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PROOF OF INSURANCE (2023 - 2023) CLOSEDTRUEREC-01 /DD/Yl(Y1f) `� CERTIFICATE OF LIABILITY INSURANCE 6�2 DATE (M3/2022 MIDONY 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(les) 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 HUB International Insurance Services Inc. 1525 Faraday Avenue Suite 150 Carlsbad, CA 92008 INSURED i.,INSURER B. ;U insurance GQmpany,_ 'IV1UU Nancy K. Bohl, Inc. D.B.A. The Counseling Team International .INSURER C.,Travelers Property Casualty Company of America 25674 20351 SW Acacia Street Floor 2 INSURER Newport Beach, CA 92660 , I ,"-"_ i INSURER E, INSURER F :..... ..... ..... . .... ._..,�.........._..-..-...__..._ COVERAGES CERTIFICATE NUMBER : REVISION NUhMBER:®I 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. ....... .. .", , "„ �,,,� _ ...... Ask"­ADDL SUBR -- P O INSURANCE �.SI�� POLICY NUMBER POLICY EFF POLICY EXP LIMITS TY X COMMERCIAL GENERAL LIABILITY EACH, OCCURRENCE _ 1,000,000 CLAIMS -MADE X OCCUR X X ACP GLO 3019795490 ETORENTED $ 8/31/2022 8/31/2023 PREMISES Oe RENTED PREMISES occurrence) 1,000,000 20,000 MFI� EXP (Any one person) $ 1,000,000.. SONAL&ADVINJURY $ ................. _PEP 3,000,000 GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE POLICY JA X LOC PROOIUCTS = COMP/OP AGG1. $ 3,000,000 CIfiHER _ _.. _ ....... A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT COd+x�daflll 1,000,000 ..,.,, X ANYAUTO X ACP BA 3019795490 rson) (Per $ m 8/31/2022 8/31/2023 B... pe , _ AOWNED UTOS ONLY SCHEDULED AUTOS BODILY INJURY HIRED NON -OWNED PROPERTY AMAGE $UMBRELLA AUTOS ONLY AUTOS ONLY '.... (PersoddonlyO.. ....... . B X B X EACH DccuRREycE $ 5,000,000 EXCESS LIAB CLAIMS -MADE ACP CAA 3019795490 _ 8/31/2022 8/31/2023 ' AGGREGATE $ ........ 5,000,000'.. DED X RETENTION$ 10,000; $ C WORKERS COMPENSATION X STATUTE ER AND EMPLOYERS' LIABILITY YIN . X UB7T831211 ..... w, ...... 8/11/2022 8/11/2023 1,000,000'. �FICERJMEMBER N / A EL. EACH ACCIDENT $ ...... ,,,,.,., . . FYPROPRIETORIPARTNERIEXECUTIVE EXCLUDED? Illandatory In NH) EL. DISEASE - EA EMPLOYEE $ 1,000,000 If pis„ describe under SCRIPTION OF OPERATIONS below _ E�L. DISEASE - $ 1,000,000 _... onal Liab ACP GLO 3019795490 q *Professional 813112022 8/31 j2_ 2023 See below for limits ' or limICY its A "Abuse Liability ACP GLO 3019795490 8/31/2022 8/31/2023 See below for limits ............ .._._. -._... DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD (1a1, Addlttonal Remarks Schedule, may be attached If more space Is required) Professional Liability I Occurrence Form 1 $1,000,000 Per Clallirl/I$3,000,000 Aggregate !Abuse Liability I Occurrence Form 1$1,000,000 Per Claiml$3,000,000 Aggregate Business Office Policy Property Locations: 1881 Business Center Dr. Suite 11, 12 A & 12 B, San Bernardino, CA 92408 1545 Anacapa Rd Suite 7C, Victorville, CA 92392 444 Camino Del Rio South, Suite 215 & #208, San Diego CA 92108 SEE ATTACHED ACORD 101 City of El Segundo, its officers, officials, employees, agents and volunteers 350 Main St. El Segundo, CA 90245 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE '" .. ACORD 25 (2016103) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: TRUEREC-01 SLU LOC #: 1 ``"CW" �ADDITIONAL REMARKS SCHEDULE , Page 1 of 1.... .. .._............ .............. ... ...... _. ......... AGENCY License # 0757776 NAMED INSURED UB International Insurance Services Inc. Nano 0351K, BohlInc. D.B.A. The Counseling Team International 2SWAca6ia Street Floor 2 PoucYNUMBER �.... ...'.�_ Newport Beach, CA 92660 EE PAGE 1 ...CARRIER----_.....�.........., ....�.__---_..,..............................................._,,.......... ......NAIC. CODE...,m...�. m. E_ PAGE EE PAGE 1 SEEP 1 EFFECTIVE DATE: E 1 ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: A CM9 2 FORM TITLE: Certificate of Liability Ira rarrce _______ ......„ Description of Operations/Locations/Vehicles: 74075 El Paseo Suite A9 & Alb, Palm Desert, CA 92260 4160 Temescal Canyon Rd Ste 309, Corona, CA 92883 41750 Rancho Los Palmas Dr ST #D-2, Rancho Mirage, CA 92270 39755 Murrieta Hot Springs Rd, Suite D160, Murrieta, CA 92563 135 S State College Blvd Ste 200, Brea, CA 92821 701 Palomar Airport Rd, #300, Carlsbad, CA 92011 232 Harrison Ave Ste D, Claremont, CA 91711 City of El Segundo, its officers, officials, employees, agents and volunteers are named as Additional Insureds with respects to General Liability per form CG8128 01/18 and Auto Liability per form AC7005 0316. Waiver of subrogation applies for General Liability and Workers Compensation. All forms valid where required by written contract. ACORD 101 (2008101) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD COMMERCIAL AUTO AC 70 05 0316 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DOW ,." * ! M This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM SUMMARY OF COVERAGES A. Effect of This Endorsement B. Newly Acquired or Formed Entities C. Employees as Insureds — Nonowned Autos D. Additional Insured by Contract, Permit or Agreement E. Supplementary Payments — Bail Bonds F. Supplementary Payments — Loss of Earnings G. Personal Effects and Property of Others Extension H. Prejudgment Interest Coverage I. Fellow Employee— Officer, Managers and Supervisors J. Hired Auto Physical Damage K. Temporary Substitute Autos — Physical Damage Coverage L. Expanded Towing Coverage M. Auto Loan or Lease Coverage N. Original Equipment Manufacturer Parts — Leased Private Passenger Types O. Deductible Amendments P. Rental Reimbursement Coverage Q. Expanded Transportation Expense R. Extra Expense— Stolen Autos S. Physical Damage Limit of Insurance T. New Vehicle Replacement Cost U. Physical Damage Coverage Extension V. Transfer of Rights of Recovery Against Others To Us W. Section IV — Business Auto Conditions — Notice of and Knowledge of Occurrence X. Hired Car Coverage Territory Y. Emergency Lock Out Z. Cancellation Condition AC 70 05 0316 Includes copyrighted material of Insurance Services Office, Inc. Page 1 of 7 with its permission ACP BA 30-0-9795490 L62S 20273 INSURED COPY AC7005031600 0001 47 0020203 COMMERCIAL AUTO AC 70 05 0316 A. EFFECT OF THIS ENDORSEMENT Coverage provided under this policy is modified by the provisions of this endorsement. If there is any conflict between the provisions of this endorsement and the provision(s) of any state - specific endorsement also attached to this poli- cy, then the provision(s) of the state -specific endorsement shall apply instead of the provi- sions of this endorsement that are in conflict, but only to the extent of the conflict, and only to the extent necessary to bring such provisions into conformance with the state requirement(s) contained in the provision(s) of the state -specific endorsement. B. NEWLY ACQUIRED OR FORMED ENTITIES The Named Insured shown in the Declarations is amended to include any organization you newly acquire or form, other than a partnership, joint venture, or limited liability company, and over which you maintain ownership or majority (more than 50%) interest; if there is no other similar in- surance available to that organization. Coverage under this provision is afforded until the 180th day after you acquire or form the organization or the end of the policy period, whichever is later. C. EMPLOYEES AS INSUREDS — NONOWNED AUTOS The following is added to paragraph A.1. Who Is An Insured of SECTION II — COVERED AUTOS LIABILITY COVERAGE: d. Any "employee" of yours is an "insured" while using a covered "auto" you don't own, hire or borrow in your business or your per- sonal affairs. D. ADDITIONAL INSURED BY CONTRACT, PERMIT OR AGREEMENT The following is added to A.1. Who Is An In- sured of SECTION II — COVERED AUTOS LIABILITY COVERAGE: Any person or organization that you are re- quired to name as an additional insured in a written contract or