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PROOF OF INSURANCE (2019) CLOSED
AC"RV CERTIFICATE OF LIABILITY INSURANCEDATE(MMIDDIYYYY) 'I'l 1 3/12/2018 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). I PRODUCER, CON'T'ACT NAME'. Noel Baxter 562)439-9731 ADDRESS,nbaxter@hmbd.com IAX IABD Insurance Services, Inc. rwrr ( �,NAPC N,�y, (562)439-4453 3633 East Broadway ADDERESS� INSURER(S)AFFORDING COVERAGE NAIC# Long Beach CA 90803-6035 INSURERA:Travelers Prop Cas Cc of Amer. ,25674 ...................._- ...._._.__.................._- -. INSURED INSURER B: Federal Technology Solutions, Inc. INSURERC: - 1828 Railroad Street INSURER D: INSURER E: Corona CA 92880 INSURER F: COVERAGES CERTIFICATE NUMBER:18-19 All Lines REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED-rO 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 POLI;IES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ILTR TYPE OF INSURANCE ADDL SU.8.R POLICY EFF POLICY EXP INSR WVI) POLICY NUMBER IMMIDDIYYYYI EMM/DD/YYYY) LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1'000'0001I A CLAIMS-MADE IE��I OCCUR LP-51M54094 3/1/2018 3/1/2019 MEDEXP(Any one son) � $ 500,0001 X srcar:crLU, n .son. $ 10,00011 II,PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 1 POLICY Il X l EMFIqf F-1 LOC 1 $ AUTOMOBILE LIABILITY �^ I6O PAUINE.�1D SINGLE LiMl11. X (Ea ar.'Adenl) $ 1,000,OOO A ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED A-BG727446 3/1/2018 3/1/2019 AUTOS AUTOS BODILY INJURY(Per accident) $ X HIRED AUTOS X NON-OWNED PROPERTY DAMAGE $ AUTOS (Per accident) $ UMBRELLAII LIAB OCCUR EACH OCCURRENCE $ 4,000,000 A X EXCESSLABV W CLAIMS-MADE ACC3RE:GATE $ 4,000,000 DED II IRETENTION$ UP-71M51978 3/1/2018 3/1/2019 $ A WORKERS COMPENSATION X 1TQRX!.lAETU- I IOFB AND EMPLOYERS'LIABILITY _ ANY PROPRIETOR/PARTNER/EXECUTIVE YIN E L EACH ACCIDENT $ 1,000,0001 OFFICER/MEMBER EXCLUDED? Y N/A (Mandatory in NH) OK25185A 3/1/2018 3/1/2019 E DISEASE-EA EM'PLOY'EE,$ 1,000,0001 If yes,describe under DESCRIPTION OF,OPERATIONS below -- E.L.DISEASE-POLICY LIMIT $ 1,000,0001 General lDESCRIPTION OFiability/LOCATIONS I includesHICLES blanket ACORD 101,Additional Remarks Schedule,If more space is reclu)rod) et additional insureds, primary/non-contributory wording, & waiver of subrogation when required by written contract, agreement, or permit per attached forms CGD2460805, CGD4250708, CGD4170112. Auto liability includes blanket additional insureds and waiver of subrogation per attached form CAT3530215. Blanket work comp waiver form WC990376 attached. City of E1 Segundo, its officers, officials, employees, agents and volunteers. CERTIFICATE HOLDER CANCELLATION! SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of E1 Segundo ACCORDANCE WITH THE POLICY PROVISIONS. 350 Main Street El Segundo, CA 90245 AUTHORIZED REPRESENTATIVE Todd Miller/GOWENS ACORD 25(2010/05) ©1988-2010 ACORD CORPORATION. All rights reserved. INS025(201005)01 The ACORD name and logo are registered marks of ACORD Policy#ZLP-51M54094 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 provided to 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- 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- L 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- ii. Supervisory, inspection, architectural or rence" or an offense which may result in a engineering activities. claim. To the extent possible, such notice should include: CG D2 46 08 05 ©2005 The St. Paul Travelers Companies, Inc. Page 1 of 2 COMMERCIAL GENERAL LIABILITY L 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 ii. The names and addresses of any injured cover under this endorsement. However, this persons and witnesses; and condition does not affect whether the insur- ance provided to the additional insured by iii. The nature and location of any injury or this endorsement is primary to "other insur- damage arising out of the "occurrence" or ance" available to the additional insured offense. which covers that person or organization as a 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 is added to SECTION V. L Immediately record the specifics of the — DEFINITIONS: claim or"suit" and the date received; and "Written contract requiring insurance" means ii. Notify us as soon as practicable. that part of any written contract or agreement The additional insured must see to it that we under which you are required to include aperson or organization as an additional in- receive written notice of the claim or suit as sured on this Coverage Part, provided that soon as practicable. the "bodily injury" and "property damage" oc- c) The additional insured must immediately curs and the "personal injury" is caused by an send us copies of all legal papers received in offense committed: connection with the claim or "suit", cooperate a. After the signing and execution of the with us in the investigation or settlement of contract or agreement by you; 