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PROOF OF INSURANCE (2015) CLOSED
CERTIFICATE OF LIABILITY INSURANCE 1 DATE( 061/12114 12114 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 `LOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED - PRESENTATIVE OR PRODUCER,, AND THE CERTIFICATE HOLDER. sMPORTANT: If the cenIfIcato holder Is an ADDITIONAL INSURED, the pollcy(los) 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 PRODUCER United Agencies, Inc. (1) CA License #0252636 301 E. Colorado Blvd. Ste. 200 Pasadena, CA 91101 Robert W. Bader INSURED West Coast Netting, Inc. 5075 Flightline Dr. Kingman, AZ 86401 Phone: 626-449 -0301 Fax: 626 - 564 -656,v :Travelers P INSURER 0: Co NAIC f 161 COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ...._ -. TYPE OF INSURANCE —_.. __ -- POLICY NUMBER .,.._ -_. _.. . __._.._.-. LIMITS GENERAL LIABILrrY EACH OCCURRENCE $ 1,000,00 A X COMMERCIAL GENERAL LIABILITY '... X X 63006181-57814 06/07/14 06107!15 "���� � � ( � Pf I Mp Ti:Ir (L a a;ier,tlw"r�Yan�D $... 100,00 CLAIMS -MADE EK OCCUR MED EXP (Any one person) $ 5,00 PERSONAL & ADV INJURY $ 1,000,00 GENERAL AGGREGATE $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP /OP AGG $ 2,000,00 F`0u.Acy I' � �w I.O - Em Ben. $ 1,000,00 AUTOMOBILE LIABILITY yo,1r�;wa @M » $ 1,000,00 B X ANY AUTO X X BA0618L578TIL14 06/07/14 06/07/15 BODILY INJURY (Per person) $ ALL AUTOS NED SCHEDULED IX BODILY INJURY (Per accident) $ NON OWNED X PROP "..Y� t -D A $ ». » :...... HIRED AUTOS AUTOS Per accidenk UMBRELLA LIAB X'...... OCCUR EACH OCCURRENCE $ 1,000,00 X AGGREGATE $ 1,000,00 B EXCESS LIAB CLAIMS -MADE CUP06181-578TIL14 06/07/14 06/07/15 Dm I X R TL ION None WORKERS COMPENSATION WC STA'TU- OIH- AND EMPLOYERS' LIABILITY YIN I JORY ANY PROPRIETORIPARTNERIEXECUIIVE E.L EACH ACCIDENT $ OFFICERIMEMBER EXCLUDED? [::] N/A (Mandatory In NH) E DISEASE - EA EMPLOYEEJ $ If yes, describe under DESCRIPTION OF OPERATIONS below F I... DISEASE •. PO4.ICY. LIMIT DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required) Subject to all policy terms, exclusions and conditions. RE: Installation of Soccer Field Netting, Campus E1 Segundo Athletic Field, El Segundo Ca, Contract #PW 13 -06; City of E1 Segundo, its officers, officials, employees and volunteers are named as an Additional Insured with respects to the General Liability and Auto Liability as required by ** SEE ATTACHWMT gE51IQCA1E HOLDER CITYELS OWN City of El Segundo City Clerk 350 Main Street El Segundo, CA 90245 ACORD 25 (2010/05) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988 -2010 ACORD CORPORATION. All rights The ACORD name and logo are registered marks of ACORD m= 00 o= o. .r o a= POLICY NUMBER: 63006181-57814 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. INTERNATIONAL AL XTEND ENDORSEMENT SEI ENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART GENERAL DESCRIPTION OF COVERAGE — This endorsement broadens coverage. However, coverage for any injury, damage or medical expenses described in any of the provisions of this endorsement may be excluded or limited by another endorsement to this Coverage Part, and these coverage broadening provisions do not apply to the extent that coverage is excluded or limited by such an endorsement. The following listing is a general cover- age description only. Limitations and exclusions may apply to these coverages. Read all the provisions of this en- dorsement and the rest of your policy carefully to determine rights, duties, and what is and is not covered. A. Broadened Named Insured B. Blanket Additional Insured — Broad Form Vendors C. Limited Worldwide Liability Coverage — In- demnity Basis D. Damage To Premises Rented To You • Perils of fire, explosion, lightning, smoke, water • Limit increased to $300,000 E. Blanket Waiver of Subrogation F. Blanket Additional Insured — Owners, Manag- ers or Lessors of Premises G. Blanket Additional Insured — Lessors of Leased Equipment H. Incidental Medical Malpractice I. Personal Injury — Assumed by Contract J. Amended Bodily Injury Definition PROVISIONS A. BROADENED NAMED INSURED 1. The following Is added to SECTION II — WHO IS AN INSURED: Any organization, other than a partnership or joint venture, over which you maintain owner- ship or majority interest on the effective date of the policy qualifies as a Named Insured.. However, coverage for any such organization will cease as of the date during the policy pe- riod that you no longer maintain ownership of, or majority interest in, such organization. 2. The following replaces Paragraph 4.a. of SECTION II — WHO IS AN INSURED: K. Bodily Injury to Co- Employees and Co- Volunteer Workers L. Aircraft Chartered with Crew M. Non -Owned Watercraft — Increased from 25 feet to 50 feet N. Increased Supplementary Payments • Cost of bail bonds increased to $2,500 • Loss of earnings increased to $500 per day O. Medical Payments — Limit increased to $10,000 per person P. Knowledge and Notice of Occurrence or Of- fense Q. Unintentional Omission R. Reasonable Force — Bodily Injury or Property Damage S. Transportation Expenses For Repatriation or Relocation of Injured Or Sick Employees a. Coverage under this provision is afforded only until the 180th day after you acquire or form the organization or the end of the policy period, whichever is earlier, unless reported in writing to us within 180 days. B. BLANKET ADDITIONAL INSURED — BROAD FORM VENDORS The following is added to SECTION II — WHO IS AN INSURED: Any person or organization that is a vendor and that you have agreed in a written contract or agreement to include as an additional insured on this Coverage Part is an insured, but only with re- spect to liability for "bodily injury" or "property damage" that: CG D4 58 10 08 © 2008 The Travelers Companies, Inc. 006818 Page 1 of 9 COMMERCIAL GENERAL LIABILITY a. Is caused by an "occurrence" that takes place after you have