PROOF OF INSURANCE (2020) CLOSED (2)DATE (MM/DDIYYYY)
CERTIFICATE OF LIABILITY INSURANCE 06124/,2019
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.
THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE
POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),
AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATIONIS 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),
PRODUCERCONTACT
BB&T INS SVCS OF CA INC/PHS/ORANGE NAMEm
72180672 PHONE (866) 467-6730 (888) 443 6112
(A/C, No, Ext): (AIC, No):
The Hartford Business Service Center
3600 Wiseman Blvd E-MAIL
San Antonio, TX 78265 ADDRESS:
INSURER(S) AFFORDING COVERAGE NAICN
INSURED INSURERA: Sentinel Insurance Company Ltd. 11000
TINA GALLI I
3945 HOLLYLINE AVE II INSURERC:
:
SHERMAN OAKS CA 91423-4603 I INSURER D
INSURER E:
INSURER F:
COVERAGES CERTIFICATE NUMBER: 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 NUMBER POLICY EFF POLICY EXP I LIMITS
J.M LW— WVD IMM/DDIYYYYI IMMIDD/YYYY1 11
COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $2,000,000
CLAIMS•MADEX (OCCUR DAMAGE TORENTEDn rt$1,000,000
POIEM159S Ica acal
X General Liability MED EXP (Any one person) $10,000
A X 72 SBA LD8291 07/23/2019 07/2312020PERSONAL&ADV INJURY $2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $4,000,000
POLICYPRO [j]LOC I PRODUCTS - COMP/OP AGG $4,000,000
DALJ JECT
OTHER: I 0
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT
�=ODILY
t! $2,000,000
ANY AUTO JURY (Per person)
A ALL OWNED SCHEDULED 72 SBA LD6291 07/23/2019 07/23/2020 BODILY INJURY (Per accident)
AUTOS AUTOS
HIRED X NON-OWNED PROPERTY DAMAGE
X AUTOS X AUTOS (Per accident)
UMBRELLA LIABOCCUR EACH OCCURRENCE
EXCESS LIAR CLAIMS- AGGREGATE
MADE
�EDI [RETENTION $
WORKERS COMPENSATION PER
AND EMPLOYERS' LIABILITY (STATUTE I �O_T_H-
I,
ANY YIN E,L, EACH ACCIDENT
PROPRIETOR/PARTNER/EXECUTIVEr— NIA
OFFICER/MEMBER EXCLUDED? IL_ E,L, DISEASE -EA EMPLOYEE
(Mandatory in NH)
If yes, describe under E L, DISEASE - POLICY LIMIT 4
DESCRIPTION OF OPERATIONS below 4
I
C
�DESCRIPTION OFOPERA 77ONS/LOCATIONS/VEHICLES (ACO to 101, Additional Remarks Schedule, may be attached If more space is required)
I Those usual to the Insured's Operations. City of EI Segundo is named and endorsed as additional insured as respects to general liability as required by
contract and per the Business Liability Coverage Form SS0008, attached to this policy.
CERTIFICATE HOLDER CANCELLATION
City of EI Segundo SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED
Attn: City Clerk & Planning Dept BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED
350 MAIN ST IN ACCORDANCE WITH THE POLICY PROVISIONS.
EL SEGUNDO CA 90245 AUTHORIZED REPRESENTATIVE
U ccB- Of
01988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
Form SS 00 08 04 05
0 2005, The Hartford
QUICK REFERENCE
BUSINESS LIABILITY COVERAGE FORM
READ YOUR POLICY CAREFULLY
BUSINESS LIABILITY COVERAGE FORM Beginning on Page
A. COVERAGES 1
Business Liability 1
Medical Expenses 2
Coverage Extension - Supplementary Payments 2
B. EXCLUSIONS 3
C. WHO IS AN INSURED 10
D. LIABILITY AND MEDICAL EXPENSES
LIMITS OF INSURANCE
14
E. LIABILITY AND MEDICAL EXPENSES GENERAL CONDITIONS
15
1. Bankruptcy
16
2. Duties In The Event Of Occurrence, Offense, Claim Or Suit
15
3. Financial Responsibility Laws
16
4. Legal Action Against Us
16
5. Separation Of Insureds
16
6. Representations
16
7. Other Insurance
16
8. Transfer Of Rights Of Recovery Against Others To Us
17
F. OPTIONAL ADDITIONAL INSURED COVERAGES
18
Additional Insureds
18
G. LIABILITY AND MEDICAL EXPENSES DEFINITIONS
20
Form SS 00 08 04 05
BUSINESS LIABILITY COVERAGE FORM
Various provisions in this policy restrict coverage. Read the entire policy carefully to determine rights, duties and what
is and is not covered.
