Loading...
PROOF OF INSURANCE (2014) CLOSED ACO..^ DATE(MM ,,,^^. �'`�'�" CERTIFICATE OF LIABILITY INSURANCE ,YYYY, THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. -ORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to )rms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the Cate holder in lieu of such endorsement( CONTACT p'�F -R N ... ACT........... �1.rlrl...Ibor ......................................................................................... (� .-.. Dealey, Renton&Associates .Extr.714 427-6810 Ac a......,,,,_,,,,_ P. O. Box 10550 Er MAEE_.. ............... ...... .. PHONE Santa Ana CA 92711-0550 ADDt'Ess:kthor) Insdra,nom I INSURERS)AFFORDING COVERAGE NAIC# ...INSURED __w............................................................................... ...,..,..... INSURER A:Tra-\rej,e[S�Cppe,[ty-Q 5palty�o Of A 25674 INSURER,..I t.Il. .,..!.�1. 1�f�.lnc.e._Cospan.Y.r...hc.a.............................. Wllldan Energy Solutions INSURER C: DBA Intergy Corporation INSURER D: g p 6130 Stoneridge Mall Rd.,#380 INSURERXE, ........................_...._... ... .. ....................._........,,..........,,,,,,,,,.......... PleasantonCA 94588 .........:..........................................................._...................................................................................................................................................................... INSURER F: I COVERAGES CERTIFICATE NUMBER:651897472 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. INTR '�F1 bU�'t 6k ° POLICY EFF POLICY EXP L TYPE OF INSURANCE INSR WVD POLICY NUMBER V(MM/DD/YYYY) (MMIDD/YYYY) LIMITS A GENERAL LIABILITY Y Y 6301158PO20 11/9/2013 11/9/2014 EACH OCCURRENCE $1,000,000 COMMERCIAL GENERAL LIABILITY PR. M w .r rt..4 ��.............$m1, m CLAIMS-MADE a OCCUR MED EXP(Any°nePersonl .$10..00 X Contractual PERSONAL&A DV INJURY $1 000.000 -, X BFPD,XCU GENERAL AGGREGATE $2,000.000 �................ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $2,000,000 POLICYIX� 44-5, I LOC $ A AUTOMOBILE LIABILITY Y Y 810115EP020 ^%/9/2.0 13 'I'/9!2014 OOMBINEL)SINULE LIMI l (Fa accident) $1,000.000 ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE HIRED AUTOS X AUTOS (Per accident) $ $ A UMBRELLA LIAB N OCCUR CUP1158P020 11/9/2013 11/9/2014 EACH OCCURRENCE $2,000,000 X EXCESS LIAB CLAIMS-MADE AGGREGATE $2,000,000 DED I RETENTION$ $ A WORKERS COMPENSATION y UB7D417816 11/9/2013 11/9/2014X WCSTATU- I IOTH- AND EMPLOYERS'LIABILITY Y(N ,�_T.QRY.,UMI,15, FR ANY PROPRIETOR/PARTNER/EXECUTIVE E L.EACH ACCIDENT $1,000,000 OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) E.L DISEASE-EA EMPLOYEE: $1,000,000 describe under DESCRIPTION . OF OPERATIONS below E .DISEASE-POLICY LIMIT $1,000.000 B Professional Liability AED977441114 11/9/2013 11/9/2014 Per Claim $1,000,000 Claims Made Annual Aggregate $2,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) General Liability policy e'xc'ludes claims arising out of the performance of professional services. Independent Contractors are included as respects to General Liability. Excess Liability Coverage Excludes ProfessionalLiability', 30 Day NOC/10 Day for NonPay of Prem Re: Professional consulting services for the implementation of the city's energy efficiency strategic plan. City of EI Segundo, its officials and employees, and Southern California Edison, its officers, agents, and employees are additional insured as respects to General and Auto See Attached... CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of EI Segundo ACCORDANCE WITH THE POLICY PROVISIONS. Stephanie Katsouleas, Public Works Director, Dept of Public Works, 350 Main Street AUTHORIZED REPRESENTATIVE EI Segundo CA 90245 U I ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: LOC#: ....._.... .� ADDITIONAL REMARKS SCHEDULE Page 1 of 1 AGENCY NAMED INSURED De-'-y, Renton &Associates IDBA Willdan Energy Solutions pr UMBER Intergy Corporation 6130 Stoneridge Mall Rd.,#380 Pleasanton CA 94588 ............... CAS. _rt NAIC CODE II 1IEFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE m ....................