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PROOF OF INSURANCE (2023) CLOSEDCI ient#: 1778682 GALLSLLCII ACORDTM CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 3/02/2022 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. 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 any rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Lea Veeneman USI Insurance Services LLC PHONE 513 852-6300 FAX 513 852-6428 A/C, No, Ext : A/C, No 312 Elm Street, 24th Floor E-MAIL ADDRESS: lea.veeneman@usi.com Cincinnati, OH 45202 INSURER(S) AFFORDING COVERAGE NAIC tf 513 852-6300 INSURER A: GIBE Insurance Corporation 39217 INSURED INSURER B : General Casualty Company of Wisconsin 24414 CB General Holdings, LLC; Galls LLC Praetorian Insurance Company INSURER C : p y 37257 1340 Russell Cave Road The Cincinnati Insurance Company INSURER D : P Y 10677 Lexington, KY 40505 INSURER E : North Pointe Insurance Co 27740 INSURER F : COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDLSUBR INSR WVD POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CGA1365959 3/01 /2022 03/01/2023 EACH OCCURRENCE $1 ,000,000 CLAIMS -MADE OCCUR PREMISES(Es .urence)$1,000,000 MED EXP (Any one person) $10,000 PERSONAL & ADV INJURY $1 ,000,000 GEN'L AGGREGATE LIMIT APPPLIIEES PER: GENERAL AGGREGATE $2,000,000 PRO- X LOC PPOLICY � JECT PRODUCTS - COMP/OPAGG $2,000,000 $ OTHER: E AUTOMOBILE LIABILITY 161000042 3/01 /2022 03/01/2023 COMBINED SINGLE LIMIT Ea accident> > 1 000 000 X BODILY INJURY (Per person) $ ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ OERTY DAMAGE Peraccident) HIRED NON -OWNED AUTOS ONLY AUTOS ONLY FX $ B X UMBRELLA LIAB X OCCUR CCU1365959 3/01/2022 03/01/2023 EACH OCCURRENCE $1 O 000 000 AGGREGATE $1 O 000 000 EXCESS LIAB CLAIMS -MADE DED I X RETENTION $1 O 000 $ c WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) N / A 1520000028 3/01/2022 03/01/2023 X PER OTH- TAT TE ER E.L. EACH ACCIDENT $1 ,000,000 E.L. DISEASE - EA EMPLOYEE $1 ,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $1 ,000,000 D Excess Liability EXS0570374 3/01/2022 03/01/2021 15,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) The General Liability and Automobile Liability include an automatic Additional Insured endorsement that provides Additional Insured status to City of El Segundo City Clerk, its officials, and employees, only when there is a written contract that requires such status, and only with regard to work performed by or on behalf of the named insured. The General Liability and Automobile Liability contains a special endorsement with Primary and Noncontributory wording, when required by written contract. The General Liability, (See Attached Descriptions) IL" a al 101 L"1111Iai l•J 01R1 a: •L•1\l fa�L•\�l•J\ City of El Segundo - City Clerk 314 Main Street El Segundo, CA 90245-3813 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) 1 of 2 #S35174431/M35159738 ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD SAPZR DESCRIPTIONS (Continued from Page 1) Automobile Liability, Umbrella Liability and Workers Compensation policies provide a Blanket Waiver of Subrogation when required by written contract, except as prohibited by law. SAGITTA 25.3 (2016/03) 2 of 2 #S35174431/M35159738 CGA136,5959 11157,111151111 Z F.3 RIK" RIII :14,51MOTA lIslmw]1411114:J Name Of Additional Insured Per ono Or OrgTani zation1s) (Location(s) Of Covered Operations, WHERE REQUIRED BY WRITTEN CONTRACT OR AGREEMENT Information required to complete this Schedulle, if not shown above, will be shown, in the Declarations. A. Section 11 — Who, Is An Insured is amended to 2. If coverage provided to the additional insured is include as an additional insured the person(s) or required by a contract or agreement, the organization(s) shown, in the Schedule, but only insurance afforded to such additional insured with respect to liability for "'bodily injury', "'property will not, be broader than that which you are damage" or "'personal and advertising injury" required by the contract or agreement to caused, in whole or in part, by: provide for' such additional insured. 