LOSS - of SECTION IV -
BUSINESS AUTO CONDITIONS that you must
notify us of an "accident" applies only when the
"accident" is known to:
(1) You, if you are an individual;
(2) A partner, if you are a partnership;
(3) A member, if you are a limited liability
company; or
(4) An executive officer or insurance manager, if
you are a corporation.

14. UNINTENTIONAL FAILURE TO DISCLOSE

HAZARDS
If you unintentionally fail to disclose any hazards
existing at the inception date of your policy, we
will not deny coverage under this Coverage
Form because of such failure.

15. HIRED AUTO - COVERAGE TERRITORY

SECTION IV, BUSINESS AUTO CONDITIONS,
PARAGRAPH B. GENERAL CONDITIONS, 7. -

POLICY PERIOD, COVERAGE TERRITORY -
is added to include the following:
(6) For short-term hired "autos", the coverage
territory with respect to Liability Coverage is
anywhere in the world provided that if the
"insured's" responsibility to pay damages for
"bodily injury" or "property damage" is
determined in a "suit," the "suit" is brought in
the United States of America, the territories
and possessions of the United States of
America, Puerto Rico or Canada or in a
settlement we agree to.

16. WAIVER OF SUBROGATION
Paragraph 5. TRANSFER OF RIGHTS OF
RECOVERY AGAINST OTHERS TO US - of

SECTION IV - BUSINESS AUTO CONDITIONS
A. Loss Conditions is amended by adding the
following:

We waive any right of recovery we may have
against any person or organization with whom
you have a written contract that requires such
waiver because of payments we make for
damages under this Coverage Form.

17. RESULTANT MENTAL ANGUISH COVERAGE
The definition of "bodily injury" in SECTION VDEFINITIONS, C. is replaced by the following:
"Bodily injury" means bodily injury, sickness or
disease sustained by any person, including
mental anguish or death resulting from any of
these.

18. EXTENDED CANCELLATION CONDITION
Paragraph 2. of the COMMON POLICY
CONDITIONS - CANCELLATION - applies
except as follows:

If we cancel for any reason other than
nonpayment of premium, we will mail or deliver
to the first Named Insured written notice of
cancellation at least 60 days before the effective
date of cancellation.
79635344 | 23-24 GL/Auto/Umb/WC/Poll/IM | Ashlyn Wooden | 4/22/2024 7:46:41 AM (PDT) | Page 28 of 29 This certificate cancels and supersedes ALL previously issued certificates.

Form HA 99 16 12 21 Page 5 of 5

19. HYBRID, ELECTRIC, OR NATURAL GAS

VEHICLE PAYMENT COVERAGE
In the event of a total loss to a "non-hybrid" auto
for which Comprehensive, Specified Causes of
Loss, or Collision coverages are provided under
this Coverage Form, then such Physical
Damage Coverages are amended as follows:
a. If the auto is replaced with a "hybrid" auto or
an auto powered solely by electricity or
natural gas, we will pay an additional 10%,
to a maximum of $2,500, of the "non-hybrid"
auto’s actual cash value or replacement
cost, whichever is less,
b. The auto must be replaced and a copy of a
bill of sale or new lease agreement received
by us within 60 calendar days of the date of
"loss,"
c. Regardless of the number of autos deemed
a total loss, the most we will pay under this
Hybrid, Electric, or Natural Gas Vehicle
Payment Coverage provision for any one
"loss" is $10,000.

For the purposes of the coverage provision,
a. A "non-hybrid" auto is defined as an auto
that uses only an internal combustion engine
to move the auto but does not include autos
powered solely by electricity or natural gas.
b. A "hybrid" auto is defined as an auto with an
internal combustion engine and one or more
electric motors; and that uses the internal
combustion engine and one or more electric
motors to move the auto, or the internal
combustion engine to charge one or more
electric motors, which move the auto.

20. VEHICLE WRAP COVERAGE
In the event of a total loss to an "auto" for which
Comprehensive, Specified Causes of Loss, or
Collision coverages are provided under this
Coverage Form, then such Physical Damage
Coverages are amended to add the following:

In addition to the actual cash value of the "auto",
we will pay up to $1,000 for vinyl vehicle wraps
which are displayed on the covered "auto" at the
time of total loss. Regardless of the number of
autos deemed a total loss, the most we will pay
under this Vehicle Wrap Coverage provision for
any one "loss" is $5,000. For purposes of this
coverage provision, signs or other graphics
painted or magnetically affixed to the vehicle are
not considered vehicle wraps.
79635344 | 23-24 GL/Auto/Umb/WC/Poll/IM | Ashlyn Wooden | 4/22/2024 7:46:41 AM (PDT) | Page 29 of 29 This certificate cancels and supersedes ALL previously issued certificates.

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