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PROOF OF INSURANCE (2019) CLOSED TE A�® CERTIFICATE OF LIABILITY INSURANCE I DA 6/22/2018) 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). PRODUCER CONTACT Edgewood Partners Ins. Center PHONE Amanda Garcia FAX License#01329370 (A/C,No.Ext): 916-576-1510 (A/C,No):916-583-7618 1765 Challenge Way, Suite 200 I E-MAIL ADDRESS: amanda.garcia@epicbrokers.com Sacramento CA 95815 I INSURER(S)AFFORDING COVERAGE NAIC# INSURERA:Valley Forge Insurance Co 20508 INSURED COOPPERS INSURER B:The Continental Insurance Company 35289 Cooperative Personnel Services I DBA: CPS HR Consulting INSURERC:American Casualty Company of Reading,PA 20427 2450 Del Paso Rd., Ste. 220 I INSURER D: Lloyds of London 85202 Sacramento CA 95834 I INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:569809393 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. INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR INSD WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) A X COMMERCIAL GENERAL LIABILITY 6072390517 7/1/2018 7/1/2019 EACH OCCURRENCE $1,000,000 CLAIMS-MADE OCCUR PREMI ETORENTED PREMISES(Ea occurrence) $1,000,000 MED EXP(Any one person) $15,000 PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 POLICY � JjRO- ECT 1:1 LOC PRODUCTS-COMP/OP AGG $2,000,000 OTHER: $ B AUTOMOBILE LIABILITY 6072390548 7/1/2018 7/1/2019 COMBINED SINGLE LIMIT $ (Ea accident) 1.000.000 ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS X X NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS (Per accident) B X UMBRELLA LAB X OCCUR 6072390551 7/1/2018 7/1/2019 EACH OCCURRENCE $6,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $6,000,000 DED I X I RETENTION$$10 000 $ C WORKERS COMPENSATION 6072390534 7/1/2018 7/1/2019PER X STATUTE OERH Stop Gap Applies C AND EMPLOYERS'LIABILITY Y/N 6072390520 7/1/2018 7/1/2019 ANY PROPRIETOR/PARTNER/EXECUTIVEE.L.EACH ACCIDENT $1,000,000 OFFICER/MEMBER EXCLUDED? ❑ N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000 D Errors&Omissions W18DC5180401 7/1/2018 7/1/2019 Per Claim/Agg $5,000,000 Claims Made/Retro Date 10/13/1989 SIR Per Claim $50,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) RE: All ContractsAA/ritten Agreements between the Certificate Holder and the Insured. Additional Insured:City of EI Segundo, its officials and employees. When required by written contract,Additional Insured status with primary coverage applies to General Liability and Automobile Liability and Waiver of Subrogation applies to General Liability,Automobile Liability,and Workers'Compensation,all per the attached endorsements. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of EI Segundo 350 Main St. EI Segundo, CA 90245 AUTHORIZED �A @ 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD CNA General Liability Extension Endorsement 1. ADDITIONAL INSUREDS a. WHO IS AN INSURED is amended to include as an Insured any person or organization described in paragraphs A. through K. below whom a Named Insured is required to add as an additional insured on this Coverage Part under a written contract or written agreement, provided such contract or agreement: (1) is currently in effect or becomes effective during the term of this Coverage Part; and (2) was executed prior to: (a) the bodily injury orproperty damage; or (b) the offense that caused the personal and advertising injury, for which such additional insured seeks coverage. b. However, subject always to the terms and conditions of this po|icy, including the limits of insurance, the Insurer will not provide such additional insured with: (1) ahigher limit ofinsurance than required bysuch contract oragreement; or (2) coverage broader than required by such contract or agreement, and in no event broader than that described bythe applicable paragraph A. through K. below. Any coverage granted by this endorsement shall apply only to the extent permissible by law. A. Controlling Interest Any person or organization with a controlling interest in a Named Anaured, but only with respect to such person or organization's liability for bodily iniury, property damage or personal and advertising injury arising out of: 1. such person ororganization's financial control ofaNamed Insured; or 2. premises such person or organization owns, maintains or controls while a Named Insured leases or occupies such premises; provided that the coverage granted by this paragraph does not apply to structural