PROOF OF INSURANCE (2026)C CERTIFICATE OF LIABILITY INSURANCE
DATE (MM/DD/YYYY)
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 CONTACT
NAM . Clndyr_Gibbens
Roach Howard Smith & Barton - Dallas PHONE FAX
744-2705
8750 N. Central Expressway, Suite 500 E-MAIL `Ex� ....... AI No :...... .........
Dallas, TX 75231 DQR0_A cgibbens(ilrhsb.com
_.........r_...
INSURERS) AFFORDING COVERAGE NAIC #
_ ................. .. .......................... - W.�................._
INSURER A: mmmmmmmmmmml Casualty Cc 20443
INSURED ...__ SPARFEN-01 INSURERS; National Fire Ins Of Hartford W 20478
Sparta Fence Inc
504 S Lemon St INsuRER G : ...........•••• _....... ...__._.
Fullerton, CA 92832 JNSURER D
mAf^ �c. d'C0TICI6''ATr- AIIIItArIFR• l"af:.n9n'In'I9 RFVIgft-J'►J...... NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. .........
AD'D1.., i�UlBli ........_.�.. -----------......__,...._..
...- ,,.
EFF.... POLIO
iLTR ....................,,
LIMITS
MMLRCY
TYPE OF INSURANCE POLICY NUMBER YYXX
A
X
COMMERCIAL GENERAL LIABILITY
Y
B7038741711
3/1/2025
3/1/2026
EACH OCCURRENCE
$ 1,000,000
f 1
'.. CLAIMS -MADE n m, OCCUR
AMA, W WAMMY il-
PR.FNIiSE'S/E�roCw<�ilranca ITITITIT$
)
1,000,000
''...-
MED EXP (Any one person)
^PERSONAL
$ 10,000
&ADV INJURY
-.........................
$ 1,000,000 ..
........,..
GEN"LAG-GREGATE
.....................�
LIMIT APPLIES PER:
.,..,.._.
GENERALAGGREGATE
.....
$2,000,000
X
PRO -
POLICY JECT ❑ LOC
PRODUCTS - COMP/OP AGG
$ 2,000,000
OTHER'..
'..$
A
AUTOMOBILE
LIABILITY
BUA 7038738002
3/1/2025
3/1/2026
Ea aWdent) GLE LINVIT
_(Ea accartcnfth ........
$1,000,000
_.... . _
X
ANY AUTO
BODILY INJURY (Per person)
$
OWNED SCHEDULED
BODILY INJURY Per accident
$
--.
AUTOS ONLY „„„ AUTOS
HIRED NON -OWNED
PROPERTY DAMAGE
$
AUTOS ONLY „„„ AUTOS ONLY
®QP4TMr Modent) ----
.•......-
-
is
A
X
UMBRELLA LIAB X OCCUR
B7038741756
3/1/2025
3/112026
EACH OCCURRENCE _
$ 5,000 000 _
EXCESS LU\B CLAIMS -MADE
Y
AGGREGATE _
$ 5,000,000
DED I X I RETENTION $ in nnn
$
B
WORKERS COMPENSATION
WC738741742
3/1/2025
3/1/2026
PER
X STATUTE ERH
AND EMPLOYERS' LIABILITY
....
ANYPROPRIETOR/PARTNER/EXECUTIVE —
OFFICERIMEMBEREXCLUDED?
NIA
E L EACH ACCIDENT
$ 1,000,000
(Mandatory in NH)
-
E L DISEASE - EA EMPLOYEE
-
$ 1 000,000
If yes, describe under
DESCRIPTION OF OPERATIONS below
E.L. DISEASE - POLICY LIMIT
$ 1 000,000
A
Employment Practices/Fiduciary
B7038741711
3/1/2025
3/1/2026
Limit:
Retroactive Date:
$10,000
10/06/2023
Liability
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required)
Cert Holders Continued: its elected and appointed officials, employees, and volunteers,
General Liability Policy are Includes a blanket automatic additional insured endorsement or provision that provides additional 'insured status to certificate holder
only When there is a Written contract between named insured and certificate holder that requires such status. General liability policy contains a special
endorsement or provision With "primary additional insured" wording.
