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PROOF OF INSURANCE (2022) CLOSEDACCORD® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 8/17/2021 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 IOA Insurance Services 130 Vantis Suite 250 CONTACT NAME: Elizabeth Leach PHONE FAX A/C No Ext : 949-297-5962 A/C, No : 949-297-5960 ADDE-MRESS: elizabeth.leach@ioausa.com INSURER(S) AFFORDING COVERAGE NAIC# Aliso Viejo CA 92656 INSURERA: Travelers Property Casualty Company of America 25674 License#: OE67768 INSURED DUTHELE-01 Duthie Electric Service Corp dba: Duthie Power Services 2335 E. Cherry Industrial Circle INSURERB: Crum & Forster Specialty Insurance Company 44520 INSURERC: Houston Casualty Company 42374 INSURERD: HSB Specialty Insurance Company 14438 Long Beach CA 90805 INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 1645768691 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. INSR LTR TYPE OF INSURANCE ADDL INSD SUBR WVD POLICY NUMBER POLICY EFF MM/DD POLICY EXP MM/DD LIMITS A X COMMERCIAL GENERAL LIABILITY Y Y Y6302A626927TIL21 7/1/2021 7/1/2022 EACH OCCURRENCE $1,000,000 CLAIMS -MADE OCCUR DAMAGE TO RENTED PREMISES Ea occurrence $ 300,000 MED EXP (Any one person) $ 5,000 PERSONAL &ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY � PE� LOC PRODUCTS - COMP/OP AGG $ 2,000,000 Deductible $ 0 OTHER: A AUTOMOBILE LIABILITY Y Y 8102N3387402114G 7/1/2021 7/1/2022 COMBINED SINGLE LIMIT Ea accident $1,000,000 X BODILY INJURY (Per person) $ ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ X PROPERTY DAMAGE Per accident $ HIRED X NON -OWNED AUTOS ONLY AUTOS ONLY A X UMBRELLALIAB X OCCUR Y Y CUP3S17641A21NF 7/1/2021 7/1/2022 EACH OCCURRENCE $15,000,000 AGGREGATE $ 15,000,000 EXCESS LAB CLAIMS -MADE DED X RETENTION $ 1 n nnn $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANYPROPRIETOR/PARTNER/EXECUTIVE Y UB7K4755032114G 7/1/2021 7/1/2022 X PER OTH- STATUTE ER E.L. EACH ACCIDENT $ 1,000,000 OFFICE R/M EMBER EXCLUDED? ❑ N/A E.L. DISEASE - EA EMPLOYEE $ 1,000,000 (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 B Contractors Pollution PKC111856 7/1/2021 7/1/2022 Occurence/Aggregate $3,000,000 C D Contractors Professional Cyber HCC2168107 660810501 7/1/2021 3/15/2021 7/1/2022 3/15/2022 Each Claim/Aggregate Each Claim/Aggregate $1,000,000 $2,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required) The certificate holder(s) is/are included as an additional insured(s) with respects to General Liability for On -going and Completed Operations as per policy form CG D6 04 02 19 and Auto Liability as per policy form CA T3 53 02 15; General Liability and Auto Liability are Primary and Non -Contributory as per policy forms CG T1 00 02 19 and CA 00 01 10 13; Waiver of Subrogation applies to General Liability as per policy form CG D4 58 02 19, Auto Liability as per policy form CA T3 53 02 15 and Workers Compensation as per policy form WC 99 03 76; Additional Insured and Waiver of Subrogation applies to Umbrella Liability only as required by written contract; Umbrella Liability follows form. Per Project Aggregate Endorsement policy form CG D3 21 01 04 is provided as required by a written contract; All coverage is only applicable as required by written contract. Contractors Pollution See Attached... CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City Clerk ACCORDANCE WITH THE POLICY PROVISIONS. City of El Segundo AUTHORIZED �REPRESENTATIVE El Segundo Main undoree 90245 @ 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: DUTHELE-01 LOC #: AGENCY IOA Insurance Services POLICY NUMBER CARRIER ADDITIONAL REMARKS ADDITIONAL REMARKS SCHEDULE Page 1 of 1 NAMED INSURED Duthie Electric Service Corp dba: Duthie Power Services 2335 E. Cherry Industrial Circle Long Beach CA 90805 NAIC CODE EFFECTIVE DATE: THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE $10,000 Deductible 'Contractors Professional (Claims Made) $10,000 Each Claim Deductible Additional Insured includes: City of El Segundo, its officers, officials, employees, agents, and volunteers ACORD 101 (2008101) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD POLICY NUMBER: Y6302A626927TIL21 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED - AUTOMATIC STATUS IF REQUIRED BY WRITTEN CONTRACT (CONTRACTORS) This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART The following is added to SECTION II — WHO IS AN (a) The Additional Insured — Owners, Les - INSURED: sees or Contractors — Scheduled Person Any person or organization that: or Organization endorsement CG 20 10 a. You agree in a written contract or agreement to 07 04 or CG 20 10 04 13, the Additional include as an additional insured on this Coverage Insured — Owners, Lessees or Contrac- Part; and tors — Completed Operations endorse- ment CG 20 37 07 04 or CG 20 37 04 13, b. Has not been added as an additional insured for or both of such endorsements with either the same project by attachment of an endorse- of those edition dates; or ment under this Coverage Part which includes (b) Either or both of the following: the Addi- such person or organization in the endorsement's tional Insured — Owners, Lessees or Con - schedule; tractors — Scheduled Person Or Organi- is an insured, but: zation endorsement CG 20 10, or the Ad- a. Only with respect to liability for "bodily injury" or ditional Insured — Owners, Lessees or "property damage" that occurs, or for "personal Contractors — Completed Operations en - injury" caused by an offense that is committed, dorsement CG 20 37, without an edition subsequent to the signing of that contract or date of such endorsement specified; agreement and while that part of the contract or the person or organization is an additional in - agreement is in effect; and sured only if the injury or damage is caused, b. Only as described in Paragraph (1), (2) or (3) be- in whole or in part, by acts or omissions of low, whichever applies: you or your subcontractor in the performance (1) If the written contract or agreement specifical- of "your work" to which the written contract or ly requires you to provide additional insured agreement applies; or coverage to that person or organization by (3) If neither Paragraph (1) nor (2) above applies: the use of: (a) The person or organization is an addi- (a) The Additional Insured — Owners, Les- tional insured only if, and to the extent sees or Contractors — (Form B) endorse- that, the injury or damage is caused by ment CG 20 10 11 85; or acts or omissions of you or your subcon- (b) Either or both of the following: the Addi- tractor in the performance of "your work" tional Insured — Owners, Lessees or Con- to which the written contract or agree - tractors — Scheduled Person Or Organi- ment applies; and zation endorsement CG 20 10 10 01, or (b) Such person or organization does not the Additional Insured — Owners, Lessees qualify as an additional insured with re - or Contractors — Completed Operations spect to the independent acts or omis- endorsement CG 20 37 10 01; sions