a|tenaUons, new construction or demolition operations performed by, on behalf of, or for such additional insured. B. Co-owner nfInsured Premises A co-owner of a premises co-owned by a Named Insured and covered under this insurance but only with respect to such co-owner's liability for bodily iniury, property damage or personal and advertising injury as co-owner of such premises. C. Grantor nfFranchise Any person or organization that has granted a franchise to a Named Anaured, but only with respect to such person or organization's liability for bodily injury, property damage or personal and advertising injury as grantor ofafranchise tothe Named Insured. D. Lessor nfEquipment Any person or organization from whom a Named Insured leases equipment, but only with respect to liability for bodily iniury, property damage or personal and advertising injury caused, in whole or in part. by the Named 8nsunmd's maintenance, operation or use of such equipment, provided that the occurrence giving rise to such bodily iniury, property damage or the offense giving rise to such personal and advertising injury takes place prior tothe termination cJsuch lease. E. Lessor nfLand Any person or organization from whom a Named Insured leases land but only with respect to liability for bodily iniury, property damage or personal and advertising injury arising out of the ownership. CNA74878XX (115) Policy NO: 6O7239OSI7 Page 2cJ13 Endorsement No: Effective Date: 7/I/20I8 Insured Name: Copyright CNA All Rights Reserved. Includes copyrighted material mInsurance Services Office,|n"..with its permission. CNA General Liability Extension Endorsement maintenance oruse ofsuch land, provided that the occurrence giving rise tosuch bodily injury orproperty dammage, or the offense giving rise to such personal and advertising iniury, hakes place prior to the termination of such lease. The coverage granted by this paragraph does not apply to structural alterations, new construction or demolition operations performed by, on behalf of, or for such additional insured. F. Lessor nfPremises An owner or lessor cJpremises leased to the Named Anaured, or such owner or lessors real estate manager, but only with respect to liability for bodily injury, property damage or personal and advertising injury arising out of the ownership, maintenance or use of such part of the premises leased to the Named Anaured, and provided that the occurrence giving rise to such bodily iniury, property damage or the offense giving rise to such personal and advertising injury takes place prior to the termination of such lease. The coverage granted by this paragraph does not apply to structural a|tenaUons, new construction or demolition operations performed by, on behalf of, or for such additional insured. G. Mortgagee,Assignee nrReceiver A mortgagee, assignee or receiver of premises but only with respect to such mortgagee, assignee or receiver's liability for bodily injury, property damage or personal and advertising injury arising out of the Named Insured's ownership, maintenance, or use of a premises by a Named Insured. The coverage granted by this paragraph does not apply to structural a|tenaUons, new construction or demolition operations performed by, on behalf of, or for such additional insured. H. State or Governmental Agency nrSubdivision or Political Subdivisions—Permits A state or governmental agency or subdivision or political subdivision that has issued a permit or authorizaUon, but only with respect to such state or governmental agency or subdivision or political subdivision's liability for bodily injury, property damage or personal and advertising injury arising out of: 1. the following hazards in connection with premises a Named Insured owns, rents, or controls and to which this insurance applies: a. the existence, maintenance, repair, construction, erection, or removal of advertising signs, avvnings, canopies, cellar entnances, coal ho|es, driveways, manho|es, manquees, hoisbsvvay openings, sidewalk vaults, street banners, ordecorations and similar exposures; or b. the constru(tion, erection, or removal of elevators; or c. the ownership, maintenance or use of any elevators covered by this insurance; or 2. the permitted or authorized operations performed by Named Insured or on a Named 8nsunmd's behalf. The coverage granted bythis paragraph does not apply to: a. Bodily iniury, property damage or personal and advertising injury arising out of operations