Throughout this policy the words "you" and "your" refer to the Named Insured shown in the Declarations. The words
"we", "us" and "our" refer to the stock insurance company member of The Hartford providing this insurance.
The word "insured" means any person or organization qualifying as such under Section C. - Who Is An Insured.
Other words and phrases that appear in quotation marks have special meaning. Refer to Section G. - Liability And
Medical Expenses Definitions.
A. COVERAGES
1. BUSINESS LIABILITY COVERAGE (BODILY
INJURY, PROPERTY DAMAGE, PERSONAL
AND ADVERTISING INJURY)
Insuring Agreement
a. We will pay those sums that the insured
becomes legally obligated to pay as
damages because of "bodily injury",
"property damage" or "personal and
advertising injury" to which this insurance
applies. We will have the right and duty to
defend the insured against any "suit"
seeking those damages. However, we will
have no duty to defend the insured against
any "suit" seeking damages for "bodily
injury", "property damage" or "personal and
advertising injury" to which this insurance
does not apply.
We may, at our discretion, investigate any
"occurrence" or offense and settle any claim
or "suit" that may result. But:
(1) The amount we will pay for damages is
limited as described in Section D. -
Liability And Medical Expenses Limits
Of Insurance; and
(2) Our right and duty to defend ends when
we have used up the applicable limit of
insurance in the payment of judgments,
settlements or medical expenses to which
this insurance applies.
No other obligation or liability to pay sums or
perrorm acts or services is covered unless
explicitly provided for under Coverage
Extension - Supplementary Payments.
b. This insurance applies:
(1) To "bodily injury" and "property
damage" only if:
(a) The "bodily injury" or "property
damage" is caused by an
"occurrence" that takes place in the
"coverage territory'
(b) The "bodily injury" or "property
damage" occurs during the policy
period; and
(c) Prior to the policy period, no insured
listed under Paragraph 1. of Section
C. — Who Is An Insured and no
"employee" authorized by you to give
or receive notice of an "occurrence"
or claim, knew that the "bodily injury"
or "property damage" had occurred,
in whole or in part. If such a listed
insured or authorized "employee"
knew, prior to the policy period, that
the "bodily injury" or "property
damage" occurred, then any
continuation, change or resumption
of such "bodily injury" or "property
damage" during or after the policy
period will be deemed to have been
known prior to the policy period.
(2) To "personal and advertising injury"
caused by an offense arising out of your
business, but only if the offense was
committed in the "coverage territory"
during the policy period.
c. "Bodily injury" or "property damage" will be
deemed to have been known to have
occurred at the earliest time when any
insured listed under Paragraph 1. of Section
C. — Who Is An Insured or any "employee"
authorized by you to give or receive notice
of an "occurrence" or claim:
(1) Reports all, or any part, of the "bodily
injury" or "property damage" to us or
any other insurer,
Form SS 00 08 04 05 Page 1 of 24
0 2005, The Hartford
BUSINESS LIABILITY COVERAGE FORM
(2) Receives a written or verbal demand or
claim for damages because of the "bodily
injury" or "property damage"; or
(3) Becomes aware by any other means that
"bodily injury" or "property damage" has
occurred or has begun to occur.
d. Damages because of "bodily injury" include
damages claimed by any person or
organization for care, loss of services or
death resulting at any time from the "bodily
injury".
e. Incidental Medical Malpractice
(1) "Bodily injury" arising out of the
rendering of or failure to render
professional health care services as a
physician, dentist, nurse, emergency
medical technician or paramedic shall
be deemed to be caused by an
"occurrence", but only if:
(a) The physician, dentist, nurse,
emergency medical technician or
paramedic is employed by you to
provide such services; and
(b) You are not engaged in the
business or occupation of providing
such services.
