PROOF OF INSURANCE (2020 - 2020) CLOSEDURTAL-1 OP ID: CP
I
CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDD/YYYY)03/24/2020
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must 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),
Alc, Ne. ExRI: nsurance Aenc)f
Kraft and Lee Insurance Agency PHgPRODUCER T "" FAX
40061 Highway 49, Suite 103 F MALI Kraft and Lee I iArc Nel. 559 683-0414
559 683 4411
P.O. Box 2040 EMAIL s:
Oakhurst, CA 93644
Kraft and Lee Insurance Agency _m )oOV RA
G..E
NAIC #
INSURER A: Sentinel Insurance ComPanV.LTD
11000
INSURED URTA, LLC m mmmm INSURER B: Hiscox Insurance Company,lnc
DBA: Unified Response Training -_
Associates INSURER C: NONE
PO Box 101 INSURER D: NONE „IT
Oakview, CA 93022 INSURER E: NONE
INSURER F: NONE
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER
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.
.._....N GENERAL LIABILITY � POLICY NUMBER Y4Y4444444 "WIA DDFYYYY% (MM/DD/YYYYI EACH OCCURRENCE $ 2
IA R X COMMERCIAL OGEN U... AD'L C SIi,B1f ..'. POLICY EFF POLICY EXP LIMITS
LTR INSD WVf1
CC 000,000
15n9�AiiiF� I 1 ._..._.....,... $.......... 1,000'......, ..
CLAIMS -MADE X OCCUR X 51SBMA18447SC 09/15/2019 09/15/2020 pREM1SESfiEaoccucaonce) 0
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY PRO-
OTHER
RO ❑ LOC
JECT
OTHER
AUTOMOBILE LIABILITY
A ANY AUTO _
ALL OWNED SCHEDULED
AUTOS AUTOS
NON -OWNED
X HIRED AUTOS X AUTOS
UMBRELLA LIAR X OCCUR
A X EXCESS LIAR CLAIMS -MADE
DE`j
D X I RETENTION$ 10,000
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y / N
E ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED? N I A
(Mandatory in NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
B Professional Liab.
Claims Made
51SBMA18447SC
51SBMA18447SC
NONE
M,PL2041111.19
MED EXP (Any one person)
$ 10,000
PERSONAL & ADV INJURY
$ 2,000,000
GENERAL AGGREGATE
........................
$ 4,000,000
PRODUCTS....._..............
......000,000
$
COMBINED SINGLE LIMIT
f Ea accidan9'1 ........
,000,000
03/11/2020 09/15/2020 BODILY INJURY (Per person)
$
BODILY INJURY (Per accident)
$
PROPERTY DAMAGE:
IPw accldenl'I
CCURRENCE $
03/11/2020 09/15/2020 AGGREGATE $
LPER TH-
STAT U T. F..... L. 1....F I?.
E.L EACH
E.L. DISEASE CIN $
EA EMPLOYEE $
E.L. DISEASE -POLICY LIMIT $
09/16/2019 09/16/2020 Each Clai
Retention
DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required)
CERTIFICATE HOLDER AND ITS OFFICIALS AND EMPLOYEES ARE NAMED AS AN
ADDITIONAL INSURED WITH RESPECT TO GENERAL LIABILITY ONLY AND INCLUDES
PRIMARY WORDING PER FORM SS 00 08 04 05 WHEN REQUIRED BY REQUIRED BY WRITTEN
CONTRACT, AGREEMENT OR PERMIT. 30 DAY NOTICE OF CANCELLATION IS INCLUDED
PER FORM # SS 12 23 06 11.
CERTIFICATE HOLDER
City of EI Segundo
Att: Barbara Voss
350 Main Street
EI Segundo, CA 90245
I
ACORD 26 (2014/01)
CITYELS
r
/�R
3,000,00
3,000,00
I
2,000,000
5,000
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
D REPRESENT 'LEVE
Kraft. ..
AUT Pe .,. •..enf9 ... yy.... _.....
,an.� ... ..w '
dL Lee I s ceA
.988-2014
ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
Various provisions inthis policy restrict coverage. Read the entire policy carefully todeteminohghtn.duUeamndwha
is and is not covered,
Throughout this policy the words "you" and "Your" refer to the Named Insured shown in the Declarations. The words
"we", "us" and "our" refer to the stock insurance company member of The Hartford providing this insurance,
The word "insured" means any person or organization qualifying as such under Section C. - Who Is An Insured.
Other words and phrases that appear in quotation modm have special meaning. Refer to Section Q, Liability And
Medical Expenses Definitions.
1. BUSINESS LIABILITY COVERAGE (BODILY
INJURY, PROPERTY DAMAGE, PERSONAL
AND ADVERTISING INJURY)
Insuring Agreement
We will pay those sums that the insured
becomes legally obligated to pay as
damages because of "bodily injury".
"property damage" or "personal and
advertising injury" to which this insurance
applies. We will have the right and duty to
defend the insured against any "suit"
seeking those damages, However, we will
have nuduty ho defend the insured against
any "mud" seeking damages for "bodily
injury", "property damage"' or "personal and
advertising injury" to which this insurance
does not apply,
We may, at our diaomUon, investigate any
"occurrenua"oroffense and settle any claim
or "suit" that may result. But:
(1) The amount wewill pay for damages is
limited as described /n Section 0. '
Liability And /Nodico| Expenses Limits
Of Insurance; and
(2) Our right and duty hxdefend ends when
we have used up the applicable limit of
insurance in the payment of judgments,
settlements nrmedical expenses towhich
this insurance applies.
Nnother obligation or liability to pay sums or
podbnn acts or services is covered unless
explicitly provided for under Coverage
Extension - Supplementary Payments.
b. This insurance applies:
(1) To "bodily injury" and "property
damage" only if:
(a) The "bodily injury" or "property
damage" is caused by on
"oocurenca''that takes place in the
.,coverage territory";
(W The "bodily injury" or "property
damage" occurs during the policy
period; and
(d Prior to the policy period, noinsured
|iahyd under Paragraph 1. of Section
C. — Who Is An Insured and no
'employee'authorized byyou hogive
or receive notion ofan''000urenue^
or claim, knew that the "bodily injury,
or "property damage" had occurred,
inwhole orinpart. |fsuch alisted
insured or authorized "employee"
knew, prior to the policy pehnd, that
the "bodily injury" or "property
damage' oncumad. then any
continuation, change or resumption
of such "bodily injury" or "property
damage" during or oMor the policy
period will be deemed to have been
known prior huthe policy period.
(2) To "personal and advertising iN«[Y"
oeuood by an offense arising out of your
buuinoas, but only if the offense was
committed in the "coverage territory"
during the policy period.
c. "Bodily injury" or "property damage" will be
deemed to have been known to have
occurred at the earliest time when any
insured listed under Paragraph 1.ofSection
O.—VVho Is An Insured or any "employee"
authorized byyou tngive orreceive notice
of an "occurrence" or claim:
(i) Reports all, or any part of the "bodily
injury" or "property damage" to us or
any other insurer;
Form 0S0008O4U6
Page of 24
0 2005.The Hartford
BUSINESS LIABILITY COVERAGE FORM
(2) Receives a written or verbal demand or
b. We will make these payments regardless of
claim for damages because of the "bodily
fault. These payments will not exceed the
injury" or "property damage'; or
applicable limit of insurance. We will pay
(3) Becomes aware by any other means that
reasonable expenses for:
"bodily injury" or "property damage" has
(1) First aid administered at the time of an
occurred or has begun to occur.
accident;
d. Damages because of "bodily injury" include
(2) Necessary medical, surgical, x-ray and
damages claimed by any person or
dental services, including prosthetic
organization for care, loss of services or
devices; and
death resulting at any time from the "bodily
(3) Necessary ambulance, hospital,
injury"•
professional nursing and funeral
e. Incidental Medical Malpractice
services.
(1) "Bodily injury" arising out of the
3. COVERAGE EXTENSION -
rendering of or failure to render
SUPPLEMENTARY PAYMENTS
professional health care services as a
a. We will pay, with respect to any claim or
physician, dentist, nurse, emergency
„ suit we investigate or settle, or any suit
medical technician or paramedic shall
against an insured we defend:
be deemed to be caused by an
"occurrence", but only if:
(1) All expenses we incur.
(a) The physician, dentist, nurse,
(2) Up to $1,000 for the cost of bail bonds
emergency medical technician or
required because of accidents or traffic
paramedic is employed by you to
law violations arising out of the use of
provide such services; and
any vehicle to which Business Liability
(b) You are not engaged in the
Coverage for "bodily injury" applies. We
do not have to furnish these bonds.
business or occupation of providing
such services.
(3) The cost of appeal bonds or bonds to
(2) For the purpose of determining the
release attachments, but only for bond
amounts within the applicable limit of
limits of insurance for incidental medical
insurance. We do not have to furnish
malpractice, any act or omission
these bonds.
together with all related acts or
omissions in the furnishing of these
(4) All reasonable expenses incurred by the
services to any one person will be
insured at our request to assist us in the
considered one "occurrence".
investigation or defense of the claim or
2. MEDICAL EXPENSES
"suit", including actual loss of earnings
up to $500 a day because of time off
Insuring Agreement
from work.
a. We will pay medical expenses as described
(5) All costs taxed against the insured in
below for "bodily injury" caused by an
the "suit".
accident:
(6) Prejudgment interest awarded against
(1) On premises you own or rent;
the insured on that part of the judgment
(2) On ways next to premises you own or
we pay. If we make an offer to pay the
rent; or
applicable limit of insurance, we will not
(3) Because of your operations;
pay any prejudgment interest based on
that period of time after the offer.
provided that:
(7) All interest on the full amount of any
(1) The accident takes place in the
judgment that accrues after entry of the
"coverage territory" and during the
judgment and before we have paid,
policy period;
offered to pay, or deposited in court the
(2) The expenses are incurred and reported
part of the judgment that is within the
to us within three years of the date of
applicable limit of insurance.
the accident; and
Any amounts paid under (1) through (7)
(3) The injured person submits to
above will not reduce the limits of insurance.
examination, at our expense, by
physicians of our choice as often as we
reasonably require.
