PROOF OF INSURANCE (2023 - 2024) CLOSED0 /Y I DATE (MMIDDYYY)
A " CERTIFICATE OF LIABILITY INSURANCE
12/ 15/2023 10/20/2023
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 Lockton Insurance Brokers, LLC INANIE�cT..
777 S. Figueroa Street, 52nd Fl. iph6ki=_ ""' N--
CA License #0F15767 E w L '_xtJ, — l-. 1 .......
Los Angeles CA 90017
(213) 689-0065 INSURERS)
INSURER A: BerkAFFORDING COVERAGE NAIC #
lev National Insurance ComnanY 38911
INSURED Granicus, INSURER�..(_..E' Am TW.4A In$ T4n99 (.Onlp
1425205 , all� � LLb�
GranicusLLC INSURER S
�. c Fe&ral InS'�.�,9�.
408 Saint Peter Street, Suite 600 INSURER D
Saint Paul MN 55102 "' --
INSURER E .
INSURER F ..
rnvConr-ce r_nATNTni /`COTICIr`ATCIaIIRAIIZ=P• I IctQe_ c RFVI".RIONNLIMRFR- 'aPA''"x'}C'i.:yy
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.
............... ......... G d .... � ......_. _ . _ .......-----....
INTR� TYPE OF INSURANCE ADDL JNSp POLICY NUMBER (MM/DOY MMtO0YNYYYY LIMITS
COMMERCIAL GENERAL LIABILITY
A Y N TCP 7024348-10 ]0/20/2023 10/20/2024
„EACHoccURRENCE $ 1000000 ...
CO I CLAIMS -MADE ❑X OCCUR
'......�RFMINAMASFS.Ea grrc.0 ,rOgnoa„), .m., $ 3OOQ.0O0
F
_.._
EXP Any one person) $ 15,000
.. ............. .......-.. ......,
.MED _ ........,_ ..
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.PERSONAL $ 1�..000000
........ ----
LIMIT APPLIES
GEN'L AGGREGATE LIMIT APPLIES PER:
_ ......_8ADVINJURY
GENERAL AGGREGATE
G . $ m2,QQ_ Q QQ.......
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POLICY PRO„
X JIECT X LOC
, PRODUCTS -COMP/OP AGG $ 2,000,000
.......OM -- _s--..„.,.
OTHER
$
A
AUTOMOBILE LIABILITY N N TCP 7024348-10 10/20/2023 10/20/2024
'COMBINED SINGLELIMIT
$ 1 000 000
Xmm ANY AUTO
BODILYINJURY(Per person)
$ XXXXXXX,,,,,
OWNED SCHEDULED
BODILY INJURY (Per accident)
$ XXXXXXX
AUTOS ONLY _; AUTOS
HIRED X NON-OWNED
X
-OPERVY bA&VBFAGr':
PR
$ XXXXXXX
AUTOS ONLYAUTOS ONLY
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X COM) $100 D •dt Coll S➢,000 D'ed
$ XXX .XXX
A
; X UMBRELLA LIAR L&I OCCUR N N 1 TCP 7024349-10 10/20/2023 10/20/2024
EACH OCCURRENCE
$ 15 000 009
EXCESS LIAB CLAIMS -MADE
AGGREGATE
_.__,.... ....._. w_.. ..--- ....
DED RETENTION $
$ XXXXXXX
A
WORKERS NSATION Y
AND EMPLOYERS' LIABILITY TWC7024349-10
10/20/2023
10/20/2024
PER � � OTH
X T E FR
.
ANY PROPRIETOR/PARTNER/EXECUTIVE
ANYPROPRIETEREXCLUER/E YN
I
E EACHA
$ 1 �Q�p�p00
NIA
(Mandatory in NH)
„ ., .L DISEASE - EA EMPLOYEE
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_
,.$.,,,_ Q00 000...
If yes, describe under
DESCRIPTION OF OPERATIONS below
E.L. DISEASE -POLICY LIMIT
$ 1 000
B
Prof. Liab. / Cyber N N I F16817867 001
12/15/2022
12/15/2023
$5M
C
Crime 8261-4911 (crime)
1/29/2023
1/29/2024
$2M
DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
RE: City of El Segundo is included as Additional Insured to the extent provided by the policy language or endorsement issued
or approved by the insurance carrier. Waiver of
Subrogation applies per attached endorsement(s) or policy language„
14568645
City of El Segundo
Attn: Admin Services, Finance A/P
350 Main Street
El Segundo CA 90245
CLLl41 IVIY JGG
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
n 1488-201nCGVD CORPORATION. All rights reserved.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
Attachment Code: D524693 Certificate ID: 14568645
Policy Number: TCP 7024348-10
G-00000-A
(Ed. )
It is understood and agreed that this endorsement amends the COMMERCIAL GENERAL LIABILITY COVERAGE
PART as follows. If any other endorsement attached to this policy amends any provision also amended by this
endorsement, then that other endorsement controls with respect to such provision, and the changes made by this
endorsement with respect to such provision do not apply.