1. Your acts, or omissions; or B. With respect to the insurance afforded to these 2. The acts or, omissions of those acting on your additional insureds, the following additional behalf; exclusions apply! in the performance of your ongoing operations for This insurance does not apply to "bodily injury" or the additional insured(s) at the location(s) ""property damage"" occurring after: designated above. 1. Atl work, including materials, parts or Howevev equipment furnished in connection with such work, on the project (other than service, 1. The insurance afforded to such additional maintenaince, or repairs) to be performed by or insured only applies to the extent permitted by on behalf of the additional insureds) at the law; and locafion of the covered operations has been completed; or CG 20 10 04 13 0 Insurance Services Office, Inc., 2012 Page I of 2 2. That portion of "your work" out of which the injiury or damage arises has been put to its intended use by any person or orglanization other than another contractor or subcontraictor engaged in performing operations for a principal as a part of the, same project. C. With respect to the insurance afforded to these additional insureds, the following is added to Section Hil — Liimiits Of insurance- 2. Avallable under the applicable Limits of Insurance, shown in'the Declarations; IMARRIT—TWOMMM This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. COMMERCIAL GENERAL LIABILITY CG 20 18 04 13 I Ji Lei :A vnky'cv; =W&m Lei 0 mwel :j am" This, endorsement modifies insurance, provided under the following: Name _2fgjE�����. WHERE REQUIRED BY WRITTEN CONTRACT OR AGREEMENT Desianation Of Premises Information required to complete this Schedule, if not shown above, will Ibe shown in the Declarations, A. Section 11 — Who Is An Insured rs amended to C. With respect, to the insurance afforded to these include as an additional insured the person(s) or additional insureds, the following is added to organization(s) shown in the Schedlule, but only Section III — Limits Of Insurance: with respect to their liability as mortgagee, If coverage provided to the additional insured is assigniee, or receiver and arising out of the required by a contract or agreement, the most we ownership, maintenance, or use of the premises will pay on behalf of the additional insured is the by you and shown in the Schedule. amount of insurance: However: 1. Required by the contract or agreement; or 1. The insurance afforded to such additional 2. Available under the applicable Limits of insured only applies to the extent permitted by Insurance shown in the Declarations; law; and whichever is less. 2. If coverage provided to the additional insured is required by a contract or agreement, the This endorsement shall not increase the insurance afforded to such additional insured applicable Limits of Insurance shown in the will not be broader than that which you are Declarations. required by the contract or agreement to provide for such additional Insured, B. This insurance does not apply to structural alterations, new construction and, demolition operations performed by or for that person or organization. CG 20 18 04 13 @ Insurance Services Office, Inc., 2012 Page 1 of 1 011id , I 1 0 --r"Walml aM TITIT41um A. ADDITIONAL INSURED BY CONTRACT OR AGREEMENT Paragraph, A.1. Who Is an Insured of SECTION 11 — LIABILITY COVERAGE is amended to in- clIude the following: Any person or organization to whom you becorn, e obligated to include as an additional Insured uin- der this policy, as a result of any contract or agreement you enter into which requires you to furnish insurance to that person or organization of the type provided by this policy, but only with re- spect to liability arising out of your operations or premises owned by or rented to you. However, the insurance provided will not exceed the lesser of: 1. The coverage and/or limits of this policy, or 2. The coverage and/or limits required by said contract or agreement. Includes copyrighted material of Insurance Services Office, IInc,, CA 80 02 0,5 12 with its permission. Page 1 of 1 This endorsement modifies insurance provided under the follow lng: COMMERCIAL GENERAL LIABiLiTY COVERAGE PART PRODUCTS/COMPLETED OP ERATtlONS UABILITY COVERAGE PART The following is added to the Other Insurance (2) You have agreed in wriiting in a contract or Condition arid supersedes any provision to the agreemient that this insurance would be contraryprimary and would not seek