Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
PROOF OF INSURANCE (2023 - 2023) CLOSED
HIRSC-1 DATE 12/01/2022Y) 12/01/2022 ACORO°° CERTIFICATE OF LIABILITY INSURANCE �►--"� THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements . PRODUCER 909-890-9707 Unickel & Associates Insurance Unickel & Assoc. Lic#0827703 CONTACT Desaraee Holefield NAME: PHONE 909-890-9707 FAX 909-890-9237 (A/C, No, EXt): (A/C, No): aDORIL dholefield@unickelinsurance.com P.O. Box 10727 San Bernardino, CA 92423-0727 INSURERS AFFORDING COVERAGE NAIC # INSURER A: Travelers Pro CasCoofAmerica 25674 INSURED Hirsch & Associates, Inc. 2221 E. Winston Rd. Ste A INSURER B:Aspen American Insurance Compa 43460 Travelers Pro Cas Co of Am INSURERC: p 25674 INSURER D Anaheim, CA 92806 INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL INSD SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 CLAIMS -MADE � OCCUR 680-8S798388-22-47 10/14/2022 10/14/2023 DAMAGE TO RENTED PREMISES Ea occurrence 1,000,000 $ MED EXP (Anyoneperson) $ 5,000 PERSONAL & ADV INJURY $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,000 POLICY X JJECT1:1 LOC PRODUCTS - COMP/OP AGG $ 4,000,000 $ OTHER: A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident 2,000,600 $ BODILY INJURY Perperson) $ ANY AUTO 680-8S798388-22-47 10/14/2022 10/14/2023 OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY Per accident $ X PROPERTY DAMAGE Per accident $ HIRED X NON -OWNED AUTOS ONLY AUTOS ONLY UMBRELLA LAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LAB CLAIMS -MADE DED RETENTION $ $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) N / A UB-8S799914-22�7-G 10/14/2022 10/14/2023 X PER OTH- STATUTE ER E.L. EACH ACCIDENT 1,000,000 $ E.L. DISEASE - EA EMPLOYEE $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT 1,000,000 $ B Professional AAAE300078-03 12/12/2022 12/12/2023 Ea Claim 2,000,000 Liability Aggregate 2,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Verification of Insurance CERTIFICATE HOLDER CANCELLATION CITEL-1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of El Segundo Y g THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Cheryl Ebert 350 Main Street El Segundo, CA 90245 AUTHORIZED REPRESENTATIVE 0. ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD COMMERCIAL. GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE DEAD IT CAREFULLY. This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART 1. The following is added to SECTION 11 — WHO IS AN INSURED: Any person or organization that you agree in a "written contract requiring insurance" to include as an additional insured on this Coverage Part, but: a. Only with respect to liabifty for "bodily injury", "property damage" or "personal injury"; and b. If, and only to the exteltt that, the injury or damage is caused by 5,cts or omissions of you or your subcontractcr in the performance of "your work" to which the "written contract requiring insurance" applies, or in connection with premises owned by or rented to you. The person or organization dies not qualify as an additional insured; c, With- respect to the independent acts or omissions of such person or organization; or d. For "bodily injury". "property damage" or "personal injury" for which such person or organization has assured liability in a Contract or agreement. The insurance provided to such additional insured is limited as follows: e. This insurance does not apply on any basis to any person or organization for which coverage as an additional insured specifically is added by another endorsement to this Coverage Part. f. This insurance does not apply to the rendering of or failure to render any "professional services". g. In the event that the Limits of Insurance of the Coverage Part shown in the Declarations exceed the limits of Gab1ity required by the "written contract requiring insurance", the insurance provided to the additional insured shall be limited to the limils of liability required by that "written contract iequiring insurance". This endorsement does not increase the limits of insurance described In Section IN — Urnits Of Insurance. h. This insurance does not apply to "bodily injury" or "property damage" caused by "your work" and included In the "products - completed operations hazard" unless the "written contract requiring insurance" specifically requires you to provide such coverage for that additional insured, and then the Insurance provided to the additional insured applies only to such "bodily injury" or "property damage" that occurs before the end of the period of time for which the "written contract requiring Insurance" requires you to provide such coverage or the end of the policy period, whichever is earlier. 