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PROOF OF INSURANCE (2021 - 2022) CLOSEDDATE (MMIDDNYYY) C CERTIFICATE OF LIABILITY INSURANCE 6M 712020 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 have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Adamson & McGoldrick Insurance Solutions NAME Brl d,q�.v_eK 1150 E. Orangethlor a AVe., SUlte 100 _ - 7714-�257-9644A, N 714 27 9833 PHONE FAX Placentia, CA 9287 �Ii°"'��` www.adamsonmcgoldrick.com .. ,..-__.-------- ------------------------ ------ ------- ............. .�......,.... INSURERA: Travelers INSURED.... INSURER B: St Paul S Morrow -Meadows Corporation 231 Benton Court iNsulxERc; City of Industry CA 91789 Ns ERD: INSURER E rnVFRAnPR CFRTIFICATF NIIMRFR• Crrl'iAgrlx REVISION NUMBERc 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. TM .............. v IN MR PE OF INSURANCE W 3 DDa WVD.. NUMBER POLICY. .. POLICV EFF POLICY E7(P I LIMITS II �, MMlpplYXYY MiOtd Y 1 A + COMMERCIAL GENERAL LIABILITY VTCT2J-CO-9322B094-TIL-20 1 7/1/2020 7/1/2021 HOCCUREYCE EACH OCCURRENCE $1000,000 CLAIMS -MADE OCCUR OC&P & XCU INCLUDE PRL•P41IS,StEpg7c.�grrpp*�1�} .r, �3l)0.000 blanket contractual Ilablil MED EXP (Any one person) $ 5,000 E.� "ter bf d rass Itab(N." PERSONAL & ADV INJURY $ 1µ� 000 000.. .... GEN"L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000 000 PRO` PRODUCTS COMP/OP P ...... �� 000 000— $2,� n HIEisz0�000 DedbleC $ AAUTOMOBILE T � � VTJ-CAP-9322B125-TIL-20 7/1/2020 7/1/2021 COMBINED SINGLE uMiT $1 �000�000 . ....__... ANOYAUTOABILITY BODILY �NdIURY(Per per .,.......... son) l $ OWNED I SCHEDULED BODILY INJURY (Per acadent)I $ l AUTOS ONLY AUTOS FiROPERTYCYAt,«%AG............... ....._HIRED . IS $. ✓... AUTOS ONLY a/ AUTOS ONLY i,Pe rTlr pNON-OWNED ......... UMBRELLA LIAB w/j OCCUR CUP-8N498906-20-25 7/1/2020 7/1/2021 E, RRENCE s51000,NO EXCESS I CLAIMS -MADE AGGREGATE GGREGA E ... .I.$.5 000,000.... ".LIAB DED RETENTION $ A WORKERS COMPENSATION UB-1N229746-20-25-K 7/1/2020 7/1/2021 75TATUTE I EOTH R.......... AND EMPLOYERS' LIABILITY Y�N`` ..mm E L EACH A N ACCIDENT $1,000 000 OFFICEANYPROPRIETOR/PARTNER/EXECUTIVE ER EXCLUDED? Mandato m NH (Mandatory NIA I E L. DISEASE EA EMPLOYEE _000 If yes, describe under I DESCRIPTION OF OPERATIONS below { I E L DISEASE - POLICY LIMIT $ 1 000 000 A Installation Floater QT6302G406387TIL20 7/1/2020 7/1/2021 Limit: $1,000,000, Ded.: $100,000 B Professional Liability 16N42611 1/21/2020 1/21/2021 Limit: $5,000,000/Retention: $150,000 B Pollution Liability 16N42611 1/21/2020 1/21/2021 Limit: $5,000,000/Retention: $25,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required) Re: All Operations City of El Segundo is listed as additional insured per attached forms. L.IGKIIII`IR.:Alr-.I"'ULU I"C VMNLCLL1AIIVM Cit of El Segundo Public Works Department Attn: Ariarine Bola 350 Main Street El Segundo CA SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Brian McGoldrick ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD 56034668 1 MORRO-1 1 20/21 Cities & Municipalities I Brigid Lopez 1 6/17/2020 11:10:11 AM (PDT) I Page 1 of 15 CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDDIYYYY) 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 have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Adamson & McGoldrick Insurance Solutions CONTACT_._._._ gid Lo e 1150 E. Orangethorpa Ave., Suite 100 PHONE" r) P Placentia, CA 92 (D Cruc..f�4a.l xty . _-- 14.2 7-9644 (nrgp No):.. 714-257 9833 > SAIL _ �_... w www.adamsonmcgoldrick.com ......... INSURED Morrow -Meadows Corporation 231 Benton Court City of Industry CA 91789 COVERAGES CERTIFICATE NUMBER: 51175,9717 AFFORDINGCOVERAGE NAIC# Lines Insurance Comoanvr 30481 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. pNSR�.... ...._. TYPE OF INS `AO%tia11'f3 i POLICY EIFF 7 Pb't.l , m X o. . _. cx EXP LT POLICY NUMBER MMdDDNYYY AAMPOF7urP'YY'1 LIMITS COMMERCIAL GENERAL LIABILITY I EACH OCCURRENCE $ i CLAIMS -MADE ,/ OCCUR �PREMISFS (Faccurrenpe) $............ ., .. .... MED EXP (Any one person) $ PERSONAL&ADVINJURY �$ .-._ . ........... ... ..,._... �. GEN'L AGGREGATE LIMIT APPLIES PER: .. --- ......... GENERAL AGGREGATE ..... $ [ PRO. POLICY ❑ JECT LOC ,._. -. --- .PRODUCTS - COMP/OP AG.. ..... $ 1. AUTOMOBILE LIABILITY AEABIKED SINGI r:I iMlT $ ANY AUTO BODILY INJURY (Per person) $ 1 OWNED SCHEDULED BODILY INJURY (Per accident) $ 4 ... AUTOS ONLY ., AUTOS HIRED f NON-OWNED6�ROPF`R'rY'CFAMAGE $ _____.... AUTOS ONLY ,,. AUTOS ONLY _QPar ac-0 enkp, . ....,EXCESS UMBRELLA LIAB O OCCUR EACH OCCURRENCE $ ... .... ESSLIA ............... .... CLAIMS MADE AGGREGATE ,,. E $ .. ........ ... _..... DEDRETENT�O.N.$... WORKERS COMPENSATION ( PER OTH- CUTE LER AND EMPLOYERS' LIABILITY YIN '....... ANYPROPRIETOR/PARTNERIEXECUTIVE OFFICER/MEMBEREXCLUDED? N/A E L EACH CCIDENT $ (Mandatory in NH) EL DISEA SE EA EMP,LOYEE _ $ ___ DIf yes, under DESCRIPTIONIPTIONONS OF OPERATIbelow . E•LDISEAS DISEASE LIMIT $ A Pollution Liability w/ mold/ fungus ZCD-41 N35876 1/21/2021 7/1/2022 $5,000,000 ($25,000 ded., 10/13/06 retro) A Professional Liability ZCD-41N35876 1/21/2021 7/1/2022 $5,000,000 ($150,000 ded., 1/21/06 retro) DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Job: Operations of the Named Insured. City of El Segundo is named GL Blanket Additional Insured per attached, only if required by written contract/agreement. LULK City of El Segundo 350 Main Street El Segundo CA 90245 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Brian McGoldrick © 1988-2015 ACORD CORPORATION. All rights reserves. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD 59755717 1 MORRO-1 121/22 Prof & Poll *FOR RENEWAL ONLY' I Brigid Lopez 11/19/2021 12:03:21 PM (PST) I Page 1 of 1 Morrow -Meadows Corporation V TC T2 J-C 0-93 22 B 094-T I L-2 0 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY BLANKET ADDITIONAL INSURED (CONTRACTORS) This endorsement modifies insurance provided under the following:. COMMERCIAL GENERAL LIABILITY COVERAGE PART 1. WHO IS AN INSURED — (Section II) is amended to include any person or organization that you agree in a "written contract requiring insurance" to include as an additional insured on this Cover- age Part, but: a) Only with respect to liability for "bodily injury", '.property damage" or "personal injury"; and b) If, and only to the extent that, the injury or damage is caused by acts or omissions of you or your subcontractor in the performance of "your work" to which the "written contract requiring insurance" applies. The person or organization does not qualify as an additional insured with respect to the independent acts or omissions of such person or organization. 2. The insurance provided to the additional insured by this endorsement is limited as follows: a) In the event that the Limits of Insurance of this Coverage Part shown in the Declarations exceed the limits of liability required by the ,.written contract requiring insurance", the in- surance provided to the additional insured shall be limited to the limits of liability re- quired by that "written contract requiring in- surance". This endorsement shall not in- crease the limits of insurance described in Section III — Limits Of Insurance. b) The insurance provided to the additional in- sured does not apply to "bodily injury", "prop- erty damage" or "personal injury" arising out of the rendering of, or failure to render, any professional architectural, engineering or sur- veying services, including: The preparing, approving, or failing to prepare or approve, maps, shop draw- ings, opinions, reports, surveys, field or- ders or change orders, or the preparing, approving, or failing to prepare or ap- prove, drawings and specifications; and ii. Supervisory, inspection, architectural or engineering activities. c) The insurance provided to the additional in- sured does not apply to "bodily injury" or '.property damage" caused by "your work" and included in the "products -completed op- erations hazard" unless the "written contract requiring insurance" specifically requires you to provide such coverage for that additional insured, and then the insurance provided to the additional insured applies only to such "bodily injury" or "property damage" that oc- curs before the end of the period of time for which the "written contract requiring insur- ance" requires you to provide such coverage or the end of the policy period, whichever is earlier. 3. The insurance provided to the additional insured by this endorsement is excess over any valid and collectible "other insurance", whether primary, excess, contingent or on any other basis, that is available to the additional insured for a loss we cover under this endorsement. However, if the ,.written contract requiring insurance" specifically requires that this insurance apply on a primary basis or a primary and non-contributory basis, this insurance is primary to "other insurance" available to the additional insured which covers that person or organization as a named insured for such loss, and we will not share with that "other insurance". But the insurance provided to the additional insured by this endorsement still is excess over any valid and collectible "other in- surance", whether primary, excess, contingent or on any other basis, that is available to the addi- tional insured when that person or organization is an additional insured under such "other insur- ance". 4. As a condition of coverage provided to the additional insured by this endorsement: a) The additional insured must give us written notice as soon as practicable of an "occur- rence" or an offense which may result in a claim. To the extent possible, such notice should include: Page 1 of 2 56034668 1 MORRO-1 120/21 Cities & Municipalities I Brigid Lopez 16/17/2020 11:10:11 AM (PDT) I Page 2 of 15 COMMERCIAL GENERAL LIABILITY I. How, when and where the 'occurrence" or offense took place; ii. The names and addresses of any injured persons and witnesses; and iii. The nature and location of any injury or damage arising out of the 'occurrence" or offense. b) If a claim is made or "suit' is brought against the additional insured, the additional insured must: L Immediately record the specifics of the claim or "suit' and the date received; and ii. Notify us as soon as practicable. The additional insured must see to it that we receive written notice of the claim or "suit' as soon as practicable. c) The additional insured must immediately send us copies of all legal papers received in connection with the claim or "suit', cooperate with us in the investigation or settlement of the claim or defense against the "suit', and otherwise comply with all policy conditions. d) The additional insured must tender the de- fense and indemnity of any claim or "suit' to any provider of "other insurance" which would cover the additional insured for a loss we cover under this endorsement. However, this condition does not affect whether the insur- ance provided to the additional insured by this endorsement is primary to 'other insur- ance" available to the additional insured which covers that person or organization as a named insured as described in paragraph 3. above. 