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PROOF OF INSURANCE (2018 - 2018) CLOSED " CERTIFi%.,ATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) C 10/13/2017 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(les)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In lieu of such ondorsernent(s). PRODUCEReCONTACT su � ON A� CM.Trane services, LLC N IIm) am Insurance Sa.r...rr..A. .i..c.�..C.e.. .u.S....l(..e_..L.9....L......0 An Affiliate of United A oraclesd Inc. PI° _ _ I FAX iourte rIV �te. 190 E MA LLaguna Halls, CA A6DIRL �; . etisunitedcrntedaenc%oe.oam .... ... ..... IN'SURFIR(S)AFFORDINGCOVERAGE ( NAICp OG23764 p.,rty Casualty Co of Amer 25674 .... ... .. INsuIz,E .... er BackflowINSURER C: p 27847 Apparatus Valve Company INSUR R B: Insurance Com anv of the West INSURE 20435 S. Susana Road ...........ff.. R.. .... Long Beach CA 90810 INSURERD: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 38371713 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 'ERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH 'OLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. .ILTS'Id TYPE OF INSURANCE ��6UNA v4vn POLICY NUMBER (M A 0DYIYYYYi (I�IMiDDPYYdUdY YY1 LIMITS A COMMERCIAL GENERAL w _................................. 1,000,000 IwaiuTY 630-8,1664090 10/31/2017 10/31/2018 EACH OCCURRENCEPR_EMSEs�Eaz NSE an CLAIMS-MADE OCCUR cu 100,000 ✓ ✓ E $...)......... .MED EXP(Any one Person)-........ $..........,, 5,000' ............................... ... ......................................... PERSONAL$ADV INJURY .. . . GENERAL-.......,.m ................ $ 1,000,0....1.0. .0 GEN AGGREGATE IMTAPPLIESPER: AGGRG 00 PRO POLICY L �_ OLOC PRODUCTS COMP/OPAGG $ 2,000 0 .. 0 OTHER; $ A AUTOMOBILE LIABILITY BA-8,1664090 10/31/2017 10/31/2018 COMBINED SINGLE LIMIT $ 1 p000rt000 ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY Per accident) $ HIRED✓ i RRpPERT bAWNED ..................AUTOS ONLY AUTOS ONLY _P'ar MAGE accl�a SD $ .............................. A UMBRELLA LIAB OCCUR CUP-9,1209005 10/31/2017 10/31/2018 AGGREGATE _ $ 5,000,000 EXCESS LIAB CLAIMS-MADE EACH OCCURRENCE DED RETENTION$ B WORKERS COMPESATION AND MPLOYERS'LIABILIITY YIN N ✓ WSD 5027341 03 8/27/2017 8/27/2018 i._eTnTUTE....0ER" ANYPROPRIETOR/PARTNER/EXECUTIVE MPLOYEE: $ 1,,.:000,00Q1. OFFICE .0010 OFFICER/MEMBEREXCLUDED? Y N/A E.L.EACH ACCIDENT , (Mandatory in NH E.L.DISEASE-EA E If yes,describe under OOO DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) The City of EI Segundo,its officers,agents„and employees are added as additional Insureds on the general liability policy only per the attached. Waiver of Subrogation is included in the general liability and work comp policies only per the attached forms. CE'R'TIFICATE HOLDER CANCELLATION' Cit O El Se 'Uhid'O SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN P'U INC'V1JOrk Dept. ACCORDANCE WITH THE POLICY PROVISIONS. 350 Main St. EI Segundo CA 90245 AUTHORIZED REPRESENTATIVE u Gary Champlin ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD 630-8J664090 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY BLANKET ADDITIONAL INSURED (CONTRACTORS) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART 1. WHO IS AN INSURED — (Section II) is amended c) The insurance provided to the additional in- to include any person or organization that you sured does not apply to "bodily injury" or agree in a "written contract requiring insurance" "property damage" caused by "your work" to include as an additional insured on this Cover- and included in the "products-completed op- age Part, but: erations hazard" unless the "written contract a) Only with respect to liability for "bodily injury", requiring insurance" specifically requires you "property damage" or"personal injury"; and to provide such coverage for that additional insured, and then the insurance provided to b) If, and only to the extent that, the injury or the additional insured applies only to such damage is caused by acts or omissions of "bodily injury" or "property damage" that oc- you or your subcontractor in the performance curs before the end of the period of time for of "your work" to which the "written contract which the "written contract requiring insur- requiring insurance applies. The person or ance" requires you to provide such coverage organization does not qualify as an additional or the end of the policy period, whichever is insured with respect to the independent acts earlier. or omissions of such person or organization. 