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PROOF OF INSURANCE (2016) CLOSEDFSCON -2 OP ID: TC F DATE (MMIDDNYYY)
��` CERTIFICATE OF LIABILITY INSURANCE
1010812015
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 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 NAME. C Dora Brock
Sierra Oak Insurance Services PHONE
Lic# OC97528 (AI,ro E) 916- 364 -7380 rnrr. N,,,: 916 -364 7381
E MAUL°... , .... .... ....
9700 Business Park Dr. Ste 105 AoolESS;
Sacramento, CA 95827
Daniel E. Brock INSURER(S) AFFORDING COVERAGE NAIC i
..........m.........
INSURERA:American Fire and Casualty Co. 24066
__.. ... ....... _. ... ...................... .__._..�.
INSURED F S Construction INSURER B: Landmark American 33138
INSURERC: RSUI Indemnity Comp
DBA: F S Construction any 2 2314
14838 Bledsoe Street Company
Sylmar, CA 91342 INSURERD:lnsurance of the West 2 ®� 7847
..
INSURER E: The Ohio Casualty Insurance Co 24074
INSURER F ;
rnA1l:RARI =S CFRTIFIrATF NIIMRPPF REVISION NUMBER,
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY 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 MAYHAVE BEEN REDUCED BY PAID CLAIMS.
ADD "SUB ., ....... , �. --- - --
'ILTR = TYPE OF INSURANCE NSD WVrl POLICY NUMBER (MMID i= Y , °MMIDDIY LIMITS
LTR L. MMIDDlYYYYI (MMIDDIYYYYI
........
B X COMMERCIAL GENERAL LIABILITY EA0I OCCURRENCE
$ 1,000,000
riAm01�f)rar� .75 rf ....$
X OCCUR X X LHA138034 01/13/2015 01/1312016
CL..Al111S I`�l,DI p.�
50 0
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$ Exluded
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I Id vONAI & ADV N UR1(
$ 1,000,000
Gl ":N L A GRC.:GAFI::I.110F APPLIES LIES PER ERAI.. A( GRI...GAIE:::
$ 2,000,000'
R ::'01 ICY � EJE T El LOC PRODUCTS- COMP /OP AGG
X
$ 2 000,00 0
+rTN-IER.
AUTOMOBILE LIABILITY
COMBINE(.) SINGLE I:..IMI1
tr .� irnc':�"h
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$ 1,000,000
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BAA56680768
08/26/2015
08/2612016
.......... ........................�......
GDRI... IIV.It.UIZY (,I >ci Lrer Orr)
ZAIL OVVNf.::CD X " "" ;vCH DUI ED
.... ._......
BODILY INJURY (Per arcudenr.)
$
JIFos AU`I0S
NON OWNI:::C:)
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$
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$
UMBRELLA LIAB
:::X:: OCCI.1R
EACH OCCURRENCE
..... - --
$ 3,000,000
C
EXCESS LIAB CLAIMS IMADE
NHA237168
01/13/2015
01/1312016
' AGGRU GA I E:.:
$ 3,000,000
...... m .... _......
- FL) '', C2E C( (N FIoN $
$
WORKERS COMPENSATION
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X 4TATIITF
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AND EMPLOYERS' LIABILITY
ANY PROPRIETORIPARTNER /EXECUTIVE YIN
X
SA 5026584 01
05/28/2015
05/28/2016
E V ACH ACC IDE N1
_
$ 1,000,000.
OFFICERIMEMBER EXCLUDED?
NIA
1 000 000
1, ()00,000
(Mandatory In NH)
L V. DISEASE I: EIAIYI OYf I::
$
If yes, describe under
r1FSCRIPTION OF OPERATIONS below
DISEASE .........................................,.......
POLICY I.. IA 1
....m..........__._......_..... - -.
$ 1,000,000
E INLAND MARINE SM056680768 08/2612015 08/26/2016 Scheduled
45,000
DESCRIPTION OF OPERATIONS f LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
RE: PW 14 -16: 2014 -2015 Curb, Gutter, Sidewalk, and other Concrete
ImprovemLents project. The City of El Segundo, its officials, officers,
agents and employees are named additional 'Insured for all liability arising
out of the operations by or on behalf of the named insured if required by
contract per attached endorsements. Primary and and Non-contributory applies
a 'HECIT-
�� r SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
a THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
The City of El Segundo 4a a, t ,�
350 Main Street , ® AUTHORIZED REPRESENTATIVE
,a „I
El Segundo, CA 90245
I
OAwa-A&codoo,
©1988 -2014 ACORD CORPORATION. All rights reserved.
ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD
LANDMARK AMERICAN INSURANCE COMPANY
This Endorsement Changes The Policy. Please Read !t Carefully.
ADDITIONAL INSURED - PRIMARY AND YOUR "LORI
This endorsement modifies insurance provided under the following: "�
COMMERCIAL GENERAL LIABILITY COVERAGE FORM
SCHEDULE
Nam of Person or Organization: THE CITY OF EL SEGUNDO Project: PW 14 -16: 2014 -2015 Curb,
350 MAIN STREET Gutter, Sidewalk, and other
EL 5EGUNDO CA 90245 Concrete Improvements
(it no entry appears above, Information required to complete this endorsement will be shown on the Declarations
ns applie.ahle to this endorsement.)
A. SECTION 11 • WHO IS AN INSURED is amended to include as an additional insured the peisan(s) or
organization(s) shown in the SCHEDULE, but only with respect to liability for "bodily injury ", `property
damage" or personal and advertising injury` caused, in whole or in part, by:
1. Your acts or omissions; or
2. The acts or omissions of those acting on your behalf;
in the performancp of your ongoing aparatkonq, nn&or '"your work" dofmptt for the additional insurart(a)
designated above included in the 'prod uc'ts- completed "rations hazard'.
R. If you are required by a written contract to provide primary insurance, this policy shall be primary and
SECTION IV -COMMERCIAL GENERAL LIABILITY CONDITIONS, 4. Othor Insurance does not apply, but
only with respect to coverage provided by this policy.
This endorsement effective 10/01/2015
forms part of Policy Number LHA138034
issuedto FS CONSTRUCTION
by Landmark American Insurance Company
RSG 15020 1207 Includes copyrighted material of Insurance Services
Office, Inc. 1984
(1165) with ita parmiesion
Policy Number. LHA138034
COMMERCIAL GENERAL LIABILITY
CG 20 0104 13
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
PRIMARY AND N �NCONT IBUTOI Y �.
OTHER INSURANCE CONDITION
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
PRODUCTS /COMPLETED OPERATIONS LIABILITY COVERAGE PART
The following is added to the Other Insurance (2) You have agreed in writing in a contract or
Condition and supersedes any provision to the agreement that this insurance would be
contrary: primary and would not seek contribution
Primary And Noncontributory Insurance from any other insurance available to the
additional insured.
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
CG 20 0104 13 © Insurance Services Office, Inc., 2012 Page 1 of 1
LANDMARK AMERICAN INSURANCE COMPANY
This Endorsement Changes The Policy. Please Read It Carefully.
WAIVER OF TRANSF'E R OF RIGHTS OF RECOVERY AGAINST
OTHERS TO US
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE FORM
PRODUCTS /COMPLETED OPERATIONS LIABILITY COVERAGE FORM
SCHEDULE
Name of Person or Organization:
Any Person or Organization As Required By Written Contract
The following is added to SECTION IV — CONDITIONS, 8. TRANSFER OF RIGHTS OF RECOVERY AGAINST
OTHERS TO US:
We waive any right of recovery we may have against the person or organization shown in the SCHEDULE above
because of payment we make for injury or damage arising out of your ongoing operations, "your product' or "your
work" done under a written contract with that person or organization and included in the "product- completed
operations hazard ". This waiver applies only tothe person or organization shown in the SCHEDULE above.
This endorsement effective 1/13/2015
forms part of Policy Number LHA138034
issued to F S CONSTRUCTI ON
by Landmark American Insurance Company
RSG 14048 1008 Includes copyrighted material of Insurance Services Office, Inc. 1992
with its permission.
LIABILITY COMMERCIAL GENERAL
Various provisions in this policy restrict coverage.
Read the entire policy carefully to determine rights,
duties and what is and is not covered.
Throughout this policy the words "you" and "your"
refer to the Named Insured shown in the Declarations,
and any other person or organization qualifying as a
Named Insured under this policy. The words "we ",
"us" and 'bur" refer to the company providing this
insurance.
The word "insured" means any person or organization
qualifying as such under Section II — Who Is An
Insured.
Other words and phrases that appear in quotation
marks have special meaning. Refer to Section V —
Definitions.
SECTION I — COVERAGES
COVERAGE A— BODILY INJURY AND PROPERTY
DAMAGE LIABILITY
1. Insuring Agreement
a. We will pay those sums that the insured
becomes legally obligated to pay as damages
because of "bodily injury" or "property damage"
to which this insurance applies. We will have
the right and duty to defend the insured against
any "suit" seeking those damages. However,
we will have no duty to defend the insured
against any "suit" seeking damages for "bodily
injury" or "property damage" to which this
insurance does not apply. We may, at our
discretion, investigate any 'occurrence" and
settle any claim or "suit" that may result. But:
(1) The amount we will pay for damages is
limited as described in Section III — Limits
Of Insurance; and
(2) Our right and duty to defend ends when we
have used up the applicable limit of
insurance in the payment of judgments or
settlements under Coverages A or B or
medical expenses under Coverage C.