5. The following definition is added to SECTION V. — DEFINITIONS: "Written contract requiring insurance" means that part of any written contract or agreement under which you are required to include a person or organization as an additional in- sured on this Coverage Part, provided that the "bodily injury" and "property damage" oc- curs and the "personal injury" is caused by an offense committed: a. After the signing and execution of the contract or agreement by you; b. While that part of the contract or agreement is in effect; and c. Before the end of the policy period. ■ g 2 of 2 0 2005Paul Travelers Companies,1: 1 56034668 1 MORRO-1 1 20/21 Cities & Municipalities I Brigid Lopez 16/17/2020 11:10:11 AM (PDT) I Page 3 of 15 Morrow -Meadows Corporation VTCT2J-CO-9322B094-TI L-20 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CONTRACTORS XTENC ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART GENERAL DESCRIPTION OF COVERAGE — This endorsement broadens coverage. However, coverage for any injury, damage or medical expenses described in any of the provisions of this endorsement may be excluded or limited by another endorsement to this Coverage Part, and these coverage broadening provisions do not apply to the extent that coverage is excluded or limited by such an endorsement. The following listing is a general cover- age description only. Limitations and exclusions may apply to these coverages. Read all the provisions of this en- dorsement and the rest of your policy carefully to determine rights, duties, and what is and is not covered. A. Aircraft Chartered With Pilot B. Damage To Premises Rented To You C. Increased Supplementary Payments D. Incidental Medical Malpractice E. Who Is An Insured — Newly Acquired Or Formed Organizations F. Who Is An Insured — Broadened Named Insured — Unnamed Subsidiaries G. Blanket Additional Insured — Owners, Managers Or Lessors Of Premises PROVISIONS A. AIRCRAFT CHARTERED WITH PILOT The following is added to Exclusion g., Aircraft, Auto Or Watercraft, in Paragraph 2. of SECTION I — COVERAGES — COVERAGE A BODILY IN- JURY AND PROPERTY DAMAGE LIABILITY: This exclusion does not apply to an aircraft that is: (a) Chartered with a pilot to any insured; (b) Not owned by any insured; and (c) Not being used to carry any person or prop- erty for a charge. B. DAMAGE TO PREMISES RENTED TO YOU 1. The first paragraph of the exceptions in Ex- clusion j., Damage To Property, in Para- graph 2. of SECTION I — COVERAGES — COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY is deleted. 2. The following replaces the last paragraph of Paragraph 2., Exclusions, of SECTION I — COVERAGES — COVERAGE A. BODILY H. Blanket Additional Insured — Lessors Of Leased Equipment L. Blanket Additional Insured — States Or Political Subdivisions — Permits J. Knowledge And Notice Of Occurrence Or Offense K. Unintentional Omission L. Blanket Waiver Of Subrogation M. Amended Bodily Injury Definition N. Contractual Liability— Railroads INJURY AND PROPERTY DAMAGE LI- ABILITY: Exclusions c. and g. through n. do not apply to "premises damage". Exclusion f.(1)(a) does not apply to "premises damage" caused by: a. Fire; b. Explosion; c. Lightning; d. Smoke resulting from such fire, explosion, or lightning; or e. Water; unless Exclusion f. of Section I — Coverage A — Bodily Injury And Property Damage Liability is replaced by another endorsement to this Coverage Part that has Exclusion — All Pollu- tion Injury Or Damage or Total Pollution Ex- clusion in its title. A separate limit of insurance applies to "premises damage" as described in Para- graph 6. of SECTION III — LIMITS OF IN- SURANCE. CG D3 16 11 11 © 2011 The Travelers Indemnity Company. All rights reserved. Page 1 of 6 5603466B 1 IMORRO 1 1 20/21 Chia*. & Murxici al.'.ities I Brigid IIqpV.=.�r. 1 6/1'7/2020 it 1.0 ::1. i. AM (PDT) I Page 4 Of 15 COMMERCIAL GENERAL LIABILITY 3. The following replaces Paragraph 6. of SEC- TION III — LIMITS OF INSURANCE: Subject to 5. above, the Damage To Prem- ises Rented To You Limit is the most we will pay under Coverage A for damages because of "premises damage" to any one premises. The Damage To Premises Rented To You Limit will apply to all "property damage" proximately caused by the same "occur- rence", whether such damage results from: fire; explosion; lightning; smoke resulting from such fire, explosion, or lightning; or water; or any combination of any of these causes. The Damage To Premises Rented To You Limit will be: a. The amount shown for the Damage To Premises Rented To You Limit on the Declarations of this Coverage Part; or b. $300,000 if no amount is shown for the Damage To Premises Rented To You Limit on the Declarations of this Coverage Part. 4. The following replaces Paragraph a. of the definition of "insured contract' in the DEFINI- TIONS Section: a. A contract for a lease of premises. How- ever, that portion of the contract for a lease of premises that indemnifies any person or organization for "premises damage" is not an "insured contract'; 5. The following is added to the DEFINITIONS Section: "Premises damage" means "property dam- age" to: a. Any premises while rented to you or tem- porarily occupied by you with permission of the owner; or b. The contents of any premises while such premises is rented to you, if you rent such premises for a period of seven or fewer consecutive days. 6. The following replaces Paragraph 4.b.(1)(b) of SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS: (b) That is insurance for "premises damage"; or 7. Paragraph 4.b.(1)(c) of SECTION IV — COMMERCIAL GENERAL LIABILITY CON- DITIONS is deleted. C. INCREASED SUPPLEMENTARY PAYMENTS 1. The following replaces Paragraph 1.b. of SUPPLEMENTARY PAYMENTS — COVER- AGES A AND B of SECTION I — COVER- AGE: b. Up to $2,500 for the cost of bail bonds required because of accidents or traffic law violations arising out of the use of any vehicle to which the Bodily Injury Liability Coverage applies. We do not have to fur- nish these bonds. 2. The following replaces Paragraph 1.d. of SUPPLEMENTARY PAYMENTS — COVER- AGES A AND B of SECTION I — COVER- AGES: d. All reasonable expenses incurred by the insured at our request to assist us in the investigation or defense of the claim or "suit", including actual loss of earnings up to $500 a day because of time off from work. D. INCIDENTAL MEDICAL MALPRACTICE 1. The following is added to the definition of "oc- currence" in the DEFINITIONS Section: "Occurrence" also means an act or omission committed in providing or failing to provide "incidental medical services", first aid or "Good Samaritan services" to a person. 2. The following is added to Paragraph 2.a.