­ Liability as required by written contract. Primary and Non-Contributing coverage, Cross Liability coverage,Waiver of Subrogation applies to GL as required by written contract. Waiver of subrogation for Work Comp is included as required by written contract. Primary and Non-Contributing coverage applies to Auto Liability as required by written contract. (WES MONROVIA) ACORD 101 (2008/01) ©2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD COMMERCIAL AUTO 8101158PO20 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BUSINESS AUTO EXTENSION ENDORSEMENT 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 excliusions 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 H. HIRED AUTO PHYSICAL DAMAGE — LOSS OF USE—INCREASED LIMIT B. BLANKET ADDITIONAL INSURED I. PHYSICAL DAMAGE — TRANSPORTATION EXPENSES—INCREASED LIMIT C. EMPLOYEE HIRED AUTO J. PERSONAL EFFECTS D. EMPLOYEES AS INSURED K. AIRBAGS E. SUPPLEMENTARY PAYMENTS — INCREASED L. NOTICE AND KNOWLEDGE OF ACCIDENT LIMITS OR LOSS F. HIRED AUTO — LIMITED WORLDWIDE M. BLANKET WAIVER OF SUBROGATION COVERAGE—INDEMNITY BASIS G. WAIVER OF DEDUCTIBLE—GLASS N. UNINTENTIONAL ERRORS OR OMISSIONS PROVISIONS A. BROAD FORM NAMED INSURED executed by you before the "bodily injury" or The following is added to Paragraph A.1., Who Is "property damage" occurs and that is in effect An Insured, of SECTION II — LIABILITY COV- during the policy period, to be named as an addi- ERAGE: tional insured is an "insured" for Liability Cover- age, but only for damages to which this insurance Any organization you newly acquire or form dur- applies and only to the extent that person or or- ing the policy period over which you maintain ganization qualifies as an "insured" under the 50% or more ownership interest and that is not Who Is An Insured provision contained in Section separately insured for Business Auto Coverage. II. Coverage under this provision is afforded only un- C. EMPLOYEE HIRED AUTO til the 184th day after you acquire or form the or- ganization or the end of the policy period, which- 1. The following is added to Paragraph A.1., ever is earlier. Who Is An Insured, of SECTION II — LI- B. BLANKET ADDITIONAL INSURED 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 SEC'T'ION 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 0310 0 2010 The Travelers Indemnity Company. Page 1 of 4 Includes copyrighted material of Insurance Services Office,Inc,with Its permission, COMMERCIAL AUTO 2. The following replaces Paragraph b. in B.S., within such country or jurisdiction, for Liability Other Insurance, of SECTION IV — BUSI- Coverage for any covered "auto" that you NESS AUTO CONDITIONS: lease, hire, rent or borrow without a driver for b. For Hired Auto Physical Damage Cover- a period of 30 days or less and that is not an age, the following are deemed to be cov- $, autoyou lease, hire, rent or borrow from ered "autos" you own: any of your "employees", partners (if you are (1) Any covered "auto" you lease, hire, a partnership), members (if you are a limited rent or borrow; and liability company) or members of their house- holds, (2) Any covered "'auto" hired or rented by (a) With respect to any claim made or "suit" your "employee" under a contract in brought outside the United States of that individual "employee's" name, America, the territories and possessions with your permission, while perform- of the United States of America, Puerto ing duties related to the conduct of Rico and Canada: your business. (I) You must arrange to defend the However, any"auto" that is leased, hired, "in- sured"against, and investigate or set- rented or bon-owed with a driver is not a tle any such claim or "suit" and keep covered "auto". us advised of all proceedings and ac- D. EMPLOYEES AS INSURED tions. The following is added to Paragraph A.I., Who Is (ii) Neither you nor any other involved An Insured, of SECTION 11 — LIABILITY COV- "insured" will make any settlement ERAGE: without our consent. Any "employee" of yours is an "insured" while us- (III) We may, at our discretion, participate ing a covered "auto" you don't own, hire or borrow in defending the "insured" against, or in your business or your personal affairs. in the settlement of, any claim or E. SUPPLEMENTARY PAYMENTS — INCREASED "suit". LIMITS (iv)We will reimburse the "insured" for 1. The following replaces Paragraph A.2.a.(2), sums that the "Insured" legally must of SECTION 11 —LIABILITY COVERAGE: pay as damages because of "bodily injury" or"property damage" to which (2) Up to $3,000 for cost of bail bonds (in- this insurance applies, that the "in- cluding bonds for related traffic law viola- sured" pays with our consent, but tions) required because of an "accident" only up to the limit described in Para- we cover. We do not have to furnish graph C., Limit Of Insurance, of SEC- these bonds. TION 11—LIABILITY COVERAGE. 