signed and executed that con- tract or agreement; and b. Arises out of "your products" which are dis- tributed or sold in the regular course of such vendor's business. The insurance provided to such vendor is subject to the following provisions: a. The limits of insurance provided to such ven- dor will be the limits which you agreed to pro- vide in the written contract or agreement, or the limits shown in the Declarations of this Coverage Part, whichever are less. b. The insurance provided to such vendor does not apply to: (1) "Bodily injury" or "property damage" for which the vendor is obligated to pay damages by reason of the assumption of Ilability in a contract or agreement. This exclusion does not apply to liability for damages that the vendor would have in the absence of the contract or agreement; (2) Any express warranty unauthorized by you; (3) Any physical or chemical change in "your products" made intentionally by such vendor; (4) Repackaging, unless unpacked solely for the purpose of inspection, demonstration, testing, or the substitution of parts under instructions from the manufacturer, and then repackaged in the original container; (5) Any failure to make such inspections, ad- justments, tests or servicing as vendors agree to perform or normally undertake to perform in the regular course of business, in connection with the distribution or sale of "your products "; (6) Demonstration, installation, servicing or repair operations, except such operations performed at such vendor's premises in connection with the sale of "your prod- ucts"; or (7) "Your products" which, after distribution or sale by you, have been labeled or re- labeled or used as a container, part or in- gredient of any other thing or substance by or for such vendor. . Coverage under this provision does not apply to: a. Any person or organization from whom you . have acquired "your products ", or any ingre- dient, part or container entering into, accom- panying or containing such products; or b. Any vendor for which coverage as an addi- tional insured specifically Is scheduled by en- dorsement. C. LIMITED WORLDWIDE LIABILITY COVERAGE — INDEMNITY BASIS I. The following replaces the definition of "cov- erage territory" in the DEFINITIONS Section: "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: (1) The "bodily injury" or "property dam- age" is caused by an "occurrence" that takes place; or (2) The "personal injury" or "advertising injury" is caused by an offense corn- mitted; in the course of travel or transportation between any places included in Para- graph a, above; or c. All other parts of the world except the ' "prohibited area ", but only if the injury or damage arises out of: (1) Goods or products made, sold, han- dled or distributed by you, or services provided by you to your customers or clients, 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 injury" or "advertising in- jury" offenses committed through the Internet or similar electronic means of communication; provided that the insured's responsibility to pay damages is determined in a "suit" on the merits brought anywhere in the world except the "prohibited area ", or in a settlement we agree to. With respect to "occurrences" that take place, or "personal injury" or "advertising injury" of- fenses committed within the territory de- scribed in Paragraph c. above, the following conditions apply: Page 2 of 9 0 2008 The Travelers Companies, Inc. CG D4 58 10 08 _ o= o= e� o` lip o= (i) This insurance is excess over any valid and collectible other insurance available to the insured, whether primary, excess, contingent or on any other basis. (ii) This insurance is not a substitute for "compulsory admitted insurance" in any country or jurisdiction included in Para- graph c. above, regardless of whether this insurance would qualify as "compul- sory admitted insurance" in such country or jurisdiction or is accepted by the ap- propriate authorities as proof of "compul- sory admitted insurance ". You agree to maintain "compulsory ad- mitted insurance" at the limits required by law. Your failure to do so will not invali- date the coverage provided for such "oc- currences" or offenses, but we will only be liable to the same extent we would have been liable had you maintained "compulsory admitted insurance ". For purposes of this Paragraph (ii), "com- pulsory admitted insurance" means in- surance that is: (1) Required to be in -force to satisfy the legal requirements of a specific coun- try or jurisdiction; and (2) Issued by an insurance fund adminis- tered by such country or jurisdiction or issued by an insurer licensed or permitted by law to do business in such country or jurisdiction. (iii) b'Vth respect to defending the insured against, or the investigation or settlement of, any claim or "suit" brought against the insured, the following will apply: (1) The phrase "We will pay....." in the first sentence of Paragraph 1.a. of SECTION I — COVERAGES — COV- ERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY and Paragraph 1.a. of SECTION i — COVERAGES — COVERAGE B PERSONAL AND ADVERTISING INJURY LIABILITY is replaced by the phrase "We will indemnify the in- sured for.... ". (2) You must arrange to defend the in- sured against, and investigate or set- tle, any claim or "suit ". (3) Neither you nor any other involved insured will make any settlement without our consent. COMMERCIAL GENERAL LIABILITY (4) We will pay expenses incurred with our consent for your defense of the insured against any "suit" seeking damages for "bodily injury", "property damage ", "personal injury" or "adver- tising injury" to which this insurance applies. (5) We may, at our discretion, participate in defending the insured against, or in the settlement of, any claim or "suit ". 