performed for the state or governmental agency or subdivision or political subdivision; or b. Bodily injury or property damage included within the prod u cts-com pleted operations hazard. With respect h)this provision's requirement that additional insured status must berequested under awritten contract or agreement. the Insurer will treat as a written contract any governmental permit that requires the Named Insured toadd the governmental entity asanadditional insured. A. Trade Show Event Lessor 1. With respect to a Named 8nsunmd's participation in a trade show event as an exhibitor, presenter or disp|ayer, any person or organization whom the Named Insured is required to include as an additional insured, but only with respect to such person or organization's liability for bodily iniury, property damage orpersonal and advertising injury caused by: CNA74878XX (115) Po|icyNo: 60723905I7 Page 3cJ13 Endorsement No: Effective Date: 7/I/20I8 Insured Name: Copyright CNA All Rights Reserved. Includes copyrighted material mInsurance Services Office,|n"..with its permission. CNA General Liability Extension Endorsement a. the Named Insured's acts or omissions; or b. the acts or omissions of those acting on the Named Insured's behalf, in the performance of the Named Insured's ongoing operations at the trade show event premises during the trade show event. 2. The coverage granted by this paragraph does not apply to bodily injury or property damage included within the products-completed operations hazard. J. Vendor Any person or organization but only with respect to such person or organization's liability for bodily injury or property damage arising out of your products which are distributed or sold in the regular course of such person or organization's business, provided that: 1. The coverage granted by this paragraph does not apply to: a. bodily injury or property damage for which such person or organization is obligated to pay damages by reason of the assumption of liability in a contract or agreement unless such liability exists in the absence of the contract or agreement; b. any express warranty unauthorized by the Named Insured; c. any physical or chemical change in any product made intentionally by such person or organization; d. repackaging, except when unpacked solely for the purpose of inspection, demonstration, testing, or the substitution of parts under instructions from the manufacturer, and then repackaged in the original container; e. any failure to make any inspections, adjustments, tests or servicing that such person or organization has agreed to make or normally undertakes to make in the usual course of business, in connection with the distribution or sale of the products; f. demonstration, installation, servicing or repair operations, except such operations performed at the such person or organization's premises in connection with the sale of a product; g. products which, after distribution or sale by the Named Insured, have been labeled or relabeled or used as a container, part or ingredient of any other thing or substance by or for such person or organization; or h. bodily injury or property damage arising out of the sole negligence of such person or organization for its own acts or omissions or those of its employees or anyone else acting on its behalf. However, this exclusion does not apply to: (1) the exceptions contained in Subparagraphs d. or f. above; or (2) such inspections, adjustments, tests or servicing as such person or organization has agreed with the Named Insured to make or normally undertakes to make in the usual course of business, in connection with the distribution or sale of the products. 2. This Paragraph J. does not apply to any insured person or organization, from whom the Named Insured has acquired such products, nor to any ingredient, part or container, entering into, accompanying or containing such products. 