Page 2 of 24 Form SS 00 08 04 05
b If we defend an insured against o "suit"
and an indemnitee o[the insured ioalso
named as a party to the "auU", we will
defend that indemnitee if all of the
following conditions are met:
(1) The "suit" against the indemnitee
seeks damages for which the insured
has assumed the liability of the
indemnitee inecontract oragreement
that is an "insured contract";
CD This insurance applies tosuch liability
assumed bythe insured;
(3) The obligation to defend, orthe cost of
the defense of, that indomndon, has
also been assumed by the insured in
the same "Insured uonbaoY'�
.
(4) The allegations in the "suit" and the
information we know about the
"boounanoa" are such that no conflict
appears hoexist between the interests
of the insured and the interest ofthe
indemnitee;
(5) The indemnitee and the insured ask
uohoconduct and control the defense
of that indemnitee against such "suit"
and agree that we can assign the
same counsel to defend the insured
and the indemnitee; and
(G) The indemnitee:
(a)Agrees inwriting to:
(U Cooperate with us in the
inveoUgohon, om0ommd or
defense ofthe "suit';
(U) Immediately send uocopies of
any demands, notices,
summonses or legal papers
received in connection with
the "suit";
(|i|)Notify any other insurer whose
coverage is available to the
indemnitee; and
(Iv) Cooperate with un with
respect to coordinating other
applicable insurance available
tothe indemnitee; and
(b) Provides us with written
authorization to:
(i) Obtain records and other
information m|mded to the
'.suit'; and
(ii) Conduct and control the
defense of the indemnitee in
such "suit".
BUSINESS LIABILITY COVERAGE FORM
Golong esthe above conditions are met,
attorneys' fees incurred by un in the
defense of that indemnitee necessary
litigation expenses incurred by us and
necessary litigation expenses incurred
by the indemnitee otour request will be
paid oaSupplementary Payments.
Notwithstanding the provisions of
Paragraph 1.b.(b) of Section B. —
Exc|usiono, such payments will not be
deemed to be daunogea for "bodily
injury" and "property damage" and will
not reduce the Limits nfInsurance,
Our obligation to defend an ineunad's
indemnitee and to pay for attorneys' fee
and necessary litigation expenses as
Supplementary Payments ends when:
(1) We have used upthe applicable limit
of insurance in the payment of
judgments orsettlements; or
(2) The conditions set forth abovo, o, the
terms of the agreement described in
Paragraph (G)above, are nolonger met.
B. EXCLUSIONS
1. Applicable ToBusiness Liability Coverage
This insurance does not apply to:
m. Expected OrIntended Injury
(i) "Bodily injury" or "property damage"
expected or intended from the
standpoint of the insured. This
exclusion does not apply to "bodily
injury" or "property damage" resulting
from the use of reasonable force to
protect persons orproperty; nr
(2) "Personal and advertising injur/'ahning
out of an offense committed by, at the
direction of or with the consent or
acquiescence of the ionured with the
expectation of inflicting "personal and
advertising injury".
b. Contractual Liability
(i) "Bodily injury''or"property damage";or
(2) "Personal and advertising injury"
for which the insured imobligated hnpay
damages by reason of the assumption of
liability in a contract or agreement,
This exclusion does not apply to liability
for damages because of,
(o) "Bodily injV0r."property damage" cv
"personal and advertising injury" that
the insured would have in the
absence of the contract or
agreement; or
Form SS 00 08 04 05 Page 3 of 24
BUSINESS LIABILITY COVERAGE FORM
(b) "Bodily injury" or "property damage"
(b) Performing duties related to the
assumed in a contract or agreement
conduct of the insured's business, or
that is an "insured contract",
(2) The spouse, child, parent, brother or
provided the "bodily injury" or
sister of that "employee" as a
"property damage" occurs
consequence of (1) above.
subsequent to the execution of the
This exclusion applies:
contract or agreement. Solely for
the purpose of liability assumed in
(1) Whether the insured may be liable as
an "insured contract", reasonable
an employer or in any other capacity;
attorneys' fees and necessary
and
litigation expenses incurred by or for
(2) To any obligation to share damages
a party other than an insured are
with or repay someone else who must
deemed to be damages because of
pay damages because of the injury.
"bodily injury" or "property damage"
This exclusion does not apply to liability
provided:
assumed by the insured under an "insured
(i) Liability to such party for, or for
contract".
the cost of, that party's defense
f. Pollution
has also been assumed in the
same "insured contract", and
(1) "Bodily injury", "property damage" or
I.personal and advertising injury
(ii) Such attorneys' fees and
arising out of the actual, alleged or
litigation expenses are for
threatened discharge, dispersal,
defense of that party against
seepage, migration, release or escape
civil or alternative dispute
of "pollutants":
resolution proceeding in which
damages to which this
(a) At or from any premises, site or
insurance applies are alleged.
location which is or was at any
c. Liquor Liability
Time owned or occupied by, or
rented or loaned to any insured.
"Bodily injury" or "property damage" for
However, this subparagraph does
which any insured may be held liable by
not apply to:
reason of:
(i) "Bodily injury" if sustained within
(1) Causing or contributing to the
a building and caused by
intoxication of any person;
smoke, fumes, vapor or soot
(2) The furnishing of alcoholic beverages to
produced by or originating from
a person under the legal drinking age or
equipment that is used to heat,
under the influence of alcohol; or
cool or dehumidify the building,
(3) Any statute, ordinance or regulation
or equipment that is used to
relating to the sale, gift, distribution or
heat water for personal use, by
use of alcoholic beverages,
the buildings occupants or their
guests;
This exclusion applies only if you are in the
„
(ii) Bodily injury or "property
business of manufacturing, distributing,
damage" for wh e
he
which you may b
selling, serving or furnishing alcoholic
held liable, you are
beverages.
d. Workers' Compensation And Similar
contractor and the owner or
lessee of such premises, site or
Laws
location has been added to your
Any obligation of the insured under a
policy as an additional insured
workers' compensation, disability benefits
with respect to your ongoing
or unemployment compensation law or
operations performed for that
any similar law.
additional insured at that
e. Employer's Liability
premises, site or location and
"Bodily injury" to:
such premises, site or location
(1) An "employee" of the insured arising
is not and never was owned or
out of and in the course of:
occupied by, or rented or
loaned to, any insured, other
(a) Employment by the insured; or
than that additional insured; or
Page 4 of 24
Form SS 00 08 04 05
BUSINESS LIABILITY COVERAGE FORM
(iii) "Bodily injury" or "property
released as part of the
damage" arising out of heat,
operations being performed
smoke or fumes from a
by such insured, contractor or
"hostile fire";
subcontractor;
(b) At or from any pemises, site or
(ii) "Bodily injury' or "property
location which is or was any
damage" sustained within o
time used by or for any insured or
building and oaoond by the
others for the hand||ng, uhorage,
release of gaoeo, fumes or
d)opmaa|, processing or treatment
vapors from materials brought
of waste;
into that building inconnection
(c) Which are or were at any time
with operations being performed
tranaported, hand|ed, ato»ad,
by you or on your behalf by o
tr*ated, disposed of, or processed
contractor orsubcontractor; cv
aowaste byurfor:
(iii) "Bodily injury" or "property
(I) Any insured; or
damage" arising out of heat'
(11) Any person nrorganization for
smoke or fumes from a
"hostile
whom you may be legally
y
' or
responsible;
(*) At or from any premises, site or
(d) At or from any premises, site or
��odononvvhiohanyinaunedorany
location on which any insured or
contractors or subcontractors
any contractors or subcontractors
working directly or indirectly on any
directly or indirectly on
ineumd'u behalf are performing
any innumd'a behalf are
operations if the operations are to
performing operations if the
test fbcmnni�o�c|eanup' vemova
'
"po||utanto" are brought on or to
nontain, tesd, detoxify or nmutnaUze,
the premises, site orlocation in
orinany way respond to. or assess
"pollutants".
connection with such operationsUhee8eu�n�
.
by such inoured, contractor or
(2) Any |oun, cost or expense arising out
nubomnironhzc However, this
of any:
subparagraph does not apply to:
(a) Request, demand, order orstatutory
(i) "Bodily injury" or "property
or regulatory requirement that any
damage' arising out of the
insured or others test for, monitor,
escape offuels, lubricants or
clean up, nymcme, oonhoin, t»oed,
other operating fluids which are
detoxify cvneutralize, uvinany way
needed to perform the nnnnu|
respond to, orassess the effects of,
e|edrius|, hydraulic or
"pollutants"; or
mechanical functions
(b) Claim or suit by or on behalf ufa
necessary for the operation of
governmental authority for
"mobile equipment" orits parts,
damages because of testing for,
ifsuch fuels, lubricants urother
monitoring, cleaning up, removing,
operating fluids escape from a
containing, (r*aUn0, detoxifying or
vehicle pad designed to hw|d,
neuhaUz|og, or in any way
store o/ receive them. This
responding to, or uomeueinQ the
exception does not apply if the
effects of, "pollutants".
"bodily injury' or "property
However, this paragraph does not
damage' ohoen out of the
apply to liability for damages because
intentional discharge, dispersal
of "property damage" that the insured
or release of the fuels,
vvnu|d have in the absence of such
lubricants or other operating
nequeat, demand, order nrstatutory or
fluids, or if such fuels, '
regu}etory requirement, or such claim
lubricants or other operating
or "suit" by or on behalf of a
fluids are brought on or to the
governmental authority,
pvemioea, site orlocation with
the intent th at they be
dinuhorged, dispersed or
Form S8OOU8O4O6 Page5of24
BUSINESS LIABILITY COVERAGE FORM
g. Aircraft, Auto Or Watercraft
(2) The use of "mobile equipment" in, or
"Bodily injury" or "property damage" arising
while in practice or preparation for, a
out of the ownership, maintenance, use or
prearranged racing, speed or
entrustment to others of any aircraft, "auto"
demolition contest or in any stunting
or watercraft owned or operated by or rented
activity.
or loaned to any insured. Use includes
i. War
operation and "loading or unloading".