agreement that is executed or signed by you prior to a "bodily injury" or "property damage" occurrence is an "insured" for Covered Auto Liability coverage. How- ever, with respect to covered "autos", such person or organization is an insured only to the extent that person or organization qualifies as an "insured" under A.1. Who is an Insured of SECTION II — COVERED AUTOS LIABILITY COVERAGE: If specifically required by the written contract or agreement referenced in the paragraph above, any coverage provided by this endorsement to an additional insured shall be primary and any other valid and collectible insurance avail- able to the additional insured shall be non- contributory with this insurance. If the written contract does not require this coverage to be primary and the additional insured's coverage to be non-contributory, then this insurance will be excess over any other valid and collectible insur- ance available to the additional insured. E. SUPPLEMENTARY PAYMENTS — BAIL BONDS Supplementary Payments of SECTION II — COVERED AUTOS LIABILITY COVERAGE is revised as follows: (2) Up to $2,500 for cost of bail bonds (including bonds for related traffic law violations) required because of an "accident" we cover. We do not have to furnish these bonds. F. SUPPLEMENTARY PAYMENTS — LOSS OF EARNINGS Supplementary Payments of the SECTION II — COVERED AUTOS LIABILITY COVERAGE is revised as follows: (4) All reasonable expenses incurred by the "in- sured" at our request, including actual loss of earnings up to $500 a day because of time off from work. G. PERSONAL EFFECTS AND PROPERTY OF OTHERS EXTENSION 1. The. Care, Custody or Control Exclusion of SECTION II — COVERED AUTOS LIABILITY COVERAGE, does not apply to "property damage" to property, other than your property, up to an amount not exceed- ing $250 in any one "accident". Coverage is excess over any other valid and collectible insurance. 2. The following paragraph is added to A.4. Coverage Extensions of SECTION III — PHYSICAL DAMAGE COVERAGE: c. We will pay up to $500 for your property that is lost or damaged as a result of a covered "loss", without applying a de- ductible. Coverage is excess over any other valid and collectible insurance. Page 2 of 7 Includes copyrighted material of Insurance Services Office, Inc. with its permission ACP BA 30-0-9795490 L82S 20273 INSURED COPY AC7005031600 0001 AC 70 05 0316 47 0020204 COMMERCIAL AUTO AC 70 05 0316 H. PREJUDGMENT INTEREST COVERAGE substitute for a covered "auto" you own that The following paragraph is added to SECTION II is out of service because of its: — COVERED AUTOS LIABILITY COVERAGE, a. Breakdown; 2. Coverage Extensions, a. Supplementary b. Repair; Payments: c. Servicing; (7) Prejudgment interest awarded against the d. "Loss"; or "insured" on that part of the judgment we pay. If we make an offer to pay the appli- e. Destruction cable limit of insurance, we will not pay The coverage that applies is the same as any prejudgment interest based on that the coverage provided for the vehicle being period of time after the offer. replaced. I. FELLOW EMPLOYEE — OFFICERS, MANAGERS, AND SUPERVISORS L. EXPANDED TOWING COVERAGE The Fellow Employee Exclusion in SECTION II 1. We will pay up to: — COVERED AUTOS LIABILITY COVERAGE is a. $100 for a covered "auto" you own of replaced as follows; the private passenger type, or A. "Bodily injury" to any fellow "employee" of b. $500 for a covered "auto" you own that the "insured" arising out of and in the course is not of the private passengertype, of the fellow "employee's" employment or while performing duties related to the con- for towing and labor costs incurred each duct of your business. This exclusion does time the covered "auto" is disabled. Howev- not apply to an "insured" who occupies a er, the labor must be performed at the place position as an officer, manager, or supervi- of disablement. sor. 2. This coverage applies only for an "auto" J. HIRED AUTO PHYSICAL DAMAGE covered on this policy for Comprehensive or If covered "auto" designation symbols 1 or 8 ap- Specified Causes of Loss Coverage and ply to Liability Coverage and if at least one au- Collision Coverages. to" you own is covered by this policy for Com- 3. Payment applies in addition to the otherwise prehensive, Specified Causes of Loss, or Colli- applicable amount of each coverage you sion coverages, then the Physical Damage have on a covered "auto". coverages provided are extended to "autos" you M. AUTO LOAN OR LEASE COVERAGE lease, hire, rent or borrow without a driver; and 1. In the event of a total "loss" to a covered provisions in the Business Auto Coverage Form "auto", we will pay any unpaid amount due applicable to Hired Auto Physical Damage apply on the loan or lease, including up to a max - up to a limit of $100,000. The deductible will be imum of $500 for early termination fees or equal to the largest deductible applicable to any penalties, for your covered "auto" less: owned "auto" for that coverage. Any Compre- a. The amount paid under SECTION III — hensi ve deductible does not apply to fire or ensi PHYSICAL DAMAGE COVERAGE of lightning. this policy; and K. TEMPORARY SUBSTITUTE AUTOS — b. Any: PHYSICAL DAMAGE COVERAGE The following is added to paragraph C. Certain 1) Overdue lease/loan payments at the "loss'; Trailers, Mobile Equipment And Temporary time of the Substitute Autos of SECTION I - COVERED 2) Financial penalties imposed under a AUTOS: lease for excessive use, abnormal If Physical Damage Coverage is provided by wear and tear or high mileage; this Coverage Form, the following types of 3) Security deposits not refunded by a vehicles are also covered "autos" for Physi- lessor; cal Damage Coverage: 4) Costs of extended warranties, Credit Any "auto" you do not own while used with Life insurance, Health, Accident, or the permission of its owner as a temporary Disability insurance purchased with the lease; and AC 70 05 0316 Includes copyrighted material of Insurance Services Office, Inc., Page 3 of 7 with its permission ACP BA 30-0-9795490 L82S 20273 INSURED COPY AC7005031600 0001 47 0020205 COMMERCIAL AUTO AC 70 05 0316 5) Carry-over balances from previous leases. 2. This coverage only applies to a "loss" which is also covered under this policy for Com- prehensive, Specified Causes of Loss, or Collision coverage. 3. Coverage does not apply to any unpaid amount due on a loan for which the covered "auto" is not the sole collateral. N. ORIGINAL EQUIPMENT MANUFACTURER PARTS — LEASED PRIVATE PASSENGER TYPES Under Paragraph C. Limit of Insurance of SECTION III — PHYSICAL DAMAGE COVERAGE, Section 4 is added as follows: 4. We will use new original equipment vehicle manufacturer parts for any private passen- ger type covered "auto" where required by the lease agreement which has a term of at least six months. If a new original equip- ment vehicle manufacturer part is not in pro- duction or distribution we may use a like, kind and quality replacement part. O. DEDUCTIBLE AMENDMENTS The following are added to the Deductible provi- sion of SECTION III — PHYSICAL DAMAGE COVERAGE: If another policy or coverage form that is not an automobile policy or coverage form issued by this company applies to the same "accident", the following applies: 1. If the deductible under this coverage is the smaller (or smallest) deductible, it will be waived: 2. If the deductible under this coverage is not the smaller (or smallest) deductible, it will be reduced by the amount of the smaller (or smallest) deductible. If a Comprehensive or Specified Causes of Loss Coverage "loss" from one "accident" involves two or more covered "autos", only the highest deductible applicable to those coverages will be applied to the "accident," if the cause of the loss is covered for those vehicles. This provision only applies if you carry Comprehensive or Specified Causes of Loss Coverage for those vehicles, and does not extend coverage to any covered "autos" for which you do not carry such coverage. No deductible applies to glass if the glass is re- paired, in a manner acceptable to us, rather than replaced. P. RENTAL REIMBURSEMENT COVERAGE 1. This coverage applies only to a covered "au- to" for which Physical Damage Coverage is provided on this policy. 