2. The following is added to the DEFINITIONS Section: "Prohibited area" means any country or juris- diction while any trade sanction, embargo, or similar regulation imposed by the United States of America applies to and prohibits the transaction of business with or within such country or jurisdiction. D. DAMAGE TO PREMISES RENTED TO YOU 1. The following replaces the last paragraph of Paragraph 2., Exclusions, of SECTION I — COVERAGES — COVERAGE A BODILY IN- JURY AND PROPERTY DAMAGE LIABIL- ITY: Exclusions c. through n. do not apply to dam- age to premises while rented to you, or tem- porarily occupied by you with permission of the owner, caused by: a. Fire; b. Explosion; c. Lightning; d. Smoke resulting from such fire, explosion, or lightning; or e. Water. A separate limit of insurance applies to such damage to premises as described in Para- graph 6. of Section 111 — Limits Of Insurance. This insurance does not apply to damage to premises while rented to you, or temporarily occupied by you with permission of the owner, caused by: a. Rupture, bursting, or operation of pres- sure relief devices; b. Rupture or bursting due to expansion or swelling of the contents of any building or structure, caused by or resulting from wa- ter; c. Explosion of steam boilers, steam pipes, steam engines, or steam turbines. CG D4 58 10 08 ® 200B The Travelers Companies, Inc. 006817 Page 3 of 9 COMMERCIAL GENERAL LIABILITY 2. The following replaces Paragraph 6. of SEC- TION III — LIMITS OF INSURANCE: Subject to 5. above, the Damage To Prem- ises 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 temporarily occupied by you with permission of the owner, caused by fire; explosion; lightning; smoke resulting from such fire, explosion, or lightning; or wa- ter. The Damage To Premises Rented To You Limit will apply to all damage proximately caused by the same 'occurrence ", whether such damage results from fire; explosion; lightning; smoke resulting from such fire, ex- plosion, or lightning; water; or any combina- tion of any of these. The Damage To Premises Rented To You Limit will be the higher of. a. $300,000; or b. The amount shown on the Declarations of this Coverage Part for Damage To Prem- ises Rented To You Limit. 4. The following replaces Paragraph a. of the definition of "insured contract" in the DEFINI- TIONS Section: a. A contract for a lease of premises. How- ever, that portion of the contract for a lease of premises that indemnifies any person or organization for damage to premises while rented to you, or tempo- rarily occupied by you with permission of the owner, caused by: (1) Fire; (2) Explosion; (3) Lightning; (4) Smoke resulting from such fire, ex- plosion, or lightning; or (5) Water. is not an "insured contract"; 5. The following replaces Paragraph 4.b.(1)(b) of SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS: (b) That is insurance for premises rented to you, or temporarily occupied by you with the permission of the owner, E. BLANKET WAIVER OF SUBROGATION The following is added to Paragraph 8., Transfer Of Rights Of Recovery Against Others To Us, of SECTION IV — COMMERCIAL GENERAL LI- ABILITY CONDITIONS: We waive any right of recovery we may have against any person or organization because of payments we make for injury or damage arising out of premises owned or occupied by or rented or loaned to you; ongoing operations performed by you or on your behalf, done under a contract with that person or organization; "your work "; or "Your products ". We waive this right where you have agreed to do so as part of a written contract, executed by you prior to loss. F. BLANKET ADDITIONAL INSURED — OWNERS, MANAGERS OR LESSORS OF PREMISES The following is added to SECTION 11— WHO IS AN INSURED: Any person or organization that is a premises owner, manager or lessor and that you have agreed in a written contract or agreement to name as an additional insured on this Coverage Part is an insured, but only with respect to liability for. "bodily injury" "property damage ", "personal Injury" or "advertising injury" that.. a. Is "bodily injury" or "property damage" caused by an "occurrence " that takes place, or "per- sonal injury" or "advertising injury" caused' by an offense that is committed, after you have signed and executed that contract or agree- ment; and b. Arises out of the ownership, maintenance or use of that part of any premises leased to you. The insurance provided to such premises owner, manager or lessor is subject to the following pro- visions: a. The limits of insurance provided to such premises owner, manager or lessor will be the limits which you agreed to provide in the written contract or agreement, or the limits shown on the Declarations of this Coverage Part, whichever are less. b. The insurance provided to such premises owner, manager or lessor does not apply to: (1) "Bodily injury" or "property damage" caused by an "occurrence" that takes place, or "personal injury" or "advertising injury" caused by an offense that is com- mitted, after you cease to be a tenant in that premises; or (2) Structural alterations, new construction or demolition operations performed by or on Page 4 of 9 ® 2008 The Travelers Companies, Inc. CG D4 58 10 08 m e= o= o= h. behalf of such premises owner, manager or lessor. c. The insurance provided to such premises owner, manager or lessor is excess over any valid and collectible other insurance available to such premises owner, manager or lessor, unless you have agreed in a written contract for this insurance to apply on a primary or contributory basis. G. BLANKET ADDITIONAL INSURED — LESSORS OF LEASED EQUIPMENT The following is added to SECTION II — WHO IS AN INSURED: Any person or organization that is an equipment lessor and that you have agreed in a written con- tract or agreement to include as an additional in- sured on this Coverage Part is an insured, but only with respect to liability for "bodily injury", "property damage ", "personal injury" or "advertis- ing injury" that: a. Is "bodily