Press Alt + R to read the document text or Alt + P to download or print.
This document contains no pages.
PROOF OF INSURANCE (2021) CLOSEDClient#: 1595302 MASTETECI
ACORDTM CERTIFICATE OF LIABILITY INSURANCE 9/DATE22/202(MMIDDrYYYY)
0
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 ADDITION I AL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed.
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on
this certificate does not confer any rights to the certificate holder in lieu of such endorsement(s).
PRODUCER CONTACT
NAMEi Gary W. Nerger
USI Insurance Services, LLC PHONE 6026664817 FAX �,,I�6105372283
Wq�Np, . ...... ... . .
2421 West Peoria Avenue, Suite 110 t E-MAIL
s, gary,nerger@usi.com
A7 orn.3n I
Phoenix,
INSURERS) AFFORDING COVERAGE
NA'Cr#
877 468-6516
INSURER A: Crum & Forster Specialty Insurance Co.
44520
INSURED
INSURER B: Hartford Accident & indemnity Company
22357
Master Technology Integrators, Inc.
INSURER C: Hartford Fire insurance Co
19682
POB 643188
INSURER 0
Los Angeles, CA 90064
INSURER E:
INSURER F;
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 CONTRACTOR OTHER DOCUMENT WITH RESPECT
TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IIS SUBJECT TO
ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES LIMITS SHOWN MAY HAVE BEE4 REDUCED BY PAID CLAIMS.
iILNSR
TR
AODL'SUSR
TYPE OF INSURANCE INSIR WVD POLICY NUMBER
POLICYeFr POLICYEXP
IMM)0O,1YYYY),(MM1`DD1YYYY), LIMITS
A
X COMMERCIAL GENERAL LIABILITY GL0065994
06/01/2020 06/0112021 EACHOCCURRENCES1111,10,00J000
CLAIMS -MADE OCCUR
PAPIA�, D
-F ORENTE
S100,000
X BI/PD Ded:1,000
_YEPEX
$10,000
PERSONAL & ADV INJURY
S to 9 QA 9_,
GEN'LAGGREGATE LIMITAPPLIES PER:
GENERAL AGGREGATE
S2,000,000
POLICY X 'X`E�.'COT' LOC
PRODUCTS - COMP/OP AGO
52,0001,000
OTHER:
C AUTOMOBILE LIABILITY 41UUAIE4581
I,wil
06101/2020 06/011202
�,�l 1000,000
I
X ANY AUTO
BODILY INJURY (Per person)
S
OWNED SCHEDULED
BODILY INicJURY (Pei accrdpi3O)
S
AUTOS ONLY AUTOS
y
X H I Q E P0 NON -OWNED
$
AU10S ONLY AUTOS ONLY
acr
L-111
$
A UMBRELLA LIAB
OCCUR
EXCESS LIAB 1 CLAIMS -MADE
DED I X, RETENI ION $0
B WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY YIN
ANY PROPRIETORMARTNER4EXECUIIj I
OFFICERIMFMBER EXCLUDEDI L Y� NIA
(Mandatory in NH)
IN p,rs aescribe under
DESCRIPTION OF OPERAi ION,�., beam%
SE0108617
41WECID0657
A Professional Liab GL0065994
0610112020 06/0112021 EACHOCCURRENCE
AGGRE GA E s2,000,000
061011/2020 06/0112021, It 'SI'A'T I TS carr!.
E L EACH ACCIDENT _§1A090J900_
FL CASEASE-EAEMPLOYEE $1,,000,000
E,L N, $EASE . POLtC _� Ls1 Op0.000
1!
, __ _�,!l
06/01/2020 06/0112021 1,000,000 per claim
1,000,000 aggregate
DESCRIPTION OF OPERATIONS R LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may he attached if more space is required)
RE: Proof of Insurance The general
liability and auto policy(s) include an automatic Additional Insured endorsement that provides Additional
Insured status to the Certificate Holder, only when there is a written contract or written agreement
between
the named insured and the certificate holder and with regard to work performed by or on behalf of the named
(See Attached Descriptions)
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
City of El Segundo THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
350 Main Street ACCORDANCE WITH THE POLICY PROVISIONS.
El Segundo, CA 90245
AUTHORIZED REPRESENTATIVE
1;e8-2-015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016103) 1 of 2 The ACORD name and logo are registered marks of ACORD
#S299000441M29139485 SK8ZP
DESCRIPTIONS (Continued from Page 1)
insured, or pertaining to leased property. The general liability, auto liability and workers' compensation
policy(s) provide a Blanket Waiver
of Subrogation in favor of the same, when required by written contract.