2. We will pay for rental reimbursement ex- penses incurred by you for the rental of an "auto" because of "loss" to a covered "auto". Payment applies in addition to the otherwise applicable amount of each coverage you have on a covered "auto." No deductibles apply to this coverage. 3. We will pay only for those expenses incurred during the policy period beginning 24 hours after the "loss" and ending, regardless of the policy's expiration, with the lesser of the following number of days: a. The number of days reasonably required to repair or replace the covered "auto". If "loss" is caused by theft, this number of days is added to the number of days it takes to locate the covered "auto" and return it to you. b. The number of days shown in the Schedule. 4. Our payment is limited to the lesser of the following amounts: a. Necessary and actual expenses incurred. b. $75 for any one day or for a maximum of 30 days. 5. This coverage does not apply while there are spare or reserve "autos" available to you for your operations. 6. If "loss" results from the total theft of a cov- ered "auto" of the private passenger type, we will pay under this coverage only that amount of your rental reimbursement ex- penses which is not already provided for un- der SECTION III — PHYSICAL DAMAGE COVERAGE Coverage Extension. Q. EXPANDED TRANSPORTATION EXPENSE Paragraph AA.a. of SECTION III — PHYSICAL DAMAGE COVERAGE is replaced by the follow- ing: We will pay up to $50 per day to a maximum of $1500 for temporary transportation expense in- curred by you because of the total theft of a Page 4 of 7 Includes copyrighted material of Insurance Services Office, Inc AC 70 05 0316 with its permission. ACP BA 30-0-9795490 L82S 20273 INSURED COPY AC7005031600 0001 47 0020206 covered "auto" of the private passenger type. We will only pay for those covered "autos" for which you carry Comprehensive or Specified Causes of Loss Coverage. We will pay for tem- porary transportation expenses incurred during the period beginning 24 hours after the theft and ending, regardless of the policy's expiration, when the covered "auto" is returned to use or we pay for its "loss". R. EXTRA EXPENSE — STOLEN AUTOS The following paragraph is added to Coverage Extensions of SECTION III — PHYSICAL DAMAGE COVERAGE: c. We will pay for up to $5,000 for the expense of returning a stolen covered "auto" to you. We will pay only for those covered "autos" for which you carry Comprehensive or Spec- ified Causes of Loss Coverage S. PHYSICAL DAMAGE LIMIT OF INSURANCE T Under SECTION III — PHYSICAL DAMAGE COVERAGE, Paragraph C., Limit of Insurance is replaced by the following: C. Limit Of Insurance 1. The most we will pay for "loss" in any one "accident" is the lesser of: a. The actual cash value of the damaged or stolen property as of the time of the "loss", or b. The cost of repairing or replacing the damaged or stolen property. 2. $1500 is the most we will pay for "loss" in any one "accident" to all electronic equip- ment that reproduces, receives or transmits audio, visual or data signals which, at the time of "loss", is: a. Permanently installed in or upon the covered "auto" in a housing, opening or other location that is not normally used by the "auto" manufacturer for the in- stallation of such equipment. b. Removable from a permanently installed housing unit as described in Paragraph 2.a. above or is an integral part of that equipment; or c. An integral part of such equipment. 3. An adjustment for depreciation and physical condition will be made in determining actual cash value in the event of a total "loss". 4. The cost of repairing or replacing may: a. Be based on an estimate which includes parts furnished by the original equip - AC 70 05 0316 ACP BA 30-0-9795490 COMMERCIAL AUTO AC 70 05 0316 ment manufacturer or other sources in- cluding non -original equipment manu- facturers and b. If a repair or replacement results in bet- ter than like kind or quality, we will not pay for the amount of the net improve- ment. 5. If we offer to pay the actual cash value of the damaged or stolen property, we will value auto advertising wraps, paint customi- zation, and similar business related advertis- ing modifications, in addition to the actual cash value of the property. Auto advertising wraps, paint customization, and similar business related advertising modifications will be valued at the cost to replace them with an adjustment made for depreciation and physical condition. NEW VEHICLE REPLACEMENT COST The following is added to the Limit of Insurance provision of SECTION III — PHYSICAL DAMAGE COVERAGE: 5. The provisions of paragraphs 1. and 3. do not apply to a covered "auto" of the private passenger type or a vehicle with a gross vehicle weight rating of 20,000 pounds or less which is a "new vehicle." In the event of a total "loss" to your new ve- hicle to which this coverage applies, we will pay at your option: a. The verifiable "new vehicle" purchase price you paid for your damaged vehi- cle, not including any insurance or war- ranties purchased; b. If it is available, the purchase price, as negotiated by us, of a "new vehicle" of the same make, model, and equipment or the most similar model available, not including any furnishings, parts, or equipment not installed by the manufac- turer or manufacturers' dealership; or. c. The market value of your damaged ve- hicle, not including any furnishings, parts, or equipment not installed by the manufacturer or manufacturer's dealer- ship. We will not pay for initiation or set up costs associated with loans or leases As used in this endorsement, a "new vehicle" means an "auto" of which you are the original owner that has not been previ- Includes copyrighted material of Insurance Services Office, Inc., with its permission L82S 20273 INSURED COPY AC7005031600 0001 Page 5 of 7 47 0020207 COMMERCIAL AUTO AC 70 05 0316 ously titled and which you purchased less than 365 days before the date of the "loss". U. PHYSICAL DAMAGE COVERAGE EXTENSIONS Under SECTION III — PHYSICAL DAMAGE COVERAGE, A. Coverage, Coverage Exten- sions, b. Loss of Use Expenses is replaced by the following: b. Loss of Use Expenses For Hired Auto Physical Damage, we will pay expenses for which an "insured" be- comes legally responsible to pay for loss of use of a vehicle rented or hired without a driver, under a written rental contract or agreement. We will pay for loss of use ex- penses if caused by: (1) Other than collision if the Declarations indicate that Comprehensive Coverage is provided for any covered "auto"; (2) Specified Causes of Loss only if the Declarations indicate that Specified Causes of Loss Coverage is provided for any covered "auto'; or (3) Collision only if the Declarations indicate that Collision Coverage is provided for any covered "auto." However, the most we will pay for any expenses for loss of use is $50 per day, to a maximum of $1,500. The insurance provided by this provision is excess over any other collectible insurance. V. TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US The following is added to the Transfer Of Rights Of Recovery Against Others To Us Condition: We waive any right of recovery we may have against any person or organization to the extent required of you by a written con- tract executed prior to any "accident" be- cause of payments we make for damages under this coverage form. W. NOTICE OF AND KNOWLEDGE OF OCCURRENCE SECTION IV — BUSINESS AUTO