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PROOF OF INSURANCE (2020) CLOSED'I DATE (MMIDD/YYYY) A�"COR"° CERTIFICATE OF LIABILITY INSURANCE 0411712019 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 have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER NAME: Christine .,,,,,,._. ITITITITITITITIT , IAP Baker, Romero &Associates Insurance Brokers, Inc. PHONE FAX NAME:; 750 Terrado Plaza #238 E Vin,; (hr11332 2258 Sousa _ s 9921 ri C. Nol. ( Covina, CA 91723 s3:ITITITITm christine@bakerromlero.com License #: OG22790RAGE A.lq # INSURERS) AF,FO,RDING COVEN ................ ... C7 ........... . INSU,RERA: TRAVELERsP QP„P,6,TV CA„SI,/ALTY CQ. OFAMArRICA ................... ... .? INSURED w3 Galvin PreservationAssociates Inc. uRERB: State CQMpsnsgtlon Insurance Fund. INSURER c:Conin.sn,s( Csspalr Cornpay 294.4 DBA GPA Consulting 231 California Street INSURERD, EI Segundo, CA 90245 INsuRER E: INSURER F COVERAGES CERTIFICATE NUMBER: 00000000-10365222 REVISION NUMBER: 436 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. !^IYQ __ ITq TYPE OF INSURANCE IIJSrI USUBM'(pi POLICY NUMBER IMMPCiOkYYM POLICY EXP POLICY EF LIMITS Y fMM100IYYYYt A .COMMERCIAL GENERAL LIABILITY Y Y 680-4H777478-19-47 03/14/2019 I03/14/2020 ..EA M.H , w OCCURRENCE CLAIMS -MADE OCCURO ,,11,,,000000 00OQO p MED EXP (Any one person) $ 5,000 G'EN'LAGGREGATE LIMIT APPLIES PER: ....... GENERAL AGGREGATE Y....�....m...mm ..2,000 u0 POLICY FX] P"0- AGG P $ 2,000,000 PERSONAL&ADV INJURY $ 1 000,00 ......IT. OTHER JECT Loc(PRoEm�loye......,,,.°P.......... 1.000.000.... JECT OMPI .., Employee Bene $ p COMBINED' VNGLE UVIT $ 1.000,xOO,9,.,., A Y Y BA -5F994222 -19 -GRP 03/14/2019 03I14I202011-6Foo LY INJURY (Per (Far para AUTOMOBILE LIABILITY ANY AUTO on) $ OWNED SCHEDULED BODILY INJURY (Per accident) $ _AUTOS ONLY AUTOS_ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY (Per ac6darltj SAGE $ VROPER EXCESS LIAB CLAIMS -MADE AGGREGATE OCCURRENCE $ 7.090',000— DEC) ,000'}000 UMBRELLA LIAR �..,..........................................., .... ...0'Q OCCUR E $ 7, A � � J RETENTION 10000 Y Y CUP-OJ605520-19-47 03/14/2019 03/14/2020 EACH ,O DED X I RETIE .. $ S B ANY PROPRIYERS' LIA BURY XECUTIVE Y / N PER OTH- Y 9114062-19 03/14/2019 03/14/2020 TXL,I �EACHmACCIDEN1� EE ,$mm,,,,,mmm,,,,,,,,,,,,,,,, WORKERS COMPENSATION TUTS R OFFICER/MEMBER EXCLUDED? NIA (Mandatory in NH) E 1,000,000 , L, DISEASE - EA EMPLOYEE ,.$ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E L DISEASE- POLICY LIMIT $ 1,000,000 C Prof. Liab.$15K Ded EEH288371840 03/14/2019 03/14/2020 $5M Per Claim retro: 3120112 C Pollution, $15k DED EHH288371840 03/14/2019 03/14/2020 a Aggregate 5,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) A.M. Best Ratings: Travelers Properly Casualty Company of America (A++ XV); Continental Casualty Company (A XV); State Compensation Insurance Fund (Not Rated) The City of EI Segundo Planning & Building Safety, its officials, and employees are Named as Additional insured(s) . This inusrance is Primary and Non -Contributory and any other insurance that may be carried by the City will be excess thereto. The following blanket forms apply to the Additional Insured(s) attached herewith: Blanket Addtional Insured CGD3810915; Coverage Xtend Endorsement CGD3790116; Auto Additional Insured Auto Coverage Plus Endorsement CAT4200215; Worker's Compensation Blanket Waiver of Subrogation SCIF Form 10217. Coverage shall) t be (continued on ACORD 101 Additional Remarks Schedule) �....�• CERTIFICATE FOLDER CANCELLATION City of EI Segundo Planning & Building Safety Department 350 Main Street EI Segundo, CA 90245-3813 AUTHORIZED REPRESENTATIVE (CRS) .- r,... ©1988-2015 ACOD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Printed by CRS on April 17, 2019 at 01:12PM SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. ACORD 25 (2016/03) AGENCY CUSTOMER ID: 00000000 LOC #: A /� ADDITIONAL REMARKS SCHEDULE 2 ,,�'/� Page of AGENCY NAMED INSURED Baker, Romero & Associates Insurance Brokers, Inc. Galvin Preservation Associates Inc. - _ -�— — DBA GPA Consulting POLICY NUMBER N/A CARRIER W NAIC CODE Multiple Carriers EFFECTIVE DATE: 11 ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25FORM TITLE: Certificate of Liability Insurance (continued from Description of Operations) canceled, non-renewed or materially altered except after thirty (30) days prior written notice has been given. ACORD 101 (2008/01) © 2008 ACORD CORPORATION, All rights reserved. The ACORD name and logo are registered marks of ACORD Printed by CRS on April 17, 2019 at 01:12PM POLICY NUMBER: 680-4H777478-19-47 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. a4JR] 4 41 1 This endorsement modifies Insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART 1. The following is added to SECTION 11— WHO IS AN INSURED: Any person or organization that you agree in a "written contract requiring insurance!" to include as an additional insured on this Coverage Part, but: a. Only with respect to liability for "bodily Injury". "property damage or "personal injury"; and b. If, and only to the extent that, the injury or damage is caused by acts or omissions of you or your subcontractor in the performance of 'your work" to which the "written contract requiring Insurance" applies, or in connection with premises owned by or rented to you. The person or organization does not qualify as an additional insured: c. With respect to the independent acts or omissions of such person or organization; or d. For "bodily injury'. "property damage or "'personal injury" for which such person or organization has assumed liability in a contract or agreement. The insurance provided to such additional insured is limited as follows: e. This insurance does not apply on any basis to any person or organization for which coverage as an additional Insured specifically Is added by another endorsement to this Coverage Pan. f. This insurance does not apply to the rendering of or failure to render any "professional services". g. In the event that the Limits of Insurance of the Coverage Part shown In the Declarations exceed the limits of liability required by the "written contract requiring Insurance", the insurance provided to the additional insured shall be limited to the limits of liability required by that "written contract requiring insurance". This endorsement does not increase the limits of insurance described in Section III — Limits Of Insurance. h. This insurance does not apply to "bodily injury" or "property damage" caused by "your work" and included in the "Products - completed operations hazard" unless the "written contract requiring insurance" specifically requires you to provide such coverage for that additional insured, and then the insurance provided to the additional insured applies only to such 'bodily injury" or "property damage" that occurs before the end of the period of time for which the "written contract requiring insurance" requires you to provide such coverage or the end of the policy period, whichever is earlier. 