The general liability and auto liability policy(s) contains a special endorsement with "Primary and
Noncontributory" wording, when required by written contract. The general liability policy is on a per
project aggregate basis. This form is subject to any/all respective policy provisions.
** Workers Comp Information **
Proprietors/Partners/Executive Officers/Members Excluded:
Adrienne Louie, Officer
Jim Kelly, Officer
RE: PW Contract #5814 (PW 18-25 El Segundo Police Department Door Security Upgrade Project)
SAGITTA 25.3 (2016/03) 2 of 2
#S29900044/M29139485
COMMERCIAL GENERAL LIABILITY
CG20330413
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
k 001 LHA Elk, &1110:4 DIM6171 01 PAXI;
COMMERCIAL GENERAL LIABILITY COVERAGE PART
A. Section 11 — Who Is An Insured is amended to
include as an additional insured any person or
organizatik.)n for ,vhorn you are perlorming
operations when you and such peTson or
a
ni gan,zaflon I, ve agr eed invir iting ir a contract of
agreerneril that such person or organization be
added as an additional insured on your policy
Such person or oigariiizatiorV is an aadiWnau
insured only pith respec� tc, liability for '"bodily
jnury'. "property damage'" or "Personal and
adverlisirig rijury" caused 'or in Marl, by
1. Your acts or omissions-, or
2 The acts or omissions of those acting on your
behalf-,
in the performance of your ongoing operations for
the additional insured.
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 orqanizafiori's status as an
additional insured uncer this endiarsernent ends
when your operations for that additorial insured
are completed.
B. With respect to the insurance afforded to these
additional insureds, the following additional
exclusions apply:
This insurance does not apply to:
1. "Bodily injury",, "property damage" or 'personal
and advertising injUry" arising out of Une
rencle'ring of or the failure to render any
professional arohilectur al engirieenng a,
surveying 'services including
a. The preparing approving, or failing to
prepare or approve. maps: shop dra,mngs,
reports surveys field, crde:"s
change cirders or drawings acid
specifications-, or
b.. Supervisory, inspection, architectural or
engineering activities
Thus e;KGIUSiOil appkes even I the clairns agarrist
any insured allege negligence or other viongdoirig
in the supervision hiring employmen'. training
raining or
monitoring of, others try that insured, 4; tl)e
".00CUjrrerrice" ruhiQh cau�"d the "bodfly injury" Or
,property Barrage " of tune offense v, nick caused
the "personal, and advertising it q ',ry' vivol,' ed the
rendering of or the failure to rerider any
J,'^rofpssional engineering or
surveying services.
CG20330413 0 Insurance Services Office, Inc, 2012 Page 1 of 2
2 "Bodily injury" or "property damage" occurring
after:
a. AH v,,;ork inclurfing rnaterals, parts or
equii,-Drnent furnished in ,onnectjan mth
such work (y,,, prro ' ject (other thran
,-ervi��e m,3u,rte-3nce ;r,° rep
� 'to tie
performed by or or,, behalf of the add*onat
rns,un &Ols) at Pre location of the covered
operations rias been Qnn,)pleted, or
b. Thal n,,,hrtion of `yaur vo*out of ,P.,hich the
injury or damage arises has been p n as
intended, use ty any person or Orgarlization
other than annther coritractor or
subcontractor engaged in performing
operations for a principal as a part of the
same project
C. With respect to the insurance afforded to these
additional insureds, the follom,ig is added to
Section III --Limits Of Insurance:
The most we will pay on behalf of the additional
insured is the amount of insurance:
1. Required by the contract or agreement you
ha, e entered into with the additional insured,,
or
Z Available under the applicable Limits of
Insurance shown in the Declarations;
whichever is less
This endorsement shall not increase the
applicable Limits of Insurance shown in the
Declarations
Page 2 of 2 0 Insurance Services Office, Inc., 2012 CG20330413
POLICY NUMBER:
COMMERCIAL GENERAL LIABILITY
CG 20 37 0413
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
so
I 19 -010. k 9. ZT.1y" I Lei 0 LIA:JOAMIXIS 1k
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART
SCHEDULE
Name Of Additional Insured Person(s)
Or Organization(s) Location And Description Of Completed Operations
Any person or organization you have agreed in a written ;Drernises covered under this policy when required by
contract t.- add as an additional insured on your policy ,,vriften contract executed prior to the `Jtoclily
providedthe written contract is executed prior to the property damage" or 'personal and advertising iii ijury'
'bodily injury', "property darnage" or "personal and
advertising inturv"
Information required to con iplete this Schedule if not shown abo%,e will be shown in the Declarations.