2. The following replaces Paragraph A.2.a.(4), (v) We will reimburse the "insured" for of SECTION 11—LIABILITY COVERAGE: the reasonable expenses incurred (4) All reasonable expenses incurred by the with our consent for your investiga- "insured" at our request, including actual tion of such claims and your defense loss of earnings up to $500 a day be- of the "Insured" against any such cause of time off from work. "'suit'", but only up to and included F. HIRED AUTO — LIMITED WORLDWIDE COV- within the limit described in Para- ERAGE—INDEMNITY BASIS graph C., Limit Of Insurance, of SECTION 11 — LIABILITY COVER- The following replaces Subparagraph (5) in Para- AGE, and not in addition to such limit. graph B-7., Policy Period, Coverage Territory, Our duty to make such payments of SECTION IV — BUSINESS AUTO CONDI- ends when we have used up the ap- TIONS: plicable limit of insurance in pay- (5) Anywhere in the world, except any country or ments for damages, settlements or jurisdiction while any trade sanction, em- defense expenses. bargo, or similar regulation Imposed by the (b) This insurance is excess over any valid United States of America applies to and pro- and collectible other insurance available hibits the transaction of business with or Page 2 of 4 0 2010 The Travelers Indemnity Company. CA T3 53 03 10 Includes copyrighted material of Insurance Services office,Inc.with its permission. COMMERCIAL AUTO to the "insured" whether primary, excess J. PERSONAL EFFECTS contingent or on any other basis. The following is added to Paragraph AA., Cover- (c) This insurance is not a substitute for re- age Extensions, of SECTION III — PHYSICAL quired or compulsory insurance in any DAMAGE COVERAGE: country outside the United States, its ter- personal Effects ritorles and possessions, Puerto Rico and Canada. We will pay up to $400 for "loss" to wearing ap- You agree to maintain all required or parel and other personal effects which are: compulsory insurance in any such coun- (1) Owned by an "insured"; and try up to the minimum limits required by (2) In or on your covered "auto". local law. Your failure to comply with This coverage applies only in the event of a total compulsory insurance requirements will theft of your covered "auto". not invalidate the coverage afforded by this policy, but we will only be liable to the No deductibles apply to this Personal Effects same extent we would have been liable coverage. had you complied with the compulsory in- K. AIRBAGS surance requirements. The following is added to Paragraph B.3., Exclu- (d) It is understood that we are not an admit- sions, of SECTION III — PHYSICAL DAMAGE ted or authorized insurer outside the COVERAGE: United States of America, its territories Exclusion 3.a. does not apply to "loss" to one or and possessions, Puerto Rico and Can- more airbags in a covered "auto"you own that in- ada. We assume no responsibility for the flate due to a cause other than a cause of "loss" furnishing of certificates of insurance, or set forth in Paragraphs A.1.b. and A.1.c., but for compliance in any way with the laws of other countries relating to insurance. only. G. WAIVER OF DEDUCTIBLE —GLASS a. if that "auto" is a covered "auto" for Compre- hensive Coverage under this policy; The following is added to Paragraph D., Deducti- ble, of SECTION III — PHYSICAL DAMAGE b. The airbags are not covered under any war- COVERAGE: ranty; and No deductible for a covered "auto" will apply to c. The airbags were not intentionally inflated. glass damage if the glass is repaired rather than We will pay up to a maximum of $1,000 for any replaced. one "loss". H. HIRED AUTO PHYSICAL DAMAGE — LOSS OF L. NOTICE AND KNOWLEDGE OF ACCIDENT OR USE—INCREASED LIMIT LOSS The following replaces the last sentence of Para- The following is added to Paragraph A.2.a., of graph A.4.b., Loss Of Use Expenses, of SEC- SECTION IV— BUSINESS AUTO CONDITIONS: TION III—PHYSICAL DAMAGE COVERAGE: Your duty to give us or our authorized representa- However, the most we will pay for any expenses tive prompt notice of the "accident' or 'lass" ap- for loss of use is $65 per day, to a maximum of plies only when the "accident' or "loss" is known $750 for any one "accident'. to: I. PHYSICAL DAMAGE — TRANSPORTATION (a) You (if you are an individual); EXPENSES—INCREASED LIMIT (b) A partner (if you are a partnership); The following replaces the first sentence in Para- (c) A member (if you are a limited liability com- graph A.4.a., Transportation Expenses, of pany); SECTION III — PHYSICAL DAMAGE COVER- (d) An executive officer, director or insurance AGE: manager (if you are a corporation or other or- We will pay up to $50 per day to a maximum of ganization); or $1,500 for temporary transportation expense in- (e) Any "employee" authorized by you to give no- curred by you because of the total theft of a cov- tice of the "accident' or"loss". ered "auto"of the private passenger type. 