No other obligation or liability to pay sums or
perform acts or services is covered unless
explicitly provided for under Supplementary
Payments — Coverages A and B.
b. This insurance applies to "bodily injury" and
"property damage" only if
(1) The "bodily injury" or "property damage" is
caused by an 'occurrence" that takes place
in the "coverage territory';
COMMERCIAL GENERAL LIABILITY
CG 00 01104 1 V
(2) The "bodily injury" or "property damage" s �' ,
occurs during the policy period; and
(3) Prior to the policy period, no insured listed
under Paragraph 1. of Section It — Who Is
An Insured and no "employee" authorized
by you to give or receive notice of an
"occurrence" or claim, knew that the "bodily
injury" or "property damage" had occurred,
in whole or in part. If such a listed insured
or authorized "employee" knew, prior to the
policy period, that the "bodily injury" or
"property damage" occurred, then any
continuation, change or resumption of such
"bodily injury" or "property damage" during
or after the policy period will be deemed to
have been known prior to the policy period.
c. 'Bodily injury" or "property damage" which
occurs during the policy period and was not,
prior to the policy period, known to have
occurred by any insured listed under
Paragraph 1. of Section II —Who Is An Insured
or any "employee" authorized by you to give or
receive notice of an "occurrence" or claim,
includes any continuation, change or
resumption of that "bodily injury" or "property
damage" after the end of the policy period.
d. 'Bodily injury" or "property damage" will be
deemed to have been known to have occurred
at the earliest time when any insured listed
under Paragraph 1. of Section II — Who Is An
Insured or any "employee" authorized by you to
give or receive notice of an 'occurrence" or
claim:
(1) Reports all, or any part, of the "bodily injury"
or "property damage" to us or any other
insurer;
(2) Receives a written or verbal demand or
claim for damages because of the "bodily
injury" or "property damage "; or
(3) Becomes aware by any other means that
"bodily injury" or "property damage" has
occurred or has begun to occur.
e. Damages because of "bodily injury" include
damages claimed by any person or
organization for care, loss of services or death
resulting at any time from the "bodily injury ".
CG 00 01 0413 © Insurance Services Office, Inc., 2012 Page 1 of 16
2. Exclusions
This insurance does not apply to:
a. Expected Or Intended Injury
"Bodily injury" or "property damage" expected
or intended from the standpoint of the insured.
This exclusion does not apply to "bodily injury"
resulting from the use of reasonable force to
protect persons or property.
b. Contractual Liability
"Bodily injury" or "property damage" for which
the insured is obligated to pay damages by
reason of the assumption of liability in a
contract or agreement. This exclusion does not
apply to liability for damages:
(1) That the insured would have in the absence
of the contract or agreement; or
(2) Assumed in a contract or agreement that is
an "insured contract ", provided the "bodily
injury" or "property damage" occurs
subsequent to the execution of the contract
or agreement. Solely for the purposes of
liability assumed in an "insured contract ",
reasonable attorneys' fees and necessary
litigation expenses incurred by or for a party
other than an insured are deemed to be
damages because of "bodily injury" or
"property damage ", provided:
(a) Liability to such party for, or for the cost
of, that party's defense has also been
assumed in the same "insured contract ";
and
(b) Such attorneys' fees and litigation
expenses are for defense of that party
against a civil or alternative dispute
resolution proceeding in which damages
to which this insurance applies are
alleged.
c. Liquor Liability
"Bodily injury" or "property damage" for which
any insured may be held liable by reason of:
(1) Causing or contributing to the intoxication of
any person;
(2) The furnishing of alcoholic beverages to a
person under the legal drinking age or
under the influence of alcohol; or
(3) Any statute, ordinance or regulation relating
to the sale, gift, distribution or use of
alcoholic beverages.
This exclusion applies even if the claims
against any insured allege negligence or other
wrongdoing in:
(a) The supervision, hiring, employment,
training or monitoring of others by that
insured; or
(b) Providing or failing to provide
transportation with respect to any
person that may be under the influence
of alcohol;
if the "occurrence" which caused the "bodily
injury" or "property damage ", involved that
which is described in Paragraph (1), (2) or (3)
above.
However, this exclusion applies only if you are
in the business of manufacturing, distributing,
selling, serving or furnishing alcoholic
beverages. For the purposes of this exclusion,
permitting a person to bring alcoholic
beverages on your premises, for consumption
on your premises, whether or not a fee is
charged or a license is required for such
activity, is not by itself considered the business
of selling, serving or furnishing alcoholic
beverages.
d. Workers' Compensation And Similar Laws
Any obligation of the insured under a workers'
compensation, disability benefits or
unemployment compensation law or any
similar law.
e. Employer's Liability
"Bodily injury" to:
(1) An "employee" of the insured arising out of
and in the course of
(a) Employment by the insured; or
(b) Performing duties related to the conduct
of the insured's business; or
(2) The spouse, child, parent, brother or sister
of that "employee" as a consequence of
Paragraph (1) above.
This exclusion applies whether the insured
may be liable as an employer or in any other
capacity and to any obligation to share
damages with or repay someone else who
must pay damages because of the injury.
This exclusion does not apply to liability
assumed by the insured under an "insured
contract ".
Page 2 of 16 © Insurance Services Office, Inc., 2012 CG 00 01 0413
f. Pollution
(d) At or from any premises, site or location
(1) "Bodily injury" or "property damage" arising
on which any insured or any contractors
out of the actual, alleged or threatened
or subcontractors working directly or
discharge, dispersal, seepage, migration,
indirectly on any insured's behalf are
release or escape of "pollutants ":
performing operations if the "pollutants"
are brought on or to the premises, site
(a) At or from any premises, site or location
or location in connection with such
which is or was at any time owned or
operations by such insured, contractor
occupied by, or rented or loaned to, any
or subcontractor. However, this
insured. However, this subparagraph
subparagraph does not apply to:
does not apply to:
(i) "Bodily injury" or "property damage"
(i) "Bodily injury" if sustained within a
arising out of the escape of fuels,
building and caused by smoke,
lubricants or other operating fluids
fumes, vapor or soot produced by or
which are needed to perform the
originating from equipment that is
normal electrical, hydraulic or
used to heat, cool or dehumidify the
mechanical functions necessary for
building, or equipment that is used to
the operation of "mobile equipment"
heat water for personal use, by the
or its parts, if such fuels, lubricants
building's occupants or their guests;
or other operating fluids escape from
(ii) "Bodily injury" or "property damage"
a vehicle part designed to hold, store
for which you may be held liable, if
or receive them. This exception does
you are a contractor and the owner
not apply if the "bodily injury" or
or lessee of such premises, site or
"property damage" arises out of the
location has been added to your
intentional discharge, dispersal or
policy as an additional insured with
release of the fuels, lubricants or
respect to your ongoing operations
other operating fluids, or if such
performed for that additional insured
fuels, lubricants or other operating
at that premises, site or location and
fluids are brought on or to the
such premises, site or location is not
premises, site or location with the
and never was owned or occupied
intent that they be discharged,
by, or rented or loaned to, any
dispersed or released as part of the
insured, other than that additional
operations being performed by such
insured; or
insured, contractor or subcontractor;
(iii) "Bodily injury" or "property damage"
(ii) "Bodily injury" or "property damage"
arising out of heat, smoke or fumes
sustained within a building and
from a "hostile fire ";
caused by the release of gases,
(b) At or from any premises, site or location
fumes or vapors from materials
which is or was at any time used by or
brought into that building in
for any insured or others for the
connection with operations being
handling, storage, disposal, processing
performed by you or on your behalf
or treatment of waste;
by a contractor or subcontractor; or
(c) Which are or were at any time
(iii) "Bodily injury" or "property damage"
transported, handled, stored, treated,
arising ,out of heat, smoke or fumes
disposed of, or processed as waste by
from a hostile fire .
or for:
(e) At or from any premises, site or location
(i) Any insured; or
on which any insured or any contractors
or subcontractors working directly or
(ii) Any person or organization for whom
indirectly on any insured's behalf are
you may be legally responsible; or
performing operations if the operations
are to test for, monitor, clean up,
remove, contain, treat, detoxify or
neutralize, or in any way respond to, or
assess the effects of, "pollutants ".
CG 00 01 0413 © Insurance Services Office, Inc., 2012 Page 3 of 16
(2) Any loss, cost or expense arising out of
any:
(a) Request, demand, order or statutory or
regulatory requirement that any insured
or others test for, monitor, clean up,
remove, contain, treat, detoxify or
neutralize, or in any way respond to, or
assess the effects of, "pollutants'; or
(b) Claim or suit by or on behalf of a
governmental authority for damages
because of testing for, monitoring,
cleaning up, removing, containing,
treating, detoxifying or neutralizing, or in
any way responding to, or assessing the
effects of, "pollutants ".
However, this paragraph does not apply to
liability for damages because of "property
damage" that the insured would have in the
absence of such request, demand, order or
statutory or regulatory requirement, or such
claim or "suit" by or on behalf of a
governmental authority.
g. Aircraft, Auto Or Watercraft
"Bodily injury" or "property damage" arising out
of the ownership, maintenance, use or
entrustment to others of any aircraft, "auto" or
watercraft owned or operated by or rented or
loaned to any insured. Use includes operation
and "loading or unloading ".
This exclusion applies even if the claims
against any insured allege negligence or other
wrongdoing in the supervision, hiring,
employment, training or monitoring of others by
that insured, if the "occurrence" which caused
the "bodily injury" or "property damage"
involved the ownership, maintenance, use or
entrustment to others of any aircraft, "auto" or
watercraft that is owned or operated by or
rented or loaned to any insured.
This exclusion does not apply to:
(1) A watercraft while ashore on premises you
own or rent;
(2) A watercraft you do not own that is:
(a) Less than 26 feet long; and
(b) Not being used to carry persons or
property for a charge;
(3) Parking an "auto" on, or on the ways next
to, premises you own or rent, provided the
"auto" is not owned by or rented or loaned
to you or the insured;
(4) Liability assumed under any "insured
contract" for the ownership, maintenance or
use of aircraft or watercraft; or
(5) "Bodily injury" or "property damage" arising
out of:
(a) The operation of machinery or
equipment that is attached to, or part of,
a land vehicle that would qualify under
the definition of "mobile equipment" if it
were not subject to a compulsory or
financial responsibility law or other
motor vehicle insurance law where it is
licensed or principally garaged; or
(b) The operation of any of the machinery
or equipment listed in Paragraph f.(2) or
f.(3) of the definition of "mobile
equipment ".
h. Mobile Equipment
"Bodily injury" or "property damage" arising out
of
(1) The transportation of "mobile equipment" by
an "auto" owned or operated by or rented or
loaned to any insured; or
(2) The use of "mobile equipment" in, or while
in practice for, or while being prepared for,
any prearranged racing, speed, demolition,
or stunting activity.
i. War
"Bodily injury" or "property damage ", however
caused, arising, directly or indirectly, out of:
(1) War, including undeclared or civil war;
(2) Warlike action by a military force, including
action in hindering or defending against an
actual or expected attack, by any
government, sovereign or other authority
using military personnel or other agents; or
(3) Insurrection, rebellion, revolution, usurped
power, or action taken by governmental
authority in hindering or defending against
any of these.
j. Damage To Property
"Property damage" to:
(1) Property you own, rent, or occupy, including
any costs or expenses incurred by you, or
any other person, organization or entity, for
repair, replacement, enhancement,
restoration or maintenance of such property
for any reason, including prevention of
injury to a person or damage to another's
property;
(2) Premises you sell, give away or abandon, if
the "property damage" arises out of any
part of those premises;
(3) Property loaned to you;
Page 4 of 16 © Insurance Services Office, Inc., 2012 CG 00 01 0413
(4) Personal property in the care, custody or
control of the insured;
(5) That particular part of real property on
which you or any contractors or
subcontractors working directly or indirectly
on your behalf are performing operations, if
the "property damage" arises out of those
operations; or
(6) That particular part of any property that
must be restored, repaired or replaced
because "your work" was incorrectly
performed on it.