"Bodily injury", "property damage" or
This exclusion applies even if the claims
"personal and advertising injury", however
against any insured allege negligence or
caused, arising, directly or indirectly, out of:
other wrongdoing in the supervision, hiring,
(1) War, including undeclared or civil war;
employment, training or monitoring of others
by that insured, if the "occurrence" which
(2) Warlike action by a military force,
caused the "bodily injury" or "property
including action in hindering or
damage" involved the ownership,
defending against an actual or
maintenance, use or entrustment to others of
expected attack, by any government,
any aircraft, "auto" or watercraft that is
sovereign or other authority using
owned or operated by or rented or loaned to
military personnel or other agents; or
any insured.
(3) Insurrection, rebellion, revolution,
This exclusion does not apply to:
usurped power, or action taken by
governmental authority in hindering or
(1) A watercraft while ashore on premises
defending against any of these,
you own or rent;
j Professional Services
(2) A watercraft you do not own that is:
"Bodily injury", "property damage" or
(a) Less than 51 feet long; and
"personal and advertising injury" arising
(b) Not being used to carry persons
out of the rendering of or failure to render
for a charge;
any professional service. This includes
(3) Parking an "auto" on, or on the ways
but is not limited to:
next to, premises you own or rent,
(1) Legal, accounting or advertising
provided the "auto" is not owned by or
services;
rented or loaned to you or the insured;
(2) Preparing, approving, or failing to
(4) Liability assumed under any "insured
prepare or approve maps, shop
contract" for the ownership,
drawings, opinions, reports, surveys,
maintenance or use of aircraft or
field orders, change orders, designs or
watercraft;
drawings and specifications;
(5) "Bodily injury" or "property damage"
(3) Supervisory, inspection, architectural
arising out of the operation of any of
or engineering activities;
the equipment listed in Paragraph f.(2)
(4) Medical, surgical, dental, x-ray or
or f.(3) of the definition of "mobile
nursing services treatment, advice or
equipment"; or
instruction;
(6) An aircraft that is not owned by any
(5) Any health or therapeutic service
insured and is hired, chartered or loaned
treatment, advice or instruction;
with a paid crew. However, this
exception does not apply if the insured
(6) Any service, treatment, advice or
has any other insurance for such "bodily
instruction for the purpose of
injury" or "property damage", whether
appearance or skin enhancement, hair
the other insurance is primary, excess,
removal or replacement or personal
contingent or on any other basis.
grooming;
h, Mobile Equipment
(7) Optical or hearing aid services
including the prescribing, preparation,
"Bodily injury" or "property damage"
fitting, demonstration or distribution of
arising out of:
ophthalmic lenses and similar
(1) The transportation of "mobile equipment"
products or hearing aid devices;
by an "auto" owned or operated by or
rented or loaned to any insured; or
Page 6 of 24 Form SS 00 08 04 05
(8) Optometry or optometric services
including but not limited to examination
of the eyes and the premohbing,
proponahon, fihing, demonstration or
distribution of ophthalmic |enaon and
similar products;
(a) Body piercing (not including ear
piercing);
(b) ToMoong, including but not limited
tothe insertion ofpigments into or
under the skin; and
(c) Similar services;
(10 Services in the practice of pharmacy;
and
(11) Computer cunsu|Ung, design or
Programming uemiuoa, including web
site design.
Paragraphs (4) and (5)ofthis exclusion du
not apply to the Incidental Medical
Malpractice coverage afforded under
Paragraph 1.m.inSection A. Coverages.
k Damage ToProperty
"Property damage" to:
(1) Property you own, rent or occupy,
including any costs or expenses
incurred by you, or any other person,
organization or enhty, for ropair,
replacemant, enhonuamen1,
n*mtonodon or maintenance of such
property for any raason, including
prevention o/ injury to o person or
damage toanother's property;
(2) P,mnaeo you sell, give away or
abandon, ifthe "property damage" arises
out ofany part ofthose premises;
(3) Property loaned huyou;
(4) Personal property inthe care, custody
nrcontrol ofthe insured;
(5) That particular part ofreal property on
which you or any contractors o,
nubonnteohum working directly or
indirectly on your behalf are performing
opaodiuna, if the "property damage"
arises out nfthose oporaUuns�or
(8) That particular part of any property
that must be reotovsd, repaired or
nap|moed because ''your work" was
incorrectly performed onit.
BUSINESS LIABILITY COVERAGE FORM
Paragraphs (1). (3) and (4) of this
exclusion do not apply to "property
damage" (other than damage by fire) to
pnmmises, including the rmntenlm of such
premises, rented tmyou for opohoduf7or
fewer nonseC-u0vedays, Aseparate Uoo�t
of |noumnoo applies to Damage To
Premises Rented ToYou aedescribed in
800Uon D. ' Limits Of Insurance.
Para0tapAx(2)ofthis, exclusion does not
apply ifQ)e pnsnlioem are 'your work" and
were never ouuupied, rented or he�d for
rental byyou.
Paragraphs (3) and (4)ofthis exclusion do
not apply hz the use ofelevators.
Paragraphs (3). (4). (6) and (8) of this
exclusion do not apply to liability assumed
under osidetrack agreement.
Paragraphs (3)and (4)ofthis exclusion do
not apply to "property damage" to
borrowed equipment while not being used
h/perform operations sdajob site.
Paragraph (G) of this exclusion does not
apply to"property damage" included |nthe
"producto-oorop|eLedoperations Aszmrd"
1. Damage To Your Product
"Property damage" to "your product"
arising out ofitovany part ofit.
m. Damage ToYour Work
"Property damage" h/ "Your work" arising
out oJdorany part ofitand included inthe
"pmduda'comp|ohadoperations hmzerd".
This exclusion does not apply if the
damaged mmdk or the work out of which
the damage arises was performed onyour
behalf hyasubcontractor.
n. Damage To Impaired Property Or
Property Not Physically Injured
"Property damage" hz"impaired property"
or property that has not been physically
injured, arising out of:
(1) A defect, deicienoy, inadequacy or
dangerous condition in "your pmduoy'
or"your wmd/';or
(2) A delay or failure by you or anyone
acting nnyour behalf to perform
contract or agreement in e000ndunon
with its terms.
This exclusion does not apply hothe |oe»
of use of other property arising out of
sudden and accidental physical injury to
"your product" o/"your work" after it has
been put hzits intended use.
Form SS 00 08 04 05 Page 7 of 24
BUSINESS LIABILITY COVERAGE FORM
o. Recall Of Products, Work Or Impaired
(c) Title of any literary or artistic work;
Property
(8) Arising out of an offense committed by
Damages claimed for any loss, cost or
an insured whose business is:
expense incurred by you or others for the
(a) Advertising, broadcasting,
loss of use, withdrawal, recall, inspection,
publishing or telecasting;
repair, replacement, adjustment, removal
(b) Designing or determining content
or disposal of:
of web sites for others; or
(1) "Your product";
(c) An Internet search, access,
(2) "Your work"; or
content or service provider.
(3) "Impaired property";
However, this exclusion does not
if such product, work or property is
apply to Paragraphs a., b. and c.
withdrawn or recalled from the market or
under the definition of "personal and
from use by any person or organization
advertising injury" in Section G. —
because of a known or suspected defect,
Liability And Medical Expenses
deficiency, inadequacy or dangerous
Definitions.
condition in it.
For the purposes of this exclusion,
p. Personal And Advertising Injury
placing an "advertisement" for or
"Personal and advertising injury":
linking to others on your web site, by
(1) Arising out of oral, written or electronic
itself, is not considered the business
publication of material, if done by or at
of advertising, broadcasting,
the direction of the insured with
publishing or telecasting;
knowledge of its falsity;
(9) Arising out of an electronic chat room
(2) Arising out of oral, written or electronic
or bulletin board the insured hosts,
publication of material whose first
owns, or over which the insured
publication took place before the
exercises control;
beginning of the policy period;
(10) Arising out of the unauthorized use of
(3) Arising out of a criminal act committed
another's name or product in your e-mailaddress,
by or at the direction of the insured;
domain name or metatags, or
any other similar tactics to mislead
(4) Arising out of any breach of contract,
another's potential customers;
except an implied contract to use
another's "advertising idea" in your
(11) Arising�utof they violationof
"advertisement";
ht of by
persons g p y y
any state or federal act.
(5) Arising out of the failure of goods,
However, this exclusion does not
products or services to conform with
apply to liability for damages that the
any statement of quality or
performance made in your
insured would have in the absence of
"advertisement";
such state or federal act;
(ti) Arising out of the wrong description of
(12) Arising out of:
the price of goods, products or services;
(a) An "advertisement" for others on
(7) Arising out of any violation of any
your web site;
intellectual property rights such as
(b) Placing a link to a web site of
copyright, patent, trademark, trade
others on your web site;
name, trade secret, service mark or
(c) Content from a web site of others
other designation of origin or
displayed within a frame or border
authenticity.
on your web site. Content includes
However, this exclusion does not
information, code, sounds, text,
apply to infringement, in your
graphics or images; or
"advertisement", of
(d) Computer code, software or
(a) Copyright;
programming used to enable:
(b) Slogan, unless the slogan is also
(i) Your web site; or
a trademark, trade name, service
(ii) The presentation or functionality
mark or other designation of origin
of an "advertisement" or other
or authenticity; or
content on your web site;
Page 8 of 24 Form SS 00 08 04 05
(13) Arising out of violation of any anti-
trust law;
nti-bnst|mw;
(14) Aho/ng out ofthe fluctuation in phnm or
value o/ any ebaoks, bonds or other
securities; or
(15) Arising out of discrimination or
humiliation committed by or at the
direction of any "executive offioer",
director, abmkholder, partner or
member ofthe insured,
q. Electronic Data
Damages arising out ofthe loss of, loss of
use of, damage to, corruption of, inability
to aucomm, or inability to manipulate
"electronic data".
r. Employment -Related Practices
"Bodily injury" or "personal and advertising
injury" to:
(1) Aperson arising out ofany:
(o) Refusal (oemploy that person;
(b) Termination of that person's
employment; or
(c) Employment-related pracmao,
poUoies, acts or omissions, such as
coemion, domotion, eva|ueUon,
reassignment, dionip|ine,
defamation, harassment, humiliation
or discrimination directed at that
person; or
(2) The opoun*, chi|d, parent, brother or
sister of that person as o
consequence of "bodily injury" or
' personal and advertising injury" to the
person at whom any of the
employment-related practices
described in Paragraphs (e). (b), or (c)
above iudirected.
