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WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY THE ZENITH
WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT
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 any person or organization named in the Schedule.
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 5.00% of the California workers compensation premium otherwise due on such remuneration.
Minimum Premium: $0.00
SCHEDULE
Person or Organization-Job Description
CITY OF VISTA
200 CIVIC CENTER DR
VISTA, CA 92804
RE: ALL WORK DONE IN CONJUNCTION WITH THE ABOVE
CAPTIONED WAIVER HOLDER
This endorsement changes the policy to which it is attached and is effective on the policy effective date unless otherwise stated.
ZENITH INSURANCE COMPANY
Endorsement Effective 09/20/2024
Insured: SAN DIEGO RESCUE MISSION.
Policy No. Z068232419
Policy Period 04/01/2024 To 04/01/2025
Issued On 10/08/2024 At SAN DIEGO, CA
WC 04-03-06-B
(Ed. 10-07) Endorsement No. 16
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ACP CAA 3029908314 INSURED 47 0001346
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THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
BUSINESS AUTO PROTECTION- GOLD
This endorsement modifies insurance provided under the following:
BUSINESS AUTO COVERAGE FORM
SUMMARY OF COVERAGES
A. Effect of This Endorsement
B. Newly Acquired or Formed Entities
C. Employees as Insureds – Nonowned Autos
D. Additional Insured by Contract, Permit or Agreement
E. Supplementary Payments – Bail Bonds
F. Supplementary Payments – Loss of Earnings
G. Personal Effects and Property of Others Extension
H. Prejudgment Interest Coverage
I. Fellow Employee – Officer, Managers and Supervisors
J. Hired Auto Physical Damage
K. Temporary Substitute Autos – Physical Damage Coverage L. Expanded Towing Coverage
M. Auto Loan or Lease Coverage
N. Original Equipment Manufacturer Parts – Leased Private Passenger Types O. Deductible Amendments
P. Rental Reimbursement Coverage
Q. Expanded Transportation Expense
R. Extra Expense – Stolen Autos
S. Physical Damage Limit of Insurance
T. New Vehicle Replacement Cost
U. Physical Damage Coverage Extension
V. Transfer of Rights of Recovery Against Others To Us
W. Section IV – Business Auto Conditions – Notice of and Knowledge of Occurrence X. Hired Car Coverage Territory
Y. Emergency Lock Out
Z. Cancellation Condition
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INSURED: POLICY #:
EFFECTIVE: EXPIRATION:
San Diego Rescue Mission, Inc
010043311
12/15/2024
12/15/2025
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If specifically required by the written contract orA. EFFECT OF THIS ENDORSEMENT agreement referenced in the paragraph above,Coverage provided under this policy is modified any coverage provided by this endorsement toby the provisions of this endorsement. If there an additional insured shall be primary andis any conflict between the provisions of this any other valid and collectible insurance avail-endorsement and the provision(s) of any state- able to the additional insured shall be non-specific endorsement also attached to this poli- contributory with this insurance. If the writtency, then the provision(s) of the state-specific contract does not require this coverage to beendorsement shall apply instead of the provi- primary and the additional insured’scoverage tosions of this endorsement that are in conflict, be non-contributory, then this insurance will bebut only to the extent of the conflict, and only to excess over any other valid and collectible insur-the extent necessary to bring such provisions ance available to the additional insured.into conformance with the state requirement(s) contained in the provision(s) of the state-specific
endorsement. E. SUPPLEMENTARY PAYMENTS – BAIL
BONDSB. NEWLY ACQUIRED OR FORMED ENTITIES
Supplementary Payments of SECTION II –The Named Insured shown in the Declarations is COVERED AUTOS LIABILITY COVERAGE isamended to include any organization you newly revised as follows:acquire or form, other than a partnership, joint venture, or limited liability company, and over (2) Up to $2,500 for cost of bail bonds (including which you maintain ownership or majority (more bonds for related traffic law violations) than 50%) interest; if there is no other similar in- required because of an “accident” wecover. surance available to that organization. Coverage We do not have to furnish these bonds.th under this provision is afforded until the 180 F. SUPPLEMENTARY PAYMENTS – LOSS OFday after you acquire or form the organization or EARNINGSthe end of the policy period, whichever is later.
Supplementary Payments of the SECTION II –C. EMPLOYEES AS INSUREDS – NONOWNED COVERED AUTOS LIABILITY COVERAGE isAUTOS revised as follows:
The following is added to paragraph A.1. Who Is (4) All reasonable expenses incurred by the “in-An Insured of SECTION II – COVERED AUTOS sured” at our request, including actual lossLIABILITY COVERAGE: of earnings up to $500 a day because of d. Any "employee" of yours is an "insured" time off from work. while using a covered "auto" you don't own, G PERSONAL EFFECTS AND PROPERTY OF.hire or borrow in your business or your per- OTHERS EXTENSIONsonal affairs. 1. The. Care, Custody or Control Exclusion ofD. ADDITIONAL INSURED BY CONTRACT, SECTION II – COVERED AUTOSPERMIT OR AGREEMENT LIABILITY COVERAGE, does not apply to The following is added to A.1. Who Is An In- "property damage" to property, other than sured of SECTION II – COVERED AUTOS your property, up to an amount not exceed- LIABILITY COVERAGE: ing $250 in any one "accident". Coverage is excess over any other valid and collectibleAny person or organization that you are re- insurance.quired to name as an additional insured in a
written contract or agreement that is executed 2. The following paragraph is added to A.4. or signed by you prior to a “bodily injury” or Coverage Extensions of SECTION III – “property damage” occurrence is an “insured” PHYSICAL DAMAGE COVERAGE:
for Covered Auto L iability coverage. How- c. We will pay up to $500 for your propertyever, with respect to covered “autos”, such that is lost or damaged as a result of aperson or organization is an insured only to covered “loss”,without applying a de-the extent that person or organization qualifies ductible. Coverage is excess over anyas an “insured”under A.1. Who is an Insured of other valid and collectible insurance.SECTION II – COVERED AUTOS LIABILITY COVERAGE:
with its permission
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H. PREJUDGMENT INTEREST COVERAGE substitute for a covered "auto" you own that The following paragraph is added to SECTION II is out of service because of its:
– COVERED AUTOS LIABILITY COVERAGE, a. Breakdown;
2. Coverage Extensions, a. Supplementary b. Repair;
Payments: c. Servicing;
(7) Prejudgment interest awarded against the d. "Loss"; or“insured” on that part of the judgment we pay. If we make an offer to pay the appli- e. Destruction cable limit of insurance, we will not pay The coverage that applies is the same as any prejudgment interest based on that the coverage provided for the vehicle being period of time after the offer. replaced.
