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PROOF OF INSURANCE (2024 - 2024) CLOSEDCERTIFICATE OF LIABILITY INSURANCE
DATE (MM/DD/YYYY)
9/12/2023
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
Marsh & McLennan Agency LLC
5500 Cherokee Avenue, Suite 300
Alexandria VA 22312
INSURED
Carahsoft Technology Corp.
FedResults, Inc.
11493 Sunset Hills Road
Suite 100
Reston VA 20190
COVERAGES CERTIFICATE NUMBER:689254962 REVISION NUMBER:
11
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.
...._ __- .Y, �,._._---------------
rNSR AD St�BR ---- P01.1CY E'FF POLNCY EYP
-TR TYPE OF INSURANCE POLICY NUMBER MM/DO/Y MWDD LIMITS
A
X
COMMERCIAL GENERAL LIABILITY
Y
ENP0651059
4/19/2023
4/19/2024
EACH OCCURRENCE
$1,000,000
I7X
CLAIMS -MADE OCCUR
PRIEMISES LEO or„a;ut—r mice
$,500 000
... .... ...... ..
MED EXP (An one person)
$ 10 000
_ _
INJURYPERSONAL &ADV
GEN'L AGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE $ 2, 000 000
E PRO,
..
POLICYE LOC
—,
PRODUCTS COMP/OP,AGG
.. $ Z000,000
OTHER;
$
A
AUTOMOBILE LIABILITY Y
EBA0651059
4/19/2023
4/19/2024
COMBIN1:DSINGLE LIMI
$1,000,000
X ANY AUTO
BODILY INJURY (Per person)
$
OWNED SCHEDULED
BODILY INJURY (Per accident)
-$mmmmmmmITITmmmmmmmmmmmmmmmmmmmmmmmm-mmmmm
AUTOS ONLY AUTOS
X TOS
6.R.g nCkAwhJ',�1GE
Al ONLY ._X AUTOS ONLY
......................
-$ ..............-..--.m........m...m....m.mmmmm..
$
A
X
UMBRELLA LIAB X OCCUR
ENP0651059
4/19/2023
4/19/2024
EACH OCCURRENCE
$5,000,000
EXCESS LIAB
AGGREGATE A
............................................................,.-
$5,000,000
DED k RETENTION $
$
WORKERS COMPENSATION
'
EMPLOYERS' LIABILITY Y / N
TA
...... ,STATUTE ,,,ER,,_,_;.
ANYPROPRIETOR/PARTNER/EXECUTIVE
E. DENT
L.EACH I
$
OFFICER/MEMBER EXCLUDED?
N / A
...E .....................................................—.............
(Mandatory in NH)
SEASCC
L E- EA EMPLOYEE.
$
If yes, describe under
DESCRIPTION OF OPERATIONS below
L
E.L. DISEASE -POLICY LIMIT
$
B
Cyber& Professional Liability
NR030043701400
6/27/2023
B/27/2024 $5,000,000 Occ
$5,000,000 Agg
C
Crime
30TP032740921
2/6/2023
2/6/2024 $6,000,000 Limit
$50,000 Deductible
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
City of El Segundo is listed as an additional insured, ATIMA.
CERTIFICATE HOLDER CANCELLATION
City of El Segundo
350 Main Street
III Segundo CA 90245
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
©1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
CinciPlus°
BUSINESS AUTO XC+°
(EXPANDED COVERAGE PLUS)
ENDORSEMENT - VIRGINIA
This endorsement modifies insurance provided by the following:
BUSINESS AUTO COVERAGE FORM
With respect to the coverage provided by this endorsement, the provisions of the Coverage Form apply unless
modified by this endorsement.
A. Liability Coverage Extensions - Supple- E. Blanket Waiver of Subrogation
mentary Payments - Higher Limits SECTION IV - BUSINESS AUTO CONDI-
SECTION II - LIABILITY COVERAGE, A. TIONS, A. Loss Conditions, 5. Transfer of
Coverage, 2. Coverage Extensions, a. Sup- Rights of Recovery Against Others to Us is
plementary Payments is amended by: amended by the addition of the following:
1. Replacing the $2,000 Limit of Insurance
for bail bonds with $4,000 in (2); and
2. Replacing the $250 Limit of Insurance for
reasonable expenses with $500 in (4).
B. Transportation Expense - Higher Limits
SECTION III - PHYSICAL DAMAGE COV-
ERAGE, A. Coverage, 4. Coverage Exten-
sions is amended by replacing $20 per day
with $50 per day, and $600 maximum with
$1,500 maximum in Extension a. Transpor- F
tation Expenses.
C. Airbag Coverage
We waive any right of recovery we may have
against any person or organization because of
payments we make for "bodily injury" or
"property damage" arising out of the operation
of a covered "auto" when you have assumed
liability for such "bodily injury" or "property
damage" under an "insured contract", provid-
ed the "bodily injury" or "property damage" oc-
curs subsequent to the execution or the "in-
sured contract".
Noncontributory Insurance
SECTION IV - BUSINESS AUTO CONDI-
TIONS, B. General Conditions, 5. Other In-
surance is amended by adding the following:
SECTION III - PHYSICAL DAMAGE COV-
ERAGE, B. Exclusions, 3.a. is amended by e. Regardless of the provisions of Para -
adding the following: graph a. above, this Coverage Form's Li-
ability Coverage is primary and we will not
However, the mechanical and electrical seek contribution from any other insur-
breakdown portion of this exclusion does not ance for any liability assumed under an
apply to the accidental discharge of an airbag. "insured contract' that requires liability to
This coverage for airbags is excess over any be assumed on a primary noncontributory
other collectible insurance or warranty. basis.
D. Glass Repair -Waiver of Deductible G. Additional Insured by Contract
SECTION III - PHYSICAL DAMAGE COV- SECTION II - LIABILITY COVERAGE, A.
ERAGE, D. Deductible is amended by adding Coverage, 1. Who is an Insured is amended
the following: to include as an insured any person or organi-
zation with which you have agreed in a valid
No deductible applies to glass damage if the written contract to provide insurance as is af-
glass is repaired in a manner acceptable to us forded by this policy.
rather than replaced.
Includes copyrighted material of ISO
AA 288 VA 01 16 Properties, Inc., with its permission.
COMMON POLICY CONDITIONS
All Coverage Parts included in this policy are subject to the following conditions.
A Cancellation
1. The first Named Insured shown in the
Declarations may cancel this policy by
mailing or delivering to us advance written
notice of cancellation.
2. We may cancel this policy by mailing or
delivering to the first Named Insured writ-
ten notice of cancellation at least:
a. 10 days before the effective date of
cancellation if we cancel for nonpay-
ment of premium; or
b. 30 days before the effective date of
cancellation if we cancel for any other
reason.
3. We will mail or deliver our notice to the
first Named Insured's last mailing address
known to us.
4. Notice of cancellation will state the effec-
tive date of cancellation. The policy pe-
riod will end on that date.
5. If this policy is cancelled, we will send the
first Named Insured any premium refund
due. If we cancel, the refund will be pro
rata. If the first Named Insured cancels,
the refund may be less than pro rata. The
cancellation will be effective even if we
have not made or offered a refund.
6. If notice is mailed, proof of mailing will be
sufficient proof of notice.
B. Changes
This policy contains all the agreements be-
tween you and us concerning the insurance af-
forded. The first Named Insured shown in the
Declarations is authorized to make changes in
the terms of this policy with our consent. This
policy's terms can be amended or waived only
by endorsement issued by us and made a part
of this policy.
C. Examination of Your Books and Records
We may examine and audit your books and
records as they -relate -to -this -policy -at any
during the policy period and up to three years
afterward.
D. Inspections and Surveys
1. We have the right to:
a. Make inspections and surveys at any
time;
b. Give you reports on the conditions we
find; and
c. Recommend changes.
2. We are not obligated to make any inspec-
tions, surveys, reports or recommenda-
tions and any such actions we do under-
take relate only to insurability and the
premiums to be charged. We do not
make safety inspections. We do not un-
dertake to perform the duty of any person
or organization to provide for the health or
safety of workers or the public. And we
do not warrant that conditions:
a. Are safe or healthful; or
b. Comply with laws, regulations, codes
or standards.
3. Paragraphs 1. and 2. of this condition ap-
ply not only to us, but also to any rating,
advisory, rate service or similar organiza-
tion which makes insurance inspections,
surveys, reports or recommendations.
4. Paragraph 2. of this condition does not
apply to any inspections, surveys, reports
or recommendations we may make rela-
tive to certification, under state or munici-
pal statutes, ordinances or regulations, of
boilers, pressure vessels or elevators.
E. Premiums
The first Named Insured shown in the Declara-
tions:
1. Is responsible for the payment of all pre-
miums; and
2. Will be the payee for any return premiums
we pay.
F. Transfer of Your Rights and Duties Under
this Policy
Your rights and duties under this policy may
not be transferred without our written consent
except in the case of death of an individual
named insured.
If you die, your rights and duties will be trans-
ferred to your legal representative but only
while acting within the scope of duties as your
legal representative. Until your legal represen-
tative is appointed, anyone having proper tem-
porary custody of your property will have your
rights and duties but only with respect to that
property.
IL 00 17 11 98 Copyright, Insurance Services Office, Inc., 1998
Policy Number: ENP0651059
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
COMMERCIAL GENERAL LIABILITY BROADENED
ENDORSEMENT - VIRGI LIA
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
A. Endorsement -Table of Contents:
1.
Employee Benefit Liabili Cove ra e.... ... ..3
C N
2.
Unintentional Failure to isclose azards...... .................. ..................... ......8
3.
Damage to Premises Dented to You ........ ...............................................................................
8
4.
5.
a Nementary Payments........................................................................9
dcaN Payments
6.
.........................................................................9
180, Day Coverage for Newly Formed or Acquired Organizations........................................9
7.
Vl9aiverofSubrogation.,....... ,.... ,...................................................................................10
8.
Automatic Additional Insured -Specified Relationships:..................................................10
Managers or Lessom of Premises;
Lessor of Leased Equipment;
• Vendors;
• State or Govemmental Ag,enc or Subdivision or Political Subdivision - Permits
or Authorizations Relatin to premises; and
Mort9.
10.
g or
quier
Pro arty Rama, a to orrow d Equipment........ . .... .
p y d E+quipment .......................... ............ ........................13
Employees as insureds Specified Health Care Services and Good Samaritan
Services............ ........ ........ ......................................................................................14
11.
Broadened Notice of Occurrence..........................................................................................14
12.
Nonowned Aircraft......... ......... ............ ......... .... ....... ... ,................ ..............
14
13.
14.
Bodily In`ury Redefined....,
Expecte Intended Injury Redefined
14
14
15.
or ......... .....a.... ...,...,...,...... .,...,.,.