2. The following is added to Paragraph CcL of SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS, The insurance provided to the additional insured is excess over any valid and collectible other insurance, whether primary, excess, contingent or on any other basis, that is available to the addiUonal insured for a loss we cover. However, if you specifically agree in the "written contract requiring insurance" that this insurance provided to the additional insured under this Coverage Part must apply on a primary basis or a primary and non-contributory basis, this insurance is primary to other insurance available to the additional insured which covers that person or organizations as a named insured for such loss, and we will not share with the other insurance, provided that: (1) The "bodily injury" or "property damage" for which coverage is sought occurs; and (2) The "personal injury" for which coverage is sought arises out of an offense committed; after you have signed that "written contract requiring insurance". But this insurance provided to the additional insured still is excess over valid and collectible other insurance, whether primary, excess, contingent or on any other basis, that is available to the additional insured when that person or organization is an additional insured under any other insurance, CG 03 8109 is 02015 The Travelers Indemnity Company. All rights reserved. Page 1 of 2 Includes the a py0ghled material of Insurance .Services Office, Inc„ wish Its permisaion COMMERCIAL GENERAL LIABILITY 3. The following is added to Paragraph 8., Transfer Of Rights Of Recovery Against Others To Us, of SECTION IV -- COMMERCIAL GENERAL LIABILITY CONDITIONS: We waive any right of recovery we may have against any person or organization because of payments we make for "bodily injury", "property damage" or 'personal injury" arising out of "your work" performed by you, or on your behalf, done under a "wrkten contract requiring insurance" with that person or organization. We waive this right only where you have agreed to do so as part of the "written contract requiring insurance" with such person or organization signed by you before, and in effect when, 'the "bodily injury" or "property damage" occurs, or the "personal injury" offense is committed, 4. The following definition is added to the DEFINITIONS Section: "Written contract requiring insurance" means that part of any written contract under which you are required to include a person or organization as an additional insured on this Coverage part, provided that the "bodily injury" and "property damage" occurs and the "personal injury" is caused by an offense committed: a. Ater you have signed that written contract; b. While that part of the written contract is in effect: and c. Before the end of the policy period. Page 2 of 2 192016 The Travelers laadeMnity Company. AIt d9fits rc;.erred. CG D3 8109 15 Includes the copyrdght rraeleri at of Insaa ence Sorvjrcav Otte, Inc., wilh its permission COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE RFEAD IT CAREFULLY. TEND IN O ;� ENT FOR ARCHITECTS, ENGINEERS AND S ' RVEYO S This endorsement modifies insurance provided under the following; COMMERCIAL GENERAL LIABILITY COVERAGE PART GENERAL DESCRIPTION OF COVERAGE - This endorsement broadens coverage. However, coverage for any injury, damage or medical expenses described in any d the provisions of this endorsement may be excluded or limited by another endorsement to this Coverage Part, and these coverage broadening provisions do not apply to the extent that coverage is excluded or limited by such an endorsement. The fallowing listing is a general coverage description only. Read all the provisions of this endorsement and the rest of your policy carefully to determine rights, Buries, and what is and is not covered. A. Non -Owned Watercraft - 75 Feet Long Or Less B. Who Is An Insured - Unnarried Subsidiaries C. Who is An Insured - Retired Partners, Members, Directors And Employees 0. Who Is An Insured - Employees And Volunteer Workers - Bodily Injury Ta Co -Employees, Co - Volunteer Workers And Retired Partners, Members, Directors And Employees E. Who Is An Insured - Newly Acquired Or Formed Lmmited Liability Companies F. Blanket Addhkmal insured - Controlling Interest G. Blanket Additional Insured - Mortgagees, Assignees, Successors Or Receivers PROVISIONS A. NON-OWNSD WATERCRAFT - 75 FEET LONG OR LESS 1. The following replace, Paragraph (2) of Exclusion 9., Aircraft, Auto Or Watercraft, in Paragraph 2. of SECTION I - COVERAGES - COVERAGE A - BODILY