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PROOF OF INSURANCE (2023) CLOSEDCERTIFICATE OF LIABILITY INSURANCE
DATE (MMIDDIYYYY)
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed.
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on
this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
PRODUCER Libert Mutual Insurance Co. Nat'l Ins NortheastAME
500 W3rd St, Suite 300 PHONE FAX
Wausau WI 54403 E-MAIL _ r)ml ........
-__--- - �R I lh r~A',�r�u 1
www.LibertyMutual.com
SULLY -MILLER CONTRACTING .., m
INSURED
COMPANY
135 S. State College Blvd.
Suite 400
Brea CA 92821
AFF DING COVERAGE .............m,m,__ „m,m,m,m,,,,,,,,,,..NAIC #
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INSURERA: Liberty Mutual Fire Insurance Company__ -..... mm23035m
INSUmRER a : LM Insurance Corporation ...._. 33600 m
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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.
POLICY.„ „a :....... ....._ _..,....,... ...... _.............. .�,,...,..._,i
INS'R TYPE OF INL NUMBER.. POLICY EFF POLICY E'XP
.4§i ., INSURANCE
LTR M I DIYYYY MMIDDIXYYY LIMITS
A
yr'
COMMERCIAL GENERAL LIABILITY
,�
TB2-631-510805-022
4/1/2022
4/1/2023
EACH OCCURRENCE
$2000,000
,�, . - ------
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CLAIMS-MADE ✓ OCCUR
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$ 5ll i�„QQQ...
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$ 10,000 mmm
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Includes XCU
PERSONALm& ADV INJURY
$ 2,Q0Q,000 mm mmmmmIT_m,m,m„m,,,
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LIMIT APPLIES PER:
GENERAL AGGREGATE
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PRODUCTS - COMPIOP A
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$ 2,000000
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OT9.CER:
$
A
AUTOMOBILE
LIABILITY
AS2-631-510805-012
4/1/2022
4/1/2023
cr)74I NEDSINGLEUMIT
LF0 M.:. y
$2,000000 ..............
ANY AUTO
BODILY INJURY (Per person)
__........rpe
$ YmmIT
OWNED SCHEDULED
BODILY INJURY (Per accident)
$
AUTOS ONLY AUTOS
____,,
NON-OWNED
R{?F�ET.G' DAMAGE
$
ONLY
AUTOS ONLY AUTOSgrrdu�artal,)
_( ......_
UMBRELLA LIAB OCCUR
,EACH OCCURREN
LIAB CLAIMS -MADE
...
AGGREGATE
$
ExCESS
ED. RETENTION$
$
B
WORKERS COMPENSATION
�/
WC5-631-510805-032
4/1/2022
4/1/2023
�/ ATIrITw,.__..�RHAND
LIABILITY y�
Covers all States except
...._.
IMEMB R/PARTNER/EXECUTIVE
EXCLUDED? N
A
NIA
ND, OH, WA, WY
E L, EACH ACCIDENT .
I
1 00 00000
Q
(Mandatory n NR /
OFFICE
(Mandatory in H)
E L DISEASE - EA EM YEE.
$ �. mmITIT
If yes describe under
.DESCRIPTION OF OPERATIONS below
E,L, DISEASE -POLICY LIMIT
$ 1,000,000
A
Automobile Physical Damage:
AS2-631-510805-012
4/1/2022
4/1/2023
All Medium, Heavy, Extra Heavy
and Trailer Types
Comp & Coll Deds: $1,500
All Private Passengers,
Pick Ups and Vans
Comp & Coll Deds: $500
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
RE: El Segundo Boulevard Improvement Project / Project No,: PW 23-02
*` See Addendum —
CERTIFICATE HOLDER CANCELLATION
Job10290474
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
Cityy of El Segundo THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
IUblic Works Department -Engineering Division ACCORDANCE WITH THE POLICY PROVISIONS.
350 Main Street
El Segundo CA 90245 AUTHORIZED REPRESENTATIVE
Diane Beaudoin
©1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (201 103) The ACORD name and logo are registered marks of ACORD
72595094 1 3-004090 1 4/22-4/23 - Sully Miller I Julie Nelson 1 1/20/2023 1:05:37 PM (EST) I Page 1 of 2
AGENCY CUSTOMER ID: 3-004090
................................. ----------
LOC #:
0
A6"R" ADDITIONAL REMARKS SCHEDULE Page of
AGENCY NAMED INSURED
Libe Mutual Insurance Co. Nat'l Ins Northeast SULLY -MILLER CONTRACTING COMPANY
_L!� . . . .............. . ...... - 135 S. State College Blvd.
POLICY NUMBER Suite 400
Brea CA 92821
CARRIER
NAIC CODE
EFFECTIVE DATE:
ACORD 101 (2008/01) @ 2008 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD ADDENDUM
72595094 1 3-004090 1 4/22-4/23 - Sully Miller I Julie Nelson 1 1/20/2023 1:05:37 PM (EST) I Page 2 of 2
Policy Number TB2-631-510805-022
Issued by LIBERTY MUTUAL FIRE INSURANCE COMPANY
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
BLANKET ADDITIONAL INSURED — OWNERS, LESSEES OR CONTRACTORS WITH
PRODUCTS/COMPLETED OPERATIONS COVERAGE
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
Name of Additional Insured Person(s) or
Organization(s):
City of El Segundo, its officers, officials,
employees and volunteers
Schedule
Location of Covered Operations:
El Segundo Boulevard Improvement Project
Project No.: PW 23-02
A. Section II —Who Is An Insured is amended to include as an additional insured:
1. Any person or organization where required by a "written contract" you have entered into where the contract
requires the entity to be added as an additional insured under your Policy; and
2. The particular person or organization, if any, shown in the Schedule of this endorsement at the location(s)
shown in the Schedule above.
B. The insurance provided to the additional insured is limited as follows:
1. The person or organization is an additional insured only with respect to liability for "bodily injury", "property
damage", or "personal and advertising injury" caused, in whole or in part, by:
a. Your acts or omissions, or the acts or omissions of those acting on your behalf, in the performance of
your ongoing operations specified in the "written contract"; or
b. "Your work" that is specified in the "written contract" but only for "bodily injury" or "property damage"
included in the "products -completed operations hazard", and only if:
(1) The "written contract" requires you to provide the additional insured such coverage; and
(2) This Coverage Part provides such coverage.
2. If the "written contract" specifically requires you to provide additional insurance coverage via;
a. The 10/01 edition of CG2010 (aka CG 20 10 10 01);
b. The 10/01 edition of CG2037 (aka CG 20 37 10 01); or
c. The 11/85 edition of CG2010 (aka CG 20 10 11 85),
then in Paragraph B.I. above, the words "caused, in whole or in part, by" are replaced by the words "arising
out of'.
3. We will not provide the additional insured any broader coverage or any higher limit of insurance than:
a. The maximum permitted by law;
LD 20 116 0120 © 2020 Liberty Mutual Insurance Page 1 of 3
Includes copyrighted material of Insurance Services Office, Inc., with its permission.
b. That is required by the "written contract";
c. That is described in 13.1. above; or
d. That is afforded to you under this Policy,
whichever is less.
4. Notwithstanding anything to the contrary in Condition 4. Other Insurance of Section IV — Commercial
General Liability Conditions, this insurance is excess over all other insurance available to the additional
insured, whether on a primary, excess, contingent or any other basis. But if required by the "written contract'
to be primary and non-contributory, this insurance will be primary and non-contributory relative to insurance
on which the additional insured is a Named Insured.
5. The insurance provided to the additional insured does not apply to "bodily injury", "property damage", or
"personal and advertising injury" arising out of:
a. The rendering of, or the failure to render, any professional architectural, engineering, or surveying
services, including:
(1) The preparing, approving, or failing to prepare or approve maps, shop drawings, opinions, reports,
surveys, field orders, change orders or drawings and specifications; and
(2) Supervisory, inspection,- architectural or engineering activities; or
b. Any premises or work for which the additional insured is specifically listed as an additional insured on
another endorsement attached to this Coverage Part.
C. Section IV —Commercial General Liability Conditions is amended as follows:
1. The Duties In The Event Of Occurrence, Offense, Claim Or Suit condition is amended to add the
following additional conditions applicable to the additional insured:
An additional insured under this endorsement will as soon as practicable:
(1) Give us written notice of an "occurrence" or an offense which may result in a claim or "suit" under this
insurance, and of any claim or "suit" that does result;
(2) Except as provided in Paragraph 13.4. of this endorsement, make available any other insurance the
additional insured has for a loss we cover under this Coverage Part;
(3) Send us copies of all legal papers received, and otherwise cooperate with us in the investigation,
defense, or settlement of any claim or "suit'; and
(4) Tender the defense and indemnity of any claim or "suit" to any other insurer or self insurer whose policy
or program applies to a loss we cover under this Coverage Part. But if the "written contract" requires
this insurance to be primary and non-contributory, this provision (4) does not apply to insurance on
which the additional insured is a Named Insured.
We have no duty to defend or indemnify an additional insured under this endorsement until we receive from
the additional insured written notice of a claim or "suit".
D. Only for the purpose of the insurance provided by this endorsement, Section V — Definitions is amended to
add the following definition:
"Written contract" means a written contract or written agreement that requires you to make a person or
organization an additional insured on this Coverage Part, provided the contract or agreement:
1. Is currently in effector becomes effective during the term of this Policy; and
LD 20 116 01 20 © 2020 Liberty Mutual Insurance Page 2 of 3
Includes copyrighted material of Insurance Services Office, Inc., with its permission„
2. Was executed prior to:
a. The "bodily Injury" or "property damage"; or
b. The offense that caused the "personal and advertising injury",
for which the additional insured seeks coverage under this Coverage Part.
All other terms and conditions of the Policy remain unchanged.
LID 20 116 01 20 © 2020 Liberty Mutual Insurance Page 3 of 3
Includes copyrighted material of Insurance Services Office, Inc., with its permission.
POLICY NUMBER: TB2-631-510805-022 COMMERCIAL GENERAL LIABILITY
CG 20 12 12 19
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED - STATE OR GOVERNMENTAL.
AGENCY OR SUBDIVISION OR POLITICAL
SUBDIVISION - PERMITS OR AUTHORIZATIONS
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
State Or Governmental Agency Or Subdivision Or Political Subdivision:
City of El Segundo, its officers, officials, employees and volunteers
Information required to complete this Schedule, if not shown above, will be shown in the Declarations. d
A. Section II — Who Is An Insured is amended to
include as an additional insured any state or
governmental agency or subdivision or political
subdivision shown in the Schedule, subject to the
following provisions:
1. This insurance applies only with respect to
operations performed by you or on your behalf
for which the state or governmental agency or
subdivision or political subdivision has issued a
permit or authorization.
However:
a. The insurance afforded to such additional
insured only applies to the extent permitted
by law; and
b. If coverage provided to the additional
insured is required by a contract or
agreement, the insurance afforded to such
additional insured will not be broader than
that which you are required by the contract
or agreement to provide for such additional
insured.
2. This insurance does not apply to:
a. 'Bodily injury", "property damage" or
"personal and advertising injury" arising out
of operations performed for the federal
government, state or municipality; or
b. "Bodily injury" or "property damage" included
within the "products -completed operations
hazard".
B. With respect to the insurance afforded to these
additional insureds, the following is added to
Section III — Limits Of Insurance:
If coverage provided to the additional insured is
required by a contract or agreement, the most we
will pay on behalf of the additional insured is the
amount of insurance:
1. Required by the contract or agreement; or
2. Available under the applicable limits of
insurance;
whichever is less.
This endorsement shall not increase the applicable
limits of insurance.
CG 20 12 12 19 © Insurance Services Office, Inc., 2018 Page 1 of 1
POLICY NUMBER: T132-631-510805-022
COMMERCIAL GENERAL LIABILITY
CG 20 01 12 19
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
PRIMARY AND NONCONTRIBUTORY TRI UTORY -
OTHER INSURANCE CONDITION
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
LIQUOR LIABILITY COVERAGE PART
PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART
The following is added to the Other Insurance
Condition and supersedes any provision to the
contrary:
Primary And Noncontributory Insurance
This insurance is primary to and will not seek
contribution from any other insurance available to
an additional insured under your policy provided
that:
(1) The additional insured is a Named Insured
under such other insurance; and
(2) You have agreed in writing in a contract or
agreement that this insurance would be
primary and would not seek contribution
from any other insurance available to the
additional insured.
CG 20 01 12 19 C Insurance Services Office, Inc., 2018 Page 1 of 1
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
DESIGNATED CONSTRICTION PROJECT(S)
GENERAL. AGGREGATE LI "IT
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
Designated Construction Project(s):
El Segundo Boulevard Improvement Project / Project No.: PW 23-02
Information reauired to complete this Schedule, if not shown above, will be shown in the Declarations.
A. For all sums which the insured becomes legally
3. Any payments made under Coverage A for
obligated to pay as damages caused by 'occur-
damages or under Coverage C for medical ex-
rences" under Section I — Coverage A, and for all
penses shall reduce the Designated Construc-
medical expenses caused by accidents under
tion Project General Aggregate Limit for that
Section I — Coverage C, which can be attributed
designated construction project. Such pay -
only to ongoing operations at a single designated
ments shall not reduce the General Aggregate
construction project shown in the Schedule above:
Limit shown in the Declarations nor shall they
1. A separate Designated Construction Project
reduce any other Designated Construction
General Aggregate Limit applies to each des-
Project General Aggregate Limit for any other
ignated construction project, and that limit is
designated construction project shown in the
equal to the amount of the General Aggregate
Schedule above.
Limit shown in the Declarations.
4. The limits shown in the Declarations for Each
2. The Designated Construction Project General
Occurrence, Damage To Premises Rented To
Aggregate Limit is the most we will pay for the
You and Medical Expense continue to apply.
sum of all damages under Coverage A, except
However, instead of being subject to the Gen -
damages because of "bodily injury" or "prop-
eral Aggregate Limit shown in the Declara-
erty damage" included in the "products-com-
tions, such limits will be subject to the applica-
pleted operations hazard", and for medical ex-
ble Designated Construction Project General
penses under Coverage C regardless of the
Aggregate Limit.
number of:
a. Insureds;
b. Claims made or "suits" brought; or
c. Persons or organizations making claims or
bringing "suits".