3. The insurance provided to the additional insured 2. The insurance provided to the additional insured by this endorsement is excess over any valid and by this endorsement is limited as follows: collectible "other insurance", whether primary, a) In the event that the Limits of Insurance of excess, contingent or on any other basis, that is this Coverage Part shown in the Declarations available to the additional insured for a loss we exceed the limits of liability required by the cover under this endorsement. However, if the "written contract requiring insurance", the in- "written contract requiring insurance" specifically surance provided to the additional insured requires that this insurance apply on a primary shall be limited to the limits of liability re- basis or a primary and non-contributory basis, quired by that "written contract requiring in- this insurance is primary to "other insurance" surance". This endorsement shall not in- available to the additional insured which covers crease the limits of insurance described in that person or organization as a named insured Section III—Limits Of Insurance. for such loss, and we will not share with that �� "other insurance". But the insurance provided to b) The insurance providedto the additional in- the additional insured by this endorsement still is sured does not apply to bodily injury", prop- excess over any valid and collectible "other in- of damage or personal injuryarising out surance", whether primary, excess, contingent or of the rendering of, or failure to render, any on any other basis, that is available to the addi- professional architectural, engineering or sur- tional insured when that person or organization is veying services, including: an additional insured under such "other insur- i. The preparing, approving, or failing to ance". prepare or approve, maps, shop draw- 4. As a condition of coverage provided to the ings, opinions, reports, surveys, field or- additional insured by this endorsement: ders or change orders, or the preparing, approving, or failing to prepare or ap- a) The additional insured must give us written prove, drawings and specifications; and notice as soon as practicable of an "occur- rence" or an offense which may result in a "occur- 1111. Supervisory, inspection, architectural or claim. To the extent possible, such notice engineering activities. should include: CG D2 46 08 05 0 2005 The St. Paul Travelers Companies, Inc. Page 1 of 2 COMMERCIAL GENERAL LIABILITY I. How, when and where the "occurrence" any provider of"other insurance"which would oroffense took place; cover the additional insured for a |000 we l ^ The names and addresses ofany injured cover under this endorsement, However, this condition dmyn not affect whether the ineur- permonn �ndvvUno�o�o� end onca provided to the additional insured by III. The nadVoo and location ofany injury or this endorsement is primary to "other |nsur- dannm0aahaingoutofthe ~ocuunmncm"or once" available to the additional insured offense. which covers that person or organization as m b\ If a claim is made or "suit" is brought against named insured as described in paragraph 3. ' the additional insured, the additional insured above. must: 5. The following definition ioadded ho SECTION V. k Immediately record the opeoUDoa of the —DEF|N|T|{}N@: claim or"auiC' and the date received; and "Written contract requiring insurance" means ki. NoUfvuaoa000n �opmocticeb|m. that padofany vvri�enoon�mctoragreement ^ under which you mn» required to include a The additional insured must see to itthat vvm person or organization a� an additional in- sured written notice of the claim or"suit" as on this Coverage Part, provided that soon mepracticable. the "bodily injury" and "property damage" un- c) The additional insured must immediately curs and the "personal i 'uwriooausedbvan send uacopies ofall legal papers received in offense committed: connection with the claim or "suit", cooperate m. After the signing and execution of the with us in the investigation o, settlement