This exclusion applies:
(1) Whether the insured may beliable as
on employer or in any other capacity;
and
(2) To any obligation to share damages
with orrepay someone else who must
pay damages because ofthe injury.
s. Asbestos
(1) "Bodily injury", "property damage" or
"pamuno| and advertising injury"
arising out cfthe "asbestos hazard".
(2) Any damegeo, judgments. settlements,
loss, costs nrexpenses that:
BUSINESS LIABILITY COVERAGE FORM
(a) May be awarded or incurred by
reason of any claim or suit
alleging actual orthreatened injury
ordamage ofany nature orkind to
persons or property which would
not have occurred in whole or /n
part but for the "asbestos hazard";
(b) Arise out of any request, damend,
order or statutory or regulatory
requirement that any insured or
others teat for, mmnik`r, clean up,
vamove, enoopnu|cde, ountain,
treat, detoxify or neutralize or in
any way respond hoorassess the
effects ofan"asbestos hozard";or
(c)Arise out of any claim msuit for
damages because of hsmhn0 for,
monKuhng, cleaning up, numoving,
onnapaulating, oontain|ng, tr»aUng,
detoxifying cxneutralizing mrinany
way responding to or assessing the
effects ofan"asbestos hazand".
Violation 0Statutes That Govern G'
Mails, Fax, Phone Calls Or Other
Methods Of Sending KDotehu| Or
Information
"Bodily injury". "property damage", or
"personal and advertising injury" arising
directly orindirectly out ufany action or
omission that violates or is alleged to
violate:
(1) The Telephone Consumer Protection
Act (TCPA).including any amendment
oforaddition hosuch law;
(2) The CAN -SPAM Act of20Q3'including
any amendment oforaddition hosuch
law; or
(3) Any otatuka, ordinance or uygu|sWon'
other than the TOPAorCAN-SPAM Act
of 2003. that prohibits or limits the
sending, transmitting, communicating or
distribution of material or information.
Damage To Premises Rented To You —
Exception For Damage By Fire, Lightning
or Explosion
Exclusions o.through h.and kthrough o`do
not apply to damage by fire. lightning or
explouimn to premises rented to you or
temporarily occupied byyou *vi(hpermission of
the ownar. A separate Limit of Insurance
applies to this coverage as described in
Section D. ' Liability And Medical Expenses
Limits DfInsurance.
Form SS 00 08 04 05 Page 9 of 24
BUSINESS LIABILITY COVERAGE FORM
2. Applicable To Medical Expenses Coverage
We will not pay expenses for "bodily injury":
a. Any Insured
To any insured, except "volunteer workers".
b. Hired Person
To a person hired to do work for or on behalf
of any insured or a tenant of any insured.
c. Injury On Normally Occupied Premises
To a person injured on that part of
premises you own or rent that the person
normally occupies.
d. Workers' Compensation And Similar
Laws
To a person, whether or not an
"employee" of any insured, if benefits for
the "bodily injury" are payable or must be
provided under a workers' compensation
or disability benefits law or a similar law.
e. Athletics Activities
To a person injured while practicing,
instructing or participating in any physical
exercises or games, sports or athletic
contests.
f. Products -Completed Operations Hazard
Included with the "products -completed
operations hazard".
g. Business Liability Exclusions
Excluded under Business Liability Coverage.
C. WHO IS AN INSURED
1. If you are designated in the Declarations as:
a. An individual, you and your spouse are
insureds, but only with respect to the
conduct of a business of which you are the
sole owner.
b. A partnership or joint venture, you are an
insured. Your members, your partners, and
their spouses are also insureds, but only with
respect to the conduct of your business.
c. A limited liability company, you are an
insured. Your members are also insureds,
but only with respect to the conduct of your
business. Your managers are insureds, but
only with respect to their duties as your
managers.
d. An organization other than a partnership,
joint venture or limited liability company, you
are an insured. Your "executive officers" and
directors are insureds, but only with respect
to their duties as your officers or directors.
Your stockholders are also insureds, but only
with respect to their liability as stockholders.
e. A trust, you are an insured. Your trustees
are also insureds, but only with respect to
their duties as trustees.
2. Each of the following is also an insured:
a. Employees And Volunteer Workers
Your "volunteer workers" only while
performing duties related to the conduct of
your business, or your "employees", other
than either your "executive officers" (if you
are an organization other than a
partnership, joint venture or limited liability
company) or your managers (if you are a
limited liability company), but only for acts
within the scope of their employment by
you or while performing duties related to
the conduct of your business.
However, none of these "employees" or
"volunteer workers" are insureds for:
(1) "Bodily injury" or "personal and
advertising injury":
(a) To you, to your partners or
members (if you are a partnership
or joint venture), to your members
(if you are a limited liability
company), or to a co -"employee"
while in the course of his or her
employment or performing duties
related to the conduct of your
business, or to your other
"volunteer workers" while
performing duties related to the
conduct of your business;
(b) To the spouse, child, parent,
brother or sister of that co -
"employee" or that "volunteer
worker" as a consequence of
Paragraph (1)(a) above;
(c) For which there is any obligation
to share damages with or repay
someone else who must pay
damages because of the injury
described in Paragraphs (1)(a) or
(b) above; or
(d) Arising out of his or her providing
or failing to provide professional
health care services.
If you are not in the business of
providing professional health care
services, Paragraph (d) does not apply
to any nurse, emergency medical
technician or paramedic employed by
you to provide such services.
(2) "Property damage" to property:
(a) Owned, occupied or used by,
Page 10 of 24 Form SS 00 08 04 05
(b) Rented to, inthe care, custody or
oonku| of, orover which physical
control is being exercised for any
purpose by you, any of your
"emp|oyoem". "volunteer workers",
any partner nrmember (if you are
a partnership or joint venduna), or
any member (if you are a limited
liability company),
b. Real Estate Manager
Any person (other than your 'emp|oyae'or
"volunteer worker"), or any organization
while acting auyour real estate manager,
x. Temporary Custodians Of Your
Property
Any person or organization having proper
temporary custody of your property if You
die. but only-,
(1) With respect bliability arising out ofthe
maintenance oruse ofthat property; and
(2) Until your legal representative has
been appointed,
d. Legal Representative |fYou Die
Your legal representative if you dky, but
only with respect to duties as such: That
repraoentativewill have all your rights and
duties under this insurance.
e. Unnamed Subsidiary
Any subsidiary and subsidiary thereof, of
yours which isalegally incorpnratedentity
of which you own a financial �m1ereot of
more than 50q& of the voting stock on the
effective date ofthis Coverage Part.
The insurance afforded herein for any
subsidiary not ohmmu in the Declarations
as a named insured does not apply to
injury ordamage with respect tnwhich an
insured under this insurance in also an
insured under another policy or would be
an insured under such policy but for its
termination or upon the exhaustion of its
limits ofinsurance.
3. Newly Acquired O,Formed Organization
Any organization you newly acquire or form,
other than a partnership, joint venture or
limited liability company, and over which you
maintain financial interest ofmore than 5096 of
the voting otook, will qualify as a Named
Insured if there is no other similar insurance
available tnthat organization. However:
a. Coverage under this provision inafforded
only until the 180th day after you acquire
or form the organization or the end of the
policy period, whichever is earlier; and
BUSINESS LIABILITY COVERAGE FORM
b. Coverage under this provision does not
apply to:
(1) "Bodily injury" or "property damage"
that occurred; or
CD "Personal and advertising injury'
arising out ofunoffense committed
before you acquired or formed the
organization.
4. Operator Of Mobile Equipment
With respect k»"mobile equipmenf'registered in
your name under any molor vehicle re0is1rubon
law, any person is on insured while driving such
equipment along a puNio highway with your
permission, Any other person or organization
responsible for the conduct of such person is
also mninsured, but only with respect to liability
arising uu!tnfthe operation m{the oquipmemi,and
only /fmocdhmrimau/amoe of any kind is available
tw that person or organization for this 64bNty.
However, no person erorganization io an inmmred
with respect to:
a. "Bodily injury" to a co -"employee" of the
person driving the equipment; or
b. "Property damage" to property owned by,
rented to, in the charge oforoccupied by
you or the employe/ of any person who is
oninsured under this provision.
5. Operator ofNonownedWatercraft
With respect hzwatercraft you dunot own that
isless than 51 feet long and isnot being used
tocarry persons for acharge, any person ioan
insured while operating such watercraft with
your permission, Any other person or
organization responsible for the conduct of
such person is also an inmmred, but only with
respect toUabifiLyafiaimQout (-,)fthe operation
of the wntenura0, and only if no other
insurance of any kind is available to that
person urorganization for this liability.
However, no person or organization is an
insured with respect to:
o. "Bodily injury" to e co -"employee" of the
person operating the watercraft; or
b. "Property damage" toproperty owned by,
rented to, in the charge oforoccupied by
you or the employer of any person who is
eninsured under this provision.
8. Additional Insureds When Required By
Written Contract, VVrdon Agreement Or
Permit
The person(s) or organ�ation(s)ldenAified in
Paragraphs a.through t below are additional
insureds when you have agreed, in avvrit{mn
Form SS 00 08 04 05 Page 11 of 24
BUSINESS LIABILITY COVERAGE FORM
contract, written agreement or because of a
(e) Any failure to make such
permit issued by a state or political
inspections, adjustments, tests or
subdivision, that such person or organization
servicing as the vendor has
be added as an additional insured on your
agreed to make or normally
policy, provided the injury or damage occurs
undertakes to make in the usual
subsequent to the execution of the contract or
course of business, in connection
agreement, or the issuance of the permit.
with the distribution or sale of the
A person or organization is an additional
products;
insured under this provision only for that
(f) Demonstration, installation,
period of time required by the contract,
servicing or repair operations,
agreement or permit,
except such operations performed
However, no such person or organization is an
at the vendor's premises in
connection with the sale of the
additional insured under this provision if such
product;
person or organization is included as an
additional insured by an endorsement issued
(g) Products which, after distribution
by us and made a part of this Coverage Part,
or sale by you, have been labeled
including all persons or organizations added
or relabeled or used as a
as additional insureds under the specific
container, part or ingredient of any
additional insured coverage grants in Section
other thing or substance by or for
F. — Optional Additional Insured Coverages.
the vendor; or
a. Vendors
(h) "Bodily injury" or "property
Any person(s) or organization(s) (referred to
damage" arising out of the sole
below as vendor), but only with respect to
negligence of the vendor for its
own acts or omissions or those of
"bodily injury" or "property damage" arising
its employees or anyone else
out of "your products" which are distributed
acting on its behalf. However, this
or sold in the regular course of the vendor's
exclusion does not apply to:
business and only if this Coverage Part
provides coverage for "bodily injury" or
(i) The exceptions contained in
"property damage" included within the
Subparagraphs (d) or (f); or
"products -completed operations hazard".