2. The following is added to Paragraph 4.a. of SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS: The insurance provided to the additional insured is excess over any valid and collectible other insurance, whether primary, excess, contingent or on any other basis, that is available to the additional insured for a loss we cover. However, if you specifically agree in the "written contract requiring insurance" that this insurance provided to the additional insured under this Coverage Part must apply on a primary basis or a primary and non-contributory basis, this insurance is primary to other insurance available to the additional insured which covers that person or organizations as a named insured for such loss, and we will not share with the other insurance, provided that: (1) The "bodily injury" or "property damage" for which coverage is sought occurs; and (2) The "personal injury" for which coverage is sought arises out of an offense committed-, after you have signed that "written contract requiring insurance". But this insurance provided to the additional insured still Is excess over valid and collectible other insurance, whether primary, excess, contingent or on any other basis, that is available to the additional insured when that person or organization is an additional insured under any other insurance. CIS D3 81 09 15 0 2015 The Travelers Indemnity Company. All rights reserved. Page 1 of 2 Includes the copyrighted material of Insurance Services Office. Inc., with its permission COMMERCIAL GENERAL LIABILITY 3. The following is added to Paragraph 8., Transfer Of Rights Of Recovery Against Others To Us, of SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS: We waive any right of recovery we may have against any person or organization because of payments we make for "bodily injury", "property damage" or "personal Injury" arising out of "your work" performed by you, or on your behalf, done under a "written contract requiring insurance" with that person or organization. We waive this right only where you have agreed to do so as part of the ""written contract requiring insurance"" with such person or organization signed by you before, and in effect when, the "bodily injury" or "property damage" occurs, or the "personal injury" offense is committed. 4. The following definition is added to the DEFINITIONS Section: "Written contract requiring insurance" means that part of any written contract under which you are required to include a person or organization as an additional insured on this Coverage Part, provided that the "bodily injury" and "property damage" occurs and the "personal injury" is caused by an offense committed: a. After you have signed that written contract: b. While that part of the written contract is in effect; and c. Before the end of the policy period. Page 2 of 2 ® 2015 The Travelers Indemnity Company. All rights reserved. CG D3 8109 15 Includes the copyrighted material of Insurance Services Office, Inc., with its permission POLICY NUMBER: 680-4x777478-19-47 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. 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 coverage description only. Limitations and exclusions may apply to these coverages. Read all the provisions of this endorsement and the rest of your policy carefully to determine rights, duties, and what is and is not covered. A. Broadened Named Insured B. Incidental Medical Malpractice C. Reasonable Force — Bodily Injury Or Property Damage D. Non -Owned Watercraft — Increased To Up To 75 feet E. Aircraft Chartered With Crew F. Damage To Premises Rented To You G. Malicious Prosecution — Exception To Knowing Violation Of Rights Of Another Exclusion H. Medical Payments — Increased Limit I. Increased Supplementary Payments J. Additional Insured — Owner, Manager Or Lessor Of Premises PROVISIONS A. BROADENED NAMED INSURED 1. The following is added to SECTION 11— WHO IS AN INSURED: Any organization, other than a. partnership or joint venture, over which you maintain ownership or majority interest on the effective date of the policy qualifies as a Named Insured. However, coverage for any such additional organization will cease as of the date during the policy period that you no longer maintain ownership of, or majority interest in. such organization. B. INCIDENTAL MEDICAL MALPRACTICE 1. The following is added to the definition of "occurrence" in the DEFINITIONS Section: K. Additional Insured — Lessor Of Leased Equipment L. Additional Insured — State Or Political Subdivisions — Permits Relating To Premises M. Additional Insured — State Or Political Subdivisions — Permits Relating To Operations N. Who Is An Insured — Newly Acquired Or Formed Organizations O. Knowledge And Notice Of Occurrence Or Offense P. Unintentional Omission Q. Waiver Of Transfer Of Rights Of Recovery Against Others To Us When Required By Written Contract R. Amended Insured Contract Definition — Railroad Easement Unless you are in the business or occupation of providing professional health care services, "occurrence" also means an act or omission committed in providing or failing to provide first aid or "Good Samaritan services" to a person. 2. The following is added to the DEFINITIONS Section: "Good Samaritan services" means any emergency medical services for which no compensation is demanded or received. 3: The following is added to Paragraph 2.a.(1) of SECTION II — WHO IS AN INSURED: Unless you are in the business or occupation of providing professional health care services, Paragraphs (1)(a), (b), (c) and (d) above CG D3 79 0116 0 2016 The Travelers Indemnity Company. All rights reserved. Page 1 of 6 COMMERCIAL GENERAL LIABILITY does not apply to any "bodily injury" arising out of any providing or failing to provide first aid or "Good Samaritan services" by any of your "employees", other than an employed doctor. Any such "employees" providing or failing to provide first aid or "Good Samaritan services" during their work hours for you will be deemed to be acting within the scope of their employment by you or performing duties related to the conduct of your business. 4. The following exclusion is added to Paragraph 2., Exclusions, of SECTION 1 — COVERAGES — COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY in COVERAGES: Sale of Pharmaceuticals "Bodily injury" or "property damage" arising out of the willful violation of a penal statute or ordinance relating to the sale of pharmaceuticals committed by, or with the knowledge or consent of, the insured. 