(2) For the purpose of determining the
limits of insurance for incidental medical
malpractice, any act or omission
together with all related acts or
omissions in the furnishing of these
services to any one person will be
considered one "occurrence".
2. MEDICAL EXPENSES
Insuring Agreement
a. We will pay medical expenses as described
below for "bodily injury" caused by an
accident:
(1) On premises you own or rent;
(2) On ways next to premises you own or
rent; or
(3) Because of your operations;
provided that:
(1) The accident takes place in the
"coverage territory" and during the
policy period;
(2) The expenses are incurred and reported
to us within three years of the date of
the accident; and
(3) The injured person submits to
examination, at our expense, by
physicians of our choice as often as we
reasonably require.
b. We will make these payments regardless of
fault. These payments will not exceed the
applicable limit of insurance. We will pay
reasonable expenses for:
(1) First aid administered at the time of an
accident;
(2) Necessary medical, surgical, x-ray and
dental services, including prosthetic
devices; and
(3) Necessary ambulance, hospital,
professional nursing and funeral
services.
3. COVERAGE EXTENSION -
SUPPLEMENTARY PAYMENTS
a. We will pay, with respect to any claim or
"suit" we investigate or settle, or any "suit"
against an insured we defend:
(1) All expenses we incur.
(2) Up to $1,000 for the cost of bail bonds
required because of accidents or traffic
law violations arising out of the use of
any vehicle to which Business Liability
Coverage for "bodily injury" applies. We
do not have to furnish these bonds.
(3) The cost of appeal bonds or bonds to
release attachments, but only for bond
amounts within the applicable limit of
insurance. We do not have to furnish
these bonds.
(4) 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.
(5) All costs taxed against the insured in
the "suit".
(6) Prejudgment interest awarded against
the insured on that part of the judgment
we pay. If we make an offer to pay the
applicable limit of insurance, we will not
pay any prejudgment interest based on
that period of time after the offer.
(7) All interest on the full amount of any
judgment that accrues after entry of the
judgment and before we have paid,
offered to pay, or deposited in court the
part of the judgment that is within the
applicable limit of insurance.
Any amounts paid under (1) through (7)
above will not reduce the limits of insurance.
Page 2 of 24 Form SS 00 08 04 05
b. If we defend an insured against a "suit"
and an indemnitee of the insured is also
named as a party to the "suit", we will
defend that indemnitee if all of the
following conditions are met:
(1) The "suit" against the indemnitee
seeks damages for which the insured
has assumed the liability of the
indemnitee in a contract or agreement
that is an "insured contract';
(2) This insurance applies to such liability
assumed by the insured;
(3) The obligation to defend, or the cost of
the defense of, that indemnitee, has
also been assumed by the insured in
the same "insured contract";
(4) The allegations in the "suit" and the
information we know about the
"occurrence" are such that no conflict
appears to exist between the interests
of the insured and the interest of the
indemnitee;
(5) The indemnitee and the insured ask
us to conduct and control the defense
of that indemnitee against such "sult"
and agree that we can assign the
same counsel to defend the insured
and the indemnitee; and
(6) The indemnitee:
(a) Agrees in writing to:
(i) Cooperate with us in the
investigation, settlement or
defense of the "suit';
(11) immediately send us copies of
any demands, notices,
summonses or legal papers
received in connection with
the "suit';
(Iii) Notify any other insurer whose
coverage is available to the
indemnitee; and
(iv) Cooperate with us with
respect to coordinating other
applicable insueance available
to the indemnitee; and
(b) Provides us with written
authorization to:
(i) Obtain records and other
information related to the
"suit"; and
(ti) Conduct and control the
defense of the indemnitee in
such "suit".
BUSINESS LIABILITY COVERAGE FORM
So long as the above conditions are met,
attorneys' fees incurred by us in the
defense of that indemnitee, necessary
litigation expenses incurred by us and
necessary litigation expenses incurred
by the indemnitee at our request will be
paid as Supplementary Payments.