contribution Priimary a ndl NoncontAbutory Insurance from any other insurance available to the additional insured. This insurance is primary to and wifl not seek contribution frorn any other insurance available to an additional insured under your policy provided thaL (1) The additional insured is, a Narned Insured under such other insurance; and CGS 20 0104,13 @Insurance SerVices Office, inc.., 2012 Page 1 of 1 1, 1; 111 1� �171111 i kill I 1, 111 1 'el. jI lazil 14" IN 0 Illy, WIN, psim With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. A. The following is added to the Other Insurance Condition in the Business Auto Coverage Form and the Other Insurance — Primary And Excess Insurance Provisions in the Motor Carrier Coverage Form and supersedes any provision to the contrary: This Coverage Form's Covered Autos Liability Coverage is primary to and will not seek contribution from any other insurance available to an "insured" under your policy provided that: 1. Such "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 such "insured". B. The following Is added to the Other Insurance Condition in the Auto Dealers Coverage Form and supersedes any provision to the cointrairy: This Coverage Form's Covered Autos Dability Coverage and General Liability Coverages are primary to and will not seek contribution from any other insurance available to an, "'insured"' under your policy provided thait: 1. Such "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 such "insured"., C.A.04 4911 16 Oc Insurance Services Office, Inc,, 2016 Page 1 of 1 PREFERRED GENERAL LIABILITY COVERAGE, EXTENSION This endorsement modifies insurance provided under the foltowing; COMMERCIAL GENERAL LIABILITY COVERAGE FORM COMMON POUCY CONDITIONS Paragraph A. 2. b within the COM1MON POLICY CONDITIONS is replaced by: b. 90 days, before the, effecfive date of cancella- tion if we cancel for any other reason, M.Ewn—mmmammm-f-T-IME "Bodily injury"' or "property damage"' expected or interilded from the standpoint of the in- sured, This exclusion does riot apply to "bodi- ly injury" or "property damage" resulting from the use of reasonable force to protect, any person or property, C. CONTRACTUAL LIABILITY �b. Contractual Liability "Bodily injury" or "property damage" for whichl the insured is obligated to, pay damages by reason of the assumption of liability in a con- tract or agreement. This exclusion does, not apply to fiability for damages: (11) That the nniskired would: have had fin the absence of the contract or agreement; or (2) Assurned in a contract or agreement that is an "insured contract", provided the bodily injury" or ""property darnage" oic- CUrs subsequent to the execution of the cointract air agreement, (2) A watercraft you do not own that is: (a) (less than 50, feet long; and (b) Not being used to carry persons or property for a charge. lo Paragraph 2. p. Electronle Diata under COVERAGE A. BODILY INJURY AND PROPERTY DAMAGE LIABILITY of SECTION I — COVERAGES withiin the COMMERCIAL GENERAL LIABILITY COVERAGE FORM is replaced by,. Darnages arising:, out of the loss of, loss oil: use of, damage to, corruption of, inability to access, or inability to manipulate "efec- tronic data" that does not reSUft frorn physical" injury to tangible property,. Includes, copyrigihted material of Insurance Services Office, Inic., CG 81 79 01 11 with its permission. Pagie 11 of 6 2. The following definition is added to SEC- TION V — DEFINITIONS: "Electronic dlata" means information, facts or programs stored as or on, created or used on, or transmitted to or from computer software, hard or floppy disks, CD-ROMSl, tapes, drives, cells, data processing devices or any oltheir media which are used with electronicafly controlled equipment. 