injury" or "property damage" caused by an "occurrence" that takes place, or "per- sonal injury" or "advertising injury" caused by an offense that is committed, after you have signed and executed that contract or agree- ment; and b. Is caused, in whole or in part, by your acts or omissions in the maintenance, operation or use by you of equipment leased to you by such equipment lessor. The insurance provided to such equipment lessor is subject to the following provisions: a. The limits of insurance provided to such equipment lessor will be the limits which you agreed to provide in the written contract or agreement, or the limits shown on the Decla- rations of this Coverage Part, whichever are less. b. The insurance provided to such equipment lessor does not apply to any "bodily injury" or "property damage" caused by an "occur- rence" that takes place, or "personal injury" or "advertising injury" caused by an offense that is committed, after the equipment lease ex- pires. c. The insurance provided to such equipment lessor is excess over any valid and collectible other insurance available to such equipment lessor, unless you have agreed in a written contract for this insurance to apply on a pri- mary or contributory basis. COMMERCIAL GENERAL LIABILITY H. INCIDENTAL MEDICAL MALPRACTICE 1. The following is added to the definition of "oc- currence" in the DEFINITIONS Section: Unless you are in the business or occupation of providing professional health care services, "occurrence" also means an act or omission committed in providing or failing to provide "incidental medical services" to a person. 2. The following is added to the- DEFINITIONS Section: "Incidental medical services" means: a. Medical, surgical, dental, laboratory, x -ray or nursing service or treatment, advice or instruction, or the related furnishing of food or beverages; b. The furnishing or dispensing of drugs or medical, dental, or surgical supplies or appliances; c. First aid; or d. "Good Samaritan services ". "Good Samaritan services" means any emer- gency medical services for which no compen- sation is demanded or received. 3. The following is added to Paragraph 2.a.(1) of SECTION II — WHO IS AN INSURED: Unless you are in the business or occupation of providing professional health care services, Paragraphs (1)(a), (b), (c) and (d) above do not apply to any "bodily injury" arising out of any providing or failing to provide "incidental medical services" by any of your "employ- ees", other than an employed doctor. Any such "employees" providing or failing to pro- vide "incidental medical services" during their work hours for you will be deemed to be act- ing within the scope of their employment by you or performing duties related to the con- duct of your business. 4. The following exclusion is added to Para- graph 2., Exclusions, of SECTION I — COV- ERAGES — COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY: Sale Of Pharmaceuticals "Bodily injury' or "property damage" arising out of the willful violation of a penal statute or ordinance relating to the sale of pharmaceuti- cals committed by, or with the knowledge or consent of, the insured. S. The following is added to Paragraph 5. of SECTION III — LIMITS OF INSURANCE: CG D4 5810 08 m 2008 The Travelers Companies, Inc. 008818 Page 5of9 COMMERCIAL GENERAL LIABILITY For the purposes of determining the applica- ble Each Occurrence Limit, all related acts or omissions committed in the providing or fail- ing to provide "incidental medical services" to any one person will be considered one "oc- currence". 6. The following is added to Paragraph 4.b., Ex- cess Insurance, of SECTION IV — COM- MERCIAL GENERAL LIABILITY CONDI- TIONS: This insurance is excess over any valid and collectible other insurance, whether primary, excess, contingent or on any other basis, that is available to any of your "employees" for "bodily injury" that arises out of providing or failing to provide "incidental medical services" to any person to the extent not subject to Paragraph 2.a.(1) of SECTION II — WHO IS AN INSURED. I. PERSONAL INJURY — ASSUMED BY CON- TRACT 1. The following replaces Exclusion e., Contrac- tual Liability, in Paragraph 2. of SECTION I — COVERAGES — COVERAGE B PER- SONAL AND ADVERTISING INJURY LI- ABILITY: e. Contractual Liability "Personal injury" or "advertising injury" 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: (1) Liability for damages that the insured would have in the absence of the contract or agreement; or (2) Liability for damages because of "personal injury" assumed in a con- tract or agreement that is an "insured contract", provided that the "personal injury" is caused by an offense com- mitted subsequent to the execution of the contract or agreement. Solely for the purposes of liability assumed in an "insured contract ", reasonable at- tomeys fees and necessary litigation expenses incurred by or for a party other than an insured will be deemed to be damages because of "personal injury", provided that: (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 attorney fees and litigation expenses are for defense of that party against a civil or alternative dispute resolution proceeding in which damages to which this in- surance applies are alleged. 2. The following replaces the third sentence of Paragraph 2. of SUPPLEMENTARY PAY- MENTS — COVERAGES A AND B: Notwithstanding the provisions or Paragraph 2.b.(2) of Section I — Coverage A — Bodily In- jury And Property Damage Liability or Para- graph 2.e. of Section I — Coverage B — Per- sonal and Advertising Injury Liability, such payments will not be deemed to be damages because of "bodily injury", "property damage" OF "personal injury", and will not reduce the limits of insurance. 