A. Section 11 - Who Is An Insured is amended to
include as an additional insured the person(s) or
organiza"iorq's) in Schedule tx,,t orlIv
respect to liability for ''bodily injury 1 1, or
property dai-nage'" cal *ed in o,,hole or in part by
your %vork' at the loration oesiqnated ari�..7
described .n the Schedule of th;s- andwsernent
performed for that additional insured and
included in the "products -completed operations
hazard".
However:
1. The insurance afforded to such additional
insured only applies to the extent permitted
by law, and
Z If coverage prcvaded to the additional insured
is required by a contract or agreement, the
insurarice afforded to such additional insured
will not be broader than that which you are
required bl the contract or agreement to
provide for such additional insured.
B. With respect to the insurance afforded to these
additional insureds, the following is adder to
Section III - Limits Of Insurance:
If coverage pro: ded to
required by a contract or
will! pay on behaff of the
amount of insurance:
the additional insured is
agreerneril the most we
additiorel! insured is the
1. Required by the contract or agreement-, or
2. Available under the applicable Limits of
Insurance shown in the Declarations-,
whichever is less,
This endorsement shall not increase the applicable
Limits of Insurance shown in the Declarations.
CG 20 37 0413 0 Q Insurance Servces Office, Inc-, 2012 Page 1 of 1
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY
This endorsement modifies insurance provided under the following-,
COMMERCIAL GENERAL LIABILITY COVERAGE PART
PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE- PART
The following is added to the Other Insurance Condition and supersedes any provision to the contrary:
Primary And Noncontributory Insurance
This insurance izs primary to and will not seek contribution from any other insurance available to an additional insured under
this policy provided that:
(1) The additional insured is a Named Insured under such other insurance-, and
(2) You have agreed in A,!'itvng in a contract or agreement prior In the injury or damage that this insurance would be primary
and WOUld not seek contribution from any other insurance available to the additional insured,
However. the insurance provided under this endorsement will not apply beyond the extent required by such contract or
agreement
ALL OTHER TERMS AND CONDITIONS OF THIS POLICY REMAIN UNCHANGED,
This endorsement forms a part of the Policy to which attached, effective on the inception date of the Policy unless otherwise
stated herein.
(The following information is required only when this endorsement is issued subsequent to preparation of the Policy.)
Endorsement effective Policy No. Endorsement No,
Named Insured
Countersigned by
CFSIC-GL-1002(10/2015)
POLICY NUMBER'.
COMMERCIAL GENERAL LIABILITY
CG 24 04 05 09
WAIVER OF TRANSFER OF RIGHTS OF RECOVERY
AGAINST OTHERS TO US
This endorsement modifies insurance provided under the following:
I
..off 0410101 &1 MR = 9:1 -FX0A 01 OVA 0 1010 6V 4 F-0-1 IN 1•
SCHEDULE
Name Of Person Or Organization:
A person or organization you have agreed in a written contract to waive any right of recovery against provided the
written contract is executed prior to the injury or damage
11riformation required to cornplete this Schedi,,jle if not shown above will be shown in the Declarations.
The following is added to Paragraph 8. Transfer Of
Rights Of Recovery Against Others To Us of
Section PJ — Conditions:
\Ne �varve anv right of recovery ove may have against
the person or org30M]011 sho,:,,n in the Schedule
above bec&.Ae of payments %ve make for rijUry or
d'atilage ar:slr-ig out of your ongoing operations or
"your 1o�+ork" &, Ie Uld&�' a conlract aP,,ith trial person
or organization and inckidec in the "products.,
compgeted operations hazard' This waiver appNies
or0y to the person or c.,rganjzalrin dio'wn in the
Schedule above.
CG240405090 (9 Insurance Services Office, inc, 2008 Page 1 of 1 0
DESIGNATED CONSTRUCTION PROJECT(S)
GENERAL AGGREGATE LIMIT SUBJECT TO A
TOTAL POLICY AGGREGATE LIMIT
This endorsement modifies insurance provided under the following -
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
Designated Construction Projects:
Any project(s) required by written ;ontract with you to be subject to a separate General Aggregate Limit and executed prior b
any "bodily injury" or "property darnage''.