of such person or organization. the person or organization is an additional in- The insurance provided to such additional insured is sured only if the injury or damage arises out subject to the following provisions: of "your work" to which the written contract or a. If the Limits of Insurance of this Coverage Part agreement applies; shown in the Declarations exceed the minimum (2) If the written contract or agreement specifical- limits required by the written contract or agree- ly requires you to provide additional insured ment, the insurance provided to the additional in - coverage to that person or organization by sured will be limited to such minimum required the use of: limits. For the purposes of determining whether CG D6 04 02 19 © 2017 The Travelers Indemnity Company. All rights reserved. Page 1 of 2 COMMERCIAL GENERAL LIABILITY b. C. this limitation applies, the minimum limits required by the written contract or agreement will be con- sidered to include the minimum limits of any Um- brella or Excess liability coverage required for the additional insured by that written contract or agreement. This provision will not increase the limits of insurance described in Section III — Limits Of Insurance. The insurance provided to such additional insured does not apply to: (1) Any "bodily injury", "property damage" or "personal injury" arising out of the providing, or failure to provide, any professional archi- tectural, engineering or surveying services, including: (a) 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 (b) Supervisory, inspection, architectural or engineering activities. (2) Any "bodily injury" or "property damage" caused by "your work" and included in the "products -completed operations hazard" un- less the written contract or agreement specifi- cally requires you to provide such coverage for that additional insured during the policy period. The additional insured must comply with the fol- lowing duties: (1) Give us written notice as soon as practicable of an "occurrence" or an offense which may result in a claim. To the extent possible, such notice should include: (a) How, when and where the "occurrence" or offense took place; (b) The names and addresses of any injured persons and witnesses; and (c) The nature and location of any injury or damage arising out of the "occurrence" or offense. (2) If a claim is made or "suit" is brought against the additional insured: (a) Immediately record the specifics of the claim or "suit" and the date received; and (b) Notify us as soon as practicable and see to it that we receive written notice of the claim or "suit" as soon as practicable. (3) Immediately send us copies of all legal pa- pers 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. (4) Tender the defense and indemnity of any claim or "suit" to any provider of other insur- ance which would cover such additional in- sured for a loss we cover. However, this con- dition does not affect whether the insurance provided to such additional insured is primary to other insurance available to such additional insured which covers that person or organiza- tion as a named insured as described in Par- agraph 4., Other Insurance, of Section IV — Commercial General Liability Conditions. Page 2 of 2 © 2017 The Travelers Indemnity Company. All rights reserved. CG D6 04 02 19 4. Other Insurance If vapid and collectible other insurance its availabIlle to the insured for a loss we cover under Coverages A or B of this Coverage Part, our obligations are limited as described in Paragraphs a. and b. below. As used anywhere in this Coverage Part, other insurance means insurance, or the funding of losses, that is provided by, through or on behalf of: (i) Another insurance company, (II) Us or any of our affiliated insurance compalnies, except when the Non cumulation of Each Occurrence Limit provision of Paragraph 5. of Section III — Limits Of Insurance or the Non cumulation of Personal and Advertising Injury Limit provision of Paragraph 4. of Section III — Limits of Insurance applies because the Amendment — Non Cumulation Of Each Occurrence Limit Of Liability And Non Cumulation Of Personal And Advertising Injury Limit endorsement is included in this policy, (iii) Any risk retention group; or (iV)Any self-insurance method or program„ in which case the insured will be deemed to be the provider of other insurance. Other insurance does not include umbrellla insurance, or excess insurance, that was bought specifically to apply in excess of the Limits of Insurance shown in the Declarations of this Coverage Part. As used anywhere in this Coverage Part, other insurer means a provider of other insurance. As used in Paragraph C. below, insurer means a provider of insurance. a. Primary Insurance This insurance is primary except when Paragraph b. bellow applies. If this insurance is primary, our obligations are not affected unless any of the other insurance is also primary. Then, we will share with alll that other insurance by the method described in Paragraph C. below, except When Paragraph d. below applies. Ill Excess Insurance (ii) That is insurance for "premises damage'; (iii) If the loss arises out of the maintenance or use of aircraft, "autos" or watercraft to the extent not subject to any exclusion in this Coverage Part that applies to aircraft, "autos" or watercraft; (IV) That is insurance available to a premises owner, manager or lessor that qualifies as an insured under Paragraph 4. of Section II — Who Is An Insured, except when Paragraph d. below applies; or (V) That is insurance available to an equipment lessor that qualifies as an insured under Paragraph 5. of Section II — Who Is An Insured, except when Paragraph d. bellow applies. (b) Any of the other insurance, whether primary, excess, contingent or on any other basis, that is available to the insured when the insured is an additional insured, or is any other insured that does not qualify as a named insured, under such other insurance. (2) When this insurance is excess, we will have no duty under Coverages A or B to defend the insured against any "suit' if any other insurer has a duty to defend the insured against that "suit". If no other insurer defends, we will undertake to do so, but we will be entitled to the insured's rights against all those other insurers. (3) When this insurance is excess over otlher insurance, we will pay only our share of the amount of the loss„ if any, that exceeds the sum of: (a) The total amount that all such other insurance would pay for the loss in the absence of this insurance; and (b) The total of alll deductible and sellf- insured amounts under alll that other (1l) This insurance is excess over: insurance. (a) Any of the other insurance, whether (4) We will share the remaining (loss, if any, primary, excess, contingent or on any with any other insurance that is not other basis: described in this Excess Insurance provision and was not bought specifically to (i) That is Fire, Extended Coverage, apply in excess