Paragraphs (1), (3) and (4) of this exclusion do
not apply to "property damage" (other than
damage by fire) to premises, including the
contents of such premises, rented to you for a
period of seven or fewer consecutive days. A
separate limit of insurance applies to Damage
To Premises Rented To You as described in
Section III — Limits Of Insurance.
Paragraph (2) of this exclusion does not apply
if the premises are "your work" and were never
occupied, rented or held for rental by you.
Paragraphs (3), (4), (5) and (6) of this
exclusion do not apply to liability assumed
under a sidetrack agreement,
Paragraph (6) of this exclusion does not apply
to "property damage" included in the "products -
completed operations hazard ".
k. Damage To Your Product
"Property damage" to "your product" arising out
of it or any part of it.
I. Damage To Your Work
"Property damage" to "your work" arising out of
it or any part of it and included in the "products -
completed operations hazard ".
This exclusion does not apply if the damaged
work or the work out of which the damage
arises was performed on your behalf by a
subcontractor.
m. Damage To Impaired Property Or Property
Not Physically Injured
"Property damage" to "impaired property" or
property that has not been physically injured,
arising out of:
(1) A defect, deficiency, inadequacy or
dangerous condition in "your product" or
"your work "; or
This exclusion does not apply to the loss of use
of other property arising out of sudden and
accidental physical injury to "your product" or
"your work" after it has been put to its intended
use.
n. Recall Of Products, Work Or Impaired
Property
Damages claimed for any loss, cost or
expense incurred by you or others for the loss
of use, withdrawal, recall, inspection, repair,
replacement, adjustment, removal or disposal
of
(1) "Your product ";
(2) "Your work'; or
(3) "Impaired property ";
if such product, work, or property is withdrawn
or recalled from the market or from use by any
person or organization because of a known or
suspected defect, deficiency, inadequacy or
dangerous condition in it.
o. Personal And Advertising Injury
"Bodily injury" arising out of "personal and
advertising injury ".
p. Electronic Data
Damages arising out of the loss of, loss of use
of, damage to, corruption of, inability to access,
or inability to manipulate electronic data.
However, this exclusion does not apply to
liability for damages because of "bodily injury ".
As used in this exclusion, electronic data
means information, facts or programs stored as
or on, created or used on, or transmitted to or
from computer software, including systems and
applications software, hard or floppy disks, CD-
ROMs, tapes, drives, cells, data processing
devices or any other media which are used
with electronically controlled equipment.
q. Recording And Distribution Of Material Or
Information In Violation Of Law
"Bodily injury" or "property damage" arising
directly or indirectly out of any action or
omission that violates or is alleged to violate:
(1) The Telephone Consumer Protection Act
(TCPA), including any amendment of or
addition to such law;
(2) The CAN -SPAM Act of 2003, including any
amendment of or addition to such law;
(2) A delay or failure by you or anyone acting (3) The Fair Credit Reporting Act (FCRA), and
on your behalf to perform a contract or any amendment of or addition to such law,
agreement in accordance with its terms. including the Fair and Accurate Credit
Transactions Act (FACTA); or
CG 00 01 0413 © Insurance Services Office, Inc., 2012 Page 5 of 16
(4) Any federal, state or local statute,
2. Exclusions
ordinance or regulation, other than the
This
insurance does not apply to:
TCPA, CAN -SPAM Act of 2003 or FCRA
and their amendments and additions, that
a.
Knowing Violation Of Rights Of Another
addresses, prohibits, or limits the printing,
"Personal and advertising injury" caused by or
dissemination, disposal, collecting,
at the direction of the insured with the
recording, sending, transmitting,
knowledge that the act would violate the rights
communicating or distribution of material or
of another and would inflict "personal and
information.
advertising injury ".
Exclusions c. through n. do not apply to damage
b.
Material Published With Knowledge Of
by fire to premises while rented to you or
Falsity
temporarily occupied by you with permission of the
"Personal and advertising injury" arising out of
owner. A separate limit of insurance applies to this
oral or written publication, in any manner, of
coverage as described in Section III — Limits Of
material, if done by or at the direction of the
Insurance.
insured with knowledge of its falsity.
COVERAGE B — PERSONAL AND ADVERTISING
c.
Material Published Prior To Policy Period
INJURY LIABILITY
1. Insuring Agreement
"Personal and advertising injury" arising out of
oral or written publication, in any manner, of
a. We will pay those sums that the insured
material whose first publication took place
becomes legally obligated to pay as damages
before the beginning of the policy period.
because of "personal and advertising injury" to
d.
Criminal Acts
which this insurance applies, We will have the
right and duty to defend the insured against
"Personal and advertising injury" arising out of
any "suit" seeking those damages. However,
a criminal act committed by or at the direction
we will have no duty to defend the insured
of the insured.
against any "suit" seeking damages for
e.
Contractual Liability
"personal and advertising injury" to which this
"Personal and advertising injury" for which the
insurance does not apply. We may, at our
discretion, investigate any offense and settle
insured has assumed liability in a contract or
any claim or "suit" that may result. But:
agreement. This exclusion does not apply to
liability for damages that the insured would
(1) The amount we will pay for damages is
have in the absence of the contract or
limited as described in Section III — Limits
agreement.
Of Insurance; and
f.
Breach Of Contract
(2) Our right and duty to defend end when we
"Personal and advertising injury" arising out of
have used up the applicable limit of
insurance in the payment of judgments or
a breach of contract, except an implied
settlements under Coverages A or B or
contract to use another's advertising idea in
„
medical expenses under Coverage C.
your advertisement .
No other obligation or liability to pay sums or
g•
Quality Or Performance Of Goods — Failure
perform acts or services is covered unless
To Conform To Statements
explicitly provided for under Supplementary
"Personal and advertising injury” arising out of
Payments — Coverages A and B.
the failure of goods, products or services to
to personal and
b. This insurance "personal
with any statement of quality or
"advertisement ".
,applies
advertising injury caused by an offense arising
performance made in your
out of your business but only if the offense was
h.
Wrong Description Of Prices
committed in the "coverage territory" during the
"Personal and advertising injury" arising out of
policy period.
the wrong description of the price of goods,
products or services stated in your
"advertisement ".
Page 6 of 16 © Insurance Services Office, Inc., 2012 CG 00 01 0413
i. Infringement Of Copyright, Patent,
Trademark Or Trade Secret
"Personal and advertising injury" arising out of
the infringement of copyright, patent,
trademark, trade secret or other intellectual
property rights. Under this exclusion, such
other intellectual property rights do not include
the use of another's advertising idea in your
"advertisement ".
However, this exclusion does not apply to
infringement, in your "advertisement ", of
copyright, trade dress or slogan.
j. Insureds In Media And Internet Type
Businesses
"Personal and advertising injury" committed by
an insured whose business is:
(1) Advertising, broadcasting, publishing or
telecasting;
(2) Designing or determining content of web
sites for others; or
(3) An Internet search, access, content or
service provider.
However, this exclusion does not apply to
Paragraphs 14.a., b. and c. of "personal and
advertising injury" under the Definitions
section.
For the purposes of this exclusion, the placing
of frames, borders or links, or advertising, for
you or others anywhere on the Internet, is not
by itself, considered the business of
advertising, broadcasting, publishing or
telecasting.
k. Electronic Chatrooms Or Bulletin Boards
"Personal and advertising injury" arising out of
an electronic chatroom or bulletin board the
insured hosts, owns, or over which the insured
exercises control.
I. Unauthorized Use Of Another's Name Or
Product
"Personal and advertising injury" arising out of
the unauthorized use of another's name or
product in your e-mail address, domain name
or metatag, or any other similar tactics to
mislead another's potential customers.
m. Pollution
"Personal and advertising injury" arising out of
the actual, alleged or threatened discharge,
dispersal, seepage, migration, release or
escape of "pollutants" at any time.
n. Pollution - related
Any loss, cost or expense arising out of any:
(1) Request, demand, order or statutory or
regulatory requirement that any insured or
others test for, monitor, clean up, remove,
contain, treat, detoxify or neutralize, or in
any way respond to, or assess the effects
of, "pollutants "; or
(2) Claim or suit by or on behalf of a
governmental authority for damages
because of testing for, monitoring, cleaning
up, removing, containing, treating,
detoxifying or neutralizing, or in any way
responding to, or assessing the effects of,
"pollutants ".
o. War
"Personal and advertising injury ", however
caused, arising, directly or indirectly, out of:
(1) War, including undeclared or civil war;
(2) Warlike action by a military force, including
action in hindering or defending against an
actual or expected attack, by any
government, sovereign or other authority
using military personnel or other agents; or
(3) Insurrection, rebellion, revolution, usurped
power, or action taken by governmental
authority in hindering or defending against
any of these.
p. Recording And Distribution Of Material Or
Information In Violation Of Law
"Personal and advertising injury" arising
directly or indirectly out of any action or
omission that violates or is alleged to violate:
(1) The Telephone Consumer Protection Act
(TCPA), including any amendment of or
addition to such law;
(2) The CAN -SPAM Act of 2003, including any
amendment of or addition to such law;
(3) The Fair Credit Reporting Act (FCRA), and
any amendment of or addition to such law,
including the Fair and Accurate Credit
Transactions Act (FACTA); or
(4) Any federal, state or local statute,
ordinance or regulation, other than the
TCPA, CAN -SPAM Act of 2003 or FCRA
and their amendments and additions, that
addresses, prohibits, or limits the printing,
dissemination, disposal, collecting,
recording, sending, transmitting,
communicating or distribution of material or
information.