CG 26 03 06 09 0 Insurance Services Office, Inc., 2008 Page 1 of 2 13
B. For all sums which the insured becomes legally C.
obligated to pay as damages caused by "occur-
rences" under Section I — Coverage A, and for all
medical expenses caused by accidents under
Section I — Coverage C, which cannot be at-
tributed only to ongoing operations at a single des-
ignated construction project shown in the Sched-
ule above:
1. Any payments made under Coverage A for
damages or under Coverage C for medical ex- D.
penses shall reduce the amount available un-
der the General Aggregate Limit or the Prod-
ucts -completed Operations Aggregate Limit,
whichever is applicable; and
2. Such payments shall not reduce any Desig-
nated Construction Project General Aggregate
Limit.
When coverage for liability arising out of the "prod-
ucts -completed operations hazard" is provided,
any payments for damages because of "bodily in-
jury" or "property damage" included in the "prod-
ucts -completed operations hazard" will reduce the
Products -completed Operations Aggregate Limit,
and not reduce the General Aggregate Limit nor
the Designated Construction Project General Ag-
gregate Limit.
If the applicable designated construction project
has been abandoned, delayed, or abandoned and
then restarted, or if the authorized contracting par-
ties deviate from plans, blueprints, designs, spec-
ifications or timetables, the project will still be
deemed to be the same construction project.
E. The provisions of Section III — Limits Of Insurance
not otherwise modified by this endorsement shall
continue to apply as stipulated.
Page 2 of 2 0 Insurance Services Office, Inc., 2008 CG 25 03 05 09
POLICY NUMBER: T132-631-510805-022 COMMERCIAL GENERAL LIABILITY
CG 24 04 12 19
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
WAIVER OF TRANSFER OF RIGHTS OF RECOVER"
AGAINST OTHERS TO US (WAIVER OF SUBROGATION)
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
ELECTRONIC DATA LIABILITY COVERAGE PART
LIQUOR LIABILITY COVERAGE PART
POLLUTION LIABILITY COVERAGE PART DESIGNATED SITES
POLLUTION LIABILITY LIMITED COVERAGE PART DESIGNATED SITES
PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART
RAILROAD PROTECTIVE LIABILITY COVERAGE PART
UNDERGROUND STORAGE TANK POLICY DESIGNATED TANKS
SCHEDULE
Of Person(s) Or Organization(s):
El Segundo Boulevard Improvement Project / Project No.: PW 23-02
Information required to complete this Schedule, if not shown above, will be shown in the Declarations,
The following is added to Paragraph 8. Transfer Of
Rights Of Recovery Against Others To Us of
Section IV — Conditions:
We waive any right of recovery against the person(s)
or organization(s) shown in the Schedule above
because of payments we make under this Coverage
Part. Such waiver by us applies only to the extent that
the insured has waived its right of recovery against
such person(s) or organization(s) prior to loss. This
endorsement applies only to the person(s) or
organization(s) shown in the Schedule above.
CG 24 04 12 19 © Insurance Services Office, Inc., 2018 Page 1 of 1
Policy Number TB2-631-510805-022
Issued by Liberty Mutual Fire Insurance Co.
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
NOTICE OF CANCELLATION TO THIRD PARTIES
This endorsement modifies insurance provided under the following:
BUSINESS AUTO COVERAGE PART
MOTOR CARRIER COVERAGE PART
GARAGE COVERAGE PART
TRUCKERS COVERAGE PART
EXCESS AUTOMOBILE LIABILITY INDEMNITY COVERAGE PART
SELF -INSURED TRUCKER EXCESS LIABILITY COVERAGE PART
COMMERCIAL GENERAL LIABILITY COVERAGE PART
EXCESS COMMERCIAL GENERAL LIABILITY COVERAGE PART
PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART
LIQUOR LIABILITY COVERAGE PART
COMMERCIAL LIABILITY — UMBRELLA COVERAGE FORM
Schedule
............_._......._____....................................................................
Name ofOth.ePe.rs.on(s) �
/ Email Address or mailing address: Number Days Notice:
Or anization s
ity of El Segundo 350 Main Street 30
Public Works Dept. El Segundo, CA 90245
................................................................................................ _............. .......
Engineering Division
A. If we cancel this policy for any reason other than nonpayment of premium, we will notify the persons or
organizations shown in the Schedule above. We will send notice to the email or mailing address listed above
at least 10 days, or the number of days listed above, if any, before the cancellation becomes effective. In no
event does the notice to the third party exceed the notice to the first named insured.
B. This advance notification of a pending cancellation of coverage is intended as a courtesy only. Our failure to
provide such advance notification will not extend the policy cancellation date nor negate cancellation of the
policy.
All other terms and conditions of this policy remain unchanged.
LIM 99 01 0511 © 2011 Liberty Mutual Group of Companies. All rights reserved. Page 1 of 1
Includes copyrighted material of Insurance Services Office, Inc., with
its permission.
COMMERCIAL GENERAL LIABILITY
CG 00 01 0413
COMMERCIAL GENERAL LIABILITY COVERAGE FORM
Various provisions in this policy restrict coverage.
(2) The "bodily injury" or "property damage"
Read the entire policy carefully to determine rights,
occurs during the policy period; and
duties and what is and is not covered.
(3) Prior to the policy period, no insured listed
Throughout this policy the words "you" and "your"
under Paragraph 1. of Section II — Who Is
refer to the Named Insured shown in the Declarations,
An Insured and no "employee" authorized
and any other person or organization qualifying as a
by you to give or receive notice of an
Named Insured under this policy. The words "we",
"occurrence" or claim, knew that the "bodily
"us" and "our" refer to the company providing this
injury' or "property damage" had occurred,
insurance.
in whole or in part. If such a listed insured or
The word "insured" means any person or organization
authorized "employee" knew, prior to the
qualifying as such under Section II — Who Is An
policy period, that the "bodily injury' or
Insured.
"property damage" occurred, then any
continuation, change or resumption of such
Other words and phrases that appear in quotation
"bodily injury' or "property damage" during
marks have special meaning. Refer to Section V —
or after the policy period will be deemed to
Definitions.
have been known prior to the policy period.
SECTION I —COVERAGES
c. "Bodily injury' or "property damage" which
COVERAGE A— BODILY INJURY AND PROPERTY
occurs during the policy period and was not,
DAMAGE LIABILITY
prior to the policy period, known to have
1. Insuring Agreement
occurred by any insured listed under Paragraph
1. of Section II — Who Is An Insured or any
a. We will pay those sums that the insured
"employee" authorized by you to give or receive
becomes legally obligated to pay as damages
notice of an "occurrence" or claim, includes
because of "bodily injury' or "property damage"
any continuation, change or resumption of that
to which this insurance applies. We will have
"bodily injury' or "property damage" after the
the right and duty to defend the insured against
end of the policy period.
any "suit" seeking those damages. However,
we will have no duty to defend the insured
d. "Bodily injury' or "property damage" will be
against any "suit" seeking damages for "bodily
deemed to have been known to have occurred
injury" or "properly damage" to which this
at the earliest time when any insured listed
insurance does not apply. W e may, at our
under Paragraph 1. of Section II —Who Is An
��
discretion, investigate any occurrence and
Insured or any "employee" authorized by you to
settle any claim or "suit" that may result. But:
give or receive notice of an "occurrence" or
claim:
(1) The amount we will pay for damages is
limited as described in Section III — Limits Of
(1) Reports all, or any part, of the "bodily injury"
Insurance; and
or "property damage" to us or any other
(2) Our right and duty to defend ends when we
insurer;
(2) Receives a written or verbal demand or
have used up the applicable limit of
insurance in the payment of judgments or
claim for damages because of the "bodily
settlements under Coverages A or B or
injury" or "property damage"; or
medical expenses under Coverage C.
(3) Becomes aware by any other means that
No other obligation or liability to pay sums or
"bodily injury' or "property damage" has
perform acts or services is covered unless
occurred or has begun to occur.
explicitly provided for under Supplementary
e. Damages because of "bodily injury' include
Payments —Coverages A and B.
damages claimed by any person or
b. This insurance applies to "bodily injury" and
organization for care, loss of services or death
"property damage" only if:
resulting at any time from the "bodily injury'.
(1) The "bodily injury' or "property damage" is
caused by an "occurrence" that takes place
in the "coverage territory';
CG 00 01 0413 © Insurance Services Office, Inc., 2012 Page 1 of 16
2. Exclusions
This insurance does not apply to:
a. Expected Or Intended Injury
"Bodily injury" or "property damage" expected
or intended from the standpoint of the insured.
This exclusion does not apply to "bodily injury"
resulting frorn the use of reasonable force to
protect persons or property.
b. Contractual Liability
"Bodily injury' or "property damage" for which
the insured is obligated to pay damages by
reason of the assumption of liability in a
contract or agreement. This exclusion does not
apply to liability for damages:
(1) That the insured would have in the absence
of the contract or agreement; or
(2) Assumed in a contract or agreement that is
an "insured contract", provided the "bodily
injury' or "property damage" occurs
subsequent to the execution of the contract
or agreement. Solely for the purposes of
liability assumed in an "insured contract",
reasonable attorneys' fees and necessary
litigation expenses incurred by or for a party
other than an insured are deemed to be
damages because of "bodily injury' or
"property damage", provided:
(a) Liability to such party for, or for the cost
of, that party's defense has also been
assumed in the same "insured contract";
and
(b) Such attorneys' fees and litigation
expenses are for defense of that party
against a civil or alternative dispute
resolution proceeding in which damages
to which this insurance applies are
alleged.
c. Liquor Liability
"Bodily injury' or "property damage" for which
any insured may be held liable by reason of:
(1) Causing or contributing to the intoxication of
any person;
(2) The furnishing of alcoholic beverages to a
person under the legal drinking age or
under the influence of alcohol; or
This exclusion applies even if the claims
against any insured allege negligence or other
wrongdoing in:
(a) The supervision, hiring, employment,
training or monitoring of others by that
insured; or
(b) Providing or failing to provide
transportation with respect to any person
that may be under the influence of
alcohol;
if the "occurrence" which caused the "bodily
injury' or "property damage", involved that
which is described in Paragraph (1), (2) or (3)
above.
However, this exclusion applies only if you are
in the business of manufacturing, distributing,
selling, serving or furnishing alcoholic
beverages. For the purposes of this exclusion,
permitting a person to bring alcoholic
beverages on your premises, for consumption
on your premises, whether or not a fee is
charged or a license is required for such
activity, is not by itself considered the business
of selling, serving or furnishing alcoholic
beverages.
d. Workers' Compensation And Similar Laws
Any obligation of the insured under a workers'
compensation, disability benefits or
unemployment compensation law or any
similar law.
e. Employer's Liability
"Bodily injury"to:
(1) An "employee" of the insured arising out of
and in the course of:
(a) Employment by the insured; or
(b) Performing duties related to the conduct
of the insured's business; or
(2) The spouse, child, parent, brother or sister
of that "employee" as a consequence of
Paragraph (1) above.
This exclusion applies whether the insured may
be liable as an employer or in any other
capacity and to any obligation to share
damages with or repay someone else who
must pay damages because of the injury.
(3) Any statute, ordinance or regulation relating This exclusion does not apply to liability
to the sale, gift, distribution or use of assumed by the insured under an "insured
alcoholic beverages. contract".
Page 2 of 16 © Insurance Services Office, Inc., 2012 CG 00 01 0413
f. Pollution
(d) At or from any premises, site or location
(1) "Bodily injury' or "property damage" arising
on which any insured or any contractors
out of the actual, alleged or threatened
or subcontractors working directly or
discharge, dispersal, seepage, migration,
"pollutants":
indirectly on any insured's behalf are
performing operations if the "pollutants"
release or escape of
are brought on or to the premises, site
(a) At or from any premises, site or location
or location in connection with such
which is or was at any time owned or
operations by such insured, contractor
occupied by, or rented or loaned to, any
or subcontractor. However, this
insured. However, this subparagraph
subparagraph does not apply to:
does not apply to:
(i) "Bodily injury" or "property damage"
(i) "Bodilyinjury' if sustained within a
J ry
arising out of the escape of fuels,
building and caused by smoke,
lubricants or other operating fluids
fumes, vapor or soot produced by or
which are needed to perform the
originating from equipment that is
normal electrical, hydraulic or
used to heat, cool or dehumidify the
mechanical functions necessary for
building, or equipment that is used to
the operation of "mobile equipment"
heat water for personal use, by the
or its parts, if such fuels, lubricants or
building's occupants or their guests;
other operating fluids escape from a
(ii) "Bodily injury' or "property damage"
vehicle part designed to hold, store
for which you may be held liable, if
or receive them. This exception does
you are a contractor and the owner
not apply if the "bodily injury' or
or lessee of such premises, site or
"property damage" arises out of the
location has been added to your
intentional discharge, dispersal or
policy as an additional insured with
release of the fuels, lubricants or
respect to your ongoing operations
other operating fluids, or if such
performed for that additional insured
fuels, lubricants or other operating
at that premises, site or location and
fluids are brought on or to the
such premises, site or location is not
premises, site or location with the
and never was owned or occupied
intent that they be discharged,
by, or rented or loaned to, any
dispersed or released as part of the
insured, other than that additional
operations being performed by such
insured; or
insured, contractor or subcontractor;
(iii) "Bodily injury' or "property damage"
(ii) "Bodily injury' or "property damage"
arising out of heat, smoke or fumes
sustained within a building and
from a "hostile fire";
caused by the release of gases,
(b) At or from any premises, site or location
fumes or vapors from materials
brought into that building in
which is or was at any time used by or
connection with operations being
for any insured or others for the
performed by you or on your behalf
handling, storage, disposal, processing
by a contractor or subcontractor; or
or treatment of waste;
(c) Which are or were at any time
(iii) "Bodily injury" or "property damage"
arising out of heat, smoke or fumes
transported, handled, stored, treated,
from a "hostile fire".
disposed of, or processed as waste by
or for:
(e) At or from any premises, site or location
(i) Any insured; or
on which any insured or any contractors
or subcontractors working directly or
(ii) Any person or organization for whom
indirectly on any insured's behalf are
you may be legally responsible; or
performing operations if the operations
are to test for, monitor, clean up,
remove, contain, treat, detoxify or
neutralize, or in any way respond to, or
assess the effects of, "pollutants".