I. FELLOW EMPLOYEE – OFFICERS,
MANAGERS, AND SUPERVISORS L. EXPANDED TOWING COVERAGE
The Fellow Employee Exclusion in SECTION II 1. We will pay up to: – COVERED AUTOS LIABILITY COVERAGE is a. $100 for a covered "auto" you own ofreplaced as follows; the private passenger type, orA. "Bodily injury" to any fellow "employee" of b. $500 for a covered "auto" you own thatthe "insured" arising out of and in the course is not of the private passenger type,of the fellow "employee's" employment or while performing duties related to the con- for towing and labor costs incurred each duct of your business. This exclusion does time the covered "auto" is disabled. Howev- not apply to an "insured" who occupies a er, the labor must be performed at the place position as an officer, manager, or supervi- of disablement. sor. 2. This coverage applies only for an "auto"
J. HIRED AUTO PHYSICAL DAMAGE covered on this policy for Comprehensive or Specified Causes of Loss Coverage andIf covered "auto" designation symbols 1 or 8 ap- Collision Coverages.ply to Liability Coverage and if at least one "au- to" you own is covered by this policy for Com- 3. Payment applies in addition to the otherwise prehensive, Specified Causes of Loss, or Colli- applicable amount of each coverage you sion coverages, then the Physical Damage have on a covered “auto”. coverages provided are extended to "autos" you M. AUTO LOAN OR LEASE COVERAGE lease, hire, rent or borrow without a driver; and 1. In the event of a total "loss" to a covered provisions in the Business Auto Coverage Form "auto", we will pay any unpaid amount due applicable to Hired Auto Physical Damage apply on the loan or lease, including up to a max-up to a limit of $100,000. The deductible will be imum of $500 for early termination fees or equal to the largest deductible applicable to any penalties, for your covered "auto" less: owned "auto" for that coverage. Any Compre- hensive deductible does not apply to fire or a. The amount paid under SECTION III – lightning. PHYSICAL DAMAGE COVERAGE of
this policy; andK. TEMPORARY SUBSTITUTE AUTOS –
PHYSICAL DAMAGE COVERAGE b. Any:
The following is added to paragraph C. Certain 1) Overdue lease/loan payments at the time of the "loss";Trailers, Mobile Equipment And Temporary Substitute Autos of SECTION I - COVERED 2) Financial penalties imposed under a AUTOS: lease for excessive use, abnormal
wear and tear or high mileage;If Physical Damage Coverage is provided by this Coverage Form, the following types of 3) Security deposits not refunded by a vehicles are also covered "autos" for Physi- lessor;
cal Damage Coverage: 4) Costs of extended warranties, Credit Any "auto" you do not own while used with Life insurance, Health, Accident, or the permission of its owner as a temporary Disability insurance purchased with the lease; and
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5 ) Carry-over balances from previous No deductible applies to glass if the glass is re- leases. paired, in a manner acceptable to us, rather than
2. This coverage only applies to a "loss" which replaced. is also covered under this policy for Com- P. RENTAL REIMBURSEMENT COVERAGE prehensive, Specified Causes of Loss, or 1. This coverage applies only to a covered "au- Collision coverage. to" for which Physical Damage Coverage is
3. Coverage does not apply to any unpaid provided on this policy. amount due on a loan for which the covered 2. We will pay for rental reimbursement ex- “auto” is not the sole collateral. penses incurred by you for the rental of an N. ORIGINAL EQUIPMENT MANUFACTURER "auto" because of "loss" to a covered "auto".
PARTS – LEASED PRIVATE PASSENGER Payment applies in addition to the otherwise TYPES applicable amount of each coverage you
Under Paragraph C. Limit of Insurance of have on a covered "auto." No deductibles SECTION III – PHYSICAL DAMAGE apply to this coverage.
COVERAGE, Section 4 is added as follows: 3. We will pay only for those expenses incurred
4. We will use new original equipment vehicle during the policy period beginning 24 hours manufacturer parts for any private passen- after the "loss" and ending, regardless of the ger type covered “auto” where required by policy's expiration, with the lesser of the the lease agreement which has a term of at following number of days:
least six months. If a new original equip- a. The number of days reasonably ment vehicle manufacturer part is not in pro- required to repair or replace the covered duction or distribution we may use a like, "auto". If "loss" is caused by theft, this kind and quality replacement part. number of days is added to the number O. DEDUCTIBLE AMENDMENTS of days it takes to locate the covered "auto" and return it to you.The following are added to the Deductible provi- sion of SECTION III – PHYSICAL DAMAGE b. The number of days shown in the COVERAGE: Schedule.
If another policy or coverage form that is not an 4. Our payment is limited to the lesser of the automobile policy or coverage form issued by following amounts:
this company applies to the same “accident”, the a. Necessary and actual expenses following applies: incurred.
1. If the deductible under this coverage is the b. $75 for any one day or for a maximum smaller (or smallest) deductible, it will be of 30 days. waived: 5. This coverage does not apply while there
2. If the deductible under this coverage is not are spare or reserve "autos" available to you the smaller (or smallest) deductible, it will be for your operations. reduced by the amount of the smaller (or 6. If "loss" results from the total theft of a cov- smallest) deductible. ered "auto" of the private passenger type, If a Comprehensive or Specified Causes of Loss we will pay under this coverage only that Coverage “loss” from one “accident” involves amount of your rental reimbursement ex- two or more covered “autos”, only the highest penses which is not already provided for un- deductible applicable to those coverages will be der SECTION III – PHYSICAL DAMAGE applied to the “accident,” if the cause of the loss COVERAGE Coverage Extension. is covered for those vehicles. This provision only Q. EXPANDED TRANSPORTATION EXPENSE applies if you carry Comprehensive or Specified Paragraph A.4.a. of SECTION III – PHYSICALCauses of Loss Coverage for those vehicles, DAMAGE COVERAGE is replaced by the follow-and does not extend coverage to any covered ing:“autos” for which you do not carry such coverage. We will pay up to $50 per day to a maximum of $1500 for temporary transportation expense in-
curred by you because of the total theft of a
with its permission.