CONDITIONS, Paragraph A is amended as follows: 6. NOTICE OF AND KNOWLEDGE OF OCCURRENCE a. Your obligation in the Duties in the Event of Accident, Claim, Suit or Loss Condi- tion relative to notification requirements applies only when the "accident" or "loss" is known to: (1) You, if you are an individual; (2) A partner, if you are a partnership; (3) A member, if you are a limited liability company; or (4) An executive officer or insurance manager, if you are a corporation. Your obligation in the. Duties in the Event of Accident, Claim, Suit or Loss Condition relative to providing us with documents concerning a claim or "suit" will not be considered breached unless the breach occurs after such claim or "suit" is known to: (1) You, if you are an individual; (2) A partner, if you are a partnership; (3) A member, if you are a limited liability company; or (4) An executive officer or insurance manager, if you are a corporation. X. HIRED CAR — COVERAGE TERRITORY Item (5) of the Policy Period, Coverage Territory GeneralConditionss replaced by the following: (5) Anywheren theworldif a covered "auto" is leased, hired, rented or borrowed without a driverfor a period of 30 days or less; and Y. EMERGENCY LOCKOUT We will reimburse you up to $100 for reasonable expense incurred for the services of a locksmith to gain entry into your covered "auto" subject to these provisions: 1. Your door key, electronic key or key entry pad has been lost, stolen or locked in your covered "auto" and you are unable to enter such "auto" , or 2. Your keyless entry device battery dies and you are unable to enter such "auto" as a re- sult, 3. Your key, electronic key or key entry pad has been lost or stolen and you have changed the lock to prevent an unauthorized entry;'and Page 6 of 7 Includes copyrighted material of Insurance Services Office, Inc with its permission. ACP BA 30-0-9795490 L62S 20273 INSURED COPY AC7005031600 0001 AC 70 05 0316 47 0020208 4. Original copies of receipts for services of a locksmith must be provided before reim- bursement is payable. Z. CANCELLATION CONDITION Paragraph A.2. of the COMMON POLICY CONDITION — CANCELLATION applies except as follows: AC 70 05 0316 ACP BA 30-0-9795490 COMMERCIAL AUTO AC 70 05 0316 If we cancel for any reason other than non- payment of premium, we will mail or deliver to the First Named Insured written notice of cancellation at least 60 days before the ef- fective date of cancellation. This provision does not apply in those states that require more than 60 days prior notice of cancella- tion. Includes copyrighted material of Insurance Services Office, Inc., with its permission L82S 20273 INSURED COPY AC7005031600 0001 Page 7 of 7 47 0020209 COMMERCIAL GENERAL LIABILITY CG 8128 01 18 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. GENERAL LIABILITY ENHANCEMENT: HUMAN SERVICES This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE FORM It is understood and agreed that the following extensions only apply in the event that no other specific coverage for the indicated loss exposure is provided under this policy. If such other more specific coverage applies, the terms, conditions, and limits of that coverage are the sole and exclusive coverage applicable under this policy, unless otherwise noted on this endorsement. The following is a summary of the Limits of Insurance and additional coverages provided by this endorsement. For complete details on specific coverages, consult the policy contract wording. ._._ ... Applicable ......... Limit of Insurance --?Me # -Coverage Additional Insured —As Required b Contract Included 7 Additional Insured — Broad Form Vendors Included 5 Additional Insured — Funding Source Additional Insured —Grantor of Franchise Included Included 4__ 6 Additional Insured —Grantor of Permits Included 4 Additional Insured — Home Care Providers Included 4 Additional Insured — Lessors Of Leased Equipment — Automatic Status When Required In Lease Agreement With You Additional Insured — Mana ers, Landlords, Or Lessors OI P'remfises Included Included 4 4 Additional Insured —Medical Directors And Administrators Included 4 Additional Insured — State Or Political Subdivision Included 5 Broadened Definition Of Bodily Injury Includes Mental An uish 9 Dama a To Premises Rented To You $1,000,000 Includes Expanded Perils 8 Damage To Property You Own, Rent, Or Occu Duties In The Event Of Occurrence, Claim Or Suit _ $50,000 Included 2 8 Employee Indemnification Defense Covera a For Em to ee $25 000 3 Extended Pro ert Dama a Included 3 Key And Lock Replacement -Janitorial Services Client Covera a $15,000 2 Liberalization Included 8 Limited Rental Lease Agreement Contractual Liability $100,000 3 Medical Payments Medical Pa ments — Athletic Activities $20,000 Amended 3 3 Medical Pa ments -Extended Reporting Period _ 3 Years 3 Named Insured — Broadened Named Insured Named Insured — NewlyAcquired _ Included Included 3 �3 Non -Owned Watercraft Less than 58 feet 2 Personal And Advertising Injury — Includes Abuse Of Process And Discrimination SupgOneTmentary Pa ments —Bail Bonds Included $7,500 9 3 Su lementa Payments — Loss Of Earnings $1 500 er da 3 Transfer Of Ri hts Of Recovery Against Other To Us Clarification 8 Unintentional Failure To Disclose A Hazard Included 8 CG 81 28 01 18 Includes copyrighted material of Insurance Services Office, Inc., Page 1 of 9 with its permission. CG 81 28 01 18 A. Key and Lock Replacement — Janitorial Services a. "Bodily injury" or "property damage" Client Coverage expected or intended from the stand point of 1. We will pay for the cost to replace keys and locks the insured. This exclusion does not apply to "property at the "client's" premises due to theft or other "bodily injury" or damage" resulting loss to keys entrusted to you by your "client", up from the use of reasonable force to protect to a $15,000 limit per occurrence/$15,000 policy persons or property. aggregate. 2. Exclusion g. Aircraft, Auto or Watercraft 2. We will not pay for loss or damage resulting from Paragraph (2) is deleted and replaced with: theft or any other dishonest or criminal act that (2) A watercraft you do not own that is: you or any of your partners, members, officers, (a) Less than 58 feet long; and "employees", "managers", directors, trustees, authorized representatives or any one to whom (b) Not being used to carry persons or you entrust the keys of a "client" for any purpose property for a charge; commit, whether acting alone or in collusion with This provision applies to any person, who with other persons. your consent, either uses or is responsible for 3. The following, when used in this coverage only, the use of a watercraft. This insurance is excess are defined as follows: over any other valid and collectible insurance available to the insured whether primary, excess, a. "Employee" means: or contingent. (1) Any natural person: 3. Exclusion j. is amended as follows: (a) While in your services or for 30 (a) Exclusion j.