3. This Paragraph J. also does not apply: a. to any vendor specifically scheduled as an additional insured by endorsement to this Coverage Part; b. to any of your products for which coverage is excluded by endorsement to this Coverage Part; nor c. if bodily injury or property damage included within the products-completed operations hazard is excluded by endorsement to this Coverage Part. CNA74879XX (1-15) Policy No: 6072390517 Page 4 of 13 Endorsement No: Effective Date: 7/1/2 018 Insured Name: Copyright CNA All Rights Reserved. Includes copyrighted material of Insurance Services Office,Inc.,with its permission. CNA General Liability Extension Endorsement K. Other Person 0rOrganization Any person or organization who is not an additional insured under Paragraphs A. through J. above. Such additional insured is an Insured solely for bodily iniury, property damage or personal and advertising injury for which such additional insured is liable because of the Named Insured's acts or omissions. The coverage granted by this paragraph does not apply to any person or organization: 1. for bodily injury, property damage, or personal and advertising injury arising out of the rendering or failure torender any professional service; 2. for bodily injury or property damage included within the prod u cts-com pleted operations hazard; nor 3. who is specifically scheduled as an additional insured on another endorsement to this Coverage Part. 2. ADDITIONAL INSURED-PRIMARY AND NON-CONTRIBUTORY T0ADDITIONAL 8NS0RED'SINSURANCE A. The Other Insurance Condition inthe COMMERCIAL GENERAL LIABILITY CONDITIONS Section is amended h)add the following paragraph: If the Named Insured has agreed in writing in a contract or agreement that this insurance is primary and non-contributory relative toan additional insured'sovvn insunance, then this insurance is primary. and the Insurer will not seek contribution from that other insurance. For the purpose of this provision 2., the additional insured's own insurance means insurance on which the additional insured is a named insured. B. With respect to persons or organizations that qualify as additional insureds pursuant to paragraph 1.K. of this endorsement, the following sentence isadded tothe paragraph above: Otherwise, and notwithstanding anything to the contrary elsewhere in this Condition, the insurance provided to such person or organization is excess of any other insurance available to such person or organization. 3. BODILY INJURY—EXPANDED DEFINITION Under DEFINITIONS the definition ofbodily injury isdeleted and replaced bythe following: Bodily injury means physical injury, sickness or disease sustained by person, including death, humi|iaUon, shock, mental anguish or mental injury sustained by that person at any time which results as a consequence of the physical injury, sickness ordisease. 4. BROAD KNOWLEDGE 0FOCCURRENCE/NOTICE 0FOCCURRENCE Under CONDITIONS, the condition entitled Duties in The Event of Occurrence, 0ffenae. Claim or Suit is amended h)add the following: A. BROAD KNOWLEDGE 0FOCCURRENCE The Named Insured must give the Insurer or the Insurer's authorized representative notice of an nccurrence, offense or claim only when the nccurrence, offense or claim is known to a natural person Named Anaured, to a partner, executive officer, manager or member of a Named Anaured, or to an employee designated byany ofthe above h)give such notice. B. NOTICE 0FOCCURRENCE The Named Anaured's rights under this Coverage Part will not be prejudiced if the Named Insured fails to give the Insurer notice of an nccurrence, offense or claim and that failure is solely due to the Named Insured's reasonable belief that the bodily injury or property damage is not covered under this Coverage Part. However, the Named Insured shall give written notice of such nccurrence, offense or claim to the Insurer assoon asthe Named Insured isaware that this insurance may apply tosuch occurrence, offense or claim. 5. BROAD NAMED INSURED WHO IS AN INSURED is amended to delete its Paragraph 3. in its entirety and replace it with the following: CNA74878XX (1 15) Po|icyNo: 60723905I7 Page 5cJ13 Endorsement No: Effective Date: 7/I/20I8 Insured Name: Copyright CNA All Rights Reserved. Includes copyrighted material mInsurance Services Office,|n"..with its permission. CNA General Liability Extension Endorsement 17. PROPERTY DAMAGE—ELEVATORS A. Under COVERAGES, Coverage A— Bodily Injury and Property Damage Liability, the paragraph entitled Exclusions is amended such that the Damage to Your Product Exclusion and subparagraphs (3), (4) and (0) of the Damage to Property Exclusion do not apply to property damage that results from the use of elevators. B. Solely for the purpose of the coverage provided by this PROPERTY DAMAGE—ELEVATORS Provision, the Other Insurance conditions isamended toadd the following paragraph: This insurance is excess over any ofthe other insunance, whether primary, excess, contingent or on any other basis that is Property insurance covering property of others damaged from the use of elevators. 