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 such contract. The waiver applies only to the The following replaces Paragraph A.5., Transfer person or organization designated in such Of Rights Of Recovery Against Others To Us, contract. of SECTION IV - BUSINESS AUTO CONDI- N. UNINTENTIONAL ERRORS OR OMISSIONS TIONS: The following is added to Paragraph B.2., Con- S. Transfer Of Rights Of Recovery Against cealment, Misrepresentation, Or Fraud, of Others To Us SECTION IV-BUSINESS AUTO CONDITIONS: We waive any right of recovery we may have The unintentional omission of, or unintentional against any person or organization to the ex- error in, any information given by you shall not tent required of you by a written contract prejudice your rights under this insurance. How- signed and executed prior to any "accident"' ever this provision does not affect our right to col- or"loss", provided that the "accident" or "loss" lect additional prerniUM or exercise our right of arises out of operations contemplated by cancellation or non-renewal. Page 4 of 4 0 2010 The Travelers indemnity Company. CA T3 53 03 10 Includes copyrighted material of Insurance Services Office,Inc.with Its permission. COMMERCIAL GENERAL LIABILITY 6301158PO20 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED - WRITTEN CONTRACTS (ARCHITECTS, ENGINEERS AND SURVEYORS) This endorsement modifies insurance provided under the following; COMMERCIAL GENERAL LIABILITY COVERAGE PART 1, The following is added to SECTION 11 —WHO IS plies only to such "bodily injury" or "property AN INSURED: damage" that occurs before the end of the pe- riod of time for which the "written contract re- Any person or organization that you agree in a written contract requiring insurance" to include as quiring insurance" requires you to provide an additional insured on this Coverage Part, but: such coverage or the end of the policy period, whichever is earlier, a. Only with respect to liability for "bodily injury", "property damage" or"personal injury"; and 2. The following is added to Paragraph 4.a, of SEC- TION IV— COMMERCIAL GENERAL LIABILITY b, If, and only to the extent that, the injury or CONDITIONS: damage is caused by acts or omissions of The insurance provided to the additional insured you or your subcontractor in the performance is excess over any valid and collectible "other in- of "your work" to which the "written contract surance", whether primary, excess, contingent or requiring 'nsurance" applies. The person or organization does not qualify as an additional on any other basis, that is available to the addi- tional insured for a loss we cover. However, if you or omissions of such person or organization. specifically agree in the "written contract requiring insurance" that this insurance provided to the ad- The insurance provided to such additional insured ditional insured under this Coverage Part must is limited as follows: apply on a primary basis or a primary and non- c. In the event that the Limits of Insurance of contributory basis. this insurance is primary to this Coverage Part shown in the Declarations "other insurance" available to :he additional in- exceed the limits of liability required by the sured which covers that person or organization as "written contract requiring insurance", the in- a named insured for such loss, and we will not surance provided to the additional insured share with that "other insurance". But this insur- shall be limited to the limits of liability required ance provided to the additional insured still is ex- by that "written contract requiring insurance". cess over any valid and collectible "other insur- This endorsement shall not increase the limits ance", whether primary, excess, contingent or on of insurance described in Section 111 — Limits any other basis, that is available to the