3. The following replaces Paragraph 2.d. of SUPPLEMENTARY PAYMENTS — COVER- AGES A AND B: d. The allegations in the "suit" and the in- formation we know about the "occur- rence" or offense are such that no conflict appears to exist between the interests of the insured and the interests of the in- demnitee; 4. The following replaces the first subparagraph of Paragraph f. of the definition of "insured contract" in the DEFINITIONS Section: f. That part of any other contract or agree- ment pertaining to your business (includ- ing 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," "property damage" or "per- sonal injury" to a third person or organiza- tion. Tort liability means a liability that would be imposed by law in the absence of any contract or agreement. J. EXTENSION OF COVERAGE — BODILY IN- JURY The following replaces the definition of "bodily in- jury" in the DEFINITIONS Section: "Bodily injury" means bodily injury, mental an- guish, mental injury, shock, fright, disability, hu- miliation, sickness or disease sustained by a per- son, including death resulting from any of these at any time. Page 6 of 9 0 2008 The Travelers Companies, Inc. CG D4 5810 08 o� _ o� r U� K. BODILY INJURY TO CO- EMPLOYEES AND CO- VOLUNTEER WORKERS The following is added to Paragraph 2.a.(1) of SECTION II — WHO IS AN INSURED: Paragraph (1)(a) above does not apply to "bodily injury" to a co- "employee" in the course of the co- "employee's" employment by you or performing duties related to the conduct of your business, or to "bodily injury" to your other "volunteer workers" while performing duties related to the conduct of your business. L. AIRCRAFT CHARTERED WITH CREW The following is added to Exclusion g., Aircraft, Auto Or Watercraft, in Paragraph 2. of SECTION I — COVERAGES — COVERAGE A BODILY IN- JURY AND PROPERTY DAMAGE LIABILITY: This exclusion does not apply to an aircraft that is: (a) Chartered with crew to any insured; (b) Not owned by any insured; and (c) Not being used to cant' any person or prop- erty for a charge. M. NON -OWNED WATERCRAFT 1. The following replaces Paragraph (2) of Ex- clusion g., Aircraft, Auto Or Watercraft, in Paragraph 2. of SECTION I — COVERAGES — COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY: (2) A watercraft you do not own that is: (a) Fifty feet long or less; and (b) Not being used to cant' any person or property for a charge. 2. The following is added to Paragraph 2. of SECTION 11— WHO IS AN INSURED: Any person or organization that, with your ex- press or implied consent, either uses or is re- sponsible for the use of a watercraft that you do not own that is: (1) Fifty feet long or less; and (2) Not being used to carry any person or property for a charge. N. INCREASED SUPPLEMENTARY PAYMENTS 1. The following replaces Paragraph 1.b. of SUPPLEMENTARY PAYMENTS — COVER- AGES A AND B of SECTION I — COVER- AGES: b. Up to $2,500 for cost of bail bonds re- quired because of accidents or traffic law violations arising out of the use of any COMMERCIAL GENERAL LIABILITY vehicle to which the Bodily Injury Liability Coverage applies. We do not have to fur- nish these bonds. 2. The following replaces Paragraph 1.d. of SUPPLEMENTARY PAYMENTS — COVER- AGES A AND B of SECTION I — COVER- AGES: 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 $500 a day because of time off from work. O. MEDICAL PAYMENTS — INCREASED LIMITS The following replaces Paragraph 7. of SECTION III — LIMITS OF INSURANCE: 7. Subject to 5. above, the Medical Expense Limit is the most we will pay under Coverage C. for all medical expenses because of "bod- ily injury" sustained by any one person, and will be the higher of: (a) $10,000; or (b) The amount shown on the Declarations of this Coverage Part for Medical Expense Limit, P. KNOWLEDGE AND NOTICE OF OCCUR- RENCE OR OFFENSE The following is added to Paragraph 2., Duties In The Event of Occurrence, Offense, Claim or Suit, of SECTION IV — COMMERCIAL GEN- ERAL LIABILITY CONDITIONS: e. The following provisions apply to Paragraph a. above, but only for the purposes of the in- surance provided under this Coverage Part to you or any insured listed in Paragraph 1. or 2. of Section II —Who Is An Insured: (1) Notice to us of such "occurrence" or of- fense must be given as soon as practica- ble only after the "occurrence" or offense is known to you (if you are an individual), any of your partners or members who is an individual (if you are a partnership or joint venture), any of your managers who is an individual (if you are a limited liability company), any of your trustees who is an individual (if you are a trust), any of your "executive officers" or directors (if you are an organization other than a partnership, joint venture, limited liability company or trust) or any "employee" authorized by you to give notice of an "occurrence" or offense. CG D4 58 10 08 ® 2008 The Travelers Companies, Inc. 006819 Page 7 of 9 COMMERCIAL GENERAL LIABILITY (2) If you are a partnership, joint venture, lim- relied upon in issuing this policy will not prejudice ited liability company or trust, and none of your rights under this insurance. However, this your partners, joint venture members, provision does not affect our right to collect addi- managers or trustees are individuals, no- tional premium or to exercise our rights of cancel - tice to us of such "occurrence" or offense lation or nonrenewal in accordance with applica- must be given as soon as practicable only ble insurance laws or regulations. after the "occurrence" or offense is known R. REASONABLE FORCE — BODILY INJURY OR by: PROPERTY DAMAGE (a) Any individual who is: (i) A partner or member of any part- nership or joint venture; (ii) A manager of any limited liability company; (iii) A trustee of any trust; or (iv) An executive officer or director of any other organization; that is your partner, joint venture member, manager or trustee; or (b) Any "employee" authorized by such partnership, joint venture, limited li- ability company, trust or other organi- zation to give notice of an "occur- rence" or offense. (3) Notice to us of such "occurrence" or of- fense will be deemed to be given as soon as practicable if it is given in good faith as soon as practicable to your workers' compensation insurer. This applies only if you subsequently give notice to us of the "occurrence" or offense as soon as prac- ticable after any of the persons described in Paragraphs e.