5. The following is added to Paragraph S. of SECTION III — LIMITS OF INSURANCE: insured. This exclusion does not apply to "bodily injury" or "property damage" resulting from the use of reasonable force to protect any person or property. D. NON -OWNED WATERCRAFT — INCREASED TO UP TO 75 FEET 1. The following replaces Paragraph (2) of Exclusion g., Aircraft, Auto Or Watercraft, in Paragraph 2. of SECTION 1 — COVERAGES — COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY: (2) A watercraft you do not own that is: (a) Less than 75 feet long; and (b) Not being used to cant' any person or property for a charge; 2. The following is added to Paragraph 2. of SECTION 11— WHO IS AN INSURED: Any person or organization that, with your express or implied consent, either uses or is responsible for the use of a watercraft that you do not own that is: For the purposes of determining the applicable Each Occurrence Limit, all related acts or omissions committed in the providing or failing to provide first aid or "Good Samaritan services" to any one person will be 3. considered one "occurrence". 6. The following is added to Paragraph 4.b., Excess Insurance, of SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS: This insurance is excess over any valid and collectible other insurance, whether primary, excess, contingent or on any other basis, that is available to any of your "employees" for "bodily injury" that arises out of providing or failing to provide first aid or "Good Samaritan services" to any person to the extent not subject to Paragraph 2.a.(1) of Section 11 — Who Is An Insured. C. REASONABLE FORCE — BODILY INJURY OR PROPERTY DAMAGE The following replaces Exclusion a., Expected Or Intended Injury, in Paragraph 2. of SECTION I — COVERAGES — COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY: a. Expected Or Intended injury Or Damage "Bodily injury" or "property damage" expected or intended from the standpoint of the (a) Less than 75 feet long; and (b) Not being used to carry any person or property for a charge; The following is added to Paragraph 4.b., Excess Insurance, of SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS: This insurance is excess over any valid and collectible other insurance, whether primary, excess, contingent or on any other basis, that is available to the insured for "bodily injury" that arises out of the use of a watercraft that you do not own that is: (a) Less than 75 feet long; and (b) Not being used to cant' any person or property for a charge. E. AIRCRAFT CHARTERED WITH CREW 1. The following is added to Exclusion g., Aircraft, Auto Or Watercraft, in Paragraph 2. of SECTION 1 — COVERAGES — COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY in COVERAGES: This exclusion does not apply to an aircraft that is: (a) Chartered with crew to any insured; Page 2 of 6 0 2016 The Travelers Indemnity Company. All rights reserved. CG D3 79 0116 (b) Not owned by any insured; and (c) Not being used to carry any person or property for a charge. 2. The following is added to Paragraph 4.b., Excess Insurance, of SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS: This insurance is excess over any valid and collectible other insurance, whether primary, excess, contingent or on any other basis, that is available to the insured for use of an aircraft that is: (a) Chartered with crew to any insured; (b) Not owned by any insured; and (c) Not being used to carry any person or property for a charge. F. DAMAGE TO PREMISES RENTED TO YOU 1. The following replaces the last paragraph of Paragraph 2.. Exclusions, of SECTION I — COVERAGES — COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY in COVERAGES: Exclusions c. through n. do not apply to damage to premises while rented to you, or temporarily occupied by you with permission of the owner, caused by: a. Fire; b. Explosion; c. Lightning; d. Smoke resulting from such fire, explosion, or lightning; or e. Water. A separate limit of insurance applies to such damage to premises as described in Paragraph 6. of Section III — Limits Of Insurance. This insurance does not apply to damage to premises while rented to you, or temporarily occupied by you with permission of the owner, caused by: a. Rupture, bursting, or operation of pressure relief devices; b. Rupture or bursting due to expansion or swelling of the contents of any building or structure, caused by or resulting from water; or c. Explosion of steam boilers, steam pipes, steam engines, or steam turbines. COMMERCIAL GENERAL LIABILITY 2. The following replaces Paragraph 6. of SECTION III — LIMITS OF INSURANCE: Subject to S. above, the Damage To Premises Rented To You Limit is the most we will pay under Coverage A for damages because of "property damage" to any one premises while rented to you, or temporarily occupied by you with permission of the owner, caused by fire; explosion; lightning; smoke resulting from such fire, explosion, or lightning; or water. The Damage To Premises Rented To You Limit will apply to all damage proximately caused by the same "occurrence", whether such damage results from: fire; explosion; lightning; smoke resulting from such fire, explosion, or lightning; or water; or any combination of any of these. The Damage To Premises Rented To You Limit will be the higher of: a. $1,000,000; or b. The amount shown on the Declarations of this Coverage Part for Damage To Premises Rented To You Limit. 3. The following replaces Paragraph a. of the definition of "insured contract" in the DEFINITIONS Section: a. A contract for a lease of premises. However, that portion of the contract for a lease of premises that indemnifies any person or organization for damage to premises while rented to you, or temporarily occupied by you with permission of the owner, caused by: (1) Fire; (2) Explosion; (3) Lightning; (4) Smoke resulting from such fire, explosion, or lightning; or (5) Water, is not an "insured contract"; 4. The following replaces Paragraph 4.b.(1)(b) of SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS: (b) That is insurance for premises rented to you, or temporarily occupied by you with the permission of the owner; CG D3 79 0116 0 2016 The Travelers indemnity Company. All rights reserved. Page 3 of 6 COMMERCIAL GENERAL LIABILITY G. MALICIOUS PROSECUTION — EXCEPTION TO KNOWING VIOLATION OF RIGHTS OF ANOTHER EXCLUSION The following is added to Exclusion a., Knowing Violation Of Rights Of Another, in Paragraph 2. of SECTION 1 — COVERAGES — COVERAGE B PERSONAL AND ADVERTISING INJURY LIABILITY: This exclusion does not apply to "personal injury" caused by malicious prosecution. H. MEDICAL PAYMENTS — INCREASED LIMIT The following replaces Paragraph 7. of SECTION III — LIMITS OF INSURANCE: 7. Subject to S. above, the Medical Expense Limit is the most we will pay under Coverage C. for all medical expenses because of "bodily injury' sustained by any one person, and will be the higher of: (a) $10,000; or (b) The amount shown on the Declarations of this Coverage Part for Medical Expense Limit. I. INCREASED SUPPLEMENTARY PAYMENTS 1. The following replaces Paragraph 1.b. of SUPPLEMENTARY PAYMENTS — COVERAGES A AND B of SECTION 1 — COVERAGES: b. Up to $2,500 for cost of bail bonds required because of accidents or traffic law violations arising out of the use of any vehicle to which the Bodily Injury Liability Coverage applies. We do not have to furnish these bonds. 