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covered "auto" of the private passenger type. ment manufacturer or other sources in- We will only pay for those covered "autos" for cluding non-original equipment manu- which you carry Comprehensive or Specified facturers and Causes of Loss Coverage. We will pay for tem- b. If a repair or replacement results in bet - porary transportation expenses incurred during ter than like kind or quality, we will not the period beginning 24 hours after the theft and pay for the amount of the net improve- ending, regardless of the policy's expiration, ment.
when the covered "auto" is returned to use or we 5. If we offer to pay the actual cash value ofpay for its "loss". the damaged or stolen property, we will R. EXTRA EXPENSE – STOLEN AUTOS value auto advertising wraps, paint customi- The following paragraph is added to Coverage zation, and similar business related advertis- Extensions of SECTION III – PHYSICAL ing modifications, in addition to the actual DAMAGE COVERAGE: cash value of the property. Auto advertising c. We will pay for up to $5,000 for the expense wraps, paint customization, and similar of returning a stolen covered “auto” to you. business related advertising modifications We will pay only for those covered “autos” will be valued at the cost to replace them for which you carry Comprehensive or Spec- with an adjustment made for depreciation ified Causes of Loss Coverage and physical condition.
S. PHYSICAL DAMAGE LIMIT OF INSURANCE T. NEW VEHICLE REPLACEMENT COST Under SECTION III – PHYSICAL DAMAGE The following is added to the Limit of Insurance COVERAGE, Paragraph C., Limit of Insurance provision of SECTION III – PHYSICAL is replaced by the following: DAMAGE COVERAGE:
C. Limit Of Insurance 5. The provisions of paragraphs 1. and 3. do not apply to a covered “auto“ of the private1. The most we will pay for “loss” in any one passenger type or a vehicle with a gross“accident” is the lesser of: vehicle weight rating of 20,000 pounds or a. The actual cash value of the damaged less which is a “new vehicle.” or stolen property as of the time of the In the event of a total “loss” to your new ve-“loss”, or hicle to which this coverage applies, we will b. The cost of repairing or replacing the pay at your option:
damaged or stolen property. a. The verifiable “new vehicle” purchase
2. $1500 is the most we will pay for “loss” in price you paid for your damaged vehi- any one “accident” to all electronic equip- cle, not including any insurance or war - ment that reproduces, receives or transmits ranties purchased; audio, visual or data signals which, at the b. If it is available, the purchase price, astime of “loss”, is: negotiated by us, of a “new vehicle” of a. Permanently installed in or upon the the same make, model, and equipment covered “auto” in a housing, opening or or the most similar model available, not other location that is not normally used including any furnishings, parts, or by the “auto” manufacturer for the in- equipment not installed by the manufac- stallation of such equipment. turer or manufacturers’ dealership; or . b. Removable from a permanently installed c. The market value of your damaged ve- housing unit as described in Paragraph hicle, not including any furnishings,
2.a. above or is an integral part of that parts, or equipment not installed by the equipment; or manufacturer or manufacturer’s dealer-
c. An integral part of such equipment. ship.
3. An adjustment for depreciation and physical We will not pay for initiation or set up costs condition will be made in determining actual associated with loans or leases cash value in the event of a total “loss”. As used in this endorsement, a “new
4. The cost of repairing or replacing may: vehicle” means an “auto” of which you are a. Be based on an estimate which includes the original owner that has not been previ- parts furnished by the original equip-
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ously titled and which you purchased less a. Your obligation in the Duties in the Event than 365 days before the date of the “loss”. of Accident, Claim, Suit or Loss Condi- tion relative to notification requirements
applies only when the “accident” orU. PHYSICAL DAMAGE COVERAGE “loss”is known to:EXTENSIONS (1) You, if you are an individual;Under SECTION III – PHYSICAL DAMAGE (2) A partner, if you are a partnership;COVERAGE, A. Coverage, Coverage Exten- sions, b. Loss of Use Expenses is replaced by (3) A member, if you are a limited liability the following: company; or
b. Loss of Use Expenses (4) An executive officer or insurance manager, if you are a corporation.For Hired Auto Physical Damage, we will pay expenses for which an “insured”be- b. Your obligation in the. Duties in the Event comes legally responsible to pay for loss of of Accident, Claim, Suit or Loss Condition use of a vehicle rented or hired without a relative to providing us with documents driver, under a written rental contract or concerning a claim or “suit”will not be agreement. We will pay for loss of use ex- considered breached unless the breach penses if caused by: occurs after such claim or “suit”is known to:(1) Other than collision if the Declarations
indicate that Comprehensive Coverage (1) You, if you are an individual; is provided for any covered “auto”; (2) A partner, if you are a partnership; (2) Specified Causes of Loss only if the (3) A member, if you are a limited Declarations indicate that Specified liability company; or Causes of Loss Coverage is provided (4) An executive officer or insurancefor any covered “auto”;or manager, if you are a corporation.(3) Collision only if the Declarations indicate that Collision Coverage is provided for
X. HIRED CAR – COVERAGE TERRITORYany covered “auto.”
Item (5) of the Policy Period, Coverage TerritoryHowever, the most we will pay for any GeneralConditionssreplaced by the following:expenses for loss of use is $50 per day, to a maximum of $1,500. The insurance provided (5) Anywheren theworldif a covered “auto”is by this provision is excess over any other leased, hired, rented or borrowed without a collectible insurance. driver for a period of 30 days or less; and V. TRANSFER OF RIGHTS OF RECOVERY Y. EMERGENCY LOCKOUT
AGAINST OTHERS TO US We will reimburse you up to $100 for reasonable The following is added to the Transfer Of Rights expense incurred for the services of a locksmith Of Recovery Against Others To Us Condition: to gain entry into your covered “auto”subject to these provisions:We waive any right of recovery we may
have against any person or organization to 1. Your door key, electronic key or key entry the extent required of you by a written con- pad has been lost, stolen or locked in your tract executed prior to any “accident”be- covered “auto”and you are unable to enter cause of payments we make for damages such “auto”, or
under this coverage form. 2. Your keyless entry device battery dies and W. NOTICE OF AND KNOWLEDGE OF you are unable to enter such "auto" as a re- OCCURRENCE sult,
3. Your key, electronic key or key entry padSECTION IV – BUSINESS AUTO has been lost or stolen and you haveCONDITIONS, Paragraph A is amended as changed the lock to prevent an unauthorizedfollows:
entry; and6. NOTICE OF AND KNOWLEDGE OF
OCCURRENCE
with its permission.