TABLE OF CONTENTS
1. Additional Insureds
2. Additional Insured - Primary And Non -Contributory To Additional Insured's Insurance
3. Bodily Injury — Expanded Definition
4. Broad Knowledge of Occurrence/ Notice of Occurrence
5. Broad Named Insured
6. Estates, Legal Representatives and Spouses
7. Expected Or Intended Injury — Exception for Reasonable Force
8. In Rem Actions
9. Incidental Health Care Malpractice Coverage
10. Joint Ventures/Partnership/Limited Liability Companies
11 Legal Liability — Damage To Premises
12. Medical Payments
13. Non -owned Aircraft Coverage
............_.� ...........
14. Non -owned Watercraft
-
15. Personal And Advertising Injury — Discrimination or Humiliation
16. Personal And Advertising Injury - Limited Contractual Liability
17. Property Damage - Elevators
18. Supplementary Payments
19. Property Damage — Patterns, Molds and Dies
20. Unintentional Failure To Disclose Hazards
21. Waiver of Subrogation — Blanket
G-00000-A Page 1 of 13
(Ed. )
Attachment Code: D524693 Certificate ID: 14568645
Policy Number: TCP 7024348-10 G-00000-A
(Ed. )
1. ADDITIONAL INSUREDS
a. WHO IS AN INSURED is amended to include as an Insured any person or organization described in
paragraphs A. through K. below whom a Named Insured is required to add as an additional insured on this
Coverage Part under a written contract or written agreement, provided such contract or agreement:
(1) is currently in effect or becomes effective during the term of this Coverage Part; and
(2) was executed prior to:
(a) the bodily injury or property damage; or
(b) the offense that caused the personal and advertising injury,
for which such additional insured seeks coverage.
b. However, subject always to the terms and conditions of this policy, including the limits of insurance, the
Insurer will not provide such additional insured with:
(1) a higher limit of insurance than required by such contract or agreement; or
(2) coverage broader than required by such contract or agreement, and in no event broader than that
described by the applicable paragraph A. through K. below.
Any coverage granted by this endorsement shall apply only to the extent permissible by law.
A. Controlling Interest
Any person or organization with a controlling interest in a Named Insured, but only with respect to such
person or organization's liability for bodily injury, property damage or personal and advertising injury
arising out of:
1. such person or organization's financial control of a Named Insured; or
2. premises such person or organization owns, maintains or controls while a Named Insured leases or
occupies such premises;
provided that the coverage granted by this paragraph does not apply to structural alterations, new
construction or demolition operations performed by, on behalf of, or for such additional insured.
B. Co-owner of Insured Premises
A co-owner of a premises co -owned by a Named Insured and covered under this insurance but only with
respect to such co -owner's liability for bodily injury, property damage or personal and advertising injury
as co-owner of such premises.
C. Grantor of Franchise
Any person or organization that has granted a franchise to a Named Insured, but only with respect to such
person or organization's liability for bodily injury, property damage or personal and advertising injury as
grantor of a franchise to the Named Insured.
D. Lessor of Equipment
Any person or organization from whom a Named Insured leases equipment, but only with respect to liability
for bodily injury, property damage or personal and advertising injury caused, in whole or in part, by the
Named Insured's maintenance, operation or use of such equipment, provided that the occurrence giving
rise to such bodily injury, property damage or the offense giving rise to such personal and advertising
injury takes place prior to the termination of such lease.
E. Lessor of Land
Any person or organization from whom a Named Insured leases land but only with respect to liability for
bodily injury, property damage or personal and advertising injury arising out of the ownership,
maintenance or use of such land, provided that the occurrence giving rise to such bodily injury, property
damage or the offense giving rise to such personal and advertising injury takes place prior to the
termination of such lease. The coverage granted by this paragraph does not apply to structural alterations,
new construction or demolition operations performed by, on behalf of, or for such additional insured.
G-00000-A Page 2 of 13
(Ed. )
Attachment Code: D524693 Certificate ID: 14568645
Policy Number: TCP 7024348-10
F. Lessor of Premises
G-00000-A
(Ed. )
An owner or lessor of premises leased to the Named Insured, or such owner or lessor's real estate
manager, but only with respect to liability for bodily injury, property damage or personal and advertising
injury arising out of the ownership, maintenance or use of such part of the premises leased to the Named
Insured, and provided that the occurrence giving rise to such bodily injury or property damage, or the
offense giving rise to such personal and advertising injury, takes place prior to the termination of such
lease. The coverage granted by this paragraph does not apply to structural alterations, new construction or
demolition operations performed by, on behalf of, or for such additional insured.
G. Mortgagee, Assignee or Receiver
A mortgagee, assignee or receiver of premises but only with respect to such mortgagee, assignee or
receiver's liability for bodily injury, property damage or personal and advertising injury arising out of the
Named Insured's ownership, maintenance, or use of a premises by a Named Insured.
The coverage granted by this paragraph does not apply to structural alterations, new construction or
demolition operations performed by, on behalf of, or for such additional insured.
H. State or Governmental Agency or Subdivision or Political Subdivisions — Permits
A state or governmental agency or subdivision or political subdivision that has issued a permit or
authorization but only with respect to such state or governmental agency or subdivision or political
subdivision's liability for bodily injury, property damage or personal and advertising injury arising out of:
1. the following hazards in connection with premises a Named Insured owns, rents, or controls and to
which this insurance applies:
a. the existence, maintenance, repair, construction, erection, or removal of advertising signs, awnings,
canopies, cellar entrances, coal holes, driveways, manholes, marquees, hoistaway openings,
sidewalk vaults, street banners, or decorations and similar exposures; or
b. the construction, erection, or removal of elevators; or
c. the ownership, maintenance or use of any elevators covered by this insurance; or
2. the permitted or authorized operations performed by a Named Insured or on a Named Insured's
behalf.