The City of El Segundo is an Additional Insured to the General Liability and Umbrella Liability policies since required by written contract.
CERTIFICATE HOLDER GANk;tL.LAIIUN
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
The City of El Segundo
350 Main St El Segundo, CA 90245 AUTHORIEDEPRESENT Tav'E
U 19015-2U115 AGUKU GUFO'UKA I Ium Au rigms reserves.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
SB146935E
(Ed. 10-19)
BLANKET ADDITIONAL INSPIRED - OWNERS, LESSEES OR CONTRACTORS
WITH PRODUCTS COMPLETED OPERATIONS COVERAGE AND
LIABILITY EXTENSION ENDORSEMENT
This endorsement modifies insurance provided under the following:
BUSINESSOWNERS LIABILITY COVERAGE PART
BUSINESSOWNERS COMMON POLICY CONDITIONS
TABLE OF CONTENTS
I. Blanket Additional Insured — including Primary -Noncontributory provision
li. Liability Extension Coverages
A.
Bodily Injury — Expanded Definition
B.
C.
Broad Knowledge of Occurrence
Estates, Legal Representatives and Spouses
D.
Fellow Employee First Aid
E.
F.
G.
H.
Personal and Advertising Injury — Discrimination or Humiliation
Personal and Advertising Injury — Broadened Eviction
Waiver of Subrogation — Blanket
Additional Insured — Extended Coverage
I. BLANKET ADDITIONAL INSURED PROVISIONS
A. Who Is An Insured is amended to include as an additional insured any person or organization whom you are
required by `written contracr to add as an additional insured on the Businessowners Liability Coverage Form.
B. The insurance provided to the additional insured is limited as follows:
1. The person or organization is an additional insured only with respect to liability for "bodily injury," 'property
damage,' or 'persmal ands advertising Injury' caused in whole or In part by:
a. Your acts or omissions; or
b. The acts or omissions of those acting on your behalf
in the performance of your ongoing operations specified in the 'written contract'; or
c. 'Your work" that is specified in the written contract but only for "bodily injury" or "property damage"
included in the products completed operations hazard, and only if :
(1) The'wrftten contract" requires you to provide the additional insured such coverage; and
(2) This Coverage Part provides such coverage.
2. Subject always to the terms and conditions of this policy, including the limits of insurance, we will not provide
such additional insured with:
a. Coverage broader than required by the 'written contract';
b. A higher limit of insurance than required by the Owritten contract.'
SB146935E (Ed. 10-19)
Page 1 of 4
Copyright, CNA All Rights Rewmed.
SB146935E
(Ed. 10-19)
C. The insurance provided to the additional insured does not apply to "bodily Injury," "property damage,"' or
"personal and advertising injury' arising out of:
a. The rendering of, or the failure to render, any professional architectural, engineering, or surveying services,
including:
(1) The preparing approving, or failing to prepare or approve maps, shop drawings, opinions, reports,
surveys, field orders, change orders or drawings and specifications; and
(2) Supervisory, inspection, architectural or engineering activities; or
b. Any premises or work for which the additional insured is specifically listed as an additional insured on another
endorsement attached to this Policy.
D. Notwithstanding anything to the contrary in the Other Insurance condition of the Businessowners Common Policy
Conditions, this insurance is excess of all other insurance available to the additional insured, whether on a
primary, excess, contingent or any other basis. But if required by the 'written contract,w this insurance will be
primary and non-contributory relative to insurance on which the additional Insured is a Named Insured,
E. Under Busin ners Liability Conditions, the Duties in the Event of Occurrence, Offense, Claim or Suit
condition is amended to add the following additional conditions applicable to the additional insured is amended as
follows:
An additional insured under this endorsement will as soon as practicable:
a. Give us written notice of an "occurrence' or an offense which may result in a claim or "suit' under this
insurance, and of any claim or'suit'that does result;
b. Tender the defense and indemnity of any claim or "'suit' to any other insurer or self insurer whose policy or
program applies to all loss we cover under this Policy;
c. Except as provided in Paragraph B.3. of this endorsement, agree to make available any other insurance the
additional insured has for a loss we cover under this Policy; and
d. Send us copies of all legal papers received, and otherwise cooperate with us in the investigation, defense, or
settlement of the claim or "'suit.'
