PROOF OF INSURANCE (2023) CLOSEDClient#: 1722483 RAFTEFIN
ACORD. CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY)
1 /27/2022
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.
Ifw1PORTAN'T: If the certificate holder i.. y( r
If SUBROGATION IS WAIVED subject to this certificate does not confer any rights t Dthe certificatelholder ln lieu f such endo per�f��ITIyONLan endorsement. Ions or be en�lo on
policies may requireent. A statement sed
PRODUCER NE! Andrew Little
Cameron M Harris & Co, LLC C HONE 98 .... N� . m.
Arc No EMI 0 495-0832
N ME
Div USI Ins andrew.little@usi.com
6100 Fairview Road Ste 1400 ADDRESS:
INSUI ER(S) AFFORDING
E NAIC:1
Charlotte, NC 28210 �..�.. - � FORDonI� COVERAGE ..
I
INSURED
Raftelis Financial Consultants, Inc.
227 West Trade Street, Ste. 1400
Charlotte, NC 28202
INSURER' A : National Hire Insurance Co. of Hartford 20478
INSURER B Con.. _. _........... ..... ........-
Continental Insurance Company 35289
INSURER c : American Casualty Company of Reading PA 120427
INSURER D: Continental mCasualty Company I2044...
INSURER.E,.m.......�_..,,,,,.,.,---,m....�.............�..........�.............. _.�....t....�..
COVERAGES CERTIFICATE NUMBER: R1=VIClnrd nil Inn P11=Q•
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
LTR
TYPE OF INSURANCE
COMMERCIAL GENERAL LIABILITY
INSR �WV
a POLICY NUMBER.... .......
k"XPi. LIMITS
MM%DDY/YY2 ). (
A
6076000011
/DDT
1/21/20 21/202 EACH CE
X�, oouR
...
AI A.. +,; RENTED
_
t
�� � �n
_.........�..r__�_q.�.._m��a.........
.,..,,J . �._...._.........��...�..............,--(And
s.................�.�.�..........
onepers„ n
PERSONAL & ADV INJURY
$1
N'L AGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE
$2
PRO-
; POLICY JECT X LOC
....,...
PRODUCTS COMP/OPA GG
$2
,...... .__. .,,,,. „.. ....
.
....... -. . ...... .....
...•_,......._
I,.
$1
D
AUTOMOBILE LIABILITY
... .----...... . ..
BUA6076000025
,Q�
...- -------- . .....
I
1/21/2022101/21/2G �.tiDMBUNLD' dELIMIF"
...� ANY AUTO
BODILY INJURY (Per person)
$
OWNED I_........ SCHEDULED
AUTOS ONLY AUTOWNED S
....mm....._._.......................•—
:. BODILY INJURY (Per accident)
...-......
$
XHIRED NON-O
. AUTOS ONLY X AUTOS ONLY
L RO0 R"ff AMAOF
,.,.. .
..�.,....... .,.m.m,. ...
B
OCC
1_i�l
CUE6076000039.
1/21/2022 01/21/2023
EACH OCCURRENCE
$5,
ExcessLAelAecu�uR
.-
AGGREGATE
sX
DED XI RETENTION$1OOIMSMADE
0 00
�
.` —
$,
C
WORKERS
ANDLMPLOYERS
WC676305637
1 /21 /2022 01 /21/2023i X `PER IOiH-
LIABfILITY
ST934F ER
AN[ROPRIE"i-ORIPARTNEWEXECUTIVEY/"
OFFICEnIMEMBER EXCLUDED? IN]
N/A
WC676000042-CA
01/21/2022 01/21/2023 EL EACHACCIDENT
w .eeeea
$1.
(Mandatory In NH)
I E L. DISEASE EA EMPLOYEE
$1
.—
If es describe under
DESCRIPTION OF OPERATIONS below
.. _._ — ---
_ ..
••
E L DISEASE POLICY LIMIT
,
$1,,
D
Professional
,,,,..�
..,,...., ,. ..... ,....
652071235
....... ...... ... ._ ..,... .
1/21/2022i01/21/202 $000 Aggregate
5,000,
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
City of El Segundo, its officials and employees are included as additional insured with respect to General
Liability and Automobile Liability coverage's. The coverage afforded to the additional insured is on a
primary basis for General Liability and Automobile Liability if required by written contract. A 30 day
(See Attached Descriptions)
000
City of El Segundo SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
350 Main Street ACCORDANCE WITH THE POLICY PROVISIONS.
El Segundo, CA 90245-0000
AUTHORIZED REPRESENTATIVE
U@ 1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016/03) 1 of 2 The ACORD name and logo are registered marks of ACORD
#S34791885/M34770019 SKUZP
DESCRIPTIONS (Continued from Page 1)
notice of cancellation will be given except for non-payment of premium will be 10 days if required by
written contract. Waiver of Subrogation with respect to the certificate holder per form G19160-B
�nuI I M cv.a kcu I ulu a) G Oi L
#S34791885/M34770019
GNA PARAMOUNT
General Liability Extension Endorsement
It is understood and agreed that this endorsement amends the COMMERCIAL GENERAL LIABILITY COVERAGE PART
as follows, If any other endorsement attached to this policy amends any provision also amended by this endorsement,
then that other endorsement controls with respect to such provision, and the changes made by this endorsement with
respect to such provision do not apply.
TABLE OF CONTENTS
1. Additional Insureds
2. Additional Insured - Primary And Non -Contributory To Additional Insured's Insurance
3. Bodily Injury - Expanded Definition
4. Broad Knowledge of Occurrence/ Notice of Occurrence
5. Broad Named Insured
6. Estates, Legal Representatives and Spouses
7. Expected Or Intended Injury - Exception for Reasonable Force
8. In Rem Actions
9. Incidental Health Care Malpractice Coverage
10. Joint Ventures/Partnership/Limtted Liability Companies
... ...............