of contract oragreement bvyou; the claim or defense against the "suit", and ' otherwise comply with all policy conditions. b. While that part of the contract or d'� The additional insured must tender the do- agreement ioineffect; and fenee and indemnity of any claim or "suit" to c. Before the end ofthe policy period. Page 2of2 0 2005 The St. Paul Travelers Companies, Inc. CG D2 46 0805 630-8,1664090 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. XTEN'D ENDORSEMENT FOR COMMERCIAL INDUSTRIES 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 J. Bodily Injury To Co-Employees And Co-Volunteer B. Blanket Additional Insured—Broad Form Vendors Workers C. Damage To Premises Rented To You K. Aircraft Chartered With Crew • Perils of fire, explosion, lightning, smoke, L. Non-Owned Watercraft— Increased From 25 Feet water To 50 Feet • Limit increased to$300,000 M. Increased Supplementary Payments D. Blanket Waiver Of Subrogation 0 Cost of bail bonds increased to$2,500 E. Blanket Additional Insured — Owners, Managers 0 Loss of earnings increased to$500 per day Or Lessors Of Premises F. Blanket Additional Insured — Lessors Of Leased N. Medical Payments- Increased Limit Equipment O. Knowledge And Notice Of Occurrence Or Offense G. Incidental Medical Malpractice P. Unintentional Omission H. Personal Injury—Assumed By Contract Q. Reasonable Force — Bodily Injury Or Property I. Amended Bodily Injury Definition Damage PROVISIONS B. BLANKET ADDITIONAL INSURED — BROAD A. BROADENED NAMED INSURED FORM VENDORS 1. The following is added to SECTION 11—WHO The following is added to SECTION 11 — WHO IS IS AN INSURED: AN INSURED: Any organization, other than a partnership or Any person or organization that is a vendor and joint venture, over which you maintain owner- that you have agreed in a written contract or ship or majority interest on the effective date agreement to include as an additional insured on of the policy qualifies as a Named Insured. this Coverage Part is an insured, but only with re- However, coverage for any such organization spect to liability for "bodily injury" or "property will cease as of the date during the policy pe- damage"that: riod that you no longer maintain ownership of, or majority interest in, such organization. a. Is caused by an "occurrence" that takes place after you have signed and executed that con- t. The following replaces Paragraph 4.a. of tract or agreement; and SECTION II—WHO IS AN INSURED: a. Coverage under this provision is afforded b. Arises out of "your products" which are dis- only until the 180th day after you acquire tributed or sold in the regular course of such or form the organization or the end of the vendor's business. policy period, whichever is earlier, unless The insurance provided to such vendor is subject reported in writing to us within 180 days. to the following provisions: CG D4 58 07 13 ©2013 The Travelers Indemnity Company.All rights reserved. Page 1 of 7 Includes copyrighted material of Insurance Services Office,Inc.with its permission. COMMERCIAL GENERAL LIABILITY a. The limits mfinsurance provided tnsuch vmn- JURY AND PROPERTY DAMAGE LIABIK= dormiUbethm |inohaxvhichyouagnmmdtopro- ITY: vide in the written contract or agreement, or Exclusions c.through In. do not apply to dam- the limits shown in the Declarations of this age to pnern\oew while rented to you, ortem- Coverage Part, whichever are less. pomari|y occupied by you with permission of b' The insurance provided to such vendor does the owner, caused by: not apply to: m- Fina; (1) "Bodily injury" or "property damage" for b. Explosion; which the vendor is obligated to pay o Lightning' dan0agam by reason of the assumption of ' ' ||abi|�v in ' contract or agreement. This d. Smoke resulting from such fire, exp|onion, exclusion does not apply bzliability for orlightning; or damages that the vendor would have in e. Water. the absence ofthe contract oragn*enment' ' A separate limit ofinsurance applies to such (2) Any express warranty unauthorized by damage to pnynnioos as described in Para- you; graph 6.ofSection III—Limits[)fInsurance. (3) Any physical mrchemical change in "your This insurance dose not apply todamage to products" made intentionally by such premises while rented to you, or temporarily