(ii) Such inspections, adjustments,
(1) The insurance afforded to the vendor
tests or servicing as the vendor
is subject to the following additional
has agreed to make or normally
exclusions:
undertakes to make in the usual
This insurance does not apply to:
course of business, in
connection with the distribution
(a) "Bodily injury" or "property
or sale of the products,
damage" for which the vendor is
(2) This insurance does not apply to any
obligated to pay damages by
insured person or organization from
reason of the assumption of
whom you have acquired such products,
liability in a contract or agreement.
or any ingredient, part or container,
This exclusion does not apply to
entering into, accompanying or
liability for damages that the
containing such products.
vendor would have in the absence
of the contract or agreement;
b. Lessors Of Equipment
(b) Any express warranty
(1) Any person or organization from
unauthorized by you;
whom you lease equipment; but only
(c) Any physical or chemical change
with respect to their liability for "bodily
"property
in the product made intentionally
injury", damage" or
"personal and advertising injury"
by the vendor;
caused, in whole or in part, by your
(d) Repackaging, except when
maintenance, operation or use of
unpacked solely for the purpose of
equipment leased to you by such
inspection, demonstration, testing,
person or organization,
or the substitution of parts under
instructions from the manufacturer,
and then repackaged in the
original container;
Page 12 of 24 Form SS 00 08 04 05
BUSINESS LIABILITY COVERAGE FORM
(2) With respect to the insurance afforded
e. Ponndn Issued By State Or Political
to these additional inoureda. this
Subdivisions
mounsnue does not apply to any
.
(1) Anyebaheorpo|� hua|uubd�ioion but
boourrenoe" which takes p|ooa after
'
only with respect to operationsyouueaaebz|*�a��hetequipmord� on
performed byyou oronyour behalf for
c Lessors OfLand Or Premises
which the state or political subdivision
(1) Any person or organization from
has issued epermit.
whom you |maao land or premises, but
(2) With respect to the insurance afforded
only with respect to liability arising out
to these add|honol innueda, this
of the ownership, maintenance or use
insurance does not apply to:
of that part of the land or premises
(a) "Bodily injury", "property damage"
leased toyou �
or "personal and advertising
(2) With respect hzthe insurance afforded
injury' arising out of operations
to these additional inaoedo, this
performed for the state or
insurance does not apply to:
municipality; or
(a) Any "occurrence" which takes
(b) "Bodi[y injury' or"property damage"
place after you cease holease that
included within the "products -
land or be a tenant /n that
completed operations hazupd"
premises; or
[ Any Other Party
(b) Structural alterations, new
`1) Any other person or organization who
construction or demolitionn
is not aninsured under Paragraphs o.
operations performed by or on
� '
through e above, but only with
behalf such person or
respect to liability for "bodily injury",
un
organization.
" property damage" or "personal and
d. Architects, Engineers Or Surveyors
advertising injury" oaumed, in whole or
(1) Any mrnhitect, engineer, or surveyor, but
in pod^ by your acts or omissions or
only with respect to liability for"bodily
the anh» or omissions of those acting
injury", "property damage" or"personal
nnyour behalf:
and advertising injury" caused, in whole
(o) In the performance of your
or in part, by your oda or omissions or
ongoing operations;
the acts oromissions ofthose acting on
`b) In connection with your premises
your behalf
owned byorrented (oyou; ur
(a) In connection with your premises; '
(c) |nconnection with "your work" and
or
included within the "products -
(b) In the performance of you/
completed operations hazand"' but
ongoing operations performed by
only if
you uronyour behalf,
(i) The written contract or written
(2) With respect to the insurance afforded
agreement requires you to
to these additional insumda, the
provide such coverage to
following additional exclusion applies:
such additional insured; and
This insurance does not apply to
(U) This Coverage Part provides
"bodily injury", "property damage' or
coverage for "bodily injury" or
"pnrouna| and advertising injury"
"property damage" included
arising out of the rendering oforthe
within the "products -
failure to render any professional
completed operations hazavd"
services byorfor you including: ' �
(2) With respect tnthe insurance afforded
(») The pmpohng, appmving, or
to these additional |naumdn. this
8yUuoe to prepare or oypmve,
insurance does not apply to:
maps, shop drawings, opinions,
"Bodily injury", "property damage" or
vepods, aumeyo, field ondom.
"pemona| and advertising injury"
change ordem, designs or
arising out ofthe rendering of, or the
drawings and specifications; or
failure to render, any professional
(b) Supemiaory, inapecUmn,
omhitectune|, engineering or surveying
architectural or engineering
services, including:
activities.
Form SS 00 08 04 05 Page 13 of 24
BUSINESS LIABILITY COVERAGE FORM
(a) The preparing, approving, or
failure to prepare or approve,
maps, shop drawings, opinions,
reports, surveys, field orders,
change orders, designs or
drawings and specifications; or
(b) Supervisory, inspection,
architectural or engineering
activities.
The limits of insurance that apply to additional
insureds are described in Section D. — Limits
Of Insurance.
How this insurance applies when other
insurance is available to an additional insured
is described in the Other Insurance Condition
in Section E. — Liability And Medical Expenses
General Conditions.
No person or organization is an insured with
respect to the conduct of any current or past
partnership, joint venture or limited liability
company that is not shown as a Named Insured in
the Declarations.
D. LIABILITY AND MEDICAL EXPENSES
LIMITS OF INSURANCE
1. The Most We Will Pay
The Limits of Insurance shown in the
Declarations and the rules below fix the most
we will pay regardless of the number of:
a. Insureds;
b. Claims made or "suits" brought; or
c. Persons or organizations making claims or
bringing "suits
2. Aggregate Limits
The most we will pay for:
a. Damages because of "bodily injury" and
"property damage" included in the
"products -completed operations hazard" is
the Products -Completed Operations
Aggregate Limit shown in the
Declarations.
b. Damages because of all other "bodily
injury", "property damage" or "personal
and advertising injury", including medical
expenses, is the General Aggregate Limit
shown in the Declarations.
This General Aggregate Limit applies
separately to each of your 'locations"
owned by or rented to you.
"Location" means premises involving the
same or connecting lots, or premises
whose connection is interrupted only by a
street, roadway or right-of-way of a
railroad.
This General Aggregate limit does not
apply to "property damage" to premises
while rented to you or temporarily
occupied by you with permission of the
owner, arising out of fire, lightning or
explosion.
3. Each Occurrence Limit
Subject to 2.a. or 2.b above, whichever
applies, the most we will pay for the sum of all
damages because of all "bodily injury",
"property damage" and medical expenses
arising out of any one 'occurrence" is the
Liability and Medical Expenses Limit shown in
the Declarations.
The most we will pay for all medical expenses
because of "bodily injury" sustained by any
one person is the Medical Expenses Limit
shown in the Declarations.
4. Personal And Advertising Injury Limit
Subject to 2.b. above, the most we will pay for
the sum of all damages because of all
"personal and advertising injury" sustained by
any one person or organization is the Personal
and Advertising Injury Limit shown in the
Declarations.
5. Damage To Premises Rented To You Limit
The Damage To Premises Rented To You
Limit is the most we will pay under Business
Liability Coverage for damages because of
"property damage" to any one premises, while
rented to you, or in the case of damage by fire,
lightning or explosion, while rented to you or
temporarily occupied by you with permission of
the owner.
In the case of damage by fire, lightning or
explosion, the Damage to Premises Rented To
You Limit applies to all damage proximately
caused by the same event, whether such
damage results from fire, lightning or explosion
or any combination of these.
6. How Limits Apply To Additional Insureds
The most we will pay on behalf of a person or
organization who is an additional insured
under this Coverage Part is the lesser of:
a. The limits of insurance specified in a
written contract, written agreement or
permit issued by a state or political
subdivision; or
b. The Limits of Insurance shown in the
Declarations.
Such amount shall be a part of and not in
addition to the Limits of Insurance shown in
the Declarations and described in this Section.
Page 14 of 24 Form SS 00 08 04 05
U more than one Unit of insurance under this
policy and any endorsements attached thereto
applies to any dm|m or'^Sw|r. the most we will pay
under this policy and the endorsements is the
single highest ||md of liability of all coverages
applicable to such claim or "suit". However, this
paragraph does not apply (othe Medical Expenses
limit set forth inParagraph 3.above.
The Limits ofInsurance of this Coverage Part apply
separately toeach consecutive annual period and to
any remaining period ofless than i%months, starting
with the beginning ofthe policy period shown in the
Deo|onaUuno, unless the policy period is extended
after issuance for onadditional period ofless than i2
months. In that oaae, the additional period will be
deemed part ofthe last preceding period for purposes
ofdetermining the Limits ofInsurance.
E. L|^4B|L|l[Y AND MEDICAL EXPENSES
GENERAL CONDITIONS
1. Bankruptcy
Bankruptcy or insolvency of the insured or of
the inoumd'u estate will not relieve us of our
obligations under this Coverage Part,
2. Dudes In The Event Of Occurrence,
Offense, Claim OrSuit
u. Notice OfOccurrence OrOffense
You or any additional insured must see to
it that we are notified as anmn an
pxnoUcob|e of an "occurrence" or an
offense which may result in a claim. To
the extent possible, notice should include:
(1) How, when and where the ''000unonoe'
moffense took place-
(3) The names and addresses of any
injured persons and witnesses; and
(3) The nature and location of any injury
or damage arising out of the
"bcuunenne'oroffense.
b. Notice Of Claim
0aclaim ismade m"suit" is brought
against any inoured, you or any additional
insured must:
(1) Immediately record the specifics of the
claim nr"suU.and the date received;
and
(%) Notify uoansoon aopracticable,
You orany additional insured must see ho
K that we receive o written ncdioo of the
claim or"suiy'aasoon aspracticable,
G. Assistance And Cooperation Of The
Insured
You and any other involved insured must:
BUSINESS LIABILITY COVERAGE FORM
(1) Immediately send uacopies of any
demands, onUcoo, summonses or
|ogo| papers received in connection
with the claim or"uui��
.