11. Legal Liability - Damage To Premises
12. Medical Payments
13. Non -owned Aircraft Coverage
14. Non -owned Watercraft
15. Personal And Advertising Injury -- Discrimination or Humiliation
16. Personal And Advertising Injury - Contractual Liability
17. Property Damage -Elevators
18. Supplementary Payments
19. unintentional Failure To Disclose Hazards
20. Waiver of Subrogation - Blanket
CNA74879XX (1-15)
Page 1 of 13
Ineivari IJamo, Raftelis Consultants, Inc.
Policy No: 607000011
Endorsement No: 1
Effective Date: 1 / 21 / 19
N CNA PARAMOUNT
General Liability Extension Endorsement
E. Lessor of Land
Any person or organization from whom a Named Insured leases land but only with respect to liability for bodily
injury, property damage or personal and advertising injury arising out of the ownership, maintenance or use
of such land, provided that the occurrence giving rise to such bodily injury or property damage, or the offense
giving rise to such personal and advertising Injury, takes place prior to the termination of such lease. The
coverage granted by this paragraph does not apply to structural alterations, new construction or demolition
operations performed by, on behalf of, or for such additional insured.
F. Lessor of Premises
An owner or lessor of premises leased to the Named Insured, or such owner or lessor's real estate manager, but
only with respect to liability for bodily injury, property damage or personal and advertising injury arising out of
the ownership, maintenance or use of such part of the premises leased to the Named insured, and provided that
the occurrence giving rise to such bodily injury, property damage or the offense giving rise to such personal
and advertising Injury takes place prior to the termination of such lease. The coverage granted by this
paragraph does not apply to structural alterations, new construction or demolition operations performed by, on
behalf of, or for such additional insured.
G. Mortgagee, Assignee or Receiver
A mortgagee, assignee or receiver of premises but only with respect to such mortgagee, assignee or receiver's
liability for bodily injury, property damage or personal and advertising injury arising out of the Named
insured's ownership, maintenance, or use of a premises by a Named Insured.
The coverage granted by this paragraph does not apply to structural alterations, new construction or demolition
operations performed by, on behalf of, or for such additional insured.
,. H. State or Governmental Agency or Subdivision or Political Subdivisions — permits
g A state or governmental agency or subdivision or political subdivision that has Issued a permit or authorization,
but only with respect to such state or governmental agency or subdivision or political subdivision's liability for
bodily Injury, property damage or personal and advertising Injury arising out of:
1. the following hazards in connection with premises a Named Insured owns, rents, or controls and 10 which
is this insurance applies:
a. the existence„ maintenance, rapir, construction, erect"on, or removal of advertising signs, awnings,
canopies, cellar entrances, coal holes, driveways, manholes, marquees, hoistaway openings, sidewalk
a vaults, street banners, or decorations and similar exposures; or
b. the construction, erection, or removal of elevators; or
N c. the ownership, maintenance or use of any elevators covered by this insurance; or
2. the permitted or authorized operations performed by a Named Insured or on a Named Insured's behalf.
The coverage granted by this paragraph does not apply to:
a. Bodily Injury, property damage or personal and advertising injury arising out of operations performed
for the state or governmental agency or subdivision or political subdivision; or
b. Bodily injury or property damage included within the products -completed operations hazard.
With respect to this provision's requirement that additional insured status must be requested under a written
contract or agreement, the insurer will treat as a written contract any governmental permit that requires the
Named Insured to add the governmental entity as an additional insured.
-------------
ONA74879XX (1-15) Policy No:
Page 3 of 13 Endorsement No:
Effective Date:
Insured roams;
ACNA PARAMOUNT
General Liability Extension Endorsement'
1. Trade Show Event Lessor
1. With respect to a Named Insured's participation in a trade show event as an exhibitor, presenter or
displayer, any person or organization whom the Named Insured is required to Include as an additional
insured, but only with respect to such person or organization's liability for bodily injury, property damage or
personal and advertising injury caused by:
a. the Named Insured's acts or omissions; or
b. the acts or omissions of those acting on the Named Insured's behalf,
in the performance of the Named Insured's ongoing operations at the trade show event premises during the
trade show event.
2. The coverage granted by this paragraph does not apply to bodily injury or property damage included
within the products -completed operations hazard.
J. Vendor
Any person or organization but only with respect to such person or organization's liability for bodily injury or
property damage arising out of your products which are distributed or sold in the regular course of such person
or organization's business, provided that:
1. The coverage granted by this paragraph does not apply to:
a. bodily injury or property damage for which such person or organization is obligated to pay damages by
reason of the assumption of liability in a contract or agreement unless such liability exists in the absence
of the contract or agreement;
b, any express warranty unauthorized by the Named Insured;
c. any physical or chemical change in any product made intentionally by such person or organization;
d. repackaging, except when unpacked solely for the purpose of inspection, demonstration, testing, or the
substitution of parts under instructions from the manufacturer, and then repackaged in the original
container;
e, any failure to make any inspections, adjustments, tests or servicing that such person or organization has
agreed to make or normally undertakes to make in the usual course of business, in connection with the
distribution or sale of the products;
f. demonstration, installation, servicing or repair operations, except such operations performed at the such
person or organization's premises in connection with the sale of a product;
g, products which, after distribution or sale by the Named Insured, have been labeled or relabeled or used
as a container, part or ingredient of any other thing or substance by or for such person or organization; or
h. bodily Injury or property damage arising out of the sole negligence of such person or organization for
Its own acts or omissions or those of its employees or anyone else acting on its behalf. However, this
exclusion does not apply to:
(1) the exceptions contained in Subparagraphs d. or f. above; or
(2) such in adjustments, tests or servicing as such person or organization has agreed with the
Named Insured to make or normally undertakes to make in the usual course of business, in
connection with the distribution or sale of the products.
2. This Paragrapb J. dries not apply to any insured person or organization, from whom the Named Insured has
acquired such products, nor to any ingredient, part or container, entering into, accompanying or containing
such products.