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4. Original copies of receipts for services of a If we cancel for any reason other than non- locksmith must be provided before reim- payment of premium, we will mail or deliver bursement is payable. to the First Named Insured written notice of cancellation at least 60 days before the ef-Z. CANCELLATION CONDITION fective date of cancellation. This provision Paragraph A.2. of the COMMON POLICY does not apply in those states that require CONDITION – CANCELLATION applies more than 60 days prior notice of cancella- except as follows: tion.
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C
G 8
1 28 01 18 Includes copyrighted material of Insurance Services Office, Inc., with its permission.
P
age 1 o
f 9
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
GENERAL LIABILITY ENHANCEMENT: HUMAN SERVICES
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE FORM
It is understood and agreed that the following extensions only apply in the event that no other specific coverage for the indicated loss exposure is provided under this policy. If such other more specific coverage applies, the terms, conditions, and limits of that coverage are the sole and exclusive coverage applicable under this policy, unless otherwise noted on this endorsement. The following is a summary of the Limits of Insurance and additional coverages provided by this endorsement.
For complete details on specific coverages, consult the policy contract wording.
Coverage Applicable Limit of Insurance Page #
A
dditional Insured – As Required by Contract Included 7
A
dditional Insured – Broad Form Vendors Included 5
A
dditional Insured – Funding Source Included 4
A
dditional Insured – Grantor of Franchise Included 6
A
dditional Insured – Grantor of Permits Included 4
A
dditional Insured – Home Care Providers Included 4
A
dditional Insured – Lessors Of Leased Equipment – Automatic Status When Required In Lease Agreement With You
Included
4 A
dditional Insured – Managers, Landlords, Or Lessors Of Premises Included 4 A
dditional Insured – Medical Directors And Administrators Included 4 A
dditional Insured – State Or Political Subdivision Included 5 B
roadened Definition Of Bodily Injury Includes Mental Anguish 9
D
amage To Premises Rented To You
$1,000,000
(Includes Expanded Perils)
8 D
amage To Property You Own, Rent, Or Occupy $50,000 2
D
uties In The Event Of Occurrence, Claim Or Suit Included 8 E
mployee Indemnification Defense Coverage For Employee $25,000 3 E
xtended Property Damage Included 3
K
ey And Lock Replacement -Janitorial Services Client Coverage $15,000 2 L
iberalization Included 8
L
imited Rental Lease Agreement Contractual Liability $100,000 3 M
edical Payments $20,000 3
M
edical Payments – Athletic Activities Amended 3
M
edical Payments – Extended Reporting Period 3 Years 3
N
amed Insured – Broadened Named Insured Included 3
N
amed Insured – Newly Acquired Included 3
N
on-Owned Watercraft Less than 58 feet 2
P
ersonal And Advertising Injury – Includes Abuse Of Process And Discrimination
Included
9 S
upplementary Payments – Bail Bonds $7,500 3
S
upplementary Payments – Loss Of Earnings $1,500 per day 3 T
ransfer Of Rights Of Recovery Against Other To Us Clarification 8 U
nintentional Failure To Disclose A Hazard Included 8
INSURED:
POLICY #: POLICY PERIOD: TO
San Diego Rescue Mission, Inc
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010043309
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with its permission.
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A. Key and Lock Replacement – Janitorial Services
Client Coverage
1. We will pay for the cost to replace keys and locks
at the “client’s” premises due to theft or other
loss to keys entrusted to you by your “client”, up
to a $15,000 limit per occurrence/$15,000 policy
aggregate.
2. We will not pay for loss or damage resulting from
theft or any other dishonest or criminal act that
you or any of your partners, members, officers,
“employees”, “managers”, directors, trustees,
authorized representatives or any one to whom
you entrust the keys of a “client” for any purpose
commit, whether acting alone or in collusion with
other persons.
3. The following, when used in this coverage only,
are defined as follows:
a. “Employee” means:
(1) Any natural person:
(a) While in your services or for 30
days after termination of service;
(b) Who you compensate directly by
salary, wages or commissions; and
(c) Who you have the right to direct
and control while performing
services for you; or
(2) Any natural person who is furnished
temporarily to you:
(a) To substitute for a permanent
“employee” as defined in Paragraph
(1) above, who is on leave; or
(b) To meet seasonal or short-term
workload conditions;
while that person is subject to your
direction and control and
performing services for you.
(3) “Employee” does not mean:
(a) Any agent, broker, person leased to
you by a labor leasing firm, factor,
commission merchant, consignee,
independent contractor or
representative of the same general
character; or
(b) Any “manager”, director or trustee
except while performing acts
coming within the scope of the
usual duties of an “employee”.
b. “Manager” means a person serving in a
directorial capacity for a limited liability
company.
B. SECTION I – COVERAGES, COVERAGE A -
BODILY INJURY AND PROPERTY DAMAGE
LIABILITY, 2. Exclusions is amended as follows:
1. Exclusion a. Expected or Intended Injury is
deleted and replaced with:
a. “Bodily injury” or “property damage”
expected or intended from the stand point of
the insured. This exclusion does not apply to
“bodily injury” or “property damage” resulting
from the use of reasonable force to protect
persons or property.
2. Exclusion g. Aircraft, Auto or Watercraft
Paragraph (2) is deleted and replaced with:
(2) A watercraft you do not own that is:
(a) Less than 58 feet long; and
(b) Not being used to carry persons or
property for a charge;
This provision applies to any person, who with
your consent, either uses or is responsible for
the use of a watercraft. This insurance is excess
over any other valid and collectible insurance
available to the insured whether primary, excess,
or contingent.