(2) Authorize us to obtain records and
other information;
(3) Cooperate with us inthe investigation,
settlement of the n|ohn or defense
against the "auit';and
(4) Assist ua, upon our request, in the
enforcement of any right against any
person or organization that may be
liable tothe insured because ofinjury
or damage to which this insurance
may also apply.
d. Obligations AtThe |nsunod'oOwn Cost
No insured will, except at that inounad'a own
coat, voluntarily make m payment, assume
any ob|igoUon, or incur any expenao, other
than for fimtaid, without Our consent,
e. Additional |nmurad'sOther Insurance
If we cover o claim or "suit" under this
Coverage Part that may also bacovered
by other insurance available to an
additional insured, such mddUimoa|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 contmot, written agreement or
permit that this insurance i's primary and
non-contributory with the udditional
inaunod'nown insurance.
t Knowledge OfAnOccurrence, Offense,
Claim OrSuit
Paragraphs a. and b. apply to you or to
any additional insured only when such
'000umawcm'', nffenme, claim or "suit' is
known to:
(1) You or any additional insured that is
an individual;
PV Any partner, if you or an additional
insured isapartnership;
(3) Any manager, if you or an additional
insured ixalimited liability company;
(4) Any "executive officer" or inmmsawoe
manager, if you or an additional
insured ioacorporation;
(S) Any trustee, if you or an additional
insured is aUuot or
.
(G) Any elected orappointed official, ifyou
or an additional insured is a political
Form SS 00 08 04 05 Page 15 of 24
BUSINESS LIABILITY COVERAGE FORM
This Paragraph f. applies separately to
you and any additional insured.
3. Financial Responsibility Laws
a. When this policy is certified as proof of
financial responsibility for the future under
the provisions of any motor vehicle
financial responsibility law, the insurance
provided by the policy for "bodily injury"
liability and "property damage" liability will
comply with the provisions of the law to
the extent of the coverage and limits of
insurance required by that law.
b. With respect to "mobile equipment" to
which this insurance applies, we will
provide any liability, uninsured motorists,
underinsured motorists, no-fault or other
coverage required by any motor vehicle
law. We will provide the required limits for
those coverages,
4. Legal Action Against Us
No person or organization has a right under
this Coverage Form:
a. To join us as a party or otherwise bring us
into a "suit" asking for damages from an
insured; or
b. To sue us on this Coverage Form unless
all of its terms have been fully complied
with.
A person or organization may sue us to recover
on an agreed settlement or on a final judgment
against an insured; but we will not be liable for
damages that are not payable under the terms of
this insurance or that are in excess of the
applicable limit of insurance, An agreed
settlement means a settlement and release of
liability signed by us, the insured and the
claimant or the claimant's legal representative.
5. Separation Of Insureds
Except with respect to the Limits of Insurance,
and any rights or duties specifically assigned
in this policy to the first Named Insured, this
insurance applies:
a. As if each Named Insured were the only
Named Insured; and
b. Separately to each insured against whom
a claim is made or "suit" is brought.
6. Representations
a. When You Accept This Policy
By accepting this policy, you agree:
(1) The statements in the Declarations
are accurate and complete;
(2) Those statements are based upon
representations you made to us; and
(3) We have issued this policy in reliance
upon your representations.
b. Unintentional Failure To Disclose
Hazards
If unintentionally you should fail to disclose
all hazards relating to the conduct of your
business at the inception date of this
Coverage Part, we shall not deny any
coverage under this Coverage Part
because of such failure.
7. Other Insurance
If other valid and collectible insurance is
available for a loss we cover under this
Coverage Part, our obligations are limited as
follows:
a. Primary Insurance
This insurance is primary except when b.
below applies. If other insurance is also
primary, we will share with all that other
insurance by the method described in c.
below.
b. Excess Insurance
This insurance is excess over any of the
other insurance, whether primary, excess,
contingent or on any other basis:
(1) Your Work
That is Fire, Extended Coverage,
Builder's Risk, Installation Risk or
similar coverage for "your work";
(2) Premises Rented To You
That is fire, lightning or explosion
insurance for premises rented to you
or temporarily occupied by you with
permission of the owner;
(3) Tenant Liability
That is insurance purchased by you to
cover your liability as a tenant for
"property damage" to premises rented
to you or temporarily occupied by you
with permission of the owner;
(4) Aircraft, Auto Or Watercraft
If the loss arises out of the maintenance
or use of aircraft, "autos" or watercraft to
the extent not subject to Exclusion g. of
Section A. — Coverages.
(5) Property Damage To Borrowed
Equipment Or Use Of Elevators
If the loss arises out of "property
damage" to borrowed equipment or
the use of elevators to the extent not
subject to Exclusion k. of Section A. —
Coverages.
Page 16 of 24 Form SS 00 08 04 05
BUSINESS LIABILITY COVERAGE FORM
(6) When You Are Added As An
When this insurance isexcess over other
Additional Insured To Other
)nuurance, we will pay only our share of
muunanom
the amount of the |ooe, if any, that
That is other insurance available to
exceeds the sum of:
you covering liability for damages
(1) The total amount that all such other
arising out of the premises or
insurance would 'pay for the loss in the
operations, orproducts and completed
absence ofthis insurance; and
operations, for you have been
(2) The total of all deductible and self -
added as an additional insured bythat
insured amounts under all that other
inuumnceor
'
insurance.
(7) When You Add Others As An
VV*will share the remaining loss, ifany, with
Additional Insured To This
any other insurance that is not described in
Insurance
this Excess Insurance provision and was not
That is other insurance available to an
bought specifically to apply in oxomau of the
additional insured.
Limits of Insurance shown in the
Hmvvavar. the following provisions
Declarations o[this Coverage Part.
apply to other insurance available to
c. Method QfSharing
any person or organization who is on
If all the other insurance permits
additional insured under this Coverage
contribution byequal shares, wawill follow
Part:
this method also. Under this approach,
(o) Primary Insurance When
each insurer contributes equal amounts
Required ByContract
until it has paid its applicable limit of
This insurance is primary if you
insurance or none of the |naa romoino,
have agreed in awritten oonhunt,
whichever comes first.
written agreement or permit that
/[ any ofthe other insurance does not permit
this insurance beprimary. If other
contribution by equal ohevea, we will
insurance ioalso primary, wewill
contribute bylimits. Under this method, each
share with all that other insurance
inouoa/a ohum in based on the ratio of its
by the method described in o.
applicable limit of insurance to the kda(
below.
applicable limits ofinsurance n/all insurers.
(b) Primary And Non -Contributory
8. Transfer Of Rights Of Recovery Against
To Other Insurance When
Others ToUe
Required By Contract
a. Transfer OyRights Of Recovery
If you have agreed in a written
If the insured has rights to recover all or
contract, written agreement or
pad of any paymont, including
permit that this insurance is
Supplementary Payments, vvohave made
primary and non-contributory with
Linder this Coverage Pad, those rights are
the additional inoumd'o own
transferred to us. The insured must do
insurance, this insurance is
nothing after loss to impair them, At our
primary and we will not seek
request, the insured will bring "suit" or
contribution from that other
transfer those rights to us and help us
insurance.
enforce them. This condition does not
Paragraphs (a) and (b) do not apply to
apply to Medical Expenses Coverage,
other insurance towhich the additional
b. Waiver O[Rights Of Recovery (Waiver
insured has been added as an
Of Subrogation)
additional insured.
|f the insured has waived any rights of
When this insurance is excess, we vviU
recovery against any person or
have noduty under this Coverage padto
organization for all orpart ufany payment,
defend the insured against any ''euiy'ifany
including Supplementary Payments, we
other insurer has e duty to defend the
have mad* under this Coverage part, we
insured against that "suit". if no other
also waive that right, provided the insured
insurer defends, we undertake do
waived {heir rights of recovery against
so, but
such person ororganization inacontract,
rights against all those other insurers,
agreement or permit that was executed
prior to the injury or damage.
Form SS 00 08 04 05 Page 17 of 24
BUSINESS LIABILITY COVERAGE FORM
F. OPTIONAL ADDITIONAL INSURED
COVERAGES
If listed or shown as applicable in the Declarations,
one or more of the following Optional Additional
Insured Coverages also apply. When any of these
Optional Additional Insured Coverages apply,
Paragraph 6. (Additional Insureds When Required
by Written Contract, Written Agreement or Permit)
of Section C., Who Is An Insured, does not apply
to the person or organization shown in the
Declarations. These coverages are subject to the
terms and conditions applicable to Business
Liability Coverage in this policy, except as
provided below:
1. Additional Insured - Designated Person Or
Organization
WHO IS AN INSURED under Section C. is
amended to include as an additional insured
the person(s) or organization(s) shown in the
Declarations, but only with respect to liability
for "bodily injury", "property damage" or
"personal and advertising injury" caused, in
whole or in part, by your acts or omissions or
the acts or omissions of those acting on your
behalf:
a. In the performance of your ongoing
operations; or
b. In connection with your premises owned
by or rented to you.
2. Additional Insured - Managers Or Lessors
Of Premises
a. WHO IS AN INSURED under Section C. is
amended to include as an additional insured
the person(s) or organization(s) shown in the
Declarations as an Additional Insured -
Designated Person Or Organization; but only
with respect to liability arising out of the
ownership, maintenance or use of that part of
the premises leased to you and shown in the
Declarations.
b. With respect to the insurance afforded to
these additional insureds, the following
additional exclusions apply:
This insurance does not apply to:
(1) Any 'occurrence" which takes place
after you cease to be a tenant in that
premises; or
(2) Structural alterations, new
construction or demolition operations
performed by or on behalf of such
person or organization.