CNA74879XX (1-15) Policy No:
Pane 4 of 13 Endorsement No:
Effective Dale:
Insured Name
Copyright CNA An Rights Reserved. Indudes copyrighted material or Insurance Servloes Omce, Inc., Mdth Its permisslon.
CNA PARAMOUNT
General Liability Extension Endorsement
3. This Paragraph J. also does not apply:
a. to any vendor specifically scheduled as an additional insured by endorsement to this Coverage Part;
b. to any of your products for which coverage is excluded by endorsement to this Coverage Part; nor
c. if bodily injury or property damage included within the products-oompleted operations hazard is
excluded by endorsement to this Coverage Part.
K. Other Person Or Organization
Any person or organization who is not an additional insured under Paragraphs A. through J. above. Such
additional insured Is an Insured solety for b*dIly Injury, property damage or personal and advertising injury
for which such additional insureds is liable because of the Named Insured's acts or omissions,
The coverage granted by this paragraph does not apply to any person or organization:
1. for bodily injury, property damage, or personal and advertising injury arising out of the rendering or
failure to render any professional service;
2. for Bodily injury or property damage included within the products -completed operations hazard; nor
3. who is specifically scheduled as an additional insured on another endorsement to this Coverage Part.
2. ADDITIONAL INSURED - PRIMARY AND NON-CONTRIBUTORY TO ADDITIONAL INSURED'S INSURANCE
A. The Other Insurance Condition in the COMMERCIAL GENERAL LIABILITY CONDITIONS Section is amended
to add the following paragraph:
If the Named Insured has agreed in writing in a contract or agreement that this insurance is primary and non-
contributory relative to an additional insured's own insurance, then this insurance is primary, and the Insurer will
not seek contribution from that other insurance. For the purpose of this Provision 2., the additional insured's own
insurance means insurance on which the additional insured is a named insured.
S. "U ;th respect to persons or organizations that qualify as additional insureds pursuant to paragraph I.K. of this
endorsement, the following sentence is added to the paragraph above:
01
Otherwise, and notwithstanding anything to the contrary elsewhere in this Condition, the insurance provided to
such person or organization is excess of any other Insurance avaliable to such person or organizatlon.
3, BODILY INJURY -EXPANDED DEFINITION
Under DEFINITIONS the definition of bodily injury is deleted and replaced by the following:
s" Bodily injury means physical injury, sickness or disease sustained by a person, including death, humiliation, shock,
mental anguish or mental injury sustained by that person at any time which results as a consequence of the physical
N Injury,sickness r disease,..
4. BROAD KNOWLEDGE OF OCCURRENCE/ NOTICE OF OCCURRENCE
Under CONDITIONS, the condition entitled Duties in The Event of Occurrence, Offense, Claim or Suit is amended
to add the following:
A. BROAD KNOWLEDGE OF OCCURRENCE
The Named Insured must give the Insurer or the Insurer"s authorized representative notice of an occurrence,
offense or claim only when the occurrence, offense or claim is known to a natural person Named Insured, to a
partner, executive officer, manager or member of a Named Insured, or to an employee designated by any of the
above to give such notice.
B. NOTICE OF OCCURRENCE
CNA74879XX (1-15)
Page 5 of 13
Insured Name:
Policy No:
Endorsement No:
Effective Date.
Copyright CNA m Rights Reserved. Includes =Ytlahted material or Insurance Swnpm Cllnrp 1w. uAlh Ile nnrrnladnn
rq,A
CNA PARAMOUNT
General Liability Extension Endorsement
The Named insured's rights under this Coverage Part will not be prejudiced if the Named Insured fails to give
the Insurer notice of an occurrence, offense or claim and that failure is solely due to the Named Insured's
reasonable belief that the bodily injury or property damage is not covered under this Coverage Part. However,
the Named Insured shall give written notice of such occurrence, offense or claim to the Insurer as soon as the
Named insured is aware that this insurance may apply to such occurrence, offense or claim.
S. BROAD NAMED INSURED
WHO IS AN INSURED is amended to delete Its Paragraph 3. in its entirety and replace it with the following:
3. Pursuant to the limitations described in Paragraph 4. below, any organization in which a Named Insured has
management control:
a, on the effective date of this Coverage Part; or
b. by reason of a Named insured creating or acquiring the organization during the policy period,
qualifies as a. Named Insured, provided that there is no other similar liability insurance, whether primary,
contributory, excess, contingsnt or otherwise, which provides coverage to such organization, or which would have
provided coverage but for the exhaustion of Its limit, and without regard to whether Its coverage is broader or
narrower than that provided by this insurance.
But this BROAD NAMED INSURED provision does not apply to:
(a) any partnership, limited liability company or joint venture; or
(b) any organization for which coverage is excluded by another endorsement attached to this Coverage Part.
For the purpose of this provision, management control means:
A. owning interests representing more than 50% of the voting, appointment or designation power for the
selection of a majority of the Board of Directors of a corporation; or
B. having the right, pursuant to a written trust agreement, to protect, control the use of, encumber or transfer or
sell property held by a trust.
4. With respect to organizations which qualify as Named Insureds by virtue of Paragraph 3. above, this insurance
does not apply to:
a. bodity injury or property damage that first occurred prior to the date of management control, or that first
occurs after management control ceases; nor
b. personal or advertising injury caused by an offense that first occurred prior to the date of management
control or that first occurs after management control ceases.
5. The insurance provided by this Coverage Part applies to Named insureds when trading under their own names
or under such other trading names or doing -business -as names (dba) as any Named Insured should choose to
employ.
6. ESTATES, LEGAL REPRESENTATIVES, AND SPOUSES
The estates, heirs„ legal representatives and spouses of any natural person insured shall also be insured under this
policy; provided, however, coverage is afforded to such estates, heirs, legal representatives, and spouses only for
claims arising solely out of their capacity or status as such. and, In the case of a spouse, where such claim seeks
damages from marital community property, jointly held property or property transferred from such natural person
Insured) to such spouse. No coverage Is provided for any act, error or omission of an estate, heir, legal
representative, or spouse outside the scope of such person's capacity or status as such, provided however that the
spouse of a natural person Named Insured and the spouses of members or partners of joint venture or partnership
Named insureds are insureds with respect to such spouses' acts, errors or omissions In the conduct of the Named)
Insured's business.