(1) or (2) above discov- ers that the "occurrence" or offense may result in sums to which the insurance provided under this Coverage Part may apply. However, if this policy includes an endorse- ment that provides limited coverage for "bod- ily injury" or "property damage" or pollution costs arising out of a discharge, release or escape of "pollutants" which contains a re- quirement that the discharge, release or es- cape of "pollutants" must be reported to us within a specific number of days after its abrupt commencement, this Paragraph e. does not affect that requirement. Q. UNINTENTIONAL OMISSION The following is added to Paragraph 6., Repre- sentations, of SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS: The unintentional omission of, or unintentional er- ror in, any information provided by you which we The following replaces Exclusion a., Expected Or Intended Injury, in Paragraph 2. of SECTION I — COVERAGES — COVERAGE A BODILY IN- JURY AND PROPERTY DAMAGE LIABILITY: a. Expected or Intended Injury or Damage "Bodily injury" or "property damage" expected or intended from the standpoint of the in- sured. This exclusion does not apply to "bod- ily injury" or "property damage" resulting from the use of reasonable force to protect any person or property. S. TRANSPORTATION EXPENSES FOR REPA- TRIATION OR RELOCATION OF INJURED OR SICK EMPLOYEES 1. The following is added to SUPPLEMENTARY PAYMENTS — COVERAGE A AND B of SECTION I — COVERAGES: We will reimburse you for the reasonable "transportation expenses" that you incur, over and above "normal transportation costs ", for the repatriation or relocation of any of your in- jured, diseased, sick or deceased "employ- ees". But only if: a. The injury, disease, sickness, or death occurred during the policy period and while such "employee" was employed or assigned to work by you anywhere in the world other than: (1) The United States of America (includ- ing its territories and possessions), Puerto Rico and Canada; and (2) Any country or jurisdiction in the "prohibited area "; b. The relocation or repatriation is neces- sary in the opinion of competent medical authorities; and c. The relocation or repatriation is from the country where the injury, disease, sick- ness, or death occurred to a destination in another country. The most we will pay as reasonable "trans- portation expenses" for the repatriation or re- location of any one of your "employees" is Page 8 of 9 0 2008 The Travelers Companies, Inc. CG D4 58 10 08 $25,000. The most we will pay as reasonable "transportation expenses" for the repatriation or relocation of all of your "employees" is $50,000. These payments will not reduce the limits of insurance. 2. The following is added to Paragraph 4.b., Ex- cess Insurance, of SECTION IV — COM- MERCIAL GENERAL LIABILITY CONDI- TIONS: This insurance is excess over any valid and collectible other insurance, whether primary, excess, contingent or on any other basis, that is available for the reasonable "transportation expenses" that you incur, over and above "normal transportation costs ", for the repatria- tion or relocation of any of your injured, dis- eased, sick or deceased "employees ". o r- m� row �r o� ow oC m� m- r. n� o i COMMERCIAL GENERAL LIABILITY 3. The following is added to the DEFINITIONS section: "Normal transportation costs" means the costs of transporting your "employee" in good health, and in conformance with your busi- ness travel policy, from the country of injury, disease, sickness, or death to the country of relocation or repatriation. "Transportation expenses" includes the fol- lowing expenses. a. Costs of embalming to meet United Stales standards; and b. All reasonable expenses of transportation to return the remains of the deceased to the country of burial or funeral. CG D4 58 10 08 ® 2008 The Travelers Companies, Inc. 008820 Page 9 of 9 POLICY NUMBER: 6300618L57814 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. OTHER INSURANCE - ADDITIONAL INSUREDS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PROVISIONS COMMERCIAL GENERAL LIABILITY CONDITIONS (Section IV), 'Paragraph 4.' (Other Insurance), is amended as follows: 1. The following is added to Paragraph a. Primary Insurance: However, if you specifically agree in a written con- tract or written agreement that the insurance pro- vided to an additional insured under this Coverage Part must apply on a primary basis, or a primary and non - contributory basis, this insur- ance is primary to other insurance that is avail- able to such additional insured which covers such additional insured as a named insured, and we will not share with that other insurance, provided that: a. The "bodily injury" or "property damage" for which coverage is sought occurs,, and m�– m•— o o� e= a o� r.. b. The "personal injury" or "advertising injury" for which coverage is sought arises out of an of- fense committed subsequent to the signing and execution of that contract or agreement by you. 2. The first Subparagraph (2) of Paragraph b. Ex- cess Insurance regarding any other primary in- surance available to you is deleted. 