INJURY AND PRCFERTY DAMAGE LIABILITY: (2) A watercraft you do not own that is: (a) 75 feet long or Ii;ss; and (b) Not being used to carry any person or property for a charge; 2. The following replaces Paragraph 2.e. of SECTION 11- WHO IS AN INSURED: e. Any person or organization that, with your express or implied consent, Either H. Blanket. Additional Insured - Governmental Entities - Permits Or Authorizations Relating To Premises I. Blanket Additional Insured _ Governmental Entities - Permits Or Authorizations Relating To Operations J. incidental Medical Malpractice K. Medical Payments - Increased Limit L. Amendment Of Excess Insurance Condition — Professional Liability M. Blanket Waiver Of Subrogation - When Required By Written Contract Or Agreement N. Contractual Liability - Railroads uses or is responsible for the use of a watercraft that you do not own that is: (1) 75 feet long or less; and (2) Not being used to carry any person or property for a charge; B. WHO IS AN INSURED - UNNAMED SUBSIDIARIES The following is added to SECTION II -WHO IS AN INSURED: Any of your subsidiaries, other than a partnership or joint venture, that is not shown as a Named Insured in the Declarations is a Tamed Insured if; a. You are the sole owner of, or maintain an ownership interest of more than 510% in, such subsidiary on the first day of the policy period; and CG D3 79 02 19 ,9) 21317 The'rravxelers Indoinnhy corn . i 6gMs reserved. Page 1 of B Includes a3pyrighted rmleriel of InsureiFao SwAces OMW, Inca. with its permission. COMMERCIAL GENERAL LIABI-ITY b. Such subsidiary is not an insured under similar other insurance:. No such subsidiary is an insured for "bodily injury„ or "property damage" that occurred, or "personal and advertising injury" caused by an offense committed: a. Before you maintained an ownership interest of more than 50°/a in such subsidiary; or b. After the date, if any, during the policy period that you no longer maintain an ownership interest of more than 50°l. in such subsidiary. For purposes of Paragraph 1, of Section 11 -- Who Is An Insured, each such subsidiary will be deemed to be designated in the Declarations as: a. A limited liability company; b. An organization other titan a partnership, joint venture or limited liability company; or c. A trust; as indicated in its name or the documents that govern its structure. G. WHO IS AN INSURED — REARED PARTNERS, MEMBERS, DIRECTORS AND EMPLOYEES The following is added to Paragraph 2. of SECTION II— WHO IS AN INSURED: Any person who Is your retired partner, member, director or "employee" that is ;performing services for you under your direct supervision, but only for acts within the scope of their employment by you or while performing duties related to the conduct of your business, However, no such retired partner, member, director oz "employed" is an insured for: (1) "Bodily injury": (a) To you, to your anent partners or members Of you art! a partnership or joint venture), to your current members (if you are a limited liability company) or to your current directors: (b) To the spouse, child, parent, brother or sister of that current partner, member or director as a consequence of Paragraph (1)(a) above; (c) For which there is any obligation to share damages with or repay someone else who must pay damages because of the injury described in Paragraph (1)(a) or (b) above; or (d) Arising out of his or her providing or failing to provide professional health care services. Unless you are in the business or occupation of providing professional health care services, Paragraphs (1)(a), (b), (c) and (d) above do not apply to "bodily injury" arising .out of providing or failing to provide first aid or "Good Samaritan services" by any of your retired partners, members, directors or "employees", other than a doctor. Any such retired partners, members, directors or "employees" providing or failing to provide first aid or "Good Samaritan services" during their work hours for you will be deemed to be acting within the scope of their employment by you or performing duties related to the conduct of your business. (2) "Personal injury": (a) To you, to your current or retired partners or members (if you. are a partnership or joint venture), to your current or retired members (if you are a limited liability company), to your other current or retired directors or "employees" while in the course of his or her employment or performing duties related to the conduct of your business, or to your other "voE nteer workers" while performing duties related to the conduct of your business; (b) To the spouse, child, parent, brother or sister