CNA74879XX (1-15)
Page 6 of 13
Policy No:
Endorsement No:
Effective Date;
Insured Name:
Copyright CNA All Flights Reserved. includes oopyMhted material of Insutanoe services Office. Inc., vAlh Its permission.
CNA CNA PARAMOUNT
General Liability Extension Endorsement
7. EXPECTED OR INTENDED INJURY— EXCEPTION FOR REASONABLE FORCE
Under COVERAGES, Coverage A — Bodily Injury And Property Damage Liability, the paragraph entitled
Exclusions is amended to delete the exclusion entitled Expected or Intended Injury and replace It with the following:
This insurance does not apply to:
Expected or Intended Injury
Bodily injury or property damage expected or intended from the standpoint of the Insured. This exclusion does not
apply to bodily Injury or property damage resulting from the use of reasonable force to protect persons or property.
S. IN REM ACTIONS
A quasi in rem action against any vessel owned or operated by or for the Named Insured, or chartered by or for the
Named Insured, will be treated in the same manner as though the action were in personam against the Named
Insured.
S. INCIDENTAL HEALTH CARE MALPRACTICE COVERAGE
Solely with respect to bodily injury that arises out of a health care incident:
A. Under COVERAGES, Coverage A — Bodily Injury And Property Damage Liability, the Insuring Agreement is
amended to replace Paragraphs 1.b.(1) and 1.b.(2) with the following:
b. This insurance applies to bodily injury provided that the professional health care services are incidental to
the Named Insured's primary business purpose, and only if:
(1) such bodily injury is caused by an occurrence that takes place in the coverage territory.
(2) the bodily injury first occurs during the policy period. All bodily injury arising from an occurrence will
be doomed to have occurred at the time of the first act, error, or omission that is part of the occurrence;
i; and
B. Under COVERAGES, Coverage A — Bodily Injury And Property Damage Liability, the paragraph entitled
Exclusions is amended to:
0
I. add the following to the Employers Liability exclusion:
u
This exclusion applies only if the bodily injury arising from a health care incident is covered by other
liability insurance available to the Insured (or which would have been available but for exhaustion of its
m limits).
N
U. delete the exclusion entitled Contractual Liability and replace it with the following:
This insurance does not apply to:
N
Contractual Liabiltty
the Insured's actual or alleged liability under any oral or written contract or agreement, including but not
limited to express warranties or guarantees.
Ili. add the following additional exclusions.
This insurance does not apply to:
Discrimination
any actual or alleged discrimination, humiliation or harassment, including but not limited to claims based on
i an individual's race, creed, Color, age, gender, national origin, religion, disability, marital status or sexual
orientation.
CNA74879XX (1-15) Policy No:
Page 7 of 13 Endorsement No:
Effective Date:
Insured Name:
CNA PARAMOUNT
General Liability Extension Endorsement
Dishonesty or Crime
Any actual or alleged dishonest, criminal or malicious act, error or omission.
Medicare/Medicaid Fraud
any actual or alleged violation of law with respect to Medicare, Medicaid, Tricare or any similar federal, state
or local governmental program.
Services Excluded by Endorsement
Any health care incident for which coverage is excluded by endorsement,
C. DEFINITIONS is amended to;
1. add the following definitions:
Heatth care incident means an act, error or omission by the Named Insured's employees or volunteer
workers in the rendering of:
a. professional health care services on behalf of the Named Insured or
b. Good Samaritan services rendered in an emergency and for which no payment is demanded or received.
Professional health care services means any health care services or the related furnishing of food,
beverages, medical supplies or appliances by the following providers In their capacity as such but solely to
the extent they are duly licensed as required:
a. Physician;
b. Nurse;
c. Nurse practitioner;
d. Emergency medical technician;
e. Paramedic;
f. Dentist;
g. Physical therapist;
h. Psychologist;
1. Speech therapist;
j. Other allied health professional; or
Professional health care services does not include any services rendered in connection with human clinical
trials or product testing.
ii. delete the definition of occurrence and replace it with the following:
Occurrence means a health care incident. All acts, errors or omissions that are logically connected by any
common fact, circumstance, situation, transaction, event, advice or decision will be considered to constitute a
single occurrence;
!if. amend the definition of Insured to:
a. add the following:
• the Named Insured's employees are Insureds with respect to:
CNA74879XX (1-15)
Page 8 of 13
Policy No: ,
Endorsement No:
Effective Date:
insured Name:
Copyright CNA All Rlghts Reserved InOW63 oopyrrghted matedal of insurance SaMces OHlce. Inc., wllh Its permisslon.
r.
0
0
0
N I CNA PARAMOUNT
General Liability Extension Endorsement
(1) bodily Injury to a co-omptoyee while in the course of the co-employse's employment by the
Named Insured or while performing duties related to the conduct of the Named insured's
business; and
(2) bodily Injury to a volunteer worker while performing duties related to the conduct of the
Named Insured's business;
when such bodily injury arises out of a health care incident.
the Named Insured's volunteer workers are insureds with respect to:
(1) bodily injury to a co -volunteer worker while performing duties related to the conduct of the
Named insured's business; and
(2) bodily injury to an employee while In the course of the employee's employment by the Named
Insured or while performing duties related to the conduct of the Named Insured's business;
when such bodily Injury arises out of a health care incident.
b. delete Subparagraphs (a), (b), (c) and (d) of Paragraph 2,a.(i) of WHO IS AN INSURED,
c. add the following:
Insured does not include any physician while acting in his or her capacity as such.