of the Limits of Insurance Builder's Risk, Installlation Risk or shown in the Declarations of this Coverage similar coverage for "your work"; Part. CG T1 00 012 19 © 2017 The Travelers (Indemnity Coimpany. All rights reserved. Page 15 of 21 Includes copyrighted material of Insurance Services Office, Inc. with its (permission. COMMERCIAL GENERAL LIABILITY c. Method Of Sharing If alll of the other insurance permits contribution by equal shares, we will fol1low this metlhod also. Under this approach each insurer contributes equal amounts until it has paid its applicable limit of insurance or none of the loss remains, whichever comes first. If any of the other insurance does not permit contribution by equal shares,, we will contribute by limits. Under this method, each insurers share is based on the ratio of its applicable Ilimit of insurance to the total alpplicable limits of insurance of alll insurers. d. Primary And Non -Contributory Insurance If Required By Written Contract If you specifically agree in a written contractor agreement that the insurance afforded to an insured under this Coverage Part must apply on a primary basis, or a primary and non- contributory basis, this insurance !is primary to other insurance that lis available to such insured which covers such insured as a named insured, and we willl not share with that otlher insuraince, provided that: (1) The "bodily injury"or "property damage" for whiclh coverage is sought occurs; and (2) The "personal and advertising injury" for which coverage is sought is caused by an offense that is committed; subsequent to the signing of that contract or agreement by you. 5. Premium Audit a. We will I compute alll premiums for this Coverage Part in accordance with our rules and rates. b. Premium shown in this Coverage Part as advance premium is a deposit premium only. At the close of each audit period we will compute the earned premium, for that period and seind notice to the first Named Insured. The due date for audit and retrospective premiums is the date shown as the due date on the bill. If the sum of the advance and audit premiums paid for the policy period is greeter thain the earned premium, we willl return the excess to the first Named Insured. a. The statements in the Declarations are accurate and complete; b. Those statements are based upon representations you made to us; and C. We have issued this policy in reliance upon your represeintations. The unintentional omission of, or unintentional error in, any information provided by you which we relied upon in issuing this policy will not prejudice 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 nonrenewed in accordance with applicable insurance laws or regulations. 7. Separation Of Insureds Except with respect to the Limits of Insurance, and any rights or duties specifically assigned in this Coverage Part to the first Named Insured, this Insurance applies: a. As if each Named Insured were the only Named linsured;and b. Separately to each insured against whom claim is made or "suit" is brought. Transfer Of Rights Of Recovery Against Others To Us If the insured has rights to recover alll or part of any payment we haw made under this Coverage Part, those rights are transferred to us. The insured must do nothing after loss to impair them. At our request, the insured will bring "suit" or transfer those rights to us and hellp us enforce them. 9. When We Do Not Renew If we decide not to renew this Coverage Part, we will mail or deliver to the first Named Insured shown in the Declarations written notice of the nonrenewal not less than 30 days before the expiration date. If notice is mailled, proof of mailing willl be sufficient proof of notice. SECTION V — DEFINITIONS 1. "Advertisement" means a notice that is broadcast or published to the geineral publlic or specific market segments about your goods, products or services for the purpose of attracting customers or supporters. For the purposes of this definition: C. The first Named Insured must keep records of a. Notices that are published include material the information we need for premium placed on the Internet or on similar electronic computation, and send us copies at such times means of communication; and as we may request. b. Regarding wel onlly that part of a website 6. Representations that is about your goods, products or services By accepting this policy, you agree: for the purposes of attracting customers or supporters is coinsidered an advertisement. Page 116 of 21 Q 2017 The Travelers Indemnity Company. All rights reserved. CG T1 00 02 19 Includes copyrighted material of Insurance Services Office, Inc. with its permission. COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ENDORSEMENTXTEND •' MANUFACTURERS ANI WHOLESALERS 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 coverage description only. Read all the provisions of this endorsement and the rest of your policy carefully to determine rights, duties, and what is and is not covered. A. Who Is An Insured —Unnamed Subsidiaries H. Blanket Additional Insured — Governmental B. Who Is An Insured — Employees And Volunteer Entities — Permits Or Authorizations Relating To Workers — Bodily Injury To Co -Employees And Operations Co -Volunteer Workers I. Blanket Additional Insured — Grantors Of Franchises C. Who Is An Insured — Newly Acquired Or Formed Limited Liability Companies D. Blanket Additional Insured —Broad Form Vendors E. Blanket Additional Insured — Controlling Interest F. Blanket Additional Insured — Mortgagees, Assignees, Successors Or Receivers G. Blanket Additional Insured — Governmental Entities — Permits Or Authorizations Relating To Premises PROVISIONS A. WHO IS AN INSURED — UNNAMED SUBSIDIARIES The following is added to SECTION II — WHO IS AN INSURED: Any of your subsidiaries, other than a partnership or joint venture, that is not shown as a Named Insured in the Declarations is a Named Insured if: a. You are the sole owner of, or maintain an ownership interest of more than 50% in, such subsidiary on the first day of the policy period; and b. Such subsidiary is not an insured under similar other insurance. No such subsidiary is an insured for "bodily injury" or "property damage" that occurred, or "personal and advertising injury" caused by an offense committed: J. Incidental Medical Malpractice K. Medical Payments — Increased Limit L. Blanket Waiver Of Subrogation M. Contractual Liability —Railroads a. Before you maintained an ownership interest of more than 50% in such subsidiary; or b. After the date, if any, during the policy period that you no longer maintain an ownership interest of more than 50% in such subsidiary. For purposes of Paragraph 1. of Section II — Who Is An Insured, each such subsidiary will be deemed to be designated in the Declarations as: a. A limited liability company; b. An organization other than a partnership, joint venture or limited liability company; or c. A trust; as indicated in its name or the documents that govern its structure. CG D4 58 02 19 © 2017 The Travelers Indemnity Company. All rights reserved. Page 1 of 5 Includes copyrighted material of Insurance Services Office, Inc. with its permission COMMERCIAL GENERAL LIABILITY B. WHO IS AN INSURED — EMPLOYEES AND VOLUNTEER WORKERS — BODILY INJURY TO CO -EMPLOYEES AND CO -VOLUNTEER WORKERS The following is added to Paragraph 2.a.