The coverage granted by this paragraph does not apply to:
a. Bodily injury, property damage or personal and advertising injury arising out of operations
performed for the state or governmental agency or subdivision or political subdivision; or
b. Bodily injury or property damage included within the products -completed operations hazard.
With respect to this provision's requirement that additional insured status must be requested under a written
contract or agreement, the Insurer will treat as a written contract any governmental permit that requires the
Named Insured to add the governmental entity as an additional insured.
I. Trade Show Event Lessor
1. With respect to a Named Insured's participation in a trade show event as an exhibitor, presenter or
displayer, any person or organization whom the Named Insured is required to include as an additional
insured, but only with respect to such person or organization's liability for bodily injury, property
damage or personal and advertising injury caused by:
a. the Named Insured's acts or omissions; or
b. the acts or omissions of those acting on the Named Insured's behalf,
in the performance of the Named Insured's ongoing operations at the trade show event premises
during the trade show event.
2. The coverage granted by this paragraph does not apply to bodily injury or property damage included
within the products -completed operations hazard.
G-00000-A Page 3 of 13
(Ed. )
Attachment Code: D524693 Certificate ID: 14568645
Policy Number: TCP 7024348-10
J. Vendor
G-00000-A
(Ed. )
Any person or organization but only with respect to such person or organization's liability for bodily injury or
property damage arising out of your products which are distributed or sold in the regular course of such
person or organization's business, provided that:
1. The coverage granted by this paragraph does not apply to:
a. bodily injury or property damage for which such person or organization is obligated to pay
damages by reason of the assumption of liability in a contract or agreement unless such liability
exists in the absence of the contract or agreement;
b. any express warranty unauthorized by the Named Insured;
c. any physical or chemical change in any product made intentionally by such person or organization;
d. repackaging, except when unpacked solely for the purpose of inspection, demonstration, testing, or
the substitution of parts under instructions from the manufacturer, and then repackaged in the
original container;
e. any failure to make any inspections, adjustments, tests or servicing that such person or organization
has agreed to make or normally undertakes to make in the usual course of business, in connection
with the distribution or sale of the products;
f. demonstration, installation, servicing or repair operations, except such operations performed at such
person or organization's premises in connection with the sale of a product;
g. products which, after distribution or sale by the Named Insured, have been labeled or relabeled or
used as a container, part or ingredient of any other thing or substance by or for such person or
organization; or
h. bodily injury or property damage arising out of the sole negligence of such person or organization
for its own acts or omissions or those of its employees or anyone else acting on its behalf. However,
this exclusion does not apply to:
(1) the exceptions contained in Subparagraphs d. or f. above; or
(2) such inspections, adjustments, tests or servicing as such person or organization has agreed
with the Named Insured to make or normally undertakes to make in the usual course of
business, in connection with the distribution or sale of the products.
2. This Paragraph J. does not apply to any insured person or organization, from whom the Named Insured
has acquired such products, nor to any ingredient, part or container, entering into, accompanying or
containing such products.
3. This Paragraph J. also does not apply:
a. to any vendor specifically scheduled as an additional insured by endorsement to this Coverage
Part;
b. to any of your products for which coverage is excluded by endorsement to this Coverage Part; nor
c. if bodily injury or property damage included within the products -completed operations hazard
is excluded by endorsement to this Coverage Part.
K. Other Person Or Organization / Your Work
Any person or organization who is not an additional insured under Paragraphs A. through J. above. Such
additional insured is an Insured solely for bodily injury, property damage or personal and advertising
injury for which such additional insured is liable because of the Named Insured's acts or omissions.
The coverage granted by this paragraph does not apply to any person or organization:
1. who is specifically scheduled as an additional insured on another endorsement to this Coverage Part;
nor
G-00000-A Page 4 of 13
(Ed. )
Attachment Code: D524693 Certificate ID: 14568645
Policy Number: TCP 7024348-10
G-00000-A
(Ed. )
2. for bodily injury or property damage included within the products -completed operations hazard
except to the extent all of the following apply:
a. this Coverage Part provides such coverage;
b. the written contract or agreement described in the opening paragraph of this ADDITIONAL
INSUREDS Provision requires the Named Insured to provide the additional insured such coverage;
and
c. the bodily injury or property damage results from your work that is the subject of the written
contract or agreement, and such work has not been excluded by endorsement to this Coverage
Part.
2. ADDITIONAL INSURED -PRIMARY AND NON-CONTRIBUTORY TO ADDITIONAL INSURED'S INSURANCE
A. The Other Insurance Condition in the COMMERCIAL GENERAL LIABILITY CONDITIONS Section is
amended to add the following paragraph:
If the Named Insured has agreed in writing in a contract or agreement that this insurance is primary and
non-contributory relative to an additional insured's own insurance, then this insurance is primary, and the
Insurer will not seek contribution from that other insurance. For the purpose of this Provision 2., the
additional insured's own insurance means insurance on which the additional insured is a named insured.