vendor; occupied by you with permission of the (4) Repackaging, unless unpacked solely for owner, caused by: the purpose of inspection, demonstration, a' Ruptupe, bursting, or operation of pmeo- 0oaUng, or the substitution of parts under sure relief devices; instructions from the manufacturer, and � Rupture orbu�t|ng due to expansion or c then repackaged inthe original oonta(ne ' � swelling ofthe contents ofany building or (5) Any failure tomake such inspections, ad- structure, caused bvorresulting from vva- ' ^uetmonha, tests or servicing as vendors ter; agree ' = o' Explosion of steam boilers, steam pipes, pe�mrminthmmogu|aroouramofbuoinmso' steam enginesmrotaanm1urbine� in connection with the distribution or sale ' ' of"your 2' The foUovvngreplaces Paragraph 8. cf S�|�~ ' �U��� VUU—��&8��� ����U���k�������2 �� Demonstration, installation, servicing �r ' ' repair operations, except such operations Subject to 5' above, the Damage To Prem- performed at such vendor's premises in imeo Rented To You Limit is the most we will connection with the oa|a of 'your prod- pay under Coverage Afor damages because ucts"; Vr of "property damage" to to any one premises (�� "Your pn)du�o"vvhioh, after distribution or while Mmnhmd to you, or temporarily occupied ` ' oa|m by you, have been |oUe|md or nw|a- by you with permission of the owner, caused be|ed or used as a container, part orin- by fire; explosion; lightning smoke resulting dient of any other thing or substance from such fire, eop|ooion, or lightning; orvvm- - orforouohvandmr. tar. �he Damage To Premises Rented To ' You Limit will apply to all damage proximately<�uverogmund�rth|mpnn/i�iondoaonotmpp|yto� ~ caused by the same "occurrence", whethera. Any person oroD@am�adon �mrn ««honlyou such damage p�eu|ta from fire; explosion; have acquired "your products", o� anY inQm+ lightning; smoke resulting from such fire, ex- ' �ient' pad or container entering into, aoco�� plosion, or lightning; water; or any conob\na- panyingorcPntminin0ouohpnoducto' �r timnofmnyofthmom. b. Any vendor for vvhich coverage as an addi- The Damage To Premises Rented To You tiona| insured mpmcifiooUyioscheduled bven-' dorsenent. Limit will bethe higher of: C. DAMAGE TO PREMISES RENTED TO YOU a' $300,000;or 1' The following nap|eoes the last paragraph of b. The amount shown onthe Declarations of Paragraph SECTIONna h �'. ������Umm�. SECTION V _ this Coverage Pa�for Damage To Prem- K� ~ -- ES — COVERAGE ABODILY IN- ises Rented To You Limit. Page 2of7 @2o13The Travelers indemnity Company.All rights reserved. CG D458 07 13 Includes copyrighted material of Insurance Services Office,Inc.with its permission. COMMERCIAL GENERAL LIABILITY 3. The following replaces Paragraph a. of the a. Is "bodily injury" or"property damage" caused definition of "insured contract" in the DEFINI- by an "occurrence" that takes place, or "per- TIONS Section: sonal injury" or "advertising injury" caused by a. A contract for a lease of premises. How- an offense that is committed, after you have ever, that portion of the contract for a signed and executed that contract or agree- lease of premises that indemnifies any ment; and person or organization for damage to b. Arises out of the ownership, maintenance or premises while rented to you, or tempo- use of that part of any premises leased to rarily occupied by you with permission of you. the owner, caused by: The insurance provided to such premises owner, (1) Fire; manager or lessor is subject to the following pro- (2) Explosion; visions: (3) Lightning; a. The limits of insurance provided to such premises owner, manager or lessor will be (4) Smoke resulting from such fire, ex- the limits which you agreed to provide in the plosion, or lightning; or written contract or agreement, or the limits (5) Water. shown on the Declarations of this Coverage Part, whichever are less. is not an "insured contract"; b. The insurance provided to such premises 4. The following replaces Paragraph 4.b.