(1) of SECTION II —WHO IS AN INSURED: Paragraphs (1)(a), (b) and (c) above do not apply to "bodily injury" to a co -"employee" while in the course of the co -"employee's" employment by you or performing duties related to the conduct of your business, or to "bodily injury" to your other "volunteer workers" while performing duties related to the conduct of your business. C. WHO IS AN INSURED — NEWLY ACQUIRED OR FORMED LIMITED LIABILITY COMPANIES The following replaces Paragraph 3. of SECTION II — WHO IS AN INSURED: 3. Any organization you newly acquire or form, other than a partnership or joint venture, and of which you are the sole owner or in which you maintain an ownership interest of more than 50%, will qualify as a Named Insured if there is no other similar insurance available to that organization. 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; 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 and advertising injury" arising out of an offense committed before you acquired or formed the organization. For the purposes of Paragraph 1. of Section II — Who Is An Insured, each such organization will be deemed to be designated in the Declarations as: a. A limited liability company; b. An organization, other than a partnership, joint venture or limited liability company; or c. A trust; as indicated in its name or the documents that govern its structure. D. BLANKET ADDITIONAL INSURED — BROAD FORM VENDORS The following is added to SECTION II — WHO IS AN INSURED: Any person or organization that is a vendor and that you have agreed in a written contract or agreement to include as an additional insured on this Coverage Part is an insured, but only with respect to liability for "bodily injury" or "property damage" that: a. Occurs subsequent to the signing of that contract or agreement; and b. Arises out of "your products" that are distributed or sold in the regular course of such vendor's business. The insurance provided to such vendor is subject to the following provisions: a. The limits of insurance provided to such vendor will be the minimum limits that you agreed to provide in the written contract or agreement, or the limits shown in the Declarations, whichever are less. b. The insurance provided to such vendor does not apply to: (1) Any express warranty not authorized by you or any distribution or sale for a purpose not authorized by you; (2) Any change in "your products" made by such vendor; (3) Repackaging, unless unpacked solely for the purpose of inspection, demonstration, testing, or the substitution of parts under instructions from the manufacturer, and then repackaged in the original container; (4) Any failure to make such inspections, adjustments, tests or servicing as vendors agree to perform or normally undertake to perform in the regular course of business, in connection with the distribution or sale of "your products"; Page 2 of 5 © 2017 The Travelers Indemnity Company. All rights reserved. CG D4 58 02 19 Includes copyrighted material of Insurance Services Office, Inc. with its permission COMMERCIAL GENERAL LIABILITY (5) Demonstration, installation, servicing or repair operations, except such operations performed at such vendor's premises in connection with the sale of "your products"; or (6) "Your products" that, after distribution or sale by you, have been labeled or relabeled or used as a container, part or ingredient of any other thing or substance by or on behalf of such vendor. Coverage under this provision does not apply to: a. Any person or organization from whom you have acquired "your products", or any ingredient, part or container entering into, accompanying or containing such products; or b. Any vendor for which coverage as an additional insured specifically is scheduled by endorsement. E. BLANKET ADDITIONAL INSURED — CONTROLLING INTEREST 1. The following is added to SECTION II —WHO IS AN INSURED: Any person or organization that has financial control of you is an insured with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" that arises out of: a. Such financial control; or b. Such person's or organization's ownership, maintenance or use of premises leased to or occupied by you. The insurance provided to such person or organization does not apply to structural alterations, new construction or demolition operations performed by or on behalf of such person or organization. G. 2. The following is added to Paragraph 4. of SECTION II — WHO IS AN INSURED: This paragraph does not apply to any premises owner, manager or lessor that has financial control of you. F. BLANKET ADDITIONAL INSURED — MORTGAGEES, ASSIGNEES, SUCCESSORS OR RECEIVERS The following is added to SECTION II — WHO IS AN INSURED: Any person or organization that is a mortgagee, assignee, successor or receiver and that you have agreed in a written contract or agreement to include as an additional insured on this Coverage Part is an insured, but only with respect to its liability as mortgagee, assignee, successor or receiver for "bodily injury", "property damage" or "personal and advertising injury" that: a. Is "bodily injury' or "property damage" that occurs, or is "personal and advertising injury" caused by an offense that is committed, subsequent to the signing of that contract or agreement; and b. Arises out of the ownership, maintenance or use of the premises for which that mortgagee, assignee, successor or receiver is required under that contract or agreement to be included as an additional insured on this Coverage Part. The insurance provided to such mortgagee, assignee, successor or receiver is subject to the following provisions: a. The limits of insurance provided to such mortgagee, assignee, successor or receiver will be the minimum limits that you agreed to provide in the written contract or agreement, or the limits shown in the Declarations, whichever are less. b. The insurance provided to such person or organization does not apply to: (1) Any "bodily injury" or "property damage" that occurs, or any "personal and advertising injury" caused by an offense that is committed, after such contract or agreement is no longer in effect; or (2) Any "bodily injury", "property damage" or "personal and advertising injury" arising out of any structural alterations, new construction or demolition operations performed by or on behalf of such mortgagee, assignee, successor or receiver. BLANKET ADDITIONAL INSURED — GOVERNMENTAL ENTITIES — PERMITS OR AUTHORIZATIONS RELATING TO PREMISES The following is added to SECTION II — WHO IS AN INSURED: Any governmental entity that has issued a permit or authorization with respect to premises owned or