(1) is deleted and replaced with: days after termination of service; (1) Property you own, rent or occupy, (b) Who you compensate directly by including any costs or expenses wages or commissions; and salary, g incurred by you, or any other person, (c) Who you have the right to direct organization or entity, for repair, and control while performing replacement, enhancement, restoration services for you; or or maintenance of such property for any (2) Any natural person who is furnished reason, including prevention of injury to temporarily to you: a person or damage to another's' property, unless the damage to property (a) To substitute for a permanent caused your "client", such case "employee" as defined in Paragraph a we will provide coverage for such w r 1 above, who is on leave; or () "property damage" for which you are (b) To meet seasonal or short-term legally obligated to pay up to a $50,000 workload conditions; limit per "occurrence". This limit is the while that person is subject to your only limit of insurance for such "property direction and control and damage" and will not be combined with performing services for you. the Each Occurrence Limit set for this in Section III — Limits of Insurance and (3) "Employee" does not mean: will be included within and not in (a) Any agent, broker, person leased to addition to the Each Occurrence Limit. you by a labor leasing firm, factor, Any and all damages paid under the commission merchant, consignee, terms and condition of this provision will independent contractor or further be applied against and will representative of the same general reduce the Aggregate Limit of Insurance character; or shown on the Declarations page, and as (b) Any "manager", director or trustee provided in the Commercial General except while performing acts Liability Coverage Form in the same coming within the scope of the manner and in addition to all other usual duties of an "employee". coverages of the Commercial General b. "Manager" means a person serving in a Liability Coverage Form that are also directorial capacity for a limited liability subject to the Aggregate Limit. company. 4. The following is added to Paragraph (2) of B. SECTION I — COVERAGES, COVERAGE A - Exclusion b. Contractual Liability of SECTION I BODILY INJURY AND PROPERTY DAMAGE — COVERAGES, COVERAGE A. BODILY LIABILITY, 2. Exclusions is amended as follows: INJURY AND PROPERTY DAMAGE LIABILITY, 1. Exclusion a. Expected or Intended Injury is under Subsection 2. Exclusions: deleted and replaced with: We agree to indemnify the Named Insured for their liability assumed in a contract or agreement Page 2 of 9 Includes copyrighted material of Insurance Services Office, Inc., CG 8128 01 18 with its permission. regarding the rental or lease of a premises on behalf of their "client", up to $100,000 per .'occurrence". This limit of insurance is the only limit of insurance for your liability assumed in a contract or agreement regarding the rental or lease of a premises on behalf of your "client" whether or not such contract qualifies as an "insured contract". This limit will not be combined with the Each Occurrence Limit set forth in Section III — Limits of Insurance and is included within and not in addition to the Each Occurrence Limit. This coverage extension only applies to rental lease agreements. This coverage is excess over any renter's liability insurance of the "client". Any and all damages paid under the terms and conditions of this provision will further be applied against and will reduce the Aggregate Limit of Insurance shown on the Declarations page, as provided in the Commercial General Liability Coverage Form in the same manner and in addition to all other coverages of the Commercial General Liability Coverage Form that are also subject to the Aggregate Limit. 5. The last Paragraph of Subsection 2. Exclusions is replaced by the following: If damage by fire to premises rented to you is not otherwise excluded, exclusions c. through n. do not apply to damage by fire, lightning, explosion, smoke or sprinkler leakage to premises while rented to you or temporarily occupied by you with permission of the owner. A separate limit of insurance applies to this coverage as described in Section III — Limits of Insurance. C. SECTION I — COVERAGES, COVERAGE C — MEDICAL PAYMENTS 1. If COVERAGE C — MEDICAL PAYMENTS is not otherwise excluded from this Coverage Part: a. The Medical Expense Limit shown on the Declarations is deleted and replaced by $20,000. $20,000 is the only limit of insurance for Medical Expenses and this limit will not be combined with any other limit of insurance. b. Subsection 1. Insuring Agreement, Paragraph a.(3)(b) is replaced by: (b) The expenses are incurred and reported to us within three years of the date of the accident; and 2. Subsection 2. Exclusions, is amended as follows: a. Exclusion a. Any Insured is deleted and replaced with: a. Any Insured To any insured, except "volunteer workers" or an insured as provided in e. Athletic Activities below. CG 81 28 01 18 b. Exclusion e. Athletics Activities is deleted and replaced with: e. Athletics Activities To a person injured while practicing or participating in any physical exercises or games, sports or athletic contests. This exclusion shall not apply to an insured while providing instruction with respect to any of the activities otherwise excluded by this provision. D. SECTION I — COVERAGES, SUPPLEMENTARY PAYMENTS — COVERAGES A AND B is amended as follows: 1. 1. b. is replaced with: b. Up to $7,500 for cost of bail bonds required because of accidents or traffic law violations arising out of the use of any vehicle to which the Bodily Injury Liability Coverage applies. We do not have to furnish these bonds. 2. 1. d. is replaced with: d. All reasonable expenses incurred by the insured at our request to assist us in the "suit", including actual loss of earnings up to $1,500 a day because of time off from work. 3. The following provision is added: We will reimburse you for defense costs that you incur in the defense of an "employee" who is directly involved in a criminal proceeding that arises out of such "employee's" acts or omissions within the scope of their employment by you or while performing duties related to the conduct of your business and which would otherwise be covered by this insurance. The most we will reimburse you for defense costs that you incur in the defense of an "employee" who is alleged to be directly involved in a criminal proceeding is $25,000, subject to an aggregate limit of $25,000 for all reimbursements that we make during the policy period on behalf of all "employees", regardless of the numbers of ..employees", claims or "suits" brought or persons or organizations making claims or bringing .,suits". E. SECTION II WHO IS AN INSURED is amended as follows: 1. If coverage for a newly acquired or formed organization is not otherwise excluded from this Coverage Part, Paragraph 3.a. is replaced with: a. Coverage under this provision is until the end of the policy period during which you acquired or formed the organization; 2. The following is also an insured: Broadened Named Insured — Any organization and subsidiary thereof which you control and actively manage (whether through ownership of voting securities, by contract, or otherwise) on the effective date of this policy. However, coverage does not apply to any organization or CG 8128 01 18 Includes copyrighted material of Insurance Services Office, Inc., Page 3 of 9 with its permission. CG 8128 01 18 subsidiary not named in the Declarations as a agreed in writing in a contract or agreement Named Insured, if they are also insured under that such person(s) or organization(s) be another similar policy, or would have been added as an additional insured on your insured but for such policy's termination or the policy. Such person(s) or organization(s) is exhaustion of its limits of insurance. an insured only with respect to liability for 3. Each of the following is also an additional "bodily injury", "property damage" or insured: "personal and advertising injury" caused, in whole or in part, by your maintenance, a. Medical Directors and Administrators — Your operation or use of equipment leased to you medical directors and administrators but by such person(s) or organization(s). only while acting within the scope of and However, the insurance afforded to such during the course of their duties as such. additional insured: Such duties do not include the furnishing or (1) Only applies to the extent permitted by failure to furnish professional services as a law; and physician or psychiatrist in the treatment of a patient. (2) Will not be broader than that which you b. Funding