We have no duty to defend or indemnify an additional insured under this endorsement until we receive from
the additional insured written notice of a claim or'suit.'
F. Under Liability and Medical Expense Definitions, the following definition is added:
'Written contract' means a written contract or agreement that requires you to make a person or organization an
additional insured on this policy, provided the contract or agreement:
a. Is currently in effect or becomes effective during the term of this policy; and
b. Was executed prior to:
(1) The 'bodily injury' or'property damage'; or
(2) The offense that caused the "personal and advertising injury';
for which the additional insured seeks coverage.
II. LIABILITY EXTENSION COVERAGES
It is understood and agreed that this endorsement amends the Businessownsrs Liability Coverage Form. 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 to such provision do
not apply.
A. Bodily Injury — Expanded Definition
,,. Under Liability and Medical ExIxmses Definitions, the definition of "Bodily Injury' is deleted and replaced with
the following:
SB146935E (Ed. 10-19) Page 2 of 4
Copyright, CNA All Rights Reserved.
SB146935E
(Ed. 10-19)
°Bodily injury" means physical injury, sickness or disease sustained by a person, including death, humiliation,
shock, mental anguish or mental injury by that person at any time which results as a consequence of the physical
injury, sickness or disease.
B. Broad Knowledge of Occurrence
Under Businessowners Liability Conditions, the condition entitled Duties In The Event of Occurrence,
Offense, Claim or Suit is amended to add the following:
Paragraphs a. and b. apply to you or to any additional insured only when such "occurrence,' offense, claim or
'suit' is known to:
(1) You or any additional insured that is an individual;
(2) Any partner, if you or an additional insured is a partnership;
(3) Any manager, if you or an additional insured is a limited liability company;
(4) Any "executive officer' or insurance manager, if you or an additional insured is a corporation;
(5) Any trustee, if you or an additional insured is a trust; or
(6) Any elected or appointed official, if you or an additional insured is a political subdivision or public entity.
This paragraph e. applies separately to you and any additional insured.
C. Estates, Legal Representative 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 as such and, in the case of a spouse, where such claim seeks
damages from marital common properly, jointly held properly, or property transferredfrom 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 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.
D. Fellow Employee First Aid Coverage
In the section entitled Who Is An Insured, paragraph 2.a.1. is amended to add the following:
The limitations described in subparagraphs 2.a.1.(a), (b) and (c) do not apply to your ''employees"' for 'bodily
injury' that results from providing cardiopulmonary resuscitation or other first aid services to a co -"employee' or
"volunteer worker" that becomes necessary while your "employseo Is performing duties in the conduct of your
business. Your 'employees! are hereby insureds for such services. But the insured status conferred by this
provision does not apply to "employ " whose duties in your business are to provide professional health care
services or health examinations.
E. Personal and Advertising Injury — Discrimination or Humiliation
1. Under Liability and Medical Expenses Definitions, the definition of "Personal and advertising injury' is
amended to add the following:
h. Discrimination or humiliation that results in injury to the feelings or reputation of a natural person, but only
if such discrimination or humiliation is:
(1) Not done intentionally by or at the direction of:
(a) The insured; or
(b) Any 'executive officer," director, stockholder, partner, member or manager (if you are a limited
liability company) of the insured; and
(2) Not directly or indirectly related to the employment, prospective employment, past employment or
termination of employment of any person or person by any insured.