Notwithstanding the provisions of
Paragraph 1.b.(b) of Section B. —
Exclusions, such payments will not be
deemed to be damages for "bodily
injury" and "property damage" and will
not reduce the Limits of Insurance.
Our obligation to defend an insured's
indemnitee and to pay for attorneys' fees
and necessary litigation expenses as
Supplementary Payments ends when:
(1) We have used up the applicable limit
of insurance in the payment of
judgments or settlements; or
(2) The conditions set forth above, or the
terms of the agreement described in
Paragraph (B) above, are no longer met.
B. EXCLUSIONS
1. Applicable To Business Liability Coverage
This insurance does not apply to:
a. Expected Or Intended Injury
(1) "Bodily injury" or "property damage"
expected or intended from the
standpoint of the insured. This
exclusion does not apply to "bodily
injury" or "property damage" resulting
from the use of reasonable force to
protect persons or property; or
(2) "Personal and advertising injury" arising
out of an offense committed by, at the
direction of or with the consent or
acquiescence of the insured with the
expectation of inflicting "personal and
advertising injury"
b. Contractual Liability
(1) "Body injury" or "property damage'; or
(2) "Personal and advertising injury"
for which the insured is obligated to pay
damages by reason of the assumption of
liability in a contract or agreement.
This exclusion does not apply to liability
for damages because of:
(a) "Bodily injury", "property damage" or
"personal and advertising injury" that
the insured would have in the
absence of the contract or
agreement; or
Form SS 00 08 04 05 Page 3 of 24
BUSINESS LIABILITY COVERAGE FORM
(b) "Bodily injury" or "property damage"
(b) Performing duties related to the
assumed in a contract or agreement
conduct of the insured's business, or
that is an "insured contract",
(2) The spouse, child, parent, brother or
provided the "bodily injury" or
sister of that "employee" as a
"property damage" occurs
consequence of (1) above.
subsequent to the execution of the
This exclusion applies:
contract or agreement. Solely for
the purpose of liability assumed in
(1) Whether the insured may be liable as
an "insured contract', reasonable
an employer or in any other capacity;
attomeys' fees and necessary
and
litigation expenses incurred by or for
(2) To any obligation to share damages
a party other than an insured are
with or repay someone else who must
deemed to be damages because of
pay damages because of the injury.
"bodily injury" or "property damage"
This exclusion does not apply to liability
provided:
assumed by the insured under an "insured
(i) Liability to such party for, or for
contract".
the cost of, that party's defense
f. Pollution
has also been assumed in the
1 "Bodily " "e damage" or
() y inu ry° "property g
same "insured contract', and
"personal and advertising injury"
(Ii) Such attorneys' fees and
arising out of the actual, alleged or
litigation expenses are for
threatened discharge, dispersal,
defense of that party against a
seepage, migration, release or escape
civil or alternative dispute
of "pollutants":
resolution proceeding in which
(a) At or from any premises, site or
damages to which this
insurance applies are alleged.
location which is or was at any
time owned or occupied by, or
c. Liquor Liability
rented or loaned to any insured.
"Bodily injury" or "property damage" for
However, this subparagraph does
which any insured may be held liable by
not apply to:
reason of:
(1) "Bodily injury" if sustained within
(1) Causing or contributing to the
a building and caused by
intoxication of any person;
smoke, fumes, vapor or soot
(2) The furnishing of alcoholic beverages to
produced by or originating from
a person under the legal drinking age or
equipment that is used to heat,
under the influence of alcohol; or
cool or dehumidify the building,
or equipment that is used to
(3) Any statute, ordinance or regulation
heat water for personal use, by
relating to the sale, gift, distribution or
the buildings occupants or their
use of alcoholic beverages.
guests;
This exclusion applies only if you are in the
(ii) "Bodily injury" or "property
business of manufacturing, distributing,
damage�� for which you may be
selling, serving or furnishing alcoholic
held liable, if you are a
beverages.