18. SUPPLEMENTARY PAYMENTS The section entitled SUPPLEMENTARY PAYMENTS—COVERAGES AAND Bisamended asfollows: A. Paragraph 1.b. is amended to delete the $250 limit shown for the cost of bail bonds and replace it with a $5.00O. limit; and B. Paragraph 1.d. is amended to delete the limit of$250 shown for daily loss of earnings and replace it with a $1,000. limit. 19. UNINTENTIONAL FAILURE TO DISCLOSE HAZARDS If the Named Insured unintentionally fails to disclose all existing hazards at the inception date of the Named 8nsunmd's Coverage Part, the Insurer will not deny coverage under this Coverage Part because of such failure. 2W. WAIVER 0F SUBROGATION - BLANKET Under CONDITIONS, the Transfer Of Rights Of Recovery Against Others To Us Condition is amended to add the following: The Insurer waives any right of recovery the Insurer may have against any person or organization because of payments the Insurer makes for injury ordamage arising out of: 1. the Named 8nsunmd'songoing operations; or 2. your work included inthe prod ucta-cnmmp|etedoperations hazard. However, this waiver applies only when the Named Insured has agreed in writing to waive such rights of recovery in a written contract or written agreement, and only if such contract or agreement: 1. isineffect orbecomes effective during the term cJthis Coverage Part; and 2. was executed prior to the bodily iniury, property damage or personal and advertising injury giving rise tothe claim. All other terms and conditions ofthe Policy remain unchanged. This endorsement, which forms a part of and is for attachment to the Policy issued by the designated Insurers, takes effect on the effective date of said Policy at the hour stated in said po|icy, unless another effective date is shown � below, and expires concurrently with said Policy. | CNA74878XX (1 15) Po|icYNo: 60723905I7 Page 13cJ13 Endorsement No: Effective Date: 7/I/20I8 Insured Name: Copyright CNA All Rights Reserved. Includes copyrighted material mInsurance Services Office,|n"..with its permission. CNA83700XX CNA (Ed. 10-15) EXTENDED COVERAGE - BA PLUS - FOR HIRED AND NON-OWNED AUTOS It is understood and agreed that this endorsement amends the BUSINESS AUTO COVERAGE FORM as follows. If any other endorsement attached to this policy amends any provision also amended by this endorsement, then that other endorsement controls with respect to such provision, and the changes made by this endorsement to such provision do not apply. TABLE OF CONTENTS I. AMENDMENTS TO LIABILITY COVERAGE A. Who Is An Insured 1. Majority Owned Corporations 2. Newly Acquired Organizations 3. Additional Insureds Required By Written Contracts 4. Employee-Hired Autos B. Increased Loss of Earnings Allowance C. Fellow Employee Coverage II. AMENDMENTS TO PHYSICAL DAMAGE COVERAGE A. Increased Loss of Use Expense B. Broadened Electronic Equipment Coverage III. AMENDMENTS TO BUSINESS AUTO CONDITIONS A. Knowledge of Accident or Loss B. Knowledge of Documents C. Waiver of Subrogation D. Unintentional Failure To Disclose Hazards E. Primary and Non-Contributory When Required By Contract IV. AMENDMENTS TO DEFINITIONS A. Broadened Bodily Injury I. AMENDMENTS TO LIABILITY COVERAGE A. Amendments to Who Is An Insured Under SECTION II — COVERED AUTOS LIABILITY COVERAGE, the paragraph entitled Who Is An Insured is amended to add the following: 1. Majority Owned Corporations Any incorporated entity in which you own a majority of the voting stock on the inception date of this Coverage Form is an "insured", but only if such entity is not an "insured" under any other liability"policy" that provides "auto" coverage. 2. Newly Acquired Organizations Any organization you newly acquire or form during the policy period, other than a limited liability company, partnership or joint venture, and in which you maintain majority ownership interest is an "insured", but only if such organization is not an "insured" under any other liability "policy" that provides "auto" coverage. The insurance afforded by this provision: CNA8370OXX (Ed. 10-15) Page 1 of 3 Copyright,CNA All Rights Reserved. CNA83700XX CNA (Ed. 10-15) a. Is effective on the date of acquisition or formation of the organization, and applies until: (1) The end of the policy period of this Coverage Form; or (2) The next anniversary of this Coverage Form's inception date, whichever is earlier; and b. Does not apply to "bodily injury" or"property damage" caused by an "accident" that occurred before you acquired or formed the organization. 