3. Additional Insured - Grantor Of Franchise
WHO IS AN INSURED under Section C. is
amended to include as an additional insured
the person(s) or organization(s) shown in the
Declarations as an Additional Insured -
Grantor Of Franchise, but only with respect to
their liability as grantor of franchise to you.
4. Additional Insured - Lessor Of Leased
Equipment
a. WHO IS AN INSURED under Section C. is
amended to include as an additional
insured the person(s) or organization(s)
shown in the Declarations as an Additional
Insured — Lessor of Leased Equipment,
but 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).
b. With respect to the insurance afforded to
these additional insureds, this insurance
does not apply to any 'occurrence" which
takes place after you cease to lease that
equipment.
5. Additional Insured - Owners Or Other
Interests From Whom Land Has Been
Leased
a. WHO IS AN INSURED under Section C. is
amended to include as an additional
insured the person(s) or organization(s)
shown in the Declarations as an Additional
Insured — Owners Or Other Interests From
Whom Land Has Been Leased, but only
with respect to liability arising out of the
ownership, maintenance or use of that part
of the land leased to you and shown in the
Declarations.
b. With respect to the insurance afforded to
these additional insureds, the following
additional exclusions apply:
This insurance does not apply to:
(1) Any 'occurrence" that takes place
after you cease to lease that land; or
(2) Structural alterations, new
construction or demolition operations
performed by or on behalf of such
person or organization.
6. Additional Insured - State Or Political
Subdivision — Permits
a. WHO IS AN INSURED under Section C. is
amended to include as an additional
insured the state or political subdivision
shown in the Declarations as an Additional
Page 18 of 24 Form SS 00 08 04 05
BUSINESS LIABILITY COVERAGE FORM
Insured —Rtate Or Political Subdivision -
(e) Any failure in make such
Pmnndo, but only with respect to
inapeotiona, adjuoknents, tests or
operations performed by you or on your
servicing as the vendor has agreed
behalf for which the state or political
to make or normally undertakes to
subdivision has issued epermit.
make in the usual course of
b. With respect to the insurance afforded to
bnnineoa, in connection with the
then* additional innuredo, the following
distribution orsale o[the products;
additional exclusions apply:
(9 Demonstration, installation,
This insurance does not apply to:
servicing or repair operations,
(1) "Bodily injury''. "property damage" or
except such operations performed
^permona/ and advertising injury"
at the vendor's premises in
connection with the oo|e of the
arising out of operations performed for
product;
the state nrmunicipality; or
"Bodily injury" or "property damage"
(g) Products which, after distribution(2)
'
included in the "product -completed
orhave been labeled
nrou|o by you,
h'r
operations" hazard.
�
relabeled or umed eo a
-
container, part mringredient ofany
7. Additiono||nyurod—Vondura
other thing orsubstance byorfor
a. WHO |SANINSURED under Section C.ia
the vendor; or
amended to include as on additional
(h) "Bodily injury" or "property
insured the person(s) or organization(s)
damage/' arising out of the sn|a
(n*fenadtobelow eovendor) shown inthe
negligence of the vendor for its
Declarations as an Additional Insured '
own acts or omissions or those of
Vendor, but only with respect to "bodily
its employees or anyone a|ao
injury" or "property dumoQe/' arising out of
acting on its baho|t However, this
your products" which are distributed or
exclusion does not apply to:
sold in the regular course of the vendor's
(i) The exceptions contained in
business and only if this Coverage Pert
Subparagraphs (d)or(f); or
provides coverage for "bodily injury" or
"property damage" included within the
(ii) Such inspections,
"pvoduots-oornpkehadoperations hmzmnd"
adjustments, tests orservicing
b. The insurance afforded to the vendor is
a� the vendor has agreed �o
subject h»the following additional exclusions:
make or normally undertakes
tomake inthe usual course of
(1) This insurance does not apply to:
buainama, in connection with
(o) "Bodily injury" or "property
the distribution or ea}a of the
damage" for which the vendor is
products.
obligated to pay damages by
(2) This insurance does not apply hoany
reason of the assumption of
insured person or organization from
liability inacontract oragreement.
whom you have acquired such
This exclusion does not apply to
ppoduots, or any |ngnedient, part or
UebUdy for damages that the
oontaimar, entering into,
vendor would have inthe absence
accompanying or containing such
ofthe contract oragreement;
products,
(b) Any express wmrnonb/
D. Additional Insured —Cnnbu|||ng Interest
unauthorized byyou�
'
VVHO IS AN INSURED under Section C. is
(c) Any physical or chemical change
amended to include as an additional insured
in the product made intentionally
the person(s) urorgenizadmn(o) shown in the
bythe vendor;
Declarations as an Additional Insured —
(d) RepaokaQing, unless unpacked
Controlling (nhanao(, but only with respect to
solely for the purpose ofinspection,
their liability arising out of:
demons(m8on, hau0ng, or the
a. Their financial control ofyou; or
substitution of parts under
b. Premises they own' maintain or onntnzl
instructions from the manufacturer,
while you lease oroccupy these premises.
and then repackaged inthe original
container;
Form SS 00 08 04 06 Page 19 of 24
BUSINESS LIABILITY COVERAGE FORM
This insurance does not apply to structural
alterations, new construction and demolition
operations performed by or for that person or
organization.
9. Additional Insured — Owners, Lessees Or
Contractors — Scheduled Person Or
Organization
a. WHO IS AN INSURED under Section C. is
amended to include as an additional
insured the person(s) or organization(s)
shown in the Declarations as an Additional
Insured — Owner, Lessees Or Contractors,
but only with respect to liability for "bodily
injury", "property damage" or "personal
and advertising injury" caused, in whole or
in part, by your acts or omissions or the
acts or omissions of those acting on your
behalf:
(1) In the performance of your ongoing
operations for the additional
insured(s); or
(2) In connection with "your work"
performed for that additional insured
and included within the "products -
completed operations hazard", but
only if this Coverage Part provides
coverage for "bodily injury" or
"property damage" included within the
"products -completed operations
hazard".
b. With respect to the insurance afforded to
these additional insureds, this insurance
does not apply to "bodily injury", "property
damage" or "personal an advertising
injury" arising out of the rendering of, or
the failure to render, any professional
architectural, engineering or surveying
services, including:
(1) The preparing, approving, or failure to
prepare or approve, maps, shop
drawings, opinions, reports, surveys,
field orders, change orders, designs or
drawings and specifications; or
(2) Supervisory, inspection, architectural
or engineering activities.
10. Additional Insured — Co -Owner Of Insured
Premises
WHO IS AN INSURED under Section C. is
amended to include as an additional insured
the person(s) or Organization(s) shown in the
Declarations as an Additional Insured — Co -
Owner Of Insured Premises, but only with
respect to their liability as co-owner of the
premises shown in the Declarations.
The limits of insurance that apply to additional
insureds are described in Section D. — Limits Of
Insurance.
How this insurance applies when other insurance
is available to an additional insured is described in
the Other Insurance Condition in Section E. —
Liability And Medical Expenses General
Conditions.
G. LIABILITY AND MEDICAL EXPENSES
DEFINITIONS
1. "Advertisement" means the widespread public
dissemination of information or images that
has the purpose of inducing the sale of goods,
products or services through:
a. (1) Radio;
(2) Television;
(3) Billboard;
(4) Magazine;
(5) Newspaper;
b. The Internet, but only that part of a web
site that is about goods, products or
services for the purposes of inducing the
sale of goods, products or services; or
c. Any other publication that is given
widespread public distribution.
However, "advertisement" does not include:
a. The design, printed material, information
or images contained in, on or upon the
packaging or labeling of any goods or
products; or
b. An interactive conversation between or
among persons through a computer network.
2. "Advertising idea" means any idea for an
"advertisement".
3. "Asbestos hazard" means an exposure or
threat of exposure to the actual or alleged
properties of asbestos and includes the mere
presence of asbestos in any form.
4. "Auto" means a land motor vehicle, trailer or
semi -trailer designed for travel on public
roads, including any attached machinery or
equipment, But "auto" does not include
"mobile equipment".
5. "Bodily injury" means physical:
a. Injury;
b. Sickness; or
c. Disease
sustained by a person and, if arising out of the
above, mental anguish or death at any time.
6. "Coverage territory" means:
Page 20 of 24 Form SS 00 08 04 05
a. The United States ofAmerica (including its
territories and pnamenakmo). Puerto Rico
and Canada;
b. International waters orairspace, but only if
the injury ordamage occurs in the course
of travel or transportation between any
places included ina.above;
o. All other parts of the world if the injury or
damage arises out of,
(1) Goods orproducts made orsold byyou
|nthe territory described ina.above;
(2) The activities ofaperson whose home
is in the territory described in a.
abova, but is away for short time on
your business; or
(8) "Personal and advertising injury"
offonaau that take place through the
Internet orsimilar electronic means of
communication
provided the inuuved'n responsibility to pay
damages in determined in the United States of
America (including its territories and
possessions), Puerto Hium or Canada, in a
,.suit" on the merits according to the
substantive law in such tondory, or in a
settlement weagree to,
7. "Electronic data" means information, /aob or
programa
u. Stored eocxon;
b. Created orused on; or
c. Transmitted to or from
computer software, including systems and
applications software, hard or floppy disks,
CD'RON18, tapes, dhveu, ooUo, data
processing devices or any other media which
are used with electronically controlled
equipment.
8. "Employee' includes a "leased worker".
"Employee" does not include o "temporary
worker".
9. "Executive officer" moans a person holding
any of the officer positions created by your
charter, omnohtuUon, by'|avvu or any other
similar governing document.
18. "Hostile Ora" means one which becomes
uncontrollable orbreaks out from where itwas
intended to be.
11. "Impaired property" means tangible property,
other than "your product" or "your work", that
cannot boused or is |aan useful because:
a. It incorporates "your pmdonf' or"your work"
that is known or thought to be defective,
deficient, inadequate or dangerous; or
BUSINESS LIABILITY COVERAGE FORM
k You have failed tofulfill the terms ofa
contract magreement;
i[such property can barestored touse by:
a. The repair, replacement, adjustment or
removal of "your product" or "your work",-
or
mdk'�or
h. Your fulfilling the hsnna of the contract or
agreement,
12. "Insured contract" maona�
a. A contract for u lease of premises.