Former Employees as Insureds .................... .............................. .......14
B. Limits of Insurance:
The
Commercial General Liability Limits of Insurance apply to the insurance provided by this
endorse-
ment, except as provided below:
1.
Employee Benefit Liability Coverage
Each Employee Limit: $1,000,000
Aggregate Limit: $3,000,000
Deductible Amount: $ 1,000
3.
Damage to Premises Rented to You
The lesser of:
a. The Each Occurrence Limit shown in the Declarations; or
b. $500,000 unless otherwise stated $
4.
Supplementary Payments
a. Bail Bonds: $2,500
b. Loss of Earnings: $ 500
5.
Medical Payments
Medical Expense Limit: $ 10,000
9.
Property Damage to Borrowed Equipment
Each Occurrence Limit: $10,000
Deductible Amount: $ 250
Includes copyrighted material of Insurance
GA 210
VA 0917 Services Office, Inc., with its permission. Page
1 of 14
Policy Number: ENP0651059
C. Coverages
this endorsement pro-
1. Employee Benefit Liability Coverage
vided:
a. The following is added to Section I -
a) You did not have
knowledge of a
Coverages:
claim or "suit" on or
Employee Benefit Liability Cover-
before the "first ef-
age
fective date" of this
endorsement.
(1) Insuring Agreement
You will be
(a) We will pay those sums that
deemed to have
the insured becomes legally
knowledge of a
obligated to pay as damag-
claim or "suit"
es caused by any act, error
when any "author -
or omission of the insured,
ized representa-
or of any other person for
tive';
whose acts the insured is
legally liable, to which this
i) Reports all, or
insurance applies. We will
any part, of the
have the right and duty to
act, error or
defend the insured against
omission to us
any "suit" seeking those
or any other
damages. However, we will
insurer;
have no duty to defend
ii) Receives a
against any "suit" seeking
written or ver-
damages to which this in-
bal demand or
surance does not apply. We
claim for dam -
may, at our discretion, in-
ages because
vestigate any report of an
of the act, Br-
act, error or omission and
ror or omis-
settle any daim or "suit' that
sion; and
may result. But:
1) The amount we will pay
b) There is no other
applicable insur-
for damages is limited
ance.
as described in Section
III - Limits of Insur- (2)
Exclusions
ance; and
This insurance does not apply to:
2) Our right and duty to
defend ends when we
(a) Bodily Injury, Property
have used up the appli-
Damage or Personal and
cable limit of insurance
Advertising Injury
in the payment of judg-
"Bodily injury", "property
ments or settlements.
damage" or "personal and
No other obligation or liabil-
advertising injury'.
ity to pay sums or perform
(b) Dishonest, Fraudulent,
acts or services is covered
Criminal or Malicious Act
unless explicitly provided for
under Supplementary
Damages arising out of any
Payments.
intentional, dishonest,
(b)—This—insurance—applies—to—
fraudulent, criminal or mali-
cious act, error or omission,
damages only if the act, er-
committed by any insured,
ror or omission, is negligent-
including the willful or redc-
ly committed in the "admin-
less violation of any statute.
istration" of your "employee
benefit program"; and
(c) Failure to Perform a Con-
1) Occurs during the policy
tract
period; or
Damages arising out of fail-
2) Occurred prior to the
ure of performance of con -
"first effective date" of
tract by any insurer.
Includes copyrighted material of Insurance
GA 210 VA 0917 Services Office, Inc., with its permission.
Page 2 of 14
Policy Number: ENP0651059
(d)
Insufficiency of Funds
(1) Taxes, Fines or Penalties
Damages arising out of an
Taxes, fines or penalties, in -
insufficiency of funds to
cluding those imposed un-
meet any obligations under
der the Internal Revenue
any plan included in the
Code or any similar state or
"employee benefit program".
local law.
(e)
Inadequacy of Perfor-
Ili) Employment -Related Prac-
mance of Invest-
tices
ment/Advice Given With
Respect to Participation
Any liability arising out of
any:
Any claim based upon:
(1) Refusal to employ;
1) Failure of any invest-
ment to perform;
(2) Termination of employ-
ment;
2) Errors in providing in-
formation on past per-
(3) Coercion, demotion,
formance of investment
evaluation, reassign -
vehicles; or
ment, discipline, defa-
mation, harassment,
3) Advice given to any
humiliation, discrimina-
person with respect to
tion or other employ -
that person's decision to
ment - related practices,
participate or not to par-
acts or omissions; or
ticipate in any plan in-
cluded in the "employee
(4) Consequential liability
benefit program".
as a result of (1), (2) or
(3) above.
(f)
Workers' Compensation
and Similar Laws
This exclusion applies
whether the insured may be
Any claim arising out of your
held liable as an employer
failure to comply with the
or in any other capacity and
mandatory provisions of any
to any obligation to share
workers' compensation, un-
damages with or repay
employment compensation
someone else who must pay
insurance, social security or
damages because of the in -
disability benefits law or any
jury.
similar law.
(3) Supplementary Payments
(g)
ERISA
Section 1 - Coverages, Sup -
Damages for which any in-
plementary Payments - Cover-
sured is liable because of li-
ages A and B also apply to this
ability imposed on a fiduci-
Coverage.
ary by the Employee Re-
tirement Income Security
b. Who is an Insured
Act of 1974, as now or
As respects Employee Benefit Lia-
hereafter amended, or by
bility Coverage, Section II - Who is
any similar federal, state or
an Insured is replaced by the follow -
local laws.
ing:
(h) Available Benefits (1) If you are designated in the Dec -
Any claim for benefits to the larations as:
extent that such benefits are (a) An individual, you and your
available, with reasonable spouse are insureds, but on -
effort and cooperation of the ly with respect to the con -
insured, from the applicable duct of a business of which
funds accrued or other col- you are the sole owner.
lectible insurance.
(b) A partnership or joint ven-
ture, you are an insured.
Your members, your part -
Includes copyrighted material of Insurance
GA 210 VA 0917 Services Office, Inc., with its permission. Page 3 of 14
Policy Number: ENP0651059
ners, and their spouses are
However, coverage under this
also insureds but only with
provision:
respect to the conduct of
your business.
(a) Is afforded only until the
180th day after you acquire
(c) A limited liability company,
or form the organization or
you are an insured. Your
the end of the policy period,
members are also insureds,
whichever is earlier; and
but only with respect to the
conduct of your business.
(b) Does not apply to any act,
Your managers are in-
error or omission that was
sureds, but only with respect
committed before you ac-
to their duties as your man-
quired or formed the organi-
agers.
zation.
(d) An organization other than a
c. Limits of Insurance
partnership, joint venture or
As respects Employee Benefit Lia-
limited liability company, you
bility Coverage, Section III - Limits
are an insured. Your "execu-
Of Insurance is replaced by the fol-
tive officers" and directors
lowing:
are insureds, but only with
respect to their duties as
(1) The Limits of Insurance shown in
your officers or directors.
Section B. Limits of Insurance,
Your stockholders are also
1. Employee Benefit Liability
insureds, but only with re-
Coverage and the rules below fix
spect to their liability as
the most we will pay regardless
stockholders.
of the number of
(e) A trust, you are an insured.
(a) Insureds;
Your trustees are also in-
sureds, but only with respect
(b) Claims made or "suits"
to their duties as trustees.
brought;
(2) Each of the following is also an
(c) Persons or organizations
insured:
making claims or bringing
"suits";
(a) Each of your "employees"
who is or was authorized to
(d) Acts, errors or omissions; or
administer your "employee
(e) Benefits included in your
benefit program";
"employee benefit program".
(b) Any persons, organizations
"employees"
(2) The Aggregate Limit shown in
or having prop-
Section B. Limits of Insurance,
er temporary authorization
'employ-
1. Employee Benefit Liability
to administer your
Coverage of this endorsement is
ee benefit program" if you
the most we will pay for all dam -
die, but only until your legal
ages because of acts, errors or
representative is appointed;
omissions negligently committed
or
in the "administration" of your
(c) Your legal representative if
"employee benefit program".
you die, but only with re-
(3) Subject to the limit described in
spect to duties as such. That
(2) above, the Each Employee
representative will have all
Limit shown in Section B. Limits
your rights and duties under
of Insurance, 1.Employee-
this Coverage Part.
Benefit Liability Coverage of
(3) Any organization you newly ac-
this endorsement is the most we
quire or form, other than a part-
will pay for all damages sus-
nership, joint venture or limited
tained by any one "employee",
liability company, and over which
including damages sustained by
you maintain ownership or major-
such "employee's" dependents
ity interest, will qualify as an in-
and beneficiaries, as a result of:
sured if no other similar insur-
(a) An act, error or omission; or
ante applies to that organization.
Includes copyrighted material of Insurance
GA 210 VA 0917 Services Office, Inc., with its permission. Page 4 of 14
Policy Number: ENP0651059
(b) A series of related acts, er-
tification of the action taken,
rors or omissions, regard-
you shall promptly reim-
less of the amount of time
burse us for such part of the
that lapses between such
Deductible Amount as we
acts, errors or omissions;
have paid.
negligently committed in the
d. Additional Conditions
"administration" of your "employ-
ee benefit program".
As respects Employee Benefit Lia-
bility Coverage, Section IV - Com-
However, the amount paid under
mercial General Liability Condi-
this endorsement shall not ex-
tions is amended as follows:
ceed, and will be subject to the
limits and restrictions that apply
(1) Item 2. Duties in the Event of
to the payment of benefits in any
Occurrence, Offense, Claim or
plan included in the "employee
Suit is replaced by the following:
benefit program."
2. Duties in the Event of an
(4) Deductible Amount
Act, Error or Omission, or
Claim or Suit
(a) Our obligation to pay dam-
ages on behalf of the in-
a. You must see to it that
sured applies only to the
we are notified as soon
amount of damages in ex-
as practicable of an act,
cess of the Deductible
error or omission which
Amount stated in the Decla-
may result in a claim.
rations as applicable to
To the extent possible,
Each Employee. The limits
notice should include:
of insurance shall not be re-
(1) What the act, error
duced by the amount of this
or omission was
deductible.
and when it oc-
(b) The Deductible Amount
curred; and
stated in the Declarations
(2) The names and
applies to all damages sus-
addresses of any-
tained by any one "employ-
one who may suf-
ee", including such "employ-
fer damages as a
ee's" dependents and bene-
result of the act,
fiaaries, because of all acts,
error or omission.
errors or omissions to which
this insurance applies.
b. If a claim is made or
"suit" is brought against
(c) The terms of this insurance,
any insured, you must:
including those with respect
to:
(1) Immediately record
the specifics of the
1) Our right and duty to
claim or "suit" and
defend the insured
the date received;
against any "suits"
and
seeking those damag-
es; and
(2) Notify us as soon
as practicable.