occupied by, or rented or loaned to, you and that you are required by any ordinance, law, building code or written contract or agreement to include as an additional insured on this Coverage Part is an insured, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" arising out of the existence, ownership, use, maintenance, repair, construction, erection or removal of any of the following for which that governmental entity has CG D4 58 02 19 © 2017 The Travelers Indemnity Company. All rights reserved. Page 3 of 5 Includes copyrighted material of Insurance Services Office, Inc. with its permission COMMERCIAL GENERAL LIABILITY issued such permit or authorization: advertising signs, awnings, canopies, cellar entrances, coal holes, driveways, manholes, marquees, hoist away openings, sidewalk vaults, elevators, street banners or decorations. H BLANKET ADDITIONAL INSURED — GOVERNMENTAL ENTITIES — PERMITS OR AUTHORIZATIONS RELATING TO OPER- ATIONS The following is added to SECTION II — WHO IS AN INSURED: Any governmental entity that has issued a permit or authorization with respect to operations performed by you or on your behalf and that you are required by any ordinance, law, building code or written contract or agreement to include as an additional insured on this Coverage Part is an insured, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" arising out of such operations. The insurance provided to such governmental entity does not apply to: a. Any "bodily injury", "property damage" or "personal and advertising injury" arising out of operations performed for the governmental entity; or b. Any "bodily injury" or "property damage" included in the "products -completed operations hazard". I. BLANKET ADDITIONAL INSURED — GRANTORS OF FRANCHISES The following is added to SECTION II — WHO IS AN INSURED: Any person or organization that grants a franchise to you is an insured, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" arising out of your operations in the franchise granted by that person or organization. If a written contract or agreement exists between you and such additional insured, the limits of insurance provided to such insured will be the minimum limits that you agreed to provide in the written contract or agreement, or the limits shown in the Declarations, whichever are less. J. INCIDENTAL MEDICAL MALPRACTICE services", first aid or "Good Samaritan services" to a person, unless you are in the business or occupation of providing professional health care services. 2. The following replaces the last paragraph of Paragraph 2.a.(1) of SECTION II — WHO IS AN INSURED: Unless you are in the business or occupation of providing professional health care services, Paragraphs (1)(a), (b), (c) and (d) above do not apply to "bodily injury" arising out of providing or failing to provide: (a) "Incidental medical services" by any of your "employees" who is a nurse, nurse assistant, emergency medical technician, paramedic, athletic trainer, audiologist, dietician, nutritionist, occupational therapist or occupational therapy assistant, physical therapist or speech - language pathologist; or (b) First aid or "Good Samaritan services" by any of your "employees" or "volunteer workers", other than an employed or volunteer doctor. Any such "employees" or "volunteer workers" providing or failing to provide first aid or "Good Samaritan services" 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 business. 3. The following replaces the last sentence of Paragraph S. of SECTION III — LIMITS OF INSURANCE: For the purposes of determining the applicable 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 person will be deemed to be one "occurrence". 4. The following exclusion is added to Paragraph 2., Exclusions, of SECTION I — COVERAGES — COVERAGE A — BODILY INJURY AND PROPERTY DAMAGE LIABILITY: 1. The following replaces Paragraph b. of the Sale Of Pharmaceuticals definition of 'occurrence" in the 'Bodily injury" or "property damage" arising DEFINITIONS Section: out of the violation of a penal statute or b. An act or omission committed in providing ordinance relating to the sale of pharmaceuticals committed by, or with the or failing to provide "incidental medical knowledge or consent of, the insured. Page 4 of 5 © 2017 The Travelers Indemnity Company. All rights reserved. CG D4 58 02 19 Includes copyrighted material of Insurance Services Office, Inc. with its permission COMMERCIAL GENERAL LIABILITY S. 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 L 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. 6. The following is added to Paragraph 4.b., Excess Insurance, of SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS: This insurance is excess over any valid and collectible other insurance, whether primary, excess, contingent or on any other basis, that is available to any of your "employees" for "bodily injury" that arises out of providing or failing to provide "incidental medical services" to any person to the extent not subject to Paragraph 2.a.(1) of Section II — Who Is An Insured. K. MEDICAL PAYMENTS— INCREASED LIMIT The following replaces Paragraph 7. of SECTION III — LIMITS OF INSURANCE: 7. Subject to Paragraph S. above, the Medical Expense Limit is the most we will pay under Coverage C for all medical expenses because of "bodily injury" sustained by any one person, and will be the higher of: a. $10,000; or b. The amount shown in the Declarations of this Coverage Part for Medical Expense Limit. BLANKET WAIVER OF SUBROGATION The following is added to Paragraph 8., Transfer Of Rights Of Recovery Against Others To Us, of SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS: If the insured has agreed in a contract or agreement to waive that insured's right of recovery against any person or organization, we waive our right of recovery against such person or organization, but only for payments we make because of: a. "Bodily injury" or "property damage" that occurs; or b. "Personal and advertising injury" caused by an offense that is committed; subsequent to the execution of the contract or agreement. M. CONTRACTUAL LIABILITY — RAILROADS 1. The following replaces Paragraph c. of the definition of "insured contract" in the DEFINITIONS Section: c. Any easement or license agreement; 2. Paragraph f.