(I no entry appears above 'information required to complete this endorsement Will be shown in the Declarations as applicable
to this endorsement)
A. For all sums which the insured becomes legally obligated to pay as damages caused by "occuuences" under. COVEk" AGE
A (SECTION 1), which can be attributed only to ongoing operations at a single des�gnated cons�luction project shown in
the Schedule above:
1. A separate Designated Consituction Project General Aggregate Limit applies to each designated construction project,
and that limit is equal to the amount sho-wrt in the Declarations of this policy.
2. Suhlect to the Total Policy Aggregate Limit the Designated Construction Project General Aggregate Limit is the most
V& will pay for the suer of 41 damages under COVERAGE A, exci!pt bi?c0o,,",e 0,1 'bodtly injury" or "property
dernage included in the `ptoducts-completed operations hazwd rega4ess of the number of
a. Insureds;
b. Claims made or "suits" brought, or
c. Persons or organizations making claims or bringing "suits."
3. Any payments made under COVERAGE. A for, darnages shall reduce the Designated Construction Project General
Aggregatet
Lirn0 fco, that designated conslrucWn pro Subject to the Total Policy Aggregate bmit, such payments
shall not reduce the General Aggregate Ln-nft shown in rhe Declarations nor shall they reduce any other Designated
Construclion Protect General Aggregate Limit for any other designated construction project shown in the SChetkite
above_
4. The limits shown to the Declarabons for Each Occurrence continue to apply. Hov%ever, instead of being subject In the
General Aggregate Limit shown in the Declaratimis, such limits will be subject to the applicable Designated
Ccnstruct•-on Protect Generali Aggregate Limit and the Total Policy Aggregate Limit
CFSIC-GL-2017(09/2016) Page 1 of 2
B. For all sums which the insured becomes legally obligated to pay as damages caused by "occurrences' under COVERAGE
A (SECTION 1), which cannot be attributed only to ongoing operations at a single designated construction project shown in
the Schedule above:
1. Any payments made under COVERAGE A for damages shall reduce the amount available under the General
Aggregate Limit or the Products -Completed Operations Aggregate Limit, whichever is applicable-, and
2. Such payments shall not reduce any Designated Construction Project General Aggregate Lit -nit
3. Such payments will reduce the Total Policy Aggregate Limit
C. When coverage for liability arising out of the "products -completed operations hazard" r. provided, any payments for
damages because of "bodily injury" or "property damage" included in the "products -completed operations hazard" will
reduce the Products -Completed Operations Aggregate Limit, and not reduce the General Aggregate Limit or the
Designated Construction Project General Aggregate Limit or the Total Policy Aggregate Limit
D The Total Policy Aggregate Limit scheduled in the Declarations of this policy is the most we will pay for the sum of. (a) all
damages covered under this policy and falling Wthin the scheduled Designated Construction Projects(s) General
Aggregate Limits described in Paragraph A of this endorsement ' and, (b) all damages covered under this policy and
failing within the General Aggregate Limit. as described in Paragraph B of this endorsement and as set forth in the
provisions of Limits of Insurance (SECTION 111) not otherwise modified by th[s endorsement The Total Policy Aggregate
Limit applies regardless of the sums indicated in the Declarations for the General Aggregate Limit or Designated
Construction Projects(s) General Aggregate Limit, and applies to all locations(s) set forth in the Schedule above,
The Total Policy Aggregate Limit applies collectively, rather than separately, to all of your scheduled locations. The Total
Policy Aggregate Limit is not reduced by payment,,, for damages covered Under this policy and failing within the "products -
completed operations hazard," but such payments will reduce the ProdUCts-Completed Operations Aggregate Limit, as
described in Paragraph C. of this endorsement
E. The provisions of Limits Of Insurance (SECTION 111) not othermse modified by this endorsement shall continue to apply
as stipulated.
ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED.
This endorsement forms a part of the Policy to which attached, effective on the inception date of the Policy unless otherwise
stated herein.
(The following information is required only when this endorsement is issued subsequent to preparation of the Policy.)
Endorsement effective Policy No. Endorsement No.
Named Insured
Countersigned by
CFSIC-GL-2017(09/2016) Page 2 of 2
COMMERCIAL AUTOMOBILE
HA 99 16 03 12
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
COMMERCIAL AUTOMOBILE BROAD FORI
ENDORSEMENT
This endorsement modifies insurance provided under the following:
BUSINESS AUTO COVERAGE FORM
To the extent that the provisions of this endorsement provide broader benefits to the "inuured"than other
provisions of the Coverage Form, the provisions of this endorsement apply.