2. The following replaces Paragraph 1.d. of SUPPLEMENTARY PAYMENTS — COVERAGES A AND B of SECTION I — COVERAGES: d. All reasonable expenses incurred by the insured at our request to assist us in the investigation or defense of the claim or "suit", including actual loss of earnings up to $500 a day because of time off from work. J. ADDITIONAL INSURED — OWNER, MANAGER OR LESSOR OF PREMISES The following is added to SECTION II — WHO IS AN INSURED: Any person or organization that is a premises owner, manager or lessor and that you have agreed in a written contract to name as an additional insured on this Coverage Part is an insured, but only with respect to liability for "bodily injury", "property damage", "personal injury" or "advertising injury" that: a. Is "bodily injury" or "property damage" caused by an "occurrence" that takes place, or "personal injury" caused by an offense that is committed, after you have signed that contract; and b. Arises out of the ownership, maintenance or use of that part of any premises leased to you under that written contract. The insurance provided to such premises owner, manager or lessor is subject to the following provisions: a. The limits of insurance provided to such premises owner, manager or lessor will be the limits which you agreed to provide in the written contract, or the limits shown on the Declarations of this Coverage Part, whichever are less. b. The insurance provided to such premises owner, manager or lessor does not apply to: (1) "Bodily injury" or "property damage" caused by an "occurrence" that takes place, or "personal injury" caused by an offense that is committed, after you cease to be a tenant in that premises; or (2) Structural alterations, new construction or demolition operations performed by or on behalf of such premises owner, manager or lessor. c. The insurance provided to such premises owner, manager or lessor is excess over any valid and collectible other insurance available to such premises owner, manager or lessor, unless you have agreed in a written contract for this insurance to apply on a primary or contributory basis. K. ADDITIONAL INSURED — LESSOR OF LEASED EQUIPMENT The following is added to SECTION II — WHO IS AN INSURED: Any person or organization that is an equipment lessor and that you have agreed in a written contract to name as an additional insured on this Coverage Part is an insured, but only with respect to liability for "bodily injury", "property damage", "personal injury" or "advertising injury" that: a. Is "bodily injury" or "property damage" caused by an "occurrence" that takes place, or "personal injury" caused by an offense that is Page 4 of 6 0 2016 The Travelers Indemnity Company. All rights reserved. CG D3 79 0116 committed, after you have signed that written contract; and b. Is caused, in whole or in part, by acts or omissions of you or any person or organization performing operations on your behalf, in the maintenance, operation or use of equipment leased to you by such equipment lessor. The insurance provided to such equipment lessor is subject to the following provisions: a. The limits of insurance provided to such equipment lessor will be the limits which you agreed to provide in the written contract, or the limits shown on the Declarations of this Coverage Part, whichever are less; and b. The insurance provided to such equipment lessor does not apply: (1) To any "bodily injury" or "property damage" caused by an "occurrence" that takes place, or "personal injury" caused by an offense that is committed, after the equipment lease expires; or (2) If the equipment is leased with an operator. c. The insurance provided to such equipment lessor is excess over any valid and collectible other insurance available to such equipment lessor, unless you have agreed in a written contract for this insurance to apply on a primary or contributory basis. L. ADDITIONAL INSURED — STATE OR POLITICAL SUBDIVISIONS — PERMITS RELATING T O PREMISES The following is added to Paragraph 2. of SECTION II — WHO IS AN INSURED: Any state or political subdivision that has issued a permit in connection with premises owned or occupied by, or rented or loaned to, you, is an insured, but only with respect to "bodily injury", "property damage", "personal injury" or "advertising injury" arising out of the existence, ownership, use, maintenance, repair, construction, erection or removal of advertising signs, awnings, canopies, cellar entrances, coal holes, driveways, manholes, marquees, hoist away openings, sidewalk vaults, elevators, street banners or decorations for which that state or political subdivision has issued such permit. COMMERCIAL GENERAL LIABILITY M. ADDITIONAL INSURED — STATE OR POLITICAL SUBDIVISIONS — PERMITS RELATING TO OPERATIONS The following is added to Paragraph 2. of SECTION II — WHO IS AN INSURED: Any state or political subdivision that has issued a permit with respect to operations performed by you or on your behalf is an Insured, but only with respect to "bodily injury", "property damage "personal injury" or "advertising injury" arising out of operations performed by you or on your behalf for which that state or political subdivision has issued such permit. However, no such state or political subdivision is an insured for: (1) "Bodily injury". "property damagee', "personal injury" or "advertising Injury" arising out of operations performed for that state or political subdivision; or (2) "Bodily injury" or "property damage" included within the "products — completed operations hazard". N. WHO IS AN INSURED — NEWLY ACQUIRED OR FORMED ORGANIZATIONS The following replaces Paragraph 4.a. of SECTION II — WHO IS AN INSURED: a. Coverage under this provision is afforded only: (1) Until the 180th day after you acquire or form the organization or the end of the policy period, whichever is earlier, if you do not report such organization in writing to us within 180 days after you acquire or form it; or (2) Until the end of the policy period, when that date is later than 180 days after you acquire or form such organizations, if you report such organization in writing to us within 180 days after you acquire or form it. O. KNOWLEDGE AND NOTICE OF OCCURRENCE OR OFFENSE The following is added to Paragraph 2., Duties In The Event of Occurrence. Offense, Claim Or Suit, of SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS: e. The following provisions apply to Paragraph a. above, but only for the purposes of the insurance provided under this Coverage Part to you or any insured listed in Paragraph 1. or 2. of Section 11— Who Is An Insured: CG D3 79 0116 0 2016 The Travelers Indemnity Company. All rights