S8146935E (Ed. 10-19)
Page 3 of 4
Copyright, CNA All Rights RGMVed.
SB146935E
(Ed. 10-19)
2. Under B. Exclusions, 1. Applicable to Business Liability Coverage, the exclusion entitled Personal and
Advertising injury is amended to add the following additional exclusions:
(1S)Discrimination Relating to Room, Dwelling or Premises
Caused by discrimination directly or indirectly related to 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.
(16)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.
(17)Fines or Penalties
Fines or penalties levied or imposed by a governmental entity because of discrimination.
3. This provision (Personal and Advertise Injury — Discrimination or Humiliation) does not apply if
Personal and Advertising Iinjury Liability is excluded either by the provisions of the Policy or by
endorsement.
F. Personal and Advertising Injury - Broadened Eviction
Under Liability and Medical Expenses Definitions, the definition of Personal and advertising injury" is
amended to delete Paragraph c. and replace it with the following:
c. The wrongful eviction from, wrongful entry into, or invasion of the right of private occupancy of a room
dwelling or premises that a person or organization occupies committed by or on behalf of its owner, landlord
or lessor.
G. Waiver of Subrogation — Blanket
We waive any right of recovery we may have against:
1. Any person or organization with whom you have a written contract that requires such a waiver.
H. Additional Insured — Extended Coverage
When an additional insured is added by this or any other endorsement attached to this Coverage Part, the section
entitled Who Is An Insured is amended to make the following natural persons insureds:
If the additional insured is:
1. An individual, then his or her spouse is an insured;
2. A partnership or joint venture, then its partners, members and their spouses are insureds;
3. A limited liability company, then its members and managers are insureds;
4. An organization other than a partnership, joint venture or limited liability company, then its executive officers,
directors and shareholders are insureds; or
S. Any type of entity, then its employees are insureds;
but only with respect to locations and operations covered by the additional insured endorsement's provisions, and
only with respect to their respective roles within their organizations. Furthermore, employees of additional
insureds are not insureds with respect to liability arising out of:
® (1) "Bodily injury' or `personal and advertising injury" to any fellow employee or to any natural person listed
in paragraphs 1. through 4. above;
(2) "Property damage' to property owned, occupied or used by their employer or by any fellow employee; or
(3) Providing or failing to provide professional health care services.
All other terms and conditions of the Policy remain unchanged.
SB146935E (Ed. 10-19) Page 4 of 4
Copyright, CNA All Rights Paserved.
rq-lyn-1
CNA80103XX
(09-14)
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
PRIMARY AND NONCONTRIBUTORY -
OTHER INSURANCE CONDITION
This endorsement modifies insurance provided under the following:
BUSINESSOWNERS COMMON POLICY CONDITIONS
The following is added to Paragraph H. Other Insurance and supersedes any provision to the contrary:
Primary And Noncontributory Insurance
This insurance is primary to and will not seek contribution from any other insurance available to an additional insured
under your policy provided that:
1. The additional insured is a Named Insured under such other insurance; and
2. You have agreed in writing in a contract or agreement that this insurance would be primary and would not seek
contribution from any other insurance available to the additional insured.
All other terms and conditions of the Policy remain unchanged.
CNA80103XX (09-14)
Page 1 of 1
Copyright, CNA All Flights Reserved. Includes copyrighted material of Insurance services office, Inc., with Its pemisslon
��AT I
CNA Connect
Endorsement Declaration
POLICY NUMBER COVERAGE PROVIDED BY
B 7038741711 CONTINENTAL CASUALTY COMPANY
151 N Franklin
CHICAGO, IL 60606
INSURED NAME AND ADDRESS
Sparta Fence Inc
504 S LEMON ST
FULLERTON, CA 92832
AGENCY NUMBER AGENCY NAME AND ADDRESS
058474 ROACH HOWARD SMITH & BARTON INC
1320 S UNIVERSITY DR STE 1000
FORT WORTH, TX 76107
Phone Number: (817)332-1313
BRANCH NUMBER BRANCH NAME AND ADDRESS
040 DALLAS BRANCH
700 N. PEARL ST., STE. 300
DALLAS, TX 75201
Phone Number: (214)220-1300
FROM - POLICY PERIOD - TO
03/01/2025 03/01/2026
This policy becomes effective and expires at 12:01 A.M. standard time at your mailing
address on the dates shown above.