3. Exclusion j. is amended as follows:
(a) Exclusion j.(1) is deleted and replaced with:
(1) Property you own, rent , or occupy,
including any costs or expenses
incurred by you, or any other person,
organization or entity, for repair,
replacement, enhancement, restoration
or maintenance of such property for any
reason, including prevention of injury to
a person or damage to another’s’
property, unless the damage to property
is caused by your “client”, in such case
we will provide coverage for such
“property damage” for which you are
legally obligated to pay up to a $50,000
limit per “occurrence”. This limit is the
only limit of insurance for such “property
damage” and will not be combined with
the Each Occurrence Limit set for this in
Section III – Limits of Insurance and
will be included within and not in
addition to the Each Occurrence Limit.
Any and all damages paid under the
terms and condition of this provision will
further be applied against and will
reduce the Aggregate Limit of Insurance
shown on the Declarations page, and as
provided in the Commercial General
Liability Coverage Form in the same
manner and in addition to all other
coverages of the Commercial General
Liability Coverage Form that are also
subject to the Aggregate Limit.
4. The following is added to Paragraph (2) of
Exclusion b. Contractual Liability of SECTION I
– COVERAGES, COVERAGE A. BODILY
INJURY AND PROPERTY DAMAGE LIABILITY,
under Subsection 2. Exclusions:
We agree to indemnify the Named Insured for
their liability assumed in a contract or agreement
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regarding the rental or lease of a premises on
behalf of their “client”, up to $100,000 per
“occurrence”. This limit of insurance is the only
limit of insurance for your liability assumed in a
contract or agreement regarding the rental or
lease of a premises on behalf of your “client”
whether or not such contract qualifies as an
“insured contract”. This limit will not be combined
with the Each Occurrence Limit set forth in
Section III – Limits of Insurance and is
included within and not in addition to the Each
Occurrence Limit. This coverage extension only
applies to rental lease agreements. This
coverage is excess over any renter’s liability
insurance of the “client”.
Any and all damages paid under the terms and
conditions of this provision will further be applied
against and will reduce the Aggregate Limit of
Insurance shown on the Declarations page, as
provided in the Commercial General Liability
Coverage Form in the same manner and in
addition to all other coverages of the Commercial
General Liability Coverage Form that are also
subject to the Aggregate Limit.
5. The last Paragraph of Subsection 2. Exclusions
is replaced by the following:
If damage by fire to premises rented to you is not
otherwise excluded, exclusions c. through n. do
not apply to damage by fire, lightning, explosion,
smoke or sprinkler leakage to premises while
rented to you or temporarily occupied by you with
permission of the owner. A separate limit of
insurance applies to this coverage as described
in Section III – Limits of Insurance.
C. SECTION I – COVERAGES, COVERAGE C –
MEDICAL PAYMENTS
1. If COVERAGE C – MEDICAL PAYMENTS is not
otherwise excluded from this Coverage Part:
a. The Medical Expense Limit shown on the
Declarations is deleted and replaced by
$20,000. $20,000 is the only limit of
insurance for Medical Expenses and this
limit will not be combined with any other limit
of insurance.
b. Subsection 1. Insuring Agreement,
Paragraph a.(3)(b) is replaced by:
(b) The expenses are incurred and reported
to us within three years of the date of
the accident; and
2. Subsection 2. Exclusions, is amended as
follows:
a. Exclusion a. Any Insured is deleted and
replaced with:
a. Any Insured
To any insured, except “volunteer
workers” or an insured as provided in e.
Athletic Activities below.
b. Exclusion e. Athletics Activities is deleted
and replaced with:
e. Athletics Activities
To a person injured while practicing or
participating in any physical exercises
or games, sports or athletic contests.
This exclusion shall not apply to an
insured while providing instruction with
respect to any of the activities otherwise
excluded by this provision.
D. SECTION I – COVERAGES, SUPPLEMENTARY
PAYMENTS – COVERAGES A AND B is amended
as follows:
1. 1. b. is replaced with:
b. Up to $7,500 for cost of bail bonds required
because of accidents or traffic law violations
arising out of the use of any vehicle to which
the Bodily Injury Liability Coverage applies.
We do not have to furnish these bonds.
2. 1. d . is replaced with:
d. All reasonable expenses incurred by the
insured at our request to assist us in the
“suit”, including actual loss of earnings up to
$1,500 a day because of time off from work.
3. The following provision is added:
We will reimburse you for defense costs that you
incur in the defense of an “employee” who is
directly involved in a criminal proceeding that
arises out of such “employee’s” acts or
omissions within the scope of their employment
by you or while performing duties related to the
conduct of your business and which would
otherwise be covered by this insurance.
The most we will reimburse you for defense
costs that you incur in the defense of an
“employee” who is alleged to be directly involved
in a criminal proceeding is $25,000, subject to an
aggregate limit of $25,000 for all reimbursements
that we make during the policy period on behalf
of all “employees”, regardless of the numbers of
“employees”, claims or “suits” brought or persons
or organizations making claims or bringing
“suits”.
E. SECTION II WHO IS AN INSURED is amended as
follows:
1. If coverage for a newly acquired or formed
organization is not otherwise excluded from this
Coverage Part, Paragraph 3.a. is replaced with:
a. Coverage under this provision is until the
end of the policy period during which you
acquired or formed the organization;
2. The following is also an insured:
Broadened Named Insured – Any organization
and subsidiary thereof which you control and
actively manage (whether through ownership of
voting securities, by contract, or otherwise) on
the effective date of this policy. However,
coverage does not apply to any organization or
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subsidiary not named in the Declarations as a
Named Insured, if they are also insured under
another similar policy, or would have been
insured but for such policy’s termination or the
exhaustion of its limits of insurance.
3. Each of the following is also an additional
insured:
a. Medical Directors and Administrators – Your
medical directors and administrators but
only while acting within the scope of and
during the course of their duties as such.
Such duties do not include the furnishing or
failure to furnish professional services as a
physician or psychiatrist in the treatment of
a patient.
b. Funding Source – Any person or
organization with respect to their liability
arising out of:
(1) Their financial control of you; or
(2) Premises they own, maintain or control
while you lease or occupy these
premises.