(1) of SECTION II — WHO IS AN INSURED: Paragraph (1)(d) above does not apply to "bodily injury" arising out of providing or fail- ing to provide: (i) "Incidental medical services" by any of your "employees" who is a nurse practi- tioner, registered nurse, licensed practical nurse, nurse assistant, emergency medi- cal technician or paramedic; or (ii) First aid or "Good Samaritan services" by any of your "employees" or "volunteer workers", other than an employed or vol- unteer doctor. Any such "employees" or "volunteer workers" providing or failing to provide first aid or "Good Samaritan ser- vices" during their work hours for you will be deemed to be acting within the scope of their employment by you or performing duties related to the conduct of your busi- ness. Page 2 of 6 © 2011 The Travelers Indemnity Company. All rights reserved. CG D3 16 11 11 !:i60'.34568 I MORRf)... 1 1 20/21. Cit::'.i. S r, Mun'icipal1ti) I Brigid Loettr.'a 1 6/1.'7/2020 ta.: 7.Dill. AM (Pi:rr) I Page 5 of 15 3. The following is added to Paragraph 5. of SECTION III — LIMITS OF INSURANCE: For the purposes of determining the applica- ble Each Occurrence Limit, all related acts or omissions committed in providing or failing to provide "incidental medical services", first aid or "Good Samaritan services" to any one per- son will be deemed to be one 'occurrence". 4. The following exclusion is added to Para- graph 2., Exclusions, of SECTION I — COW ERAGES — COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY: Sale Of Pharmaceuticals "Bodily injury" or "property damage" arising out of the willful violation of a penal statute or ordinance relating to the sale of pharmaceuti- cals committed by, or with the knowledge or consent of, the insured. 5. The following is added to the DEFINITIONS Section: "Incidental medical services" means: a. Medical, surgical, dental, laboratory, x-ray or nursing service or treatment, advice or instruction, or the related furnishing of food or beverages; or b. The furnishing or dispensing of drugs or medical, dental, or surgical supplies or appliances. "Good Samaritan services" means any emer- gency medical services for which no compen- sation is demanded or received. 6. The following is added to Paragraph 4.b., Ex- cess Insurance, of SECTION IV — COM- MERCIAL GENERAL LIABILITY CONDI- TIONS: The insurance is excess over any valid and collectible other insurance available to the in- sured, whether primary, excess, contingent or on any other basis, that is available to any of your "employees" or "volunteer workers" for "bodily injury" that arises out of providing or failing to provide "incidental medical ser- vices", first aid or "Good Samaritan services" to any person to the extent not subject to Paragraph 2.a.(1) of Section II — Who Is An Insured. E. WHO IS AN INSURED — NEWLY ACQUIRED OR FORMED ORGANIZATIONS The following replaces Paragraph 4. of SECTION II — WHO IS AN INSURED: COMMERCIAL GENERAL LIABILITY 4. Any organization you newly acquire or form, other than a partnership, joint venture or lim- ited liability company, of which you are the sole owner or in which you maintain the ma- jority ownership interest, will qualify as a Named Insured if there is no other insurance which provides similar coverage to that or- ganization. However: a. Coverage under this provision is afforded only: (1) Until the 180th day after you acquire or form the organization or the end of the policy period, whichever is earlier, if you do not report such organization in writing to us within 180 days after you acquire or form it; or (2) Until the end of the policy period, when that date is later than 180 days after you acquire or form such organization, if you report such organization in writing to us within 180 days after you acquire or form it, and we agree in writing that it will con- tinue to be a Named Insured until the end of the policy period; b. Coverage A does not apply to "bodily injury" or "property damage" that occurred before you acquired or formed the organization; and c. Coverage B does not apply to "personal in- jury" or "advertising injury" arising out of an offense committed before you acquired or formed the organization. F. WHO IS AN INSURED — BROADENED NAMED INSURED — UNNAMED SUBSIDIARIES The following is added to SECTION II — WHO IS AN INSURED: Any of your subsidiaries, other than a partnership, joint venture or limited liability company, that is not shown as a Named Insured in the Declara- tions is a Named Insured if you maintain an own- ership interest of more than 50% in such subsidi- ary on the first day of the policy period. No such subsidiary is an insured for "bodily injury" or "property damage" that occurred, or "personal injury" or "advertising injury" caused by an of- fense committed after the date, if any, during the policy period, that you no longer maintain an ownership interest of more than 50% in such sub- sidiary. CG D3 16 11 11 © 2011 The Travelers Indemnity Company. All rights reserved, Page 3 of 6 56034668 1 MORRO-1 1 20/21 C,c,­, ru Ra ir.,p,l,rx :, p Sni.gid Lopez 1 6/17/2020 11::10:11 A.M trDT� I Page 6 of 15 COMMERCIAL GENERAL LIABILITY G. BLANKET ADDITIONAL INSURED — OWNERS, MANAGERS OR LESSORS OF PREMISES The following is added to SECTION II — WHO IS AN INSURED: Any person or organization that is a premises owner, manager or lessor and that you have agreed in a written contract or agreement to in- clude as an additional insured on this Coverage Part is an insured, but only with respect to liability for "bodily injury", "property damage", "personal injury" or "advertising injury" that: a. Is "bodily injury" or "property damage" that occurs, or is "personal injury" or "advertising injury" caused by an offense that is commit- ted, subsequent to the execution of that con- tract or agreement; and b. Arises out of the ownership, maintenance or use of that part of any premises leased to you. The insurance provided to such premises owner, manager or lessor is subject to the following pro- visions: a. The limits of insurance provided to such premises owner, manager or lessor will be the minimum limits