CG 00 01 0413 0 Insurance Services Office, Inc., 2012 Page 3 of 16
(2) Any loss, cost or expense arising out of any.
(a) Request, demand, order or statutory or
regulatory requirement that any insured
or others test for, monitor, clean up,
remove, contain, treat, detoxify or
neutralize, or in any way respond to, or
assess the effects of, "pollutants"; or
(b) Claim or suit by or on behalf of a
governmental authority for damages
because of testing for, monitoring,
cleaning up, removing, containing,
treating, detoxifying or neutralizing, or in
any way responding to, or assessing the
effects of, "pollutants".
However, this paragraph does not apply to
liability for damages because of "property
damage" that the insured would have in the
absence of such request, demand, order or
statutory or regulatory requirement, or such
claim or "suit" by or on behalf of a
governmental authority.
g. Aircraft, Auto Or Watercraft
"Bodily injury' or "property damage" arising out
of the ownership, maintenance, use or
entrustment to others of any aircraft, "auto" or
watercraft owned or operated by or rented or
loaned to any insured. Use includes operation
and "loading or unloading".
This exclusion applies even if the claims
against any insured allege negligence or other
wrongdoing in the supervision, hiring,
employment, training or monitoring of others by
that insured, if the "occurrence" which caused
the "bodily injury' or "property damage"
involved the ownership, maintenance, use or
entrustment to others of any aircraft, "auto" or
watercraft that is owned or operated by or
rented or loaned to any insured.
This exclusion does not apply to:
(1) A watercraft while ashore on premises you
own or rent;
(2) A watercraft you do not own that is:
(a) Less than 26 feet long; and
(b) Not being used to carry persons or
property for a charge;
(3) Parking an "auto" on, or on the ways next
to, premises you own or rent, provided the
"auto" is not owned by or rented or loaned
to you or the insured;
(4) Liability assumed under any "insured
contract" for the ownership, maintenance or
use of aircraft or watercraft; or
(5) "Bodily injury" or "property damage" arising
out of:
(a) The operation of machinery or
equipment that is attached to, or part of,
a land vehicle that would qualify under
the definition of "mobile equipment" if it
were not subject to a compulsory or
financial responsibility law or other
motor vehicle insurance law where it is
licensed or principally garaged; or
(b) The operation of any of the machinery
or equipment listed in Paragraph f.(2) or
f.(3) of the definition of "mobile
equipment".
h. Mobile Equipment
"Bodily injury" or "property damage" arising out
of:
(1) The transportation of "mobile equipment" by
an "auto" owned or operated by or rented or
loaned to any insured; or
(2) The use of "mobile equipment" in, or while
in practice for, or while being prepared for,
any prearranged racing, speed, demolition,
or stunting activity.
i. War
"Bodily injury" or "property damage", however
caused, arising, directly or indirectly, out of:
(1) War, including undeclared or civil war;
(2) Warlike action by a military force, including
action in hindering or defending against an
actual or expected attack, by any
government, sovereign or other authority
using military personnel or other agents; or
(3) Insurrection, rebellion, revolution, usurped
power, or action taken by governmental
authority in hindering or defending against
any of these.
j. Damage To Property
"Property damage" to:
(1) Property you own, rent, or occupy, including
any costs or expenses incurred by you, or
any other person, organization or entity, for
repair, replacement, enhancement,
restoration or maintenance of such property
for any reason, including prevention of injury
to a person or damage to another's
property;
(2) Premises you sell, give away or abandon, if
the "property damage" arises out of any part
of those premises;
(3) Property loaned to you;
Page 4 of 16 © Insurance Services Office, Inc., 2012 CG 00 01 0413
(4) Personal property in the care, custody or
control of the insured;
(5) That particular part of real property on
which you or any contractors or
subcontractors working directly or indirectly
on your behalf are performing operations, if
the "property damage" arises out of those
operations; or
(6) That particular part of any property that
must be restored, repaired or replaced
because "your work" was incorrectly
performed on it.
Paragraphs (1), (3) and (4) of this exclusion do
not apply to "property damage" (other than
damage by fire) to premises, including the
contents of such premises, rented to you for a
period of seven or fewer consecutive days. A
separate limit of insurance applies to Damage
To Premises Rented To You as described in
Section III —Limits Of Insurance.
Paragraph (2) of this exclusion does not apply if
the premises are "your work" and were never
occupied, rented or held for rental by you.
Paragraphs (3), (4), (5) and (6) of this exclusion
do not apply to liability assumed under a
sidetrack agreement.
Paragraph (6) of this exclusion does not apply
to "property damage" included in the
"products -completed operations hazard".
k. Damage To Your Product
"Property damage" to "your product" arising out
of it or any part of it.
I. Damage To Your Work
"Property damage" to "your work" arising out of
it or any part of it and included in the
"products -completed operations hazard".
This exclusion does not apply if the damaged
work or the work out of which the damage
arises was performed on your behalf by a
subcontractor.
m. Damage To Impaired Property Or Property
Not Physically Injured
"Property damage" to "impaired property' or
property that has not been physically injured,
arising out of:
(1) A defect, deficiency, inadequacy or
dangerous condition in "your product" or
"your work"; or
This exclusion does not apply to the loss of use
of other property arising out of sudden and
accidental physical injury to "your product" or
"your work" after it has been put to its intended
use.
n. Recall Of Products, Work Or Impaired
Property
Damages claimed for any loss, cost or expense
incurred by you or others for the loss of use,
withdrawal, recall, inspection, repair,
replacement, adjustment, removal or disposal
of:
(1) "Your product";
(2) "Your work'; or
(3) "Impaired property';
if such product, work, or property is withdrawn
or recalled from the market or from use by any
person or organization because of a known or
suspected defect, deficiency, inadequacy or
dangerous condition in it.
o. Personal And Advertising Injury
"Bodily injury" arising out of "personal and
advertising injury'.
p. Electronic Data
Damages arising out of the loss of, loss of use
of, damage to, corruption of, inability to access,
or inabilityto manipulate electronic data.
However, this exclusion does not apply to
liability for damages because of "bodily injury'.
As used in this exclusion, electronic data
means information, facts or programs stored as
or on, created or used on, or transmitted to or
from computer software, including systems and
applications software, hard or floppy disks,
CD-ROMs, tapes, drives, cells, data processing
devices or any other media which are used with
electronically controlled equipment.
Recording And Distribution Of Material Or
Information In Violation Of Law
"Bodily injury' or "property damage" arising
directly or indirectly out of any action or
omission that violates or is alleged to violate:
(1) The Telephone Consumer Protection Act
(TCPA), including any amendment of or
addition to such law;
(2) The CAN-SPAM Act of 2003, including any
amendment of or addition to such law;
(2) A delay or failure by you or anyone acting (3) The Fair Credit Reporting Act (FCRA), and
on your behalf to perform a contract or any amendment of or addition to such law,
agreement in accordance with its terms. including the Fair and Accurate Credit
Transactions Act (FACTA); or
CG 00 01 0413 0 Insurance Services Office, Inc., 2012 Page 5 of 16
(4) Any federal, state or local statute, ordinance
or regulation, other than the TCPA,
CAN-SPAM Act of 2003 or FCRA and their
amendments and additions, that addresses,
prohibits, or limits the printing,
dissemination, disposal, collecting,
recording, sending, transmitting,
communicating or distribution of material or
information.
Exclusions c. through n. do not apply to damage
by fire 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.
COVERAGE B — PERSONAL AND ADVERTISING
INJURY LIABILITY
1. Insuring Agreement
a. We will pay those sums that the insured
becomes legally obligated to pay as damages
because of "personal and advertising injury' to
which this insurance applies. We will have the
right and duty to defend the insured against any
"suit" seeking those damages. However, we will
have no duty to defend the insured against any
"suit" seeking damages for "personal and
advertising injury' to which this insurance does
not apply. We may, at our discretion,
investigate any offense and settle any claim or
"suit" that may result. But:
(1) The amount we will pay for damages is
limited as described in Section III — Limits Of
Insurance; and
(2) Our right and duty to defend end when we
have used up the applicable limit of
insurance in the payment of judgments or
settlements under Coverages A or B or
medical expenses under Coverage C.
No other obligation or liability to pay sums or
perform acts or services is covered unless
explicitly provided for under Supplementary
Payments —Coverages A and B.
b. This insurance applies to "personal and
advertising injury' caused by an offense arising
out of your business but only if the offense was
committed in the "coverage territory' during the
policy period.
2. Exclusions
This insurance does not apply to:
a. Knowing Violation Of Rights Of Another
"Personal and advertising injury" caused by or
at the direction of the insured with the
knowledge that the act would violate the rights
of another and would inflict "personal and
advertising injury'.
b. Material Published With Knowledge Of
Falsity
"Personal and advertising injury' arising out of
oral or written publication, in any manner, of
material, if done by or at the direction of the
insured with knowledge of its falsity.
c. Material Published Prior To Policy Period
"Personal and advertising injury" arising out of
oral or written publication, in any manner, of
material whose first publication took place
before the beginning of the policy period.
d. Criminal Acts
"Personal and advertising injury' arising out of
a criminal act committed by or at the direction
of the insured.
e. Contractual Liability
"Personal and advertising injury' for which the
insured has assumed liability in a contract or
agreement. This exclusion does not apply to
liability for damages that the insured would
have in the absence of the contract or
agreement.
f. Breach Of Contract
"Personal and advertising injury" arising out of
a breach of contract, except an implied contract
to use another's advertising idea in your
"advertisement".
g. Quality Or Performance Of Goods — Failure
To Conform To Statements
"Personal and advertising injury" arising out of
the failure of goods, products or services to
conform with any statement of quality or
performance made in your "advertisement".
h. Wrong Description Of Prices
"Personal and advertising injury" arising out of
the wrong description of the price of goods,
products or services stated in your
"advertisement".
Page 6 of 16 © Insurance Services Office, Inc., 2012 CG 00 01 0413
i. Infringement Of Copyright, Patent,
Trademark Or Trade Secret
"Personal and advertising injury' arising out of
the infringement of copyright, patent,
trademark, trade secret or other intellectual
property rights. Under this exclusion, such other
intellectual property rights do not include the
use of another's advertising idea in your
"advertisement".
However, this exclusion does not apply to
infringement, in your "advertisement", of
copyright, trade dress or slogan.
j. Insureds In Media And Internet Type
Businesses
"Personal and advertising injury" committed by
an insured whose business is:
(1) Advertising, broadcasting, publishing or
telecasting;
(2) Designing or determining content of web
sites for others; or
(3) An Internet search, access, content or
service provider.
However, this exclusion does not apply to
Paragraphs 14.a., b. and c. of "personal and
advertising injury' under the Definitions section.
For the purposes of this exclusion, the placing
of frames, borders or links, or advertising, for
you or others anywhere on the Internet, is not
by itself, considered the business of advertising,
broadcasting, publishing or telecasting.
k. Electronic Chatrooms Or Bulletin Boards
"Personal and advertising injury" arising out of
an electronic chatroom or bulletin board the
insured hosts, owns, or over which the insured
exercises control.
I. Unauthorized Use Of Another's Name Or
Product
"Personal and advertising injury" arising out of
the unauthorized use of another's name or
product in your e-mail address, domain name
or metatag, or any other similar tactics to
mislead another's potential customers.
m. Pollution
"Personal and advertising injury" arising out of
the actual, alleged or threatened discharge,
dispersal, seepage, migration, release or
escape of "pollutants" at anytime.
n. Pollution -related
Any loss, cost or expense arising out of any:
(1) Request, demand, order or statutory or
regulatory requirement that any insured or
others test for, monitor, clean up, remove,
contain, treat, detoxify or neutralize, or in
any way respond to, or assess the effects
of, "pollutants"; or
(2) Claim or suit by or on behalf of a
governmental authority for damages
because of testing for, monitoring, cleaning
up, removing, containing, treating,
detoxifying or neutralizing, or in any way
responding to, or assessing the effects of,
"pollutants".
o. War
"Personal and advertising injury', however
caused, arising, directly or indirectly, out of:
(1) War, including undeclared or civil war;
(2) Warlike action by a military force, including
action in hindering or defending against an
actual or expected attack, by any
government, sovereign or other authority
using military personnel or other agents; or
(3) Insurrection, rebellion, revolution, usurped
power, or action taken by governmental
authority in hindering or defending against
any of these.
p. Recording And Distribution Of Material Or
Information In Violation Of Law
"Personal and advertising injury' arising directly
or indirectly out of any action or omission that
Violates or is alleged to violate:
(1) The Telephone Consumer Protection Act
(TCPA), including any amendment of or
addition to such law;
(2) The CAN-SPAM Act of 2003, including any
amendment of or addition to such law,
(3) The Fair Credit Reporting Act (FCRA), and
any amendment of or addition to such law,
including the Fair and Accurate Credit
Transactions Act (FACTA); or
(4) Any federal, state or local statute, ordinance
or regulation, other than the TCPA,
CAN-SPAM Act of 2003 or FCRA and their
amendments and additions, that addresses,
prohibits, or limits the printing,
dissemination, disposal, collecting,
recording, sending, transmitting,
communicating or distribution of material or
information.
CG 00 0104 13 © Insurance Services Office, Inc., 2012 Page 7 of 16
COVERAGE C — MEDICAL PAYMENTS
1. Insuring Agreement
a. We will pay medical expenses as described
below for "bodily injury" caused by an accident:
(1) On premises you own or rent;
(2) On ways next to premises you own or rent;
or
(3) Because of your operations;
provided that:
(a) The accident takes place in the
"coverage territory" and during the policy
period;
(b) The expenses are incurred and reported
to us within one year of the date of the
accident; and
(c) The injured person submits to
examination, at our expense, by
physicians of our choice as often as we
reasonably require.
b. We will make these payments regardless of
fault. These payments will not exceed the
applicable limit of insurance. We will pay
reasonable expenses for:
(1) First aid administered at the time of an
accident;
(2) Necessary medical, surgical, X-ray and
dental services, including prosthetic
devices; and
(3) Necessary ambulance, hospital,
professional nursing and funeral services.