reserved. Page S of 6 COMMERCIAL GENERAL LIABILITY (1) Notice to us of such "occurrence" or of an offense must be given as soon as practicable only after the "occurrence" or offense is known to you (if you are an individual), any of your partners or members who is an individual (if you are a partnership or joint venture), any of your managers who is an individual (if you are a limited liability company), any of your trustees who is an individual (if you are a trust), any of your "executive officers" or directors (if you are an organization other than a partnership, joint venture, limited liability company or trust), or any "employee" (such as an insurance, loss control or risk manager or administrator) authorized by you to give notice of an "occurrence" or offense. Knowledge by any other "employee" of an "occurrence" or offense does not imply that you also have such knowledge. (2) If you are a partnership, joint venture, limited liability company or trust, and none of your partners, joint venture members, managers or trustees are individuals, notice to us of such "occurrence" or offense must be given as soon as practicable only after the "occurrence" or offense is known by: (a) Any individual who is: (1) A partner or member of any partnership or joint venture; (11) A manager of any limited liability company; (ill) A trustee of any trust; or (Iv) An executive officer or director of any other organization; that is your partner, joint venture member, manager or trustee; or (b) Any "employee" authorized by such partnership, joint venture, limited liability company, trust or other organization to give notice of an "occurrence" or offense. health insurer. This applies only if you subsequently give notice to us of the "occurrence" or offense as soon as practicable after any of the persons described in Paragraphs e. (1) or (2) above discovers that the "occurrence" or offense may result in sums to which the insurance provided under the Coverage Part may apply. P. UNINTENTIONAL OMISSION The following is added to Paragraph 6., Representations, of SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS: The unintentional omission of, or unintentional error in, any information provided by you which we relied upon in issuing this policy will not prejudice your rights under this insurance. However, this provision does not affect our right to collect additional premium or to exercise our rights of cancellation or nonrenewal in accordance with applicable insurance laws or regulations. Q. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US WHEN REQUIRED BY WRITTEN CONTRACT The following is added to Paragraph 8., Transfer of Rights of Recovery Against Others to Us, of SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS: We waive any right of recovery we may have against any person or organization because of payments we make for injury or damage arising out of premises owned or occupied by or rented or loaned to you; ongoing operations performed by you or on your behalf, done under a written contract with that person or organization: 'your work"; or 'your products". We waive this right where you have agreed to do so as part of a written contract signed by you prior to loss. R. AMENDED INSURED CONTRACT DEFINITION — RAILROAD EASEMENT 1. The following replaces Paragraph c. of the definition of "insured contract" in the DEFINITIONS Section: (3) Notice to us of such "occurrence" or c. Any easement or license agreement; offense will be deemed to be given as soon as practicable if it is given in good 2. Paragraph C(1) of the definition of "insured faith as soon as practicable to your contract" in the DEFINITIONS Section is workers' compensation, accident, or deleted. Page 6 of 6 0 2016 The Travelers indemnity Company. All rights reserved. CG D3 79 0116 COMMERCIAL GENERAL LIABILITY POLICY NUMBER: 680-4H777476-19-47 ISSUE DATE: 12/14/2018 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. TOTAL AGGREGATE LIMIT OTHER THAN PROJECTS AND DESIGNATED PROJECT' AND LOCATION AGGREGATE LIMITS This endorsement modes insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE The Limits of Insurance shown in the Declarations are replaced by the following: LIMITS OF INSURANCE Total Aggregate Limit $ 10, 000, 000 (Other Than Projects and Products -Completed Operations) Designated Location Aggregate Limit $ 2,000,000 (Other Than Products -Completed Operations) Designated Project Aggregate Limit $ 2,000,000 (Other Than Products -Completed Operations) General Aggregate Limit $ 2,000,000 (Other Than Products -Completed Operations) Products -Completed Operations Aggregate Limit $ 2,000,000 Personal and Advertising Injury Limit $ 1,000,000 Each Occurrence Limit $ 1,000,000 Damage To Premises Rented to You Limit $ 1,000,000 Any One Premises Medical Expense Limit $ lo, 000 Any One Person Designated Projects: Each °pro j ect" for which you have agreed, in a written contract which is in effect during this policy period, to provide a separate General Aggregate Limit, provided that the contract in signed and executed by you before the "bodily injury" or "property damage" occurs. Designated Locations: All locations listed in Item 3. of the Common Policy Declarations or in any Master Pac Account Exposure Endorsement included in this policy. CG D4 69 0714 0 2014 The Travelers. Indemnity Company. All rights reserved. Page 1 of 4 COMMERCIAL GENERAL LIABILITY PROVISIONS A. The following replaces SECTION III — LIMITS OF INSURANCE: 1. a. The Limits of Insurance shown in the Schedule above and the rules below fix the most we will pay regardless of the number of: (1) Insureds; (2) Claims made or "suits" brought; (3) Persons or organizations making claims or bringing "suits'; or (4) Designated "projects" or "locations" shown in the Schedule above. b. The Total Aggregate Limit shown in the Schedule above is the most we will pay for the sum of all amounts under the Des- ignated Location Aggregate Limit and all amounts under the General Aggregate Limit. This includes: (1) Damages under Coverage A, except damages because of "bodily injury" or "property damage" included in the "products -completed operations haz- ard"; (2) Damages under Coverage B; and (3) Medical expenses under Coverage C. c. A Designated Project Aggregate Limit is provided and is also shown in the Sched- ule above. The Designated Project Ag- gregate Limit is subject to all of the follow- ing provisions: (1) The Designated Project Aggregate Limit is the most we will pay for the sum of: (a) Damages under Coverage A be- cause of "bodily injury" and "property damage" caused by "occurrences"; and (b) Medical expenses under Cover- age C for "bodily injury" caused by accidents; which can be attributed only to opera- tions at a single designated "project" shown in the Schedule above. (2) The Designated Project Aggregate Limit applies separately to each des- ignated "project". (3) The Designated