3. Additional Insureds Required By Written Contract Any person or organization that you are required by written contract to make an additional insured under this insurance is an "insured", but only with respect to that person or organization's legal liability for acts or omissions of a person who qualifies as an "insured" for Liability Coverage under Section II —Who Is An Insured of this Coverage Form. 4. Employee-Hired Autos Any "employee" of yours is an "insured" while operating with your permission an "auto" hired or rented under a contract in that "employee's" name, while performing duties related to the conduct of your business. With respect to provisions A.1. and A.2. above, "policy" includes those policies that were in force on the inception date of this Coverage Form, but: i. Which are no longer in force; or ii. Whose limits have been exhausted. B. Increased Loss of Earnings Allowance Under SECTION II — COVERED AUTOS LIABILITY COVERAGE, the paragraph entitled Coverage Extensions is amended under Supplementary Payment subparagraph (4) to delete the $250 a day limit for loss of earnings and replace it with a $500 a day limit. C. Fellow Employee Coverage Under SECTION II — COVERED AUTOS LIABILITY COVERAGE, the paragraph entitled Exclusions is amended to delete the exclusion entitled Fellow Employee. II. AMENDMENTS TO PHYSICAL DAMAGE COVERAGE A. Increased Loss of Use Expense Under SECTION III — PHYSICAL DAMAGE COVERAGE, the paragraph entitled Coverage Extensions is amended under Loss of Use Expenses to delete the maximum of$600, and replace it with a maximum of $800. B. Broadened Electronic Equipment Coverage Under SECTION III — PHYSICAL DAMAGE COVERAGE, the paragraph entitled Exclusions is amended to delete paragraphs 5.a through 5.d. in their entirety, and replace them with the following: 5. Exclusions 4.c. and 4.d. above do not apply to "loss" to any electronic equipment that at the time of "loss" is: a. Permanently installed in or upon a covered "auto", nor to such equipment's antennas or other accessories used with such equipment. A $100 deductible applies to this provision, and supersedes any otherwise applicable deductible; or b. Designed to be operated solely by use of the power from the "auto's" electrical system and is: (1) Removable from a housing unit which is permanently installed in or upon the covered "auto"; (2) An integral part of the same unit housing any electronic equipment described in paragraphs a. or b.(1) above; or (3) Necessary for the normal operation of the covered "auto" or the monitoring of the covered "auto's"operating system. CNA83700XX (Ed. 10-15) Page 2 of 3 Copyright,CNA All Rights Reserved. CNA83700XX CNA (Ed. 10-15) III. AMENDMENTS TO BUSINESS AUTO CONDITIONS A. Knowledge of Accident or Loss Under BUSINESS AUTO CONDITIONS, the Loss Condition entitled Duties In the Event of Accident, Claims, Suit, or Loss is amended to add the following subparagraph a.(4): (4) If your"employees" know of an "accident" or"loss", this will not mean that you have such knowledge until such "accident" or "loss" is known to a natural person Named Insured, to a partner, executive officer, manager or member of a Named Insured, or to an "employee"designated by any of the above to be your insurance manager. B. Knowledge of Documents Under BUSINESS AUTO CONDITIONS, the Loss Condition entitled Duties In the Event of Accident, Claims, Suit, or Loss is amended to add the following subparagraph b.(6): (6) If your "employees" know of documents concerning a claim or "suit", this will not mean that you have such knowledge until such documents are known to a natural person Named Insured, to a partner, executive officer, manager or member of a Named Insured, or to an "employee"designated by any of the above to be your insurance manager. C. Waiver of Subrogation Under BUSINESS AUTO CONDITIONS, the Loss Condition entitled Transfer Of Rights Of Recovery Against Others To Us is amended to add the following: We waive any right of recovery we may have, because of payments we make for injury or damage, against any person or organization for whom or which you are required by written contract or agreement to obtain this waiver from us. This injury or damage must arise out of your activities under a contract with that person or organization. You must agree to that requirement