2. Exclusions
We will not pay expenses for "bodily injury":
a. Any Insured
To any insured, except "volunteer workers".
b. Hired Person
To a person hired to do work for or on behalf of
any insured or a tenant of any insured.
c. Injury On Normally Occupied Premises
To a person injured on that part of premises
you own or rent that the person normally
occupies.
d. Workers' Compensation And Similar Laws
To a person, whether or not an "employee" of
any insured, if benefits for the "bodily injury" are
payable or must be provided under a workers'
compensation or disability benefits law or a
similar law.
e. Athletics Activities
To a person injured while practicing, instructing
or participating in any physical exercises or
games, sports, or athletic contests.
f. Products -Completed Operations Hazard
Included within the "products -completed
operations hazard".
g. Coverage A Exclusions
Excluded under Coverage A.
SUPPLEMENTARY PAYMENTS — COVERAGES A
AND B
1. We will pay, with respect to any claim we
investigate or settle, or any "suit" against an
insured we defend:
a. All expenses we incur.
b. Up to $250 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.
c. The cost of bonds to release attachments, but
only for bond amounts within the applicable
limit of insurance. We do not have to furnish
these bonds.
d. All reasonable expenses incurred by the
insured at our request to assist us in the
investigation or defense of the claim or "suit",
including actual loss of earnings up to $250 a
day because of time off from work.
e. All court costs taxed against the insured in the
"suit". However, these payments do not include
attorneys' fees or attorneys' expenses taxed
against the insured.
f. Prejudgment interest awarded against the
insured on that part of the judgment we pay. If
we make an offer to pay the applicable limit of
insurance, we will not pay any prejudgment
interest based on that period of time after the
offer.
Page 8 of 16 © Insurance Services Office, Inc., 2012 CG 00 01 0413
g. All interest on the full amount of any judgment
that accrues after entry of the judgment and
before we have paid, offered to pay, or
deposited in court the part of the judgment that
is within the applicable limit of insurance.
These payments will not reduce the limits of
insurance.
2. If we defend an insured against a "suit" and an
indemnitee of the insured is also named as a party
to the "suit", we will defend that indemnitee if all of
the following conditions are met:
a. The "suit" against the indemnitee seeks
damages for which the insured has assumed
the liability of the indemnitee in a contract or
agreement that is an "insured contract";
b. This insurance applies to such liability assumed
by the insured;
c. The obligation to defend, or the cost of the
defense of, that indemnitee, has also been
assumed by the insured in the same "insured
contract';
d. The allegations in the "suit" and the information
we know about the "occurrence" are such that
no conflict appears to exist between the
interests of the insured and the interests of the
indemnitee;
e. The indemnitee and the insured ask us to
conduct and control the defense of that
indemnitee against such "suit" and agree that
we can assign the same counsel to defend the
insured and the indemnitee; and
f. The indemnitee:
(1) Agrees in writing to:
(a) Cooperate with us in the investigation,
settlement or defense of the "suit";
(b) Immediately send us copies of any
demands, notices, summonses or legal
papers received in connection with the
"suit";
(c) Notify any other insurer whose coverage
is available to the indemnitee; and
(d) Cooperate with us with respect to
coordinating other applicable insurance
available to the indemnitee; and
(2) Provides us with written authorization to:
(a) Obtain records and other information
related to the "suit"; and
(b) Conduct and control the defense of the
indemnitee in such "suit".
So long as the above conditions are met, attorneys'
fees incurred by us in the defense of that
indemnitee, necessary litigation expenses incurred
by us and necessary litigation expenses incurred
by the indemnitee at our request will be paid as
Supplementary Payments. Notwithstanding the
provisions of Paragraph 2.b.(2) of Section I —
Covcrage A — Bodily Injury And Property Damage
Liability, such payments will not be deemed to be
damages for "bodily injury' and "property damage"
and will not reduce the limits of insurance.
Our obligation to defend an insured's indemnitee
and to pay for attorneys' fees and necessary
litigation expenses as Supplementary Payments
ends when we have used up the applicable limit of
insurance in the payment of judgments or
settlements or the conditions set forth above, or
the terms of the agreement described in
Paragraph f. above, are no longer met.
SECTION II —WHO IS AN INSURED
1. If you are designated in the Declarations as:
a. An individual, you and your spouse are
insureds, but only with respect to the conduct of
a business of which you are the sole owner.
b. A partnership or joint venture, you are an
insured. Your members, your partners, and
their spouses are also insureds, but only with
respect to the conduct of your business.
c. A limited liability company, you are an insured.
Your members are also insureds, but only with
respect to the conduct of your business. Your
managers are insureds, but only with respect to
their duties as your managers.
d. An organization other than a partnership, joint
venture or limited liability company, you are an
insured. Your "executive officers" and directors
are insureds, but only with respect to their
duties as your officers or directors. Your
stockholders are also insureds, but only with
respect to their liability as stockholders.
e. A trust, you are an insured. Your trustees are
also insureds, but only with respect to their
duties as trustees.
CG 00 01 0413 0 Insurance Services Office, Inc., 2012 Page 9 of 16
2. Each of the following is also an insured:
a. Your "volunteer workers" only while performing
duties related to the conduct of your business,
or your "employees", other than either your
"executive officers" (if you are an organization
other than a partnership, joint venture or limited
liability company) or your managers (if you are
a limited liability company), but only for acts
within the scope of their employment by you or
while performing duties related to the conduct
of your business. However, none of these
"employees" or "volunteer workers" are
insureds for:
(1) "Bodily injury' or "personal and advertising
injury':
(a) To you, to your partners or members (if
you are a partnership or joint venture), to
your members (if you are a limited
liability company), to a co -"employee"
while in the course of his or her
employment or performing duties
related to the conduct of your business,
or to your other "volunteer workers"
while performing duties related to the
conduct of your business;
(b) To the spouse, child, parent, brother or
sister of that co -"employee" or
"volunteer worker" 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.
(2) "Property damage" to property:
(a) Owned, occupied or used by;
(b) Rented to, in the care, custody or control
of, or over which physical control is
being exercised for any purpose by;
you, any of your "employees", "volunteer
workers", any partner or member (if you are
a partnership or joint venture), or any
member (if you are a limited liability
company).
b. Any person (other than your "employee" or
"volunteer worker"), or any organization while
acting as your real estate manager.
c. Any person or organization having proper
temporary custody of your property if you die,
but only:
(1) With respect to liability arising out of the
maintenance or use of that property, and
(2) Until your legal representative has been
appointed.
d. Your legal representative if you die, but only
with respect to duties as such. That
representative will have all your rights and
duties under this Coverage Part.
3. 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 interest, 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
until the 90th day after you acquire or form the
organization or the end of the policy period,
whichever is earlier;
b. Coverage A does not apply to "bodily injury' or
"property damage" that occurred before you
acquired or formed the organization; and
c. Coverage B does not apply to "personal and
advertising injury' arising out of an offense
committed before you acquired or formed the
organization.
No person or organization is an insured with respect to
the conduct of any current or past partnership, joint
venture or limited liability company that is not shown
as a Named Insured in the Declarations.
SECTION III — LIMITS OF INSURANCE
1. The Limits of Insurance shown in the Declarations
and the rules below fix the most we will pay
regardless of the number of:
a. Insureds;
b. Claims made or "suits" brought; or
c. Persons or organizations making claims or
bringing "suits".
2. The General Aggregate Limit is the most we will
pay for the sum of:
a. Medical expenses under Coverage C;
b. Damages under Coverage A, except damages
because of "bodily injury' or "property damage"
included in the "products -completed operations
hazard"; and
c. Damages under Coverage B.
Page 10 of 16 0 Insurance Services Office, Inc., 2012 CG 00 01 0413
3. The Products -Completed Operations Aggregate
Limit is the most we will pay under Coverage A for
damages because of "bodily injury" and "property
damage" included in the "products -completed
operations hazard".
4. Subject to Paragraph 2. above, the Personal And
Advertising Injury Limit is the most we will pay
under Coverage B for the sum of all damages
because of all "personal and advertising injury"
sustained by any one person or organization.
S. Subject to Paragraph 2. or 3. above, whichever
applies, the Each Occurrence Limit is the most we
will pay for the sum of:
a. Damages under Coverage A; and
b. Medical expenses under Coverage C
because of all "bodily injury' and "property
damage" arising out of any one "occurrence".
6. Subject to Paragraph 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 you or temporarily occupied by you
with permission of the owner.
7. Subject to Paragraph S. above, the Medical
Expense Limit is the most we will pay under
Coverage C for all medical expenses because of
"bodily injury' sustained by any one person.
The Limits of Insurance of this Coverage Part apply
separately to each consecutive annual period and to
any remaining period of less than 12 months, starting
with the beginning of the policy period shown in the
Declarations, unless the policy period is extended
after issuance for an additional period of less than 12
months. In that case, the additional period will be
deemed part of the last preceding period for purposes
of determining the Limits of Insurance.
SECTION IV— COMMERCIAL GENERAL LIABILITY
CONDITIONS
1. Bankruptcy
Bankruptcy or insolvency of the insured or of the
insured's estate will not relieve us of our
obligations under this Coverage Part.
2. Duties In The Event Of Occurrence, Offense,
Claim Or Suit
a. You must see to it that we are notified as soon
as practicable of an "occurrence" or an offense
which may result in a claim. To the extent
possible, notice should include:
(1) How, when and where the "occurrence" or
offense took place;
(2) The names and addresses of any injured
persons and witnesses; and
(3) The nature and location of any injury or
damage arising out of the "occurrence" or
offense.
b. If a claim is made or "suit" is brought against
any insured, you must:
(1) Immediately record the specifics of the
claim or "suit" and the date received; and
(2) Notify us as soon as practicable.
You must see to it that we receive written notice
of the claim or "suit" as soon as practicable.
c. You and any other involved insured must:
(1) Immediately send us copies of any
demands, notices, summonses or legal
papers received in connection with the
claim or "suit";
(2) Authorize us to obtain records and other
information;
(3) Cooperate with us in the investigation or
settlement of the claim or defense against
the "suit"; and
(4) Assist us, upon our request, in the
enforcement of any right against any person
or organization which may be liable to the
insured because of injury or damage to
which this insurance may also apply.
d. No insured will, except at that insured's own
cost, voluntarily make a payment, assume any
obligation, or incur any expense, other than for
first aid, without our consent.
3. Legal Action Against Us
No person or organization has a right under this
Coverage Part:
a. To join us as a party or otherwise bring us into
a "suit" asking for damages from an insured; or
b. To sue us on this Coverage Part unless all of
its terms have been fully complied with.
A person or organization may sue us to recover on
an agreed settlement or on a final judgment
against an insured; but we will not be liable for
damages that are not payable under the terms of
this Coverage Part or that are in excess of the
applicable limit of insurance. An agreed settlement
means a settlement and release of liability signed
by us, the insured and the claimant or the
claimant's legal representative.
CG 00 01 0413 © Insurance Services Office, Inc., 2012 Page 11 of 16
4. Other Insurance
If other valid and collectible insurance is available
to the insured for a loss we cover under Coverages
A or B of this Coverage Part, our obligations are
limited as follows:
a. Primary Insurance
This insurance is primary except when
Paragraph b. below applies. If this insurance is
primary, our obligations are not affected unless
any of the other insurance is also primary.
Then, we will share with all that other insurance
by the method described in Paragraph c.
below.
b. Excess Insurance
(1) This insurance is excess over:
(a) Any of the other insurance, whether
primary, excess, contingent or on any
other basis:
(i) That is Fire, Extended Coverage,
Builder's Risk, Installation Risk or
similar coverage for "your work'
(ii) That is Fire insurance for premises
rented to you or temporarily
occupied by you with permission of
the owner;
(III) That is insurance purchased by you
to cover your liability as a tenant for
"property damage" to premises
rented to you or temporarily
occupied by you with permission of
the owner; or
(iv) If the loss arises out of the
maintenance or use of aircraft,
"autos" or watercraft to the extent not
subject to Exclusion g. of Section I —
Coverage A — Bodily Injury And
Property Damage Liability.
(b) Any other primary insurance available to
you covering liability for damages arising
out of the premises or operations, or the
products and completed operations, for
which you have been added as an
additional insured.
(2) When this insurance is excess, we will have
no duty under Coverages A or B to defend
the insured against any "suit" if any other
insurer has a duty to defend the insured
against that "suit". If no other insurer
defends, we will undertake to do so, but we
Will be entitled to the insured's rights against
all those other insurers.
(3) When this insurance is excess over other
insurance, we will pay only our share of the
amount of the loss, if any, that exceeds the
sum of:
(a) The total amount that all such other
insurance would pay for the loss in the
absence of this insurance; and
(b) The total of all deductible and
self -insured amounts under all that other
insurance.
(4) We will share the remaining loss, if any, with
any other insurance that is not described in
this Excess Insurance provision and was not
bought specifically to apply in excess of the
Limits of Insurance shown in the
Declarations of this Coverage Part.
c. Method Of Sharing
If all of the other insurance permits contribution
by equal shares, we will follow this method
also. Under this approach each insurer
contributes equal amounts until it has paid its
applicable limit of insurance or none of the loss
remains, whichever comes first.
If any of the other insurance does not permit
contribution by equal shares, we will contribute
by limits. Under this method, each insurer's
share is based on the ratio of its applicable limit
of insurance to the total applicable limits of
insurance of all insurers.
5. Premium Audit
a. We will compute all premiums for this
Coverage Part in accordance with our rules
and rates.
b. Premium shown in this Coverage Part as
advance premium is a deposit premium only. At
the close of each audit period we will compute
the earned premium for that period and send
notice to the first Named Insured. The due date
for audit and retrospective premiums is the date
shown as the due date on the bill. If the sum of
the advance and audit premiums paid for the
policy period is greater than the earned
premium, we will return the excess to the first
Named Insured.
c. The first Named Insured must keep records of
the information we need for premium
computation, and send us copies at such times
as we may request.
6. Representations
By accepting this policy, you agree:
a. The statements in the Declarations are
accurate and complete;
Page 12 of 16 © Insurance Services Office, Inc., 2012 CG 00 01 0413
b. Those statements are based upon
representations you made to us; and
c. We have issued this policy in reliance upon
your representations.