which you agreed to pro- vide in the written contract or agreement, or the limits shown on the Declarations, which- ever are less. b. The insurance provided to such premises owner, manager or lessor does not apply to: (1) Any "bodily injury" or "property damage" that occurs, or "personal injury" or "adver- tising injury" caused by an offense that is committed, 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 premises owner, lessor or manager. c. The insurance provided to such premises owner, manager or lessor is excess over any valid and collectible other insurance available to such premises owner, manager or lessor, whether primary, excess, contingent or on any other basis, unless you have agreed in the written contract or agreement that this in- surance must be primary to, or non- contributory with, such other insurance, in which case this insurance will be primary to, and non-contributory with, such other insur- ance. H. BLANKET ADDITIONAL INSURED — LESSORS OF LEASED EQUIPMENT The following is added to SECTION II — WHO IS AN INSURED: Any person or organization that is an equipment lessor and that you have agreed in a written con- tract or agreement to include as an insured on this Coverage Part is an insured, but only with re- spect to liability for "bodily injury", "property dam- age", "personal injury" or "advertising injury" that: a. Is "bodily injury" or "property damage" that occurs, or is "personal injury" or "advertising injury" caused by an offense that is commit- ted, subsequent to the execution of that con- tract or agreement; and b. Is caused, in whole or in part, by your acts or omissions in the maintenance, operation or use of equipment leased to you by such equipment lessor. The insurance provided to such equipment lessor is subject to the following provisions: a. The limits of insurance provided to such equipment lessor will be the minimum limits which you agreed to provide in the written contract or agreement, or the limits shown on the Declarations, whichever are less. b. The insurance provided to such equipment lessor does not apply to any "bodily injury" or "property damage" that occurs, or "personal injury" or "advertising injury" caused by an of- fense that is committed, after the equipment lease expires. c. The insurance provided to such equipment lessor is excess over any valid and collectible other insurance available to such equipment lessor, whether primary, excess, contingent or on any other basis, unless you have agreed in the written contract or agreement that this insurance must be primary to, or non-contributory with, such other insurance, in which case this insurance will be primary to, and non-contributory with, such other in- surance. I. BLANKET ADDITIONAL INSURED — STATES OR POLITICAL SUBDIVISIONS — PERMITS The following is added to SECTION II — WHO IS AN INSURED: Any state or political subdivision that has issued a permit in connection with operations performed by you or on your behalf and that you are required Page 4 of 6 © 2011 The Travelers Indemnity Company. All rights reserved. CG D3 16 11 11 e C /�. I "gid Loper, 1 6/17/2026:f 11-10:1.1. AM (&>PJ�'j I Page 7 of 15 5E"41 �Jg E,C9 M©G'+.GtCJ..I .'41 rl Cities � X�9a1'r�tC 1... P.1 C.^'� C�Y,r Aq. by any ordinance, law or building code to include as an additional insured on this Coverage Part is an insured, but only with respect to liability for "bodily injury", "property damage", "personal in- jury" or "advertising injury" arising out of such op- erations. The insurance provided to such state or political subdivision does not apply to: a. Any "bodily injury," "property damage," "per- sonal injury" or "advertising injury" arising out of operations performed for that state or po- litical subdivision; or b. Any "bodily injury" or "property damage" in- cluded in the "products -completed operations hazard". J. KNOWLEDGE AND NOTICE OF OCCUR- RENCE OR OFFENSE The following is added to Paragraph 2., Duties In The Event of Occurrence, Offense, Claim or Suit, of SECTION IV — COMMERCIAL GEN- ERAL LIABILITY CONDITIONS: e. The following provisions apply to Paragraph a. above, but only for the purposes of the in- surance provided under this Coverage Part to you or any insured listed in Paragraph 1. or 2. of Section II — Who Is An Insured: (1) Notice to us of such "occurrence" or of- fense must be given as soon as practica- ble only after the "occurrence" or offense is known by you (if you are an individual), any of your partners or members who is an individual (if you are a partnership or joint venture), any of your managers who is an individual (if you are a limited liability company), any of your "executive offi- cers" or directors (if you are an organiza- tion other than a partnership, joint venture or limited liability company) or any "em- ployee" authorized by you to give notice of an "occurrence" or offense. (2) If you are a partnership, joint venture or limited liability company, and none of your partners, joint venture members or man- agers are individuals, notice to us of such "occurrence" or offense must be given as soon as practicable only after the "occur- rence" or offense is known by: COMMERCIAL GENERAL LIABILITY (ii) A manager of any limited liability company; or (iii) An executive officer or director of any other organization; that is your partner, joint venture member or manager; or (b) Any "employee" authorized by such partnership, joint venture, limited li- ability company or other organization to give notice of an "occurrence" or offense. (3) Notice to us of such "occurrence" or of an offense will be deemed to be given as soon as practicable if it is given in good faith as soon as practicable to your work- ers' compensation insurer. This applies only if you subsequently give notice to us of the "occurrence" or offense as soon as practicable after any of the persons de- scribed in Paragraphs e. (1) or (2) above discovers that the "occurrence" or offense may result in sums to which the insurance