D. The Other Insurance condition is amended to delete Paragraph b.(1) in its entirety and replace it with the
following:
Other Insurance
b. Excess Insurance
(1) To the extent this insurance applies, it is excess over any other insurance, self insurance or risk transfer
instrument, whether primary, excess, contingent or on any other basis, except for insurance purchased
specifically by the Named Insured to be excess of this coverage.
10. JOINT VENTURES / PARTNERSHIP / LIMITED LIABILITY COMPANIES
WHO IS AN INSURED is amended to delete its last paragraph and replace it with the following:
No person or organization is an Insured with respect to the conduct of any current or past partnership, joint venture or
limited liability company that is not shown as a Named Insured in the Declarations, except that if the Named Insured
was a joint venturer, partner, or member of a limited liability company and such joint venture, partnership or limited
liability company terminated prior to or during the policy period„ such Named Insured Is an Insured with respect to
its interest In such joint venture, partnership or limited liability company but only to the extent that,:
a. any offense giving rise to personal and advertising Injury occurred prior to such termination date, and the
personal and advertising injury arising out of such offense first occurred after such termination date;
b, the bodily injury or property damage first occurred after such termination date; and
c. there is no other valid and collectible insurance purchased specifically to insure the partnership, joint venture or
limited liability company.
11. LEGAL LIABILITY— DAMAGE TO PREMISES
A. Under CCIVERAG15S, Coverage A — Bodily Injury and Property damage Liability, the paragraph entitled
Exclusions is amended to delete the first paragraph Immediately following subparagraph (6) of the Damage to
Property exclusion and replace It with the following:
Paragraphs (1), (3) and (4) of this exclusion do not apply to property damage (other than damage by fire) to
premises rented to the Named Insured or temporarily occupied by the Named Insured with the permission of the
CNA74879XX (1-15)
Page 9 of 13
Insured Name -
Policy No:
Endorsement No:
Effective Date:
copyright CNA All Rights Reserved. Includes copyriphted material or Insurance Services Office Inc. vAth fin narmiadnn
CN CNA PARAMOUNT
General Liability Extension Endorsement
owner, nor to the contents of premises rented to the Named Insured for a period of 7 or fewer consecutive days.
A separate limit of insurance applies to Damage To Premises Rented To You as described in LIMITS OF
INSURANCE.
B. Under COVERAGES, Coverage A — Bodily Injury and Property Damage Liability, the paragraph entitled
Exclusions is amended to delete its last paragraph and replace it with the following:
Exclusions c. through n. do not apply to damage by fire to premises while rented to a Named Insured or
temporarily occupied by a Named Insured with permission of the owner, nor to damage to the contents of
premises rented to a Named Insured for a period of 7 or fewer consecutive days.
A separate limit of insurance applies to this coverage as described in the LIMITS OF INSURANCE Section.
C. LIMITS OF INSURANCE Is amended to delete Paragraph $. (the Damage To Premises Rented To You Limit) and
replace it with the following:
6. Subject to Paragraph 5. above, (the Each Occurrence Limit), the Damage To Premises Rented To You Limit
is the most the Insurer will pay under COVERAGE A for damages because of property damage to:
a. any one premises while rented to a Named Insured or temporarily occupied by a Named Insured with
the permission of the owner; and
b. contents of such premises if the premises is rented to the Named Insured for a period of 7 or fewer
consecutive days.
The Damage To Premises Rented To You Limit Is $200,000. unless a higher Damage to Premises Rented to
You Limit is shown in the Declarations.
D. The Other Insurance Condition is amended to delete Paragraph b.(1)(a)(H), and replace it with the following:
(ii) That is property insurance for premises rented to a Named Insured, for premises temporarily occupied by the
Named Insured with the permission of the owner; or for personal property of others In the Named Insured's
care, custody or control;
E. This Provision 11. does not apply if liability for damage to premises rented to a Named Insured is excluded by
another endorsement attached to this Coverage Part,
12, MEDICAL PAYMENTS
A. LIMITS OF INSURANCE is amended to delete Paragraph 7. (the Medical Expense Limit) and replace it with the
following:
7. Subject to Paragraph 5. above (the Each Occurrence Limit), the Medical Expense Limit is the most the
Insurer will pay under Coverage C - Medical Payments for all medical expenses because of bodily Injury
sustained by any one person. The Medical Expense Limit Is the greater of:
(1) $15,000 unless a different amount is shown here: ; or
(2) the amount shown in the Declarations for Medical Expense Limit.
B. Under COVERAGES, Coverage C — Medical Payments, the Insuring Agreement Is amended to replace
Paragraph 1.a.(3)(b) with the following:
(b) The expenses are incurred and reported to the Insurer within three years of the date of the accident; and
13. NON -OWNED AIRCRAFT
Under COVERAGES, Coverage A — Bodily Injury and Property Damage Liability, the paragraph entitled
Exclusions is amended as follows:
CNA74879XX (1-15)
Pane 10 of 13
Insured Name
Policy No:
Endorsement No:
Effective Date:
Copyright CNA All Rights Reserved. Includes copyrighted material of Insurance Services of ice, Inc., YAM Its permisslon.
r.
O
0
0
0
DI
CNA PARAMOUNT
General Liability Extension Endorsement
The exclusion entitled Aircraft, Auto or Watercraft is amended to add the following:
This exclusion does not apply to an aircraft not owned by any Named insured, provided that:
1. the pilot in command holds a currently effective certificate issued by the duly constituted authority of the United
States of America or Canada, designating that person as a commercial or airline transport pilot;
2. the aircraft is rented with a trained, paid crew to the Named Insured; and
3. the aircraft is not being used to carry persons or property for a charge.
14. NON -OWNED WATERCRAFT
Under COVERAGES, Coverage A -- Bodity Injury and Property Damage Liability, the paragraph entitled
Exclusions is amended to delete subparagraph (2) of the exclusion entitled Aircraft, Auto or Watercraft, and
replace it with the following.