This endorsement changes your policy. Please read it carefully.
The Named Insured is a Corporation.
The Endorsement Premium Is $14.00 ADDITIONAL
Terrorism Risk Insurance Act Endorsement Premium
Audit Period is Annual
INSURED Page 1 of 4
POLICY NUMBER INSURED NAM AND ADDRESS
7038741711 Sparta Fence Inc
504 S LEMON ST
FULLERTON, CA 92832
SCR'EDULE OF LOCATIONS AND COV OE
LOCATION 1 BUILDING 1
418 E COMMON WEALTH AVE UNIT 2
FULTERON, CA 92832
Construction:Joisted Masonry
Class Description: Fence Dealers - With Installation
LOCATION 2 BUILDING 1
406 E COMMON WEALTH AVE UNIT 4
FULTERON, CA 92832
Construction:Joisted Masonry
Class Description: Fence Dealers - With Installation
INSURED Page 2 of 4
POLICY NUMBER INSURED AND ADDRESS
B 7038741711 Sparta Fence Inc
504 S LEMON ST
FULLERTON, CA 92832
ADDITIONAL INTEREST SCHEDULE
LOCATION 1 BUILDING 1
The following has been added to your policy effective 06/11/2025
Types Owners , Lessees or Contractors
Additional Interest Name and Address:
CITY OF EL SEGUNDO
350 MAIN ST
EL SEGUNDO , CA 90245
Types Notice of Cancellation or Material Coverage Change
Additional Interest Name and Address:
CITY OF EL SEGUNDO
350 MAIN ST
EL SEGUNDO , CA 90245
LOCATION 2 BUILDING 1
The following has been added to your policy effective 06/11/2025
Type: Owners , Lessees or Contractors
Additional Interest Name and Address:
CITY OF EL SEGUNDO
350 MAIN ST
EL SEGUNDO CA 90245
Types Notice of Cancellation or Material Coverage Change
Additional Interest Name and Addresss
CITY OF EL SEGUNDO
350 MAIN ST
EL SEGUNDO , CA 90245
INSURED Page 3 of 4
FORMS AND ENDORSEMENTS SCHEDULE
The following list shows the Forms, Schedules and Endorsements by Line of Business that are
a part of this policy.
COMMON
The following forms have been added to your policy, effective 06/11/2025
FORM NUMBER FORM TITLE
SB147052C 06/2016 Notice of Cancellation or Material Coverage Change
G56015B 11/1991 ENDORSEMENT EFFECTIVE 06/11/2025
COMMERCIAL GENERAL LIABILITY
The following forms have been added to your policy, effective 06/11/2025
FORM NUMBER FORM TITLE
SB300120C 06/2011 Additional Insured - Owners, Lessees or Contractor
Chairman of the Board
Countersignature
Secretary
SB-146895-A (Ed. 01/06) INSURED Page 4 of 4
POLICY NUMBER INSURED NAME AND ADDRESS
B 7038741711 Sparta Fence Inc
504 S LEMON ST
FULLERTON, CA 92832
P C QES
ENDORSEMENT EFFECTIVE 06/11/2025
This Change Endorsement changes the Policy. Please read it carefully.
This Change Endorsement is a part of your Policy and takes effect on the
effective date of your Policy, unless another effective date is shown.