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 de- agreement is in effect; and fense and indemnity of any claim or "suit' to c. Before the end of the policy period. Page 2 of 2 ©2005 The St. Paul Travelers Companies, Inc. CG D2 46 08 05 Policy#ZLP-51M54094 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. TECHNOLOGY XTE D ENDORSEMENT 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. Reasonable Force Property Damage— Ex- K. Blanket Additional Insured— Persons Or Or- ception To Expected Or Intended Injury Ex- ganizations For Your Ongoing Operations As clusion Required By Written Contract Or Agreement B. Non-Owned Watercraft Less Than 75 Feet L. Blanket Additional Insured— Broad Form C. Aircraft Chartered With Pilot Vendors D. Damage To Premises Rented To You M. Who Is An Insured— Unnamed Subsidiaries E. Increased Supplementary Payments N. Who Is An Insured— Liability For Conduct Of F. Who Is An Insured —Employees And Volun- Unnamed Partnerships Or Joint Ventures teer Workers— First Aid 0. Medical Payments— Increased Limits G. Who Is An Insured —Employees— Supervi- P. Contractual Liability— Railroads sory Positions Q. Knowledge And Notice Of Occurrence Or Of- H. Who Is An Insured— Newly Acquired Or fense Formed Organizations R. Unintentional Omission I. Blanket Additional Insured —Owners, Manag- S. Blanket Waiver Of Subrogation ers Or Lessors Of Premises J. Blanket Additional Insured— Lessors Of Leased Equipment PROVISIONS B. NON-OWNED WATERCRAFT LESS THAN 75 A. REASONABLE FORCE PROPERTY DAMAGE — FEET EXCEPTION TO EXPECTED OR INTENDED IN- The following replaces Paragraph (2) of Exclusion JURY EXCLUSION g., Aircraft, Auto Or Watercraft, in Paragraph 2. The following replaces Exclusion a., Expected Or of SECTION I — COVERAGES — COVERAGE A Intended Injury, in Paragraph 2., of SECTION I — BODILY INJURY AND PROPERTY DAMAGE COVERAGES — COVERAGE A BODILY IN- LIABILITY: JURY AND PROPERTY DAMAGE LIABILITY: (2) A watercraft you do not own that is: a. Expected Or Intended Injury Or Damage (a) Less than 75 feet long; and "Bodily injury" or "property damage" expected or (b) Not being used to carry any person or intended from the standpoint of the insured. This property for a charge. exclusion does not apply to "bodily injury" or C. AIRCRAFT CHARTERED WITH PILOT "property damage" resulting from the use of rea- sonable force to protect any person or property. The following is added to Exclusion g., Aircraft, Auto Or Watercraft, in Paragraph 2. of SECTION CG D4 17 01 12 ©2012 The Travelers Indemnity Company. All rights reserved. Page 1 of 6 Includes copyrighted material of Insurance Services Office, Inc.with its permission. COMMERCIAL GENERAL LIABILITY I — COVERAGES — COVERAGE A BODILY IN- 4. The following replaces Paragraph a. of the JURY AND PROPERTY DAMAGE LIABILITY: definition of "insured contract" in the DEFINI- This exclusion does not apply to an aircraft that TIONS Section: is: a. A contract for a lease of premises. How- (a) Chartered with a pilot to any insured; ever, that portion of the contract for a lease of premises that indemnifies any (b) Not owned by any insured; and person or organization for "premises (c) Not being used to carry any person or prop- damage" is not an "insured contract"; erty for a charge. 5. The following is added to the DEFINITIONS D. DAMAGE TO PREMISES RENTED TO YOU Section: 1. The first paragraph of the exceptions in Ex- "Premises damage" means "property dam- clusion j., Damage To Property, in Para- age" to: graph 2. of SECTION I — COVERAGES — a. Any premises while rented to you or tem- COVERAGE A BODILY INJURY AND porarily occupied by you with permission PROPERTY DAMAGE LIABILITY is deleted. of the owner; or 2. The following replaces the last paragraph of b. The contents of any premises while such Paragraph 2., Exclusions, of SECTION I — premises is rented to you, if you rent such COVERAGES — COVERAGE A BODILY IN- premises for a period of seven or fewer JURY AND PROPERTY DAMAGE LIABIL- consecutive days. ITY: 6. The following replaces Paragraph 4.b.(1)(b) Exclusions c., g. and h., and Paragraphs (1), of SECTION IV — COMMERCIAL GENERAL (3) and (4) of Exclusion j., do not apply to LIABILITY CONDITIONS: "premises damage Exclusion f,(1)(a) does (b) That is insurance for "premises damage"; not apply to "premises damage caused by fire unless Exclusion f. of Section I — Cover- age A — Bodily Injury And Property Damage 7. Paragraph 4.b.(1)(c) of SECTION IV — Liability is replaced by another endorsement COMMERCIAL GENERAL LIABILITY CON- to this Coverage Part that has Exclusion - All DITIONS is deleted. Pollution Injury Or Damage or Total Pollution E. INCREASED SUPPLEMENTARY PAYMENTS Exclusion in its title. A separate limit of insur- ance applies to "premises damage" as de- 1. The following replaces Paragraph 1.b. of scribed in Paragraph 6. of Section III — Limits SUPPLEMENTARY PAYMENTS — COVER- insurance. AGES A AND B of SECTION I — COVER- Of AGES: 3. The following replaces Paragraph 6. of SEC- TION III—LIMITS OF INSURANCE: b. Up to $2,500 for cost of bail bonds re- quired because of accidents or traffic law 6. Subject to 5. above, the Damage To violations arising out of the use of any Premises Rented To You Limit is the vehicle to which the Bodily Injury Liability most we will pay under Coverage A for Coverage applies. We do not have to fur- damages because of "premises damage" nish these bonds. to any one premises. 