(1)(b) owner, manager or lessor does not apply to: of SECTION IV — COMMERCIAL GENERAL (1) "Bodily injury" or "property damage" LIABILITY CONDITIONS: caused by an "occurrence" that takes (b) That is insurance for premises rented to place, or "personal injury" or "advertising you, or temporarily occupied by you with injury" caused by an offense that is com- the permission of the owner; mitted, after you cease to be a tenant in D. BLANKET WAIVER OF SUBROGATION that premises; or The following is added to Paragraph 8., Transfer (2) Structural alterations, new construction ordemolition operations performed by or on Of Rights Of Recovery Against Others To Us, behalf of such premises owner, manager of SECTION IV — COMMERCIAL GENERAL LI- or lessor. a ABILITY CONDITIONS: c. The insurance provided to such premises We waive any right of recovery we may have owner, manager or lessor is excess over any against any person or organization because of valid and collectible other insurance available payments we make for injury or damage arising to such premises owner, manager or lessor, out of premises owned or occupied by or rented unless you have agreed in a written contract or loaned to you; ongoing operations performed for this insurance to apply on a primary or by you or on your behalf, done under a contract contributory basis. with that person or organization; "your work"; or F. BLANKET ADDITIONAL INSURED — LESSORS "your products". We waive this right where you OF LEASED EQUIPMENT have agreed to do so as part of a written contract, The following is added to SECTION II— WHO IS executed by you prior to loss. AN INSURED: E. BLANKET ADDITIONAL INSURED — OWNERS, Any person or organization that is an equipment MANAGERS OR LESSORS OF PREMISES lessor and that you have agreed in a written con- The following is added to SECTION II — WHO IS tract or agreement to include as an additional in- AN INSURED: sured on this Coverage Part is an insured, but Any person or organization that is a premises only with respect to liability for "bodily injury", owner, manager or lessor and that you have `property"damage"', "personal injury" or "advertis- agreed in a written contract or agreement to ing injurythat: name as an additional insured on this Coverage a. Is "bodily injury" or"property damage" caused Part is an insured, but only with respect to liability by an "occurrence" that takes place, or "per- for "bodily injury", "property damage", "personal sonal injury" or "advertising injury" caused by injury" or"advertising injury"that: an offense that is committed, after you have CG D4 58 07 13 ©2013 The Travelers Indemnity Company.All rights reserved. Page 3 of 7 Includes copyrighted material of Insurance Services Office,Inc.with its permission. COMMERCIAL GENERAL LIABILITY signed and executed that contract or agree- 3. The following is added to Paragraph 2.a.(1) of ment; and SECTION II—WHO IS AN INSURED: b. Is caused, in whole or in part, by your acts or Unless you are in the business or occupation omissions in the maintenance, operation or of providing professional health care services, use by you of equipment leased to you by Paragraphs (1)(a), (b), (c) and (d) above do such equipment lessor. not apply to any "bodily injury" arising out of The insurance provided to such equipment lessor any providing or failing to provide "incidental medical services" by any of your"employees", is subject to the following provisions: other than an employed doctor. Any such a. The limits of insurance provided to such "employees" providing or failing to provide equipment lessor will be the limits which you "incidental medical services" during their work agreed to provide in the written contract or hours for you will be deemed to be acting agreement, or the limits shown on the Decla- within the scope of their employment by you rations of this Coverage Part, whichever are or performing duties related to the conduct of less. your business. b. The insurance provided to such equipment 4. The following exclusion is added to Para- lessor does not apply to any "bodily injury" or graph 2., Exclusions, of SECTION I — COV- "property damage"caused by an "occurrence" ERAGES — COVERAGE A BODILY INJURY that takespersonal injury" or ad- , or "laceAND PROPERTY DAMAGE LIABILITY: p vertising injury" caused by an offense that is Sale Of Pharmaceuticals committed, after the equipment lease expires. "Bodily injury" or "property damage" arising c. The insurance provided to such equipment out of the willful violation of a penal statute or lessor is excess over any valid and collectible