CG 00 01 0413 © Insurance Services Office, Inc., 2012 Page 7 of 16
COVERAGE C — MEDICAL PAYMENTS
1. Insuring Agreement
a. We will pay medical expenses as described
below for "bodily injury" caused by an accident:
(1) On premises you own or rent;
(2) On ways next to premises you own or rent;
or
(3) Because of your operations;
provided that:
(a) The accident takes place in the
"coverage territory" and during the policy
period;
(b) The expenses are incurred and reported
to us within one year of the date of the
accident; and
(c) The injured person submits to
examination, at our expense, by
physicians of our choice as often as we
reasonably require.
b. We will make these payments regardless of
fault. These payments will not exceed the
applicable limit of insurance. We will pay
reasonable expenses for:
(1) First aid administered at the time of an
accident;
(2) Necessary medical, surgical, X -ray and
dental services, including prosthetic
devices; and
(3) Necessary ambulance, hospital,
professional nursing and funeral services.
2. Exclusions
We will not pay expenses for "bodily injury ":
a. Any Insured
To any insured, except "volunteer workers ".
b. Hired Person
To a person hired to do work for or on behalf of
any insured or a tenant of any insured.
c. Injury On Normally Occupied Premises
To a person injured on that part of premises
you own or rent that the person normally
occupies.
d. Workers' Compensation And Similar Laws
To a person, whether or not an "employee" of
any insured, if benefits for the "bodily injury"
are payable or must be provided under a
workers' compensation or disability benefits
law or a similar law.
e. Athletics Activities
To a person injured while practicing, instructing
or participating in any physical exercises or
games, sports, or athletic contests.
f. Products - Completed Operations Hazard
Included within the "products- completed
operations hazard ".
g. Coverage A Exclusions
Excluded under Coverage A.
SUPPLEMENTARY PAYMENTS — COVERAGES A
AND B
1. We will pay, with respect to any claim we
investigate or settle, or any "suit" against an
insured we defend:
a. All expenses we incur.
b. Up to $250 for cost of bail bonds required
because of accidents or traffic law violations
arising out of the use of any vehicle to which
the Bodily Injury Liability Coverage applies. We
do not have to furnish these bonds.
c. The cost of bonds to release attachments, but
only for bond amounts within the applicable
limit of insurance. We do not have to furnish
these bonds.
d. All reasonable expenses incurred by the
insured at our request to assist us in the
investigation or defense of the claim or "suit ",
including actual loss of earnings up to $250 a
day because of time off from work.
e. All court costs taxed against the insured in the
"suit ". However, these payments do not include
attorneys' fees or attorneys' expenses taxed
against the insured.
f. Prejudgment interest awarded against the
insured on that part of the judgment we pay. If
we make an offer to pay the applicable limit of
insurance, we will not pay any prejudgment
interest based on that period of time after the
offer.
Page 8 of 16 © Insurance Services Office, Inc., 2012 CG 00 01 0413
g. All interest on the full amount of any judgment
that accrues after entry of the judgment and
before we have paid, offered to pay, or
deposited in court the part of the judgment that
is within the applicable limit of insurance.
These payments will not reduce the limits of
insurance.
2. If we defend an insured against a "suit" and an
indemnitee of the insured is also named as a party
to the "suit ", we will defend that indemnitee if all of
the following conditions are met:
a. The "suit" against the indemnitee seeks
damages for which the insured has assumed
the liability of the indemnitee in a contract or
agreement that is an "insured contract ";
b. This insurance applies to such liability
assumed by the insured;
c. The obligation to defend, or the cost of the
defense of, that indemnitee, has also been
assumed by the insured in the same "insured
contract ";
d. The allegations in the "suit" and the information
we know about the "occurrence" are such that
no conflict appears to exist between the
interests of the insured and the interests of the
indemnitee;
e. The indemnitee and the insured ask us to
conduct and control the defense of that
indemnitee against such "suit" and agree that
we can assign the same counsel to defend the
insured and the indemnitee; and
f. The indemnitee:
(1) Agrees in writing to:
(a) Cooperate with us in the investigation,
settlement or defense of the "suit ";
(b) Immediately send us copies of any
demands, notices, summonses or legal
papers received in connection with the
"suit";
(c) Notify any other insurer whose coverage
is available to the indemnitee; and
(d) Cooperate with us with respect to
coordinating other applicable insurance
available to the indemnitee; and
(2) Provides us with written authorization to:
(a) Obtain records and other information
related to the "suit "; and
(b) Conduct and control the defense of the
indemnitee in such "suit ".
So long as the above conditions are met,
attorneys' fees incurred by us in the defense of
that indemnitee, necessary litigation expenses
incurred by us and necessary litigation expenses
incurred by the indemnitee at our request will be
paid as Supplementary Payments.
Notwithstanding the provisions of Paragraph
2.b.(2) of Section I — Coverage A — Bodily Injury
And Property Damage Liability, such payments will
not be deemed to be damages for "bodily injury"
and "property damage" and will not reduce the
limits of insurance.
Our obligation to defend an insured's indemnitee
and to pay for attorneys' fees and necessary
litigation expenses as Supplementary Payments
ends when we have used up the applicable limit of
insurance in the payment of judgments or
settlements or the conditions set forth above, or
the terms of the agreement described in
Paragraph f. above, are no longer met,
SECTION II — WHO IS AN INSURED
1. If you are designated in the Declarations as:
a. An individual, you and your spouse are
insureds, but only with respect to the conduct
of a business of which you are the sole owner.
b. A partnership or joint venture, you are an
insured. Your members, your partners, and
their spouses are also insureds, but only with
respect to the conduct of your business.
c. A limited liability company, you are an insured.
Your members are also insureds, but only with
respect to the conduct of your business. Your
managers are insureds, but only with respect
to their duties as your managers.
d. An organization other than a partnership, joint
venture or limited liability company, you are an
insured. Your "executive officers" and directors
are insureds, but only with respect to their
duties as your officers or directors. Your
stockholders are also insureds, but only with
respect to their liability as stockholders.
e. A trust, you are an insured. Your trustees are
also insureds, but only with respect to their
duties as trustees.
CG 00 01 0413 © Insurance Services Office, Inc., 2012 Page 9 of 16
2. Each of the following is also an insured:
a. Your "volunteer workers" only while performing
duties related to the conduct of your business,
or your "employees ", other than either your
"executive officers" (if you are an organization
other than a partnership, joint venture or limited
liability company) or your managers (if you are
a limited liability company), but only for acts
within the scope of their employment by you or
while performing duties related to the conduct
of your business. However, none of these
"employees" or "volunteer workers" are
insureds for:
(1) 'Bodily injury" or "personal and advertising
injury":
(a) To you, to your partners or members (if
you are a partnership or joint venture),
to your members (if you are a limited
liability company), to a co- "employee"
while in the course of his or her
employment or performing duties related
to the conduct of your business, or to
your other "volunteer workers" while
performing duties related to the conduct
of your business;
(b) To the spouse, child, parent, brother or
sister of that co- "employee" or
"volunteer worker" as a consequence of
Paragraph (1)(a) above;
(c) For which there is any obligation to
share damages with or repay someone
else who must pay damages because of
the injury described in Paragraph (1)(a)
or (b) above; or
(d) Arising out of his or her providing or
failing to provide professional health
care services.
(2) 'Property damage" to property:
(a) Owned, occupied or used by;
(b) Rented to, in the care, custody or
control of, or over which physical control
is being exercised for any purpose by;
you, any of your "employees ", "volunteer
workers ", any partner or member (if you are
a partnership or joint venture), or any
member (if you are a limited liability
company).
b. Any person (other than your "employee" or
"volunteer worker "), or any organization while
acting as your real estate manager.
c. Any person or organization having proper
temporary custody of your property if you die,
but only:
(1) With respect to liability arising out of the
maintenance or use of that property; and
(2) Until your legal representative has been
appointed.
d. Your legal representative if you die, but only
with respect to duties as such. That
representative will have all your rights and
duties under this Coverage Part.
3. Any organization you newly acquire or form, other
than a partnership, joint venture or limited liability
company, and over which you maintain ownership
or majority interest, will qualify as a Named
Insured if there is no other similar insurance
available to that organization. However:
a. Coverage under this provision is afforded only
until the 90th day after you acquire or form the
organization or the end of the policy period,
whichever is earlier;
b. Coverage A does not apply to "bodily injury" or
"property damage" that occurred before you
acquired or formed the organization; and
c. Coverage B does not apply to "personal and
advertising injury" arising out of an offense
committed before you acquired or formed the
organization.
No person or organization is an insured with respect
to the conduct of any current or past partnership, joint
venture or limited liability company that is not shown
as a Named Insured in the Declarations.
SECTION III — LIMITS OF INSURANCE
1. The Limits of Insurance shown in the Declarations
and the rules below fix the most we will pay
regardless of the number of
a. Insureds;
b. Claims made or "suits" brought; or
c. Persons or organizations making claims or
bringing "suits ".
2. The General Aggregate Limit is the most we will
pay for the sum of:
a. Medical expenses under Coverage C;
b. Damages under Coverage A, except damages
because of "bodily injury" or "property damage"
included in the "products- completed operations
hazard "; and
c. Damages under Coverage B.
Page 10 of 16 © Insurance Services Office, Inc., 2012 CG 00 0104 13
3. The Products - Completed Operations Aggregate
Limit is the most we will pay under Coverage A for
damages because of "bodily injury" and "property
damage" included in the "products- completed
operations hazard ".
4. Subject to Paragraph 2. above, the Personal And
Advertising Injury Limit is the most we will pay
under Coverage B for the sum of all damages
because of all "personal and advertising injury"
sustained by any one person or organization.
S. Subject to Paragraph 2. or 3. above, whichever
applies, the Each Occurrence Limit is the most we
will pay for the sum of:
a. Damages under Coverage A; and
b. Medical expenses under Coverage C
because of all "bodily injury" and "property
damage" arising out of any one "occurrence ".