Source — Any person or are required by the contract or agreement to provide for such additional organization with respect to their liability insured. arising out of: (1) Their financial control of you; or A person's or organization's status as an additional insured under this endorsement (2) Premises they own, maintain or control ends when their contract or agreement with while you lease or occupy these you for such leased equipment ends. premises. With respect to the insurance afforded to This insurance does not apply to: these additional insureds, this insurance (a) Any "occurrence" or offense which does not apply to any "occurrence" which takes place after you cease to takes place after the equipment lease lease or occupy that premises; or expires. (b) Structural alterations, new f. Grantors of Permits — Any state or construction or demolition governmental agency or subdivision or operations performed by or on political subdivision granting you a permit in behalf of that person or connection with your premises subject to the organization. following additional provision: c. Home Care Providers — At the first Named This insurance applies only with respect to Insured's option, any person or organization the following hazards for which the state or under your direct supervision and control governmental agency or subdivision or while providing on your behalf private home political subdivision has issued a permit or respite or foster home care for the authorization in connection with premises developmentally disabled. you own, rent or control and to which this d. Managers, Landlords, or Lessors of insurance applies: Premises — Any person or organization with (1) The existence, maintenance, repair, respect to liability arising out of the construction, erection or removal of ownership, maintenance or use of that part advertising signs, awnings, canopies, of the premises leased or rented to you cellar entrances, coal holes, driveways, subject to the following additional manholes, marquees, hoist away exclusions: openings, sidewalk vaults, street This insurance does not apply to: banners or decorations and similar (1) Any "occurrence" which takes place exposures; or (2) The construction, erection or removal of after you cease to be a tenant in that elevators; or premises. (3) The ownership, maintenance or use of (2) Structural alterations, new construction any elevators covered by this insurance. or demolition operations performed by or on behalf of the person or However: organization. (1) The insurance afforded to such e. Lessor of Leased Equipment — Automatic additional insured only applies to the Status When Required in Lease Agreement extent permitted by law; and With You - Any person(s) or organization(s) from whom you lease equipment when you and such person(s) or organization(s) have Page 4 of 9 Includes copyrighted material of Insurance Services Office, Inc., CG 8128 01 18 with its permission. CG 81 28 01 18 (2) If coverage provided to the additional 2. Even if the requirements of Paragraph insured is required by a contract or 1. immediately above are met agreement, the insurance afforded to establishing this coverage as primary such additional insured will not be and the additional insured's coverage broader than that which you are as being non-contributory, this coverage required by the contract or agreement to will be excess over any other insurance provide for such additional insured. available to the additional insured which g. State or Political Subdivision — Any state or is conferred onto said person or organization by a separate additional political subdivision with whom; you agreed under a written contract or agreement to add insured endorsement. as an additional insured to your policy but h. Broad Form Vendors — Any person(s) or only with respect to their liability with respect organization(s) which or who is or are a to on -going operations performed by you or vendor of "your products" with whom you on your behalf for which the state or political agreed under a written contract or subdivision has issued a permit or license. agreement to add as an additional insured to This insurance does not apply to: your policy, but only with respect to "bodily injury" or "property damage" arising out of 1. "Bodily injury', property damage" or .your products" which are distributed or sold "personal and advertising injury" arising in the regular course of the vendor's out of operations performed for the state business, subject to the following additional or political subdivision; or exclusions: 2. "Bodily injury" or "property damage" The insurance afforded the vendor does not included within the "products -completed apply to: operations hazard". 1. "Bodily injury" or "property damage" for The insurance provided to such additional P which the vendor is obligated to pay insured state or political subdivision by this damages by reason of the assumption endorsement is further limited as follows: of liability in a contract or agreement. 1. The additional insured is covered only This exclusion does not apply to liability for such sums that such additional for damages that the vendor would have insured is legally obligated to pay as in the absence of the contract or damages under tort law principles to the agreement; injured party because of "bodily injury", 2. Any express warranty unauthorized by '.property damage" or "personal and you; advertising injury" to which this insurance applies, and in accordance 3. Any physical or chemical change the with the stated policy limits, exclusions, vendor intentionally made to the limitations and conditions except as product; expressly modified by this endorsement. 4. Repackaging, except when unpacked 2. The limits of insurance are those set solely for the purpose of inspection, forth in the policy Declarations or those demonstration, testing, or the specified in the written contract or substitution of parts under instructions agreement referenced above, whichever from the manufacturer, and then is less. repackaged in the original container; Other Insurance 5. Any failure to make such inspections, adjustments, tests or servicing as the 1. If specifically required by the written vendor has agreed to make or normally contract or agreement referenced undertakes to make in the usual course above, any coverage provided by this of business, in connection with the Subsection g. to an additional insured distribution or sale of the products. shall be primary and any other valid and collectible insurance available to the 6. Demonstration, installation, servicing or additional insured shall be non- repair operations, except such operations performed at the vendor's contributory with this insurance. If the written contract does not require this premises in connection with the sale of coverage to be primary and the the product; additional insured's coverage to be non- 7. Products which, after distribution or sale contributory, then this insurance will be by you, have been labeled or relabeled excess over any other valid and or used as a container, part or collectible insurance available to the ingredient of any other thing or additional insured. substance by or for the vendor; or CG 8128 01 18 Includes copyrighted material of Insurance Services Office, Inc., Page 5 of 9 with its permission. CG 8128 01 18 8. "Bodily injury" or "property damage" excess over any other valid and arising out of the negligence _ of the collectible insurance available to the vendor for its own acts or omissions or additional insured. those of its employees or anyone else 2. Even if the requirements of Paragraph acting on its behalf and which was not 1. immediately above are met caused in whole or in part by you or any establishing this coverage as primary person or organization acting on your and the additional insured's coverage