2) Your duties, and the du-
ties of any other in-
You must see to it that
volved insured, in the
we receive written no -
event of an act, error or
tice of the claim or "suit"
omission, or claim;
as soon as practicable.
apply irrespective of the ap- c. You and any other in-
plication of the Deductible volved insured must:
Amount.
(1) Immediately send
(d) We may pay any part or all us copies of any
of the Deductible Amount to demands, notices,
effect settlement of any summonses or le -
claim or "suit' and, upon no- gal papers re -
Includes copyrighted material of Insurance
GA 210 VA 0917 Services Office, Inc., with its permission. Page 5 of 14
Policy Number: ENP0651059
ceived in connec-
tion with the claim
or "suit;
(2)
Authorize us to ob-
tain 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 en-
forcement of any
right against any
person or organi-
zation which may
be liable to the in-
sured because of
an act, error or
omission 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 without our
consent.
(2) Item 5. Other Insurance is re-
placed by the following:
5. Other Insurance
If other valid and collectible
insurance is available to the
insured for a loss we cover
under this Coverage Part,
our obligations are limited as
follows:
a. Primary Insurance
This insurance is prima-
ry except when c. below
applies. If this insurance
is primary, our obliga-
tions are not affected
unless any -of -the -other
insurance is also prima-
ry. Then, we will share
with all that other insur-
ance by the method de-
scribed in b. below.
b. Method of Sharing
If all of the other insur-
ance permits contribu-
tion by equal shares,
we will follow this meth-
od also. Under this ap-
proach 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 in-
surance does not permit
contribution by equal
shares, we will contrib-
ute 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 insur-
ers.
c. No Coverage
This insurance shall not
cover any loss for which
the insured is entitled to
recovery under any
other insurance in force
previous to the effective
date of this Coverage
Part.
e. Additional Definitions
As respects Employee Benefit Lia-
bility Coverage, Section V - Defini-
tions is amended as follows:
(1) The following definitions are
added:
1. 'Administration" means:
a. Providing information to
"employees", including
their dependents and
beneficiaries, with re-
spect to eligibility for or
scope of "employee
benefit programs";
b. Interpreting
the
"em-
ployee benefit
pro-
grams";
c. Handling
records
in
connection
with
the
"employee
benefit
pro-
grams"; or
d. Effecting, continuing or
terminating any "em-
ployee's" participation in
any benefit included in
Includes copyrighted material of Insurance
GA 210 VA 0917 Services Office, Inc., with its permission. Page 6 of 14
Policy Number ENP0651059�
the "employee benefit
c. Unemployment insur-
program".
ance, social security
benefits, workers' com-
However, "administration"
pensation and disability
does not include:
benefits; and
a. Handling payroll deduc-
d. Vacation plans, includ-
tions; or
ing buy and sell pro-
b. The failure to effect or
grams; leave of ab-
maintain any insurance
sence programs, includ-
or adequate limits of
ing military, maternity,
coverage of insurance,
family, and civil leave;
including but not limited
tuition assistance plans;
to unemployment insur-
transportation and
ance, social security
health club subsidies.
benefits, workers' com-
4. "First effective date" means
pensation and disability
the date upon which cover -
benefits.
age was first effected in a
2. "Cafeteria plans" means
series of uninterrupted re -
plans authorized by applica-
newals of insurance cover-
ble law to allow "employees"
age.
to elect to pay for certain
(2) The following definitions are de -
benefits with pre-tax dollars.
leted in their entirety and re-
3. "Employee benefit pro-
placed by the following:
grams" means a program
g, "Employee" means a person
providing some of all of the
actively employed, formerly
following benefits to "em-
employed, on leave of ab-
ployees", whether provided
sence or disabled, or retired.
through a "cafeteria plan" or
"Employee" includes a
otherwise:
'leased worker". "Employee"
a. Group life insurance;
does not include a "tempo -
group accident or health
rary worker".
insurance; dental, vision
21. "Suit" means a civil proceed -
and hearing plans; and
ing in which money damag-
flexible spending ac-
es because of an act, error
counts; provided that no
or omission to which this in -
one other than an "em-
surance applies are alleged.
ployed' may subscribe
"Suit" includes:
to such benefits and
such benefits are made
a. An arbitration proceed -
generally available to
ing in which such dam -
those "employees" who
ages are claimed and to
satisfy the plan's eligibil-
which the insured must
ity requirements;
submit or does submit
with our consent;
b. Profit sharing plans,
employee savings
b. Any other alternative
plans, employee stock
dispute resolution pro -
ownership plans, pen-
ceeding in which such
sion plans and stock
damages are claimed
subscription plans, pro-
and to which the in-
vided that no one other
sured submits with our
than an "employee"
consent; or
may subscribe to such
benefits and such bene-
c. appeal of a civil pro-
fits are made generally
ce
ceeding.
available to all "employ-
ees" who are eligible
under the plan for such
benefits;
Includes copyrighted material of Insurance
GA 210 VA 0917 Services Office, Inc., with its permission. Page 7 of 14
Policy Number: ENP0651059
2. Unintentional Failure to Disclose Haz-
terioration, hidden
ards
or latent defect or
Section IV - Commercial General Liabil-
any quality in
property that caus-
ity Conditions, 7. Representations is
es it to damage or
amended by the addition of the following:
destroy itself;
Based on our dependence upon your rep-
3) Smog;
resentations as to existing hazards, it un-
intentionally you should fail to disclose all
4) Mechanical break -
such hazards at the inception date of your
down, including
policy, we will not reject coverage under
rupture or bursting
this Coverage Part based solely on such
caused by centrif-
failure.
ugal force;
3. Damage to Premises Rented to You
5) Settling, cracking,
a. The last Paragraph of 2. Exclusions
shrinking or ex-
under Section I - Coverage A - Bod-
pansion;
ily Injury and Property Damage Li-
6) Nesting or infesta-
ability is replaced by the following:
tion, or discharge
Exclusions c. through q. do not apply
"property
or release of waste
products or secre-
to damage" by fire, explo-
tions, by insects,
Sion, lightning, smoke or soot to
birds, rodents or
premises while rented to you or tem-
other animals; or
porarily occupied by you with permis-
sion of the owner, for which the
7) Presence, growth,
amount we will pay is limited to the
proliferation,
Damage to Premises Rented to
spread or any ac-
You Limit as described in Section III
tivity of fungus, in-
- Limits of Insurance.
cluding mold or
b. The insurance provided under Sec-
mildew, and anymycotox ins,
tion I - Coverage A - Bodily Injury
spores, scents or
and Property Damage Liability ap-
'property
byproducts pro -
plies to damage" arising out
duoed or released
of water damage to premises that are
by fungi.
both rented to and occupied by you.
(1) As respects Water Damage Le-
(b) "Property damage" caused
directly or indirectly by any
gal Liability, as provided in Para-
of the following:
graph 3.b. above:
The exclusions(i)
under Section I -
Earthquake, volcanicusions
eruption, landslide or
Coverage A - Bodl'ly Injury and
any other earth move -
Property Damage Liability, 2.
ment;
Exclusions, other than i. War
and the Nuclear Energy Liabil-
(ii) Water that backs up or
ity Exclusion (Broad Form), are
overflows or is other -
deleted and the following are
wise discharged from a
added:
sewer, drain, sump,
This insurance does not apply to:
sump pump or related
equipment;
(a) "Property damage":
(iiQ Water -under -the -ground
(i) Assumed in any con-
surface pressing on, or
tractor agreement; or
flowing or seeping
through:
(ii) Caused by or resulting
from any of the follow-
1) Foundations, walls,
ing:
floors or paved
surfaces;
1) Wear and tear;
2) Basements,
2) Rust or other cor-
whether paved or
rosion, decay, de-
not; or
Includes copyrighted material of Insurance
GA 210 VA 09 17 Services Office, Inc., with its permission. Page 8 of 14
Policy Number: ENP0651059
C.
3) Doors, windows or
ning, smoke or soot,
other openings.
while rented to you; or
(c) "Property damage" caused
c. In the case of damage
by or resulting from water
by water, while rented
that leaks or flows from
to and occupied by you.
plumbing, heating, air condi-
tioning, fire protection sys-
(2) The most we will pay is limited as
tems, or other equipment,
described in Section B. Limits of
caused by or resulting from
Insurance, 3. Damage to Prem-
freezing, unless:
ises Rented to You of this en-
dorsement.
(i) You did your best to
maintain heat in the
4. Supplementary Payments
building or structure; or
Under Section I - Supplementary Pay-
(ii) You drained the equip-
ments - Coverages A and B:
ment and shut off the
a. Paragraph 2. is replaced by the fol-
water supply if the heat
lowing:
was not maintained.
Up to the limit shown in Section B.
(d) "Property damage" to:
Limits of Insurance, 4.a. Bail Bonds
(1) Plumbing, heating, air
of this endorsement for cost of bail
conditioning, fire protec-
bonds required because of accidents
tion systems, or other
or traffic law violations arising out of
equipment or applianc-
the use of any vehicle to which the
es; or
Bodily Iryury Liability Coverage ap-
plies. We do not have to furnish these
(i) The interior of any
bonds.
building or structure, or
to personal property in
b. Paragraph 4. is replaced by the fol-
the building or structure,
lowing:
caused by or resulting
All reasonable expenses incurred by
from rain, snow, sleet or
the insured at our request to assist us
ice, whether driven by
in the investigation or defense of the
wind or not.
claim or "suit", including actual loss of
Limit of Insurance
earnings up to the limit shown in Sec-
tion B. Limits of Insurance, 4.1b.
With respect to the insurance afford-
Loss Of Earnings of this endorsement
ed in Paragraphs 3.a. and 3.1b. above,
per day because of time off from
the Damage to Premises Rented to
work.
You Limit as shown in the Declara-
tions is amended as follows:
5. Medical Payments
(1) Paragraph 6. of Section III - The Medical Expense Limit of Any One
Limits of Insurance is replaced Person as stated in the Declarations is
by the following: amended to the limit shown in Section B.