6. Subject to Paragraph 5. above, the Damage To
Premises Rented To You Limit is the most we will
pay under Coverage A for damages because of
"property damage" to any one premises, while
rented to you, or in the case of damage by fire,
while rented to you or temporarily occupied by you
with permission of the owner.
7. Subject to Paragraph 5. above, the Medical
Expense Limit is the most we will pay under
Coverage C for all medical expenses because of
"bodily injury" sustained by any one person.
The Limits of Insurance of this Coverage Part apply
separately to each consecutive annual period and to
any remaining period of less than 12 months, starting
with the beginning of the policy period shown in the
Declarations, unless the policy period is extended
after issuance for an additional period of less than 12
months. In that case, the additional period will be
deemed part of the last preceding period for purposes
of determining the Limits of Insurance.
SECTION IV — COMMERCIAL GENERAL LIABILITY
CONDITIONS
1. Bankruptcy
Bankruptcy or insolvency of the insured or of the
insured's estate will not relieve us of our
obligations under this Coverage Part.
2. Duties In The Event Of Occurrence, Offense,
Claim Or Suit
a. You must see to it that we are notified as soon
as practicable of an "occurrence" or an offense
which may result in a claim. To the extent
possible, notice should include:
(1) How, when and where the "occurrence" or
offense took place;
(2) The names and addresses of any injured
persons and witnesses; and
(3) The nature and location of any injury or
damage arising out of the "occurrence" or
offense.
b. If a claim is made or "suit" is brought against
any insured, you must:
(1) Immediately record the specifics of the
claim or "suit" and the date received; and
(2) Notify us as soon as practicable.
You must see to it that we receive written
notice of the claim or "suit" as soon as
practicable.
c. You and any other involved insured must:
(1) Immediately send us copies of any
demands, notices, summonses or legal
papers received in connection with the
claim or "suit';
(2) Authorize us to obtain records and other
information;
(3) Cooperate with us in the investigation or
settlement of the claim or defense against
the "suit "; and
(4) Assist us, upon our request, in the
enforcement of any right against any
person or organization which may be liable
to the insured because of injury or damage
to which this insurance may also apply.
d. No insured will, except at that insured's own
cost, voluntarily make a payment, assume any
obligation, or incur any expense, other than for
first aid, without our consent.
3. Legal Action Against Us
No person or organization has a right under this
Coverage Part:
a. To join us as a party or otherwise bring us into
a "suit" asking for damages from an insured; or
b. To sue us on this Coverage Part unless all of
its terms have been fully complied with.
A person or organization may sue us to recover on
an agreed settlement or on a final judgment
against an insured; but we will not be liable for
damages that are not payable under the terms of
this Coverage Part or that are in excess of the
applicable limit of insurance. An agreed settlement
means a settlement and release of liability signed
by us, the insured and the claimant or the
claimant's legal representative.
CG 00 01 0413 © Insurance Services Office, Inc., 2012 Page 11 of 16
4. Other Insurance
If other valid and collectible insurance is available
to the insured for a loss we cover under
Coverages A or B of this Coverage Part, our
obligations are limited as follows:
a. Primary Insurance
This insurance is primary except when
Paragraph b. below applies. If this insurance is
primary, our obligations are not affected unless
any of the other insurance is also primary.
Then, we will share with all that other
insurance by the method described in
Paragraph c. below,
b. Excess Insurance
(1) This insurance is excess over:
(a) Any of the other insurance, whether
primary, excess, contingent or on any
other basis:
(i) That is Fire, Extended Coverage,
Builder's Risk, Installation Risk or
similar coverage for "your work';
(ii) That is Fire insurance for premises
rented to you or temporarily
occupied by you with permission of
the owner;
(iii) That is insurance purchased by you
to cover your liability as a tenant for
"property damage" to premises
rented to you or temporarily
occupied by you with permission of
the owner; or
(iv) If the loss arises out of the
maintenance or use of aircraft,
"autos" or watercraft to the extent not
subject to Exclusion g. of Section I —
Coverage A — Bodily Injury And
Property Damage Liability.
(b) Any other primary insurance available to
you covering liability for damages
arising out of the premises or
operations, or the products and
completed operations, for which you
have been added as an additional
insured.
(2) When this insurance is excess, we will have
no duty under Coverages A or B to defend
the insured against any "suit" if any other
insurer has a duty to defend the insured
against that "suit ". If no other insurer
defends, we will undertake to do so, but we
will be entitled to the insured's rights
against all those other insurers.
(3) When this insurance is excess over other
insurance, we will pay only our share of the
amount of the loss, if any, that exceeds the
sum of:
(a) The total amount that all such other
insurance would pay for the loss in the
absence of this insurance; and
(b) The total of all deductible and self -
insured amounts under all that other
insurance.
(4) We will share the remaining loss, if any,
with any other insurance that is not
described in this Excess Insurance
provision and was not bought specifically to
apply in excess of the Limits of Insurance
shown in the Declarations of this Coverage
Part.
c. Method Of Sharing
If all of the other insurance permits contribution
by equal shares, we will follow this method
also. Under this approach each insurer
contributes equal amounts until it has paid its
applicable limit of insurance or none of the loss
remains, whichever comes first.
If any of the other insurance does not permit
contribution by equal shares, we will contribute
by limits. Under this method, each insurer's
share is based on the ratio of its applicable
limit of insurance to the total applicable limits of
insurance of all insurers.
5. Premium Audit
a. We will compute all premiums for this
Coverage Part in accordance with our rules
and rates.
b. Premium shown in this Coverage Part as
advance premium is a deposit premium only.
At the close of each audit period we will
compute the earned premium for that period
and send notice to the first Named Insured,
The due date for audit and retrospective
premiums is the date shown as the due date
on the bill. If the sum of the advance and audit
premiums paid for the policy period is greater
than the earned premium, we will return the
excess to the first Named Insured.
c. The first Named Insured must keep records of
the information we need for premium
computation, and send us copies at such times
as we may request.
6. Representations
By accepting this policy, you agree:
The statements in the Declarations are
accurate and complete;
Page 12 of 16 © Insurance Services Office, Inc., 2012 CG 00 01 0413
b. Those statements are based upon
representations you made to us; and
c. We have issued this policy in reliance upon
your representations.
7. Separation Of Insureds
However, "auto" does not include "mobile
equipment ".
3. "Bodily injury" means bodily injury, sickness or
disease sustained by a person, including death
resulting from any of these at any time.
Except with respect to the Limits of Insurance, and 4.
any rights or duties specifically assigned in this
Coverage Part to the first Named Insured, this
insurance applies:
a. As if each Named Insured were the only
Named Insured; and
b. Separately to each insured against whom claim
is made or "suit" is brought.
8. Transfer Of Rights Of Recovery Against Others
To Us
If the insured has rights to recover all or part of
any payment we have made under this Coverage
Part, those rights are transferred to us. The
insured must do nothing after loss to impair them,
At our request, the insured will bring "suit" or
transfer those rights to us and help us enforce
them.
9. When We Do Not Renew
If we decide not to renew this Coverage Part, we
will mail or deliver to the first Named Insured
shown in the Declarations written notice of the
nonrenewal not less than 30 days before the
expiration date.
If notice is mailed, proof of mailing will be sufficient
proof of notice.
SECTION V — DEFINITIONS
1. "Advertisement" means a notice that is broadcast
or published to the general public or specific
market segments about your goods, products or
services for the purpose of attracting customers or
supporters. For the purposes of this definition:
a. Notices that are published include material
placed on the Internet or on similar electronic
means of communication; and
b. Regarding web sites, only that part of a web
site that is about your goods, products or
services for the purposes of attracting
customers or supporters is considered an
advertisement,
2. "Auto" means:
a. A land motor vehicle, trailer or semitrailer
designed for travel on public roads, including
any attached machinery or equipment, or
b. Any other land vehicle that is subject to a
compulsory or financial responsibility law or
other motor vehicle insurance law where it is
licensed or principally garaged,
"Coverage territory" means:
a. The United States of America (including its
territories and possessions), Puerto Rico and
Canada;
b. International waters or airspace, but only if the
injury or damage occurs in the course of travel
or transportation between any places included
in Paragraph a. above; or
c. All other parts of the world if the injury or
damage arises out of
(1) Goods or products made or sold by you in
the territory described in Paragraph a.
above;
(2) The activities of a person whose home is in
the territory described in Paragraph a.
above, but is away for a short time on your
business; or
(3) "Personal and advertising injury" offenses
that take place through the Internet or
similar electronic means of communication;
provided the insured's responsibility to pay
damages is determined in a "suit" on the
merits, in the territory described in Paragraph
a. above or in a settlement we agree to.
5. "Employee" includes a "leased worker ",
"Employee" does not include a "temporary
worker ".
6. "Executive officer" means a person holding any of
the officer positions created by your charter,
constitution, bylaws or any other similar governing
document.
7. "Hostile fire" means one which becomes
uncontrollable or breaks out from where it was
intended to be.
8. "Impaired property" means tangible property, other
than "your product" or "your work ", that cannot be
used or is less useful because:
a. It incorporates "your product" or "your work"
that is known or thought to be defective,
deficient, inadequate or dangerous; or
b. You have failed to fulfill the terms of a contract
or agreement;
if such property can be restored to use by the
repair, replacement, adjustment or removal of
"your product" or "your work" or your fulfilling the
terms of the contract or agreement.
CG 00 01 0413 © Insurance Services Office, Inc., 2012 Page 13 of 16
9. "Insured contract" means:
a. A contract for a lease of premises. However,
that portion of the contract for a lease of
premises that indemnifies any person or
organization for damage by fire to premises
while rented to you or temporarily occupied by
you with permission of the owner is not an
"insured contract ":
b. A sidetrack agreement;
c. Any easement or license agreement, except in
connection with construction or demolition
operations on or within 50 feet of a railroad;
d. An obligation, as required by ordinance, to
indemnify a municipality, except in connection
with work for a municipality;
e. An elevator maintenance agreement;
That part of any other contract or agreement
pertaining to your business (including an
indemnification of a municipality in connection
with work performed for a municipality) under
which you assume the tort liability of another
party to pay for "bodily injury" or "property
damage" to a third person or organization. Tort
liability means a liability that would be imposed
by law in the absence of any contract or
agreement.