3. For purposes of the coverage provided for Electronic Data, Paragraph 17. in SECTION V — DEFINITIONS is replaced byn 17. "Property damage" rneans: 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 lime of the physical injury that caused: It; or b, Loss of use of tangible property that is not physically injured. All such lloss of use shall Ibe deemed to occur at the time olf the "OCCUrrence" that caused it; or c. Loss of, loss of use of, clarnage to, corruption of, Inability to access,, or inability to property manipulate "elec- tronic data",, resulling, frorn physical injury, to tangible property. AllI such loss of "electronic data"shall be deemed to occur at the time of the "occurrence" that caused it. For purposes of this insurance, '"electron- ic data" is not tangible property. �111 �04�0 1. The last paragraph after, the listed exclusions under COVERAGE A. BODILY INJURY All PROPERTY DAMAGE LIABILITY of SEC- TION I — COVERAGES within the COW MERCIAL GENERAL LIABILITY COVER- AGE FORM is replaced by: Exclusions c. through nm do not apply to "property damage," by fire; smoke from a "hostile fire", explosion; lightning; smoke re- sulting frorri such explosion or lightning; colli- slion by "mobile equipment" or leakage frorm fire protection systeirris to prernises while rented 10 YOU or temporarily occupied by you, with permission of the owner. A separate limit of insurance applies to this coverage as de scribed in SECTION III — LIMITS OF Ifil- SURANCE. 2. Paragraph 6. of SECTION III — LIMITS OF INSURANCE within the COMMERCIAL GENERAL LIABILITY COVERAGE FORM is replaced by: 6. Subject to 5., above, the Darnage To Premises Rented To YOU Limit is the most we Will play in aniy one event under COVERAGE A. BODILY INJURY AND, PROPERTY DAMAGE for damages be- cause of "property damage" from fire; srnoke from a "hostile fire"'; explosion; lightning; smoke resulting from such ex- plosion or lightning; collision by "mobile equipment" or leakage from fire protection systernis to premises while rented to you or terTiplorari1y occupied by your with pler- mission of the owner. I i Paragraph I.a. under COVERAGE Ci, MEDICAL PAYMENTS of SECTION I — COVERAGES within the COMMERCIAL GENERAL LIABILITY COVERAGE FORM is replaced by� zZM-WM= aWewilt pay me6cal expenses as de- scribed below for "bodily injury" caused by an accident., (1) On premises you Ownor rent; (2), On ways next to premises you own or rent; or (3), Because of your operations: Provided that: (ai) The accident takes place in: the "coverage territory" amid during the polllicy period; (b) The expenses are incurred and reported to US within 0-vele years of the date of thel accident; and (c) The injured person subrnits to examination, at our explense, by physicians of our choice as, often as we, reasonable require. Includes copyrighted material of Insurance Services Office, inc., Page 2 of 6, with its permission, CG 81 79 011 111 1. We will pay, with respect to any clairn we investigate or settle, or any "suit" against an insured! we defend; a. All expenses we incur. b. Up to $5,000, for cost of bail bonds re, quired because of accidents or traffic law violations arising out of the use of any vehicle to whict-i the Bodily Injury Liability Coverage applies. We do not have to, fur- nish these bonds, c�,, The cost of bonds to irelease attach- i-nents, but only for bond amounts within the applicable limit of insurance, We do have to furnish these bonds. d. All reasonable expenses incurred by the insured at our request to, assist us in the irivestigation or defense of the claim or "suit", Including actual loss of earnings, up to, $5010 a day because of time off from work. e. All costs taxed against the "insured" In any, "suit". f. Prejudgment interest awarded against the Insured an that part of the judgment we play. IIf we make an offer to, pay the appik cable limit of insurance, we will not play any prejudgment Interest based on that period of time after the offer. g. All Interest on the full amount of any judgment that accrues after entry of the Judgment and before we have paid, of- fered to play, or deposited in court the part of the judgment that is within the applica- ble limit of insurance. These payments will not reduce the limits of insurance. 