1 BROAD FORM INSURED
A. Subsidiaries and Newly Acquired or
Formed Organizations
The Named Insured shown in the
Declarations ieamended toinclude:
(1) Any legal business entity other than o
partnership orjoint venture, formed as a
subsidiary in which you have an
ownership /nkenao1 of more than 50% on
the effective date of the Coverage Form.
However, the Named Insured does not
include any subsidiary that is on
"insured" under any other automobile
policy or would be an "insured" under
such a policy but for its termination or
the exhaustion ofits Limit cdInsurance.
(2) Any organization that is acquired or
formed by you and over which you
maintain majority ownership. However,
the Named Insured does not include any
newly formed oracquired organization:
(a) That is e partnership or joint
venture.
(b) That inon"ineunod"under any other
policy,
(c) That has exhausted its Limit of
Insurance under any other policy, ox
(d) 180 days or more akar its
acquisition or formation by you,
unless you have given us notice of
the acquisition or formation.
Coverage does not apply to "bodily
injury" or"property damage" that results
from an"acoidmn8"that occurred before
you formed oracquired the organization.
B. Employees osInsureds
Paragraph A.1. - WHO /S AN INSURED ' of
SECTION )| ' LIABILITY COVERAGE is
amended \oadd:
d. Any "employee" of yours while using a
covered "ou1o" you don't mwn, hire or
borrow in your business or your
personal affairs.
C. Lessors asinsureds
Paragraph A.1.'WHO |SANINSURED 'of
8anUon U - Liability Coverage is amended to
e. The lessor ofacovered "auto/ while the
"auto" is leased toyou under owritten
agreement if
(1) The agreement requires you to
provide direct primary insurance for
the lessor and
(2) The "auto" is leased without a driver.
Such a leased "auto" will be considered a
covered "auto" you own and not mcovered
"auto" you hie*.
D. Additional Insured if Required byContract
(1) Paragraph A.1. -VVHD IS AN INSURED
' of Section U ' Liability Coverage is
amended to add:
L When you have ugneed, in awhtten
contract ovwritten agreement, that a
person or organization be added as
on additional insured on your
business auto policy, such person or
organization iaen"inourod".but only
to the extent such paneun or
organization is liable for "bodily
injury" or"property damage" caused
Uythe conduct o/un"insuvad"under
paragraphs a. or b. of Who Is An
Insured with regard to the
ownarahip, maintenance or use of a
covered "auto."
@2O11.The Hartford (includes copyrighted material
Form HASA1G83 12 ofISO Properties, Ino.with its pormismion.) Page 1of5
The insurance afforded to any such
additional insured applies only U the
"bodily injury" or "property damage"
(1) During the policy period, and
(2) Subsequent Vathe execution cfsuch
written contract, and
(3) Prior to the expiration of the period
of time that the written contract
requires such insurance boprovided
to the additional insured.
(2) How Limits Apply
If you have agreed in a written contract
or written agreement that another
person or organization boadded aean
additional insured on your po|icy, the
most we will pay on behalf of such
additional insured is the lesser of:
(e) The Umhm of insurance specified in
the written contract or written
agreement; or
(b) The Limits of Insurance shown in
the Declarations.
Such amount shall be apart ofand not
in addition to Limits cdInsurance shown
in the Declarations and described in this
Section.
(3) Additional Insureds Other Insurance
U we cover a claim or "suit" under this
Coverage Part that may also becovered
by other insurance available to an
additional insurad, such additional
insured must submit such claim or "suit"
to the other insurer for doh*noa and
indemnity.
However, this provision does not apply
to the extent that you have agreed in a
written contract or written agreement
that this insurance is primary and non-
contributory with the additional insured's
on'non1ributorywiththaaddiUona|inoured'u
own insurance.
(4) Duties in The Event OfAccident, Claim,
Suit orLoss
If you have agreed in owritten oonhmd
or written agreement that another
person or organization beadded aoan
additional insured on your po|iny, the
additional insured shall be required to
comply with the provisions in LOSS
CONDITIONS 2. ' DUTIES IN THE
EVENT OF ACCIDENT, CLAIM . SUIT
OR LOSS — OF SECTION N —
BUSINESS AUT(] COND)T|ONS, in the
same manner aathe Named Insured.
E. Primary and if
Required by Contract
Only with respect to insurance provided to
an additional insured in 1.D. ' Additional
Insured If Required by Conkac1, the
following provisions apply:
(3) Primary Insurance When Required By
Contract
This insurance is primary if you have
agreed in o written contract or written
agreement that this insurance be
primary. U other insurance is also
primary, we will share with all that other
insurance by the method described in
Other Insurance G.d.