2. The following replaces Paragraph 1.d. of The Damage To Premises Rented To SUPPLEMENTARY PAYMENTS — COVER- You Limit will be: AGES A AND B of SECTION I — COVER- a. The amount shown for the Damage AGES: To Premises Rented To You Limit on d. All reasonable expenses incurred by the the Declarations of this Coverage insured at our request to assist us in the Part; or investigation or defense of the claim or b. $300,000 if no amount is shown for "suit", including actual loss of earnings up the Damage To Premises Rented To to $500 a day because of time off from You Limit on the Declarations of this work. Coverage Part. Page 2 of 6 ©2012 The Travelers Indemnity Company. All rights reserved. CG D4 17 01 12 Includes copyrighted material of Insurance Services Office, Inc.with its permission. COMMERCIAL GENERAL LIABILITY F. WHO IS AN INSURED — EMPLOYEES AND your "employees" who hold a supervisory posi- VOLUNTEER WORKERS— FIRST AID tion. 1. The following is added to the definition of"oc- H. WHO IS AN INSURED — NEWLY ACQUIRED currence" in the DEFINITIONS Section: OR FORMED ORGANIZATIONS Unless you are in the business or occupation The following replaces Paragraph 4. of SECTION of providing professional health care services, II — WHO IS AN INSURED of the Commercial "occurrence" also means an act or omission General Liability Coverage Form, and Paragraph committed by any of your "employees" or 3. of SECTION II — WHO IS AN INSURED of the "volunteer workers", other than an employed Global Companion Commercial General Liability or volunteer doctor, in providing or failing to Coverage Form, to the extent such coverage provide first aid or "Good Samaritan services" forms are part of your policy: to a person. Any organization you newly acquire or form, other 2. The following is added to Paragraph 2.a.(1) of than a partnership or joint venture, of which you SECTION II —WHO IS AN INSURED: are the sole owner or in which you maintain the majority ownership interest, will qualify as a Unless you are in the business or occupation Named Insured if there is no other insurance of providing professional health care services, which provides similar coverage to that organiza- Paragraphs (1 )(a), (b), (c) and (d) above do tion. However: not apply to "bodily injury" arising out of pro- a. Coverage under this provision is afforded viding or failing to provide first aid or "Good only: Samaritan services" by any of your "employ- ees" or "volunteer workers", other than an (1) Until the 180th day after you acquire or employed or volunteer doctor. Any of your form the organization or the end of the "employees" or "volunteer workers" providing policy period, whichever is earlier, if you or failing to provide first aid or "Good Samari- do not report such organization in writing tan services" during their work hours for you to us within 180 days after you acquire or will be deemed to be acting within the scope form it; or of their employment by you or performing du- (2) Until the end of the policy period, when ties related to the conduct of your business. that date is later than 180 days after you acquire or form such organization, if you 3. The following is added to Paragraph 5. of report such organization in writing to us SECTION III — LIMITS OF INSURANCE: within 180 days after you acquire or form For the purposes of determining the applica- it, and we agree in writing that it will con- ble Each Occurrence Limit, all related acts or tinue to be a Named Insured until the end omissions committed by any of your"employ- of the policy period; ees" or "volunteer workers" in providing or b. Coverage A does not apply to "bodily injury" failing to provide first aid or "Good Samaritan or "property damage" that occurred before services"to any one person will be deemed to you acquired or formed the organization; and be one "occurrence". c. Coverage B does not apply to "personal in- 4. The following is added to the DEFINITIONS jury" or "advertising injury" arising out of an Section: offense committed before you acquired or Good Samaritan services means any emer- formed the organization. gency medical services for which no compen- I. BLANKET ADDITIONAL INSURED — OWNERS, sation is demanded or received. MANAGERS OR LESSORS OF PREMISES G. WHO IS AN INSURED — EMPLOYEES — SU- The following is added to SECTION II — WHO IS PERVISORY POSITIONS AN INSURED: The following is added to Paragraph 2.a.