This exclusion does not apply to:
(2) a watercraft that is not owned by any Named Insured, provided the watercraft is:
(a) less than 75 feet long; and
(b) not being used to carry persons or property for a charge,
15. PERSONAL AND ADVERTISING INJURY —DISCRIMINATION OR HUMILIATION
A. Under DEFINITIONS, the definition of personal and advertising Injury is amended to add the following tort:
• Discrimination or humiliation that results in injury to the feelings or reputation of a natural person.
B. Under COVERAGES, Coverage B — Personal and Advertising injury Liabiltty, the paragraph entitled
Exclusions is amended to:
1. delete the Exclusion entitled Knowing Violation Of Rights Of Another and replace it with the following:
This insurance does not apply to:
Knowing Violation of Rights of Another
Personal and advertising injury caused by or at the direction of the Insured with the knowledge that the act
would violate the rights of another and would inflict personal and advertising injury. This exclusion shall not
apply to discrimination or humiliation that results in injury to the feelings or reputation of a natural person, but
only if such discrimination or humiliation is not done intentionally by or at the direction of:
(a) the Named Insured; or
(b) any executive officer, director, stockholder, partner, member or manager (if the Named Insured is a
limited liability company) of the Named insured.
2. add the following exclusions:
This insurance does not apply to:
Employment Related Discrimination
discrimination or humiliation directly or indirectly related to the employment, prospective employment, past
employment or termination of employment of any person by any Insured.
Premises Related Discrimination
discrimination or humiliation arising out of the sale, rental, lease or sub -lease or prospective sale, rental,
lease or sub -lease of any room, dwelling or premises by or at the direction of any Insured.
CNA74B79XX (1-15)
Page I of 1.14
Insured Name.
Policy No:
Endorsement No:
Effective Date:
Copyright CNA All Rlghls Reserved includes copyrighted matedal of insurance Services ofim, Inc., vrlth Its permission.
CNA PARAMOUNT
General Liability Extension Endorsement
Notwithstanding the above, there is no coverage for fines or penalties levied or imposed by a governmental entity
because of discrimination.
The coverage provided by this PERSONAL AND ADVERTISING INJURY —DISCRIMINATION OR HUMILIATION
Provision does not apply to any person or organization whose status as an Insured derives solely from
• Provision 1. ADDITIONAL INSUREDS of this endorsement; or
attachment of an additional insured endorsement to this Coverage Part.
16. PERSONAL AND ADVERnsiNG INJURY - CONTRACTUAL LIABILITY
A. Under COVERAGES, Coverage B —Personal and Advertising Injury Liability, the paragraph entitled
Exclusions is amended to delete the exclusion entitled Contractual Liability and replace It with the following:
This insurance does not apply to:
Contractual Liability
Personal and advertising injury for which the Insured has assumed liability in a contract or agreement.
This exclusion does not apply to liability for damages:
(1) that the Insured would have in the absence of the contract or agreement; or
(2) assumed in a contract or agreement that is an insured contract provided the offense that caused such
personal or advertising Injury first occurred subsequent to the execution of such insured contract. Solely
for the purpose of liability assumed in an insured contract, reasonable attorney fees and necessary litigation
expenses incurred by or for a party other than an Insured are deemed to be damages because of personal
and advertising Injury provided:
(a) liability to such party for, or for the cost of, that party's defense has also been assumed in such Insured
contract; and
(b) such attorney fees and litigation expenses are for defense of such party against a civil or alternative
dispute resolution proceeding in which covered damages are alleged.
B. Solely for the purpose of the coverage provided by this paragraph, DEFINITIONS is amended to delete the
definition of insured contract in its entirety, and replace it with the following:
Insured contract means that part of a written contract or written agreement pertaining to the Named Insured's
business under which the Named Insured assumes the tort liability of another party to pay for personal or
advertising injury arising out of the offense of false arrest, detention or imprisonment. Tort liability means a
liability that would be imposed by law in the absence of any contract or agreement.
C. Solely for the purpose of the coverage provided by this paragraph, the following changes are made to the Section
entitled SUPPLEMENTARY PAYMENTS — COVERAGES A AND B.
1. Paragraph 2.d. is replaced by the following:
d. The allegations in the suit and the information the insurer knows about the offense alleged in such suit
are such that no conflict appears to exist between the interests of the Insured and the interests of the
indemnites;
2. The first unnumbered paragraph beneath Paragraph 2.f.(2)(b) is deleted and replaced by the following:
So long as the above conditions are met, attorneys fees incurred by the Insurer in the defense of that
indemnitee, necessary litigation expenses incurred by the Insurer, and necessary litigation expenses incurred
by the indemnitee at the Insurer's request will be paid as defense costs. Notwithstanding the provisions of
Paragraph e.(2) of the Contractual Liability exclusion (as amended by this Endorsement), such payments will
CNA74879XX (1-16)
Page 12 of 13
Policy No:
Endorsement No:
Effective Date:
Insured Name:
Copyright CNA All Rights Reserved. Includes copyrighted material or Insurance services Oflloe. Inc., with Its pernisston.
CNA PARAMOUNT
General Liability Extension Endorsement
not be deemed to be damages for personal and advertising injury and will not reduce the limits of
insurance.
D. This PERSONAL AND ADVERTISING INJURY - LIMITED CONTRACTUAL LIABILITY Provision does not
apply if Coverage B —Personal and Advertising Injury Liability is excluded by another endorsement attached
to this Coverage Part.
17. PROPERTY DAMAGE— ELEVATORS
A. Linder COVERAGES, Coverage A — Bodily Injury and Property Damage Liability, the paragraph entitled
Exclusions is amended such that the Damage to Your Product Exclusion and subparagraphs (3), (4) and (6) of
the Damage to Property Exclusion do not apply to property damage that results from the use of elevators.
B. Solely for the purpose of the coverage provided by this PROPERTY DAMAGE — ELEVATORS Provision, the
Other Insurance conditions is amended to add the following paragraph:
This insurance is excess over any of the other insurance, whether primary, excess, contingent or on any other
basis that is Property insurance covering property of others damaged from the use of elevators.