ordinance relating to the sale of pharmaceuti- other insurance available to such equipment cals committed by, or with the knowledge or lessor, unless you have agreed in a written consent of, the insured. contract for this insurance to apply on a pri- 5. The following is added to Paragraph 5. of mary or contributory basis. SECTION III— LIMITS OF INSURANCE: G. INCIDENTAL MEDICAL MALPRACTICE For the purposes of determining the applica- ble1. The following is added to the definition of"oo- Each Occurrence Limit, all related acts or omissions committed in the providing or fail- currence" in the DEFINITIONS Section: ing to provide "incidental medical services" to Unless you are in the business or occupation any one person will be considered one "oc- of providing professional health care services, currence". "occurrence" also means an act or omission 6. The following is added to Paragraph 4.b., Ex- committed in providing or failing to provide cess Insurance, of SECTION IV — COM- "incidental medical services"to a person. MERCIAL GENERAL LIABILITY CONDI- 2. The following is added to the DEFINITIONS TIONS: Section: This insurance is excess over any valid and "Incidental medical services" means: collectible other insurance, whether primary, excess, contingent or on any other basis, that a. Medical, surgical, dental, laboratory, x-ray is available to any of your "employees" for or nursing service or treatment, advice or "bodily injury" that arises out of providing or instruction, or the related furnishing of failing to provide "incidental medical services" food or beverages; to any person to the extent not subject to b. The furnishing or dispensing of drugs or Paragraph 2.a.(1) of SECTION II — WHO IS medical, dental, or surgical supplies or AN INSURED. appliances; H. PERSONAL INJURY — ASSUMED BY CON- c. First aid; or TRACT d. "Good Samaritan services". 1. The following replaces Exclusion e., Contrac- tual Liability, in Paragraph 2. of SECTION I "Good Samaritan services" means any emer- — COVERAGES — COVERAGE B PER- gency medical services for which no compen- SONAL AND ADVERTISING INJURY LI- sation is demanded or received. ABILITY: Page 4 of 7 ©2013 The Travelers Indemnity Company.All rights reserved. CG D4 58 07 13 Includes copyrighted material of Insurance Services Office,Inc.with its permission. COMMERCIAL GENERAL LIABILITY e. Contractual Liability the insured and the interests of the in- "Personal injury" or"advertising injury' for demnitee; which the insured is obligated to pay 4. The following replaces the first subparagraph damages by reason of the assumption of of Paragraph f. of the definition of "insured liability in a contract or agreement. This contract" in the DEFINITIONS Section: exclusion does not apply to: f. That part, of any other contract or agree- (1) Liability for damages that the insured ment pertaining to your business (includ- would have in the absence of the ing an indemnification of a municipality in contract or agreement; or connection with work performed for a municipality) under which you assume the (2) Liability for damages because of tort liability of another party to pay for "personal injury" assumed in a con- "bodily injury," "property damage" or"per- tract oragreement that is an "insured conal injury" to a third, person or organiza- contract', provided that the "personal tion. Tort liability means a liability that injury" is caused by an offense com- would be imposed by law in the absence miffed subsequent to the execution of of any contract or agreement. the contract or agreement. Solely for 1. AMENDED BODILY INJURY DEFINITION the purposes of liability assumed in an "insured contract", reasonable at- The following replaces the definition of"bodily in- torneys fees and necessary litigation jury" in the DEFINITIONS Section: expenses incurred by or for a party "Bodily injury" means bodily injury, mental an- other than an insured will be deemed guish, mental injury, shock, fright, disability, hu- to be damages because of "personal miliation, sickness or disease sustained by a per injury" provided that: son,, including death resulting from any of these at (a) Liability to such party for, or for any time. the cost of, that party's defense J. BODILY INJURY TO CO-EMPLOYEES AND has also been assumed in the CO-VOLUNTEER WORKERS same"insured contract"; and The following is added to Paragraph 2.a.