additional Of Insurance. insured when that person or organization is an d. This insurance does not apply to the render- additional insured under any "other insurance". ing of or failure to render any "professional 3. The following is added to SECTION IV — COM- services" or construction management errors MERCIAL GENERAL LIABILITY CONDITIONS: or omissions. Duties Of An Additional Insured e. This insurance does not apply to "bodily in- As a condition of coverage prov ded to the addi- jury" or "property damage" caused by "your tional insured: work" and included in the "products- a. The additional insured must give us written completed operations hazard" unless the "written contract requiring insurance' specifi- notice as soon as practicable of an "occur- cally requires you to provide such coverage rence" or an offense which may result in a for that additional insured, and then the insur- claim. To the extent possible, such notice ance provided to the additional insured ap- should include: CG D414 04 08 0 2008 The Travelers Compan'es, nc. Page 9 of 2 COMMERCIAL GENERAL LIABILITY I. How, when and where the "occurrence" any provider of other insurance which would or offense took place; cover the additional insured for a loss we IL The names and addresses of any injured cover. However, this condition does not affect persons and witnesses; and whether this insurance provided to the addi- iii. The nature and location of any injury or tional insured is primary to that other insur- damage arising out of the "occurrence" or ance available to the additional insured which offense. covers that person or organization as a named insured. b. If a claim is made or "suit" is brought against the additional insured, the additional insured 4. The following is added to the DEFINITIONS Sec- must: tion: i. Immediately record the specifics of the "Written contract requiring insurance" means that claim or"suit"and the date received; and part of any written contract or agreement under which you are required to include a person or or- ganization as an additional insured on this Cover- The additional insured must see to it that we age Part, provided that the "bodily injury" and receive written notice of the claim or "suit" as "property damage" occurs and the "personal in- soon as practicable. jury" is caused by an offense committed: c. The additional insured must immediately send a. After the signing and execution of the contract us copies of all legal papers received in con- or agreement by you; nection with the claim or"suit", cooperate with b. While that part of the contract or agreement is us in the investigation or settlement of the in effect; and claim or defense against the "suit", and oth- erwise comply with all policy conditions. c. Before the end of the policy period. d. The additional insured must tender the de- fense and indemnity of any claim or "suit' to Page 2 of 2 02008 The Travelers Companies, Inc. CG D4 14 04 08 Auto insurance always follows the car, not the owner. Thus the vehicle owner's insurance is always primary. Below are the excerpted paragraphs from the ISO Business Auto Coverage form which explains the coverage. Section 11 Liability Coverage, A. Coverage, 1. Who Is An Insured, c. anyone liable for the conduct of an "insured" described above but only to the extent of that liability Section IV Business Auto Conditions, B. General Conditions, 5. Other Insurance c. Regardless of the provisions of Paragraph a. above, this Coverage Form's Liability Coverage is primary for any liability assumed under an "insured contract". Section V Definitions, H. "Insured contract" means:, 5. "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 to pay for "bodily injury" or "property damage" to a third party or organization. Tort liability means a liability that would be imposed by law in the absence of any contract or agreement. By California state law the Insured's Auto insurance will always be primary with respect to the Insured's owned autos. COMMERCIAL AUTO b. Return the stolen property, at our ex- 5. Other Insurance pense. We will pay for any damage that a. For any covered "auto" you own, this results to the"auto" from the theft; or coverage form provides primary insur- c. Take all or any part of the damaged or ance. For any covered "auto" you don't stolen property at an agreed or appraised own. the insurance provided by this cov- value_ erage form is excess over any other col- If we