7. Separation Of Insureds
Except with respect to the Limits of Insurance, and
any rights or duties specifically assigned in this
Coverage Part to the first Named Insured, this
insurance applies:
a. As if each Named Insured were the only
Named Insured; and
b. Separately to each insured against whom claim
is made or "suit" is brought.
8. Transfer Of Rights Of Recovery Against Others
To Us
If the insured has rights to recover all or part of any
payment we have made under this Coverage Part,
those rights are transferred to us. The insured
must do nothing after loss to impair them. At our
request, the insured will bring "suit" or transfer
those rights to us and help us enforce them.
9. When We Do Not Renew
If we decide not to renew this Coverage Part, we
will mail or deliver to the first Named Insured
shown in the Declarations written notice of the
nonrenewal not less than 30 days before the
expiration date.
If notice is mailed, proof of mailing will be sufficient
proof of notice.
SECTION V — DEFINITIONS
1. "Advertisement" means a notice that is broadcast
or published to the general public or specific
market segments about your goods, products or
services for the purpose of attracting customers or
supporters. For the purposes of this definition:
a. Notices that are published include material
placed on the Internet or on similar electronic
means of communication; and
b. Regarding web sites, only that part of a web
site that is about your goods, products or
services for the purposes of attracting
customers or supporters is considered an
advertisement.
2. "Auto" means:
a. A land motor vehicle, trailer or semitrailer
designed for travel on public roads, including
any attached machinery or equipment; or
b. Any other land vehicle that is subject to a
compulsory or financial responsibility law or
other motor vehicle insurance law where it is
licensed or principally garaged.
However, "auto" does not include "mobile
equipment".
3. "Bodily injury' means bodily injury, sickness or
disease sustained by a person, including death
resulting from any of these at any time.
4. "Coverage territory' means:
a. The Unitcd Statcs of America (including its
territories and possessions), Puerto Rico and
Canada;
b. International waters or airspace, but only if the
injury or damage occurs in the course of travel
or transportation between any places included
in Paragraph a. above; or
c. All other parts of the world if the injury or
damage arises out of:
(1) Goods or products made or sold by you in
the territory described in Paragraph a.
above;
(2) The activities of a person whose home is in
the territory described in Paragraph a.
above, but is away for a short time on your
business; or
(3) "Personal and advertising injury' offenses
that take place through the Internet or
similar electronic means of communication;
provided the insured's responsibility to pay
damages is determined in a "suit" on the merits, in
the territory described in Paragraph a. above or in
a settlement we agree to.
S. "Employee" includes a "leased worker".
"Employee" does not include a "temporary
worker".
6. "Executive officer" means a person holding any of
the officer positions created by your charter,
constitution, bylaws or any other similar governing
document.
7. "Hostile fire" means one which becomes
uncontrollable or breaks out from where it was
intended to be.
8. "Impaired property' means tangible property, other
than "your product" or "your work", that cannot be
used or is less useful because:
a. It incorporates "your product" or "your work"
that is known or thought to be defective,
deficient, inadequate or dangerous; or
b. You have failed to fulfill the terms of a contract
or agreement;
if such property can be restored to use by the
repair, replacement, adjustment or removal of
"your product" or "your work" or your fulfilling the
terms of the contract or agreement.
CG 00 01 0413 0 Insurance Services Office, Inc., 2012 Page 13 of 16
9."Insured contract" means:
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 to premises
while rented to you or temporarily occupied by
you with permission of the owner is not an
"insured contract";
b. A sidetrack agreement;
c. Any easement or license agreement, except in
connection with construction or demolition
operations on or within 50 feet of a railroad;
d. An obligation, as required by ordinance, to
indemnify a municipality, except in connection
with work for a municipality;
e. An elevator maintenance agreement;
f. That part of any other contract or agreement
pertaining to your business (including an
indemnification of a municipality in connection
with work performed for a municipality) under
which you assume the tort liability of another
party to pay for "bodily injury" or "property
damage" to a third person or organization. Tort
liability means a liability that would be imposed
by law in the absence of any contract or
agreement.
Paragraph f. does not include that part of any
contract or agreement:
(1) That indemnifies a railroad for "bodily injury'
or "property damage" arising out of
construction or demolition operations, within
50 feet of any railroad property and
affecting any railroad bridge or trestle,
tracks, road -beds, tunnel, underpass or
crossing;
(2) That indemnifies an architect, engineer or
surveyor for injury or damage arising out of:
(a) Preparing, approving, or failing to
prepare or approve, maps, shop
drawings, opinions, reports, surveys,
field orders, change orders or drawings
and specifications; or
(b) Giving directions or instructions, or
failing to give them, if that is the primary
cause of the injury or damage; or
(3) Under which the insured, if an architect,
engineer or surveyor, assumes liability for
an injury or damage arising out of the
insured's rendering or failure to render
professional services, including those listed
in (2) above and supervisory, inspection,
architectural or engineering activities.
10."Leased worker" means a person leased to you by
a labor leasing firm under an agreement between
you and the labor leasing firm, to perform duties
related to the conduct of your business. "Leased
worker" does not include a "temporary worker".
11."Loading or unloading" means the handling of
property:
a. After it is moved from the place where it is
accepted for movement into or onto an aircraft,
watercraft or "auto";
b. While it is in or on an aircraft, watercraft or
"auto"; or
c. While it is being moved from an aircraft,
watercraft or "auto" to the place where it is
finally delivered;
but "loading or unloading" does not include the
movement of property by means of a mechanical
device, other than a hand truck, that is not
attached to the aircraft, watercraft or "auto".
12."Mobile equipment" means any of the following
types of land vehicles, including any attached
machinery or equipment:
a. Bulldozers, farm machinery, forklifts and other
vehicles designed for use principally off public
roads;
b. Vehicles maintained for use solely on or next to
premises you own or rent;
c. Vehicles that travel on crawler treads;
d. Vehicles, whether self-propelled or not,
maintained primarily to provide mobility to
permanently mounted:
(1) Power cranes, shovels, loaders, diggers or
drills; or
(2) Road construction or resurfacing equipment
such as graders, scrapers or rollers;
e. Vehicles not described in Paragraph a., b., c.
or d. above that are not self-propelled and are
maintained primarily to provide mobility to
permanently attached equipment of the
following types:
(1) Air compressors, pumps and generators,
including spraying, welding, building
cleaning, geophysical exploration, lighting
and well servicing equipment; or
(2) Cherry pickers and similar devices used to
raise or lower workers;
f. Vehicles not described in Paragraph a., b., c.
or d, above maintained primarily for purposes
other than the transportation of persons or
cargo.
Page 14 of 16 © Insurance Services Office, Inc., 2012 CG 00 01 0413
However, self-propelled vehicles with the
following types of permanently attached
equipment are not "mobile equipment" but will
be considered "autos":
(1) Equipment designed primarily for:
(a) Snow removal;
(b) Road maintenance, but not construction
or resurfacing; or
(c) Street cleaning;
(2) Cherry pickers and similar devices mounted
on automobile or truck chassis and used to
raise or lower workers; and
(3) Air compressors, pumps and generators,
including spraying, welding, building
cleaning, geophysical exploration, lighting
and well servicing equipment.
However, "mobile equipment" does not include any
land vehicles that are subject to a compulsory or
financial responsibility law or other motor vehicle
insurance law where it is licensed or principally
garaged. Land vehicles subject to a compulsory or
financial responsibility law or other motor vehicle
insurance law are considered "autos".
13."Occurrence" means an accident, including
continuous or repeated exposure to substantially
the same general harmful conditions.
14."Personal and advertising injury' means injury,
including consequential "bodily injury', arising out
of one or more of the following offenses:
a. False arrest, detention or imprisonment;
b. Malicious prosecution;
c. The wrongful eviction from, wrongful entry into,
or invasion of the right of private occupancy of
a room, dwelling or premises that a person
occupies, committed by or on behalf of its
owner, landlord or lessor;
d. Oral or written publication, in any manner, of
material that slanders or libels a person or
organization or disparages a person's or
organization's goods, products or services;
e. Oral or written publication, in any manner, of
material that violates a person's right of privacy;
f. The use of another's advertising idea in your
"advertisement'; or
g. Infringing upon another's copyright, trade dress
or slogan in your "advertisement".
15."Pollutants" mean any solid, liquid, gaseous or
thermal irritant or contaminant, including smoke,
vapor, soot, fumes, acids, alkalis, chemicals and
waste. Waste includes materials to be recycled,
reconditioned or reclaimed.
16."Products-completed operations hazard":
a. Includes all "bodily injury' and "property
damage" occurring away from premises you
own or rent and arising out of "your product" or
"your work" except:
(1) Products that are still in your physical
possession; or
(2) Work that has not yet been completed or
abandoned. However, "your work" will be
deemed completed at the earliest of the
following times:
(a) When all of the work called for in your
contract has been completed.
(b) When all of the work to be done at the
job site has been completed if your
contract calls for work at more than one
job site.
(c) When that part of the work done at a job
site has been put to its intended use by
any person or organization other than
another contractor or subcontractor
working on the same project.
Work that may need service, maintenance,
correction, repair or replacement, but which
is otherwise complete, will be treated as
completed.
b. Does not include "bodily injury' or "property
damage" arising out of:
(1) The transportation of property, unless the
injury or damage arises out of a condition in
or on a vehicle not owned or operated by
you, and that condition was created by the
"loading or unloading" of that vehicle by any
insured;
(2) The existence of tools, uninstalled
equipment or abandoned or unused
materials; or
(3) Products or operations for which the
classification, listed in the Declarations or in
a policy Schedule, states that
products -completed operations are subject
to the General Aggregate Limit.
17."Property damage" means:
a. Physical injury to tangible property, including all
resulting loss of use of that property. All such
loss of use shall be deemed to occur at the
time of the physical injury that caused it; or
b. Loss of use of tangible property that is not
physically injured. All such loss of use shall be
deemed to occur at the time of the
"occurrence" that caused it.
For the purposes of this insurance, electronic data
is not tangible property.
CG 00 01 0413 © Insurance Services Office, Inc., 2012 Page 15 of 16
As used in this definition, electronic data means
information, facts or programs stored as or on,
created or used on, or transmitted to or from
computer software, including systems and
applications software, hard or floppy disks,
CD-ROMs, tapes, drives, cells, data processing
devices or any other media which are used with
electronically controlled equipment.
18."Suit" means a civil proceeding in which damages
because of "bodily injury", "property damage" or
"personal and advertising injury' to which this
insurance applies are alleged. "Suit" includes:
a. An arbitration proceeding in which such
damages are claimed and to which the insured
must submit or does submit with our consent;
or
b. Any other alternative dispute resolution
proceeding in which such damages are
claimed and to which the insured submits with
our consent.
19."Temporary worker" means a person who is
furnished to you to substitute for a permanent
"employee" on leave or to meet seasonal or
short-term workload conditions.
20."Volunteer worker" means a person who is not
your "employee", and who donates his or her work
and acts at the direction of and within the scope of
duties determined by you, and is not paid a fee,
salary or other compensation by you or anyone
else for their work performed for you.
21."Your product":
a. Means:
(1) Any goods or products, other than real
property, manufactured, sold, handled,
distributed or disposed of by:
(a) You;
(b) Others trading under your name; or
(c) A person or organization whose
business or assets you have acquired;
and
(2) Containers (other than vehicles), materials,
parts or equipment furnished in connection
with such goods or products.
b. Includes:
(1) Warranties or representations made at any
time with respect to the fitness, quality,
durability, performance or use of "your
product"; and
(2) The providing of or failure to provide
warnings or instructions,
c. Does not include vending machines or other
property rented to or located for the use of
others but not sold.
22."Your work":
a. Means:
(1) Work or operations performed by you or
on your behalf; and
(2) Materials, parts or equipment furnished in
connection with such work or operations.
b. Includes:
(1) Warranties or representations made at any
time with respect to the fitness, quality,
durability, performance or use of "your
work"; and
(2) The providing of or failure to provide
warnings or instructions.
Page 16 of 16 0 Insurance Services Office, Inc., 2012 CG 00 01 0413
POLICY NUMBER: AS2-631-510805-012
COMMERCIAL AUTO
CA20481013
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
DESIGNATED INSURED FOR
COVERED AUTOS LIABILITY COVERAGE
This endorsement modifies insurance provided under the following:
AUTO DEALERS COVERAGE FORM
BUSINESS AUTO COVERAGE FORM
MOTOR CARRIER COVERAGE FORM
With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified
by this endorsement.
This endorsement identifies person(s) or organization(s) who are "insureds" for Covered Autos Liability Coverage
under the Who Is An Insured provision of the Coverage Form. This endorsement does not alter coverage provided
in the Coverage Form.
SCHEDULE
Name Of Person(s) Or Organization(s):
City of El Segundo, its officers, officials, employees and volunteers
Information required to complete this Schedule, if not shown above, will be shown in the Declarations.
Each person or organization shown in the Schedule is
an "insured" for Covered Autos Liability Coverage, but
only to the extent that person or organization qualifies
as an "insured" under the Who Is An Insured provision
contained in Paragraph A.1. of Section II — Covered
Autos Liability Coverage in the Business Auto and
Motor Carrier Coverage Forms and Paragraph D.2. of
Section I — Covered Autos Coverages of the Auto
Dealers Coverage Form.
CA 20 48 10 13 © Insurance Services Office, Inc., 2011 Page 1 of 1
Policy Number: AS2-631-510805-012
Issued by: Liberty Mutual Fire Insurance Co.
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
DESIGNATED INSURED - NONCONTRIBUTING
This endorsement modifies insurance provided under the following:
BUSINESS AUTO COVERAGE FORM
GARAGE COVERAGE FORM
MOTOR CARRIERS COVERGE FORM
TRUCKERS COVERAGE FORM
With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified
by this endorsement.
This endorsement identifies person(s) or organization(s) who are "insureds" under the Who Is An Insured Provision
of the Coverage Form. This endorsement does not alter coverage provided in the Coverage form.
Schedule
Name of Person(s) or Organizations(s):
The City of El Segundo, its elected officials, officers, employees and volunteers
Regarding Designated Contract or Project:
All Operations of the named insured performed under written contract or agreement
Each person or organization shown in the Schedule of this endorsement is an "insured" for Liability Coverage, but
only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured Provision
contained in Section 11 of the Coverage Form.