g
contractor and the owner or
d. Workers' Compensation And Similar
lessee of such premises, site or
Laws
location has been added to your
Any obligation of the insured under a
policy as an additional insured
workers' compensation, disability benefits
with respect to your ongoing
or unemployment compensation law or
operations performed for that
any similar law.
additional insured at that
e. Employer's Liability
premises, site or location and
"Bodily injury" to:
such premises, site or location
is not and never was owned or
(1) An "employee" of the insured arising
occupied by, or rented or
out of and in the course of:
loaned to, any insured, other
(a) Employment by the insured; or
than that additional insured; or
Page 4 of 24 Form SS 00 08 04 05
BUSINESS LIABILITY COVERAGE FORM
(iii) "Bodily injury" or "property
released as part of the
damage" arising out of heat,
operations being performed
smoke or fumes from a
by such insured, contractor or
"hostile fire";
subcontractor;
(b) At or from any premises, site or
(ii) "Bodily injury" or "property
location which is or was at any
damage" sustained within a
time used by or for any insured or
building and caused by the
others for the handling, storage,
release of gases, fumes or
disposal, processing or treatment
vapors from materials brought
of waste;
into that building in connection
(c) Which are or were at any time
with operations being performed
transported, handled, stored,
by you or on your behalf by a
treated, disposed of, or processed
contractor or subcontractor; or
as waste by or for:
(iii) "Bodily injury" or "property
(1) Any insured; or
damage" arising out of heat,
smoke or fumes from a
(il) Any person or organization for
"hostile fire'; or
whom you may be legally
responsible;
(e) At or from any premises, site or
location on which any insured or any
(d) At or from any premises, site or
contractors or subcontractors
location on which any insured or
working directly or indirectly on any
any contractors or subcontractors
insured's behalf are performing
working directly or indirectly on
operations if the operations are to
any insured's behalf are
test for, monitor, clean up, remove,
performing operations if the
contain, treat, detoxify or neutralize,
"pollutants" are brought on or to
or in any way respond to, or assess
the premises, site or location in
the effects of, "pollutants".
connection with such operations
(2) Any loss, cost or expense arising out
by such insured, contractor or
of any:
subcontractor. However, this
subparagraph does not apply to:
(a) Request, demand, order or statutory
(1) "Bodily injury" or "property
or regulatory requirement that any
damage" arising out of the
insured or others test for, monitor,
escape of fuels, lubricants or
dean up, remove, contain, treat,
other operating fluids which are
detoxify or neutralize, or in any way
needed to perform the normal
respond to, or assess the effects of,
electrical, hydraulic or
"pollutants'; or
mechanical functions
(b) Claim or suit by or on behalf of a
necessary for the operation of
governmental authority for
"mobile equipment" or its parts,
damages because of testing for,
if such fuels, lubricants or other
monitoring, cleaning up, removing,
operating fluids escape from a
containing, treating, detoxifying or
vehicle part designed to hold,
neutralizing, or in any way
store or receive them. This
responding to, or assessing the
exception does not apply if the
effects of, "pollutants".
"bodily injury" or "property
However, this paragraph does not
damage" arises out of the
apply to liability for damages because
intentional discharge, dispersal
of "property damage" that the insured
or release of the fuels,
would have in the absence of such
lubricants or other operating
request, demand, order or statutory or
fluids, or if such fuels,
regulatory requirement, or such claim
lubricants or other operating
or "suit" by or on behalf of a
fluids are brought on or to the
governmental authority.
premises, site or location with
the intent that they be
discharged, dispersed or
Form SS 00 08 04 05 Page 5 of 24
BUSINESS LIABILITY COVERAGE FORM
g. Aircraft, Auto Or Watercraft
"Bodily injury' or "property damage" arising
out of the ownership, maintenance, use or
entrustment to others of any aircraft, "auto"
or watercraft owned or operated by or rented
or loaned to any insured. Use includes
operation and "loading or unloading".
This exclusion applies even if the claims
against any insured allege negligence or
other wrongdoing In the supervision, hiring,
employment, training or monitoring of others
by that insured, if the "occurrence" which
caused the "bodily injury" or "property
damage" involved the ownership,
maintenance, use or entrustment to others of
any aircraft, "auto" or watercraft that is
owned or operated by or rented or loaned to
any insured.