18. SUPPLEMENTARY PAYMENTS
The section entitled SUPPLEMENTARY PAYMENTS— COVERAGES A AND B is amended as follows:
A. Paragraph i.b. is amended to delete the $250 limit shown for the cost of bail bonds and replace it with a $5,000.
limit; and
B. Paragraph 1.d, Is amended to delete the limit of $250 shown for daily loss of earnings and replace it with a
$1,000, limit.
19. UNINTENTIONAL FAILURETO DISCLOSE HAZARDS
If the Named Insured unintentionally fails to disclose all existing hazards at the inception data of the Named
Insured's Coverage Part, the Insurer will not deny coverage under this Coverage Part because of such failure.
20, WAIVER OF SUBROGATION - BLANKET
Under CONDITIONS, the Transfer Of Rights Of Recovery Against Others To Us Condition is amended to add the
following:
The Insurer waives any right of recovery the Insurer may have against any person or organization because of
payments the Insurer makes for injury or damage arising out of:
1. the Named Insured's ongoing operations; or
2. your work included in the products -completed operations hazard.
However, this waiver applies only when the Named Insured has agreed in writing to waive such rights of recovery in
a written contract or written agreement, and only if such contract or agreement:
1. is in effector becomes effective during the term of this Coverage Part; and
2. was executed prior to the bodily injury, property damage or personal and advertising injury giving rise to the
claim.
All other terms and conditions of the Policy remain unchanged,
This endorsement, which forms a part of and is for attachment to the Policy issued by the designated Insurers, takes
effect on the effective date of said Policy at the hour stated in said Policy, unless another effective date is shown below,
and expires concurrently with said Policy.
CNA74879XX (1-15)
Page 13 of 13
Policy No:
Endorsement No:
Effective Date:
Insured Name:
Copyright CNA AG Flights Reserved Includes oopyrIghled malerlat of Insurance Services Of e, Inc., Mh Its permisslon.
r�>
F
It is understood and agreed that this endorsement amends the BUSINESS AUTO COVERAGE FORbI as follows.
If any other endorsement attached to this policy amends any provision also amended by this endorsement, then
that other endorsement controls with respect to such provision, and the changes made by this endorsement to
such provision do not apply.
TABLE OF CONTENTS
►7
A. Who Is An Insured
1. Majority- Owned Corporations
2. Newly Acquired Organizations
3. Additional Insureds Required By Written Contracts
4. Employee -Hired Autos
B. Increased Loss of Earnings Allowance
C. Fellow Employee Coverage
II. AMENDMENTS TO PHYSICAL DAMAGE COVERAGE
A. Increased Loss of Use Expense
B. Broadened Electronic Equipment Coverage
III. MMENDMENTS TO BUSINESS AUTO CONDITIONS
A. Knowledge of Accident or Loss
B. Knowledge of Documents
C. Waiver of Subrogation
D. Unintentional Failure To Disclose Hazards
E. Primary and Non -Contributory When Required By Contract
IV. AMENDMENTS TO DEFINITIONS
A. Broadened Bodily Injury
I. Ai1IENDNIENTS TO LIABILITY COVERAGE
A. Amendments to Who Is An Insured
Under SECTION II — COVERED AUTOS LIABILITY COVERAGE, the paragraph entitled Who Is An
Insured is amended to add the following:
1. Majority Owned Corporations
Any incorporated entity in which you own a majority of the voting stock on the inception date of
this Coverage Form is an insured, but only if such entity is not an insured under any other liability
"policy" that provides auto coverage.
2. Newly Acquired Organizations
Form o: o icy o: 6 0 7 6 0 U 0 -.
Endorsement Effective Date: 1/2t/2019 Policy Effective Date: 1/21/2019
Endorsement No: 1 ; Page: a of b Policy Page: x of y
Underwriting Company: National Fire Ins. Co. of Harf
w
Any organization you newly acquire or form during the policy period, other than a limited liability
company, partnership or joint venture, and in which you maintain majority ownership interest is an
insured, but only if such organization is not an insured under any other liability "policy" that
provides auto coverage. The insurance afforded by this provision:
a. Is effective on the date of acquisition or formation of the organization, and applies until:
(1) The end of the policy period of this Coverage Form; or
(2) The next anniversary of this Coverage Form's inception date,
whichever is earlier; and
b. Does not apply to bodily injury or property damage caused by an accident that occurred before
you acquired or formed the organization.
3. Additional Insureds Required By Written Contract
Any person or organization that you are required by written contract to make an additional insured
under this insurance is an insured, but only with respect to that person or organization's legal
liability for acts or omissions of a person who qualifies as an insured for Liability Coverage tinder
SECTION II - WHO IS AN INSURED of this Coverage Form.
4. Employee -Hired Autos
Any employee of yours is an insured while operating with your permission an auto hired or rented
under a contract in that employee's name, while performing duties related to the conduct of your
business.
With respect to provisions A.1. and A.2. above, "policy" includes those policies that were in force on
the inception date of this Coverage Form, but:
i. Which are no longer in force; or
ii. Whose limits have been exhausted-
B. Increased Loss of Earnings Allowance
Under SECTION II — COVERED AUTOS LIABILITY COVERAGE, the paragraph entitled Coverage
Extensions is amended tinder Supplementary Payment subparagraph (4) to delete the $250. a day limit
for loss of earnings and replace it with a $500. a day limit.
C. Fellow Employee Coverage
Under SECTION II — COVERED AUTOS LIABILITY COVERAGE, the paragraph entitled Exclusions is
amended to delete the exclusion entitled Fellow Employee,
II. AMENDMENTS TO PHYSICAL DAMAGE COVERAGE
A. Increased Loss of Use Expense
Under SECTION III— PHYSICAL DAMAGE COVERAGE, the paragraph entitled Coverage Extensions is
amended under Loss of Use Expenses to delete the maximum of $600., and replace it with a maximum
of $800.