B. With respect to persons or organizations that qualify as additional insureds pursuant to paragraph I.K. of
this endorsement, the following sentence is added to the paragraph above:
Otherwise, and notwithstanding anything to the contrary elsewhere in this Condition, the insurance provided
to such person or organization is excess of any other insurance available to such person or organization.
3. BODILY INJURY — EXPANDED DEFINITION
Under DEFINITIONS, the definition of bodily injury is deleted and replaced by the following:
Bodily injury means physical injury, sickness or disease sustained by a person, including death, humiliation,
shock, mental anguish or mental injury sustained by that person at any time which results as a consequence of
the physical injury, sickness or disease.
4. BROAD KNOWLEDGE OF OCCURRENCE/ NOTICE OF OCCURRENCE
Under CONDITIONS, the condition entitled Duties in The Event of Occurrence, Offense, Claim or Suit
Condition is amended to add the following provisions:
A. BROAD KNOWLEDGE OF OCCURRENCE
The Named Insured must give the Insurer or the Insurer's authorized representative notice of an
occurrence, offense or claim only when the occurrence, offense or claim is known to a natural person
Named Insured, to a partner, executive officer, manager or member of a Named Insured, or to an
employee designated by any of the above to give such notice.
B. NOTICE OF OCCURRENCE
The Named Insured's rights under this Coverage Part will not be prejudiced if the Named Insured fails to
give the Insurer notice of an occurrence, offense or claim and that failure is solely due to the Named
Insured's reasonable belief that the bodily injury or property damage is not covered under this Coverage
Part. However, the Named Insured shall give written notice of such occurrence, offense or claim to the
Insurer as soon as the Named Insured is aware that this insurance may apply to such occurrence, offense
or claim.
5. BROAD NAMED INSURED
WHO IS AN INSURED is amended to delete its Paragraph 3. in its entirety and replace it with the following:
3. Pursuant to the limitations described in Paragraph 4. below, any organization in which a Named Insured
has management control:
a. on the effective date of this Coverage Part; or
G-00000-A Page 5 of 13
(Ed. )
Attachment Code: D524693 Certificate ID: 14568645
Policy Number: TCP 7024348-10 G-00000-A
(Ed. )
b. by reason of a Named Insured creating or acquiring the organization during the policy period,
qualifies as a Named Insured, provided that there is no other similar liability insurance, whether primary,
contributory, excess, contingent or otherwise, which provides coverage to such organization, or which would
have provided coverage but for the exhaustion of its limit, and without regard to whether its coverage is
broader or narrower than that provided by this insurance.
But this BROAD NAMED INSURED provision does not apply to:
(a) any partnership orjoint venture; or
(b) any organization for which coverage is excluded by another endorsement attached to this Coverage
Part.
For the purpose of this provision, and of this endorsement's JOINT VENTURES / PARTNERSHIP /
LIMITED LIABILITY COMPANIES provision, management control means:
A. owning interests representing more than 50% of the voting, appointment or designation power for the
selection of a majority of the Board of Directors of a corporation, or the members of the management
board of a limited liability company; or
B. having the right, pursuant to a written trust agreement, to protect, control the use of, encumber or
transfer or sell property held by a trust.
4. With respect to organizations which qualify as Named Insureds by virtue of Paragraph 3. above, this
insurance does not apply to:
a. bodily injury or property damage that first occurred prior to the date of management control, or that
first occurs after management control ceases; nor
b. personal or advertising injury caused by an offense that first occurred prior to the date of
management control or that first occurs after management control ceases.
5. The insurance provided by this Coverage Part applies to Named Insureds when trading under their own
names or under such other trading names or doing -business -as names (dba) as any Named Insured should
choose to employ.
6. ESTATES, LEGAL REPRESENTATIVES, AND SPOUSES
The estates, heirs, legal representatives and spouses of any natural person Insured shall also be insured under
this policy; provided, however, coverage is afforded to such estates, heirs, legal representatives, and spouses
only for claims arising solely out of their capacity or status as such and, in the case of a spouse, where such
claim seeks damages from marital community property, jointly held property or property transferred from such
natural person Insured to such spouse. No coverage is provided for any act, error or omission of an estate,
heir, legal representative, or spouse outside the scope of such person's capacity or status as such, provided
however that the spouse of a natural person Named Insured and the spouses of members or partners of joint
venture or partnership Named Insureds are Insureds with respect to such spouses' acts, errors or omissions
in the conduct of the Named Insured's business.
7. EXPECTED OR INTENDED INJURY— EXCEPTION FOR REASONABLE FORCE
Under COVERAGES, Coverage A — Bodily Injury And Property Damage Liability, the paragraph entitled
Exclusions is amended to delete the exclusion entitled Expected or Intended Injury and replace it with the
following:
This insurance does not apply to:
Expected or Intended Injury
Bodily injury or property damage expected or intended from the standpoint of the Insured. This exclusion
does not apply to bodily injury or property damage resulting from the use of reasonable force to protect
persons or property.
G-00000-A Page 6 of 13
(Ed. )
Attachment Code: D524693 Certificate ID: 14568645
Policy Number: TCP 7024348-10
8. IN REM ACTIONS
G-00000-A
(Ed. )
A quasi in rem action against any vessel owned or operated by or for the Named Insured, or chartered by or for
the Named Insured, will be treated in the same manner as though the action were in personam against the
Named Insured.