provided under this Coverage Part may apply. However, if this Coverage Part includes an en- dorsement that provides limited coverage for "bodily injury" or "property damage" or pollution costs arising out of a discharge, release or es- cape of "pollutants" which contains a requirement that the discharge, release or escape of "pollut- ants" must be reported to us within a specific number of days after its abrupt commencement, this Paragraph e. does not affect that require- ment. K. UNINTENTIONAL OMISSION The following is added to Paragraph 6., Repre- sentations, of SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS: The unintentional omission of, or unintentional error in, any information provided by you which we relied upon in issuing this policy will not preju- dice your rights under this insurance. However, this provision does not affect our right to collect additional premium or to exercise our rights of cancellation or nonrenewal in accordance with applicable insurance laws or regulations. L. BLANKET WAIVER OF SUBROGATION (a) Any individual who is: The following is added to Paragraph 8., Transfer (i) A partner or member of any part- Of Rights Of Recovery Against Others To Us, nership or joint venture; of SECTION IV — COMMERCIAL GENERAL LI- ABILITY CONDITIONS: CG D3 16 11 11 © 2011 The Travelers Indemnity Company. All rights reserved. Page 5 of 6 3F0316FS I MbX2FBO 1 1 20/21 C.it'i.. Ni M,u i p.hit. :ie„ I F4.,i9id 9Lop,F 1 6/17/2020 11u10:1I A.tN(F'nT) I P,.;qe 8 oP 15 COMMERCIAL GENERAL LIABILITY If the insured has agreed in a contract or agree- ment to waive that insured's right of recovery against any person or organization, we waive our right of recovery against such person or organiza- tion, but only for payments we make because of: a. "Bodily injury" or "property damage" that oc- curs; or b. "Personal injury" or "advertising injury" caused by an offense that is committed; subsequent to the execution of that contract or agreement. M. AMENDED BODILY INJURY DEFINITION The following replaces the definition of "bodily injury" in the DEFINITIONS Section: 3. "Bodily injury" means bodily injury, mental anguish, mental injury, shock, fright, disability, humiliation, sickness or disease sustained by a person, including death resulting from any of these at any time. N. CONTRACTUAL LIABILITY — RAILROADS 1. The following replaces Paragraph c. of the definition of "insured contract" in the DEFINI- TIONS Section: c. Any easement or license agreement; 2. Paragraph f.(1) of the definition of "insured contract" in the DEFINITIONS Section is de- leted. Page 6 of 6 © 2011 The Travelers Indemnity Company. All rights reserved, CG D3 16 11 11 56014C68 1 MC1RRO-1 1 20/21. Cities A MuriicipalitP es 0 Bragg. Lop— 1 6/17/2020 1.1t10:11 AN (PDT) I Page 9 OF 1.5 Morrow -Meadows Corporation VTJ-CAP-9322B 125-TI L-20 COMMERCIAL AUTO THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED - PRIMARY AND NON-CONTRIBUTORY WITH OTHER INSURANCE - CONTRACTORS This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM PROVISIONS 1. The following is added to Paragraph c. in A.1., Who Is An Insured, of SECTION II — COVERED AUTOS LIABILITY COVERAGE: This includes any person or organization who you are required under a written contract or agreement, that is signed by you before the "bodily injury" or "property damage" occurs and that is in effect during the policy period, to name as an additional insured for Covered Autos Liability Coverage, but only for damages to which this insurance applies and only to the extent of that person's or organization's liability for the conduct of another "insured". 2. The following is added to Paragraph B.6., Other Insurance of SECTION IV — BUSINESS AUTO CONDITIONS: Regardless of the provisions of paragraph a. and paragraph d. of this part 6.Other Insurance, this insurance is primary to and non-contributory with applicable other insurance under which an additional insured person or organization is a named insured when a written contract or agreement with you, that is signed by you before the "bodily injury" or "property damage" occurs and that is in effect during the policy period, requires this insurance to be primary and non- contributory. CA T4 99 02 16 0 2016 The Travelers Indemnity Company. All rights reserved. Page 1 of 1 Includes copyrighted material of Insurance Services Office, Inc. with its permission. 603466,R I I111bR.RO-'1. 1 20/2'1. C'ikieS & dNlx c.pea7.�a.t:i.. I Br.igi.ld Lopez I G/].7/2020 '1.11. 10:,Ill. AM (PDT) a Pige 1.0 ol:''. 15 Morrow -Meadows Corporation VTJ-CAP-9322B 125-TI L-20 COMMERCIAL AUTO THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BUSINESS AUTO EXTENSION ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM GENERAL DESCRIPTION OF COVERAGE — This endorsement broadens coverage. however, coverage for any injury, damage or medical expenses described in any of the provisions of this endorsement may be excluded or limited by another endorsement to the Coverage Part, and these coverage broadening provisions do not apply to the extent that coverage Is excluded or limited by such an endorsement. The following listing is a general cover- age description only. Limitations and exclusions may apply to these coverages. Read all the provisions of this en- dorsement and the rest of your policy carefully to determine rights, duties, and what Is and Is not covered. A. BROAD FORM NAMED INSURED H. HIRED AUTO PHYSICAL DAMAGE — LOSS OF B. BLANKET ADDITIONAL INSURED USE— INCREASED LIMIT C. EMPLOYEE HIRED AUTO 1. PHYSICAL DAMAGE — TRANSPORTATION EXPENSES — INCREASED LIMIT D. EMPLOYEES AS INSURED J. PERSONAL PROPERTY E. SUPPLEMENTARY PAYMENTS — INCREASED K. AIRBAGS LIMITS L. NOTICE AND KNOWLEDGE OF ACCIDENT OR F. HIRED AUTO — LIMITED WORLDWIDE COV- LOSS ERAGE — INDEMNITY BASIS M. BLANKET WAIVER OF SUBROGATION G. WAIVER OF DEDUCTIBLE — GLASS N. UNINTENTIONAL ERRORS OR OMISSIONS PROVISIONS A. BROAD FORM NAMED INSURED The following Is added to Paragraph AA., Who