2. If we defend an insured against a ""suit'" and an inderrintee, of the insured is also named as a party to, the "suft", we will defend that indem- nittee it all of the following conditions are rnet: a. The "suit" against the indeminitoe seeks darnages, for which the insured has as,- surned the fiabilfty of the indeninitee in a contract or agreernent that is an "Insured contract"; b. This injsurance applies to such liability as- sunned 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 allegatOns in the "suit"' and the In- formation we know about the "occur- rence"are such that no conflict appears, to exist between the interests of the in- sured and the interests of the indemnitee; e. The inderninitee and the insured ask Lis, to conduct and control the defense of that In- derrinitee a,ga,inst such "suit" arid agree that we can assign the sarrie counsel) to defend the insured and the inderrinitee; and f. The indeirriniltee: (1) Agrees in writing to: (a), Cooperate with up, in the iinvestli- gation, settlement or defense of the `suit"w (b) Ininiediately send Lis copies of any demands, notices, sum- monses or legal papers received In connection with the "suit"; (c), Notify any other insurer whose coverage is available to the iin- deminitw and (d) Cooperate with us with respect to coordinating other applicable insurance available to the in- derrinitee; and (2) Provides us with wrilten aUlhoriza- tIon to: (a) Obtain records arid! other infor- mation r6lated to the `suit"; and (b) Conduct arid control the defense of the indernnifee in such "suit". Muir obligation to defend an insured's In- derninitee and to play for attorneys' fees and necessary l�itigatioln expenses as Supplementary Payments ends when we have used up, the apphicablie, limit of In- surance in the IpaymenC of judgments or settlements or the conditions set forth above, or the terms of the agreernent de- scribed in Paragraph f. above, are ino longer met. Includes copyrighted material of Insurance Services office, Inc., CG 81 79 01 11 with its PerMiSsiol'j, Page 3 of 6 FELLOW EITIPLOTEE COTERAGE — SIPERT1- SOR OR HIGHER Paragraph 2.a.(1) of SECTION 11 — WHO IS AN INSURED within the COM11MERCIAL GENERAL LIABILITY COVERAGE FORM does not apply to the following: Your supervisory or rnanagernient ""employees" for "bodily !injury" only. Darnages, owed to an injured) co -'employee" or ",volunteer worker" M11 be reduced by any annount paid or available to the injured co -"'employee"" or "volunteer worker" under any other vapid and collectible insurance, Throughout this policy the words, "you" and "your" refer to any corporation or other business organiza- fion, other than a joint venture, in which the first Niamed Insured has or acquires duriing the policy period an ownership interest of moire than 50% and is subject to the managernient control of the first Namied linsuired or its subsidiaries, and which is domiciled within the United States of America or its territories or possessions. Paragraph 3.a. of SECTION 11 — WHO IS AN INSURED within the COMMERCIAL GENERAL LIABILITY COVERAGE FORM is replaced by,, a. Coverage under this provision is afforded on]y until the 1201h day after you acquiire or form the organization or the end of the policy peri- old, whichever is earlier; L. AMENDMENT OF AGGREGATE LIMIT OF INSURANCE The Gieneiral Aggregate Limit Of Insurance refer- enced in Paragraph 2. of SECTION III — LIMiITS OF INSURANCE within the COMMERCIAL GENERAL LIABILITY COVERAGE FORM applies separately to: 1. Each of your "locations" owned by or irenited to you; and 2. Each of your projects away from prennises owned by or rented to you. "Location" means premises involving the same or connecting (lots, or premises whose conniectioni is interrupted only by a street, roadway, waterway or right-olf-way of a railroad, Knowledge of an "occurrence", offense, clairni or "Suit" by your agent, servant or "eirriployee" shall not be considered knowledge by you unless YOU, your insurance manager or any other person you designate has received notice of the "occur- rence", offense, cilairn or ",suill" Irorn your agent, servant, or "employee," Paragraph 4. li (1)(a) in the Other Insurance condition of SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS within the COMMERCIAL GENERAL LIABILITY COVER- AGE FORM is replaced by: milnz4zfl7W-=_ (1) This inSlUirance is excess over: (a) any of the ot,hier insurance, whether primary, excess, conitin- gent or on aniy other basis: (I) That is Fire, Extended Colv- erage, Builders Aisk; Instailla- tion Risk or similar coverage for "Your work"; (I i) That is insurance covering Fire-, smoke, from a "hostile fire"; elxplosioln; llghtnlng, !smoke resulting from such explosion or ligihtning, collu- sion by "mobfle equipment"' or leakage from fire protec- tion systems for prerniises while rented to YOU or ternpo- rarfly