behalf. However, this exclusion does not as being non-contributory, this coverage apply to: will be excess over any other insurance (a) The exceptions contained in available to the additional insured which Subparagraphs 4. or 6.; or is conferred onto said person or (b) Such inspections, adjustments, organization by a separate additional tests or servicing as the vendor insured endorsement. has agreed to make or normally I. Grantor of Franchise — Any person(s) or undertakes to make in the usual organization(s) with whom you agreed under course of business, in connection a written contract or agreement to add as an with the distribution or sale of the additional insured to your policy but only with products. respect to their liability as grantor of a The insurance provided to such additional franchise to you. insured vendor by this endorsement is The insurance provided to such additional further limited as follows: insured franchisor by this endorsement is 1. The additional insured is covered only further limited as follows: for such sums that such additional 1. The additional insured is covered only insured is legally obligated to pay as for such sums that such additional damages under tort law principles to the insured is legally obligated to pay as injured party because of "bodily injury", damages under tort law principles to the "property damage" or "personal and injured party because of "bodily injury", advertising injury" to which this "property damage" or "personal and insurance applies, and in accordance advertising injury" to which this with the stated policy limits, exclusions, insurance applies, and in accordance limitations and conditions except as with the stated policy limits, exclusions, expressly modified by this endorsement. limitations and conditions except as 2. The limits of insurance are those set expressly modified by this endorsement. forth in the policy Declarations or those 2. The limits of insurance are those set specified in the written contract or forth in the policy Declarations or those agreement referenced above in the first specified in the written contract or paragraph of this Subsection h., agreement referenced above, whichever whichever is less. is less. This insurance does not apply to any Other Insurance insured person or organization, from whom 1. If specifically required by the written you have acquired such products, or any contract or agreement referenced above ingredient, part or container, entering into, in the first paragraph of this Subsection accompanying or containing such products. i., any coverage provided by this Other Insurance endorsement to an additional insured 1. If specifically required by the written shall be primary and any other valid and contract or agreement referenced above collectible insurance available to the in the first paragraph of this Subsection additional insured shall be non- contributory with this insurance. If the h., any coverage provided by this endorsement to an additional insured written contract does not require this shall be primary and any other valid and coverage to be primary and the additional insured's coverage to be non - collectible insurance available to the contributory, then this insurance will be additional insured shall be non- contributory with this insurance. If the excess over any other valid and written contract does not require this collectible insurance available to the coverage to be primary and the additional insured. additional insured's coverage to be non- 2. Even if the requirements of Paragraph contributory, then this insurance will be 1. immediately above are met establishing this coverage as primary and the additional insured's coverage as being non-contributory, this coverage Page 6 of 9 Includes copyrighted material of Insurance Services Office, Inc., CG 8128 01 18 with its permission. CG 81 28 01 18 will be excess over any other insurance 2. The limits of insurance are those set available to the additional insured which forth in the policy and Declarations or is conferred onto said person or those specified in the written contract, organization by a separate additional lease, sublease or agreement insured endorsement. referenced in the first Paragraph of this j. As Required by Contract — Any person or Subsection j., whichever is less. organization for whom "you" are performing With respect to the insurance afforded to an operations, or to whom you are leasing, additional insured under this Subsection j., subleasing or otherwise entrusting the use the following exclusions are added: or occupancy of premises owned by or 1. This insurance does not apply if the rented to 'you", only as specified under a written contract, lease, sublease or written contract, lease, sublease or agreement referenced in the first agreement that requires that such person or Paragraph of this Subsection j. above organization be added as an additional was not executed by the "Named insured on "your" policy. Such person or Insured" prior to the "occurrence" giving organization is an additional insured only rise to the additional insured's potential with respect to liability caused, in whole or in liability. part, by the acts or omissions of the "Named Insured" or the acts the acts or omissions of 2. This insurance does not apply to the those acting on your behalf in the additional insured's liability to indemnify, performance of the "Named Insureds" defend or hold harmless a third party. ongoing operations for the additional insured 3. This insurance does not apply to "bodily or in connection with such premises owned injury", "property damage" or "personal by or rented to a "Named Insured", but in and advertising injury" for which the both instances only as specified under the additional insured is obligated to pay written contract, lease, sublease or damages by reason of the assumption agreement. A person's or organization's of liability in a contract or agreement. status as an additional insured under this This exclusion does not apply to liability endorsement ends the earlier of when 'your" for damages that the additional insured on -going operations for that additional would have in the absence of the insured are completed or when "you" no contract or agreement. longer are contractually required to include 4. "Bodily injury", "property damage" or such person or organization as an additional "personal and advertising injury" arising insured under "your" policy. out of the rendering of, or the failure to The insurance provided to an additional render, any professional architectural, insured by this endorsement is limited as engineering or, surveying services, follows: including: 1. The additional insured is covered only (a) The preparing, approving, or failing for such damages which are caused, in to prepare or approve, maps, shop whole or in part, by the acts or drawings, opinions, reports, omissions of the "Named Insured" to surveys, field orders, change orders which the additional insured is entitled or drawings and specifications; and to be indemnified by the "Named (b) Supervisory, ` inspection, archi- Insured" pursuant to the written tectural or engineering activities. contract, lease, sublease or agreement referenced in the first paragraph of this 5. "Bodily injury" or "property damage" subsection i. above and only for those occurring after: sums that the additional insured is (a) All work, including materials, parts legally obligated to pay as damages or equipment furnished in under tort law principles to the injured connection with such work, on the party because of "bodily injury", project (other than service "property damage" or "personal and maintenance or repairs) to be advertising injury" to which this performed by or on behalf of the insurance applies, and in accordance additional insured(s) at the site of with the stated policy