(4) Primary And Non'ContributnryTo Other
Insurance When Required ByContract
If you have agreed in o written contract
or written agreement that this insurance
is primary and non-contributory with the
additional inounad'u own inauranoe, this
insurance is primary and we will not
seek contribution from that other
insurance.
Paragraphs (3)and (4)donot apply !oother
insurance to which the additional insured
has been added aoanadditional insured.
When this insurance ieexcess, wewill have no
duty to defend the insured against any "auit" if
any other insurer has a duty to defend the
insured against that "suit". U no other insurer
defends, we will undertake iodo so, but we will
be entitled to the insumad'e rights against a//
those other insurers.
When this insurance is oxnaae over other
inuunance, we will pay only our share of the
amount of the |one, if any, that exceeds the mum
(1) The total amount that all such other
insurance would pay for the loss in the
absence ofthis insurance; and
(2) The total of all deductible and self-insured
amounts under all that other insurance.
We will share the remaining |oau, if any, by the
method described inOther Insurance 5.d.
2\ AUTOS RENTED 8YEMPLOYEES
Any "auto" hired or rented by your
on your behalf and at your direction will be
considered an"au1u"you hire.
The OTHER INSURANCE Condition ioamended
by adding the following:
@2O11.The Hartford (Includes copyrighted material
Form HA 9916 03 12 ofISO Properties, /nc.with its permission.) Page 2 of
If an "employee's" personal insurance also
applies on an excess basis to a covered "auto"
hired or rented by your "employee" on your
behalf and at your direction, this insurance will
be primary to the "employee's" personal
insurance.
3. AMENDED FELLOW EMPLOYEE EXCLUSION
EXCLUSION 5. - FELLOW EMPLOYEE - of
SECTION II - LIABILITY COVERAGE does not
apply if you have workers' compensation
insurance in -force covering all of your
"employees".
Coverage is excess over any other collectible
insurance.
4. HIRED AUTO PHYSICAL DAMAGE COVERAGE
If hired "autos" are covered "autos" for Liability
Coverage and if Comprehensive, Specified
Causes of Loss, or Collision coverages are
provided under this Coverage Form for any
"auto" you own, then the Physical Damage
Coverages provided are extended to "autos" you
hire or borrow, subject to the following limit.
The most we will pay for "loss" to any hired
"auto" is:
(1) 5100,000;
(2) The actual cash value of the damaged or
stolen property at the time of the "loss"; or
(3) The cost of repairing or replacing the
damaged or stolen property,
whichever is smallest, minus a deductible. The
deductible will be equal to the largest deductible
applicable to any owned "auto" for that
coverage. No deductible applies to "loss" caused
by fire or lightning. Hired Auto Physical Damage
coverage is excess over any other collectible
insurance. Subject to the above limit, deductible
and excess provisions, we will provide coverage
equal to the broadest coverage applicable to any
covered "auto" you own.
We will also cover loss of use of the hired "auto"
if it results from an "accident", you are legally
liable and the lessor incurs an actual financial
loss, subject to a maximum of $1000 per
"accident".
This extension of coverage does not apply to
any "auto" you hire or borrow from any of your
"employees", partners (if you are a partnership),
members (if you are a limited liability company),
or members of their households.
5. PHYSICAL DAMAGE - ADDITIONAL
TEMPORARY TRANSPORTATION EXPENSE
COVERAGE
Paragraph A.4.a. of SECTION III - PHYSICAL
DAMAGE COVERAGE is amended to provide a
limit of $50 per day and a maximum limit of
$1,000.
6. LOAN/LEASE GAP COVERAGE
Under SECTION III - PHYSICAL DAMAGE
COVERAGE, in the event of a total "loss" to a
covered "auto", we will pay your additional legal
obligation for any difference between the actual
cash value of the "auto" at the time of the "loss"
and the "outstanding balance" of the loan lease.
"Outstanding balance" means the amount you
owe on the loan/lease at the time of "loss" less
any amounts representing taxes; overdue
payments; penalties, interest or charges
resulting from overdue payments; additional
mileage charges; excess wear and tear charges;
lease termination fees; security deposits not
returned by the lessor; costs for extended
warranties, credit life Insurance, health, accident
or disability insurance purchased with the loan or
lease; and carry-over balances from previous
loans or leases.
7. AIRBAG COVERAGE
Under Paragraph B. EXCLUSIONS - of
SECTION III - PHYSICAL DAMAGE
COVERAGE, the following is added:
The exclusion relating to mechanical breakdown
does not apply to the accidental discharge of an
airbag.