Paragraph f. does not include that part of any
contract or agreement:
(1) That indemnifies a railroad for "bodily injury"
or "property damage" arising out of
construction or demolition operations, within
50 feet of any railroad property and
affecting any railroad bridge or trestle,
tracks, road -beds, tunnel, underpass or
crossing;
(2) That indemnifies an architect, engineer or
surveyor for injury or damage arising out of:
(a) Preparing, approving, or failing to
prepare or approve, maps, shop
drawings, opinions, reports, surveys,
field orders, change orders or drawings
and specifications; or
(b) Giving directions or instructions, or
failing to give them, if that is the primary
cause of the injury or damage; or
(3) Under which the insured, if an architect,
engineer or surveyor, assumes liability for
an injury or damage arising out of the
insured's rendering or failure to render
professional services, including those listed
in (2) above and supervisory, inspection,
architectural or engineering activities.
10. "Leased worker" means a person leased to you by
a labor leasing firm under an agreement between
you and the labor leasing firm, to perform duties
related to the conduct of your business. "Leased
worker" does not include a "temporary worker ".
11. "Loading or unloading" means the handling of
property:
a. After it is moved from the place where it is
accepted for movement into or onto an aircraft,
watercraft or "auto ";
b. While it is in or on an aircraft, watercraft or
"auto"; or
c. While it is being moved from an aircraft,
watercraft or "auto" to the place where it is
finally delivered;
but "loading or unloading" does not include the
movement of property by means of a mechanical
device, other than a hand truck, that is not
attached to the aircraft, watercraft or "auto ".
12. "Mobile equipment" means any of the following
types of land vehicles, including any attached
machinery or equipment:
a. Bulldozers, farm machinery, forklifts and other
vehicles designed for use principally off public
roads;
b. Vehicles maintained for use solely on or next to
premises you own or rent;
c. Vehicles that travel on crawler treads;
d. Vehicles, whether self - propelled or not,
maintained primarily to provide mobility to
permanently mounted:
(1) Power cranes, shovels, loaders, diggers or
drills; or
(2) Road construction or resurfacing equipment
such as graders, scrapers or rollers;
e. Vehicles not described in Paragraph a., b., c.
or d. above that are not self - propelled and are
maintained primarily to provide mobility to
permanently attached equipment of the
following types:
(1) Air compressors, pumps and generators,
including spraying, welding, building
cleaning, geophysical exploration, lighting
and well servicing equipment; or
(2) Cherry pickers and similar devices used to
raise or lower workers;
f. Vehicles not described in Paragraph a., b., c.
or d. above maintained primarily for purposes
other than the transportation of persons or
cargo.
Page 14 of 16 © Insurance Services Office, Inc., 2012 CG 00 01 0413
However, self - propelled vehicles with the
following types of permanently attached
equipment are not "mobile equipment" but will
be considered "autos ":
(1) Equipment designed primarily for:
(a) Snow removal;
(b) Road maintenance, but not construction
or resurfacing; or
(c) Street cleaning;
(2) Cherry pickers and similar devices mounted
on automobile or truck chassis and used to
raise or lower workers; and
(3) Air compressors, pumps and generators,
including spraying, welding, building
cleaning, geophysical exploration, lighting
and well servicing equipment.
However, "mobile equipment" does not include
any land vehicles that are subject to a compulsory
or financial responsibility law or other motor
vehicle insurance law where it is licensed or
principally garaged. Land vehicles subject to a
compulsory or financial responsibility law or other
motor vehicle insurance law are considered
"autos ".
13. "Occurrence" means an accident, including
continuous or repeated exposure to substantially
the same general harmful conditions.
14. "Personal and advertising injury" means injury,
including consequential "bodily injury ", arising out
of one or more of the following offenses:
a. False arrest, detention or imprisonment;
b. Malicious prosecution;
c. The wrongful eviction from, wrongful entry into,
or invasion of the right of private occupancy of
a room, dwelling or premises that a person
occupies, committed by or on behalf of its
owner, landlord or lessor;
d. Oral or written publication, in any manner, of
material that slanders or libels a person or
organization or disparages a person's or
organization's goods, products or services;
e. Oral or written publication, in any manner, of
material that violates a person's right of
privacy;
f. The use of another's advertising idea in your
"advertisement "; or
16. "Prod ucts-completed operations hazard ":
a. Includes all "bodily injury" and "property
damage" occurring away from premises you
own or rent and arising out of "your product" or
"your work" except:
(1) Products that are still in your physical
possession; or
(2) Work that has not yet been completed or
abandoned. However, "your work" will be
deemed completed at the earliest of the
following times:
(a) When all of the work called for in your
contract has been completed.
(b) When all of the work to be done at the
job site has been completed if your
contract calls for work at more than one
job site,
(c) When that part of the work done at a job
site has been put to its intended use by
any person or organization other than
another contractor or subcontractor
working on the same project.
Work that may need service, maintenance,
correction, repair or replacement, but which
is otherwise complete, will be treated as
completed.
b. Does not include "bodily injury" or "property
damage" arising out of:
(1) The transportation of property, unless the
injury or damage arises out of a condition in
or on a vehicle not owned or operated by
you, and that condition was created by the
"loading or unloading" of that vehicle by any
insured;
(2) The existence of tools, uninstalled
equipment or abandoned or unused
materials; or
(3) Products or operations for which the
classification, listed in the Declarations or in
a policy Schedule, states that products -
completed operations are subject to the
General Aggregate Limit.
17. "Property damage" means:
a. Physical injury to tangible property, including
all resulting loss of use of that property. All
such loss of use shall be deemed to occur at
the time of the physical injury that caused it; or
g. Infringing upon another's copyright, trade dress b. Loss of use of property that is not
tangible ro
9� P P Y
or slogan in your "advertisement ". physically injured. All such loss of use shall be
15. "Pollutants" mean any solid, liquid, gaseous or deemed to occur at the time of the
thermal irritant or contaminant, including smoke, "occurrence" that caused it.
vapor, soot, fumes, acids, alkalis, chemicals and For the purposes of this insurance, electronic data
waste. Waste includes materials to be recycled, is not tangible property.
reconditioned or reclaimed.
CG 00 01 0413 © Insurance Services Office, Inc., 2012 Page 15 of 16
As used in this definition, electronic data means
information, facts or programs stored as or on,
created or used on, or transmitted to or from
computer software, including systems and
applications software, hard or floppy disks, CD-
ROMs, tapes, drives, cells, data processing
devices or any other media which are used with
electronically controlled equipment.
18. "Suit" means a civil proceeding in which damages
because of "bodily injury ", "property damage" or
"personal and advertising injury" to which this
insurance applies are alleged. "Suit" includes:
a. An arbitration proceeding in which such
damages are claimed and to which the insured
must submit or does submit with our consent;
or
b. Any other alternative dispute resolution
proceeding in which such damages are
claimed and to which the insured submits with
our consent.
19. "Temporary worker" means a person who is
furnished to you to substitute for a permanent
"employee" on leave or to meet seasonal or short -
term workload conditions.
20. "Volunteer worker" means a person who is not
your "employee ", and who donates his or her work
and acts at the direction of and within the scope of
duties determined by you, and is not paid a fee,
salary or other compensation by you or anyone
else for their work performed for you.
21. "Your product ":
a. Means:
(1) Any goods or products, other than real
property, manufactured, sold, handled,
distributed or disposed of by:
(a) You;
(b) Others trading under your name; or
(c) A person or organization whose
business or assets you have acquired;
and
(2) Containers (other than vehicles), materials,
parts or equipment furnished in connection
with such goods or products.
b. Includes:
(1) Warranties or representations made at any
time with respect to the fitness, quality,
durability, performance or use of "your
product "; and
(2) The providing of or failure to provide
warnings or instructions.
c. Does not include vending machines or other
property rented to or located for the use of
others but not sold.
22. "Your work ":
a. Means:
(1) Work or operations performed by you or on
your behalf; and
(2) Materials, parts or equipment furnished in
connection with such work or operations.
b. Includes:
(1) Warranties or representations made at any
time with respect to the fitness, quality,
durability, performance or use of "your
work'; and
(2) The providing of or failure to provide
warnings or instructions.
Page 16 of 16 © Insurance Services Office, Inc., 2012 CG 00 0104 13
COMMERCIAL AUTO
CA 8810 0113
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
BUSINESS AUTO COVERAGE ENHANCEMENT ENDORSEMENT
This endorsement modifies insurance provided under the following: 4 v
BUSINESS AUTO COVERAGE FORM
With respect to coverage afforded by this endorsement, the provisions of the policy apply unless modified
by the endorsement.
COVERAGE INDEX
SUBJECT VI I N NQMBER
ADDITIONAL INSURED BY CONTRACT, AGREEMENT OR PERMIT
3
ACCIDENTAL AIRBAG DEPLOYMENT
12
AMENDED DUTIES IN THE EVENT OF ACCIDENT, CLAIM, SUIT OR LOSS
19
AMENDED FELLOW EMPLOYEE EXCLUSION
5
AUDIO, VISUAL AND DATA ELECTRONIC EQUIPMENT COVERAGE
13
BROAD FORM INSURED
1
BODILY INJURY REDEFINED
22
EMPLOYEES AS INSUREDS (including employee hired auto)
2
EXTENDED CANCELLATION CONDITION
23
EXTRA EXPENSE - BROADENED COVERAGE
10
GLASS REPAIR - WAIVER OF DEDUCTIBLE
15
HIRED AUTO PHYSICAL DAMAGE (including employee hired auto and loss of use)
6
HIRED AUTO COVERAGE TERRITORY
20
LOAN/ LEASE GAP
14
PARKED AUTO COLLISION COVERAGE (WAIVER OF DEDUCTIBLE)
16
PERSONAL EFFECTS COVERAGE
11
PHYSICAL DAMAGE - ADDITIONAL TRANSPORTATION EXPENSE COVERAGE
B
RENTAL REIMBURSEMENT
9
SUPPLEMENTARY PAYMENTS
4
TOWING AND LABOR
7
TWO OR MORE DEDUCTIBLES
17
UNINTENTIONAL FAILURE TO DISCLOSE HAZARDS
16
WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US
20
SECTION 11- LIABILITY COVERAGE is amended as follows:
1. BROAD FORM INSURED
SECTION II - LIABILITY COVERAGE, paragraph A.I. - WHO IS AN INSURED is amended to include
the following as an insured:
d. Any legally incorporated entity of which you own more than 50 percent of the voting stock
during the policy period. However, "insured" does not include any organization that:
(1) Is a partnership or joint venture; or
(2) Is an insured under any other automobile policy; or
(3) Has exhausted its Limit of Insurance under any other automobile policy.