The following is added to the Other Insurance Condition:
If you have agreed in a written agreement that this policy will be primary and without right of contribution
from any insurance in force for an Additional Insured for liability arising out of your operations, and the
agreement was executed priorto the "bodily injury" or "property damage", then this insurance will be primary
and we will not seek contribution from such insurance.
AC 84 23 08 11 © 2010, Liberty Mutual Group of Companies. All rights reserved. Page 1 of 1
Includes copyrighted material of Insurance Services Office, Inc. with its
permission.
POLICY NUMBER: AS2-631-510805-012 COMMERCIAL AUTO
CA 04 44 10 13
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
WAIVER OF TRANSFER OF RIGHTS OF RECOVERY
AGAINST OTHERS TO US (WAIVER OF SUBROGATION)
This endorsement modifies insurance provided under the following. -
AUTO DEALERS COVERAGE FORM
BUSINESS AUTO COVERAGE FORM
MOTOR CARRIER COVERAGE FORM
With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified
by the endorsement.
SCHEDULE
Name(s) Of Person(s) Or Organization(s):
City of El Segundo, its officers, officials, employees and volunteers
I Information required to complete this Schedule, if not shown above, will be shown in the Declarations.
The Transfer Of Rights Of Recovery Against Others
To Us condition does not apply to the person(s) or
organization(s) shown in the Schedule, but only to the
extent that subrogation is waived prior to the "accident"
or the "loss" under a contract with that person or
organization.
CA 04 44 10 13 © Insurance Services Office, Inc., 2011 Page 1 of 1
Policy Number AS2-631-510805-012
Issued by Liberty Mutual Fire Insurance Co.
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
NOTICE OF CANCELLATION TO THIRD PARTIES
This endorsement modifies insurance provided wider the fulluwing.
BUSINESS AUTO COVERAGE PART
MOTOR CARRIER COVERAGE PART
GARAGE COVERAGE PART
TRUCKERS COVERAGE PART
EXCESS AUTOMOBILE LIABILITY INDEMNITY COVERAGE PART
SELF -INSURED TRUCKER EXCESS LIABILITY COVERAGE PART
COMMERCIAL GENERAL LIABILITY COVERAGE PART
EXCESS COMMERCIAL GENERAL LIABILITY COVERAGE PART
PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART
LIQUOR LIABILITY COVERAGE PART
COMMERCIAL LIABILITY - UMBRELLA COVERAGE FORM
Schedule
__-m..... ..........
.....
......_-
Name of Other Persons) / Eail Address or mailing ad.d.res.s: _ Number Days Notice:
Orcganization(s): _.uu.............. .......... ...........
_.........
City of El Segundo 350 Main Street 30
Public Works Dept. — EngineerinmDiv. _ El Segundo. CA 90245
.................................. — ..........................._........ —
A. If we cancel this policy for any reason other than nonpayment of premium, we will notify the persons or
organizations shown in the Schedule above. We will send notice to the email or mailing address listed above
at least 10 days, or the number of days listed above, if any, before the cancellation becomes effective. In no
event does the notice to the third party exceed the notice to the first named insured.
B. This advance notification of a pending cancellation of coverage is intended as a courtesy only. Our failure to
provide such advance notification will not extend the policy cancellation date nor negate cancellation of the
policy.
All other terms and conditions of this policy remain unchanged.
LIM 99 01 0511 © 2011 Liberty Mutual Group of Companies. All rights reserved. Page 1 of 1
Includes copyrighted material of Insurance Services Office, Inc., with
its permission.
COMMERCIAL AUTO
CA 00 01 1013
(BUSINESS AUTO COVERAGE FORM
Various provisions in this policy restrict coverage.
Read the entire policy carefully to determine rirohts,
duties and what is and is not covered.
Throughout this policy the words "you" and "your"
refer to the Named Insured shown in the Declarations.
The words "we", "us" and "our" refer to the company
providing this insurance.
Other words and phrases that appear in quotation
marks have special meaning. Refer to Section V —
Definitions.
SECTION I — COVERED AUTOS
Item Two of the Declarations shows the "autos" that
are covered "autos" for each of your coverages. The
following numerical symbols describe the "autos" that
may be covered "autos". The symbols entered next to
a coverage on the Declarations designate the only
"autos" that are covered "autos".
A. Description Of Covered Auto Designation
Symbols
Symbol'i
............ ...... _ ........
Description Of Covered Auto Designation Symbols
1
Any "Auto" ���re
2
ut s ._._
Owned "Autos" Only those..
"autos" you own (and for Covered Autos Liability Coverage any "trailers'
Only you don't own while attached to power units you own). This includes those "autos'
you acquire ownership of after the policy begins.
....................
3
—................................................... �......_.
Owned Private Only the private passenger "autos" you own. This includes those private
Passenger passenger "autos" you acquire ownership of after the policy begins.
"Autos" Only _ _.........._ .......... _._.
4
_...........
Owned Only those "autos" you own that are not of the private passenger type (and for
"Autos" Other Covered Autos Liability Coverage any "trailers" you don't own while attached t
Than Private power units you own). This includes those "autos" not of the private passenger typE
Passenger you acquire ownership of after the policy begins.
"Autos" Only
µrequired
5
Owned "Autos' Only those "autos" you own that are to have no-fault benefits in the state
Subject To where they are licensed or principally garaged. This includes those "autos" you
No-fault acquire ownership of after the policy begins provided they are required to have
no-fault benefits in the state where they are licensed or principally garaged.
_....�
6
.................................... ........... .........
Owned "Autos" Only those "autos" you own that because of the law in the state where they are
Subject To A licensed or principally garaged are required to have and cannot reject Uninsured
Compulsory Motorists Coverage. This includes those "autos" you acquire ownership of after the
Uninsured policy begins provided they are subject to the same state uninsured motorists
Motorists Law requirement.
_ww�._u_......_..................................... ._.....�.__.. ....
7
Specifically Onlym�
those autos' described in Item Three of the Declarations for which a
Described premium charge is shown (and for Covered Autos Liability Coverage any "trailers'
"Autos" you don't own while attached to any power unit described in Item Three).
8
............................
Hired "Autos" Only those "autos" you lease, hire, rent or borrow. This does not include any "auto"
Only you lease, hire, rent or borrow from any of your "employees", partners (if you are
partnership), members (if you are a limited liability company) or members of their
households.
9
........... ................................. ..... ._.............
Non -owned Only those "autos" you do not own, lease, hire, rent or borrow that are used in
"Autos" Only connection with your business. This includes "autos" owned by your "employees",
partners (if you are a partnership), members (if you are a limited liability company
or members of their households but only while used in your business or your
personal affairs.
CA 00 01 10 13 © Insurance Services Office, Inc., 2011 Page 1 of 12
19
Mobile Only those "autos" that are land vehicles and that would qualify under the definit
Equipment of "mobile equipment" under this policy if they were not subject to a compulsory
Subject To financial responsibility law or other motor vehicle insurance law where they E
Compulsory Or licensed or principally garaged.
Financial
Responsibility
Or Other Motor
Vehicle
Insurance Law
Only
B. Owned Autos You Acquire After The Policy
Begins
1. If Symbols 1, 2, 3, 4, 5,6 or 19 are entered next
to a coverage in Item Two of the Declarations,
then you have coverage for "autos" that you
acquire of the type described for the remainder
of the policy period.
2. But, if Symbol 7 is entered nextto a coverage in
Item Two of the Declarations, an "auto" you
acquire will be a covered "auto" for that
coverage only if:
a. We already cover all "autos" that you own
for that coverage or it replaces an "auto"
you previously owned that had that
coverage; and
b. You tell us within 30 days after you acquire it
that you want us to cover it for that
coverage.
C. Certain Trailers, Mobile Equipment And
Temporary Substitute Autos
If Covered Autos Liability Coverage is provided by
this Coverage Form, the following types of vehicles
are also covered "autos" for Covered Autos
Liability Coverage:
1. "Trailers" with a load capacity of 2,000 pounds
or less designed primarily for travel on public
roads.
2. "Mobile equipment" while being carried or
towed by a covered "auto".
3. Any "auto" you do not own while used with the
permission of its owner as a temporary
substitute for a covered "auto" you own that is
out of service because of its:
a. Breakdown;
b. Repair;
c. Servicing;
d. "Loss"; or
e. Destruction.
SECTION II - COVERED AUTOS LIABILITY
COVERAGE
A. Coverage
We will pay all sums an "insured" legally must pay
as damages because of "bodily injury" or "property
damage" to which this insurance applies, caused
by an "accident" and resulting from the ownership,
maintenance or use of a covered "auto".
We will also pay all sums an "insured" legally must
pay as a "covered pollution cost or expense" to
which this insurance applies, caused by an
"accident" and resulting from the ownership,
maintenance or use of covered "autos". However,
we will only pay for the "covered pollution cost or
expense" if there is either "bodily injury" or
"property damage" to which this insurance applies
that is caused by the same "accident".
We have the right and duty to defend any "insured"
against a "suit" asking for such damages or a
"covered pollution cost or expense". However, we
have no duty to defend any "insured" against a
"suit" seeking damages for "bodily injury" or
"property damage" or a "covered pollution cost or
expense" to which this insurance does not apply.
We may investigate and settle any claim or "suit"
as we consider appropriate. Our duty to defend or
settle ends when the Covered Autos Liability
Coverage Limit of Insurance has been exhausted
by payment of judgments or settlements.
1. Who Is An Insured
The following are "insureds":
a. You for any covered "auto".
b. Anyone else while using with your
permission a covered "auto" you own, hire
or borrow except:
(1) The owner or anyone else from whom
you hire or borrow a covered "auto".
This exception does not apply if the
covered "auto" is a "trailer" connected to
a covered "auto" you own.
Page 2 of 12 0 Insurance Services Office, Inc., 2011 CA 00 01 10 13
(2)Your "employee" if the covered "auto" is
owned by that "employee" or a member
of his or her household.
(3) Someone using a covered "auto" while
he or she is working in a business of
selling, servicing, repairing, parking or
storing "autos" unless that business is
yours.
(4)Anyone other than your "employees",
partners (if you are a partnership),
members (if you are a limited liability
company) or a lessee or borrower or any
of their "employees", while moving
property to or from a covered "auto".
(5)A partner (if you are a partnership) or a
member (if you are a limited liability
company) for a covered "auto" owned by
him or her or a member of his or her
household.
c. Anyone liable for the conduct of an
"insured" described above but only to the
extent of that liability.
2. Coverage Extensions
a. Supplementary Payments
We will pay for the "insured":
(1)AII expenses we incur.
(2) Up to $2,000 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.
(3)The cost of bonds to release
attachments in any "suit" against the
"insured" we defend, but only for bond
amounts within our Limit of Insurance.
(4)All reasonable expenses incurred by the
"insured" at our request, including actual
loss of earnings up to $250 a day
because of time off from work.
(5)AII court costs taxed against the
"insured" in any "suit" against the
"insured" we defend. However, these
payments do not include attorneys' fees
or attorneys' expenses taxed against the
"insured".
(6)AII interest on the full amount of any
judgment that accrues after entry of the
judgment in any "suit" against the
"insured" we defend, but our duty to pay
interest ends when we have paid, offered
to pay or deposited in court the part of
the judgment that is within our Limit of
Insurance.
These payments will not reduce the Limit of
Insurance.
b. Out-of-state Coverage Extensions
While a covered "auto" is away from the
state where it is licensed, we will:
(1)Increase the Limit of Insurance for
Covcrcd Autos Liability Coverage to
meet the limits specified by a compulsory
or financial responsibility law of the
jurisdiction where the covered "auto" is
being used. This extension does not
apply to the limit or limits specified by
any law governing motor carriers of
passengers or property.
(2) Provide the minimum amounts and types
of other coverages, such as no-fault,
required of out-of-state vehicles by the
jurisdiction where the covered "auto" is
being used.
We will not pay anyone more than once for
the same elements of loss because of these
extensions.
B. Exclusions
This insurance does not apply to any of the
following:
1. Expected Or Intended Injury
"Bodily injury" or "property damage" expected
or intended from the standpoint of the
"insured".
2. Contractual
Liability assumed under any contract or
agreement.
But this exclusion does not apply to liability for
damages:
a. Assumed in a contract or agreement that is
an "insured contract", provided the "bodily
injury" or "property damage" occurs
subsequent to the execution of the contract
or agreement; or
b. That the "insured" would have in the
absence of the contract or agreement.
3. Workers' Compensation
Any obligation for which the "insured" or the
"insured's" insurer may be held liable under any
workers' compensation, disability benefits or
unemployment compensation law or any
similar law.
CA 00 01 10 13 © Insurance Services Office, Inc., 2011 Page 3 of 12
4. Employee Indemnification And Employer's
Liability
"Bodily injury" to:
a. An "employee" of the "insured" arising out of
and in the course of:
(1) Employment by the "insured"; or
(2) Performing the duties related to the
conduct of the "insured's" business; or
b. The spouse, child, parent, brother or sister
of that "employee" as a consequence of
Paragraph a. above.
This exclusion applies:
(1) Whether the "insured" may be liable as
an employer or in any other capacity;
and
(2) To any obligation to share damages with
or repay someone else who must pay
damages because of the injury.
But this exclusion does not apply to "bodily
injury" to domestic "employees" not entitled to
workers' compensation benefits or to liability
assumed by the "insured" under an "insured
contract". For the purposes of the Coverage
Form, a domestic "employee" is a person
engaged in household or domestic work
performed principally in connection with a
residence premises.
5. Fellow Employee
"Bodily injury" to:
a. Any fellow "employee" of the "insured"
arising out of and in the course of the fellow
"employee's" employment or while
performing duties related to the conduct of
your business; or
b. The spouse, child, parent, brother or sister
of that fellow "employee" as a consequence
of Paragraph a. above.
6. Care, Custody Or Control
"Property damage" to or "covered pollution cost
or expense" involving property owned or
transported by the "insured" or in the "insured's"
care, custody or control. But this exclusion does
not apply to liability assumed under a sidetrack
agreement.
