Insured Name:
Copyright CNA All Rights Reserved. Includes copyrighted material of Insurance Services Office, Inc., with its permission. 00020002460792047243224
Cannon Corporation
09/01/2023
7039996776
76264808 | 23-24 GL/AL/WC/UM/PL | Adrianna Padilla | 9/14/2023 11:14:57 AM (PST) | Page 4 of 9 283
CNA PARAMOUNT
Blanket Additional Insured - Owners, Lessees or
Contractors - with Products-Completed
Operations Coverage Endorsement
Primary and Noncontributory Insurance
With respect to other insurance available to the additional insured under which the additional insured is a named insured, this insurance is primary to and will not seek contribution from such other insurance, provided that a written contract requires the insurance provided by this policy to be:
1. primary and non-contributing with other insurance available to the additional insured; or
2. primary and to not seek contribution from any other insurance available to the additional insured.
But except as specified above, this insurance will be excess of all other insurance available to the additional insured.
VI. Solely with respect to the insurance granted by this endorsement, the section entitled COMMERCIAL GENERAL LIABILITY CONDITIONS is amended as follows:
The Condition entitled Duties In The Event of Occurrence, Offense, Claim or Suit is amended with the addition of the following:
Any additional insured pursuant to this endorsement will as soon as practicable:
1. give the Insurer written notice of any claim, or any occurrence or offense which may result in a claim;
2. send the Insurer copies of all legal papers received, and otherwise cooperate with the Insurer in the investigation, defense, or settlement of the claim; and
3. make available any other insurance, and tender the defense and indemnity of any claim to any other insurer or self-insurer, whose policy or program applies to a loss that the Insurer covers under this coverage part. However, if the written contract requires this insurance to be primary and non-contributory, this paragraph 3. does not apply to insurance on which the additional insured is a named insured.
The Insurer has no duty to defend or indemnify an additional insured under this endorsement until the Insurer receives written notice of a claim from the additional insured.
VII. Solely with respect to the insurance granted by this endorsement, the section entitled DEFINITIONS is amended to add the following definition:
Written contract means a written contract or written agreement that requires you to make a person or organization an additional insured on this coverage part, provided the contract or agreement:
A. is currently in effect or becomes effective during the term of this policy; and B. was executed prior to:
1. the bodily injury or property damage; or
2. the offense that caused the personal and advertising injury; for which the additional insured seeks coverage.
Any coverage granted by this endorsement shall apply solely to the extent permissible by law.
All other terms and conditions of the Policy remain unchanged.
This endorsement, which forms a part of and is for attachment to the Policy issued by the designated Insurers, takes effect on the effective date of said Policy at the hour stated in said Policy, unless another effective date is shown below, and expires concurrently with said Policy.
Policy No:
Effective Date:
CNA75079XX (10-16)
Insured Name:
Copyright CNA All Rights Reserved. Includes copyrighted material of Insurance Services Office, Inc., with its permission. 7039996776
Cannon Corporation
09/01/2023
76264808 | 23-24 GL/AL/WC/UM/PL | Adrianna Padilla | 9/14/2023 11:14:57 AM (PST) | Page 5 of 9 284
CNA PARAMOUNT
Waiver of Transfer of Rights of Recovery Against
Others to the Insurer Endorsement
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART
SCHEDULE
Name Of Person Or Organization:
ANY PERSON OR ORGANIZATION WHOM THE NAMED INSURED HAS AGREED IN WRITING IN A
CONTRACT OR AGREEMENT TO WAIVE SUCH RIGHTS OF RECOVERY, BUT ONLY IF SUCH CONTRACT OR AGREEMENT:
1.IS IN EFFECT OR BECOMES EFFECTIVE DURING THE TERM OF THIS COVERAGE PART; AND
2.WAS EXECUTED PRIOR TO THE BODILY INJURY, PROPERTY DAMAGE OR PERSONAL AND ADVERTISING INJURY GIVING RISE TO THE CLAIM.
(Information required to complete this Schedule, if not shown above, will be shown in the Declarations.) Under COMMERCIAL GENERAL LIABILITY CONDITIONS, it is understood and agreed that the condition entitled Transfer Of Rights Of Recovery Against Others To Us is amended by the addition of the following:
With respect to the person or organization shown in the Schedule above, the Insurer waives any right of recovery the Insurer may have against such person or organization because of payments the Insurer makes for injury or damage arising out of the Named Insured’s ongoing operations or your work included in the products-completed operations hazard.
All other terms and conditions of the Policy remain unchanged.
This endorsement, which forms a part of and is for attachment to the Policy issued by the designated Insurers, takes effect on the effective date of said Policy at the hour stated in said Policy, unless another effective date is shown below, and expires concurrently with said Policy.