Limits of Insurance, 5. Medical Pay-
6. Subject to Paragraph S. ments of this endorsement.
above, the Damage to
Premises Rented tc) You 6. 180 Day Coverage for Newly Formed or
Limit is the most we will pay Acquired Organizations
under Coverage A - Bodily Section II - Who is an Insured is
Injury and Property Dam- amended as follows:
age Liability for damages
because of 'property dam- Subparagraph a. of Paragraph 3. is re -
age" to any one premises: placed by the following:
GA 210 VA 0917
a. While rented to you, or a. Insurance under this provision is af-
temporarily occupied by forded only until the 180th day after
you with permission of you acquire or form the organization
the owner; or the end of the policy period,
b. In the case of damage whichever is earlier;
by fire, explosion, light -
Includes copyrighted material of Insurance
Services Office, Inc., with its permission. Page 9 of 14
Policy Number: ENP0651059
7. Waiver of Subrogation
This insurance does not ap-
Section IV - Commercial General Liabil-
ply to:
ity Conditions, 9. Transfer of Rights of
(1) Any "occurrence" which
Recovery Against Others to Us is
takes place after you
amended by the addition of the following:
cease to be a tenant in
We waive any right of recovery we may
that premises;
have against any person or organization
(ii) Sliucluial alleialions,
against whom you have agreed to waive
new construction or
such right of recovery in a written contract
demolition operations
or agreement because of payments we
performed by or on be -
make for injury or damage arising out of
half of such additional
your ongoing operations or "your work"
insured.
done under a written contract or agree-
ment with that person or organization and
(b) Lessor of Leased Equip -
included in the "products -completed oper-
ment
ations hazard". However, our rights may
Any person or organization
only be waived prior to the "occurrence"
from whom you lease
giving rise to the injury or damage for
equipment when you and
which we make payment under this Cov-
such person(s) or organiza-
erage Part The insured must do nothing
tion(s) have agreed per Par -
after a loss to impair our rights. At our re-
agraph 8.a.(1) of this en -
quest, the insured will bring "suit" ortrans-
dorsement to provide insur-
fer those rights to us and help us enforce
ante. Such person(s) or or -
those rights.
ganization(s) are insureds
8. Automatic Additional Insured - Speci-
only with respect to liability
fied Relationships
for "bodily injury', "property
damage" or "personal and
a. The following is added to Section II -
advertising injury' caused, in
Who is an Insured:
whole or in part, by your
(1) Any person(s) or organization(s)
maintenance, operation or
use of equipment leased to
described in Paragraph 8.a.(2) of
you by such person(s) or or -
this endorsement (hereinafter re-
ganization(s). A person's or
ferred to as additional insured)
organization's status as an
whom you are required to add as
additional insured under this
an additional insured under this
endorsement ends when
Coverage Part by reason of a
their contract or agreement
written contract, written agree-
with you for such leased
ment, written permit or written
equipment ends. However,
authorization.
this insurance does not ap-
(2) Only the following persons or or-
ply to any "occurrence"
ganizations are additional in-
which takes place after the
sureds under this endorsement,
equipment lease expires.
and insurance coverage provided
(c) Vendors
to such additional insureds is lim-
ited as provided herein:
Any person or organization
(a) Managers or Lessors of
(referred to below as ven-
dor) with whom you have
agreed per Paragraph
The manager or lessor of a
8.a.(1) of this endorsement
- - - - - -premises-leased-to-you-with—
-to-provide insurance, but -on ---
whom you have agreed per
ly with respect to 'bodily in -
Paragraph 8.a.(1) of this en-
jury"or "property damage"
dorsement to provide insur-
our "
ance, but only with respect
which are distributed or sold
to liability arising out of the
in the regular course of the
g
ownership, maintenance or
vendor's business, subject
use of that part of the prem-
to the following additional
ises leased to you, subject
exclusions:
to the following additional
exclusions:
Includes copyrighted material of Insurance
GA 210 VA 09 17 Services Office, Inc., with its permission. Page 10 of 14
Policy Number: ENP0651059
(i) The insurance afforded
dor's premises in
the
vendor does not
connection with the
apply
to:
sale of the product;
1)
"Bodily injury' or
7) Products which, af-
"property damage"
ter distribution or
for which the ven-
sale by you, have
dor is obligated to
been labeled or re-
pay damages by
labeled or used as
reason of the as-
a container, part or
sumption of liability
ingredient of any
in a contract or
other thing or sub -
agreement. This
stance by or for the
exclusion does not
vendor; or
apply to liability for
damages that the
8) "Bodily injury' or
vendor would have
"property damage"
in the absence of
arising out of the
the contract or
sole negligence of
agreement;
the vendor for its
own acts or omis-
2)
Any express war-
sions or those of
ranty unauthorized
its employees or
by you;
anyone else acting
on its behalf. How
3)
Any physical or
ever, this exclusion
chemical change in
does not apply to:
the product made
intentionally by the
a) The excep-
vendor;
tions contained
in Paragraphs
4)
Repackaging, ex-
(c) (i) 4) or 6)
kept when un-
of this en -
packed solely for
dorsement; or
the purpose of in-
spection, demon-
b) Such inspec-
stration, testing, or
tions, adjust -
the substitution of
ments, tests or
parts under in-
servicing as
structions from the
the vendor has
manufacturer, and
agreed to
then repackaged in
make or nor -
the original con-
mally under-
tainer;
takes to make
in the usual
5)
Any failure to make
course of
such inspections,
business, in
aclustments, tests
connection
or servicing as the
with the distri-
vendor has agreed
bution or sale
to make or normal-
of the prod-
ly undertakes to
ucts.
make in the usual
course of busi-
(ii) This insurance does not
ness, in connection
apply to any insured
with the distribution
person or organization:
or sale of the
products;
1) From whom you
have acquired
6)
Demonstration, in-
such products, or
stallation, servicing
any ingredient, part
or repair opera-
or container, enter-
tions, except such
ing into, accompa-
operations per-
nying or containing
formed at the ven-
such products; or
Includes copyrighted material of Insurance
GA 210 VA 0917
Services Office, Inc., with its permission.
Page 11 of 14
Policy Number: ENP0651059
2) When liability in-
spect to their liability as
cluded within the
mortgagee, assignee, or re-
"products-
ceiver and arising out of the
completed opera-
ownership, maintenance, or
tions hazard" has
use of the premises by you.
been excluded un-
However, this insurance
der this Coverage
does not apply to structural
Part with respect to
alterations, new construction
such products.
and demolition operations
(d) State or Governmental
performed by or for that per -
son or organization.
Agency or Subdivision or
Political Subdivision -
(3) The insurance afforded to addi-
Permits or Authorizations
tional insureds described in Par -
Relating to Premises
agraph 8.a.(1) of this endorse -
Any state or governmental
ment:
agency or subdivision or po-
(a) Only applies to the extent
litical subdivision with which
permitted by law; and
you have agreed per Para-
graph 8.a.(1) of this en-
b Will not be broader than that
()
dorsement to provide insu
re
which are wired b- Y q y
anoe, subject to the follow
the written contract, written
ing additional provision:
agreement, written permit or
written authorization to pro -
This insurance applies only
vide for such additional in -
with respect to the following
sured; and
hazards for which the state
or governmental agency or
(c) Does not apply to any per -
subdivision or political sub-
son, organization, vendor,
division has issued a permit
state, governmental agency
or authorization in connec-
or subdivision or political
tion with premises you own,
subdivision, specifically
rent or control and to which
named as an additional in -
this insurance applies:
sured under any other provi-
sion of, or endorsement
(1) The existence, mainte-
added to, this Coverage
nance, repair, construc-
Part, provided such other
tion, erection or removal
provision or endorsement
of advertising signs,
covers the injury or damage
awnings, canopies, cel-
for which this insurance ap-
lar entrances, coal
plies.
holes, driveways, man-
holes, marquees, hoist
b. With respect to the insurance afford -
away openings, side-
ed to the additional insureds de -
walk vaults, street ban-
scribed in Paragraph 8.a.(1) of this
ners or decorations and
endorsement, the following is added
similar exposures; or
to Section III - Limits of Insurance:
(i) The construction, erec-
The most we will pay on behalf of the
tion or removal of eleva-
additional insured is the amount of in -
tors; or
surance:
(ii) The ownership, mainte-
(1) Required by the written contract,
-- - -- - -_ -nance-or-use-of-any-el--
-- written agreement, written permit
evators covered by this
or written authorization described
insurance.
in Paragraph 8.a.(1) of this en-
dorsement; or
(e) Mortgagee, Assignee or
Receiver
2 Available under the applicable
() pp
Limits of Insurance shown in the
Any person or organization
Declarations;
with whom you have agreed
per Paragraph 8.a.(1) of this
whichever is less.
endorsement to provide in-
surance, but only with re -
Includes copyrighted material of Insurance
GA 210 VA 0917 Services Office, Inc., with
its permission. Page 12 of 14
Policy Number: ENP0651059
This endorsement shall not increase
b. With respect to the insurance provid-
the applicable Limits of Insurance
ed by this section of the endorse -
shown in the Declarations.
ment, the following additional provi-
sions apply:
c. Section IV - Commercial General
Liability Conditions is amended to
(1) The Limits of Insurance shown in
include the following:
the Declarations are replaced by
the limits designated in Section
Automatic Additional Insured Pro-
B. Limits of Insurance, 9.
vision
Property Damage to Borrowed
This insurance applies only if the
Equipment of this endorsement
"bodily injury" or "property damage"
with respect to coverage provid-
occurs, or the "personal and advertis-
ed by this endorsement. These
ing injury' offense is committed:
limits are inclusive of and not in
addition to the limits being re-
(1) During the policy period; and
placed. The Limits of Insurance
shown in Section B. Limits of
(2) Subsequent to your execution of
Insurance, 9. Property Damage
the written contract or written
to Borrowed Equipment of this
agreement, or the issuance of a
endorsement fix the most we will
written permit or written authori-
pay in any one "occurrence" re-
zation, described in Paragraph
gardless of the number of:
8.a.(1).
(a) Insureds;
d. Section IV - Commercial General
Liability Conditions is amended as
(b) Claims made or "suits"
follows:
brought; or
Condition S. Other Insurance is
(c) Persons or organizations
amended to include:
making claims or bringing
"suits".
Primary and Noncontributory In-
surance
(2) Deductible Clause
This insurance is primary to and will
(a) Our obligation to pay dam -
not seek contribution from any other
ages on your behalf applies
insurance available to an additional
only to the amount of dam -
insured per Paragraph 8.a.(1) of this
ages for each "occurrence"
endorsement provided that:
which are in excess of the
Deductible Amount stated inSection
(1) The additional insured is a
B. Limits of Insur-
Named Insured under such other
ance, 9. Property Damage
insurance; and
to Borrowed Equipment of
(2) You have agreed in writing in a
this endorsement. The limits
contract, agreement, permit or
of insurance will not be re-
authorization described in 8.a.(2)
duced by the application of
of this endorsement that this in-
such Deductible Amount.
surance would be primary and
(b) Section IV - Commercial
would not seek contribution from
General Liability Condi-
any other insurance available to
tions, 2. Duties in the
the additional insured.