Paragraph d. (2) of this provision does not apply to a policy written to apply specifically in
excess of this policy.
e. Any organization you newly acquire or form, other than a partnership or joint venture, of which
you own more than 50 percent of the voting stock. This automatic coverage is afforded onlyfor
180 days from the date of acquisition or formation. However, coverage under this provision
does not apply:
(1) if there is similar insurance or a self - insured retention plan available to that organization;
© 2013 Liberty Mutual Insurance
CA 88 10 01 13 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 7
(2) If the Limits of Insurance of any other insurance policy have been exhausted; or
(3) To "bodily injury" or "property damage" that occurred before you acquired or formed the
organization.
2. EMPLOYEES AS INSUREDS
SECTION II - LIABILITY COVERAGE, paragraph A.I. - WHO IS AN INSURED is amended to include
the following as an insured:
f. Any "employee" of yours while using a covered "auto" you do not own, hire or borrow, but
only for acts within the scope of their employment by you, Insurance provided by this endorse-
ment is excess over any other insurance available to any "employee ".
g. An "employee" of yours while operating an "auto" hired or borrowed under a written contract
or agreement in that "employee's" name, with your permission, while performing duties re-
lated to the conduct of your business and within the scope of their employment. Insurance
provided by this endorsement is excess over any other insurance available to the "employee ".
3. ADDITIONAL INSURED BY CONTRACT, AGREEMENT OR PERMIT
SECTION II - LIABILITY COVERAGE, paragraph A.1. - WHO IS AN INSURED is amended to include
the following as an insured:
h. Any person or organization with respect to the operation, maintenance or use of a covered
"auto ", provided that you and such person or organization have agreed in a written contract,
agreement, or permit issued to you by governmental or public authority, to add such person, or
organization, or governmental or public authority to this policy as an "insured ".
However, such person or organization is an "insured ":
(1) Only with respect to the operation, maintenance or use of a covered "auto ";
(2) Only for "bodily injury" or "property damage" caused by an "accident" which takes
place after you executed the written contract or agreement, or the permit has been
issued to you; and
(3) Only for the duration of that contract, agreement or permit
4. SUPPLEMENTARY PAYMENTS
SECTION 11 - LIABILITY COVERAGE, Coverage Extensions, 2.a. Supplementary Payments, para-
graphs (2) and (4) are replaced by the following:
(2) Up to $3,000 for cost of bail bonds (including bonds for related traffic violations) required
because of an "accident" we cover. We do not have to furnish these bonds.
(4) All reasonable expenses incurred by the insured at our request, including actual loss of earn-
ings up to $500 a day because of time off from work.
5. AMENDED FELLOW EMPLOYEE EXCLUSION
In those jurisdictions where, by law, fellow employees are not entitled to the protection afforded to
the employer by the workers compensation exclusivity rule, or similar protection, the following
provision is added:
SECTION II - LIABILITY, exclusion B.5. FELLOW EMPLOYEE does not apply if the "bodily injury"
results from the use of a covered "auto" you own or hire.
SECTION 111 - PHYSICAL DAMAGE COVERAGE is amended as follows:
6. HIRED AUTO PHYSICAL DAMAGE
Paragraph A.4. Coverage Extensions of SECTION III - PHYSICAL DAMAGE COVERAGE, is amended
by adding the following:
If hired "autos" are covered "autos" for Liability Coverage, and if Comprehensive, Specified
Causes of Loss or Collision coverage are provided under the Business Auto Coverage Form for any
"auto" you own, then the Physical Damage coverages provided are extended to "autos ":
a. You hire, rent or borrow; or
® 2013 Liberty Mutual Insurance
CA 88 10 01 13 Includes copyrighted material of Insurance Services Office, Inc„ with its permission. Page 2 of 7
b. Your "employee" hires or rents under a written contract or agreement in that "employee's"
name, but only if the damage occurs while the vehicle is being used in the conduct of your
business,
subject to the following limit and deductible:
A. The most we will pay for "loss" in any one "accident" or "loss" is the smallest of:
(1) $50,000; or
(2) The actual cash value of the damaged or stolen property as of the time of the "loss "; or
(3) The cost of repalring or replacing the damaged or stolen property with other property of
like kind and quality, minus a deductible.
B. The deductible will be equal to the largest deductible applicable to any owned "auto" for that
coverage.
C. Subject to the limit, deductible and excess provisions described in this provision, we will
provide coverage equal to the broadest coverage applicable to any covered "auto" you own.
D. Subject to a maximum of $1,000 per "accident ", we will also cover the actual loss of use of the
hired "auto" if it results from an "accident ", you are legally liable and the lessor incurs an
actual financial loss,
E. This coverage extension does not apply to:
(1) Any "auto" that is hired, rented or borrowed with a driver; or
(2) Any "auto" that is hired, rented or borrowed from your "employee ".
For the purposes of this provision, SECTION V - DEFINITIONS is amended by adding the following:
"Total loss" means a "loss" in which the cost of repairs plus the salvage value exceeds the actual
cash value.
7. TOWING AND LABOR
SECTION III - PHYSICAL DAMAGE COVERAGE, paragraph A.2. Towing, is amended by the addition
of the following:
We will pay towing and labor costs incurred, up to the limits shown below, each time a covered
"auto" classified and rated as a private passenger type, "light truck" or "medium truck" is dis-
abled:
a. For private passenger type vehicles, we will pay up to $50 per disablement.
b. For "light trucks ", we will pay up to $50 per disablement. "Light trucks" are trucks that have a
gross vehicle weight (GVW) of 10,000 pounds or less.
c. For "medium trucks" , we will pay up to $150 per disablement. "Medium trucks" are trucks that
have a gross vehicle weight (GVW) of 10,001 - 20,000 pounds.
However, the labor must be performed at the place of disablement.
8. PHYSICAL DAMAGE -ADDITIONAL TRANSPORTATION EXPENSE COVERAGE
Paragraph A.4.a., Coverage Extension of SECTION III - PHYSICAL DAMAGE COVERAGE, is amend-
ed to provide a limit of $50 per day and a maximum limit of $1,500
© 2013 Liberty Mutual Insurance
CA 88 10 01 13 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 3 of 7
9. RENTAL REIMBURSEMENT
SECTION III - PHYSICAL DAMAGE COVERAGE, A. COVERAGE, is amended by adding the following:
a. We will pay up to $75 per day for rental reimbursement expenses incurred by you for the renta I
of an "auto" because of "accident" or "loss ", to an "auto" for which we also pay a "loss"
under Comprehensive, Specified Causes of Loss or Collision Coverages. We will pay only for
those expenses incurred after the first 24 hours following the "accident" or "loss" to the
covered "auto,"
b. Rental Reimbursement will be based on the rental of a comparable vehicle, which in many
cases may be substantially less than $75 per day, and will only be allowed for the period of
time it should take to repair or replace the vehicle with reasonable speed and similar quality, up
to a maximum of 30 days.
c. We will also pay up to $500 for reasonable and necessary expenses incurred by you to remove
and replace your tools and equipment from the covered "auto ".
d. This coverage does not apply unless you have a business necessity that other "autos" avail-
able for your use and operation cannot fill.
e. If "loss" results from the total theft of a covered "auto" of the private passenger type, we will
pay under this coverage only that amount of your rental reimbursement expenses which is not
already provided under Paragraph 4. Coverage Extension.
f. No deductible applies to this coverage.
For the purposes of this endorsement provision, materials and equipment do not include "personal
effects" as defined in provision 11.
10. EXTRA EXPENSE - BROADENED COVERAGE
Under SECTION III - PHYSICAL DAMAGE COVERAGE, A. COVERAG E, we will pay for the expense of
returning a stolen covered "auto" to you. The maximum amount we will pay is $1,000.
11. PERSONAL EFFECTS COVERAGE
A. SECTION III - PHYSICAL DAMAGE COVERAGE, A. COVERAGE, is amended by adding the
following:
If you have purchased Comprehensive Coverage on this policy for an "auto" you own and that
"auto" is stolen, we will pay, without application of a deductible, up to $600 for "personal
effects" stolen with the "auto."
The insurance provided under this provision is excess over any other collectible insurance.
B. SECTION V -DEFINITIONS is amended by adding the following:
For the purposes of this provision, "personal effects" mean tangible property that is worn or
carried by an insured." "Personal effects" does not include tools, equipment, jewelry, money
or securities.
12. ACCIDENTAL AIRBAG DEPLOYMENT
SECTION III - PHYSICAL DAMAGE COVERAGE, B. EXCLUSIONS is amended by adding the follow-
ing:
If you have purchased Comprehensive or Collision Coverage under this policy, the exclusion for
"loss" relating to mechanical breakdown does not apply to the accidental discharge of an airbag.
Any insurance we provide shall be excess over any other collectible insurance or reimbursement by
manufacturer's warranty. However, we agree to pay any deductible applicable to the other cov-
erage or warranty.
13. AUDIO, VISUAL AND DATA ELECTRONIC EQUIPMENT COVERAGE
SECTION III - PHYSICAL DAMAGE COVERAGE, B. EXCLUSIONS, exception paragraph a. to exclu-
sions 4.c, and 4.d. is deleted and replaced with the following:
© 2013 Liberty Mutual Insurance
CA 88 10 0113 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 4 of 7
Exclusion 4.c. and 4.d, do not apply to:
a. Electronic equipment that receives or transmits audio, visual or data signals, whether or not
designed solely for the reproduction of sound, if the equipment is permanently installed in the
covered "auto" at the time of the "loss" and such equipment is designed to be solely operated
by use of the power from the "auto's" electrical system, in or upon the covered "auto" and
physical damage coverages are provided for the covered "auto "; or
If the "loss" occurs solely to audio, visual or data electronic equipment or accessories used with
this equipment, then our obligation to pay for, repair, return or replace damaged or stolen property
will be reduced by a $100 deductible.