is An Insured, of SECTION II — COVERED AUTOS LIABILITY COVERAGE: Any organization you newly acquire or form dur- ing the policy period over which you maintain 50% or more ownership interest and that is not separately insured for Business Auto Coverage. Coverage under this provision is afforded only un- til the 180th day after you acquire or form the or- ganization or the end of the policy period, which- ever Is eadler:. B. BLANKETADDITIONAL INSURED The following is added to Paragraph c. In A.1., Who Is An Insured, of SECTION II — COVERED AUTOS LIABILITY COVERAGE: Any person or organization who Is required under a written contract or agreement between you and that person or organization, that Is signed and executed by you before the "bodily injury" or "properly damage" occurs and that Is In effect during the policy period, to be named as an addl- tlonal Insured Is an "insured" for Covered Autos Liability Coverage, but only for damages to which this insurance applies and only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured provision contained in Section II. C. EMPLOYEE HIRED AUTO 1. The following is added to Paragraph A.1., Who Is An Insured„ of SECTION II — COW ERED AUTOS LIABILITY COVERAGE: An "employee" of yours is an "insured" while operating an "auto" hired or rented under a contract or agreement in an "employee's" name, with your permission, while performing duties related to the conduct of your busi- ness. 2. The following replaces Paragraph b. in B.S., Other Insurance, of SECTION IV — BUSI- NESS AUTO CONDITIONS: b. For Hired Auto Physical Damage Cover- age, the following are deemed to be cov- ered "autos" you own: (1) Any covered "auto" you lease, hire, rent or borrow; and (2) Any covered "auto" hired or rented by your "employee" under a contract in an "employee's" name, with your CA T3 53 0215 ® 2015 The Travelers Indemnity Company. Ali rights reserved. Page 1 of 4 Includes oopyrlghted material of Insurance Services Office, Inc. with Its permission. 6034666 1 MDSi.idO 1 1 20/2'1. Cities &. mini.cipal.A.ties a Brigid I:. pet, 1 6/I.'1/2020 11.�106 1 AM (PDT) ( Page 11. of.. IS COMMERCIAL AUTO permission, while performing duties (a) With respect to any claim made or "suit" related to the conduct of your busi- brought outside the United States of ness, America, the territories and possessions However, any "'auto" that is leased, hired, of the United Slates of America, Puerto rented or borrowed with a driver Is not a Rico and Canada: covered "auto". (1) You must arrange to defend the "in- --D.- EMPLOYEES AS INSURED -_ __ .__________-, sured_,against, and-Investigate-orset-- The following is added to Paragraph A.1„ Ile any such claim or "sunk"'" and keep Who is us advised of all proceedings and ac An Insured, of SECTION 11— COVERED AUTOS tions. LIABILITY COVERAGE: Any "'employee" of yours i an "insured" while us- (11) Neither you nor any other Involved 1'Ill ma "insured" will make any settlement Ing a covered "auto" you don't own, hire or borrow without our i mat. In your business or your personal affairs. E. SUPPLEMENTARY PAYMENTS — INCREASED (III) We may, at our discretion, partlolpate In defending the "Insured'" against, or LIMITS In the settlement of, any claim or 1. The following replaces Paragraph A.2.a.(2), "suit". of SECTION II — COVERED AUTOS LIABIL- (iv) We will reimburse the "Insured' for ITY COVERAGE: sums that the "Insured" legally must (2) Up to $3,000 for cost of ball bonds (in- pay as damages because of "bodily cluding bonds for related traffic law viola- Injury" or "properly damage" to which tion) required because of an "accident" this Insurance applies, that the "in - we cover. We do not have to furnish sured" pays with our consent, but these bonds. only up to the limit described in Para- 2. The following replaces Paragraph A.2,a.(4), graph C., Limits Of Insurance, of of SECTION II — COVERED AUTOS LIABIL- SECTION II — COVERED AUTOS ITY COVERAGE: LIABILITY COVERAGE. (4) All reasonable expenses Incurred by the (v) We will reimburse the "Insured" for "insured" at our request, Including actual the reasonable expenses incurred loss of earnings up to $500 a day be- with our consent for your Investiga- cause of time off from work. tion of such claims and your defense F. HIRED AUTO — LIMITED WORLDWIDE COV- of the "insured" against any such ERAGE — INDEMNITY BASIS "suit", but only up to and included within the limit described in Para - The following replaces Subparagraph (5) in Para- graph C., Limits Of Insurance, of graph B.7., Policy Period, Coverage Territory, SECTION II — COVERED AUTOS — of SECTION IV — BUSINESS AUTO CONDI- LIABILITY COVERAGE, and not in TIONS: addition to such limit. Our duty to (5) Anywhere in the world, except any country or make such payments ends when we Jurisdiction while any trade sanction, em- have used up the applicable limit of bargo, or similar regulation imposed by the insurance In payments for damages, United States of America applies to and pro- settlements or defense expenses, hibits the transaction of business with or (b) This insurance is excess over any valid within such country or Jurisdiction, for Cov- and collectible other Insurance available ered Autos Liability Coverage for any covered to the "insured' whether primary, excess, "auto" that you lease, hire, rent or borrow contingent or on any other basis, without a driver for period of 30 days or less and that is not an auto you lease, hire, rent (c) This Insurance Is not a substitute for re - or borrow from any of your "employees", quired or compulsory Insurance In any partners (if you are a partnership), members country, outside the United States [is ter - (if you are a limited liability company) or ritories and possessions, Puerto Rico and Canada members of their households. Page 2 of 4 9 2D15 The Travelers Indemnity Company. All rights reserved. CA T3 53 02 15 Includes copyrighted material of Insurance Services orrice, Inc. with Its permisslon. 56634668 a MOStRO 1. 