3. The following is added to Paragraph b. Excess Insurance, as an additional subparagraph under Subparagraph (1): That is available to the insured when the insured is added as an additional insured under any other policy, including any umbrella or excess policy. CG DO 37 04 05 Copyright 2005 The St. Paul Travelers Companies, Inc. All rights reserved. Page 1 of 1 006611 POLICY NUMBER: BA0618L578TIL14 COMMERCIAL AUTO THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY, BUSINESS AUTO EXTENSION ENDORSEMENT T This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modi- fied by the endorsement. GENERAL DESCRIPTION OF COVERAGE — This endorsement broadens coverage. However, coverage for any injury, damage or medical expenses described in any of the provisions of this endorsement may be excluded or limited by another endorsement to the Coverage Part, and these coverage broadening provisions do not apply to the extent that coverage is excluded or limited by such an endorsement. The following listing is a general cover- age description only. Limitations and exclusions may apply to these coverages. Read all the provisions of this en- dorsement and the rest of your policy carefully to determine rights, duties, and what is and is not covered. A. BROAD FORM NAMED INSURED B. BLANKET ADDITIONAL INSURED C. EMPLOYEE HIRED AUTO D. EMPLOYEES AS INSURED E. SUPPLEMENTARY PAYMENTS — INCREASED LIMITS F. HIRED AUTO — LIMITED WORLDWIDE COVERAGE — INDEMNITY BASIS G. WAIVER OF DEDUCTIBLE — GLASS PROVISIONS A. BROAD FORM NAMED INSURED The following is added to Paragraph A.1., Who Is An Insured, of SECTION II — LIABILITY COV- ERAGE: Any organization you newly acquire or form dur- ing the policy period over which you maintain 50% or more ownership interest and that is not separately insured for Business Auto Coverage. Coverage under this provision is afforded only un- til the 180th day after you acquire or form the or- ganization or the end of the policy period, which- ever is earlier. B. BLANKET ADDITIONAL INSURED H. HIRED AUTO PHYSICAL DAMAGE — LOSS OF USE — INCREASED UMIT I. PHYSICAL DAMAGE — TRANSPORTATION EXPENSES — INCREASED LIMIT J. PERSONAL EFFECTS K. AIRBAGS L. NOTICE AND KNOWLEDGE OF ACCIDENT OR LOSS M. BLANKET WAIVER OF SUBROGATION N. UNINTENTIONAL ERRORS OR OMISSIONS executed by you before the "bodily injury" or "property damage" occurs and that is in effect during the policy period, to be named as an addi- tional insured is an "insured" for Liability Cover- age, but only for damages to which this insurance applies and only to the extent that person or or- ganization qualifies as an "insured" under the Who Is An Insured provision contained in Section II. C. EMPLOYEE HIRED AUTO 1. The following is added to Paragraph A.1., Who Is An Insured, of SECTION II — LI- ABILITY COVERAGE: The following is added to Paragraph c. in A.1., An "employee" of yours is an "insured" while Who Is An Insured, of SECTION 11— LIABILITY operating an "auto" hired or rented under a COVERAGE: contract or agreement in that "employee's" name, with your permission, while performing Any person or organization who is required under duties related to the conduct of your busi- a written contract or agreement between you and ness. that person or organization, that is signed and CA T3 53 03 10 ® 2010 The Travelers Indemnity Company. Page 1 of 4 Includes copyrighted material of Insurance Services Office, Inc. with its permission. w� �s o� a o=� 001996 COMMERCIAL AUTO 2. The following replaces Paragraph b. in B.S., Other Insurance, of SECTION IV — BUSI- NESS AUTO CONDITIONS: b. For Hired Auto Physical Damage Cover- age, the following are deemed to be cov- ered "autos" you own: (1) Any covered "auto" you lease, hire, rent or borrow; and (2) Any covered "auto" hired or rented by your "employee" under a contract in that individual "employee's" name, with your permission, while perform- ing duties related to the conduct of your business. However, any "auto" that is leased, hired, rented or borrowed with a driver is not a covered "auto ". D. EMPLOYEES AS INSURED The following is added to Paragraph A.1., Who Is An Insured, of SECTION II — LIABILITY COW ERAGE: Any "employee" of yours is an "insured" while us- ing a covered "auto" you don't own, hire or borrow in your business or your personal affairs. E. SUPPLEMENTARY PAYMENTS — INCREASED LIMITS 1. The following replaces Paragraph A.2.a.(2), of SECTION II — LIABILITY COVERAGE: (2) Up to $3,000 for cost of bail bonds (in- cluding bonds for related traffic law viola- tions) required because of an "accident" we cover. We do not have to furnish these bonds. 2. The following replaces Paragraph A.2.a.(4), of SECTION II — LIABILITY COVERAGE: (4) All reasonable expenses incurred by the "insured" at our request, including actual loss of earnings up to $500 a day be- cause of time off from work. F. HIRED AUTO — LIMITED WORLDWIDE COW ERAGE — INDEMNITY BASIS The following replaces Subparagraph (5) in Para- graph B.7., Policy Period, Coverage Territory, of SECTION IV — BUSINESS AUTO CONDI- TIONS: (5) Anywhere in the world, except any country or jurisdiction while any trade sanction, em- bargo, or similar regulation imposed by the United States of America applies to and pro- hibits the transaction of business with or within such country or jurisdiction, for Liability Coverage for any covered "auto" that you lease, hire, rent or borrow without a driver for a period of 30 days or less and that is not an "auto" you lease, hire, rent or borrow from any of your "employees ", partners (if you are a partnership), members (if you are a limited liability company) or members of their house- holds. (a) With respect to any claim made or "suit" brought outside the United States of America, the territories and possessions of the United States of America, Puerto Rico and Canada: (i) You must arrange to defend the "in- sured" against, and investigate orset- tle any such claim or "suit" and keep us advised of all proceedings and ac- tions. (ii) Neither you nor any other involved "insured" will make any settlement without our consent. (iii) We may, at our discretion, participate in defending the "insured" against, or in the settlement of, any claim or "suit ". (iv) We will reimburse the "insured" for sums that the "insured" legally must pay as damages