Policy No:
Effective Date:
CNA75008XX (10-16)
Insured Name:
Copyright CNA All Rights Reserved. Includes copyrighted material of Insurance Services Office, Inc., with its permission. 00020002460792047243228
Cannon Corporation
7039996776
09/01/2023
76264808 | 23-24 GL/AL/WC/UM/PL | Adrianna Padilla | 9/14/2023 11:14:57 AM (PST) | Page 6 of 9 285
Business Auto Policy
Endorsement
ADDITIONAL INSURED - PRIMARY AND NON-CONTRIBUTORY
It is understood and agreed that this endorsement amends the BUSINESS AUTO COVERAGE FORM as follows:
SCHEDULE
Name of Additional Insured Person Or Organization
ANY PERSON OR ORGANIZATION THAT YOU ARE REQUIRED BY WRITTEN CONTRACT OR WRITTEN AGREEMENT TO NAME AS AN ADDITIONAL INSURED.
1. In conformance with paragraph A.1.c. of Who Is An Insured of Section II - LIABILITY COVERAGE, the person or organization scheduled above is an insured under this policy.
2. The insurance afforded to the additional insured under this policy will apply on a primary and non-contributory basis if you have committed it to be so in a written contract or written agreement executed prior to the date of the “accident” for which the additional insured seeks coverage under this policy.
All other terms and conditions of the policy remain unchanged This endorsement, which forms a part of and is for attachment to the policy issued by the designated Insurers, takes effect on the Policy Effective date of said policy at the hour stated in said policy, unless another effective date (the Endorsement Effective Date) is shown below, and expires concurrently with said policy.
Policy No:
Policy Effective Date:
Policy Page: 1 of 1
Form No: CNA71527XX (10-2012)
Endorsement Effective Date:
Endorsement No:
Underwriting Company:
© Copyright CNA All Rights Reserved.
Cannon Corporation
7040001609
09/01/2023
Continental Insurance Company A XV
09/01/2023
76264808 | 23-24 GL/AL/WC/UM/PL | Adrianna Padilla | 9/14/2023 11:14:57 AM (PST) | Page 7 of 9 286
POLICY NUMBER: COMMERCIAL AUTO
CA 04 4410 13
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
WAIVER OF TRANSFER OF RIGHTS OF RECOVERY
AGAINST OTHERS TO US (WAIVER OF SUBROGATION)
This endorsement modifies insurance provided under the following:
AUTO DEALERS COVERAGE FORM
BUSINESS AUTO COVERAGE FORM
MOTOR CARRIER COVERAGE FORM
With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement.
This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below.
SCHEDULE
The Transfer Of Rights Of Recovery Against
Others To Us condition does not apply to the
person(s) or organization(s) shown in the Schedule,
but only to the extent that subrogation is waived prior to the "accident" or the "loss" under a contract with
that person or organization.
CA 04441013 © Insurance Services Office, Inc., 2011 Page 1 of 1 Name(s) Of Person(s) Or Organization(s):
All persons or organizations as required by written contract or agreement Information required to complete this Schedule, if not shown above, will be shown in the Declarations.
Named Insured:
Endorsement Effective Date:
Cannon Corporation
7040001609
09/01/2023
76264808 | 23-24 GL/AL/WC/UM/PL | Adrianna Padilla | 9/14/2023 11:14:57 AM (PST) | Page 8 of 9 287
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
Countersigned by
Authorized Representative
Form WC 04 03 06 (1) Printed in U.S.A.
Policy Expiration Date:
WAIVER OF OUR RIGHT TO RECOVER FROM
OTHERS ENDORSEMENT - CALIFORNIA
Policy Number:
Effective Date:
Named Insured and Address:
We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule.
The additional premium for this endorsement shall be 2 % of the California workers' compensation premium otherwise due on such remuneration.
SCHEDULE
Person or Organization Job Description
Any person or organization from whom you are required by written contract or agreement to obtain this waiver of rights from us
09/01/2023
09/01/2024
72WEOL6H1H
Cannon Corporation
1050 Southwood Drive
San Luis Obispo CA 93401
76264808 | 23-24 GL/AL/WC/UM/PL | Adrianna Padilla | 9/14/2023 11:14:57 AM (PST) | Page 9 of 9 288
Contributor Name
Date of Contribution Recipient Officer/
Candidate
Contribution Amount Refunded: Yes or No; Date of Refund Please list all contributions in excess of $250 (either as a single payment or in aggregate) made within the past 12 months to officers of the agency involved in the above-mentioned proceeding by any parties (applicants) or their agents or representatives, including corporations, limited liability companies (LLCs), or other business entities and principals thereof, that are affiliated with the above-referenced proceeding. You may attach attach additional pages as necessary to list contributions made to involved agency officers and provide additional information about the contributor's relationship with the recipient.
This form must be updated after each contribution, and no less than 45 days before any agency consideration regarding the above-referenced application. Completion of this form does not waive or in any way impact a party's obligation to disclose such contributions over $250 on the record of the proceeding pursuant to Government Code section 84308(e).
Reference #:
(File or Contract #)
Applicant/Interested Party Campaign Contribution Disclosure Form l Land use, entitlements, licenses, permits, franchises, contracts (excluding labor and competitively bid contracts) Applicant/Interested Party Information
Contribution Disclosure (Government Code section 84308) Sign and Date
I declare under penalty of perjury that the information which has been included in this Disclosure Form is true and correct.
Applicant Phone
Representative/
Agent
Email
Business
Address Website
Address Line 2 Fax
City
State Zip Code
Name and subject matter of applicant's proceeding
Signed Date
289