7. Handling Of Property
"Bodily injury" or "property damage" resulting
from the handling of property:
a. Before it is moved from the place where it is
accepted by the "insured" for movement into
or onto the covered "auto"; or
b. After it is moved from the covered "auto" to
the place where it is finally delivered by the
"insured".
8. Movement Of Property By Mechanical
Device
"Bodily injury" or "property damage" resulting
from the movement of property by a
mechanical device (other than a hand truck)
unless the device is attached to the covered
"auto".
9. Operations
"Bodily injury" or "property damage" arising out
of the operation of:
a. Any equipment listed in Paragraphs 6.b. and
6.c. of the definition of "mobile equipment";
or
b. Machinery or equipment that is on, attached
to or part of a land vehicle that would qualify
under the definition of "mobile equipment" if
it were not subject to a compulsory or
financial responsibility law or other motor
vehicle insurance law where it is licensed or
principally garaged.
10. Completed Operations
"Bodily injury" or "property damage" arising out
of your work after that work has been
completed or abandoned.
In this exclusion, your work means:
a. Work or operations performed by you or on
your behalf; and
b. Materials, parts or equipment furnished in
connection with such work or operations.
Your work includes warranties or
representations made at any time with respect
to the fitness, quality, durability or performance
of any of the items included in Paragraph a. or
b. above.
Your work will be deemed completed at the
earliest of the following times:
(1) When all of the work called for in your
contract has been completed;
(2) When all of the work to be done at the
site has been completed if your contract
calls for work at more than one site; or
(3) When that part of the work done at a job
site has been put to its intended use by
any person or organization other than
another contractor or subcontractor
working on the same project.
Page 4 of 12 © Insurance Services Office, Inc., 2011 CA 00 01 10 13
Work that may need service, maintenance,
correction, repair or replacement, but which is
otherwise complete, will be treated as
completed.
11.Pollution
"Bodily injury" or "property damage" arising out
of the actual, alleged or threatened discharge,
dispersal, seepage, migration, release or
escape of "pollutants":
a. That are, or that are contained in any
property that is:
(1) Being transported or towed by, handled
or handled for movement into, onto or
from the covered "auto";
(2) Otherwise in the course of transit by or
on behalf of the "insured"; or
(3) Being stored, disposed of, treated or
processed in or upon the covered "auto";
b. Before the "pollutants" or any property in
which the "pollutants" are contained are
moved from the place where they are
accepted by the "insured" for movement into
or onto the covered "auto"; or
c. After the "pollutants" or any property in
which the "pollutants" are contained are
moved from the covered "auto" to the place
where they are finally delivered, disposed of
or abandoned by the "insured".
Paragraph a. above does not apply to fuels,
lubricants, fluids, exhaustgases or other similar
"pollutants" that are needed for or result from
the normal electrical, hydraulic or mechanical
functioning of the covered "auto" or its parts if:
(1)The "pollutants" escape, seep, migrate
or are discharged, dispersed or released
directly from an "auto" part designed by
its manufacturer to hold, store, receive or
dispose of such "pollutants"; and
(2)The "bodily injury", "property damage" or
"covered pollution cost or expense" does
not arise out of the operation of any
equipment listed in Paragraphs 6.b. and
6.c. of the definition of "mobile
equipment".
Paragraphs b. and c. above of this exclusion
do not apply to "accidents" that occur away
from premises owned by or rented to an
"insured" with respect to "pollutants" not in
or upon a covered "auto" if:
(a)The "pollutants" or any property in
which the "pollutants" are contained
are upset, overturned or damaged as
a result of the maintenance or use of
a covered "auto"; and
(b)The discharge, dispersal, seepage,
migration, release or escape of the
"pollutants" is caused directly by such
upset, overturn or damage.
12.War
"Bodily injury" or "property damage" arising
directly or indirectly out of:
a. War, including undeclared or civil war;
b. Warlike action by a military force, including
action in hindering or defending against an
actual or expected attack, by any
government, sovereign or other authority
using military personnel or other agents; or
c. Insurrection, rebellion, revolution, usurped
power or action taken by governmental
authority in hindering or defending against
any of these.
13.Racing
Covered "autos" while used in any professional
or organized racing or demolition contest or
stunting activity, or while practicing for such
contest or activity.This insurance also does not
apply while that covered "auto" is being
prepared for such a contest or activity.
C. Limit Of Insurance
Regardless of the number of covered "autos",
"insureds", premiums paid, claims made or
vehicles involved in the "accident", the most we will
pay for the total of all damages and "covered
pollution cost or expense" combined resulting from
any one "accident" is the Limit Of Insurance for
Covered Autos Liability Coverage shown in the
Declarations.
CA 00 01 10 13 © Insurance Services Office, Inc., 2011 Page 5 of 12
All "bodily injury", "property damage" and "covered
pollution cost or expense" resulting from
continuous or repeated exposure to substantially
the same conditions will be considered as resulting
from one "accident".
No one will be entitled to receive duplicate
payments for the same elements of "loss" under
this Coverage Form and any Medical Payments
Coverage endorsement, Uninsured Motorists
Coverage endorsement or Underinsured Motorists
Coverage endorsement attached to this Coverage
Part.
SECTION III - PHYSICAL DAMAGE COVERAGE
A. Coverage
1. We will pay for "loss" to a covered "auto" or its
equipment under:
a. Comprehensive Coverage
From any cause except:
(1) The covered "auto's" collision with
another object; or
(2)The covered "auto's" overturn.
b. Specified Causes Of Loss Coverage
Caused by:
(1) Fire, lightning or explosion;
(2) Theft;
(3) Windstorm, hail or earthquake;
(4) Flood;
(5) Mischief or vandalism; or
(6)The sinking, burning, collision or
derailment of any conveyance
transporting the covered "auto".
c. Collision Coverage
Caused by:
(1)The covered "auto's" collision with
another object; or
(2)The covered "auto's" overturn.
2. Towi ng
We will pay up to the limit shown in the
Declarations for towing and labor costs incurred
each time a covered "auto" of the private
passenger type is disabled. However, the labor
must be performed at the place of disablement.
3. Glass Breakage - Hitting A Bird Or Animal -
Falling Objects Or Missiles
If you carry Comprehensive Coverage for the
damaged covered "auto", we will pay for the
following under Comprehensive Coverage:
a. Glass breakage;
b. "Loss" caused by hitting a bird or animal;
and
c. "Loss" caused by falling objects or missiles.
However, you have the option of having glass
breakage caused by a covered "auto's" collision
or overturn considered a "loss" under Collision
Coverage.
4. Coverage Extensions
a. Transportation Expenses
We will pay up to $20 per day, to a
maximum of $600, for temporary
transportation expense incurred by you
because of the total theft of a covered
"auto" of the private passenger type. We will
pay only for those covered "autos" for which
you carry either Comprehensive or Specified
Causes Of Loss Coverage. We will pay for
temporary transportation expenses incurred
during the period beginning 48 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".
b. Loss Of Use Expenses
For Hired Auto Physical Damage, we will
pay expenses for which an "insured"
becomes legally responsible to pay for loss
of use of a vehicle rented or hired without
driver under a written rental contract or
agreement. We will pay for loss of use
expenses if caused by:
(1) Other than collision only if the
Declarations indicates that
Comprehensive Coverage is provided for
any covered "auto";
(2) Specified Causes Of Loss only if the
Declarations indicates that Specified
Causes Of Loss Coverage is provided for
any covered "auto"; or
Page 6 of 12 © Insurance Services Office, Inc., 2011 CA 00 01 1013
(3) Collision only if the Declarations
indicates that Collision Coverage is
provided for any covered "auto".
However, the most we will pay for any
expensesfor loss of use is $20 per day, to a
maximum of $600.
B. Exclusions
1. We will not pay for "loss" caused by or resulting
from any of the following. Such "loss" is
excluded regardless of any other cause or
event that contributes concurrently or in any
sequence to the "loss".
a. Nuclear Hazard
(1) The explosion of any weapon employing
atomic fission or fusion; or
(2) Nuclear reaction or radiation, or
radioactive contamination, however
caused.
b. War Or Military Action
(1) War, including undeclared or civil war;
(2) Warlike action by a military force,
including action in hindering or defending
against an actual or expected attack, by
any government, sovereign or other
authority using military personnel or
other agents; or
(3) Insurrection, rebellion, revolution,
usurped power or action taken by
governmental authority in hindering or
defending against any of these.
2. We will not pay for "loss" to any covered "auto"
while used in any professional or organized
racing or demolition contest or stunting activity,
or while practicing for such contest or activity.
We will also not pay for "loss" to any covered
"auto" while that covered "auto" is being
prepared for such a contest or activity.
3. We will not pay for "loss" due and confined to:
a. Wear and tear, freezing, mechanical or
electrical breakdown.
b. Blowouts, punctures or other road damage
to tires.
This exclusion does not apply to such "loss"
resulting from the total theft of a covered
"auto".
4. We will not pay for "loss" to any of the following:
a. Tapes, records, discs or other similar audio,
visual or data electronic devices designed
for use with audio, visual or data electronic
equipment.
b. Any device designed or used to detect
speed -measuring equipment, such as radar
or laser detectors, and any jamming
apparatus intended to elude or disrupt
speed -measuring equipment.
c. Any electronic equipment, without regard to
whether this equipment is permanently
installed, that reproduces, receives or
transmits audio, visual or data signals.
d. Any accessories used with the electronic
equipment described in Paragraphc. above.
5. Exclusions 4.c. and 4.d. do not apply to
equipment designed to be operated solely by
use of the power from the "auto's" electrical
system that, at the time of "loss", is:
a. Permanently installed in or upon the
covered "auto";
b. Removable from a housing unit which is
permanently installed in or upon the
covered "auto";
c. An integral part of the same unit housing
any electronic equipment described in
Paragraphs a. and b. above; or
d. Necessary for the normal operation of the
covered "auto" or the monitoring of the
covered "auto's" operating system.
6. We will not pay for "loss" to a covered "auto"
due to "diminution in value".
C. Limits Of Insurance
1. The most we will pay for:
a. "Loss" to any one covered "auto" is the
lesser of:
(1) The actual cash value of the damaged
or stolen property as of the time of the
"loss"; or
(2)The cost of repairing or replacing the
damaged or stolen property with other
property of like kind and quality.
b. All electronic equipment that reproduces,
receives or transmits audio, visual or data
signals in any one "loss" is $1,000, if, at the
time of "loss", such electronic equipment is:
(1) 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
installation of such equipment;
CA 00 01 10 13 © Insurance Services Office, Inc., 2011 Page 7 of 12
(2) Removable from a permanently installed
housing unit as described in Paragraph
b.(1)above; or
(3)An integral part of such equipment as
described in Paragraphs b.(1) and b.(2)
above.
2. An adjustment for depreciation and physical
condition will be made in determining actual
cash value in the event of a total "loss".
3. If a repair or replacement results in better than
like kind or quality, we will not pay for the
amount of the betterment.
D. Deductible
For each covered "auto", our obligation to pay for,
repair, return or replace damaged or stolen
property will be reduced by the applicable
deductible shown in the Declarations. Any
Comprehensive Coverage deductible shown in the
Declarations does not apply to "loss" caused by
fire or lightning.
SECTION IV - BUSINESS AUTO CONDITIONS
The following conditions apply in addition to the
Common Policy Conditions:
A. Loss Conditions
1. Appraisal For Physical Damage Loss
If you and we disagree on the amount of "loss",
either may demand an appraisal of the "loss".
In this event, each party will select a competent
appraiser. The two appraisers will select a
competent and impartial umpire. The
appraisers will state separately the actual cash
value and amount of "loss". If they fail to agree,
they will submit their differences to the umpire.
A decision agreed to by any two will be binding.
Each party will:
a. Pay its chosen appraiser; and
b. Bear the other expenses of the appraisal
and umpire equally.
If we submit to an appraisal, we will still retain
our right to deny the claim.
2. Duties In The Event Of Accident, Claim, Suit
Or Loss
We have no duty to provide coverage under this
policy unless there has been full compliance
with the following duties:
a. In the event of "accident", claim, "suit" or
"loss", you must give us or our authorized
representative prompt notice of the
"accident" or "loss". Include:
(1) How, when and where the "accident" or
"loss" occurred;
(2)The "insured's" name and address; and
(3)To the extent possible, the names and
addresses of any injured persons and
witnesses.
b. Additionally, you and any other involved
"insured" must:
(1)Assume no obligation, make no payment
or incur no expensewithout our consent,
except at the "insured's" own cost.
(2) Immediately send us copies of any
request, demand, order, notice,
summons or legal paper received
concerning the claim or "suit".
(3) Cooperate with us in the investigation or
settlement of the claim or defense
against the "suit".
(4)Authorize us to obtain medical records or
other pertinent information.
(5) Submit to examination, at our expense,
by physicians of our choice, as often as
we reasonably require.
c. If there is "loss" to a covered "auto" or its
equipment, you must also do the following:
(1) Promptly notify the police if the covered
"auto" or any of its equipment is stolen.
(2) Take all reasonable steps to protect the
covered "auto" from further damage.
Also keep a record of your expenses for
consideration in the settlement of the
claim.
(3) Permit us to inspect the covered "auto"
and records proving the "loss" before its
repair or disposition.
(4)Agree to examinations under oath at our
request and give us a signed statement
of your answers.
3. Legal Action Against Us
No one may bring a legal action against us
under this Coverage Form until:
a. There has been full compliance with all the
terms of this Coverage Form; and
b. Under Covered Autos Liability Coverage, we
agree in writing that the "insured" has an
obligation to pay or until the amount of that
obligation has finally been determined by
judgment after trial. No one has the right
under this policy to bring us into an action to
determine the "insured's" liability.
Page 8 of 12 0 Insurance Services Office, Inc., 2011 CA 00 01 1013
4. Loss Payment - Physical Damage
Coverages
At our option, we may:
a. Pay for, repair or replace damaged or stolen
property;
b. Return the stolen property, at our expense.
We will pay for any damage that results to
the "auto" from the theft; or
c. Take all or any part of the damaged or
stolen property at an agreed or appraised
value.
If we pay for the "loss", our paymentwill include
the applicable sales tax for the damaged or
stolen property.
5. Transfer Of Rights Of Recovery Against
Others To Us
If any person or organization to or for whom we
make payment under this Coverage Form has
rights to recover damages from another, those
rights are transferred to us. That person or
organization must do everything necessary to
secure our rights and must do nothing after
"accident" or "loss" to impair them.