9. INCIDENTAL HEALTH CARE MALPRACTICE COVERAGE
Solely with respect to bodily injury that arises out of a health care incident:
A. Under COVERAGES, Coverage A — Bodily Injury And Property Damage Liability, the Insuring
Agreement is amended to replace Paragraphs 1.b.(1) and 1.b.(2) with the following:
b. This insurance applies to bodily injury provided that the professional health care services are incidental
to the Named Insured's primary business purpose, and only if:
(1) such bodily injury is caused by an occurrence that takes place in the coverage territory.
(2) the bodily injury first occurs during the policy period. All bodily injury arising from an occurrence
will be deemed to have occurred at the time of the first act, error, or omission that is part of the
occurrence; and
B. Under COVERAGES, Coverage A — Bodily Injury And Property Damage Liability, the paragraph entitled
Exclusions is amended to:
i. add the following to the Employers Liability exclusion:
This exclusion applies only if the bodily injury arising from a health care incident is covered by other
liability insurance available to the Insured (or which would have been available but for exhaustion of its
limits).
ii. delete the exclusion entitled Contractual Liability and replace it with the following:
This insurance does not apply to:
Contractual Liability
the Insured's actual or alleged liability under any oral or written contract or agreement, including but not
limited to express warranties or guarantees.
iii. add the following additional exclusions.
This insurance does not apply to:
Discrimination
any actual or alleged discrimination, humiliation or harassment, that includes but shall not be limited to
claims based on an individual's race, creed, color, age, gender, national origin, religion, disability,
marital status or sexual orientation.
Dishonesty or Crime
Any actual or alleged dishonest, criminal or malicious act, error or omission.
Medicare/Medicaid Fraud
any actual or alleged violation of law with respect to Medicare, Medicaid, Tricare or any similar federal,
state or local governmental program.
Services Excluded by Endorsement
Any health care incident for which coverage is excluded by endorsement.
C. DEFINITIONS is amended to:
i. add the following definitions:
Health care incident means an act, error or omission by the Named Insured's employees or
volunteer workers in the rendering of:
G-00000-A Page 7 of 13
(Ed. )
Attachment Code: D524693 Certificate ID: 14568645
Policy Number: TCP 7024348-10
a. professional health care services on behalf of the Named Insured or
G-00000-A
(Ed. )
b. Good Samaritan services rendered in an emergency and for which no payment is demanded or
received.
Professional health care services means any health care services or the related furnishing of food,
beverages, medical supplies or appliances by the following providers in their capacity as such but solely
to the extent they are duly licensed as required:
a. Physician;
b. Nurse;
c. Nurse practitioner;
d. Emergency medical technician;
e. Paramedic;
f. Dentist;
g. Physical therapist;
h. Psychologist;
i. Speech therapist;
j. Other allied health professional; or
Professional health care services does not include any services rendered in connection with human
clinical trials or product testing.
ii. delete the definition of occurrence and replace it with the following:
Occurrence means a health care incident. All acts, errors or omissions that are logically connected by
any common fact, circumstance, situation, transaction, event, advice or decision will be considered to
constitute a single occurrence;
iii. amend the definition of Insured to:
a. add the following:
• the Named Insured's employees are Insureds with respect to:
(1) bodily injury to a co -employee while in the course of the co -employee's employment by
the Named Insured or while performing duties related to the conduct of the Named
Insured's business; and
(2) bodily injury to a volunteer worker while performing duties related to the conduct of the
Named Insured's business;
when such bodily injury arises out of a health care incident.
• the Named Insured's volunteer workers are Insureds with respect to:
(1) bodily injury to a co -volunteer worker while performing duties related to the conduct of
the Named Insured's business; and
(2) bodily injury to an employee while in the course of the employee's employment by the
Named Insured or while performing duties related to the conduct of the Named Insured's
business;
when such bodily injury arises out of a health care incident.
b. delete Subparagraphs (a), (b), (c) and (d) of Paragraph 2.a.(1) of WHO IS AN INSURED.
c. add the following:
Insured does not include any physician while acting in his or her capacity as such.
G-00000-A Page 8 of 13
(Ed. )
Attachment Code: D524693 Certificate ID: 14568645
Policy Number: TCP 7024348-10
G-00000-A
(Ed. )
D. The Other Insurance condition is amended to delete Paragraph b.(1) in its entirety and replace it with the
following:
Other Insurance
b. Excess Insurance
(1) To the extent this insurance applies, it is excess over any other insurance, self insurance or risk
transfer instrument, whether primary, excess, contingent or on any other basis, except for insurance
purchased specifically by the Named Insured to be excess of this coverage.
10. JOINT VENTURES / PARTNERSHIP / LIMITED LIABILITY COMPANIES
WHO IS AN INSURED is amended to delete its last paragraph and replace it with the following:
No person or organization is an Insured with respect to:
• the conduct of any current or past partnership or joint venture that is not shown as a Named Insured in
the Declarations; nor
• the conduct of a current or past limited liability company in which a Named Insured's interest does/did
not rise to the level of management control;
except that if the Named Insured was a joint venturer, partner, or member of such a limited liability company,
and such joint venture, partnership or limited liability company terminated prior to or during the policy period,
then such Named Insured is an Insured with respect to its interest in such joint venture, partnership or limited
liability company but only to the extent that:
a. any offense giving rise to personal and advertising injury occurred prior to such termination date, and the
personal and advertising injury arising out of such offense, first occurred after such termination date;
b. the bodily injury or property damage first occurred after such termination date; and
c. there is no other valid and collectible insurance purchased specifically to insure the partnership, joint venture
or limited liability company.