1 20/21. (_ibis & Municipi:a.l.l r.ies I S,rili.d 1,ope7. 1 6(1,7/2020 11.1.:1.6 1.:1., AM (PD'r) ( Page 1.2 01:. '1.5 You agree to maintain all required or compulsory insurance in any such coun- try up to the minimum limits required by local law. Your failure to comply with compulsory insurance requirements will not invalidate the coverage afforded by this policy, but we will only be liable to the K. same extent we, would. have. been ..iiabie........ had you complied with the compulsory in- surance requirements. (d) It is understood that we are not an admit- ted or authorized Insurer outside the United States of America, its territories and possessions, Puerto Rico and Can- ada. We assume no responsibility for the furnishing of certificates of insurance, or for compliance in any way with the laws of other countries relating to Insurance, G. WAIVER OF DEDUCTIBLE — GLASS The following Is added to Paragraph D., Deducti- ble, of SECTION III — PHYSICAL DAMAGE COVERAGE: No deducible for a covered 'auto" will apply to glass damage if the glass Is repaired rather than replaced. H. HIRED AUTO PHYSICAL DAMAGE — LOSS OF USE — INCREASED LIMIT The following replaces the last sentence of Para- graph A4.b., Loss Of Use Expenses, of SEC- TION III — PHYSICAL DAMAGE COVERAGE: However, the most we will pay for any expenses for loess of use is $65 per day, to a maximum of $750 for any one "accident". PHYSICAL DAMAGE — TRANSPORTATION EXPENSES —INCREASED LIMIT The following replaces the first sentence in Para- graph A.4.a., Transportation Expenses, of SECTION III — PHYSICAL DAMAGE COVER- AGE: We Wil pay up to $50 per day to a maximum of $1,600 for temporary transportation expense In- curred by you because of the total theft of a cov. ered "auto" of the private passenger type. J. PERSONAL PROPERTY The following is added to Paragraph AA., Cover- age Extensions, of SECTION III — PHYSICAL DAMAGE COVERAGE: Personal Property We will pay up to $400 for "loss" to wearing ap- pairel and other personal property which is: (1) Owned by an "Insured"; and COMMERCIAL AUTO (2) In or on your covered "auto", This coverage applies only in the event of a total theft of your covered "auto". No deductibles apply to this Personal Property coverage. AIRBAGS The foltowing'ls added to"Pardgra:,ph BM3 ; Extlu-� sions, of SECTION III — PHYSICAL DAMAGE COVERAGE: Exclusion 3,a. does not apply to "loss", to one or more airbags in a covered "auto" you own that in- flate due to a cause other than a cause of "loss" set forth in Paragraphs A.1.b. and A.1.c., but only: a. If that "auto" Is a covered "auto" for Compre- henslve Coverage under this policy; b. The alrbags are not covered under any war- ranty; and c. The airbags were not intentionally inflated. We will pay up to a maximum of $1,000 for any one ""loss", L. NOTICE AND KNOWLEDGE OF ACCIDENT OR LOSS The following Is added to Paragraph A.2.a.., of SECTION IV — BUSINESS AUTO CONDITIONS: Your duty to give us or our authorized representa- tive prompt notice of the "accident" or "loss" ap- plies only when the "accident"" or "loss" Is known to: (a) You (if you are an individual); (b) A partner (if you are a partnership); (c) A member (if you are a limited liability com- pany); (d) An executive officer, director or Insurance manager (if you are a corporation or other or- ganization); or (a) Any "employee" authorized by you to give no- tice of the "accident" or "loss", M. BLANKET WAIVER OF SUBROGATION The following replaces Paragraph A,6,, Transfer Of Rights Of Recovery Against Others To Us, of SECTION IV .- BUSINESS AUTO CONDI- TIONS: 5. Transfer Of Rights Of Recovery Against Others To Us We waive any right of recovery we may have against any person or organization to the ex- tent required of you by a written contract signed and executed prior to any "accident" or "loss", provided that the "accident" or "loss'" arises out of operations contemplated by CA T3 53 02 15 ® 2015 The Traveler: Indemnity Company. All rights reserved. Page 3 of 4 Includes copyrighted material of Insurance Services Office, Inc. with Its permission, 560344668 1 MOR.RRO 1 1 20/21. C".Lx.es F Municipalities I B,,Agi.d f.,oper ( G/1.7/2020 1.1..1.0:'1.'I.. PAIN OUI') ( S$.9e 1.., .l:' '1..r COMMERCIAL AUTO such contract. The waiver applies only to the person or organization designated in such contract. N. UNINTENTIONAL ERRORS OR OMISSIONS The following is added to Paragraph 5.2,, Con... cealment, Misrepresentation, Or Fraud, of SECTION, IV— BUSINESS ALTO CONDITIONS: The unintentional omisslon of, or unintentional error in, any information given by you shall not prejudice your rights under this insurance. How- ever this provision does not affect our right to col- lect additional premium or exercise our right of cancellation or non -renewal. Page 4 of 4 ® 2016 The Travelers Indemnity Company. All rights reserved. Includes copyrighted material of Insurance Services 010ce, Inc. vAlh Its permission. CAT3630216 6Pt',.ip.668 1 C!ORi2(:k...a 1 20/21. Cities 6. Muai,:ipalities ( Brigid Lopez 1 6/1.1/2020 '1.'1. 10:1.'1. .AM (PDT.') I Page 5 1.4 of 15 ��� WORKERS COMPENSATION AND ONE TOWER SQUARE EMPLOYERS LIABILITY POLICY HARTFORD, CT 06183 ENDORSEMENT WC 99 03 76 ( A) — 001 POLICY NUMBER: UB-1N229746-20-25-K WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT - CALIFORNIA (BLANKET WAIVER) 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. The additional premium for this endorsement shall be 02.000 % of the California workers' compensation pre- mium. Schedule Person or Organization Job Description ANY PERSON OR ORGANIZATION FOR WHICH THE INSURED HAS AGREED BY WRITTEN CONTRACT EXECUTED PRIOR TO LOSS TO FURNISH THIS WAIVER. This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective 7/1/2020 Policy No. UB-1N229746-20-25-K Endorsemen o. Insured Morrow -Meadows Corporation ,, Pr ium Insurance Company Countersigned by Page 1 of 1 56034668 1 MORRO-1 1 20/21 Cities & Municipalities I Brigid Lopez 16/17/2020 11:10:11 AM (PDT) I Page 15 of 15