Event of Occurrence, of-
9. Property Damage to Borrowed Equip-
fense, Claim Or Suit, ap-
ment
plies to each claim or "suit'
irrespective of the amount.
a. The following is added to Exclusion
2.j. Damage to Property under Sec-
(c) We may pay any part or all
tion I - Coverage A - Bodily Injury
of the deductible amount to
and Property Damage Liability:
effect settlement of any
claim or "suit" and, upon no -
Paragraphs (3) and (4) of this exclu-
tification of the action taken,
sion do not apply to tools or equip-
you shall promptly reim-
ment loaned to you, provided they are
burse us for such part of the
not being used to perform operations
deductible amount as has
at the time of loss.
been paid by us.
Includes copyrighted material of Insurance
GA 210 VA 0917 Services Office, Inc., with its permission. Page 13 of 14
Policy Number: ENP0651059
10. Employees As Insureds - Specified
Health Care Services And Good Samar-
itan Services
Paragraph 2.a.(1xd) under Section II -
Who Is An Insured does not apply to:
a. Your "employees" who provide pro-
fessional health care seiviczs un yuw
behalf as a duly licensed nurse,
emergency medical technician or
paramedic in the jurisdiction where an
"occurrence" or offense to which this
insurance applies takes place; or
b. Your "employees" or "volunteer work-
ers", other than an employed or vol-
unteer doctor, providinq first aid or
good samaritan services during their
work hours for you will be deemed to
be acting within the scope of their
employment by you or performing du-
ties related to the conduct of your
business.
11. Broadened Notice Of Occurrence
Paragraph a. of Condition 2. Duties In
The Event Of Occurrence, Offense,
Claim Or Suit under Section IV - Com-
mercial General Liability Conditions is
replaced by the following:
a. You must see to it that we are notified
as soon as practicable of an "occur-
rence" or an offense which may result
in a claim. To the extent possible, no-
tice should include:
(1) How, when and where the "oc-
currence" or offense took place;
(2) The names and addresses of
any injured persons and wit-
nesses; and
(3) The nature and location of any
iryury or damage arising out of
the "occurrence" or offense.
This requirement applies only when
the "occurrence" or offense is known
to an "authorized representative".
12. Nonowned Aircraft
The following _ is -added -to-Exclusion -
Aircraft, Auto Or Watercraft under Sec-
tion I - Coverage A - Bodily Injury And
Property Damage Liability:
This exclusion does not apply to an air-
craft you do not own, provided that:
a. The pilot in command holds a current
effective certificate, issued by a duly
constituted authority of the United
States of America or Canada, desig-
nating that person as a commercial or
airline transport pilot;
b. The aircraft is rented with a trained,
paid crew; and
c. The aircraft does not transport per-
sons or cargo for a charge.
13. Bodily Injury Redefined
Section V - Definitions, 4. "Bodily injury"
is replaced by the following:
4. "Bodily injury" means bodily harm or
injury, sickness, disease, disability,
humiliation, shock, fright, mental an-
guish or mental injury, including care,
loss of services or death resulting
from any of these at any time.
14. Expected Or Intended Injury Redefined
The last sentence of Exclusion 2.a. Ex-
pected Or Intended Injury under Sec-
tion I - Coverage A - Bodily Injury And
Property Damage Liability is replaced by
the following:
This exclusion does not apply to "bodily
injury" or "property damage" resulting from
the use of reasonable force to protect per-
sons or property.
15. Former Employees As Insureds
The following is added to Paragraph 2.
under Section II -Who Is An Insured:
2. Each of the following is also an in-
sured:
Any of your former "employees", di-
rectors, managers, members, part-
ners or "executive officers", including
but not limited to retired, disabled or
those on leave of absence, but only
for acts within the scope of their em-
ployment by you or for duties related
to the conduct of your business.
Includes copyrighted material of Insurance
GA 210 VA 0917 Services Office, Inc., with its permission. Page 14 of 14
COMMERCIAL GENERAL LIABILITY
CG20431219
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED - AUTOMATIC STATUS WHEN
REQUIRED IN WRITTEN CONTRACT OR AGREEMENT
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
A. Section II — Who Is An Insured is amended to
include as an additional insured any person(s) or
organization(s) for whom you have agreed in
writing in a contract or agreement that such per-
son(s) or organization(s) be added as an addi-
tional insured on your policy. Such person(s) or
organization(s) is an additional insured only with
respect to liability for:
1. 'Bodily injury" or "property damage" not in-
cluded in the "products -completed operations
hazard"; or
2. "Personal and advertising injury";
caused by, in whole or in part, your acts or omis-
sions or the acts or omissions of those acting on
your behalf in the performance of your opera-
tions.
B. The insurance afforded to such additional in-
sured described in Paragraph A. of this en-
dorsement:
1. Only applies to the extent permitted by law;
and
2. Will not be broader than that which you are
required by the contract or agreement to pro-
vide for such additional insured.
C. With respect to insurance afforded to these addi-
tional insureds, the following additional exclusion
applies:
This insurance does not apply to "bodily injury",
"property damage" or "personal and advertising
injury" due to rendering of or failure to render any
professional service. This includes but is not lim-
ited to:
1. Legal, accounting or advertising services;
2. Preparing, approving, or failing to prepare or
approve, maps, shop drawings, opinions, re-
ports, surveys, field orders, change orders or
drawings or specifications;
3. Inspection, supervision, quality control, archi-
tectural or engineering activities done by or
for you on a project on which you serve as
construction manager;
4. Engineering services, including related su-
pervisory or inspection services;
S. Medical, surgical, dental, X-ray or nursing
services treatment, advice or instruction;
6. Any health or therapeutic service treatment,
advice or instruction;
7. Any service, treatment, advice or instruction
for the purpose of appearance or skin en-
hancement, hair removal or replacement, or
personal grooming or therapy;
8. Any service, treatment, advice or instruction
relating to physical fitness, including service,
treatment, advice or instruction in connection
with diet, cardiovascular fitness, bodybuilding
or physical training programs;
9. Optometry or optical or hearing aid services
including the prescribing, preparation, fitting,
demonstration or distribution of ophthalmic
lenses and similar products or hearing aid
devices;
10. Body piercing services;
11. Services in the practice of pharmacy,
12. Law enforcement or firefighting services; and
13. Handling, embalming, disposal, burial, cre-
mation or disinterment of dead bodies.
This exclusion applies even if the claims against
any insured allege negligence or other wrongdo-
ing in the supervision, hiring, employment, train-
ing or monitoring of others by that insured, if the
"occurrence" which caused the "bodily injury" or
"property damage", or the offense which caused
the "personal and advertising injury", involved
the rendering of or failure to render any profes-
sional service.
CG 20 43 12 19 © Insurance Services Office, Inc., 2018 Page 1 of 2
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
COMMERCIAL GENERAL LIABILITY BROADENED
ENDORSEMENT - VIRGINIA
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
A. Endorsement -Table of Contents:
1. Employee Benefit Liabilii Coveragge.., ,.3
2. Unintentional Failure to Asclose tlazards...... ........... ............ ..............,..,..8
. Damage to Premises Rented to You........................................................................8
. Sup lementary Payments ..................... ................................................... 9
5. Me rcal Payments ...........................................................................................................9
6. 180 Day Coverage for Newly Formed or Acquired Organizations........................................9
7. "it'lla,iver of Subrogation..,. ......... ..............................................................10
8. Automatic Additional Insured -Specified Relationships: .................................................. 10
• Managers or Lessors of Premises;
• Lessor of Leased Equipment;
• Vendors;
• State or Governmental Agenor.Subdivision or Political Subdivision - Permits
or Authorizations Relatin to 'Premises; and
• Mortgagee, Assignee or l ecelv�er
9. Property ama a to orrowed Equipment..............................................................13
10. Employees as insureds Specified Health Care Services and Good Samaritan
Services........ ............... ......,., .......................................................................................14
11. Broadened Notice of Occurrence ................................. -................................... ..,..,............. . 14
12. Nonowned Aircraft.... ..................... ......... ,.,... .....14
13. Bodily In Redefined.. ....... 14
14. Expects or Intended Injury Redefined 14
15. Former Employees as Insureds ......... ......... ................... .................. ..............,....14
B. Limits of Insurance:
The Commercial General Liability Limits of Insurance apply to the insurance provided by this endorse-
ment, except as provided below:
1. Employee Benefit Liability Coverage
Each Employee Limit: $1,000,000
Aggregate Limit: $3,000,000
Deductible Amount: $ 1,000
3. Damage to Premises Rented to You
The lesser of:
a. The Each Occurrence Limit shown in the Declarations; or
b. $500,000 unless otherwise stated $
4. Supplementary Payments
a. Bail Bonds: $2,500
b. Loss of Earnings: $ 500
5. Medical Payments
Medical Expense Limit: $ 10,000
9. Property Damage to Borrowed Equipment
Each Occurrence Limit: $10,000
Deductible Amount: $ 250
Includes copyrighted material of Insurance
GA 210 VA 0917 Services Office, Inc., with its permission. Page 1 of 14
C. Coverages
1. Employee Benefit Liability Coverage
a. The following is added to Section I -
Coverages:
Employee Benefit Liability Cover-
age
(1) Insuring Agreement
(a) We will pay those sums that
the insured becomes legally
obligated to pay as damag-
es caused by any act, error
or omission of the insured,
or of any other person for
whose acts the insured is
legally liable, 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
against any "suit" seeking
damages to which this in-
surance does not apply. We
may, at our discretion, in-
vestigate any report of an
act, error or omission 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 Insur-
ance; and
2) Our right and duty to
defend ends when we
have used up the appli-
cable limit of insurance
in the payment of judg-
ments or settlements.
No other obligation or liabil-
ity to pay sums or perform
acts or services is covered
unless explicitly provided for
under Supplementary
Payments.
(b)This--insuranceappliesto
damages only if the act, er-
ror or omission, is negligent-
ly committed in the "admin-
istration" of your "employee
benefit program'; and
1) Occurs during the policy
period; or
2) Occurred prior to the
'first effective date" of
this endorsement pro-
vided:
a) You did not have
knowledge of a
claim or "suit" on or
before the "first ef-
fective date" of this
endorsement.
You will be
deemed to have
knowledge of a
claim or "suit"
when any "author-
ized representa-
tive'';
Reports all, or
any part, of the
act, error or
omission to us
or any other
insurer;
ii) Receives a
written or ver-
bal demand or
claim for dam-
ages because
of the act, er-
ror or omis-
sion; and
b) There is no other
applicable insur-
ance.
(2) Exclusions
This insurance does not apply to:
(a) Bodily Injury, Property
Damage or Personal and
Advertising Injury
"Bodily injury", "property
damage" or "personal and
advertising injury".
(b) Dishonest, Fraudulent,
Criminal or Malicious Act
Damages arising out of any
intentional, dishonest,
fraudulent, criminal or mali-
- cious act, --error or -omission,
committed by any insured,
including the willful or reck-
less violation of any statute.
(c) Failure to Perform a Con-
tract
Damages arising out of fail-
ure of performance of con-
tract by any usurer.