of that current or retired partner, member, director, "employee" or 'volunteer worker" as a consequence of Paragraph (2)(a) above; (c) For which t3tore is any obligation to share damages with or repay someone else who trust pay damages because of the injury described in Paragraph (2)(a) or (b) above; or (d) Arising out of his or her providing or failing to provide professional health care services. (3) °Property damage" to property: (a) Owned, occupied or used by: or (b) Rented to, in the care, custody or control of, or over which physical control is being exercised for any purpose by; you, any cf your retired partners, members or directors, your current or retired "employees" or "volunteer workers", any current partner or member (if you are a partnership or joint venture), or any current member (if you are a limited liatI tity company) or current director_ Page 2 of 6 ® 2017 The Travelers indemnity Company, All rights ttirvwdf GG D3 79 02 19 Indudes copyrighted material of insurance ervirserr Mica, Inc. with Its permission. D. WHO IS AN INSURED - EMPLOYEES AND VOLUNTEER WORKERS - BODILY INJURY TO CO -EMPLOYEES, CO -VOLUNTEER WORKERS AND RETIRED PARTNERS, MEMBERS, DIRECTORS AND EMPLOYEES The following is added to Paragraph 2.a.(1) of SECTION It - WHO IS AN I NSURED; Paragraphs (1)(a), (b) and (c) above do not apply to 'bodily injury" to a current or retired co - "employee" while in the course of the co - "employee's" employment by you or performing duties related to the conduct of your business, or to "bodily injury" to your other "volunteer workers" or retired parners, members or directors while performing duties related to the conduct of your business. E. WHO IS AN INSURED - NEWLY ACQUIRED OR FORMED LIMITED LIABILITY COMPANIES The following replaces Paragraph 3. of SECTION If - WHO IS AN INSURED: 3. Any organization you newly acquire or form, other than a partnerships or joint venture, and of which you are the side owner or in which you maintain an ownership interest of more than 50%, will qualify as a Named Insured if there is no other similar insurance available to that organization, However: a. Coverage under this provision is afforded only: (1) Until the 180th day after you acquire or form the organization or the end of the policy period, whichever is earlier, if you do not report such organization in writing to us within 180 days after you acquire or form It: or (2) Until the end •of the policy period, when that date is later than 180 days after you acquire or form such organization, if you report such organization in writing to us within 180 days after boll acquire or forum it; b. Coverage A does not apply to "bodily injury" or "propiaty damage" that occurred before yoj acquired or formed the organization; and c. Coverage 8 does not apply to "personal and advertising Injury" arising out of an offense committed before you acquired or formed the organization. For the purposes of Paragraph 1. of Section 11 -- Who Is An ensured, each such COMMERCIAL GENERAL LIABILITY organization will be deemed to be designated in the Declarations as: a. A limited liability company; b. An organization ocher than a partnership, joint venture or limited liability company, or c. A twst: as indicated in its name or the documents that govern i#s 5tructure, F. BLANKET ADDITIONAL INSURED CONTROLLING INTEREST 1. The following is added to SECTION 11 - WHO IS AN INSURED: Any person or organization that has financial control of you is an insured with respect to liability for "bodiy injury" "property damage" or "personal and advertising injury" that arises out of; a. Such financial control; or b. Such person's or organization's ownership, maintenance or use of premises leased to or occupied by you. The insurance provided to such person or organization does not apply to structural alterations, new construction or demolition operations performed by or on behalf of such person or organization. 2. The following is added to Paragraph 4. of SECTIO N 11- WHO IS AN INSURED: This paragraph does not apply to any premises owner, manager or lessor that has financial control of you. G. BLANKET ADDITIONAL INSURED - MORTGAGEES, ASSIGNEES, SUCCESSORS OR RECEIVERS The following is added to SECTION 11- WHO IS AN INSURED: Any person or organization that is a mortgagee, assignee, successor or receiver and that you have agreed in a written contract or agreement to include as an additional insured on the Coverage Part is an insured, but only with respect to its liability as mortgagee, assignee. successor or receiver for "bodily injury", ,"property damage" or "personal and advertising injury" that: a. Is "bodily