B. General Conditions
1. Bankruptcy
Bankruptcy or insolvency of the "insured" or the
"insured's" estate will not relieve us of any
obligations under this Coverage Form.
2. Concealment, Misrepresentation Or Fraud
This Coverage Form is void in any case of fraud
by you at any time as it relates to this Coverage
Form. It is also void if you or any other
"insured", at any time, intentionally conceals or
misrepresents a material fact concerning:
a. This Coverage Form;
b. The covered "auto";
c. Your interest in the covered "auto"; or
d. A claim under this Coverage Form.
3. Liberalization
If we revise this Coverage Form to provide
more coverage without additional premium
charge, your policy will automatically provide
the additional coverage as of the day the
revision is effective in your state.
4. No Benefit To Bailee - Physical Damage
Coverages
We will not recognize any assignment or grant
any coverage for the benefit of any person or
organization holding, storing or transporting
property for a fee regardless of any other
provision of this Coverage Form.
5. Otherinsurance
a. For any covered "auto" you own, this
Coverage Form provides primary insurance.
For any covered "auto" you don't own, the
insurance provided by this Coverage Form
is excess over any other collectible
insurance. However, while a covered "auto"
which is a "trailer" is connected to another
vehicle, the Covered Autos Liability
Coverage this Coverage Form provides for
the "trailer" is:
(1) Excess while it is connected to a motor
vehicle you do not own; or
(2) Primary while it is connected to a
covered "auto" you own.
b. For Hired Auto Physical Damage Coverage,
any covered "auto" you lease, hire, rent or
borrow is deemed to be a covered "auto"
you own. However, any "auto" that is leased,
hired, rented or borrowed with a driver is not
a covered "auto".
c. Regardless of the provisions of Paragraph
a. above, this Coverage Form's Covered
Autos Liability Coverage is primary for any
liability assumed under an "insured
contract".
d. When this Coverage Form and any other
Coverage Form or policy covers on the
same basis, either excess or primary, we will
pay only our share. Our share is the
proportion that the Limit of Insurance of our
Coverage Form bears to the total of the
limits of all the Coverage Forms and policies
covering on the same basis.
6. Premium Audit
a. The estimated premium for this Coverage
Form is based on the exposures you told us
you would have when this policy began. We
will compute the final premium due when
we determine your actual exposures. The
estimated total premium will be credited
against the final premium due and the first
Named Insured will be billed for the
balance, if any. The due date for the final
premium or retrospective premium is the
date shown as the due date on the bill. If the
estimated total premium exceeds the final
premium due, the first Named Insured will
get a refund.
b. If this policy is issued for more than one
year, the premium for this Coverage Form
will be computed annually based on our
rates or premiums in effect at the beginning
of each year of the policy.
CA 00 01 10 13 © Insurance Services Office, Inc., 2011 Page 9 of 12
7. Policy Period, Coverage Territory
Under this Coverage Form, we cover
"accidents" and "losses" occurring:
a. During the policy period shown in the
Declarations; and
b. Within the coverage territory.
The coverage territory is:
(1) The United States of America;
(2) The territories and possessions of the
United States of America;
(3) Puerto Rico;
(4)Canada; and
(5)Anywhere in the world if a covered "auto"
of the private passenger type is leased,
hired, rented or borrowed withouta driver
for a period of 30 days or less,
provided that the "insured's" responsibility to
pay damages is determined in a "suit" on the
merits, in the United States of America, the
territories and possessions of the United States
of America, Puerto Rico or Canada, or in a
settlement we agree to.
We also cover "loss" to, or "accidents"
involving, a covered "auto" while being
transported between any of these places.
8. Two Or More Coverage Forms Or Policies
Issued By Us
If this Coverage Form and any other Coverage
Form or policy issued to you by us or any
company affiliated with us applies to the same
"accident", the aggregate maximum Limit of
Insurance under all the Coverage Forms or
policies shall not exceed the highest applicable
Limit of Insurance under any one Coverage
Form or policy. This condition does not apply to
any Coverage Form or policy issued by us or an
affiliated company specifically to apply as
excess insurance over this Coverage Form.
SECTION V - DEFINITIONS
A. "Accident" includes continuous or repeated
exposureto the same conditions resulting in "bodily
injury" or "property damage".
B. "Auto" means:
1. A land motor vehicle, "trailer" or semitrailer
designed for travel on public roads; or
2. Any other land vehicle that is subject to a
compulsory or financial responsibility law or
other motor vehicle insurance law where it is
licensed or principally garaged.
However, "auto" does not include "mobile
equipment".
C. "Bodily injury" means bodily injury, sickness or
disease sustained by a person, including death
resulting from any of these.
D. "Covered pollution cost or expense" means any
cost or expense arising out of:
1. Any request, demand, order or statutory or
regulatory requirement that any "insured" or
others test for, monitor, clean up, remove,
contain, treat, detoxify or neutralize, or in any
way respond to, or assess the effects of,
"pollutants"; or
2. Any claim or "suit" by or on behalf of a
governmental authority for damages because
of testing for, monitoring, cleaning up,
removing, containing, treating, detoxifying or
neutralizing, or in any way responding to, or
assessing the effects of, "pollutants".
"Covered pollution cost or expense" does not
include any cost or expense arising out of the
actual, alleged or threatened discharge, dispersal,
seepage, migration, release or escape of
"pollutants":
a. That are, or that are contained in any
property that is:
(1) Being transported or towed by, handled
or handled for movement into, onto or
from the covered "auto";
(2) Otherwise in the course of transit by or
on behalf of the "insured'; or
(3) Being stored, disposed of, treated or
processed in or upon the covered "auto";
b. Before the "pollutants" or any property in
which the "pollutants" are contained are
moved from the place where they are
accepted by the "insured" for movement into
or onto the covered "auto"; or
c. After the "pollutants" or any property in
which the "pollutants" are contained are
moved from the covered "auto" to the place
where they are finally delivered, disposed of
or abandoned by the "insured".
Page 10 of 12 © Insurance Services Office, Inc., 2011 CA 00 01 1013
Paragraph a. above does not apply to fuels,
lubricants, fluids, exhaustgases or other similar
"pollutants" that are needed for or result from
the normal electrical, hydraulic or mechanical
functioning of the covered "auto" or its parts, if:
(1)The "pollutants" escape, seep, migrate
or are discharged, dispersed or released
directly from an "auto" part designed by
its manufacturer to hold, store, receive or
dispose of such "pollutants"; and
(2)The "bodily injury", "property damage" or
"covered pollution cost or expense" does
not arise out of the operation of any
equipment listed in Paragraph 6.b. or
6.c. of the definition of "mobile
equipment'.
Paragraphs b. and c. above do not apply to
"accidents" that occur away from premises
owned by or rented to an "insured" with respect
to "pollutants" not in or upon a covered "auto" if:
(a) The "pollutants" or any property in which the
"pollutants" are contained are upset,
overturned or damaged as a result of the
maintenance or use of a covered "auto";
and
(b)The discharge, dispersal, seepage,
migration, release or escape of the
"pollutants" is caused directly by such upset,
overturn or damage.
E. "Diminution in value" means the actual or
perceived loss in market value or resale value
which results from a direct and accidental "loss".
F. "Employee" includes a 'leased worker".
"Employee" does not include a "temporary
worker".
G. "Insured" means any person or organization
qualifying as an insured in the Who Is An Insured
provision of the applicable coverage. Except with
respect to the Limit of Insurance, the coverage
afforded applies separately to each insured who is
seeking coverage or againstwhom a claim or "suit"
is brought.
H. "Insured contract' means:
1. A lease of premises;
2. A sidetrack agreement;
3. Any easement or license agreement, except in
connection with construction or demolition
operations on or within 50 feet of a railroad;
5. That part of any other contract or agreement
pertaining to your business (including an
indemnification of a municipality in connection
with work performed for a municipality) under
which you assume the tort liability of another to
pay for "bodily injury" or "property damage" to a
third party or organization. Tort liability means a
liability that would be imposed by law in the
absence of any contract or agreement; or
6. That part of any contract or agreement entered
into, as part of your business, pertaining to the
rental or lease, by you or any of your
"employees", of any "auto". However, such
contract or agreement shall not be considered
an "insured contract" to the extent that it
obligates you or any of your "employees" to pay
for "property damage" to any "auto" rented or
leased by you or any of your "employees".
An "insured contract' does not include that part of
any contract or agreement:
a. That indemnifies a railroad for "bodily injury"
or "property damage" arising out of
construction or demolition operations, within
50 feet of any railroad property and affecting
any railroad bridge or trestle, tracks,
roadbeds, tunnel, underpass or crossing;
b. That pertains to the loan, lease or rental of
an "auto" to you or any of your "employees",
if the "auto" is loaned, leased or rented with
a driver; or
c. That holds a person or organization
engaged in the business of transporting
property by "auto" for hire harmless for your
use of a covered "auto" over a route or
territory that person or organization is
authorized to serve by public authority.
I. "Leased worker" means a person leased to you by
a labor leasing firm under an agreement between
you and the labor leasing firm to perform duties
related to the conduct of your business. "Leased
worker" does not include a "temporary worker".
J. "Loss" means direct and accidental loss or
damage.
K. "Mobile equipment' means any of the following
types of land vehicles, including any attached
machinery or equipment:
1. Bulldozers, farm machinery, forklifts and other
vehicles designed for use principally off public
roads;
4. An obligation, as required by ordinance, to 2. Vehicles maintained for use solely on or nextto
indemnify a municipality, except in connection premises you own or rent;
with work for a municipality; 3. Vehicles that travel on crawler treads;
CA 00 01 10 13 © Insurance Services Office, Inc., 2011 Page 11 of 12
4. Vehicles, whether self-propelled or not,
maintained primarily to provide mobility to
permanently mounted:
a. Power cranes, shovels, loaders, diggers or
drills; or
b. Road construction or resurfacing equipment
such as graders, scrapers or rollers;
5. Vehicles not described in Paragraph 1., 2., 3. or
4. above that are not self-propelled and are
maintained primarily to provide mobility to
permanently attached equipment of the
following types:
a. Air compressors, pumps and generators,
including spraying, welding, building
cleaning, geophysical exploration, lighting
and well -servicing equipment; or
b. Cherry pickers and similar devices used to
raise or lower workers; or
6. Vehicles not described in Paragraph 1., 2., 3. or
4. above maintained primarily for purposes
other than the transportation of persons or
cargo. However, self-propelled vehicles with
the following types of permanently attached
equipment are not "mobile equipment" but will
be considered "autos":
a. Equipment designed primarily for:
(1) Snow removal;
(2) Road maintenance, but not construction
or resurfacing; or
(3) Street cleaning;
b. Cherry pickers and similar devices mounted
on automobile or truck chassis and used to
raise or lower workers; and
C. Air compressors, pumps and generators,
including spraying, welding, building
cleaning, geophysical exploration, lighting or
well -servicing equipment.
However, "mobile equipment" does not include
land vehicles that are subject to a compulsory or
financial responsibility law or other motor vehicle
insurance law where it is licensed or principally
garaged. Land vehicles subject to a compulsory or
financial responsibility law or other motor vehicle
insurance law are considered "autos".
L. "Pollutants" means any solid, liquid, gaseous or
thermal irritant or contaminant, including smoke,
vapor, soot, fumes, acids, alkalis, chemicals and
waste. Waste includes materials to be recycled,
reconditioned or reclaimed.
M. "Property damage" means damage to or loss of
use of tangible property.
N. "Suit" means a civil proceeding in which:
1. Damages because of "bodily injury" or
"property damage"; or
2. A "covered pollution cost or expense";
to which this insurance applies, are alleged.
"Suit" includes:
a. An arbitration proceeding in which such
damages or "covered pollution costs or
expenses" are claimed and to which the
"insured" must submit or does submit with
our consent; or
b. Any other alternative dispute resolution
proceeding in which such damages or
"covered pollution costs or expenses" are
claimed and to which the insured submits
with our consent.
O. "Temporary worker" means a person who is
furnished to you to substitute for a permanent
"employee" on leave or to meet seasonal or
short-term workload conditions.
P. "Trailer" includes semitrailer.
Page 12 of 12 © Insurance Services Office, Inc., 2011 CA 00 01 10 13
WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT —
CALIFORNIA
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. (This agreement applies only to the
extent that you perform work under a written contract that requires you to obtain this agreement from us.)
You must maintain payroll records accurately segregating the remuneration of your employees while engaged in
the work described in the Schedule.
The additional premium for this endorsement shall be 0% of the California workers' compensation premium
otherwise due on such remuneration.
Schedule
[Additional premium is a percent of the California Manual Workers Compensation premium. Subject to a minimum
premium charge of $ 0]
Person Organi ation Job Description
City of El Segundo, its officers, officials, El Segundo Boulevard Improvement
employees and volunteers Project
Project No.: PW 23-02
Issued by Co 2 - Liberty Mutual Fire Insurance Company
For attachment to Policy No. WC5-631-510805-032 Effective Date 04/01/2022 Premium $
Issued to
WC 04 03 06 R1 Page 1 of 1
Ed. 0812013
NOTICE OF CANCELLATION TO THIRD PARTIES
A. If we cancel this policy for any reason other than nonpayment of premium, we will notify the persons or
organizations shown in the Schedule below. We will send notice to the email or mailing address listed below at
least 10 days, or the number of days listed below, if any, before cancellation becomes effective. In no event
does the notice to the third party exceed the notice to the first named insured.
B. This advance notification of a pending cancellation of coverage is intended as a courtesy only. Our failure to
provide such advance notification will not extend the policy cancellation date nor negate cancellation of the
policy.
Name of Other Person(s) /
Organization(s):
City of El Segundo
SCHEDULE
Email Address or mailing address
350 Main Street
Public Works Dept. — Engineering Division
El Segundo, CA 90245
All other terms and conditions of this policy remain unchanged.
Issued by
For attachment to Policy No. WC5-631-510805-032 Effective Date 04/01/2022
Issued to
WC 99 20 75 © 2016 Liberty Mutual Insurance
Ed. 12/01 /2016
Number Days Notice:
Premium $
30
Page 1 of 1