Includes copyrighted material of Insurance
GA 210 VA 0917 Services Office, Inc., with its permission. Page 2 of 14
GA 210 VA 0917
(d)
Insufficiency of Funds
(i) Taxes, Fines or Penalties
Damages arising out of an
Taxes, fines or penalties, in -
insufficiency of funds to
cluding those imposed un-
meet any obligations under
der the Internal Revenue
any plan included in the
Code or any similar state or
"employee benefit program".
local law.
(e)
Inadequacy of Perfor-
(j) Employment -Related Prac-
mance of Invest-
tices
ment/Advice Given With
Respect to Participation
Any liability arising out of
any:
Any claim based upon:
(1) Refusal to employ;
1) Failure of any invest-
ment to perform;
(2) Termination of employ-
ment;
2) Errors in providing in-
formation on past per-
(3) Coercion, demotion,
formance of investment
evaluation, reassign -
vehicles; or
ment, discipline, defa-
mation, harassment,
3) Advice given to any
humiliation, discrimina-
person with respect to
tion or other employ -
that person's decision to
ment - related practices,
participate or not to par-
acts or omissions; or
ticipate in any plan in-
cluded in the "employee
(4) Consequential liability
benefit program".
as a result of (1), (2) or
(3) above.
(f)
Workers' Compensation
and Similar Laws
This exclusion applies
whether the insured may be
Any claim arising out of your
held liable as an employer
failure to comply with the
or in any other capacity and
mandatory provisions of any
to any obligation to share
workers' compensation, un-
damages with or repay
employment compensation
someone else who must pay
insurance, social security or
damages because of the in -
disability benefits law or any
jury.
similar law.
(3) Supplementary Payments
(g)
ERISA
Section I -Coverages, Sup -
Damages for which any in-
plementary Payments - Cover-
sured is liable because of li-
ages A and B also apply to this
ability imposed on a fiduci-
Coverage.
ary by the Employee Re-
tirement Income Security
b. Who is an Insured
Act of 1974, as now or
As respects Employee Benefit Lia-
hereafter amended, or by
bility Coverage, Section II - Who is
any similar federal, state or
an Insured is replaced by the follow -
local laws.
ing:
(h) Available Benefits (1) If you are designated in the Dec -
Any claim for benefits to the larations as:
extent that such benefits are (a) An individual, you and your
available, with reasonable spouse are insureds, but on -
effort and cooperation of the ly with respect to the con -
insured, from the applicable duct of a business of which
funds accrued or other col- you are the sole owner.
lectible insurance.
(b) A partnership or joint ven-
ture, you are an insured.
Your members, your part -
Includes copyrighted material of Insurance
Services Office, Inc., with its permission. Page 3 of 14
ners, and their spouses are
However, coverage under this
also insureds but only with
provision:
respect to the conduct of
your business.
(a) Is afforded only until the
180th day after you acquire
(c) A limited liability company,
or form the organization or
you are an insured. Your
the end of the policy period,
members are also insureds,
whichever is earlier; and
but only with respect to the
conduct of your business.
(b) Does not apply to any act,
Your managers are in-
error or omission that was
sureds, but only with respect
committed before you ac-
to their duties as your man-
quired or formed the organi-
agers.
zation.
(d) An organization other than a
c. Limits of Insurance
partnership, joint venture or
As respects Employee Benefit Lia-
limited liability company, you
bility Coverage, Section III - Limits
are an insured. Your "execu-
Of Insurance is replaced by the fol-
tive officers" and directors
lowing:
are insureds, but only with
respect to their duties as
(1) The Limits of Insurance shown in
your officers or directors.
Section B. Limits of Insurance,
Your stockholders are also
1. Employee Benefit Liability
insureds, but only with re-
Coverage and the rules below fix
spect to their liability as
the most we will pay regardless
stockholders.
of the number of:
(e) A trust, you are an insured.
(a) Insureds;
Your trustees are also in-
sureds, but only with respect
(b) Claims made or "suits"
to their duties as trustees.
brought;
(2) Each of the following is also an
(c) Persons or organizations
insured:
making claims or bringing
"suits";
(a) Each of your "employees"
who is or was authorized to
(d) Acts, errors or omissions; or
administer your "employee
(e) Benefits included in your
benefit program';
"employee benefit program".
(b) Any persons, organizations
"employees"
(2) The Aggregate Limit shown in
or having prop-
Section B. Limits of Insurance,
er temporary authorization
"employ-
1. Employee Benefit Liability
to administer your
Coverage of this endorsement is
ee benefit program" if you
the most we will pay for all dam -
die, but only until your legal
ages because of acts, errors or
representative is appointed;
omissions negligently committed
or
in the "administration" of your
(c) Your legal representative if
"employee benefit program".
you die, but only with re-
(3) Subject to the limit described in
spect to duties as such. That
(2) above, the Each Employee
representative will have all
Limit shown in Section B. Limits
your rights and duties under
__of Insurance, 1. Employee
this Coverage Part.
Benefit Liability Coverage of
(3) Any organization you newly ac-
this endorsement is the most we
quire or form, other than a part-
will pay for all damages sus-
nership, joint venture or limited
tained by any one "employee",
liability company, and over which
including damages sustained by
you maintain ownership or major-
such "employee's" dependents
ity interest, will qualify as an in-
and beneficiaries, as a result of:
sured if no other similar insur-
(a) An act, error or omission; or
ance applies to that organization.
Includes copyrighted material of Insurance
GA 210 VA 0917 Services Office, Inc., with its permission. Page 4 of 14
(b) A series of related ads, er-
rors or omissions, regard-
less of the amount of time
that lapses between such
ads, errors or omissions;
negligently committed in the
"administration" of your "employ-
ee benefit program".
However, the amount paid under
this endorsement shall not ex-
ceed, and will be subject to the
limits and restrictions that apply
to the payment of benefits in any
plan included in the "employee
benefit program."
(4) Deductible Amount
tification of the action taken,
you shall promptly reim-
burse us for such part of the
Deductible Amount as we
have paid.
d. Additional Conditions
As respects Employee Benefit Lia-
bility Coverage, Section IV - Com-
mercial General Liability Condi-
tions is amended as follows:
(1) Item 2. Duties in the Event of
Occurrence, Offense, Claim or
Suit is replaced by the following:
2. Duties in the Event of an
Act, Error or Omission, or
Claim or Suit
(a)
Our obligation to pay dam-
ages on behalf of the in-
a. You must see to it that
sured applies only to the
we are notified as soon
amount of damages in ex-
as practicable of an act,
cess of the Deductible
error or omission which
Amount stated in the Decla-
may result in a claim.
rations as applicable to
To the extent possible,
Each Employee. The limits
notice should include:
of insurance shall not be re-
(1) What the act, error
duced by the amount of this
or omission was
deductible.
and when it oc-
(b)
The Deductible Amount
curred; and
stated in the Declarations
(2) The names and
applies to all damages sus-
addresses of any-
tained by any one "employ-
one who may suf-
ee", including such "employ-
fer damages as a
ee's" dependents and bene-
result of the act,
ficiaries, because of all acts,
error or omission.
errors or omissions to which
this insurance applies.
b. If a claim is made or
"suit" is brought against
c
()
The terms of this insurance,
any insured, you must:
including those with respect
to:
(1) Immediately record
the specifics of the
1 Our right and du to
g
claim or "suit" and
defend the insured
the date received;
against any "suits"
and
seeking those damag-
es; and
(2) Notify us as soon
as practicable.
2) Your duties, and the du-
ties of any other in-
You must see to it that
volved insured, in the
we receive written no -
event of an act, error or
tice of the claim or "suit"
omission, or claim;
as soon as practicable.
apply irrespective of the ap-
c. You and any other in-
plication of the Deductible
volved insured must:
Amount.
(1) Immediately send
(d)
We may pay any part or all
us copies of any
of the Deductible Amount to
demands, notices,
effect settlement of any
summonses or le -
claim or "suit" and, upon no-
gal papers re -
Includes copyrighted material of Insurance
GA 210 VA 0917 Services Office, Inc., with its permission. Page 6 of 14
ceived in connec-
tion with the claim
or "suit';
(2)
Authorize us to ob-
tain 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 en-
forcement of any
right against any
person or organi-
zation which may
be liable to the in-
sured because of
an act, error or
omission 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 without our
consent.
(2) Item 5. Other Insurance is re-
placed by the following:
GA 210 VA 0917
5. Other Insurance
we will follow this meth-
od also. Under this ap-
proach 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 in-
surance does not permit
contribution by equal
shares, we will contrib-
ute 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 insur-
ers.
c. No Coverage
This insurance shall not
cover any loss for which
the insured is entitled to
recovery under any
other insurance in force
previous to the effective
date of this Coverage
Part.
e. Additional Definitions
As respects Employee Benefit Lia-
bility Coverage, Section V - Defini-
tions is amended as follows:
If other valid and collectible (1) The following definitions are
added:
insurance is available to the
insured for a loss we cover 1.
'Administration" means:
under this Coverage Part,
our obligations are limited as
a. Providing information to
follows:
"employees", including
their dependents and
a. Primary Insurance
beneficiaries, with re-
This insurance is prima-
spect to eligibility for or
"employee
ry except when c. below
scope of
benefit programs';
applies. If this insurance
is primary, our obliga-
b. Interpreting the "em-
tions are not affected
ployee benefit pro-
_unless_any_of_the-other ___
grams"„
insurance is also prima-
ry. Then, we will share
c. Handling records in
with all that other insur-
connection with the
ance by the method de-
"employee benefit pro-
scribed in b. below.
grams'; or
b. Method of Sharing
d. Effecting, continuing or
terminating any "em-
If all of the other insur-
ployee's" participation in
ance permits contribu-
any benefit included in
tion by equal shares,
Includes copyrighted material of Insurance
Services Office, Inc., with its permission.