(1) of the definition of "insured contract" in the DEFINITIONS Section is deleted. CG D4 58 02 19 © 2017 The Travelers Indemnity Company. All rights reserved. Page 5 of 5 Includes copyrighted material of Insurance Services Office, Inc. with its permission POLICY NUMBER: Y6302A626927TIL21 Total General Aggregate Limit: $ Designated Project(s): COMMERCIAL GENERAL LIABILITY ISSUE DATE: 07- 01- 21 :1 ZfAJ WAt Z gA a H Wil CJCIo (if no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) A. The Total General Aggregate Limit stated in the Schedule above is the most we will pay for the sum of all: 1. Medical Expenses under COVERAGE C (SECTION 1); 2. Damages under COVERAGE A (SECTION 1), except damages because of "bodily injury" or "property damage" included in the "products - completed operations hazard"; and 0. Damages under COVERAGE B (SECTION I regardless of the number of: 1. Insureds; i b. Claims made or "suits" brought; c. Persons or organizations making claims bringing "suits"; or 2. Designated "projectsn listed in the SCHE ULE above. B. For all sums which the insured becomes legally obligated to pay as damages caused by "occur- rences" under COVERAGE A (SECTION 1), and for all medical expenses caused by accidents un- "11=7 J�Llb tributed only to operations at a single designated "project" shown in the Schedule above: 1. A separate Designated Project General Ag- gregate Limit applies to each designated "pro- ject", and that limit is equal to the amount of the General Aggregate Limit shown in the Declarations. 2. Subject to the Total General Aggregate Limit stated in the Schedule above, the Designated Project General Aggregate Limit is the most we will pay for the sum of all damages under COVERAGE A, except damages because of "bodily injury" or "property damage" included in the "products -completed operations haz- ard", and for medical expenses under COV- ERAGE C regardless of the number of: a. Insureds; b. Claims made or "suits" brought; or c. Persons or organizations making claims or bringing "suits". COMMERCIAL GENERAL LIABILITY 3. Any payments made under COVERAGE A for damages or under COVERAGE C for medical expenses shall reduce both the Total General Aggregate Limit stated in the Schedule above, and the Designated Project General Aggregate Limit for that designated "project". Such payments shall not reduce the General Aggregate Limit shown in the Declarations nor shall they reduce any other Designated Project General Aggregate Limit for any other designated "project" shown in the Schedule above. 4. The limits shown in the Declarations for Each Occurrence, Damage To Premises Rented To You and Medical Expense continue to apply. However, instead of being subject to the General Aggregate Limit shown in the Decla- rations, such limits will be subject to both the Total General Aggregate Limit stated in the Schedule above, and the applicable Desig- nated Project General Aggregate Limit. C. For all sums which the insured becomes legally obligated to pay as damages caused by "occur- rences" under COVERAGE A (SECTION 1), and for all medical expenses caused by accidents un- der COVERAGE C (SECTION 1), which cannot be attributed only to operations at a single desig- nated "project" shown in the Schedule above: 1. Any payments made under COVERAGE A for damages or under COVERAGE C for medical expenses shall reduce the amount available under the Total General Aggregate Limit stated in the Schedule above and the General Aggregate Limit, or the Prod ucts-Com pleted Operations Aggregate Limit, whichever is ap- plicable; and 2. Such payments shall not reduce any Desig- nated Project General Aggregate Limit. As respects this Provision C., the limits shown in the Declarations for Each Occurrence, Damage To Premises Rented To You and Medical Ex- pense continue to apply. D. Part 2. of SECTION III — LIMITS OF INSURANCE is deleted and replaced by the following: 2. The General Aggregate Limit is the most we will pay for the sum of: a. Damages under Coverage B; and b. Damages from "occurrences" under COVERAGE A (SECTION 1) and for all medical expenses caused by accidents under COVERAGE C (SECTION 1) which cannot be attributed only to operations at a single designated "project" shown in the SCHEDULE above. E. When coverage for liability arising out of the "products -completed operations hazard" is pro- vided, any payments for damages because of "bodily injury" or "property damage" included in the "products -completed operations hazard" will reduce the Products -Completed Operations Ag- gregate Limit, and not reduce the Total General Aggregate Limit stated in the Schedule above, the General Aggregate Limit, or the Designated Pro- ject General Aggregate Limit. F. For the purposes of this endorsement the Defini- tions Section is amended by the addition of the following definition: "Project" means an area away from premises owned by or rented to you at which you are per- forming operations pursuant to a contract or agreement. For the purposes of determining the applicable aggregate limit of insurance, each "project" that includes premises involving the same or connecting lots, or premises whose con- nection is interrupted only by a street, roadway, waterway or right-of-way of a railroad shall be considered a single "project". G. The provisions of LIMITS OF INSURANCE (SECTION 111) not otherwise modified by this en- dorsement shall continue to apply as stipulated. POLICY NUMBER: 810-2N338740-21-14-G COMMERCIAL AUTO This endoirsernenil rnodiifies insurance provided under the folllcming: BUSINESS AUT01 COVERAG31H FORM! GENERAL DESCRIPTION OF COVERAGE ­­ This endorsement birciadens coverage, IHowauever, coveiragie for any injury" clarnage or medical expenses described in, any, of the provisions of this, endorsement imiaiy be excluded or himited y another endorsement to the Goverage Part, and these cloverage broadienflIg PrWiSlOrrs do inot apply to the extent thiat coverage is excluded or himited by Such an endorsernent The following listing its a general cciver- age description only. Limitabons arid exclusions may apply to these coverages. Read all the provisions of this en- dorsement and the rest of your policy carefully to delerrnine rights, duties, and what is and is not covered ABROAD FORM NAMED IINSURIED B, BLANKET ADDITIONAL INSURED C. EMPLOYEE HIRED AUTO D, EMPLOYEES AS INSURED ESUPPLEMENTARY PAYMENTS — INCREASED LIMITS F, HIRED AUTO — LIMITIED WORLDWIDE COV- Eeh,Q5_—WAD&ru1VtTY BA-SIS— PROVISIONS A. BROAD FORM NAMED INSURED The following is added to, Paragraph A.I., Who Is An Insured, of SECTION II —COVE ED AUTOS LIAIML11TY COVERAGE: Any organi7a(min youi newly acquiire or form dur- ing the poky 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 Lin- ht the 1 80th: day after you acquire or form the ganization or the end of the policy period, which- ever jr, eadierr. The Wlowing is added to Paragraph c. in AA., Who Iles An, Insured, of SECTION 1111 — COVERED AUTOS LIABILITY COVERAGE Any, person or organization who is requuiredl under a written contract or agreement between, you and that person or organization, that is signed and execk0ed by you before the "boddy injury" or 'property darriage" occurs anid that is in effect during the poficy period, to be named as, an addi- hanall insured is an insured" for Covered Autos Liability Coverage, bUt only for darnages to which R. AIRED AUTO PAITSICAL DAMAGE — LOSS 07 INCREASED L11MIT 1. PHYSICAL DAMAGE — TRANSPORTATION EXPENSES —INCREASED ILIMIIT J. PERSONAL PROPERTY K. AIRBAGS LNOTICE AND KNOWLEDGE OF ACCIIDIENT OiIR LOiSS M. BLAINKET WA11VER OF SUBIROGATIOIN N. UNINTENTIONAL ERRORS OR OMISSIONS this insurance applies and only to the extent that person cur organization qualifies as an '11111SUred" under the Who Is An linslured provision containied in Section 1111. 