(1) of Any person or organization that is a premises SECTION II —WHO IS AN INSURED: owner, manager or lessor is an insured, but only with respect to liability arising out of the owner- Paragraphs (1)(a), (b) and (c) above do not apply ship, maintenance or use of that part of any prem- to "bodily injury" or "personal injury" to a co- ises leased to you. "employee" in the course of the co-"employee's" The insurance provided to such premises owner, employment by you arising out of work by any of manager or lessor does not apply to: CG D4 17 01 12 ©2012 The Travelers Indemnity Company. All rights reserved. Page 3 of 6 Includes copyrighted material of Insurance Services Office, Inc.with its permission COMMERCIAL GENERAL LIABILITY a. Any "bodily injury" or "property damage" L. BLANKET ADDITIONAL INSURED — BROAD caused by an "occurrence" that takes place, FORM VENDORS or "personal injury" or "advertising injury" The following is added to SECTION II — WHO IS caused by an offense that is committed, after AN INSURED: you cease to be a tenant in that premises; or Any person or organization that is a vendor and b. Structural alterations, new construction or that you have agreed in a written contract or demolition operations performed by or on be- agreement to include as an additional insured on half of such premises owner, manager or les- this Coverage Part is an insured, but only with re- sor. spect to liability for "bodily injury" or "property J. BLANKET ADDITIONAL INSURED — LESSORS damage" that: OF LEASED EQUIPMENT a. Is caused by an "occurrence" that takes place The following is added to SECTION II — WHO IS after you have signed and executed that con- AN INSURED: tract or agreement; and Any person or organization that is an equipment b. Arises out of "your products" which are dis- lessor is an insured, but only with respect to liabil- tributed or sold in the regular course of such ity for "bodily injury", "property damage", "per- vendor's business. sonal injury" or "advertising injury" caused, in The insurance provided to such vendor is subject whole or in part, by your acts or omissions in the to the following provisions: maintenance, operation or use by you of equip- ment leased to you by such equipment lessor. a. The limits of insurance provided to such ven- The insurance provided to such equipment lessor dor will be the limits which you agreed to pro- vide in the written contract or agreement, or does not apply to any "bodily injury" or "property the limits shown in the Declarations, which- damage" caused by an "occurrence" that takes ever are less. place, or "personal injury" or "advertising injury" caused by an offense that is committed, after the b. The insurance provided to such vendor does equipment lease expires. not apply to: K. BLANKET ADDITIONAL INSURED — PERSONS (1) Any express warranty not authorized by OR ORGANIZATIONS FOR YOUR ONGOING you; OPERATIONS AS REQUIRED BY WRITTEN (2) Any change in "your products" made by CONTRACT OR AGREEMENT such vendor; The following is added to SECTION II — WHO IS AN INSURED: (3) Repackaging, unless unpacked solely for the purpose of inspection, demonstration, Any person or organization that is not otherwise testing, or the substitution of parts under an insured under this Coverage Part and that you instructions from the manufacturer, and have agreed in a written contract or agreement to then repackaged in the original container; include as an additional insured on this Coverage Part is an insured, but only with respect to liability (4) Any failure to make such inspections, ad- for"bodily injury" or"property damage" that: justments, tests or servicing as vendors agree to perform or normally undertake to a. Is caused by an "occurrence" that takes place perform in the regular course of business, after you have signed and executed that con- in connection with the distribution or sale tract or agreement; and of"your products"; b. Is caused, in whole or in part, by your acts or (5) Demonstration, installation, servicing or omissions in the performance of your ongoing repair operations, except such operations operations to which that contract or agree- performed at such vendor's premises in ment applies or the acts or omissions of any connection with the sale of"your prod- person or organization performing such op- ucts"; or erations on your behalf. (6) "Your products" which, after distribution The limits of insurance provided to such insured or sale by you, have been labeled or re- will be the limits which you agreed to provide in labeled or used as a container, part or in- the written contract or agreement, or the limits gredient of any other thing or substance shown in the Declarations, whichever are less. by or on behalf of such vendor. Page 4 of 6 ©2012 The Travelers Indemnity Company. All rights reserved. CG D4 17 01 12 Includes copyrighted material of Insurance Services Office, Inc.with its permission. COMMERCIAL GENERAL LIABILITY Coverage under this provision does not apply to: (b) The amount shown on the Declarations of a. Any person or organization from whom you this Coverage Part for Medical Expense have acquired "your products", or any ingre- Limit. dient, part or container entering into, accom- P. CONTRACTUAL LIABILITY— RAILROADS panying or containing such products; or 1. The following replaces Paragraph c. of the b. Any vendor for which coverage as an addi- definition of "insured contract" in the DEFINI- tional insured specifically is scheduled by en- TIONS Section: dorsement. c. Any easement or license agreement; M. WHO IS AN INSURED — UNNAMED SUBSIDI- 2. Paragraph f.