because of "bodily injury" or "property damage" to which this insurance applies, that the "in- sured" pays with our consent, but only up to the limit described in Para- graph C., Limit Of Insurance, of SEC- TION II — LIABILITY COVERAGE. (v) We will reimburse the "insured" for the reasonable expenses incurred with our consent for your investiga- tion of such claims and your defense of the "insured" against any such "suit", but only up to and included within the limit described in Para- graph C., Limit Of Insurance, of SECTION II — LIABILITY COVER- AGE, and not in addition to such limit. Our duty to make such payments ends when we have used up the ap- plicable limit of insurance in pay- ments for damages, settlements or defense expenses. (b) This insurance is excess over any valid and collectible other insurance available Page 2 of 4 02010 The Travelers Indemnity Company. CA T3 53 03 10 Includes copyrighted material of Insurance Services Office, Inc. with its permission. to the "insured" whether primary, excess contingent or on any other basis. (c) This insurance is not a substitute for re- quired or compulsory insurance in any country outside the United States, its ter- ritories and possessions, Puerto Rico and Canada. You agree to maintain all required or compulsory insurance in any such coun- try up to the minimum limits required by local law. Your failure to comply with compulsory insurance requirements will not invalidate the coverage afforded by this policy, but we will only be liable to the same extent we would have been liable had you complied with the compulsory in- surance requirements. (d) It is understood that we are not an admit- ted or authorized insurer outside the United States of America, its territories and possessions, Puerto Rico and Can- ada. We assume no responsibility for the furnishing of certificates of insurance, or for compliance in any way with the laws of other countries relating to insurance. G. WAIVER OF DEDUCTIBLE— GLASS The following is added to Paragraph D., Deducti- ble, of SECTION III — PHYSICAL DAMAGE COVERAGE: No deductible for a covered "auto" will apply to glass damage if the glass is repaired rather than replaced. H. HIRED AUTO PHYSICAL DAMAGE — LOSS OF USE — INCREASED LIMIT The following replaces the last sentence of Para- graph A.4.b., Lass Of Use Expenses, of SEC- TION III — PHYSICAL DAMAGE COVERAGE: However, the most we will pay for any expenses for loss of use is $65 per day, to a maximum of $750 for any one "accident ". I. PHYSICAL DAMAGE — TRANSPORTATION EXPENSES — INCREASED LIMIT The following replaces the first sentence in Para- graph A.4.a., Transportation Expenses, of SECTION III — PHYSICAL DAMAGE COVER- AGE: We will pay up to $50 per day to a maximum of $1,500 for temporary transportation expense in- curred by you because of the total theft of a cov- ered "auto" of the private passenger type. COMMERCIAL AUTO J. PERSONAL EFFECTS The following is added to Paragraph AA., Cover- age Extensions, of SECTION III — PHYSICAL DAMAGE COVERAGE: Personal Effects We will pay up to $400 for "loss" to wearing ap- parel and other personal effects which are: (1) Owned by an "insured "; and (2) In or on your covered "auto ". This coverage applies only in the event of a total theft'of your covered "auto ". No deductibles apply to this Personal Effects coverage. K. AIRBAGS The following is added to Paragraph B.3., Exclu- sions, of SECTION III — PHYSICAL DAMAGE COVERAGE: Exclusion 3.a. does not apply to "loss" to one or more airbags in a covered "auto" you own that in- flate due to a cause other than a cause of "loss" set forth in Paragraphs A.1.b. and A -1.c., but only: a. If that "auto" is a covered "auto" for Compre- hensive Coverage under this policy; b. The airbags are not covered under any war- ranty; and c. The airbags were not intentionally inflated. We will pay up to a maximum of $1,000 for any one "loss ". L. NOTICE AND KNOWLEDGE OF ACCIDENT OR LOSS The following is added to Paragraph A.2.a., of SECTION IV — BUSINESS AUTO CONDITIONS: Your duty to give us or our authorized representa- tive prompt notice of the "accident" or "loss" ap- plies only when the 'accident" or "loss" is known to: (a) You (if you are an individual); (b) A partner (if you are a partnership); (c) A member (if you are a limited liability com- pany); (d) An executive officer, director or insurance manager (if you are a corporation or other or- ganization); or (e) Any "employee" authorized by you to give no- tice of the "accident" or "loss ". CA T3 53 03 10 0 2010 The Travelers Indemnity Company. Page 3 of 4 Includes copyrighted material of Insurance Services Office, Inc. with its permission. COMMERCIAL AUTO M. BLANKET WAIVER OF SUBROGATION The following replaces Paragraph A.S., Transfer Of Rights Of Recovery Against Others To Us. of SECTION IV — BUSINESS AUTO CONDI- TIONS: S. Transfer Of Rights Of Recovery Against Others To Us We waive any right of recovery we may have against any person or organization to the ex- tent required of you by a written contract signed and executed prior to any "accident" or "loss ", provided that the "accident' or "loss" arises out of operations contemplated by o= o= a= o n hT O� Page 4 of 4 001996 such contract. The waiver applies only to the person or organization designated in such contract. N. UNINTENTIONAL ERRORS OR OMISSIONS The following is added to Paragraph B.2., Con- cealment, Misrepresentation, Or Fraud, of SECTION IV — BUSINESS AUTO CONDITIONS: The unintentional omission of, or unintentional error in, any information given by you shall not prejudice your rights under this insurance. How- ever this provision does not affect our right to col- lect additional premium or exercise our right of cancellation or non - renewal. © 2010 The Travelers Indemnity Company. CA T3 53 03 10 Includes copyrighted material or Insurance Services Office, Inc. with Its permission.