injury" or "property damage" that occurs,, or is "Personal and advertising injury" caused by an offense that is committed, CG D3 79 0219 0 2017 The Travelers indemnity Company. AD rights reserved. Page 3 of b Includes �Wyrighted material of insurance Services Office. Inc, with its perrnlesion. COMMERCIAL GENERAL LIABL"ITY subsequent to the signing of that contract or agreement: and b. Arises out of the ownership, maintenance or use of the premises for which that mortgagee, assignee, successor or receiver is required under that contract or agreement to be included as an additional insured on this Coverage Part The insurance provided to such mortgagee, assignee, successor or receier is subject to the following provisions: a. The limits of insurance provided to such mortgagee, assignee, successor or receiver will be the minimum limits that you agreed to provide in the wrltten contract or agreement, or the limits shown in the Declarations, whichever are less. b. The insurance provided to such person or organization does not apfly to: (t) Any "bodily injury" or "property damage" that occurs, or a -;y "personal and advertising injury" caused by an offense that is committed, afler such contract or agreement is no longer in effect; or (2) Any "bodily injury", "property damage" or "Personal and advertising injury" arising aut of any structural alterations, new construction or demolition operations performed by or on behalf of such mortgagee, assignee, successor or receiver. H. BLANKET ADDITIONAL INSURED — GOVERNMENTAL ENTITIE'S — PERMITS OR AUTHORIZATIONS RELATING TO PREMISES The following is added to SECTION It — WHO i5 AN INSURED: Any governmental entity that'has issued a permit or authorization with respect to premises owned or occupied by, or rented or loaned to, you and that you are required by any ordinance, law, building code or written contract or agreement to include as an additional insured on this Coverage Part is an insured, but only with respect to liability for "bodi?y injury". "property damage' or "personal and advertising injury" arising out of the existence, ownership, use, maintenance, repair, construction, erection or removal of any of the following for which that governmental entity has issued such permit or authorization, advertising signs, awnings. canopies, cellar entrances, coal _holes, driveways, manholes, marquees, hoist away openings, sidewalk vaults, elevators, street banners or decorations, 1. BLANKET ADDITIONAL INSURED — GOVERNMENTAL ENTITIES — PERMITS OR AUTHORIZATIONS RELATING, TO OPERATIONS The following is added to SECTION 11— WHO IS AN INSURED: Any governmental entity that has issued a permit or authorization with respect to operations performed by you or on your behalf and that you are required by any ordinance, law, building code or written contract or agreement to include as an additional insured on this Coverage Part is an insured, but only with respect to #lability for "bodily injury" "property damage" or "personal and advertising injury" arising out of such operations. The insurance provided to such governmental entity does not apply to: a. Any "bodily injury", "property damage" or "personal and advertising injury" arising out of operations performed for the governmental entity: or b. Any "bodily injury" or "property damage" included in the "products -completed operations hazard". J. INCIDENTAL MEDICAL MALPRACTICE f. The following replaces Paragraph b. of the definition of "occurrences in the DEFINITIONS Section: b. An act or omission committed in providing or failing to provide "incidental medical services", first aid or "Good Samaritan services" to a person, unless you are in the business or occupation of providing professional health care services. 2. The following replaces the last paragraph of Paragraph 2.a.(1) of SECTION 11 — WHO IS AN INSURED: Unless you are in the business or occupation of providing professional health care services, Paragraphs (1)(a), (b), (c) and (d) above do not apply to "bodily injury" arising out of providing or failing to provide: (a) "Incidental medical services" by any of your "employees" who is a nurse, nurse assistant, emergency medical technician, paramedic, athletic trainer, audiologist dietician, nutritionist, Page 4 of 6 a 2017 The Tr®velers In de!MnNy Cornpaany, All fights neserved. CG D3 79 0219 inductee ca)yrlghred material of kuwranee Sprvknas Oftle, InC. With fts permtssion. occupational therapist or occupational therapy assistant, physical therapist or speech -language pathologist; or (b) First aid or "Good Samaritan services° by any of your "employees" or "volunteer workers", other than an employed or volunteer doctor. Any such "employees" or "volunteer workers° providing or failing to provide first aid or "Good Samaritan services" during their work hours for you will be deemed to be acting within the scope of their employment by you or performing duties related to the conduct of your business. 