Project Aggregate Limit does not apply to damages be- cause of "bodily injury" or "property damage" included in the "products - completed operations hazard". In- stead, the Products -Completed Op- erations Aggregate Limit shown in the Schedule above and described in 3. below applies to such damages. (4) The Designated Project Aggregate Limit does not apply to damages un- der Coverage B. Instead, the General Aggregate Limit shown in the Sched- ule above and described in 2. below applies to such damages. (5) Any payments made for damages or medical expenses to which the Des- ignated Project Aggregate Limit ap- plies shall reduce the Designated Project Aggregate Limit for that des- ignated "project". Such payments shall not reduce the Total Aggregate Limit shown in the Schedule above, the General Aggregate Limit shown in the Schedule above and described in 2. below, the Designated Project Ag- gregate Limit for any other designat- ed esignated "project" shown in the Schedule above or the Designated Location Aggregate Limit shown in the Sched- ule above. d. Subject to the Total Aggregate Limit shown in the Schedule above and de- scribed in b. above, a Designated Loca- tion Aggregate Limit is provided and is al- so shown in the Schedule above. The Designated Location Aggregate Limit is subject to all of the following provisions: (1) The Designated Location Aggregate Limit is the most we will pay for the sum of: (a) Damages under Coverage A be- cause of "bodily injury" and "property damage" caused by "occurrences"; and (b) Medical expenses under Cover- age C for "bodily injury" caused by accidents; which can be attributed only to opera- tions at a single designated "location" shown in the Schedule above. (2) The Designated Location Aggregate Limit applies separately to each des- ignated "location". Page 2 of 4 0 2014 The Travelers. Indemnity Company. All rights reserved. CG D4 69 07 14 (3) The Designated Location Aggregate Limit does not apply to damages be- cause of "bodily injury" or "property damage" included in the "products - completed operations hazard." In- stead, the Products -Completed Op- erations Aggregate Limit shown in the Schedule above and described in 3. below applies to such damages. (4) The Designated Location Aggregate Limit does not apply to damages un- der Coverage B. Instead, the General Aggregate Limit shown in the Sched- ule above and described in 2. below applies to such damages. (5) Any payments made for damages or medical expenses to which the Des- ignated Location Aggregate Limit ap- plies shall reduce both the Total Ag- gregate Limit shown in the Schedule above and the Designated Location Aggregate Limit for that designated "location". Such payments shall not reduce the General Aggregate Limit shown in the Schedule above and described in 2. below, the Designated Project Aggregate Limit shown in the Schedule above or the Designated Location Aggregate Limit for any oth- er designated "location" shown in the Schedule above. 2. Subject to the Total Aggregate Limit shown in the Schedule above and described in 1.b. above, a General Aggregate Limit is provided and is also shown in the Schedule above. The General Aggregate Limit is subject to all of the following provisions: a. The General Aggregate Limit is the most we will pay for the sum of: (1) Damages under Coverage A be- cause of "bodily injury" and "property damage" caused by "occurrences", and medical expenses under Cover- age C for "bodily injury" caused by accidents, which cannot be attributed only to operations at a single desig- nated "project" or "location" shown in the Schedule above; and (2) Damages under Coverage B. b. The General Aggregate Limit does not apply to damages for "bodily injury' or "property damage" included in the "prod- ucts -completed operations hazard." In- COMMERCIAL GENERAL LIABILITY stead, the Products -Completed Opera- tions Aggregate Limit shown in the Schedule above and described in 3. be- low applies to such damages. c. Any payments made for damages or medical expenses to which the General Aggregate Limit applies shall reduce both the Total Aggregate Limit shown in the Schedule above and the General Aggre- gate Limit shown in the Schedule above. Such payments shall not reduce the Des- ignated Project Aggregate Limit for any designated "project'" shown in the Sched- ule above or the Designated Location Aggregate Limit for any designated "loca- tion" shown in the Schedule above. 3. If coverage for liability arising out of the "'products -completed operations hazard" is provided, the Products -Completed Operations Aggregate Limit shown in the Schedule above is the most we will pay under Coverage A for damages because of "bodily injury" or "prop- erty damage" included in the "products - completed operations hazard". Any payments made for such damages shall reduce the Products -Completed Operations Aggregate Limit shown in the Schedule above. Such payments shall not reduce the Total Aggre- gate Limit shown in the Schedule above, the General Aggregate Limit shown in the Schedule above, the Designated Project Ag- gregate Limit for any designated "project" shown in the Schedule above or the Desig- nated Location Aggregate Limit for any des- ignated "location" shown in the Schedule above. 4. Subject to the Total Aggregate Limit and the General Aggregate Limit shown in the Schedule above and described in 1.b. and 2. above, the Personal and Advertising Injury Limit is the most we will pay under Coverage B for the sum of all damages because of all "personal injury" and all "advertising injury" sustained by any one person or organization. S. Subject to the Total Aggregate Limit and ei- ther the Designated Location Aggregate Limit or the General Aggregate Limit, subject to the Designated Project Aggregate Limit or subject to the Products -Completed Operations Ag- gregate Limit, shown in the Schedule above and described in 1. b., 1.c, 1.d., 2. and 3. above, whichever apply or applies, the Each Occurrence Limit is the most we will pay for the sum of: CG D4 69 0714 0 2014 The Travelers. Indemnity Company. All rights reserved. Page 3 of 4 COMMERCIAL GENERAL LIABILITY a. Damages under Coverage A; and b. Medical expenses under Coverage C because of all "bodily injury" and "property damage" arising out of any one "occurrence". 6. Subject to the Each Occurrence Limit shown in the Schedule above and described in S. above, the Damage To Premises Rented To You Limit is the most we will pay under Cov- erage A for damages because of "property damage" to any one premises, while rented to you, or in the case of damage by fire, while rented to you or temporarily occupied by you with permission of the owner. 