occupied by you with permission of the owner; or (iii) That is insurance to cover Your liability as a tenant for "proper- ly damage" to premises while rented to, you or temporarily occupied by YOU with permis- sion of the owner; or Includes copyrighted material of insurance Services Office, Inc., Page 4 of 6 with its permission, CG 81 79 011 111 Jv) If the loss arises out of the maintenance oNI r use of: aircraft, ll or watercraft to the extent riot subject 'to Para. graph 2, g. Aircraft, Aultof Or Watercraft under COVER- AGE A. BODILY INJURY AND, PROPERTY DAMAGE LIABILITY of SECTION I — COVERAGES within the COMMERCIAL GENERAL LIABILITY COVERAGE FORK 0., UNINTENTIONAL FAIILUR'E TO DISCLOSE HAZARDS The following is added to, Paragraphi 6. Representations of SECTION JV —..- COM. �MERCIAL GENERAL LIABILITY CONDITIONS within thie COMMERCIAL GENERAL LIABILITY COVERAGE FORM: Any unintentional faillure to disclose all exposuires or hazards existing as of the effective date of the Commercial General Liability Coverage Form or at any firnel during the policy period wli riot invalIi- date or adversely affect the coverage for such exposure or hazard. However, you must report the undisclosed exposure or hazard to us as soon as reasonably possible after the exposure or hazard is discovered, 0 0 ff This condition does, not apply to any person or organization to w,hiich your waived this condition by written contract or agreement, but only to the extent that subrogahon is, waived prior to the "bodily injury" or "property, damage" under a contract with that person or organization. YMIII [U-4 The folllIowing is added to SECTION IV — CONDITIONS within the COMMERCIAL GEN- ERAL LIABILITY COVERAGE FOlRM: Expanded Coverage Territory 1 If a "Salt" is brought in a part of the "coverage territory" that is, outside the United States of Arnerica (inCIU&rg its territories, and posses- sions), Puerto Rico l or Canada, arid we are prevented by law', or otherwise, from defend.. Ing the insured, the insured will initiate a de- fense of the "surit". We will reimburse the lin- suredi, under Supplementary Paymients, for any reasonable and necessary expenses, 411- curred for the defense of a "'suit"' seeking damages to which this insurance applies, that we would have paid had we been, able to ex- ercise our right and duty to, defend. If the insured blecomes legally, obligated to pay SUrns because of damages to which this insurance all in a part of the "coverage territory" that is, oulsildle the United States of America (including , its territories and polsses- sionis), Puerto Moo or Ganada, and we are prevented by law, or otherwise, from paying such sums on the inslured's behalf, we will re- imburse, the Insured for such sums. 2. All paynients or reirribursements, we make for damages because of judgments or, settle- ments will be made in U.S. Currency at the prevailing exchange rate at the time the in.- suiredi became legally obfigated to play such sums, All payments or reirribursenients we, make for expenses under Supplementary �Payments wwwilll be made In U-S, currency at the prevailing exchange rate at the III the expenses were incurred. 1 Any disputes between you and us as to whether there is coverage under 'thiis plolIicy miust be filed in the courts of the United States of America (including its, territories and possessions), Puerto Riico or Canada. 4., The insured must fully maintain any colverage requilred by law, regidlation or other governmen- tal authority during the policy, period, except for recIUCUOin of the aggregate firnilts due to pay- ments of claims, judgments or settlements. Failure to maintain SlUch coverage reqIuired by law, regulatlon or other governmental authorl- ty will not invalidate this Insurance. However, thiIs insurance will apply as if the requirred coveragie by law, regulation or other, golvern- rnental authority was in full effect. Includes copyrighted material of Insurance Services Office, Inc., CG 811 79 01 11 with its permission, Page 5 of 6 For purposes of this coverage onily, the following; is added to Paragraph 4.b,(1) (a) under Other Insurance, of SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS within the COMMERCIAL GENERAL LIABILITY COVER- AGE FOR', If the insured's liability to pay damages is determined ins a "suit"" brought outside the Idnited States of America (including its territories and possessions), Puerto Rico or Canada; or That is coverage required by law, regulation or other governmental authority in a part of the coverage territory" that is outside the United States of America (including its territories , and possessions), Puerto Rico, or Canada. For purposes of this coverage only, Paragraphs 4. of SECTION V — DEFINITIONS within the COMMERCIAL GENERAL LIABILITY COVER- AGE FORM is replaced by,. 