prior to an "accident"or"loss." D. Unintentional Failure To Disclose Hazards Under BUSINESS AUTO CONDITIONS, the General Condition entitled Concealment, Misrepresentation or Fraud is amended to add the following: Your failure to disclose all hazards existing on the inception date of this Coverage Form shall not prejudice you with respect to the coverage provided by this insurance, provided such failure or omission is not intentional. E. Primary and Non-Contributory When Required By Contract Under BUSINESS AUTO CONDITIONS, the General Condition entitled Other Insurance is amended to add the following: Notwithstanding provisions 5.a. through 5.d. above, the coverage provided by this Coverage Form shall be on a primary and non-contributory basis when required to be so by a written contract entered into prior to "accident"or"loss." IV. AMENDMENTS TO DEFINITIONS A. Broadened Bodily Injury Under DEFINITIONS, the definition of"bodily injury" is deleted and replaced by the following: "Bodily injury" means physical injury, sickness or disease sustained by a person, including death, mental anguish or mental injury sustained by that person which results as a consequence of the physical injury, sickness or disease. All other terms and conditions of the Policy remain unchanged. CNA83700XX (Ed. 10-15) Page 3 of 3 Copyright,CNA All Rights Reserved. I G-19160-B CNA (Ed. 11/97) WORKERS' COMPENSATION AND EMPLOYERS' LIABILITY INSURANCE POLICY BLANKET WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS This endorsement changes the policy to which it is attached. It is agreed that Part One — Workers' Compensation Insurance G. Recovery From Others and Part Two — Employers' Liability Insurance H. Recovery From Others are amended by adding the following: We will not enforce our right to recover against persons or organizations. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) PREMIUM CHARGE The charge will be an amount to which you and we agree that is a percentage of the total standard premium for California exposure. The amount is 2%. G-19160-B Page 1 of 1 (Ed. 11/97) WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 00 0313 (Ed. 4-84) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT Wehave the right to recover our payments from anyone liable for oninjury covered by this policy. Wewill 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.) This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. Schedule ALL PERSONS AND/OR ORGANIZATIONS THAT ARE REQUIRED BY WRITTEN CONTRACT OR AGREEMENT WITH THE INSURED, EXECUTED PRIOR TO THE ACCIDENT OR LOSS, THAT WAIVER OF SUBROGATION BE PROVIDED UNDER THIS POLICY FOR WORK PERFORMED BY YOU FOR THAT PERSON AND/OR ORGANIZATION 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 07/0I/20I8 Ponoymo. 6O723BOS34 Endorsement No. Insured Cooperative Personnel Services Premium$ Insurance Company CNA Insurance Company Countersigned by WC 00 0313 (Ed. 4-84) Copyright 1903National Council onCompensation Insurance. WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 42 03 04 B (Ed. 6-14) TEXAS WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT This endorsement applies only to the insurance provided by the policy because Texas is shown in Item 3.A. of the Information Page. 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, but this waiver applies only with respect to bodily injury arising out of the operations described in the Schedule where you are required by a written contract to obtain this waiver from us. This endorsement shall not operate directly or indirectly to benefit anyone not named in the Schedule. The premium for this endorsement is shown in the Schedule. Schedule 1. ( )Specific Waiver Name of person or organization (X) Blanket Waiver Any person or organization for whom the Named Insured has agreed by written contract to furnish this waiver. 2. Operations: ALL TEXAS OPERATIONS 3. Premium: The premium charge for this endorsement shall be 2 percent of the premium developed on payroll in connection with work performed for the above person(s)or organization(s) arising out of the operations described. 4. Advance Premium: SEE SCHEDULE 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 07/01/2018 Policy No. 2072390534 Endorsement No. Insured Cooperative Personel Services Premium Insurance Company CAN Insurance Companies Countersigned by WC420304B (Ed. 06-14) Copyright 2014 National Council on Compensation Insurance,Inc.All Rights Reserved.