7. Subject to the Each Occurrence Limit shown in the Schedule above and described in S. above, the Medical Expense Limit is the most we will pay under Coverage C for all medical expenses because of "bodily injury" sustained by any one person. The Limits of Insurance of this Coverage Part ap- ply separately to each consecutive annual period and to any remaining period of less than 12 months, starting with the beginning of the policy period shown in the Declarations, unless the poli- cy period is extended after issuance for an addi- tional period of less than 12 months. In that case, the additional period will be deemed part of the last preceding period for purposes of determining the Limits of Insurance. B. The following is added to the DEFINITIONS Sec- tion: "Location" means any premises owned by or rented to you shown in the Schedule above. For the purposes of determining the applicable ag- gregate limit of insurance, each "location" that in- cludes a premises involving the same or connect- ing lots, or premises whose connection is inter- rupted only by a street. roadway or waterway, or by a right-of-way of a railroad, shall be considered a single "location". "Project" means any area, away from premises owned by or rented to you, shown in the schedule above at which you are performing operations pursuant to a contract or agreement. For the pur- poses of determining the applicable aggregate limit of insurance, each "project" that includes a premises involving the same or connecting lots, or premises whose connection is interrupted only by a street, roadway or waterway, or by a right-of- way of a railroad, shall be considered a single "project". Page 4 of 4 ® 2014 The Travelers. Indemnity Company. All rights reserved. CG D4 69 07 14 Policy Number: BA -51'994222 -19 -GRP COMMERCIAL AUTO THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. AUTO COVERAGE PICKS 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. BLANKET ADDITIONAL INSURED B. EMPLOYEE HIRED AUTO C. EMPLOYEES AS INSURED D. SUPPLEMENTARY PAYMENTS — INCREASED LIMITS E. TRAILERS — INCREASED LOAD CAPACITY F. HIRED AUTO PHYSICAL DAMAGE G. PHYSICAL DAMAGE — TRANSPORTATION EXPENSES—INCREASED LIMIT A. BLANKET ADDITIONAL INSURED The following is added to Paragraph A.1., Who Is An Insured, of SECTION II — COVERED AUTOS LIABILITY COVERAGE: Any person or organization who is required under a written contract or agreement between you and that person or organization, that is signed and executed by you before the "bodily injury" or ""property damage" occurs and that is in effect during the policy period, to be named as an addi- tional insured is an "insured" for Covered Autos Liability Coverage, but only for damages to which this insurance applies and only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured provision contained in Section II. B. EMPLOYEE HIRED AUTO 1. The following is added to Paragraph A.1., Who Is An Insured, of SECTION II — COV- ERED AUTOS LIABILITY COVERAGE: An "'employee" of yours is an "insured" while operating a covered "auto" hired or rented' under a contract or agreement in an "em- ployee's" name, with your permission, while H. AUDIO, VISUAL AND DATA ELECTRONIC "EQUIPMENT— INCREASED LIMIT I. WAIVER OF DEDUCTIBLE — GLASS J. PERSONAL PROPERTY K. AIRBAGS L. AUTO LOAN LEASE GAP M. BLANKET WAIVER OF SUBROGATION performing duties related to the conduct of your business. 2. The following replaces Paragraph b. in B.5., Other Insurance, of SECTION IV — BUSI- NESS AUTO CONDITIONS: b. For Hired Auto Physical Damage Cover- age, the following are deemed to be cov- ered "autos" you own: (1) Any covered "auto" you lease, hire, rent or borrow; and (2) Any covered "auto" hired or rented by your "employee" under a contract in an "employee's" name, with your permission, while performing duties related to the conduct of your busi- ness. However, any "auto" that is leased, hired, rented or borrowed with a driver is not a covered "auto". C. EMPLOYEES AS INSURED The following is added to Paragraph A.1., Who Is An Insured, of SECTION II — COVERED AUTOS LIABILITY COVERAGE: CA T4 20 0215 ® 2015 The Travelers Indemnity Company. All rights reserved. Page 1 of 3 Includes copyrighted material of Insurance Services Office, Inc. with Its permission. COMMERCIAL. AUTO Any "employee" of yours is an "insured" while us- ing a covered "auto" you don't own, hire or borrow in your business or your personal affairs. D. SUPPLEMENTARY PAYMENTS — INCREASED LIMITS 1. The following replaces Paragraph A.2.a.(2) of SECTION II — COVERED AUTOS LIABILITY COVERAGE: (2) Up to $3,000 for cost of bail bonds (in- cluding bonds for related traffic law viola- tions) required because of an "accident" we cover. We do not have to furnish these bonds. 2. The following replaces Paragraph A.2.a.(4) of SECTION II — COVERED AUTOS LIABILITY COVERAGE: (4) All reasonable expenses incurred by the "Insured"" at our request, including actual loss of earnings up to $500 a day be- cause of time off from work. E. TRAILERS — INCREASED LOAD CAPACITY The following replaces Paragraph C.I. of SEC- TION I — COVERED AUTOS: 1. "Trailers" with a load capacity of 3,000 pounds or less designed primarily for travel on public roads. F. HIRED AUTO PHYSICAL DAMAGE The following is added to Paragraph A.4., Cover- age Extensions, of SECTION III — PHYSICAL DAMAGE COVERAGE: Hired Auto Physical Damage Coverage If hired "autos" are covered "autos" for Covered Autos Liability Coverage but not covered "autos" for Physical Damage Coverage, and this policy also provides Physical Damage Coverage for an owned "auto", then the Physical Damage Cover- age is extended to "autos" that you hire, rent or borrow subject to the following: (1) The most we will pay for "loss" to any one "auto" that you hire, rent or borrow is the lesser of: (a) $50,000; (b) The actual cash value of the damaged or stolen property as of the time of the 'loss'; or (c) The cost of repairing or replacing the damaged or stolen property with other property of like kind and quality. (2) An adjustment for depreciation and physical condition will be made in determining actual cash value in the event of a total "loss". (3) If a repair or replacement results in better than like kind or quality, we will not pay for the amount of betterment. (4) A deductible equal to the highest Physical Damage deductible applicable to any owned covered "auto". (5) This Coverage Extension does not apply to: (a) Any "auto" that is hired, rented or bor- rowed with a driver; or (b) Any "auto" that is hired, rented or bor- rowed from your "employee". G. PHYSICAL DAMAGE — TRANSPORTATION EXPENSES — INCREASED LIMIT The following replaces the first sentence in Para- graph AA.a., Transportation Expenses, of SECTION III — PHYSICAL DAMAGE COVER- AGE: We will pay up to $50 per day to a maximum of $1,500 for temporary transportation expense in- curred by you because of the total theft of a cov- ered "auto" of the private passenger type. H. AUDIO, VISUAL AND DATA ELECTRONIC EQUIPMENT— INCREASED LIMIT Paragraph C.1.b. of SECTION III — PHYSICAL DAMAGE COVERAGE is deleted. I. WAIVER OF DEDUCTIBLE — GLASS The