11. LEGAL LIABILITY — DAMAGE TO PREMISES
A. Under COVERAGES, Coverage A — Bodily Injury and Property Damage Liability, the paragraph entitled
Exclusions is amended to delete the first paragraph immediately following subparagraph (6) of the Damage
to Property exclusion and replace it with the following:
Paragraphs (1), (3) and (4) of this exclusion do not apply to property damage (other than damage by fire,
lightning, explosion, smoke or leakage from automatic fire protective systems) to premises rented to the
Named Insured or temporarily occupied by the Named Insured with the permission of the owner, nor to the
contents of premises rented to the Named Insured for a period of 7 or fewer consecutive days. A separate
limit of insurance applies to Damage To Premises Rented To You as described in LIMITS OF INSURANCE.
B. Under COVERAGES, Coverage A — Bodily Injury and Property Damage Liability, the paragraph entitled
Exclusions is amended to delete its last paragraph and replace it with the following:
Exclusions c. through n. do not apply to damage by fire, lightning, explosion, smoke or leakage from
automatic fire protective systems to premises while rented to a Named Insured or temporarily occupied by a
Named Insured with permission of the owner, nor to damage to the contents of premises rented to a
Named Insured for a period of 7 or fewer consecutive days.
A separate limit of insurance applies to this coverage as described in the LIMITS OF INSURANCE Section.
C. LIMITS OF INSURANCE is amended to delete Paragraph 6. (the Damage To Premises Rented To You
Limit) and replace it with the following:
6. Subject to Paragraph 5. above, (the Each Occurrence Limit), the Damage To Premises Rented To You
Limit is the most the Insurer will pay under COVERAGE A for damages because of property damage
to:
G-00000-A Page 9 of 13
(Ed. )
Attachment Code: D524693 Certificate ID: 14568645
Policy Number: TCP 7024348-10 G-00000-A
(Ed. )
a. any one premises while rented to a Named Insured or temporarily occupied by a Named Insured
with the permission of the owner; and
b. contents of such premises if the premises is rented to the Named Insured for a period of 7 or fewer
consecutive days.
The Damage To Premises Rented To You Limit is $500,000. unless a higher Damage to Premises
Rented to You Limit is shown in the Declarations.
D. The Other Insurance Condition is amended to delete Paragraph b.(1)(a)(ii), and replace it with the
following:
(ii) That is property insurance for premises rented to a Named Insured, for premises temporarily occupied
by the Named Insured with the permission of the owner; or for personal property of others in the
Named Insured's care, custody or control;
E. This Provision 11. does not apply if liability for damage to premises rented to a Named Insured is excluded
by another endorsement attached to this Coverage Part.
12. MEDICAL PAYMENTS
A. LIMITS OF INSURANCE is amended to delete Paragraph 7. (the Medical Expense Limit) and replace it with
the following:
7. Subject to Paragraph 5. above (the Each Occurrence Limit), the Medical Expense Limit is the most the
Insurer will pay under Coverage C — Medical Payments for all medical expenses because of bodily
injury sustained by any one person. The Medical Expense Limit is the greater of:
(1) $15,000 unless a different amount is shown here: @ @ @ @ @ @ @ @ @ @ @ @ @ @ ; or
(2) the amount shown in the Declarations for Medical Expense Limit.
B. Under COVERAGES, the Insuring Agreement of Coverage C — Medical Payments is amended to replace
Paragraph 1.a.(3)(b) with the following:
(b) The expenses are incurred and reported to the Insurer within three years of the date of the accident; and
13. NON -OWNED AIRCRAFT
Under COVERAGES, Coverage A — Bodily Injury and Property Damage Liability, the paragraph entitled
Exclusions is amended as follows:
The exclusion entitled Aircraft, Auto or Watercraft is amended to add the following:
This exclusion does not apply to an aircraft not owned by any Named Insured, provided that:
1. the pilot in command holds a currently effective certificate issued by the duly constituted authority of the
United States of America or Canada, designating that person as a commercial or airline transport pilot;
2. the aircraft is rented with a trained, paid crew to the Named Insured; and
3. the aircraft is not being used to carry persons or property for a charge.
14. NON -OWNED WATERCRAFT
Under COVERAGES, Coverage A — Bodily Injury and Property Damage Liability, the paragraph entitled
Exclusions is amended to delete subparagraph (2) of the exclusion entitled Aircraft, Auto or Watercraft, and
replace it with the following.
This exclusion does not apply to:
(2) a watercraft that is not owned by any Named Insured, provided the watercraft is:
(a) less than 75 feet long; and
(b) not being used to carry persons or property for a charge.
G-00000-A Page 10 of 13
(Ed. )
Attachment Code: D524693 Certificate ID: 14568645
Policy Number: TCP 7024348-10 G-00000-A
(Ed. )
15. PERSONAL AND ADVERTISING INJURY —DISCRIMINATION OR HUMILIATION
A. Under DEFINITIONS, the definition of personal and advertising injury is amended to add the following
tort:
• Discrimination or humiliation that results in injury to the feelings or reputation of a natural person.