pay for the "loss", our payment will in- lectible insurance. However, while a cov- clude the applicable sales tax for the dam- ered "auto" which is a "trailer" is con- aged or stolen property. netted to another vehicle, the Liability Coverage this coverage form provides for 5. Transfer Of Rights Of Recovery Against the "trailer"is: Others To Us person or organization to or for whom (1) Excess while it is connected to a mo- If any P 9 for vehicle you do not own_ we make payment under this coverage form has rights to recover damages from another, (�� Primary while it is connected to a those rights are transferred to us. That person covered "auto" you own. or organization must do everything necessary b. For Hired Auto Physical Damage Cover- to secure our rights and must do nothing after age, any covered "auto" you lease, hire, "accident" or"loss"to impair them. rent or borrow is doemed to be a covered B. General Conditions "auto" you own. However, any "auto" that is leased, hired. rented or borrowed with 1. Bankruptcy a driver is not a covered "auto"_ Bankruptcy or insolvency of the "insured" or c. Regardless of the provisions of Para- the "insured's" estate will not relieve us of any graph a. above, this coverage form's Li- obligations under this coverage form_ ability Coverage is primary for any liability 2. Concealment, Misrepresentation Or Fraud assumed under an "insured contract". This coverage form is void in any case of d. When this coverage form and any other fraud by you at any time as it relates to this coverage form or policy covers on the coverage form_ It is also void if you or any same basis, either excess or primary, we other"insured", at any time, intentionally con- will pay only our share. Our share is the ceal or misrepresent a material fact concern- proportion that the Limit of Insurance of ing: our coverage form bears to the total of a. This coverage form: the limits of all the coverage forms and policies covering an the same basis. b. The covered"auto"; 6. Premium Audit c. Your interest in the covered "auto": or a. The estimated premium for this coverage d. A claim under this coverage form. form is based on the exposures you told 3. Liberalization us you would have when this policy be- If we revise this coverage form to provide gan_ We will compute the final premium more coverage without additional premium due when we determine your actual ex- charge, your policy will automatically provide posures. The estimated total premium will the additional coverage as of the day the re- be credited against the final premium due and the first Named Insured will be billed vision is effective in your state. for the balance, if any The due date for 4. No Benefit To Bailee — Physical Damage the final premium or retrospective pre- Coverages mium is the date shown as the due date We will not recognize any assignment or on the bill. If the estimated total premium grant any coverage for the benefit of any per- exceeds the final premium due, the first son or organization holding, storing or trans- Named Insured will get a refund. porting property for a fee regardless of any b. If this policy is issued for more than one other provision of this coverage form. year, the premium for this coverage form will be computed annually based on our rates or premiums in effect at the begin- ning of each year of the policy. CA 00 01 03 10 (Re, 02-1 ; 0 Insurance Services Office, Inc., 2009 Page 9 of 12 COMMERCIAL AUTO THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET WAIVER OF SUBROGATION This endorsement modifies insurance provided under the following; BUSINESS AUTO COVERAGE FORM GARAGE COVERAGE FORM MOTOR CARRIER COVERAGE FORM TRUCKERS COVERAGE FORM With respect to coverage provided by this endorse- required of you by a written contract executed ment, the provisions of the Coverage Form apply prior to any "accident" or "loss", provided that the unless modified by the endorsement. "accident" or 'loss" arises out of the operations Paragraph 5. Transfer of Rights Of Recovery contemplated by such contract. The waiver ap- Against Others To Us of the CONDITIONS section plies only to the person or organization desig- is replaced by the following: Hated in such contract. S. Transfer Of Rights Of Recovery Against Oth- ers To Us We waive any right of recovery we may have against any person or organization to the extent CA T3 40 08 08 0 2008 The Travelers Companies, Inc. Page 1 of 1