3. The following replaces the last sentence of Paragraph 5. of SECTION III — LIMITS OF INSURANCE: For the purposes of determining the applicable Each Occurrence Limit, all related acts or omissions committed in providing or failing to provide "incidental medical services", first aid cr "Good -Samaritan services" to any one piw-son will be deemed to be one "occurrence". 4. The fallowing exclusion is added to Paragraph 2., Exclusions, of SECTION i — COVERAGES — COWRAGIE A — BODILY INJURY AND PROPERTY DAMAGE LIABILITY: sale Of Pharmaceuticals "Bodily injury" or "property damage" arising out of the violation o! a penal statute or ordinance relating to the sale of pharmaceuticals committed by, or with the knowledge or consent cf the insured, S. The following is added to the DEFINITIONS Section: "Incidental medical ser%ices" cleans: a. Medical, surgical, dental, laboratory, x- ray or nursing service or treatment, advice or instruc,ion, or the related furnishing of food or beverages; or b. The furnishing or cispensing of drugs or medical, dental, or surgical supplies or appliances. 6. The following is added to Paragraph 4,b., Excess insurance, of SECTION IV -- COMMERCIAL GENERAL LIABILITY CONDMONS: This insurance is excess over any valid and collectible other insurance, whether primary, excess, contingent or on any other basis, COMMERCIAL GENERAL LIABILITY that is available to any of your "employees" for "bodily injury" that arises out of providing or failing to provide "incidental medical services" to any person to the extent not subject to Paragraph 2,a.(1) of Section II — Who Is An Insured. K. MEDICAL PAYMENTS -- INCREASER LIMIT The following replaces Paragraph 7. of SECTION III — LIMITS OF INSURANCE: 7. Subject to Paragraph 5. above, the Medical Expense Limit is the most we will pay under Coverage C for all medical expenses because ' of "bodily injury" sustained by any one person, and will be the higher of: a. $10,000; or b. The amount shown in the Declarations of this Coverage Part for Medical Expense Limit, L. AMENDMENT OF EXCESS INSURANCE CONDITION PROFESSIONAL LIABILITY The following is added to Paragraph 4.b., Excess insurance, of SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS; This Insurance is excess over any of the other insurance, whether primary, excess, contingent or on any other basis. that is Professional Liability or similar coverage, to the extent the loss is not subject to the professional services exclusion of Coverage A or Coverage S. M. BLANKET WAIVER OF SUBROGATION — WHHiEN REQUIRED BY WRITTEN CONTRACT OR AGREEMENT The following is added to Paragraph 8., Transfer Of Rights Of Recovery Against Others To Us, of SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS; If the insured has agreed in a written contract or agreement to waive that insured's tight of recovery against any person or organization, we waive our right of recovery against such person or organization, but only for payments we make because of: a. "Bodily injury" or "property damage" that occurs; or b. "Personal and advertising injury" caused by an offense that is committed; subsequent to the signing of that contract or agreement. CG D3 79 0219 0 2017 The -rtavefem Indemnity Qpprroatry. A 69hts reseNed. Paige 5 of S Inchides Dopyrighted prae40rINI of IftSWOW, Ser 710045 (XRcO, Ins with its permission, COMMERCIAL GENERAL LIABILITY N. CONTRACTUAL LIABILITY — RAILROADS 1. The following replaces Paragraph c. of the definition of "insured contract" in the DEFINITIONS Section: c. Any easement or license agreement, 2. Paragraph f.(1) of the definiticm of "insured contract° in the DEFlhnTIONS Section is deleted. Page 6 of 6 is 2017 The Travelers Indefinr rlty Company, AEI rights reserved. CG 03 79 0219 Includes capyifghtud owedst of Insurance SerVces Ofte, Inc. with its permission. TRAVELERS"I"WORKERS COMPENSATION AND ONE TOWER SQUARE EMPLOYERS LIABILITY POLICY HARTFORD CT 06IB3 ENDORSEMENT WC 99 03 76 ( A) - 001 POLICY NUMBER: UB-7X077550-21-47-G WAIVER OF CUR 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 ARCHITECTS WHICH THE INSURED HAS AGREED BY WRITTEN CONTRACT EXECUTED PRIOR TO LOSS TO FURNISH THIS WAIVER, This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is fequin-A 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 OP ISSUE: 05-17-21 STASSIGN: Page 1 of 1