following is added to Paragraph D., Deducti- ble, of SECTION III — PHYSICAL DAMAGE COVERAGE: No deductible for a covered "auto" will apply to glass damage if the glass is repaired rather than replaced. J. PERSONAL PROPERTY The following is added to Paragraph AA., Cover- age Extensions, of SECTION III — PHYSICAL DAMAGE COVERAGE: Personal Property Coverage We will pay up to $400 for "loss" to wearing ap- parel and other personal property which is: (1) Owned by an "insured"; and (2) in or on your covered "auto". This coverage only applies in the event of a total theft of your covered "auto". No deductibles apply to Personal Property cover- age. Page 2 of 3 0 2015 The Travelers indemnity Company. All rights reserved. CA T4 20 02 15 Includes copyrighted material of Insurance Services Office, Inc. with its permission. K. AIRBAGS The following is added to Paragraph B.3., Exclu- sions, of SECTION III — PHYSICAL DAMAGE COVERAGE: Exclusion 3.a. does not apply to "loss" to one or more airbags in a covered "auto" you own that in- flate due to a cause other than a cause of "loss" set forth in Paragraphs A.1.b. and A.1.c., but only: a. If that "auto" is a covered "auto" for Compre- hensive Coverage under this policy; b. The airbags are not covered under any war- ranty; and c. The airbags were not intentionally inflated. We will pay up to a maximum of $1,000 for any one "loss". L. AUTO LOAN LEASE GAP The following is added to Paragraph A.4., Cover- age Extensions, of SECTION III — PHYSICAL DAMAGE COVERAGE: Auto Loan Lease Gap Coverage for Private Passenger Type Vehicles In the event of a total "loss" to a covered "auto" of the private passenger type shown in the Schedule or Declarations for which Physical Damage Cov- erage is provided, we will pay any unpaid amount due on the lease or loan for such covered "auto" less the following: (1) The amount paid under the Physical Damage Coverage Section of the policy for that "auto'; and COMMERCIAL AUTO (2) Any: (a) Overdue lease or loan payments at the time of the "loss'; (b) Financial penalties imposed under a lease for excessive use, abnormal wear and tear or high mileage; (c) Security deposits not returned by the les- sor, (d) Costs for extended warranties, Credit Life Insurance, Health, Accident or Disability Insurance purchased with the loan or lease; and (e) Carry-over balances from previous loans or leases. M. BLANKET WAIVER OF SUBROGATION The following replaces Paragraph A.S., Transfer Of Rights Of Recovery Against Others To Us, of SECTION IV — BUSINESS AUTO CONDI- TIONS: S. Transfer Of Rights Of Recovery Against Others To Us We waive any right of recovery we may have against any person or organization to the ex- tent required of you by a written contract exe- cuted prior to any "accident" or "loss", pro- vided that the "accident" or "loss" arises out of the operations contemplated by such con- tract. The waiver applies only to the person or organization designated in such contract. CA T4 20 02 15 0 2015 The Travelers Indemnity Company. All rights reserved. Page 3 of 3 Includes copyrighted material of Insurance Services Office, Inc. with its permission. POLICY NUMBER: CVP-DJ60SS20-19-47 UMBRELLA ISSUE DATE: 12/14/2018 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. SCHEDULE OF UNDERLYING INSURANCE This endorsement modifies insurance provided under the following: COMMERCIAL EXCESS LIABILITY (UMBRELLA) INSURANCE Item 6 of the Declarations to include: POLICY LIMITS (000 OMITTED) 680-004$777478-19 1,000 BACK ZMPLOYEE 1,000 AGGREGATE 680-0048777478-19 1,000 EACH OCCURRENCE 2,000 GENERAL AGGREGATE 2,000 PROD/COMP OPS AGG BA-SF994222-19 1,000 CSL COVERAGE COMPANY EMPLOYEE BENEFITS TIL LIABILITY GENERAL LIABILITY TIL AUTO LIABILITY TIL 9114062-19 1,000 EACH ACCIDENT EMPLOYER'S LIABILITY CA 1,000 AGG3 EMPLOYEE DISEASE 1,000 EACH EMPLOYEE DISEASE The policies shown above are issued in one or more of the Travelers Companies. The above company(s) translates as follows: TIL TRAVELERS PROPERTY CASUALTY COMPANY OF AMERICA TIL TRAVELERS PROPERTY CASUALTY COMPANY OF AMERICA TIL TRAVELERS PROPERTY CASUALTY COMPANY OF AMERICA CA "(If you have any employee exposure in the State of New York, the Employers Liability Limits are applicable only to bodily injury to your "non -subject employees° as defined under Rule VIII - Limits of Liability, A.2., of the WC/EL Manual of the State of New York)a PRODUCER: HALL & COMPANY OFFICE: SPECIALIST A&8 21X CG DO 23 04 96 Page 1 of 1 Policy Number: CUP-OJ605520-1947 UMBRELLA THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF O it RIGHT TO RECOVER FROM OCHER This endorsement modifies insurance provided under the following: COMMERCIAL EXCESS LIABILITY (UMBRELLA) INSURANCE The following is added to Paragraph 11., OUR RIGHT a. "Bodily injury" or "property damage" caused by an TO RECOVER FROM OTHERS., of SECTION IV — "occurrence" that takes place; or CONDITIONS.: b. "Personal injury" or "advertising injury" caused by If the insured has agreed in a contract or agreement an "offense" that is committed; to waive that insured's right of recovery against any subsequent to the execution of the contract or agree - person or organization, we waive our right of recovery ment. against such person or organization, but only for payments we make because of: UM 04 88 07 08 ® 2008 The Travelers Companies, Inc. Page 1 of 1 includes the copyrighted material of Insurance Services Office, Inc. with its permission. ENDORSEMENT AGREEMENT BROKER COPY WAIVER OF SUBROGATION' BLANKET IASIS 9114062-19 F-UN0j RENEWAL SC HOME OFFICE 7-10-60-68 SAN FRANCISCO EFFECTIVE MARCH 14, 2019 AT 12.01 A.M. PAGE 1 OF 1 ALL EFFECTIVE DATES ARE AND EXPIRING MARCH 14, 2020 AT 12.01 A.M. AT 12:01 AM PACIFIC STANDARD TIME OR THE TIME INDICATED AT PACIFIC STANDARD TIME GPA CONSULTING 231 CALIFORNIA ST EL SEGUNDO, CA 90245 WE HAVE THE RIGHT TO RECOVER OUR PAYMENTS FROM ANYONE LIABLE FOR AN INJURY COVERED BY THIS POLICY. WE WILL NOT ENFORCE OUR RIGHT AGAINST THE PERSON OR ORGANIZATION NAMED IN THE SCHEDULE. THIS AGREEMENT APPLIES ONLY TO THE EXTENT THAT YOU PERFORM WORK UNDER A WRITTEN CONTRACT THAT REQUIRES YOU TO OBTAIN THIS AGREEMENT FROM US. THE ADDITIONAL PREMIUM FOR THIS ENDORSEMENT SHALL BE 2.00% OF THE TOTAL POLICY PREMIUM. SCHEDULE P'ERSO'N OR ORGANIZATION ANY PERSON OR ORGANIZATION FOR WHOM THE NAMED INSURED HAS AGREED BY WRITTEN CONTRACT TO FURNISH THIS WAIVER JOB DESCRIPTION BLANKET WAIVER OF SUBROGATION NOTHING IN THIS ENDORSEMENT CONTAINED SHALL BE HELD TO VARY, ALTER, WAIVE OR EXTEND ANY OF THE TERMS, CONDITIONS, AGREEMENTS, OR LIMITATIONS OF THIS POLICY OTHER THAN AS STATED. NOTHING ELSEWHERE IN THIS POLICY SHALL BE HELD TO VARY, ALTER, WAIVE OR LIMIT THE TERMS, CONDITIONS, AGREEMENTS OR LIMITATIONS OF THIS ENDORSEMENT. COUNTERSIGNED AND ISSUED AT SAN FRANCISCO: AUTHORIZED REPRESENTIVE' SCIF FORM 10217 (REV.7.2014) MARCH 13, 2019 J/'.�' 2572 PRESIDENT AND CEO OLD DP 217