This insurance does not apply to:
(a) Any “occurrence” or offense which
takes place after you cease to
lease or occupy that premises; or
(b) Structural alterations, new
construction or demolition
operations performed by or on
behalf of that person or
organization.
c. Home Care Providers – At the first Named
Insured’s option, any person or organization
under your direct supervision and control
while providing on your behalf private home
respite or foster home care for the
developmentally disabled.
d. Managers, Landlords, or Lessors of
Premises – Any person or organization with
respect to liability arising out of the
ownership, maintenance or use of that part
of the premises leased or rented to you
subject to the following additional
exclusions:
This insurance does not apply to:
(1) Any “occurrence” which takes place
after you cease to be a tenant in that
premises.
(2) Structural alterations, new construction
or demolition operations performed by
or on behalf of the person or
organization.
e. Lessor of Leased Equipment – Automatic
Status When Required in Lease Agreement
With You - Any person(s) or organization(s)
from whom you lease equipment when you
and such person(s) or organization(s) have
agreed in writing in a contract or agreement
that such person(s) or organization(s) be
added as an additional insured on your
policy. Such person(s) or organization(s) is
an insured only with respect to liability for
"bodily injury", "property damage" or
"personal and advertising injury" caused, in
whole or in part, by your maintenance,
operation or use of equipment leased to you
by such person(s) or organization(s).
However, the insurance afforded to such
additional insured:
(1) Only applies to the extent permitted by
law; and
(2) Will not be broader than that which you
are required by the contract or
agreement to provide for such additional
insured.
A person’s or organization’s status as an
additional insured under this endorsement
ends when their contract or agreement with
you for such leased equipment ends.
With respect to the insurance afforded to
these additional insureds, this insurance
does not apply to any "occurrence" which
takes place after the equipment lease
expires.
f. Grantors of Permits – Any state or
governmental agency or subdivision or
political subdivision granting you a permit in
connection with your premises subject to the
following additional provision:
This insurance applies only with respect to
the following hazards for which the state or
governmental agency or subdivision or
political subdivision has issued a permit or
authorization in connection with premises
you own, rent or control and to which this
insurance applies:
(1) The existence, maintenance, repair,
construction, erection or removal of
advertising signs, awnings, canopies,
cellar entrances, coal holes, driveways,
manholes, marquees, hoist away
openings, sidewalk vaults, street
banners or decorations and similar
exposures; or
(2) The construction, erection or removal of
elevators; or
(3) The ownership, maintenance or use of
any elevators covered by this insurance.
However:
(1) The insurance afforded to such
additional insured only applies to the
extent permitted by law; and
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(2) If coverage provided to the additional
insured is required by a contract or
agreement, the insurance afforded to
such additional insured will not be
broader than that which you are
required by the contract or agreement to
provide for such additional insured.
g. State or Political Subdivision – Any state or
political subdivision with whom you agreed
under a written contract or agreement to add
as an additional insured to your policy but
only with respect to their liability with respect
to on-going operations performed by you or
on your behalf for which the state or political
subdivision has issued a permit or license.
This insurance does not apply to:
1. “Bodily injury”, “property damage” or
“personal and advertising injury” arising
out of operations performed for the state
or political subdivision; or
2. “Bodily injury” or “property damage”
included within the “products-completed
operations hazard”.
The insurance provided to such additional
insured state or political subdivision by this
endorsement is further limited as follows:
1. The additional insured is covered only
for such sums that such additional
insured is legally obligated to pay as
damages under tort law principles to the
injured party because of “bodily injury”,
“property damage” or “personal and
advertising injury” to which this
insurance applies, and in accordance
with the stated policy limits, exclusions,
limitations and conditions except as
expressly modified by this endorsement.
2. The limits of insurance are those set
forth in the policy Declarations or those
specified in the written contract or
agreement referenced above, whichever
is less.
Other Insurance
1. If specifically required by the written
contract or agreement referenced
above, any coverage provided by this
Subsection g. to an additional insured
shall be primary and any other valid and
collectible insurance available to the
additional insured shall be non-
contributory with this insurance. If the
written contract does not require this
coverage to be primary and the
additional insured’s coverage to be non-
contributory, then this insurance will be
excess over any other valid and
collectible insurance available to the
additional insured.
2. Even if the requirements of Paragraph
1. immediately above are met
establishing this coverage as primary
and the additional insured’s coverage
as being non-contributory, this coverage
will be excess over any other insurance
available to the additional insured which
is conferred onto said person or
organization by a separate additional
insured endorsement.
h. Broad Form Vendors – Any person(s) or
organization(s) which or who is or are a
vendor of “your products” with whom you
agreed under a written contract or
agreement to add as an additional insured to
your policy, but only with respect to “bodily
injury” or “property damage” arising out of
“your products” which are distributed or sold
in the regular course of the vendor’s
business, subject to the following additional
exclusions:
The insurance afforded the vendor does not
apply to:
1. “Bodily injury” or “property damage” for
which the vendor is obligated to pay
damages by reason of the assumption
of liability in a contract or agreement.
This exclusion does not apply to liability
for damages that the vendor would have
in the absence of the contract or
agreement;
2. Any express warranty unauthorized by
you;
3. Any physical or chemical change the
vendor intentionally made to the
product;
4. Repackaging, except when unpacked
solely for the purpose of inspection,
demonstration, testing, or the
substitution of parts under instructions
from the manufacturer, and then
repackaged in the original container;
5. Any failure to make 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.
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
by you, have been labeled or relabeled
or used as a container, part or
ingredient of any other thing or
substance by or for the vendor; or
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8. “Bodily injury” or “property damage”
arising out of the negligence of the
vendor for its own acts or omissions or
those of its employees or anyone else
acting on its behalf and which was not
caused in whole or in part by you or any
person or organization acting on your
behalf. However, this exclusion does not
apply to:
(a) The exceptions contained in
Subparagraphs 4. or 6.; 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.
The insurance provided to such additional
insured vendor by this endorsement is
further limited as follows:
1. The additional insured is covered only
for such sums that such additional
insured is legally obligated to pay as
damages under tort law principles to the
injured party because of “bodily injury”,
“property damage” or “personal and
advertising injury” to which this
insurance applies, and in accordance
with the stated policy limits, exclusions,
limitations and conditions except as
expressly modified by this endorsement.