11. The fc)llowing is added to Paragraph A.1., Who Is An Inslured, of SECTION III — COV- ERED AUTOS LIABILITY COVERAGE, An "employee" of yoijrs lis an "insiured" whiille operating an "auto" hived or rented under a contract or uagreernent In an "erriployee's" name, witl) your permission, white performing duties, related to trine 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 Daniage Cover- age, the following are deemed to be clov- ered "autos" you owm (11) Any covered "autio"' you lease, hire, rent or borrow� and (2) Any covered "auto" hired or rented by' your. "emplioyee" under a, contract In an "erriployee's" nanne, With Your CA T3 53 02 115 0 015 The TraMeirSinru�uu°nnui�ny Ccjj,fvany, AN f ights mserved, Page III of 4 Iris JUdjes copynghied numateroal of in Seroces Office, Inc, mth its permiSSk)R COMMERCIAL AUTO permission, w1hile performing diLihes related to the condUCt of your busi- ness However, any "aUtO" that is Ieaserl, hired, rerited or borrowed with a rinver is not as covered "auta`_ The folflawing is added to Paragraph A.11., Who Is An Insured, of SECTION 11 - COVERED AUTOS LIABILITY COVERAGE, Any "ernployee" Of YCKWIS is an "iinsuired" w1hille I Ing a covered "auto" you don't owini, hire or borrow un, your business or your pm?ersonaal aiffairs, E. SUPPLEMENTARY PAYMENTS - INCREASED LIMITS 1. The following replaces Paragraph A.2.a.(2), Groff SECTION III - COVERED AUTOS LIABIL- ITY COVERAGE, (2) Up, to, $3,000 for cost of bad bonds (in- cliI lbon!ds for related) traffic Ilaw, vrola. twins) required because of an, "accident" we co,ver. We do, not have to furnish these bands. (a), With respect to any clwrn niade or "swl` brought outside the United! States of America, the territories and possessions of the United States of Ainenca, Puerto Rico, and Canada I (i) You must arranige to defend the )n- sured" against, and finvesfigate or set- tle any such clarm or "'suit" and keep us advised of afl proceedings and ac- ti,01II& (0) Neither you nor any other involIved "iffisured" wihl make any settenient withokn our coinsent, (Ili), We may, at our discrefion, partmipate in defending the ' insured"' against, or in the settlement of, any claim or ""suit (iv) We will reinnibiurser the "insifired" for Sums that the "insured" legally must pay as damages beCaUse of "bodily injury" of "property damage" to which this insurance applies, that the "in- suired" pays with our consent, biI rinly up to the lirnk described in Para- . The following replaces Paragraph A.2.a.(4), graph C., Lrnids Olf Insurance, (,-)f of SECTION III - COVERED AUTOS LIAE111I SECTION 11 - COVERED ALITIOS ITY COVIERAGE- LIABILITY COVERAGE, (4) All reasonable expenses incurred by thie (v) We will reimbILArse the "insured" for ""insured"" at our request, including actual the reason,able expenses incurred loss of earnings up, to $5,010, a day I with our consent for YOUr invesfiga- cause of time off frorn: work. twin of such claims and Your defense of the `iinsured" agarnst any such F. HIRED AUTO - LIMITED WORLDWIDE COV- 11suit", but finIly up . to and included ERAGE - INDEMNITY BASIS within the limit described in Para. - The fohomfig replaces SILrbiparagraph (5) in Para- graph C., Limits Of Insurance, of graph 8.7., Policy IPerliod, Coveiragie Territory, SIEC'MION 11 - COVERED AUTOS of SECTION IV - BUSINESS AUTO CONDI- LIABILITY COVERAGE, and not in TIIONS, Iddiltilolo to, such tirnit, Our cluty to (5) Anywhere in, the world, except any country or malke such payments ends when we jurisdiction whfle any tradle sanction, ern.- have used up the applicable finfit of bar q,o, or smilar regulation Gniposed by the insurance in payments for daniages, I Jinited States of AnI applies to ainiii piro- settlements or defense expenses I the transaction of business with or (b) "J"r hues insurance us excess over any vallid within such country I junsdicfion, for Cov- and collfecfible other insurance availabille erect Autos, Liabilty Cciverage for alf)y covered to the. "insured" whether prinfary, excess, "auto"' that you lease,, hire, rent or borrow contingent or an any other bI without a driver for a perjoid oIf 30, days or less (o 'phis ins,uranice is not a subSfitUte for re - and that is notan "auto" you lease, hire, refit qUired or cornpullsory Insurance in any of, borrow firom any I your "ernployees", COUntry outside the United States, fits ter - partners (If YOUI are a partinership), mernbers, ritories and possessions, Puerto Rico and (if you are a lirriAted fability company) or, Canada. members of their households. Page 2 of 4 1ra2Gt5TIieTra,vererslin,deiniuiityCoimpail"jy Affrights reserved— CA3 5302 15 Indudes copyrighted matenali of irsurance Services, Office, IiI wM its peI You agree to maintain alll required or compulsory insurance udm any such coa"un- tryu up to the Mlin"rnrnunm ihnmdts rewpuireal by local Ilawv. Your failure to connply Mth compulsory inswurance, rertuurennents will snot invalidate the coverage afforded IYsy this polilcy, Ihut we will only be liable to the saume extent we wound have been linable had you coniplued ,ritl•u the compulsory in- surance requirements. (dl) It Is understood that weare not an admit— ted or authorized insurer ou.utside the United States of Amnerica, its territories and possessions" Puertcu Rmo and Can- ada. We assiurrre no responsibitiity for the furnishing of certificates of mnslwairance, or for cornphance in any way with the laws of other countries relatonip to insurance— G. WAIVER OF DEDUCTIBLE —CLASS The fotiovuunig is added to Paragraph D.,, Deducti- ble, of SECTION IIIII — PHYSICAL DAMAGE E COVERAGE. No deductible for a covered; "auto"" w utl apply to glass damage rt the glass is repaired rather, than replaced. H. HIRED AUTO PHYSICAL DAMAGE — LOSS OF USE — INCREASED LIMIT The following repllaaces the last sentence of Para- graph A.4I.IE., Lass Of Use Expenses, of SEC- TION IIIII— P'HYSIC'AL IDAMAG,E COVEIRA ,Eu. However, the arlost we wwillt Ipiry for any expenses for toss of use is i65 per day, to a nmaKirnIU m Of ".F 750,, for any one "'accident"_ The following replaces the first sentence in Para-. gralph A. .a. Transportation Expenses, of SECTION Illy — PHYSICAL DAMAGE COVER. AGE:. We wwwilI (play Lip to $sty per day to as rmmaxlnmurm Of $ 1,500, for ternmporaryr transportation expense in- cuirred by you because of the totall theft of «a cov- ered "auto" of the private passenger' type, J. PERSONAL PROPERTY The fotllovwing is Wadded to Paragraph AA., Cover- age Extensions, of SECTION III — PHYSICAL DAI MIA IE COVERAGE: Personal Property "w!"w"e wwdl pay up to 400 for Moss"," to wearing aip_ parel and other personat property ~which is, (1) Owned by an "insured", and COMMERCIAL AUTO () In or on your cowered `aUto",,.. This coverage applies ormty un the event of a total theft of your covered "auto" . No a eduiwtiNes alpipty to, this Personal Property coverage.. K. AIIRSAGS The