However, that portion ofthe contract for a
lease of premises that indemnifies any
person ororganization for damage byfire,
lightning orexplosion (opremises while
rented to you urtemporarily occupied by
you with permission of the owner is
subject to the Damage To Premises
Rented ToYou limit described in Section
O. —LiabiUtyand Medical Expenses Limits
of Insurance.
b Asidetrack agreement;
o. Any easement or license agreement,
including an easement or license
agreement in connection with construction
or demolition operations on or within 50
feet ofami|mad�
.
U. Any obligation, as required by ordinance,
to indemnify a municipa/hy, except in
connection with work for amunicipality;
e, Anelevator maintenance agreement; or
[ That pad of any other contract or
agreement pertaining to your business
(including an indemnification of a
municipality in connection with work
performed for a municipality) under which
you assume the tort liability of another
party hapay for "bodily injury" or"property
damage" toathird person ororganization,
provided the "bodily injury" or "property
damage" is oauoed, inwhole orin part, by
you or by those acting on your behalf,
Tort liability means oliability that would ba
imposed by law in the absence of any
contract or agreement,
Paragraph [ includes that part of any
contract or agreement that indemnifies a
railroad for "bodily injury" or "property
damage" arising out of construction or
demolition operations within 50 het of any
railroad property and affecting any railroad
bridge or trestle, traoko, road'bedu, tunnel,
underpass orcrossing.
Hnwover. Paragraph f. does not include
that part ofany contract oragreement:
Form SSOU0U04DS Page21uf%4
BUSINESS LIABILITY COVERAGE FORM
(1) That indemnifies an architect,
engineer or surveyor for Injury or
damage arising out of:
(a) Preparing, approving or failing to
prepare or approve maps, shop
drawings, opinions, reports,
surveys, field orders, change
orders, designs or drawings and
specifications; or
(b) Giving directions or instructions,
or failing to give them, if that is the
primary cause of the injury or
damage; or
(2) Under which the insured, if an
architect, engineer or surveyor,
assumes liability for an injury or
damage arising out of the insured's
rendering or failure to render
professional services, including those
listed in (1) above and supervisory,
inspection, architectural or
engineering activities.
13. "Leased worker" means a person leased to
you by a labor leasing firm under an
agreement between you and the labor leasing
firm, to perform duties related to the conduct of
your business. "Leased worker" does not
include a "temporary worker".
14. "Loading or unloading" means the handling of
property:
a. After it is moved from the place where it is
accepted for movement into or onto an
aircraft, watercraft or "auto";
b. While it is in or on an aircraft, watercraft or
"auto'; or
c. While it is being moved from an aircraft,
watercraft or "auto" to the place where it is
finally delivered;
but "loading or unloading" does not include the
movement of property by means of a mechanical
device, other than a hand truck, that is not
attached to the aircraft, watercraft or "auto".
15. "Mobile equipment" means any of the following
types of land vehicles, including any attached
machinery or equipment:
a. Bulldozers, farm machinery, forklifts and
other vehicles designed for use principally
off public roads;
b. Vehicles maintained for use solely on or
next to premises you own or rent;
c. Vehicles that travel on crawler treads;
d. Vehicles, whether self-propelled or not, on
which are permanently mounted:
(1) Power cranes, shovels, loaders,
diggers or drills; or
(2) Road construction or resurfacing
equipment such as graders, scrapers
or rollers;
e. Vehicles not described in a., b., c., or d.
above that are not self-propelled and are
maintained primarily to provide mobility to
permanently attached equipment of the
following types:
(1) Air compressors, pumps and
generators, including spraying,
welding, building cleaning,
geophysical exploration, lighting and
well servicing equipment; or
(2) Cherry pickers and similar devices
used to raise or lower workers;
f. Vehicles not described in a., b., c., or d.
above maintained primarily for purposes
other than the transportation of persons or
cargo.
However, self-propelled vehicles with the
following types of permanently attached
equipment are not "mobile equipment" but
will be considered "autos":
(1) Equipment, of at least 1,000 pounds
gross vehicle weight, designed
primarily for:
(a) Snow removal;
(b) Road maintenance, but not
construction or resurfacing; or
(c) Street cleaning;
(2) Cherry pickers and similar devices
mounted on automobile or truck
chassis and used to raise or lower
workers; and
(3) Air compressors, pumps and
generators, including spraying,
welding, building cleaning,
geophysical exploration, lighting and
well servicing equipment.
16. "Occurrence" means an accident, including
continuous or repeated exposure to substantially
the same general harmful conditions.
17. "Personal and advertising injury" means injury,
including consequential "bodily injury", arising
out of one or more of the following offenses:
a. False arrest, detention or imprisonment;
b. Malicious prosecution;
Page 22 of 24 Form SS 00 08 04 05
c. The wrongful eviction from, wrongful entry
into, or invasion of the right of private
occupancy of a room, dwelling or
premises that the person occupies,
committed by or on behalf of its owner,
landlord or lessor;
d. Oral, written or electronic publication of
material that slanders or libels a person or
organization or disparages a person's or
organization's goods, products or services;
e. Oral, written or electronic publication of
material that violates a person's right of
privacy;
f. Copying, in your "advertisement', a
person's or organization's "advertising
idea" or style of "advertisement';
g. Infringement of copyright, slogan, or title of
any literary or artistic work, in your
"advertisement'; or
h. Discrimination or humiliation that results in
injury to the feelings or reputation of a
natural person.
18. "Pollutants" means any solid, liquid, gaseous or
thermal irritant or contaminant, including smoke,
vapor, soot, fumes, acids, alkalis, chemicals and
waste. Waste includes materials to be recycled,
reconditioned or reclaimed.
19. "Products -completed operations hazard';
a. Includes all "bodily injury" and "property
damage" occurring away from premises
you own or rent and arising out of "your
product" or "your work" except:
(1) Products that are still in your physical
possession; or
(2) Work that has not yet been completed
or abandoned. However, "your work"
will be deemed to be completed at the
earliest of the following times:
(a) When all of the work called for in
your contract has been completed.
(b) When all of the work to be done at
the job site has been completed if
your contract calls for work at
more than one job site.
(c) When that part of the work done at
a job site has been put to its
intended use by any person or
organization other than another
contractor or subcontractor
working on the same project.
BUSINESS LIABILITY COVERAGE FORM
Work that may need service, maintenance,
correction, repair or replacement, but
which is otherwise complete, will be
treated as completed.
The "bodily injury" or "property damage"
must occur away from premises you own
or rent, unless your business includes the
selling, handling or distribution of "your
product' for consumption on premises you
own or rent.
b. Does not include "bodily injury" or
"property damage" arising out of:
(1) The transportation of property, unless
the injury or damage arises out of a
condition in or on a vehicle not owned
or operated by you, and that condition
was created by the "loading or
unloading" of that vehicle by any
insured; or
(2) The existence of tools, uninstalled
equipment or abandoned or unused
materials,
20. "Property damage" means:
a. Physical injury to tangible property,
including all resulting loss of use of that
property. All such loss of use shall be
deemed to occur at the time of the
physical injury that caused it; or
b. Loss of use of tangible property that is not
physically injured. All such loss of use
shall be deemed to occur at the time of
"occurrence" that caused it.
As used in this definition, "electronic data" is
not tangible property.
21. "Suit" means a civil proceeding in which
damages because 'of "bodily injury", "property
damage" or "personal and advertising injury"
to which this insurance applies are alleged.
"Suit" includes:
a. An arbitration proceeding in which such
damages are claimed and to which the
insured must submit or does submit with
our consent; or
b. Any other alternative dispute resolution
proceeding in which such damages are
claimed and to which the insured submits
with our consent.
22. "Temporary worker" means a person who is
furnished to you to substitute for a permanent
"employee" on leave or to meet seasonal or
short-term workload conditions.
23. "Volunteer worker" means a person who:
a. Is not your "employee';
Form SS 00 08 04 05 Page 23 of 24
BUSINESS LIABILITY COVERAGE FORM
b. Donates his or her work;
c. Acts at the direction of and within the
scope of duties determined by you; and
d. Is not paid a fee, salary or other
compensation by you or anyone else for
their work performed for you.
24. "Your product':
a. Means:
(1) Any goods or products, other than real
property, manufactured, sold, handled,
distributed or disposed of by:
(a) You;
(b) Others trading under your name;
or
(c) A person or organization whose
business or assets you have
acquired; and
(2) Containers (other than vehicles),
materials, parts or equipment
furnished in connection with such
goods or products.
b. Includes:
(1) Warranties or representations made at
any time with respect to the fitness,
quality, durability, performance or use
of "your product; and
(2) The providing of or failure to provide
warnings or instructions.
c. Does not include vending machines or
other property rented to or located for the
use of others but not sold.
25. "Your work":
a. Means:
(1) Work or operations performed by you
or on your behalf; and
(2) Materials, parts or equipment
furnished in connection with such work
or operations.
b. Includes:
(1) Warranties or representations made at
any time with respect to the fitness,
quality, durability, performance or use
of "your work"; and
(2) The providing of or failure to provide
warnings or instructions.
Page 24 of 24 Form SS 00 08 04 05
CITY OF EL SEGUNDO
WORKERS' COMPENSATION DECLARATION
WARNING; FAILURE TO SECURE WORKERS' (COMPENSATION COVERAGE
IS UNLAWFUL AND SUBJECTS AN EMPLOYER TO CRIMINAL PENALTIES
AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ('$1100•
IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED
FOR IN LABOR CODE § 3706, INTEREST, AND ATTORNEY'S FEES.
I affirm under penalty of perjury under the laws of California one of the following declarations:
(_) I have and will maintain a certificate of consent of 'self -insure for workers" coMpensMt an, 'iss'ued' by I
of Industrial Relations as provided for by Labor Code § 3700 for the performance of the wo* set1orth1he
with the City of El Segundo.
Policy No.
(__) I have and will maintain workers' compensation insurance as required by Labor Code § 3700 fot," j
of the work for which the agreement with the City of El Segundo is executed. My workers'
carrier and policy number are:
Policy Number Expiration Date
Carrier
Name of Agent
u �����IIIIIIIIIIIIIVi�� i � Iw�'""i��l W u�
Phone #
• _ w • ,w w
• N N • w • • n pX • • MIN N '; p •