8. ELECTRONIC EQUIPMENT - BROADENED
COVERAGE
a. The exceptions to Paragraphs B.4 -
EXCLUSIONS - of SECTION III - PHYSICAL
DAMAGE COVERAGE are replaced by the
following:
Exclusions 4.c. and 4.d. do not apply to
equipment designed to be operated solely
by use of the power from the "auto's"
electrical system that, at the time of "loss",
is:
(1) Permanently installed in or upon
the covered "auto";
(2) Removable from a housing unit
which is permanently installed in
or upon the covered "auto";
(3) An integral part of the same unit
housing any electronic
equipment described in
Paragraphs (1) and (2) above; or
© 2011, The Hartford (Includes copyrighted material
Form HA 99 16 03 12 of ISO Properties, Inc., with its permission.) Page 3 of 5
(4) Necessary for the normal
operation of the covered "auto" or
the monitoring of the covered
"auto's" operating system.
b. Section III — Version CA 00 01 03 10 of the
Business Auto Coverage Form, Physical
Damage Coverage, Limit of Insurance,
Paragraph C.2 and Version CA 00 01 10 01 of
the Business Auto Coverage Form, Physical
Damage Coverage, Limit of Insurance,
Paragraph C are each amended to add the
following:
$1,500 is the most we will pay for "loss" in
any one "accident" to all electronic
equipment (other than equipment designed
solely for the reproduction of sound, and
accessories used with such equipment)
that reproduces, receives or transmits
audio, visual or data signals which, at the
time of "loss", is:
(1) Permanently installed in or upon
the covered "auto" in a housing,
opening or other location that is not
normally used by the "auto"
manufacturer for the installation of
such equipment;
(2) Removable from a permanently
installed housing unit as described
in Paragraph 2.a. above or is an
integral part of that equipment; or
(3) An integral part of such equipment.
c. For each covered "auto", should loss be limited
to electronic equipment only, our obligation to
pay for, repair, return or replace damaged or
stolen electronic equipment will be reduced by
the applicable deductible shown in the
Declarations, or $250, whichever deductible is
less.
9. EXTRA EXPENSE - BROADENED
COVERAGE
Under Paragraph A. - COVERAGE - of SECTION
III - PHYSICAL DAMAGE COVERAGE, we will
pay for the expense of returning a stolen covered
"auto" to you.
10. GLASS REPAIR -WAIVER OF DEDUCTIBLE
Under Paragraph D. - DEDUCTIBLE - of SECTION
III - PHYSICAL DAMAGE COVERAGE, the
following is added:
If another Hartford Financial Services Group,
Inc. company policy or coverage form that is not
an automobile policy or coverage form applies to
the same "accident", the following applies:
(1) If the deductible under this Business Auto
Coverage Form is the smaller (or smallest)
deductible, it will be waived;
(2) If the deductible under this Business Auto
Coverage Form is not the smaller (or
smallest) deductible, it will be reduced by
the amount of the smaller (or smallest)
deductible.
12. AMENDED DUTIES IN THE EVENT OF
ACCIDENT, CLAIM, SUIT OR LOSS
The requirement in LOSS CONDITIONS 2.a. -
DUTIES IN THE EVENT OF ACCIDENT,CLAIM,
SUIT OR LOSS - of SECTION IV - BUSINESS
AUTO CONDITIONS that you must notify us of
an "accident" applies only when the "accident" is
known to:
(1) You, if you are an individual;
(2) A partner, if you are a partnership;
(3) A member, if you are a limited liability
company; or
(4) An executive officer or insurance manager, if
you are a corporation.
13. UNINTENTIONAL FAILURE TO DISCLOSE
HAZARDS
If you unintentionally fail to disclose any hazards
existing at the inception date of your policy, we
will not deny coverage under this Coverage
Form because of such failure.
14. HIRED AUTO - COVERAGE TERRITORY
Paragraph e. of GENERAL CONDITIONS 7. -
POLICY PERIOD, COVERAGE TERRITORY -
of SECTION IV - BUSINESS AUTO
CONDITIONS is replaced by the following:
e. For short-term hired "autos", the coverage
territory with respect to Liability Coverage is
anywhere in the world provided that if the
"insured's" responsibility to pay damages for
"bodily injury" or "property damage" is
determined in a "suit," the "suit" is brought in
the United States of America, the territories
and possessions of the United States of
America, Puerto Rico or Canada or in a
settlement we agree to.