(1) of the definition of "insured ARIES contract" in the DEFINITIONS Section is de- The following is added to SECTION II — WHO IS leted. AN INSURED: Q. KNOWLEDGE AND NOTICE OF OCCUR- Any of your subsidiaries, other than a partnership RENCE OR OFFENSE or joint venture, that is not shown as a Named In- The following is added to Paragraph 2., Duties In sured in the Declarations is a Named Insured if: The Event of Occurrence, Offense, Claim or a. You maintain an ownership interest of more Suit, of SECTION IV — COMMERCIAL GEN- than 50% in such subsidiary on the first day ERAL LIABILITY CONDITIONS: of the policy period; and e. The following provisions apply to Paragraph b. Such subsidiary is not an insured under simi- a. above, but only for the purposes of the in- lar other insurance. surance provided under this Coverage Part to No such subsidiary is an insured for"bodily injury" you or any insured listed in Paragraph 1. or 2. or "property damage" that occurred, or "personal of Section II —Who Is An Insured: injury" or "advertising injury" caused by an of- (1) Notice to us of such 'occurrence" or of- fense committed: fense must be given as soon as practica- a. Before you maintained an ownership interest ble only after the 'occurrence" or offense is known to you (if you are an individual), of more than 50/o in such subsidiary; or any of your partners or members who is b. After the date, if any, during the policy period an individual (if you are a partnership or that you no longer maintain an ownership in- joint venture), any of your managers who terest of more than 50% in such subsidiary. is an individual (if you are a limited liability N. WHO IS AN INSURED — LIABILITY FOR CON- company), any of your trustees who is an DUCT OF UNNAMED PARTNERSHIPS OR individual (if you are a trust), any of your JOINT VENTURES "executive officers" or directors (if you are The following replaces the last paragraph of an organization other than a partnership, joint venture, limited liability company or SECTION II—WHO IS AN INSURED: trust) or any "employee" authorized by No person or organization is an insured with re- you to give notice of an 'occurrence" or spect to the conduct of any current or past part- offense. nership or joint venture that is not shown as a Named Insured in the Declarations. This para- (2) If you are a partnership, joint venture, lim- ited liability company or trust, and none of graph does not apply to any such partnership or your partners, joint venture members, joint venture that otherwise qualifies as an in- managers or trustees are individuals, no- sured under Section II —Who Is An Insured. tice to us of such 'occurrence" or offense O. MEDICAL PAYMENTS—INCREASED LIMITS must be given as soon as practicable only The following replaces Paragraph 7. of SECTION after the 'occurrence" or offense is known III— LIMITS OF INSURANCE: by: 7. Subject to 5. above, the Medical Expense (a) Any individual who is: Limit is the most we will pay under Coverage (i) A partner or member of any part- C for all medical expenses because of"bodily injury" sustained by any one person, and will nership or joint venture; be the higher of: (ii) A manager of any limited liability (a) $10,000; or company; CG D4 17 01 12 ©2012 The Travelers Indemnity Company. All rights reserved. Page 5 of 6 Includes copyrighted material of Insurance Services Office, Inc.with its permission, COMMERCIAL GENERAL LIABILITY (iii) A trustee of any trust; or abrupt commencement, this Paragraph e. (iv) An executive officer or director of does not affect that requirement. any other organization; R. UNINTENTIONAL OMISSION that is your partner, joint venture The following is added to Paragraph 6., Repre- member, manager or trustee; or sentations, of SECTION IV — COMMERCIAL (b) Any "employee" authorized by such GENERAL LIABILITY CONDITIONS: partnership, joint venture, limited li- The unintentional omission of, or unintentional ar- ability company, trust or other organi- ror in, any information provided by you which we zation to give notice of an "occur- relied upon in issuing this policy will not prejudice rence" or offense. your rights under this insurance. However, this (3) Notice to us of such "occurrence" or of- provision does not affect our right to collect addi- fense will be deemed