14. LOAN / LEASE GAP COVERAGE
A. Paragraph C., LIMIT OF INSURANCE cf SECTION III - PHYSICAL DAMAGE COVERAGE is
amended by add ing the following:
The most we will pay for a "total loss" to a covered "auto" owned by or leased to you in any
one "accident" is the greater of the:
1. Balance due under the terms of the loan or lease to which the damaged covered "auto" is
subject at the time of the "loss" less the amount of:
a. Overdue payments and financial penalties associated with those payments as of the
date of the "loss ",
b. Financial penalties imposed under a lease due to high mileage, excessive use or ab-
normal wear and tear,
c. Costs for extended warranties, Credit Life Insurance, Health, Accident or Disability
Insurance purchased with the loan or lease,
d. Transfer or rollover balances from previous loans or leases,
e. Final payment due under a "Balloon Loan ",
f. The dollar amount of any unrepaired damage which occurred prior to the "total loss"
of a covered "auto ",
g. Security deposits not refunded by a lessor,
h. All refunds payable or paid to you as a result of the early termination of a lease
agreement or as a result of the early termination of any warranty or extended service
agreement on a covered "auto ",
i. Any amount representing taxes,
j. Loan or lease termination fees; or
2. The actual cash value of the damage or stolen property as of the time of the "loss ".
An adjustment for depreciation and physical condition will be made in determining the actual
cash value at the time of the "loss ". This adjustment is not applicable in Texas.
B. ADDITIONAL CONDITIONS
This coverage applies only to the original loan for which the covered "auto" that incurred the
loss serves as collateral, or lease written on the covered "auto" that incurred the loss.
C. SECTION V- DEFINTIONS is changed byadding the following:
As used in this endorsement provision, the following definitions apply:
"Total loss" means a "loss" in which the cost of repairs plus the salvage value exceeds the
actual cash value.
A "balloon loan" is one with periodic payments that are insufficient to repay the balance over
the term of the loan, thereby requiring a large final payment.
© 2013 Liberty Mutual Insurance
CA 88 10 01 13 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 5 of 7
15. GLASS REPAIR - WAIVER OF DEDUCTIBLE
Paragraph D. Deductible of SECTION III - PHYSICAL DAMAGE COVERAGE is amended by the
addition of the following:
No deductible applies to glass damage if the glass is repaired rather than replaced.
16. PARKED AUTO COLLISION COVERAGE (WAIVER OF DEDUCTIBLE)
Paragraph D. Deductible of SECTION III - PHYSICAL DAMAGE COVERAGE is amended by the
addition of the following.
The deductible does not apply to "loss" caused by collision to such covered "auto" of the private
passenger type or light weight truck with a gross vehicle weight of 10,000 lbs. or less as defined by
the manufacturer as maximum loaded weight the "auto" is designed to carry while it is:
a. In the charge of an "insured ";
b. Legally parked; and
c. Unoccupied.
The "loss" must be reported to the police authorities within 24 hours of known damage.
The total amount of the damage to the covered "auto" must exceed the deductible shown in the
Declarations,
This provision does not apply to any "loss" if the covered "auto" is In the charge of any person or
organization engaged in the automobile business.
17. TWO OR MORE DEDUCTIBLES
Under SECTION III PHYSICAL DAMAGE COVERAGE, if two or more company policies or coverage
forms apply to the same accident, the following applies to paragraph D. Deductible:
a. If the applicable Business Auto deductible is the smaller (or smallest) deductible it will be
waived; or
b. If the applicable Business Auto deductible is not the smaller (or smallest) deductible it will be
reduced by the amount of the smaller (or smallest) deductible; or
c. If the loss involves two or mare Business Auto coverage forms or policies the smaller (or
smallest) deductible will be waived.
For the purpose of this endorsement company means any company that is part of the Liberty
Mutual Group.
SECTION IV - BUSINESS AUTO CONDITIONS is amended as follows:
18. UNINTENTIONAL FAILURE TO DISCLOSE HAZARDS
SECTION IV- BUSINESS AUTO CONDITIONS, Paragraph B.2. is amended by adding the following:
If you unintentionally fail to disclose any hazards, exposures or material facts existing as of the
inception date or renewal date of the Business Auto Coverage Form, the coverage afforded by this
policy will not be prejudiced.
However, you must report the undisclosed hazard of exposure as soon as practicable after its
discovery, and we have the right to collect additional premium for any such hazard or exposure.
19. AMENDED DUTIES IN THE EVENT OF ACCIDENT, CLAIM, SUIT, OR LOSS
SECTION IV - BUSINESS AUTO CONDITIONS, paragraph A.2.a. is replaced in its entirety by the
following:
a. In the event of "accident ", claim, "suit" or "loss ", you must promptly notify us when it is
known to:
1. You, if you are an individual;
2. A partner, if you are a partnership;
3. Member, if you are a limited liability company;
4. An executive officer or the "employee" designated by the Named Insured to give such
notice, if you are a corporation.
a` 2013 Liberty Mutual Insurance
CA 8810 0113 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 6 of 7
To the extent possible, notice to us should include:
(1) How, when and where the "accident" or "loss" took place;
(2) The "insureds" name and address; and
(3) The names and addresses of any injured persons and witnesses.
20. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US
SECTION IV - BUSINESS AUTO CONDITIONS, paragraph A.5., Transfer of Rights of Recovery
Against Others to Us, is amended by the addition of the following:
If the person or organization has waived those rights before an "accident" or "loss ", our rights are
waived also.
21, HIRED AUTO COVERAGE TERRITORY
SECTION IV - BUSINESS AUTO CONDITIONS, paragraph B.7., Policy Period, Coverage Territory, is
amended by the addition of the following:
f. For "autos" hired 30 days or less, the coverage territory is anywhere in the world, provided that
the insured's responsibility to pay for damages is determined in a "suit ", on the merits, in the
United States, the territories and possessions of the United States of America, Puerto Rico or
Canada or in a settlement we agree to.
This extension of coverage does not apply to an "auto" hired, leased, rented or borrowed with
a driver.
SECTION V - DEFINITIONS is amended as follows:
22. BODILY INJURY REDEFINED
Under SECTION V - DEFINTIONS, definition C. is replaced by the following:
"Bodily injury" means physical injury, sickness or disease sustained by a person, including mental
anguish, mental injury, shock, fright or death resulting from any of these at anytime.
COMMMON POLICY CONDITIONS
23. EXTENDED CANCELLATION CONDITION
COMMON POLICY CONDITIONS, paragraph A. - CANCELLATION condition applies except as fol-
lows:
If we cancel for any reason other than nonpayment of premium, we will mail to the first Named
Insured written notice of cancellation at least 60 days before the effective date of cancellation. This
provision does not apply in those states which require more than 60 days prior notice of cancella-
tion.
O 2D13 Liberty Mutual Insurance
CA 88 10 01 13 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 7 of 7
WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY VVC 99 06 34
(Ed. 8-00)
WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT - BLANKET
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).
The additional premium for this endorsement shall be
otherwise due.
Person or Organization
ANY PERSON OR
ORGANIZATION WHEN
REQUIRED BY WRITTEN
CONTRACT
3 % of the total California Workers' Compensation premium
Schedule
Job Description
ALL CALIFORNIA
OPERATIONS
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 05/29/2015 Policy No. WSA 5026584 01 Endorsement No.
Insured FIERROS, JOSE ANGEL ROJO Premium $ INCL .
Insurance Company INSURANCE COMPANY OF THE WEST
Countersigned By
WC 99 06 34
(Ed. 8 -00)
WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 99 06 34
(Ed. 8 -00)
WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT - BLANKET
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).
The additional premium for this endorsement shall be
otherwise due.
Person or Organization
ANY PERSON OR
ORGANIZATION WHEN
REQUIRED BY WRITTEN
CONTRACT
3 % of the total California Workers' Compensation premium
Schedule
Job Description
ALL CALIFORNIA
OPERATIONS
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 05/28/2015 Policy No. WSA 5026584 01 ` Endorsement No.
Insured FIERROS , JOSE ANGEL ROJO I " Premium $ INCL .
Insurance Company INSURANCE COMPANY OF THE WEST
WC 99 06 34
(Ed. 8 -00)
Countersigned By
MMMUN
Sandoval, Lili
From: Shilling, Mona
Sent: Thursday, October 08, 2015 4:53 PM
To: Sandoval, Lili
Subject: FW: ES - FS Construction Insurance: For Concrete Project
FYI
From: Bola, Arianne
Sent: Thursday, October 08, 2015 4:43 PM
To: Berger, Karl (Assistant City Attorney)
Cc: Shilling, Mona; Hegvold, Julie; King, David
Subject: RE: ES - FS Construction Insurance: For Concrete Project
Thank you!
Warmest Regards,
Arianne Bola
CITY OF EL SEGUNDO
PUBLIC WORKS DEPARTMENT
P: (310) 524 -2364
visit us at www.eI5 acg rn�9a. ee
Please Conserve Water
Visit these links to learn more...
www.bewaterwise.com
hIJ9 'L /l MM. u . ojilvaatqh?v=3bPok fir 4
WIp wu r autrrb a mtV tch IT r ti" -yFqu4
From: Berger, Karl (Assistant City Attorney)
Sent: Thursday, October 08, 2015 4:40 PM
To: Bola, Arianne
Cc: Shilling, Mona; Hegvold, Julie; King, David
Subject: ES - FS Construction Insurance: For Concrete Project
OK. You can use that insurance. Attached is signed contract. Thanks!
From: Bola, Arianne [mailto:ABola else undo or j
Sent: Thursday, October 8, 2015 3:55 PM
To: Berger, Karl (Assistant City Attorney) <kber er @hen leyla rou .com>
Cc: Shilling, Mona <MShilhn else undo.or >; Hegvold, Julie <jhe void else undo „or >; King, David
< kin !role IaW rou .co
m>
Subject: RE: FS Construction Insurance: For Concrete Project
Hi Karl,
Please see attached files sent by the insurance agent of FS Construction. Kindly let me know if the insurance is
acceptable.