CHANGES - NOTICE OF CANCELLATION
OR MATERIAL COVERAGE CHANGE
This endorsement modifies insurance provided under the following:
BUSINESSOWNERS COMMON POLICY CONDITIONS
In the event of cancellation or material change that reduces or
restricts the insurance afforded by this Coverage Part (other
than the reduction of aggregate limits through payment of
claims), we agree to mail written notice of cancellation or
material change at a minimum of thirty (30) days prior to such
cancellation or material change, to:
SCHEDULE
Name of Designated Entity: CITY OF EL SEGUNDO
Address/Contact Information of Designated Entity:
350 MAIN ST EL SEGUNDO CA 90245
*Information required to complete this Schedule, if not shown
above, will be shown in the Declarations.
The following conditions are added:
1. If the policy is cancelled or not renewed, we will give
written notice of such cancellation or nonrenewal to the
Designated Entity shown in the Schedule above, or in the
Declarations, at a minimum of thirty (30) days prior to
such cancellation or nonrenewal. Such notice may be
delivered or sent by any means of our choosing. The notice
to the Designated Entity will state the effective date of
Chairman of the Board
G-56015-B (ED. 11/91)
secretary
POLICY NUMBER INSURED NAME AND ADDRESS
B 7038741711 Sparta Fence Inc
504 S LEMON ST
FULLERTON, CA 92832
LInL CRM
ENDORSEMENT EFFECTIVE 06/11/2025
This Change Endorsement changes the Policy. Please read it carefully.
This Change Endorsement is a part of your Policy and takes effect on the
effective date of your Policy, unless another effective date is shown.
cancellation or nonrenewal. However, such notice of
cancellation or nonrenewal is solely for the purpose of
informing the Designated Entity of the effective date of
cancellation or nonrenewal and does not grant, alter, or
extend any rights or obligations under this policy.
2. If we cancel or elect not to renew the policy for any
reason other than nonpayment of premium, we will give
written notice to the Designated Entity shown in the
Schedule above, or in the Declarations, at a minimum of
thirty (30) days prior to such cancellation or nonrenewal,
at the same time notice is given to the first Named
Insured.
3. If we cancel or elect not to renew this policy for
nonpayment of premium, we will give written notice to the
Designated Entity shown in the Schedule above, or in the
Declarations. Such notice may be provided before or after
the effective date of cancellation or nonrenewal.
4. Failure to give notice in accordance with the terms of
this endorsement does not:
a. Alter the effective date of policy cancellation,
nonrenewal or expiration;
b. Render such cancellation or nonrenewal ineffective;
c. Grant, alter, or extend any rights or obligations
under this policy; or
d. Extend the insurance beyond the effective date of
cancellation or policy expiration, whichever comes
first.
All other terms and conditions of the Policy remain unchanged.
a,Wmm d ut eoud
G-56015-B (ED. 11/91)
0�0011111
sty
SB147052C
(Ed. 6-16)
CHANGES - NOTICE OF CANCELLATION
OR MATERIAL COVERAGE CHANGE
This endorsement modifies insurance provided under the following:
BUSINESSOWNERS COMMON POLICY CONDITIONS
In the event of cancellation or material change that reduces or restricts the insurance afforded by this Coverage Part (other
than the reduction of aggregate limits through payment of claims), we agree to mail written notice of cancellation or
material change at a minimum of thirty (30) days prior to such cancellation or material change, to:
of
Information of
SCHEDULE
*Information required to complete this Schedule, if not shown above, will be shown in the Declarations.
The following conditions are added:
1. If the policy is cancelled or not renewed, we will give written notice of such cancellation or nonrenewal to the
Designated Entity shown in the Schedule above, or in the Declarations, at a minimum of thirty (30) days prior to
such cancellation or nonrenewal. Such notice may be delivered or sent by any means of our choosing. The notice
to the Designated Entity will state the effective date of cancellation or nonrenewal. However, such notice of
cancellation or nonrenewal is solely for the purpose of informing the Designated Entity of the effective date of
cancellation or nonrenewal and does not grant, alter, or extend any rights or obligations under this policy.