to be given as soon tional premium or to exercise our rights of cancel- as practicable if it is given in good faith as lation or nonrenewal in accordance with applica- soon as practicable to your workers' ble insurance laws or regulations. compensation insurer. This applies only if S. BLANKET WAIVER OF SUBROGATION you subsequently give notice to us of the The following is added to Paragraph 8., Transfer "occurrence" or offense as soon as prac- Of Rights Of Recovery Against Others To Us, ticable after any of the persons described of SECTION IV — COMMERCIAL GENERAL LI- in Paragraphs e. (1) or (2) above discov- ABILITY CONDITIONS: ers that the "occurrence" or offense may result in sums to which the insurance If the insured has agreed in a contract or agree- provided under this Coverage Part may ment to waive that insured's right of recovery apply. against any person or organization, we waive our right of recovery against such person or organiza- ment that provides limited coverage for "bod- However, if this policy includes an endorse- tion, but only for payments we make because of: ily injury" or "property damage" or pollution a. "Bodily injury" or "property damage" caused costs arising out of a discharge, release or by an "occurrence" that takes place; or escape of "pollutants" which contains a re- b. "Personal injury" or "advertising injury" quirement that the discharge, release or es- caused by an offense that is committed; cape of "pollutants" must be reported to us subsequent to the execution of the contract or within a specific number of days after its agreement. Page 6 of 6 ©2012 The Travelers Indemnity Company. All rights reserved. CG D4 17 01 12 Includes copyrighted material of Insurance Services Office, Inc.with its permission. Policy#BA-8G727446 COMMERCIAL AUTO 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 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 H. HIRED AUTO PHYSICAL DAMAGE — LOSS OF B. BLANKET ADDITIONAL INSURED USE— INCREASED LIMIT I. PHYSICAL DAMAGE — TRANSPORTATION C. EMPLOYEE HIRED AUTO EXPENSES — INCREASED LIMIT D. EMPLOYEES AS INSURED J. PERSONAL PROPERTY E. SUPPLEMENTARY PAYMENTS — INCREASED K. AIRBAGS LIMITS L. NOTICE AND KNOWLEDGE OF ACCIDENT OR F. HIRED AUTO — LIMITED WORLDWIDE COV- LOSS ERAGE— INDEMNITY BASIS M. BLANKET WAIVER OF SUBROGATION G. WAIVER OF DEDUCTIBLE— GLASS N. UNINTENTIONAL ERRORS OR OMISSIONS PROVISIONS A. BROAD FORM NAMED INSURED this insurance applies and only to the extent that The following is added to Paragraph A.1., Who Is person or organization qualifies as an "insured" An Insured, of SECTION II — COVERED AUTOS under the Who Is An Insured provision contained LIABILITY COVERAGE: in Section II. Any organization you newly acquire or form dur- C. EMPLOYEE HIRED AUTO ing the policy period over which you maintain 1. The following is added to Paragraph A.1., 50% or more ownership interest and that is not Who Is An Insured, of SECTION II — COV- separately insured for Business Auto Coverage. ERED AUTOS LIABILITY COVERAGE: Coverage under this provision is afforded only un- An "employee" of yours is an "insured" while til the 180th day after you acquire or form the or- operating an "auto" hired or rented under a ganization or the end of the policy period, which- contract or agreement in an "employee's" ever is earlier. name, with your permission, while performing duties related to the conduct of your busi- B. BLANKET ADDITIONAL INSURED ness. The following is added to Paragraph c. in A.1., 2. The following replaces Paragraph b. in B.5., Who Is An Insured, of SECTION II — COVERED Other Insurance, of SECTION IV — BUSI- AUTOS LIABILITY COVERAGE: NESS AUTO CONDITIONS: Any person or organization who is required under b. For Hired Auto Physical Damage Cover- a written contract or agreement between you and age, the following are deemed to be cov- that person or organization, that is signed and ered "autos" you own: executed by you before the "bodily injury" or (1) Any covered "auto" you lease, hire, "property damage" occurs and that is in effect rent or borrow; and during the policy period, to be named as an addi- (2) Any covered "auto" hired or rented by tional insured is an "insured" for Covered Autos your "employee" under a contract in Liability Coverage, but only for damages to which - an "employee's" name,--with your CA T3 53 02 15 ©2015 The Travelers Indemnity Company.All rights reserved. Page 1 of 4 Includes copyrighted material of Insurance Services Office, Inc.with its permission. COMMERCIAL AUTO permission, while performing duties (a) With respect to any claim made or "suit" related to the conduct of your busi- brought outside the United States of ness. America, the territories and possessions However, any "auto" that is leased, hired, of the United States of America, Puerto rented or borrowed with a driver is not a Rico and Canada: covered "auto". (i) You must arrange to defend the "in- D. EMPLOYEES AS INSURED sured" against, and investigate or set- tle any such claim or "suit" and keep The'following is added to Paragraph A.1., Who Is us advised of all proceedings and ac- An Insured, of SECTION II — COVERED AUTOS tions. LIABILITY COVERAGE: (ii) Neither you nor any other involved Any "employee" of yours is an "insured" while us- "insured" will make any settlement ing a covered "auto" you don't own, hire or borrow without our consent. in your business or your personal affairs. (iii) We may, at our discretion, participate E. SUPPLEMENTARY PAYMENTS — INCREASED in defending the "insured" against, or LIMITS in the settlement of, any claim or 1. The following replaces Paragraph A.2.a.