fol1lowing its adlded to Paragraph B.3." Exclu- sions, of SECTION III[ — PHYSICAL DAMAGE COVERA dE: Exclusion 3.a. does not appaily to toss," to one or nmorlee airbags, rn a covered "auto" you own that in- flate dUe to a cause other than a, Cause of"loss" set fon-th in Paragraphs A.1.bi. and A.1.c., but orally a,. If that °auto" Is a covered `auto" for ornpre- henswe Coverage under this policy; b. The airbags are not covered under any war- ranty-, and . The wrbags were not intentionally inflated, e wilt pay up to «a rmaxnnnunm of $1,00 for any one "loans"". L. NOTICE AND KNOWLEDGE OF ACCIDENT OR LOSS The ffol,lowwuna is added to Paragraph A..a., of SECTION IV — IBUSINESS AUTO CONDITIONS: Yours duty to give us Or our authorized representa- tive prompt notice of the "accident" or "Ilcrss" alp_. plies only w 1hen the "accident" or "loss" GIs Iknown to: (a) You (if you are an indivnduual), (b) A partner ('if you are a partnership) (c) A umernber (ulf you are a Illnmpted liability corn- pany); (d) An executive officer, director or insurance rmanader (of you are a corporation �or other or- ganization); or (e) An:y "$emmlployee" authorized by you to give niol- tnce of fie "accident" or "lons'". fWl. BLANKET WAIVER OF SUBROGATION The following replaces Paragraph A.S.„ Transfer Of Rights Of Recovery Against fathers To Us, of SECTION II — BUSINESS AUTO CONDI- TIONS: S. Transfer Of Rights Of Recovery Against Others To Us ww'yde waive any night of recovery we may have aigatlnst any person or or arniization to the ex- tent required of you by a written contract signed and executed prior to any "accident" or "llcrss" , (provided that the `acu;aident" or "llos"s" anises cnuurt of operations contemplated by CA T3 SS 02 115 0 2015 The Tr<aveBeirs Indemnity coammpsany mwul rights reserved. Page T of 4 Indumdes copyrig1hted rrmamaernar or Ilrnsuraiace Serwoi;es Office, linen um tb its nermms&on. COMMERCIAL AUTO such contract, The waliver apipfies only to the The umintentionall ormssion of, or unmtenhonal person or orgamzation designated m such enrlor in, any Iinfrmatiion given by you shallil not contract prejudice your rights under tlhts iilnnoalrance. How - NI. UNINTENTIONAL ERRORS OR OMISSIONS ever thus provmon does not affect ouir right to coi- The foll1lowing is atiddedl to Paragraph B.2., Coni- le ct additional premiurn or exercise our nght of cealimient, Mis rep resentallion, Or Fraud,, of canceiiatmn or non-renie,wal. SECTION IV — BUSINESS AUTO CONDITIONS, Page 4 of 4 @ 2015 The TraWLrs Indemnity Company AD rights reserved, CA T3, 53 02 15 4nctudes capyrighted mWfliM of 110-ArArance SeNices Offim, hic wth, its pprmisskm COMMERCIAL AUTO 4. Loss Payment — Physical Damage Cover- ages At our option, we may: a. Pay for, repair or replace damaged or sto- len property; b. Return the stolen property, at our ex- pense. We will pay for any damage that results to the "auto" from the theft; or c. Take all or any part of the damaged or stolen property at an agreed or appraised value. If we pay for the "loss", our payment will in- clude the applicable sales tax for the dam- aged or stolen property. S. Transfer Of Rights Of Recovery Against Others To Us If any person or organization to or for whom we make payment under this Coverage Form has rights to recover damages from another, those rights are transferred to us. That person or organization must do everything necessary to secure our rights and must do nothing after "accident" or "loss" to impair them. B. General Conditions 1. Bankruptcy Bankruptcy or insolvency of the "insured" or the "insured's" estate will not relieve us of any obligations under this Coverage Form. 2. Concealment, Misrepresentation Or Fraud This Coverage Form is void in any case of fraud by you at any time as it relates to this Coverage Form. It is also void if you or any other "insured", at any time, intentionally con- ceals or misrepresents a material fact con- cerning: a. This Coverage Form; b. The covered "auto"; c. Your interest in the covered "auto"; or d. A claim under this Coverage Form. 3. Liberalization If we revise this Coverage Form to provide more coverage without additional premium charge, your policy will automatically provide the additional coverage as of the day the re- vision is effective in your state. 4. No Benefit To Bailee — Physical Damage Coverages We will not recognize any assignment or grant any coverage for the benefit of any per- son or organization holding, storing or trans- porting property for a fee regardless of any other provision of this Coverage Form. S. Other Insurance a. For any covered "auto" you own, this Coverage Form provides primary insur- ance. For any covered "auto" you don't own, the insurance provided by this Cov- erage Form is excess over any other col- lectible insurance. However, while a cov- ered "auto" which is a "trailer" is con- nected to another vehicle, the Covered Autos Liability Coverage this Coverage Form provides for the "trailer" is: (1) Excess while it is connected to a mo- tor vehicle you do not own; or (2) Primary while it is connected to a covered "auto" you own. b. For Hired Auto Physical Damage Cover- age, any covered "auto" you lease, hire, rent or borrow is deemed to be a covered "auto" you own. However, any "auto" that is leased, hired, rented or borrowed with a driver is not a covered "auto". c. Regardless of the provisions of Para- graph a. above, this Coverage Form's Covered Autos Liability Coverage is pri- mary for any liability assumed under an "insured contract". d. When this Coverage Form and any other Coverage Form or policy covers on the same basis, either excess or primary, we will pay only our share. Our share is the proportion that the Limit of Insurance of our Coverage Form bears to the total of the limits of all the Coverage Forms and policies covering on the same basis. 6. Premium Audit a. The estimated premium for this Coverage Form is based on the exposures you told us you would have when this policy be- gan. We will compute the final premium due when we determine your actual ex- posures. The estimated total premium will be credited against the final premium due and the first Named Insured will be billed for the balance, if any. The due date for the final premium or retrospective pre- mium is the date shown as the due date on the bill. If the estimated total premium exceeds the final premium due, the first Named Insured will get a refund. CA 00 01 10 13 © Insurance Services Office, Inc., 2011 Page 9 of 12 WORKERS COMPENSATION AND EMPLOYERS LIABILITY POLICY HARTFORD CT 06183 ENDORSEMENT WC 99 03 76 ( A) - 001 POLICY NUMBER: UB-7K475503-21-14-G 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 2.00 % 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 07-01-21 Policy No. UB-7K475503-20-14-G Endorsement No. Insured Duthie Electric Service Corp dba: Duthie Power Services Premium Insurance Company Countersigned by Travelers Property Casualty Company of America DATE OF ISSUE: 07-01-21 STASSIGN: Page 1 of 1