2. If we cancel or elect not to renew the policy for any reason other than nonpayment of premium, we will give
written notice to the Designated Entity shown in the Schedule above, or in the Declarations, at a minimum of thirty
(30) days prior to such cancellation or nonrenewal, at the same time notice is given to the first Named Insured.
3. If we cancel or elect not to renew this policy for nonpayment of premium, we will give written notice to the
Designated Entity shown in the Schedule above, or in the Declarations. Such notice may be provided before or
after the effective date of cancellation or nonrenewal.
4. Failure to give notice in accordance with the terms of this endorsement does not:
a. Alter the effective date of policy cancellation, nonrenewal or expiration;
b. Render such cancellation or nonrenewal ineffective;
c. Grant, alter, or extend any rights or obligations under this policy; or
d. Extend the insurance beyond the effective date of cancellation or policy expiration, whichever comes first.
All other terms and conditions of the Policy remain unchanged.
SB147052C (Ed. 6-16)
Page 1 of 1
Copyright, CNA All Rights Rasorved.
rrr r SB-300120-C
(Ed. 06/11)
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS -
SCHEDULED PERSON OR ORGANIZATION WITH PRODUCTS COMPLETED
OPERATIONS COVERAGE
This endorsement modifies insurance provided under the following:
BUSINESSOWNERS LIABILITY COVERAGE FORM
SCHEDULE*
Name Of Person Or Organization:
* Information required to complete this Schedule if not shown on this endorsement will be shown in the Declarations.
A. The following is added to Paragraph C. Who Is An
Insured:
4. Any person(s) or organization(s) shown in the
Schedule is also an additional insured, but only
with respect to liability for *bodily injury," "property
damage" or *personal and advertising injury,*
caused, in whole or in part, by:
a. Your acts or omissions; or
b. The acts or omissions of those acting on your
behalf
in the performance of your ongoing operations for
the additional insured(s); at the location(s)
designated above; or
c. "Your work" that is included in the "products -
completed operations hazard" and performed
for the additional insured, but only if this
Policy provides such coverage, and only if the
written contract or written agreement requires
you to provide the additional insured such
coverage.
B. The insurance provided to the additional insured does
not apply to "bodily injury,": "property damage," or
"personal and advertising injury" arising out of:
SB-300120-C
(Ed. 06/11)
1. The rendering of, or the failure to render any
professional architectural, engineering, or
surveying services, including:
(a) The preparing, approving, or failing to prepare
or approve maps, shop drawings, opinions,
reports, surveys, field orders, change orders
or drawings and specifications; and
(b) Supervisory, inspection, architectural or
engineering activities.
2. "Bodily Injury," "property damage," or "personal
and advertising injury" arising out of any premises
or work for which the additional insured is
specifically listed as an additional insured on
another endorsement attached to this Policy.
C. The following is added to Paragraph H. of the
Businessowners Common Policy Conditions:
H. Odw Insurance
This insurance is excess over any other insurance
naming the additional insured as an insured
whether primary, excess, contingent or on any
other basis unless a written contract or written
agreement specifically requires that this insurance
be either primary or primary and noncontributing.
Page 1 of 1
151 N. Franklin St.
Chicago, IL 60606
Policy Numba From Niq Pedod TO Coverage Na ProvIded II y Agency
B7038741711 03/01/25 03/01/26 Continental Casualty Company 058474040
Sparta Fence Inc ROACH HOWARD SMITH & BARTON INC
504 S LEMON ST 1320 S UNIVERSITY DR STE 1000
FULLERTON, CA 92832 FORT WORTH, TX 76107
** REVISED PAYMENT PLAN SCHEDULE **
THE BILLING FOR THIS POLICY WILL BE
FORWARDED TO YOU DIRECTLY FROM CNA.
THE PREMIUM AMOUNT FOR THIS TRANSACTION
IS $14.00 .
THIS PREMIUM WILL BE INVOICED BY CNA ON
A SEPARATE STATEMENT ACCORDING TO THE
PAYMENT OPTION YOU SELECT.
ISSUE DATE 06/25/25