B. Under COVERAGES, Coverage B — Personal and Advertising Injury Liability, the paragraph entitled
Exclusions is amended to:
1. delete the Exclusion entitled Knowing Violation Of Rights Of Another and replace it with the following:
This insurance does not apply to:
Knowing Violation of Rights of Another
Personal and advertising injury caused by or at the direction of the Insured with the knowledge that
the act would violate the rights of another and would inflict personal and advertising injury. This
exclusion shall not apply to discrimination or humiliation that results in injury to the feelings or reputation
of a natural person, but only if such discrimination or humiliation is not done intentionally by or at the
direction of:
(a) the Named Insured; or
(b) any executive officer, director, stockholder, partner, member or manager (if the Named Insured is
a limited liability company) of the Named Insured.
2. add the following exclusions:
This insurance does not apply to:
Employment Related Discrimination
Discrimination or humiliation directly or indirectly related to the employment, prospective employment,
past employment or termination of employment of any person by any Insured.
Premises Related Discrimination
discrimination or humiliation arising out of the sale, rental, lease or sub -lease or prospective sale,
rental, lease or sub -lease of any room, dwelling or premises by or at the direction of any Insured.
Notwithstanding the above, there is no coverage for fines or penalties levied or imposed by a governmental
entity because of discrimination.
The coverage provided by this PERSONAL AND ADVERTISING INJURY —DISCRIMINATION OR
HUMILIATION Provision does not apply to any person or organization whose status as an Insured derives
solely from
• Provision 1. ADDITIONAL INSURED of this endorsement; or
• attachment of an additional insured endorsement to this Coverage Part.
16. PERSONAL AND ADVERTISING INJURY - LIMITED CONTRACTUAL LIABILITY
A. Under COVERAGES, Coverage B —Personal and Advertising Injury Liability, the paragraph entitled
Exclusions is amended to delete the exclusion entitled Contractual Liability and replace it with the
following:
This insurance does not apply to:
Contractual Liability
Personal and advertising injury for which the Insured has assumed liability in a contract or agreement.
This exclusion does not apply to liability for damages:
(1) that the Insured would have in the absence of the contract or agreement; or
G-00000-A Page 11 of 13
(Ed. )
Attachment Code: D524693 Certificate ID: 14568645
Policy Number: TCP 7024348-10
G-00000-A
(Ed. )
(2) assumed in a contract or agreement that is an insured contract provided the offense that caused such
personal or advertising injury first occurred subsequent to the execution of such insured contract.
Solely for the purpose of liability assumed in an insured contract, reasonable attorney fees and
necessary litigation expenses incurred by or for a party other than an Insured are deemed to be
damages because of personal and advertising injury provided:
(a) liability to such party for, or for the cost of, that party's defense has also been assumed in such
insured contract; and
(b) such attorney fees and litigation expenses are for defense of such party against a civil or alternative
dispute resolution proceeding in which covered damages are alleged.
B. Solely for the purpose of the coverage provided by this paragraph, DEFINITIONS is amended to delete the
definition of insured contract in its entirety, and replace it with the following:
Insured contract means that part of a written contract or written agreement pertaining to the Named
Insured's business under which the Named Insured assumes the tort liability of another party to pay for
personal or advertising injury arising out of the offense of false arrest, detention or imprisonment. Tort
liability means a liability that would be imposed by law in the absence of any contract or agreement.
C. Solely for the purpose of the coverage provided by this paragraph, the following changes are made to the
Section entitled SUPPLEMENTARY PAYMENTS — COVERAGES A AND B:
1. Paragraph 2.d. is replaced by the following:
d. The allegations in the suit and the information the Insurer knows about the offense alleged in such
suit are such that no conflict appears to exist between the interests of the Insured and the interests
of the indemnitee;
2. The first unnumbered paragraph beneath Paragraph 2.f.(2)(b) is deleted and replaced by the following:
So long as the above conditions are met, attorneys fees incurred by the Insurer in the defense of that
indemnitee, necessary litigation expenses incurred by the Insurer, and necessary litigation expenses
incurred by the indemnitee at the Insurer's request will be paid as defense costs. Notwithstanding the
provisions of Paragraph e.(2) of the Contractual Liability exclusion (as amended by this Endorsement),
such payments will not be deemed to be damages for personal and advertising injury and will not
reduce the limits of insurance.
D. This PERSONAL AND ADVERTISING INJURY - LIMITED CONTRACTUAL LIABILITY Provision does not
apply if Coverage B —Personal and Advertising Injury Liability is excluded by another endorsement
attached to this Coverage Part.
17. PROPERTY DAMAGE — ELEVATORS
A. Under COVERAGES, Coverage A — Bodily Injury and Property Damage Liability, the paragraph entitled
Exclusions is amended such that the Damage to Your Product Exclusion and subparagraphs (3), (4) and
(6) of the Damage to Property Exclusion do not apply to property damage that results from the use of
elevators.
B. Solely for the purpose of the coverage provided by this PROPERTY DAMAGE — ELEVATORS Provision,
the Other Insurance conditions is amended to add the following paragraph:
This insurance is excess over any of the other insurance, whether primary, excess, contingent or on any
other basis that is Property insurance covering property of others damaged from the use of elevators.