(2), "suit". of SECTION II — COVERED AUTOS LIABIL- (iv) We will reimburse the "insured" for ITY COVERAGE: sums that the "insured" legally must (2) Up to $3,000 for cost of bail bonds (in- pay as damages because of "bodily cluding bonds for related traffic law viola- injury" or "property damage" to which tions) required because of an "accident" this insurance applies, that the "in- we cover. We do not have to furnish sured" pays with our consent, but these bonds. only up to the limit described in Para- 2. The following replaces Paragraph A.2.a.(4), graph C., Limits Of Insurance, of of SECTION II — COVERED AUTOS LIABIL- SECTION II — COVERED AUTOS ITY COVERAGE: LIABILITY COVERAGE. (4) All reasonable expenses incurred by the (v) We will reimburse the "insured" for "insured" at our request, including actual the reasonable expenses incurred loss of earnings up to $500 a day be- with our consent for your investiga- cause of time off from work. tion of such claims and your defense of the "insured" against any such F. HIRED AUTO — LIMITED WORLDWIDE COV- "suit", but only up to and included ERAGE— INDEMNITY BASIS within the limit described in Para- The following replaces Subparagraph (5) in Para- graph C., Limits Of Insurance, of graph B.7., Policy Period, Coverage Territory, SECTION II — COVERED AUTOS of SECTION IV — BUSINESS AUTO CONDI- LIABILITY COVERAGE, and not in TIONS: addition to such limit. Our duty to (5) Anywhere in the world, except any country or make such payments ends when we jurisdiction while any trade sanction, em- have used up the applicable limit of bargo, or similar regulation imposed by the insurance in payments for damages, United States of America applies to and pro- settlements or defense expenses. hibits the transaction of business with or (b) This insurance is excess over any valid within such country or jurisdiction, for Cov- and collectible other insurance available ered Autos Liability Coverage for any covered to the "insured" whether primary, excess, "auto" that you lease, hire, rent or borrow contingent or on any other basis. without a driver for a period of 30 days or less (c) This insurance is not a substitute for re- and that is not an "auto" you lease, hire, rent quired or compulsory insurance in any or borrow from any of your "employees", country outside the United States, its ter- partners (if you are a partnership), members ritories and possessions, Puerto Rico and (if you are a limited liability company) or. Canada. members of their households. Page 2 of 4 ©2015 The Travelers Indemnity Company.All rights reserved. CA T3 53 02 15 Includes copyrighted material of Insurance Services Office, Inc.with its permission. COMMERCIAL AUTO You agree to maintain all required or (2) In or on your covered "auto". compulsory insurance in any such coun- This coverage applies only in the event of a total try up to the minimum limits required by theft of your covered "auto". local law. Your failure to comply with No deductibles apply to this Personal Property compulsory insurance requirements will not invalidate the coverage afforded by coverage. this policy, but we will only be liable to the K. AIRBAGS same extent we would have been liable The following is added to Paragraph B.3., Exclu- had you complied with the compulsory in- sions, of SECTION III — PHYSICAL DAMAGE surance requirements. COVERAGE: (d) It is understood that we are not an admit- Exclusion 3.a. does not apply to "loss" to one or ted or authorized insurer outside the more airbags in a covered "auto" you own that in- United States of America, its territories flate due to a cause other than a cause of "loss" and possessions, Puerto Rico and Can- set forth in Paragraphs A.1.b. and A.1.c., but ada. We assume no responsibility for the only: furnishing of certificates of insurance, or a. If that "auto" is a covered "auto" for Compre- for compliance in any way with the laws hensive Coverage under this policy; of other countries relating to insurance. b. The airbags are not covered under any war- G. WAIVER OF DEDUCTIBLE —GLASS ranty; and The following is added to Paragraph D., Deducti- c. The airbags were not intentionally inflated. ble, of SECTION III — PHYSICAL DAMAGE We will pay up to a maximum of $1,000 for any COVERAGE: one "loss". No deductible for a covered "auto" will apply to L. NOTICE AND KNOWLEDGE OF ACCIDENT OR glass damage if the glass is repaired rather than LOSS replaced. The following is added to Paragraph A.2.a., of H„ HIRED AUTO PHYSICAL DAMAGE — LOSS OF SECTION IV— BUSINESS AUTO CONDITIONS: USE — INCREASED LIMIT Your duty to give us or our authorized representa- The following replaces the last sentence of Para- tive prompt notice of the "accident" or "loss" ap- graph AA.b., Loss Of Use Expenses, of SEC- plies only when the "accident" or "loss" is known TION III — PHYSICAL DAMAGE COVERAGE: to: However, the most we will pay for any expenses (a) You (if you are an individual); for loss of use is $65 per day, to a maximum of (b) A partner (if you are a partnership); $750 for any one "accident". (c) A member (if you are a limited liability com- I. PHYSICAL DAMAGE — TRANSPORTATION pany); EXPENSES — INCREASED LIMIT (d) An executive officer, director or insurance The following replaces the first sentence in Para- manager (if you are a corporation or other or- graph A.4.a., Transportation Expenses, of ganization); or SECTION III — PHYSICAL DAMAGE COVER- (e) Any "employee" authorized by you to give no- AGE: tice of the "accident" or"loss". We will pay up to $50 per day to a maximum of M. BLANKET WAIVER OF SUBROGATION $1,500 for temporary transportation expense in- The following replaces Paragraph A.5., Transfer curred by you because of the total theft of a cov- Of Rights Of Recovery Against Others To Us, ered "auto" of the private passenger type. of SECTION IV — BUSINESS AUTO CONDI- J. PERSONAL PROPERTY TIONS: The following is added to Paragraph AA., Cover- 5. Transfer Of Rights Of Recovery Against age Extensions, of SECTION III — PHYSICAL Others To Us DAMAGE COVERAGE: We waive any right of recovery we may have Personal Property against any person or organization to the ex- tent required of you by a written contract We will pay up to $400 for "loss" to wearing ap- signed and executed prior to any "accident" parel and other personal property which is: or"loss", provided that the "accident" or"loss" (1) Owned by an "insured"; and arises out of operations contemplated by CA T3 53 02 15 ©2015 The Travelers Indemnity Company.All rights reserved. Page 3 of 4 Includes copyrighted material of Insurance Services Office, Inc.with its permission. COMMERCIAL AUTO such contract. The waiver applies only to the The unintentional omission of, or unintentional person or organization designated in such error in, any information given by you shall not contract. prejudice your rights under this insurance. How- N. UNINTENTIONAL ERRORS OR OMISSIONS ever this provision does not affect our right to col- The following is added to Paragraph B.2., Con- lect additional premium or exercise our right of cealment, Misrepresentation, Or Fraud, of cancellation or non-renewal. SECTION IV— BUSINESS AUTO CONDITIONS: Page 4 of 4 ©2015 The Travelers Indemnity Company.All rights reserved. CA T3 53 02 15 Includes copyrighted material of Insurance Services Office, Inc.with its permission, Policy#ZLP-51M54094 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. OTHER INSURANCE - ADDITIONAL INSUREDS - PRIMARY AND ON-CONTRIBUTORY WITH RESPECT TO CERTAIN OTHER INSURANCE This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART The following is added to Paragraph 4. a., Primary (1) The "bodily injury" or"property damage"for which Insurance, of SECTION IV — COMMERCIAL GEN- coverage is sought is caused by an "occurrence" ERAL LIABILITY CONDITIONS: that takes place; and However, if you specifically agree in a written contract (2) The "personal injury" or "advertising injury" for or agreement that the insurance afforded to an addi- which coverage is sought arises out of an offense tional insured under this Coverage Part must apply on that is committed; a primary basis, or a primary and non-contributory basis, this insurance is primary to other insurance that subsequent to the signing and execution of that con- is available to such additional insured which covers tract or agreement by you, such additional insured as a named insured, and we will not share with that other insurance, provided that: CG D4 25 07 08 0 2008 The Travelers Companies,Inc. Page 1 Of 1 «��KVr � WORKERS COMPENSATION Y L AND EMPLOYERS LIABILITY POLICY ENDORSEMENT WC 99 03 76 ( A)— POLICY NUMBER: WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT - CALIFORNIA (BLANKET WAIVER) 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. The additional premium for this endorsement shall be % of the California workers' compensation pre- mium. Schedule Person or Organization Job Description This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective 3/1/2018 Policy No. OK25185A - Endorsement No. Insured Premium Insurance Company Travelers Prop Cas Co of America Countersigned by DATE OF ISSUE: - - ST ASSIGN: Page 1 of 1