limits and policy the covered operations has been conditions. This coverage does not completed; or apply for defense or indemnity of the (b) That portion of 'your work" out of additional insured if state or federal law which the injury or damage arises does not permit indemnification of the has been put to its intended use by additional insured by the "Named any person or organization other Insured" for the claim of the third party. than another contractor or CG 8128 01 18 Includes copyrighted material of Insurance Services Office, Inc., Page 7 of 9 with its permission. CG 81 28 01 18 subcontractor engaged in performing operations for a principal as a part of the same project. Other Insurance 1. If specifically required by the written contract, lease, sublease or agreement referenced in the first Paragraph of this Subsection j. above, any coverage provided by this endorsement to an additional insured shall be primary and any other valid and collectible insurance available to the additional insured shall be non-contributory with this insurance. If the written contract, lease or sublease does not require this coverage to be primary and the additional insured's coverage to be non-contributory, then this insurance will be excess over any other valid and collectible insurance available to the additional insured. 2. Even if the requirements of Paragraph 1. immediately above are met establishing this coverage as primary and the additional insured's coverage as being non-contributory, this coverage will be excess over other insurance available to the additional insured which is conferred onto said person or organization by a separate additional insured endorsement. Definitions Solely for purposes of the insurance afforded to an additional insured by this endorsement: "Named Insured" is defined as the entity to whom the insurance policy is issued as shown on the Declarations. "You" or "your" means a "Named Insured" as defined above. F. SECTION III — LIMITS OF INSURANCE is amended as follows: 1. Paragraph 6 is replaced with: 6. Subject to 5. above, the Damage To Premises Rented to You Limit is the most we will pay under Coverage A for damages because of "property damage" to any one premises, while rented to you or in the case of damage by fire while rented to or temporarily occupied by you with permission of the owner. The limit is increased to $1,000,000. However, if damage by fire to premises rented to you is not otherwise excluded, the word fire in the above paragraph is replaced with fire, lightning, explosion, smoke or sprinkler leakage. G. SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS is amended as follows: 1. Duties In The Event Of Occurrence, Offense, Claim Or Suit is amended as follows: a. The following is added to Paragraph a.: However, this condition only applies when the "occurrence" or offense is known to: i. You, if you are an individual; ill. A partner, if you are a partnership; or iii. An executive officer or insurance manager, if you are a corporation. b. The following is added to Paragraph b.: However, this condition will not be considered breached unless the breach occurs after such claim or "suit" is known to: i. You, if you are an individual; ii. A partner, if you are a partnership; or !if. An executive officer or insurance manager, if you are a corporation. 2. Subsection 4. Other Insurance, Paragraph b. Excess Insurance, Item (1)(a)(ii) is replaced by the following if damage to premises rented to you is not otherwise excluded: (ii) That is fire, lightning, explosion, smoke or sprinkler leakage insurance for premises rented to you or temporarily occupied by you with permission of the owner. 3. Subsection 6. Representations is amended to include: d. Your failure to disclose all hazards or prior "occurrences" or offenses existing as of the inception date of the policy shall not prejudice the coverage afforded by this policy provided such failure to disclose all hazards or prior "occurrences" or offenses is not intentional. This provision does not affect our right to collect additional premium or exercise our right of cancellation or nonrenewal. 4. Subsection 8. Transfer of Rights of Recovery Against Others to Us is amended to include: Therefore, the insured can waive the insurer's Rights of Recovery prior to the occurrence of a loss, provided the waiver is made in a written contract. 5. The following condition is added: 10. 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 revision is effective in your state, provided that this implementation date falls within 45 days prior to or during the policy period stated in the Declarations. Page 8 of 9 Includes copyrighted material of Insurance Services Office, Inc., CG 8128 01 18 with its permission. H. SECTION V — DEFINITIONS is amended as follows: 1. Paragraph 3. 'Bodily Injury" is deleted and replaced with the following: "Bodily Injury": a. Means bodily injury, sickness, or disease sustained by a person and includes mental anguish resulting from any of these; and b. Except for mental anguish, includes death resulting from the foregoing (Item a. above) at any time. 2. If damage by fire to premises rented to you is not otherwise excluded, Paragraph 9. 'Insured Contract", Item a. is replaced by the following: a. A contract for a lease of premises. However, that portion of the contract for a lease of premises that indemnifies any person or organization for damage by fire, lightning, explosion, smoke or sprinkler leakage to premises while rented to you or temporarily occupied by you with permission of the owners is not an "insured contract; 3. Paragraph 14. 'Personal and Advertising Injury" is amended as follows: a. Item b. is deleted and replaced with the following: b. Malicious prosecution or abuse of process; b. Item h. is added: h. 'Personal and advertising injury" also means injury, including consequential "bodily injury", arising out of discrimination based on race, color, religion, sex, age or national origin, except when: (1) Done intentionally by or at the direction of, or with the knowledge or consent of: (a) Any insured; or CG 8128 01 18 b. Any executive officer, director, stockholder, partner or member of the insured; or (2) Directly or indirectly related to the employment, former or prospective employment, termination of employment, demotion, failure to promote or application for employment of any person or persons by an insured; or (3) Directly or indirectly related to the sale, rental, lease or sublease or prospective sales, rental, lease or sub -lease of any room, dwelling or premises by or at the direction of any insured; or (4) Insurance for such discrimination is prohibited by or held in violation of law, public policy, legislation, court decision or administrative ruling This coverage does not apply to fines or penalties imposed because of discrimination. 4. "Client' as used in this endorsement means: a. An individual, company or organization with whom you have a written contract or work order for your services for a described premises and have billed for your services; or b. A person under your direct care and supervision for whom you are providing goods and/or services. All terms and conditions of this policy apply unless modified by this endorsement. CG 8128 01 18 Includes copyrighted material of Insurance Services Office, Inc., Page 9 of 9 with its permission. /� WORKERS COMPENSATION TRAVELER'S AND ONE TOWER SQUARE EMPLOYERS LIABILITY POLICY HARTFORD CT 06183 ENDORSEMENT WC 99 03 76 ( A) - 001 POLICY NUMBER: UB-7T831211-22-42-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 PSYCHOLOGISTS, MENTAL HEALTH COUNSELORS WHICH THE INSURED HAS AGREED AND THERAPISTS 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 Policy No. Endorsement No. Insured Premium Insurance Company Countersigned by DATE OF ISSUE: 08-12-22 STASSIGN: Page i of 1