4. "Coverage territory" means anywhere in the world withi the exception of any country or ju- risdiclion which is subject to trade or other eGOMMiC sanction or ernbargo, by the United States of America, Paragraph 3. of SECTION V. — DEFINITIONS within the COMMERCIAL GENERAL LIABILITY COVERAGE FORM is replaced by: 3. "Bodily iinjury" means, bodily unijuiry, sickness or disease Sustained by a person, including mental anguish, injury, or illness or emotional distress and/or death resultingi from any of those at any time. ASITIME"ItUals 9. "Insured contract" means: aa contract for lease of premises, Howev- er, that portion of the contract for a lease of preimises, that indemnities any person or organization for "property damage" by fire; si,noke from a "hostile fire", explo- sion; lightningi; smoke resulting from such explosion or lightning,- collision by "mobile equipment" or leakage from fire protection systerns to prernises whille rented to you or temporarily occupied by you with per- mission of the owner is not an "'insured cointract". If we revise this endorsement to provide more coverage without additional premiurn charge, your policy will automatically provide the coverage as of the day the revision is, effective in your state. Includes copyrighted material of Insurance Services Office, Inc., Page 6 of 6 with its permission, CG 81 79 011 111 POLICY NUMBER: COMMERCIAL AUTO CA 04 44 10 13 THIS ENDORSEMENT CHANGES THE, POLICY. PLEASE READ IT CAREFULLY. WAIVER OFTRANSPER OF RIGHTS, OF RECOVERY AGAINST OTHERS TO US (WAIVER OF SUBROGAT:ION) This endorsement modifies insurance provided under the following With respect to coverage provided by this endorsement, the provisions of the Coverage Form aipply unless modified by the endorsement. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below, Named Insured: Endorsement Effective Date: Information required to complete this Schedule, if not shown above, wilt be shown in the Declarations. The Transfer Of Rights Of Recovery Against Others To Us condifion does not apply to the person(s,) or organization(s) shown in the Schedule, but only to the extent that subrogation, is, walved prior to the "accident" or the "loss" under a contract with that person or organization. CA 04 44 10 13 0( Insurance Services Office, Inc,,2011 1 Page 1 of 1 CCU1365959 COMMERCIAL LIABILITY UMBRELLA CUI 24 03 09 00 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ft 0 A� A MR AL 26 COMMER0AL LIABILITY UMBRELLA COVERAGE PART Rr*T2rF4-11M Name Of Person Or Organization: PER G40-2 (It no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endlorsement.) The Transfer Of Rights Of Recovery Against Others To Us Condition under Section IV — Conditions is amended by the addition of the following:� We waive any right of' recovery we may have against the person or organization shlown in the Schedule above be- cause of payments we make for injury or damage arising out of your ongoing operations or "your work"' done under a contract with that person or organization and included in the "prod ILI!CtS-COM pleted operations hazard". This waiver applies oinly to the person or organization shown in the Schedule abiove. 1 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 00 03 113 (Ed. 4-84) WAIVER OF OUR, RIGHT TO RECOVER FROM OTHERS ENDORSEMENT We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not en- force 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,) Schedule This endorsement changes the policy to whicb it is attacaied and iis, effective on the date issued unless otherwise stated, (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective Insured Insurance Company WC 00 03 13 policy No - Countersigned by Endorsement No,. Premium $ Capynght 1983 National! Council on Compensation Insurance,