No deductible applies to glass damage if the 15. WAIVER OF SUBROGATION
glass is repaired rather than replaced. TRANSFER OF RIGHTS OF RECOVERY
11. TWO OR MORE DEDUCTIBLES AGAINST OTHERS TO US - of SECTION IV -
Under Paragraph D. - DEDUCTIBLE - of SECTION BUSINESS AUTO CONDITIONS is amended by
III - PHYSICAL DAMAGE COVERAGE, the adding the following:
following is added:
© 2011, The Hartford (Includes copyrighted material
Form HA 99 16 03 12 of ISO Properties, Inc., with its permission.) Page 4 of 5
We waive any right of recovery we may have
against any person or organization with whom
you have a written contract that requires such
waiver because of payments we make for
damages under this Coverage Form.
16. RESULTANT MENTAL ANGUISH COVERAGE
The definition of "bodily injury" in SECTION V -
DEFINITIONS is replaced by the following:
"Bodily injury" means bodily injury, sickness or
disease sustained by any person, including
mental anguish or death resulting from any of
these.
17. EXTENDED CANCELLATION CONDITION
Paragraph 2. of the COMMON POLICY
CONDITIONS - CANCELLATION - applies
except as follows:
If we cancel for any reason other than
nonpayment of premium, we will mail or deliver
to the first Named Insured written notice of
cancellation at least 60 days before the effective
date of cancellation.
18. HYBRID, ELECTRIC, OR NATURAL GAS
VEHICLE PAYMENT COVERAGE
In the event of a total loss to a "non -hybrid" auto
for which Comprehensive, Specified Causes of
Loss, or Collision coverages are provided under
this Coverage Form, then such Physical
Damage Coverages are amended as follows:
a.lf the auto is replaced with a "hybrid" auto or
an auto powered solely by electricity or natural
gas, we will pay an additional 10%, to a
maximum of $2,500, of the "non -hybrid" auto's
actual cash value or replacement cost,
whichever is less,
b.The auto must be replaced and a copy of a bill
of sale or new lease agreement received by us
within 60 calendar days of the date of "loss,"
c. Regardless of the number of autos deemed a
total loss, the most we will pay under this
Hybrid, Electric, or Natural Gas Vehicle
Payment Coverage provision for any one
"loss" is $10,000.
For the purposes of the coverage provision,
a.A "non -hybrid" auto is defined as an auto that
uses only an internal combustion engine to
move the auto but does not include autos
powered solely by electricity or natural gas.
b.A "hybrid" auto is defined as an auto with an
internal combustion engine and one or more
electric motors; and that uses the internal
combustion engine and one or more electric
motors to move the auto, or the internal
combustion engine to charge one or more
electric motors, which move the auto.
19. VEHICLE WRAP COVERAGE
In the event of a total loss to an "auto" for which
Comprehensive, Specified Causes of Loss, or
Collision coverages are provided under this
Coverage Form, then such Physical Damage
Coverages are amended to add the following:
In addition to the actual cash value of the "auto''
we will pay up to $1,000 for vinyl vehicle wraps
which are displayed on the covered "auto" at the
time of total loss. Regardless of the number of
autos deemed a total loss, the most we will pay
under this Vehicle Wrap Coverage provision for
any one "loss" is $5,000. For purposes of this
coverage provision, signs or other graphics
painted or magnetically affixed to the vehicle are
not considered vehicle wraps.
© 2011, The Hartford (Includes copyrighted material
Form HA 99 16 03 12 of ISO Properties, Inc., with its permission.) Page 5 of 5
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
WAIVER OF OUR RIGHT TO RECOVER FROM
OTHERS ENDORSEMENT - CALIFORNIA
Policy Number: 41 WEC ID0657 Endorsement Number:
Effective Date: 06/01/20 Effective hour is the same as stated on the Information Page of the policy.
Named Insured and Address: MASTER TECHNOLOGY INTEGRATORS INC
P.O. BOX 643188
LOS ANGELES CA 90064
We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our
right against the person or organization named in the Schedule. (This agreement applies only to the extent that you
perform work under a written contract that requires you to obtain this agreement from us.)
You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work
described in the Schedule.
The additional premium for this endorsement shall be 2 % of the California workers' compensation premium otherwise due
on such remuneration.
SCHEDULE
Person or Organization
Job Description
Any person or organization from whom you are required by written contract or agreement to obtain this waiver of rights
from us
Countersigned by
Form WC 04 03 06 (1) Printed in U.S.A.
Process Date: 04/22/20
Authorized Representative
Policy Expiration Date: 06/01/21