18. SUPPLEMENTARY PAYMENTS
The section entitled SUPPLEMENTARY PAYMENTS — COVERAGES A AND B is amended as follows:
A. Paragraph 1.b. is amended to delete the $250 limit shown for the cost of bail bonds and replace it with a
$5,000. limit; and
B. Paragraph 1.d. is amended to delete the limit of $250 shown for daily loss of earnings and replace it with a
$1,000. limit.
G-00000-A Page 12 of 13
(Ed. )
Attachment Code: D524693 Certificate ID: 14568645
Policy Number: TCP 7024348-10
19. PROPERTY DAMAGE - PATTERNS MOLDS AND DIES
G-00000-A
(Ed. )
Under COVERAGES, Coverage A — Bodily Injury and Property Damage Liability, the paragraph entitled
Exclusions is amended to delete subparagraphs (3) and (4) of the Exclusion entitled Damage to Property, but
only with respect to patterns, molds or dies that are in the care, custody or control of the Insured, and only if
such patterns, molds or dies are not being used to perform operations at the time of loss. A limit of insurance of
$25,000 per policy period applies to this PROPERTY DAMAGE - PATTERNS MOLDS AND DIES coverage,
and this limit:
A. is included within the General Aggregate Limit as described in LIMITS OF INSURANCE; and
B. applies excess over any valid and collectible property insurance available to the Insured, including any
deductible applicable to such insurance; the Other Insurance condition is changed accordingly.
20. UNINTENTIONAL FAILURE TO DISCLOSE HAZARDS
If the Named Insured unintentionally fails to disclose all existing hazards at the inception date of the Named
Insured's Coverage Part, the Insurer will not deny coverage under this Coverage Part because of such failure.
21. WAIVER OF SUBROGATION - BLANKET
Under CONDITIONS, the condition entitled Transfer Of Rights Of Recovery Against Others To Us is
amended to add the following:
The Insurer waives any right of recovery the Insurer may have against any person or organization because of
payments the Insurer makes for injury or damage arising out of:
1. the Named Insured's ongoing operations; or
2. your work included in the products -completed operations hazard.
However, this waiver applies only when the Named Insured has agreed in writing to waive such rights of
recovery in a written contract or written agreement, and only if such contract or agreement:
1. is in effect or becomes effective during the term of this Coverage Part; and
2. was executed prior to the bodily injury, property damage or personal and advertising injury giving rise
to the claim.
All other terms and conditions of the Policy remain unchanged.
This endorsement, which forms a part of and is for attachment to the Policy issued by the designated Insurers, takes
effect on the effective date of said Policy at the hour stated in said Policy, unless another effective date is shown
below, and expires concurrentiz with said Policy.
G-00000-A Page 13 of 13
(Ed. )
Attachment Code: D528048 Certificate ID: 14568645
CIVA
Workers Compensation And Employers Liability Insurance
Policy Endorsement
We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not
enforce our right against the person or organization named in the Schedule. This agreement applies only to the
extent that you perform work under a written contract that requires you to obtain this agreement from us.
This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule.
Any person or organization for which the employer has agreed by written contract, executed prior to loss, may
execute a waiver of subrogation. However, for purposes of work performed by the employer in Missouri, this
waiver of subrogation does not apply to any construction group of classifications as designated by the waiver of
right to recover from others (subrogation) rule in our manual.
Schedule
Any Person or Organization on whose behalf you are required to obtain this waiver of our right to recover
from under a written contract or agreement.
The premium charge for the endorsement is reflected in the Schedule of Operations.
All other terms and conditions of the policy remain unchanged.
This endorsement, which forms a part of and is for attachment to the policy issued by the designated Insurers,
takes effect on the Policy Effective Date of said policy at the hour stated in said policy, unless another effective
date (the Endorsement Effective Date) is shown below, and expires concurrently with said policy unless another
expiration date is shown below.
Form No: WC 00 03 13 (04-1984) Policy No: WC 6 43664067 -I
Endorsement Effective Date: Endorsement Expiration Date: Policy Effective Date: 10/20/2022
Endorsement No: 34; Page: 1 of 1 Policy Page: 255 of 411
Underwriting Company: The Continental Insurance Company, 151 N Franklin St, Chicago, IL 60606
Copyright 1983 National Council on Compensation Insurance.
Attachment Code: D529218 Certificate ID: 14568645
WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY
WC 04 03060484
' m 10 M r m• •
elmsk
•.
We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not
enforce our right against the person or organization named in the Schedule. (This agreement applies only to the
extent that you perform work under a written contract that requires you to obtain this agreement from us.)
You must maintain payroll records accurately segregating the remuneration of your employees while engaged in
the work described in the Schedule.
The additional premium for this endorsement shall be 2% of the California workers' compensation
premium otherwise due on such remuneration.
Person or Organization
Schedule
Job Description
Any person or organization for which you have agreed to waive your rights of recovery in a written contract, provided such
contract was executed prior to the date of loss.
This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated.
(The information below is required only when this endorsement is issued subsequent to preparation of the policy)
Endorsement Effective Policy No. Endorsement No.
10/20/2023 TWC 7024349 10
Insured Premium
Granicus, l
Insurance Company: Countersigned
by
Riverport Insurance Company
WC 04 03 06 04 84 1998 by the Workers' Compensation Insurance Rating Bureau of California. Page 1 Of 1
All rights reserved. From the WCIRB's California Workers' Compensation
Insurance Forms Manual 2001.