(1) of (b) Such attorney fees and litigation SECTION 11—WHO IS AN INSURED: expenses are for defense of that Paragraph (1)(a) above does not apply to "bodily party against a civil or alternative injury" to a co-"employee" in the Course of the co- dispute resolution proceeding in ""employee's'" employment by you or performing which damages to which this in- duties related to the, conduct of your business, or surance applies are alleged. to "'bodily injury"' to your other "Volunteer workers" 2. The following replaces the third sentence of while performing duties related to the conduct of your business. Paragraph 2. of SUPPLEMENTARY PAY- MENTS—COVERAGES A AND B: K. AIRCRAFT CHARTERED WITH CREW Notwithstanding the provisions of Paragraph The following is added to Exclusion g., Aircraft, 2.b.(2) of Section I — Coverage A— Bodily In Auto Or Watercraft, in Paragraph 2. of SECTION jury And Property Damage Liability or Para- I — COVERAGES — COVERAGE A BODILY IN- JURY AND PROPERTY DAMAGE LIABILITY: graph 2.e. of Section I — Coverage B — Per- This exclusion does not apply to an aircraft that sonal and Advertising Injury Liability, such is: payments will not be deemed to be damages because of "bodily injury", "property damage" (a) Chartered with crew to any insured; or "personal injury", and will not reduce the (b) Not owned by any insured; and limits of insurance. (c) Not being used to carry any person or prop- 3. The following replaces Paragraph 2.d. of erty for a charge. SUPPLEMENTARY PAYMENTS — COVER- L. NON-OWNED WATERCRAFT AGES A AND B: 1. The following replaces Paragraph (2) of Ex- d. The allegations in the "suit" and the in- clusion 9., Aircraft, Auto Or Watercraft, in formation we know about the "occur- Paragraph 2. of SECTION I — COVERAGES rence" or offense are such that no conflict — COVERAGE A BODILY INJURY AND appears to exist between the interests of PROPERTY DAMAGE LIABILITY: CG D4 58 07 13 @ 2013 The Travelers indemnity Company.All rights reserved. Page 5 of 7 Includes copyrighted material of Insurance Services Office,Inc.with its permission. COMMERCIAL GENERAL LIABILITY (2) A watercraft you do not own that is: e. The following provisions apply to Paragraph (a) Fifty feet long or less; and a. above, but only for the purposes of the in- (b) Not being used to car an surance provided under this Coverage Part to g carry y person or property for a charge. you or any insured listed in Paragraph 1. or 2. of Section II—Who Is An Insured: 2. The following is added to Paragraph 2. of (1) Notice to us of such "occurrence" or of- fense must be given as soon as practica- Any person or organization that, with your ex- ble only after the "occurrence" or offense press or implied consent, either uses or is re- is known to you (if you are an individual), sponsible for the use of a watercraft that you any of your partners or members who is do not own that is: an individual (if you are a partnership or (1) Fifty feet long or less; and joint venture), any of your managers who (2) Not being used to carry any person or is an individual (if you are a limited liability property for a charge. company), any of your trustees who is an M. INCREASED SUPPLEMENTARY PAYMENTS individual (if you are a trust), any of your "executive officers" or directors (if you are 1. The following replaces Paragraph 1.b. of an organization other than a partnership, SUPPLEMENTARY PAYMENTS — COVER- joint venture, limited liability company or AGES A AND B of SECTION I — COVER- trust) or any "employee" authorized by AGES: you to give notice of an "occurrence" or b. Up to $2,500 for cost of bail bonds re- offense. quired because of accidents or traffic law 2 If violations arising out of the use of any ( ) you area partnership,joint venture, lim- vehicle to which the Bodily Injury Liability ited liability company or trust, and none of your partners, joint venture members, Coverage applies. We do not have to fur- nish these bonds. managers or trustees are individuals, no- tice to us of such "occurrence" or offense 2. The following replaces Paragraph 1.d. of must be given as soon as practicable only SUPPLEMENTARY PAYMENTS — COVER- after the "occurrence" or