2. The limits of insurance are those set
forth in the policy Declarations or those
specified in the written contract or
agreement referenced above in the first
paragraph of this Subsection h.,
whichever is less.
This insurance does not apply to any
insured person or organization, from whom
you have acquired such products, or any
ingredient, part or container, entering into,
accompanying or containing such products.
Other Insurance
1. If specifically required by the written
contract or agreement referenced above
in the first paragraph of this Subsection
h., any coverage provided by this
endorsement to an additional insured
shall be primary and any other valid and
collectible insurance available to the
additional insured shall be non-
contributory with this insurance. If the
written contract does not require this
coverage to be primary and the
additional insured’s coverage to be non-
contributory, then this insurance will be
excess over any other valid and
collectible insurance available to the
additional insured.
2. Even if the requirements of Paragraph
1. immediately above are met
establishing this coverage as primary
and the additional insured’s coverage
as being non-contributory, this coverage
will be excess over any other insurance
available to the additional insured which
is conferred onto said person or
organization by a separate additional
insured endorsement.
i. Grantor of Franchise – Any person(s) or
organization(s) with whom you agreed under
a written contract or agreement to add as an
additional insured to your policy but only with
respect to their liability as grantor of a
franchise to you.
The insurance provided to such additional
insured franchisor by this endorsement is
further limited as follows:
1. The additional insured is covered only
for such sums that such additional
insured is legally obligated to pay as
damages under tort law principles to the
injured party because of “bodily injury”,
“property damage” or “personal and
advertising injury” to which this
insurance applies, and in accordance
with the stated policy limits, exclusions,
limitations and conditions except as
expressly modified by this endorsement.
2. The limits of insurance are those set
forth in the policy Declarations or those
specified in the written contract or
agreement referenced above, whichever
is less.
Other Insurance
1. If specifically required by the written
contract or agreement referenced above
in the first paragraph of this Subsection
i., any coverage provided by this
endorsement to an additional insured
shall be primary and any other valid and
collectible insurance available to the
additional insured shall be non-
contributory with this insurance. If the
written contract does not require this
coverage to be primary and the
additional insured’s coverage to be non-
contributory, then this insurance will be
excess over any other valid and
collectible insurance available to the
additional insured.
2. Even if the requirements of Paragraph
1. immediately above are met
establishing this coverage as primary
and the additional insured’s coverage
as being non-contributory, this coverage
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will be excess over any other insurance
available to the additional insured which
is conferred onto said person or
organization by a separate additional
insured endorsement.
j. As Required by Contract – Any person or
organization for whom “you” are performing
operations, or to whom you are leasing,
subleasing or otherwise entrusting the use
or occupancy of premises owned by or
rented to “you”, only as specified under a
written contract, lease, sublease or
agreement that requires that such person or
organization be added as an additional
insured on “your” policy. Such person or
organization is an additional insured only
with respect to liability caused, in whole or in
part, by the acts or omissions of the “Named
Insured” or the acts the acts or omissions of
those acting on your behalf in the
performance of the “Named Insured’s”
ongoing operations for the additional insured
or in connection with such premises owned
by or rented to a “Named Insured”, but in
both instances only as specified under the
written contract, lease, sublease or
agreement. A person’s or organization’s
status as an additional insured under this
endorsement ends the earlier of when “your”
on-going operations for that additional
insured are completed or when “you” no
longer are contractually required to include
such person or organization as an additional
insured under “your” policy.
The insurance provided to an additional
insured by this endorsement is limited as
follows:
1. The additional insured is covered only
for such damages which are caused, in
whole or in part, by the acts or
omissions of the “Named Insured” to
which the additional insured is entitled
to be indemnified by the “Named
Insured” pursuant to the written
contract, lease, sublease or agreement
referenced in the first paragraph of this
subsection i. above and only for those
sums that the additional insured is
legally obligated to pay as damages
under tort law principles to the injured
party because of “bodily injury”,
“property damage” or “personal and
advertising injury” to which this
insurance applies, and in accordance
with the stated policy limits and policy
conditions. This coverage does not
apply for defense or indemnity of the
additional insured if state or federal law
does not permit indemnification of the
additional insured by the “Named
Insured” for the claim of the third party.
2. The limits of insurance are those set
forth in the policy and Declarations or
those specified in the written contract,
lease, sublease or agreement
referenced in the first Paragraph of this
Subsection j., whichever is less.
With respect to the insurance afforded to an
additional insured under this Subsection j.,
the following exclusions are added:
1. This insurance does not apply if the
written contract, lease, sublease or
agreement referenced in the first
Paragraph of this Subsection j. above
was not executed by the “Named
Insured” prior to the “occurrence” giving
rise to the additional insured’s potential
liability.
2. This insurance does not apply to the
additional insured’s liability to indemnify,
defend or hold harmless a third party.
3. This insurance does not apply to “bodily
injury”, “property damage” or “personal
and advertising injury” for which the
additional insured is obligated to pay
damages by reason of the assumption
of liability in a contract or agreement.
This exclusion does not apply to liability
for damages that the additional insured
would have in the absence of the
contract or agreement.
4. “Bodily injury”, “property damage” or
“personal and advertising injury” arising
out of the rendering of, or the failure to
render, any professional architectural,
engineering or, surveying services,
including:
(a) The preparing, approving, or failing
to prepare or approve, maps, shop
drawings, opinions, reports,
surveys, field orders, change orders
or drawings and specifications; and
(b) Supervisory, inspection, archi-
tectural or engineering activities.
5. “Bodily injury” or “property damage”
occurring after:
(a) All work, including materials, parts
or equipment furnished in
connection with such work, on the
project (other than service
maintenance or repairs) to be
performed by or on behalf of the
additional insured(s) at the site of
the covered operations has been
completed; or
(b) That portion of “your work” out of
which the injury or damage arises
has been put to its intended use by
any person or organization other
than another contractor or
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subcontractor engaged in
performing operations for a
principal as a part of the same
project.