Page 6 of 14
the "employee benefit
c. Unemployment insur-
program".
ance, social security
However, "administration"
benefits, workers' com-
pensation and disability
does not induce:
benefits; and
a. Handling payroll deduc-
d. Vacation plans, includ-
tions; or
ing buy and sell pro-
b. The failure to effect or
grams; leave of ab-
maintain any insurance
sence programs, indud-
or adequate limits of
ing military, maternity,
coverage of insurance,
family, and civil leave;
induding but not limited
tuition assistance plans;
to unemployment insur-
transportation and
ance, social security
health club subsidies.
benefits, workers' com-
4. "First effective date" means
pensation and disability
the date upon which cover -
benefits.
age was first effected in a
2. "Cafeteria plans" means
series of uninterrupted re -
plans authorized by applica-
newals of insurance cover-
ble law to allow "employees"
age.
to elect to pay for certain
(2) The following definitions are de -
benefits with pre-tax dollars.
leted in their entirety and re-
3. "Employee benefit pro-
placed by the following:
grams" means a program
g, 'Employee" means a person
providing some of all of the
actively employed, formerly
following benefits to "em-
employed, on leave of ab-
ployees", whether provided
sence or disabled, or retired.
through a "cafeteria plan" or
"Employee" includes a
otherwise:
'leased worker". "Employee"
a. Group life insurance;
does not include a "tempo -
group accident or health
rary worker".
insurance; dental, vision
21. "Suit" means a civil proceed -
and hearing plans; and
ing in which money damag-
flexble spending ac-
es because of an act, error
counts; provided that no
or omission to which this in -
one other than an "em-
surance applies are alleged.
ployee" may subscribe
"Suit" includes:
to such benefits and
such benefits are made
a. An arbitration proceed -
generally available to
ing in which such dam -
those "employees" who
ages are claimed and to
satisfy the plan's eligibil-
which the insured must
ity requirements;
submit or does submit
b. Profit sharing plans,
with our consent;
employee savings
b. Any other alternative
plans, employee stock
dispute resolution pro -
ownership plans, pen-
ceeding in which such
sion plans and stock
damages are daimed
subscription plans, pro-
and to which the in-
vided that no one other
sured submits with our
than an "employee"
consent; or
may subscribe to such
benefits and such bene-
c. An appeal of a civil pro-
fits are made generally
ceeding.
available to all "employ-
ees" who are eligible
under the plan for such
benefits;
Includes copyrighted material of Insurance
GA 210 VA 0917 Services Office, Inc., with its permission. Page 7 of 14
2. Unintentional Failure to Disclose Haz- terioration, hidden
ands or latent defect or
Section IV - Commercial General Liabil- any quality in
it Conditions, 7. Representations is property that damage
or
Y p es it to damage or
amended by the addition of the following: destroy itself;
Based on our dependence upon your rep-
3) Smog;
resenlations as to existing hazards, if un-
intentionally you should fail to disclose all
4) Mechanical break -
such hazards at the inception date of your
down, including
policy, we will not reject coverage under
rupture or bursting
this Coverage Part based solely on such
caused by centrif-
failure.
ugal force;
3. Damage to Premises Rented to You
5) Settling, cracking,
a. The last Paragraph of 2. Exclusions
shrinking or ex-
pansion;
under Section I - Coverage A - Bod-
ily Injury and Property Damage Li-
6) Nesting or infesta-
ability is replaced by the following:
tion, or discharge
or release of waste
Exclusions c. through q. do not apply
products o secre-
to "property damage" by fire, explo-
by insects,
sion, lightning, smoke or soot to
irds, rodents or
birds, rodents
b
premises while rented to you or tem-
other animals; or
porarily occupied by you with permis-
sion of the owner, for which the
7) Presence, growth,
amount we will pay is limited to the
proliferation,
Damage to Premises Rented to
spread or any ac-
You Limit as described in Section III
tivity of fungus, in-
- Limits of Insurance.
cluding mold or
b. The insurance provided under Sec-
mildew, and any
m
tion I - Coverage A - Bodily Injury
9 Y 1 rY
spores, scents or
ores, scents
and Property Damage Liability ap-
byproducts pro -
plies to "property damage" arising out
duced or released
of water damage to premises that are
by fungi.
both rented to and occupied by you.
(b) 'Property damage" caused
(1) As respects Water Damage Le-
directly or indirectly by any
gal Liability, as provided in Para-
of the following:
graph 3.b. above:
g
(1) Earthquake, volcanic
The exclusions under Section I -
eruption, landslide or
Coverage A - Bodily Injury and
any other earth move -
Property Damage Liability, 2.
ment;
Exclusions, other than i. War
and the Nuclear Energy Liabil-
(ii) Water that backs up or
ity Exclusion (Broad Form), are
overflows or is other -
deleted and the following are
wise discharged from a
added:
sewer, drain, sump,
This insurance does not apply to:
sump pump or related
equipment;
(a) "'Pilop'erty damage"-,,
-(ii)-Water-under-the-ground
(1) Assumed in any con-
surface pressing on, or
tract or agreement; or
flowing or seeping
through:
(ii) Caused by or resulting
from any of the follow-
1) Foundations, walls,
ing:
floors or paved
surfaces;
1) Wear and tear;
2) Basements,
2) Rust or other cor-
whether paved or
rosion, decay, de-
not; or
Includes copyrighted material of Insurance
GA 210 VA 0917 Services Office, Inc., with its permission. Page 8 of 14
c
3) Doors, windows or
ning, smoke or soot,
other openings.
while rented to you; or
(c) "Property damage" caused
c. In the case of damage
by or resulting from water
by water, while rented
that leaks or flows from
to and occupied by you.
plumbing, heating, air condi-
tioning, fire protection sys-
(2) The most we will pay is limited as
tems, or other equipment,
described in Section B. Limits of
caused by or resulting from
Insurance, 3. Damage to Prem-
freezing, unless:
ises Rented to You of this en-
dorsement.
(1) You did your best to
maintain heat in the
4. Supplementary Payments
building or structure; or
Under Section I - Supplementary Pay -
(!I) You drained the equip-
ments - Coverages A and B:
ment and shut off the
a. Paragraph 2. is replaced by the fol-
water supply if the heat
lowing:
was not maintained.
(d) "Property damage" to:
Up to the limit shown in Section B.
Limits of Insurance, 4.a. Bail Bonds
(� Plumbing, heating, air
of this endorsement for cost of bail
conditioning, fire protec-
bonds required because of accidents
tion systems, or other
or traffic law violations arising out of
equipment or applianc-
the use of any vehicle to which the
es; or
Bodily Injury Liability Coverage ap-
plies. We do not have to furnish these
(IQ The interior of any
bonds.
building or structure, or
to personal property in
b. Paragraph 4. is replaced by the fol-
the building or structure,
lowing:
caused by or resulting
All reasonable expenses incurred by
from rain, snow, sleet or
the insured at our request to assist us
ice, whether driven by
in the investigation or defense of the
wind or not.
claim or "suit", including actual loss of
Limit of Insurance
earnings up to the limit shown in Sec-
tion B. Limits of Insurance, 4.b.
With respect to the insurance afford-
Loss Of Earnings of this endorsement
ed in Paragraphs 3.a. and 3.b. above,
per day because of time off from
the Damage to Premises Rented to
work.
You Limit as shown in the Dedara-
tions is amended as follows:
5. Medical Payments
(1) Paragraph 6. of Section III - The Medical Expense Limit of Any One
Limits of Insurance is replaced Person as stated in the Declarations is
by the following: amended to the limit shown in Section B.
Limits of Insurance, 5. Medical Pay-
6. Subject to Paragraph 5. ments of this endorsement.
above, the Damage to
Premises Rented to You 6. 180 Day Coverage for Newly Formed or
Limit is the most we will pay Acquired Organizations
under Coverage A - Bodily Section II - Who is an Insured is
Injury and Property Dam- amended as follows:
age Liability for damages
because of 'property dam- Subparagraph a. of Paragraph 3. is re -
age" to any one premises: placed by the following:
GA 210 VA 0917
a. While rented to you, or a. Insurance under this provision is af-
temporarily occupied by forded only until the 180th day after
you with permission of you acquire or form the organization
the owner, or the end of the policy period,
b. In the case of damage whichever is earlier;
by fire, explosion, light -
Includes copyrighted material of Insurance
Services Office, Inc., with its permission. Page 9 of 14
7. Waiver of Subrogation
This insurance does not ap-
Section IV - Commercial General Liabil-
ply to:
ity Conditions, 9. Transfer of Rights of
(i) Any "occurrence" which
Recovery Against Others to Us is
takes place after you
amended by the addition of the following:
cease to be a tenant in
We waive any right of recovery we may
that premises;
have against any peisun ui uiganizaliun
(ii) Slruclural alterations,
against whom you have agreed to waive
new construction or
such right of recovery in a written contract
demolition operations
or agreement because of payments we
performed by or on be -
make for injury or damage arising out of
half of such additional
your ongoing operations or 'your work"
insured.
done under a written contract or agree-
ment with that person or organization and
(b) Lessor of Leased Equip -
included in the "products -completed oper-
ment
ations hazard". However, our rights may
Any person or organization
only be waived prior to the "occurrence"
from whom you lease
giving rise to the injury or damage for
equipment when you and
which we make payment under this Cov-
such person(s) or organiza-
erage Part. The insured must do nothing
tion(s) have agreed per Par -
after a loss to impair our rights. At our re-
agraph 8.a.(1) of this en -
quest, the insured will bring "suit" ortrans-
dorsement to provide insur-
fer those rights to us and help us enforce
anee. Such person(s) or or -
those rights.
ganization(s) are insureds
8. Automatic Additional Insured - Speci-
only with respect to liability
fied Relationships
for "bodily injury', "property
damage" or "personal and
a. The following is added to Section II -
advertising injury' caused, in
Who is an Insured:
whole or in part, by your
(1) Any person(s) or organization(s)
maintenance, operation or
use of equipment leased to
described in Paragraph 8.a.(2) of
you by such person(s) or or -
this endorsement (hereinafter re-
ganization(s). A person's or
ferred to as additional insured)
organization's status as an
whom you are required to add as
additional insured under this
an additional insured under this
endorsement ends when
Coverage Part by reason of a
their contract or agreement
written contract, written agree-
with you for such leased
ment, written permit or written
equipment ends. However,
authorization.
this insurance does not ap-
(2) Only the following persons or or-
ply to any "occurrence"
ganizations are additional in-
which takes place after the
sureds under this endorsement,
equipment lease expires.