offense is known AGES A AND B of SECTION I — COVER- by: AGES: d. All reasonable expenses incurred by the (a) Any individual who is: insured at our request to assist us in the (I) A partner or member of any part- investigation or defense of the claim or nership or joint venture; "suit including actual loss of earnings up (ii) A manager of any limited liability to $500 a day because of time off from company; work. (iii)A trustee of any trust; or N. MEDICAL PAYMENTS—INCREASED LIMIT (iv)An executive officer or director of The following replaces Paragraph 7. of SECTION any other organization; III— LIMITS OF INSURANCE: 7. Subject to 5. above, the Medical Expense that is your partner, joint venturemember, manager or trustee; or Limit is the most we will pay under Coverage C. for all medical expenses because of"bod- (b) Any "employee" authorized by such ily injury" sustained by any one person, and partnership, joint venture, limited li- will be the higher of: ability company, trust or other organi- (a) $10,000; or zation to give notice of an "occur- rence"or offense. (b) The amount shown on the Declarations of this (3) Notice to us of such "occurrence" or of- LimitCoverage Part for Medical Expense fense will be deemed to be given as soon as practicable if it is given in good faith as O. KNOWLEDGE AND NOTICE OF OCCUR- soon as practicable to your workers' RENCE OR OFFENSE compensation insurer. This applies only if The following is added to Paragraph 2., Duties In you subsequently give notice to us of the The Event of Occurrence, Offense, Claim or "occurrence" or offense as soon as prac- Suit, of SECTION IV — COMMERCIAL GEN- ticable after any of the persons described ERAL LIABILITY CONDITIONS: in Paragraphs e.(1) or (2) above discov- Page 6 of 7 ©2013 The Travelers Indemnity Company.All rights reserved. CG D4 58 07 13 Includes copyrighted material of Insurance Services Office,Inc.with its permission. COMMERCIAL GENERAL LIABILITY ers that the "occurrence" or offense may your rights under this insurance. However, this result in sums to which the insurance provision does not affect our right to collect addi- provided under this Coverage Part may tional premium or to exercise our rights of cancel- apply. lation or nonrenewal in accordance with applica- However, if this policy includes an endorse- ble insurance laws or regulations. ment that provides limited coverage for "bod- Q REASONABLE FORCE — BODILY INJURY OR ily injury' or "property damage" or pollution PROPERTY DAMAGE costs arising out of a discharge, release or escape of "pollutants" which contains a re- The following replaces Exclusion a., Expected Or quirement that the discharge, release or es- Intended Injury, in Paragraph 2. of SECTION I — cape of "pollutants" must be reported to us COVERAGES — COVERAGE A BODILY IN- within a specific number of days after its JURY AND PROPERTY DAMAGE LIABILITY: abrupt commencement, this Paragraph e. does not affect that requirement. a. Expected or Intended Injury or Damage P. UNINTENTIONAL OMISSION "Bodily injury" or "property damage" expected The following is added to Paragraph 6., Repre- or intended from the standpoint of the in- sentations, of SECTION IV — COMMERCIAL sured. This exclusion does not apply to "bod- GENERAL LIABILITY CONDITIONS: ily injury" or "property damage" resulting from The unintentional omission of, or unintentional er- the use of reasonable force to protect any ror in, any information provided by you which we person or property. relied upon in issuing this policy will not prejudice CG D4 58 07 13 ©2013 The Travelers Indemnity Company.All rights reserved. Page 7 of 7 Includes copyrighted material of Insurance Services Office, Inc.with its permission. WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 99 06 34 (Ed.&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 3% of the total California Workers'Compensation premium otherwise due. Schedule Person or Organization Job DescriDtion Any person or organization for which this All California Operations waiver is required Policy Number: WSD 5027 .. P 341 03 Insured: Backflow Apparatus &Valve Com an Y Endorsement Effective:8/27/2017 Coverage Provided by: Issue Date: Countersigned by: WC 99 06 34 (Ed.8-0O) 4371713 1 17-1A GL.. AIWn TNh wr I Hnrh-4— --.,i