Other Insurance
1. If specifically required by the written
contract, lease, sublease or agreement
referenced in the first Paragraph of this
Subsection j. above, any coverage
provided by this endorsement to an
additional insured shall be primary and
any other valid and collectible insurance
available to the additional insured shall
be non-contributory with this insurance.
If the written contract, lease or sublease
does not require this coverage to be
primary and the additional insured’s
coverage to be non-contributory, then
this insurance will be excess over any
other valid and collectible insurance
available to the additional insured.
2. Even if the requirements of Paragraph
1. immediately above are met
establishing this coverage as primary
and the additional insured’s coverage
as being non-contributory, this coverage
will be excess over other insurance
available to the additional insured which
is conferred onto said person or
organization by a separate additional
insured endorsement.
Definitions
Solely for purposes of the insurance
afforded to an additional insured by this
endorsement:
“Named Insured” is defined as the entity to
whom the insurance policy is issued as
shown on the Declarations.
“You” or “your” means a “Named Insured” as
defined above.
F. SECTION III – LIMITS OF INSURANCE is amended
as follows:
1. Paragraph 6 is replaced with:
6. Subject to 5. above, the Damage To
Premises Rented to You Limit is the most
we will pay under Coverage A for damages
because of “property damage” to any one
premises, while rented to you or in the case
of damage by fire while rented to or
temporarily occupied by you with permission
of the owner. The limit is increased to
$1,000,000.
However, if damage by fire to premises
rented to you is not otherwise excluded, the
word fire in the above paragraph is replaced
with fire, lightning, explosion, smoke or
sprinkler leakage.
G. SECTION IV – COMMERCIAL GENERAL LIABILITY
CONDITIONS is amended as follows:
1. Duties In The Event Of Occurrence, Offense,
Claim Or Suit is amended as follows:
a. The following is added to Paragraph a.:
However, this condition only applies when
the “occurrence” or offense is known to:
i. You, if you are an individual;
ii. A partner, if you are a partnership; or
iii. An executive officer or insurance
manager, if you are a corporation.
b. The following is added to Paragraph b.:
However, this condition will not be
considered breached unless the breach
occurs after such claim or “suit” is known to:
i. You, if you are an individual;
ii. A partner, if you are a partnership; or
iii. An executive officer or insurance
manager, if you are a corporation.
2. Subsection 4. Other Insurance , Paragraph b.
Excess Insurance, Item (1)(a)(ii) is replaced by
the following if damage to premises rented to you
is not otherwise excluded:
(ii) That is fire, lightning, explosion, smoke or
sprinkler leakage insurance for premises
rented to you or temporarily occupied by you
with permission of the owner.
3. Subsection 6. Representations is amended to
include:
d. Your failure to disclose all hazards or prior
“occurrences” or offenses existing as of the
inception date of the policy shall not
prejudice the coverage afforded by this
policy provided such failure to disclose all
hazards or prior “occurrences” or offenses is
not intentional. This provision does not affect
our right to collect additional premium or
exercise our right of cancellation or
nonrenewal.
4. Subsection 8. Transfer of Rights of Recovery
Against Others to Us is amended to include:
Therefore, the insured can waive the insurer’s
Rights of Recovery prior to the occurrence of a
loss, provided the waiver is made in a written
contract.
5. The following condition is added:
10. Liberalization
If we revise this coverage form to provide more
coverage without additional premium charge,
your policy will automatically provide the
additional coverage as of the day the revision is
effective in your state, provided that this
implementation date falls within 45 days prior to
or during the policy period stated in the
Declarations.
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H. SECTION V – DEFINITIONS is amended as follows:
1. Paragraph 3. “Bodily Injury” is deleted and
replaced with the following:
“Bodily Injury”:
a. Means bodily injury, sickness, or disease
sustained by a person and includes mental
anguish resulting from any of these; and
b. Except for mental anguish, includes death
resulting from the foregoing (Item a. above)
at any time.
2. If damage by fire to premises rented to you is not
otherwise excluded, Paragraph 9. “Insured
Contract”, Item a. is replaced by the following:
a. A contract for a lease of premises. However,
that portion of the contract for a lease of
premises that indemnifies any person or
organization for damage by fire, lightning,
explosion, smoke or sprinkler leakage to
premises while rented to you or temporarily
occupied by you with permission of the
owners is not an “insured contract”;
3. Paragraph 14. “Personal and Advertising Injury”
is amended as follows:
a. Item b. is deleted and replaced with the
following:
b. Malicious prosecution or abuse of
process;
b. Item h. is added:
h. “Personal and advertising injury” also
means injury, including consequential
“bodily injury”, arising out of
discrimination based on race, color,
religion, sex, age or national origin,
except when:
(1) Done intentionally by or at the
direction of, or with the knowledge
or consent of:
(a) Any insured; or
b. Any executive officer, director,
stockholder, partner or
member of the insured; or
(2) Directly or indirectly related to the
employment, former or prospective
employment, termination of
employment, demotion, failure to
promote or application for
employment of any person or
persons by an insured; or
(3) Directly or indirectly related to the
sale, rental, lease or sublease or
prospective sales, rental, lease or
sub-lease of any room, dwelling or
premises by or at the direction of
any insured; or
(4) Insurance for such discrimination is
prohibited by or held in violation of
law, public policy, legislation, court
decision or administrative ruling
This coverage does not apply to fines or
penalties imposed because of discrimination.
4. “Client” as used in this endorsement means:
a. An individual, company or organization with
whom you have a written contract or work
order for your services for a described
premises and have billed for your services;
or
b. A person under your direct care and
supervision for whom you are providing
goods and/or services.
All terms and conditions of this policy apply unless modified by this endorsement.
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00022422 8 Exhibit D
AGREEMENT TO COMPLY WITH CALIFORNIA LABOR LAW REQUIREMENTS [Labor Code §§ 1720, 1771.1, 1773.8, 1775, 1776, 1777.5, 1813, 1860, 1861, 3700
NOT APPLICABLE TO THIS CONTRACT
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00022422 8 Exhibit E
EXHIBIT E
SPECIAL PROVISIONS
This Contract is subject to the following provisions, if checked:
1. State of California grant conditions, as attached.
2. Federal grant conditions, as attached.
3. Other conditions, as attached.
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