and insurance coverage provided
(c) Vendors
to such additional insureds is lim-
ited as provided herein:
Any person or organization
(a) Managers or Lessors of
(referred to below as ven-
dor) with whom you have
Premises
agreed per Paragraph
The manager or lessor of a
8.a.(1) of this endorsement
premises -leased -to -you with
to -provide insurance, -but -on -
whom you have agreed per
ly with respect to 'bodily in -
Paragraph 8.a.(1) of this en-
jury" or 'property damage"
dorsement to provide insur-
arising out of'your products"
ante, but only with respect
which are distributed or sold
to liability arising out of the
in the regular course of the
ownership, maintenance or
vendor's business, subject
use of that part of the prem-
to the following additional
ises leased to you, subject
exclusions:
to the following additional
exclusions:
Includes copyrighted material of Insurance
GA 210 VA 09 17 Services Office, Inc., with its permission. Page 10 of 14
GA 210 VA 0917
(i) The insurance afforded dor's premises in
the vendor does not connection with the
apply to: sale of the product;
1)
"Bodily injury' or
7) Products which, af-
"property damage"
ter distribution or
for which the ven-
sale by you, have
dor is obligated to
been labeled or re-
pay damages by
labeled or used as
reason of the as-
a container, part or
sumption of liability
ingredient of any
in a contract or
other thing or sub -
agreement. This
stance by or for the
exclusion does not
vendor; or
apply to liability for
damages that the
8) "Bodily injury' or
vendor would have
'property damage"
in the absence of
arising out of the
the contract or
sole negligence of
agreement;
the vendor for its
own acts or omis-
2)
Any express war-
sions or those of
ranty unauthorized
its employees or
by you;
anyone else acting
on its behalf. How-
3)
Any physical or
exclusion
ever, this ex
chemical change in
does not apply to:
the product made
intentionally by the
a) The excep-
vendor;
tions contained
4)
Repackaging, ex-
in Paragraphs
(c) (i) 4) or 6)
cept when un-
of this en -
packed solely for
dorsement; or
the purpose of in-
spection, demon-
b) Such inspec-
stration, testing, or
tions, adlust-
the substitution of
ments, tests or
parts under in-
servicing as
structions from the
the vendor has
manufacturer, and
agreed to
then repackaged in
make or nor -
the original con-
mally under-
tainer;
takes to make
5)
Any failure to make
in the usual
such inspections,
course of
business, in
adjustments, tests
connection
or servicing as the
with the distri-
vendor has agreed
bution or sale
to make or normal-
of the prod -
ly undertakes to
ucts.
make in the usual
course of busi- (ii)
This insurance does not
ness, in connection
apply to any insured
with the distribution
person or organization:
or sale of the
products;
1) From whom you
have acquired
6)
Demonstration, in-
such products, or
stallation, servicing
any ingredient, part
or repair opera-
or container, enter-
tions, except such
ing into, accompa-
operations per-
nying or containing
formed at the ven-
such products; or
Includes copyrighted material of Insurance
Services Office, Inc., with its permission.
Page 11 of 14
2) When liability in-
spect to their liability as
cluded within the
mortgagee, assignee, or re-
"products-
ceiver and arising out of the
completed opera-
ownership, maintenance, or
tions hazard" has
use of the premises by you.
been excluded un-
However, this insurance
der this Coverage
does not apply to structural
Part with respect to
alterations, new construction
such products.
and demolition operations
(d) State or Governmentalperformed
by or for that per -
son or organization.
Agency or Subdivision or
Political Subdivision -
(3) The insurance afforded to addi-
Permits or Authorizations
tional insureds described in Par -
Relating to Premises
agraph 8.a.(1) of this endorse -
Any state or governmental
ment:
agency or subdivision or po
(a) Only applies to the extent
litical subdivision with which
permitted by law; and
you have agreed per Para-
graph 8.a.(1) of this en-
b Will not be broader than that
()
dorsement to provide insu
re
which are wired b- y q y
anoe, subject to the follow
the written contract, written
ing additional provision:
agreement, written permit or
written authorization to pro -
This insurance applies only
vide for such additional in -
with respect to the following
sured; and
hazards for which the state
or governmental agency or
(c) Does not apply to any per -
subdivision or political sub-
son, organization, vendor,
division has issued a permit
state, governmental agency
or authorization in connec-
or subdivision or political
tion with premises you own,
subdivision, specifically
rent or control and to which
named as an additional in -
this insurance applies:
sured under any other provi-
sion of, or endorsement
(1) The existence, mainte-
added to, this Coverage
nance, repair, construe-
Part, provided such other
tion, erection or removal
provision or endorsement
of advertising signs,
covers the injury or damage
awnings, canopies, cel-
for which this insurance ap-
lar entrances, coal
plies.
holes, driveways, man-
holes, marquees, hoist
b. With respect to the insurance afford -
away openings, side-
ed to the additional insureds de -
walk vaults, street ban-
scribed in Paragraph 8.a.(1) of this
ners or decorations and
endorsement, the following is added
similar exposures; or
to Section III - Limits of Insurance:
(i) The construction, erec-
The most we will pay on behalf of the
tion or removal of eleva-
additional insured is the amount of in -
tors; or
surance:
(ii) The ownership, mainte-
(1) Required by the written contract,
- ---- -- nance-or-use-of-any-el--
written agreement, written permit
evators covered by this
or written authorization described
insurance.
in Paragraph 8.a.(1) of this en-
dorsement; or
(e) Mortgagee, Assignee or
Receiver
(2) Available under the applicable
Limits of Insurance shown in the
Any person or organization
Declarations;
with whom you have agreed
per Paragraph 8.a.(1) of this
whichever is less.
endorsement to provide in-
surance, but only with re -
Includes copyrighted material of Insurance
GA 210 VA 0917 Services Office, Inc., with its permission. Page 12 of 14
This endorsement shall not increase
b. With respect to the insurance provid-
the applicable Limits of Insurance
ed by this section of the endorse -
shown in the Declarations.
ment, the following additional provi-
c. Section IV - Commercial General
sions apply:
Liability Conditions is amended to
(1) The Limits of Insurance shown in
include the fallowing:
the Declarations are replaced by
Automatic Additional Insured Pro-
the limits designated in Section
B. Limits of Insurance, 9.
vision
Property Damage to Borrowed
This insurance applies only if the
Equipment of this endorsement
"bodily injury" or "property damage"
with respect to coverage provid-
occurs, or the "personal and advertis-
ed by this endorsement. These
ing injury' offense is committed:
limits are inclusive of and not in
addition to the limits being re-
(1) During the policy period; and
placed. The Limits of Insurance
shown in Section B. Limits of
(2) Subsequent to your execution of
Insurance, 9. Property Damage
the written contract or written
to Borrowed Equipment of this
agreement, or the issuance of a
endorsement fix the most we will
written permit or written authori-
pay in any one "occurrence" re-
zation, described in Paragraph
gardless of the number of:
8.a.(1).
(a) Insureds;
d. Section IV - Commercial General
Liability Conditions is amended as
(b) Claims made or "suits"
follows:
brought; or
Condition 5. Other Insurance is
(c) Persons or organizations
amended to include:
making claims or bringing
Primary and Noncontributory In-
"suits".
surance
(2) Deductible Clause
This insurance is primary to and will
(a) Our obligation to pay dam -
not seek contribution from any other
ages on your behalf applies
insurance available to an additional
only to the amount of dam -
insured per Paragraph 8.a.(1) of this
ages for each "occurrence"
endorsement provided that:
which are in excess of the
(1) The additional insured is a
Deductible Amount stated in
Section B. Limits of Insur-
Named Insured under such other
ance, 9. Property Damage
insurance; and
to Borrowed Equipment of
(2) You have agreed in writing in a
this endorsement. The limits
contract, agreement, permit or
of insurance will not be re-
authorization described in 8.a.(2)
duced by the application of
of this endorsement that this in-
such Deductible Amount.
surance would be primary and
(b) Section IV - Commercial
would not seek contribution from
General Liability Condi-
any other insurance available to
tions, 2. Duties in the
the additional insured.
Event of Occurrence, of-
9. Property Damage to Borrowed Equip-
fense, Claim Or Suit, ap-
ment
plies to each claim or "suit"
irrespective of the amount.
a. The following is added to Exclusion
2.j. Damage to Property under Sec-
(c) We may pay any part or all
tion I - Coverage A - Bodily Injury
of the deductible amount to
and Property Damage Liability:
effect settlement of any
claim or "suit" and, upon no -
Paragraphs (3) and (4) of this exclu-
tification of the action taken,
sion do not apply to tools or equip-
you shall promptly reim-
ment loaned to you, provided they are
burse us for such part of the
not being used to perform operations
deductible amount as has
at the time of loss.
been paid by us.
Includes copyrighted material of Insurance
GA 210 VA 0917 Services Office, Inc., with its permission. Page 13 of 14
10. Employees As Insureds - Specified
Health Can: Services And Good Samar-
itan Services
Paragraph 2.a.(1)(d) under Section II -
Who Is An Insured does not apply to:
a. Your "employees" who provide pro-
fessional health care sevicxi�s un yuui
behalf as a duly licensed nurse,
emergency medical technician or
paramedic in the jurisdiction where an
"occurrence" or offense to which this
insurance applies takes place; or
b. Your "employees" or 'Volunteer work-
ers", other than an employed or vol-
unteer doctor, providinq first aid or
good samaritan services during their
work hours for you will be deemed to
be acting within the scope of their
employment by you or performing du-
ties related to the conduct of your
business.
11. Broadened Notice Of Occurrence
Paragraph a. of Condition 2. Duties In
The Event Of Occurrence, Offense,
Claim Or Suit under Section IV - Com-
mercial General Liability Conditions is
replaced by the following:
a. You must see to it that we are notified
as soon as practicable of an "occur-
rence" or an offense which may result
in a claim. To the extent possible, no-
tice should include:
(1) How, when and where the "oc-
currence" or offense took place;
(2) The names and addresses of
any injured persons and wit-
nesses; and
(3) The nature and location of any
injury or damage arising out of
the "occurrence" or offense.
This requirement applies only when
the "occurrence" or offense is known
to an "authorized representative".
12. Nonowned Aircraft
The following is added to Exclusion 2.g.
Aircraft, Auto Or Watercraft under Sec-
tion I - Coverage A - Bodily Injury And
Property Damage Liability:
This exclusion does not apply to an air-
craft you do not own, provided that:
a. The pilot in command holds a current
effective certificate, issued by a duly
constituted authority of the United
States of America or Canada, desig-
nating that person as a commercial or
airline transport pilot;
b. The aircraft is rented with a trained,
paid crew; and
c. The aircraft does not transport per-
sons or cargo fbr a charge.
13. Bodily Injury Redefined
Section V - Definitions, 4. "Bodily injury'
is replaced by the following:
4. "Bodily injury" means bodily harm or
injury, sickness, disease, disability,
humiliation, shock, fright, mental an-
guish or mental injury, including care,
loss of services or death resulting
from any of these at any time.
14. Expected Or Intended Injury Redefined
The last sentence of Exclusion 2.a. Ex-
pected Or Intended Injury under Sec-
tion I - Coverage A - Bodily Injury And
Property Damage Liability is replaced by
the following:
This exclusion does not apply to 'bodily
injury" or "property damage" resulting from
the use of reasonable force to protect per-
sons or property.
15. Former Employees As Insureds
The following is added to Paragraph 2.
under Section II -Who Is An Insured:
2. Each of the following is also an in-
sured:
Any of your former "employees", di-
rectors, managers, members, part-
ners or "executive officers", including
but not limited to retired, disabled or
those on leave of absence, but only
for acts within the scope of their em-
ployment by you or for duties related
to the conduct of your business.
Includes copyrighted material of Insurance
GA 210 VA 0917 Services Office, Inc., with its permission. Page 14 of 14