B. Broadened Electronic Equipment Coverage
Under SECTION ill — PHYSICAL DAMAGE COVERAGE, the paragraph entitled Exclusions is amended to
delete paragraphs 5.a through 5.d. in their entirety, and replace them with the following:
5. Exclusions4.c. and 4.d. above do not apply to loss to any electronic equipment that at the time of
loss is:
°orrn o, i A 1 Poficy No. 25
Endorsement Effective Date: 1/21/2019 Policy Effective 1/21/2019
Endorsement No: 1 ; Page: a of b Policy Page: x of y
Underwriting Company: Natioinal Fire Insurance Cc, or Hartford
CNA
a. Permanently installed in or upon a covered auto, nor to such equipment's antennas or other
accessories used with such equipment. A $100 deductible applies to this provision, and
supersedes any otherwise applicable deductible; or
b. Designed to be operated solely by use of the power from the auto's electrical system and is:
(1) Removable from a housing unit which is permanently installed in or upon the covered auto;
(2) An integral part of the same unit housing any electronic equipment described in paragraphs
a. or b.(1) above; or
(3) Necessary for the normal operation of the covered auto or the monitoring of the covered
auto's operating system.
Ill. AMENDMENTS TO BUSINESS AUTO CONDITIONS
A. Knowledge of Accident or Loss
Under BUSINESS AUTO CONDITIONS, the Loss Condition entitled Duties In the Event of Accident,
Claims, Suit, or Loss is amended to add the followingsubparagraph a.(4):
(4) If your employees know of an accident or loss, this will not mean that you have such knowledge
until such accidentor loss is known to a natural person Named Insured, to a partner, executive
officer, manager or member of a Named Insured, or to an employee designated by any of the above
to be your insurance manager.
B. Knowledge of Documents
Under BUSINESS AUTO CONDITIONS, the Loss Condition entitled Duties In the Event of Accident,
Claims, Suit, or Loss is amended to add the following subparagraph b.(6):
(6) If your employees know of documents concerning a claim or suit, this will not mean that you have
such knowledge until such documents are known to a natural person Named Insured, to a partner,
executive officer, manager or member of a Named Insured, or to an employee designated by any of
the above to be your insurance manager.
C. Waiver of Subrogation
Under BUSINESS AUTO CONDITIONS, the Loss Condition entitled Transfer Of Rights Of Reco►ery
Against Others To Us is amended to add the following:
We waive any right of recovery we may have, because of payments we make for injury or damage,
against any person or organization for whom or which you are required by written contract or
agreement to obtain this waiver from its.
This injury or damage must arise out of your activities tinder a contract with that person or
organization.
You must agree to that requirement prior to an accident or loss.
D. Unintentional Failure To Disclose Hazards
Under BUSINESS AUTO CONDITIONS, the General Condition entitled Concealment, Misrepresentation
or Fraud is amended to add the following:
Your failure to disclose all hazards existing on the inception date of this Coverage Form shall not
prejudice you with respect to the coverage provided by this insurance, provided such failure or omission
is not intentional.
E. Primary and Non -Contributory When Required By Contract
Under BUSINESS AUTO CONDITIONS, the General Condition entitled Other Insurance is amended to
add the following:
arnI NO: :) o aCy M a
Endorsement Effective Date: 1/21/2019 Policy Effective Date: 1/21/2019
Endorsement No: 1„ Page: a of b Policy Page: x of y
tlnderwrining Company: National Fire Insurance Co. of Hartford
CMA
Notwithstanding provisions S.a. through S.d. above, the coverage provided by this Coverage Form shall
be on a primary and non-contributory basis when required to be so by a written contract entered into
prior to accident or loss.
IV. AMENDMENTS TO DEFINITIONS
A. Broadened Bodily Injury
Under DEFINITIONS, the definition of bodily injury is deleted and replaced by the following:
Bodily injury means physical injury, sickness or disease sustained by a person, including death, mental
anguish or mental injury sustained by that person which results as a consequence of the physical injury,
sickness or disease.
All other terms and conditions of the policy remain unchanged.
This endorsement, which forms a part of and is for attachment to the policy issued by the designated Insurers,
takes effect on the Policy Effective date of said policy at the hour stated in said policy, unless another
effective date (the Endorsement Effective bate) is shown below, and expires concurrently with said policy.
Form No: CNA83700XX (10-2015) Policy No: 607600025
Endorsement Effective Date: 1/21/2019 Policy Effective Date: 1/21/2019
Endorsement No: 1 _ ; Page: a of b Policy Page: x of y
Underwriting Company: National Fire Insurance Co. of Hartford
This endorsement changes the policy to which it is attached.
It is agreed that Part One - Workers' Compensation Insurance G. Recovery From Others and Part Two -
Employers' Liability Insurance H. Recovery From Others are amended by adding the following:
We will not enforce our right to recover against persons or organizations. (This agreement applies only to the
extent that you perform work under a written contract that requires you to obtain this agreement from us.)
PREMIUM CHARGE - Refer to the Schedule of Operations
The charge will be an amount to which you and we agree that is a percentage of the total standard premium for
California exposure. The amount is 2%.
All other terms and conditions of the policy remain unchanged.
This endorsement, which forms a part of and is for attachment to the policy issued by the designated Insurers,
takes effect on the Policy Effective Date of said policy at the hour stated in said policy, unless another
effective date (the Endorsement Effective Date) is shown below, and expires concurrently with said policy
unless another expiration date is shown below.
Form No: G-19160-8 (11-1997)
Endorsement Effective mate: Endorsement Expiration Date:
Endorsement No: 2; Page; 1 of 1
Underwriting Company: American Casualty Company of Reading, Pennsylvania, 151 N Franklin St,
Chicago, IL 60606
0 Copyright CNA All Rights Reserved
Policy No: WC 6 76000042
Policy Effective Date: 01/21/2022
Policy Page: 32 of 46