This exclusion does not apply to:
(1) A watercraft while ashore on premises
you own or rent;
(2) A watercraft you do not own that is:
(a) Less than 51 feet long; and
(b) Not being used to carry persons
for a charge;
(3) Parking an "auto" on, or on the ways
next to, premises you own or rent,
provided the "auto" is not owned by or
rented or loaned to you or the insured;
(4) Liability assumed under any "insured
contract" for the ownership,
maintenance or use of aircraft or
watercraft;
(5) "Bodily Injury" or "property damage"
arising out of the operation of any of
the equipment listed in Paragraph f.(2)
or f.(3) of the definition of "mobile
equipment"; or
(6) An aircraft that is not owned by any
insured and is hired, chartered or loaned
with a paid crew. However, this
exception does not apply if the insured
has any other insurance for such "bodily
injury" or "property damage", whether
the other insurance is primary, excess,
contingent or on any other basis.
h. Mobile Equipment
"Bodily injury" or "property damage"
arising out of:
(1) The transportation of "mobile equipment"
by an "auto" owned or operated by or
rented or loaned to any insured; or
(2) The use of "mobile equipment" in, or
while in practice or preparation for, a
prearranged racing, speed or
demolition contest or in any stunting
activity.
i. War
"Bodily injury", "property damage" or
"personal and advertising injury", however
caused, arising, directly or indirectly, out of:
(1) War, including undeclared or civil war;
(2) Warlike action by a military force,
including action in hindering or
defending against an actual or
expected attack, by any government,
sovereign or other authority using
military personnel or other agents; or
(3) Insurrection, rebellion, revolution,
usurped power, or action taken by
governmental authority in hindering or
defending against any of these.
Professional Services
"Bodily injury", "property damage" or
"personal and advertising injury" arising
out of the rendering of or failure to render
any professional service. This includes
but is not limited to:
(1) Legal, accounting or advertising
services;
(2) Preparing, approving, or failing to
prepare or approve maps, shop
drawings, opinions, reports, surveys,
field orders, change orders, designs or
drawings and specifications;
(3) Supervisory, inspection, architectural
or engineering activities;
(4) Medical, surgical, dental, x-ray or
nursing services treatment, advice or
instruction;
(5) Any health or therapeutic service
treatment, advice or instruction;
(6) Any service, treatment, advice or
instruction for the purpose of
appearance or skin enhancement, hair
removal or replacement or personal
grooming;
(7) Optical or hearing aid services
including the prescribing, preparation,
fitting, demonstration or distribution of
ophthalmic lenses and similar
products or hearing aid devices;
Page 6 of 24 Form SS 00 08 04 06
BUSINESS LIABILITY COVERAGE FORM
(8) Optometry or optometric services
Paragraphs (1), (3) and (4) of this
including but not limited to examination
exclusion do not apply to "property
of the eyes and the prescribing,
damage" (other than damage by fire) to
preparation, fifting,demonstration or
premises, including the contents of such
distribution of ophthalmic lenses and
premises, rented to you for a period of 7 or
similar products;
fewer consecutive days. A separate Limit
(9) Any:
of Insurance applies to Damage To
(a) Body piercing (not Including ear
Premises Rented To You as described in
piercing);
Section D. - Limits Of Insurance.
(b) Tattooing, including but not limited
Paragraph (2) of this exclusion does not
to the insertion of pigments into or
apply If the premises are "your work" and
under the skin; and
were never occupied, rented or held for
rental by you.
(c) Similar services;
Paragraphs (3) and (4) of this exclusion do
(10) Services in the practice of pharmacy;
not apply to the use of elevators.
and
Paragraphs (3), (4). (5) and (6) of this
(11) Computer consulting, design or
exclusion do, not apply to liability assumed
programming services, including web
under a sidetrack agreement.
site design.
Paragraphs (3) and (4) of this exclusion do
Paragraphs (4) and (5) of this exclusion do
not apply to "property damage" to
not apply to the Incidental Medical
borrowed equipment while not being used
Malpractice coverage afforded under
to perform operations at a job site.
Paragraph 1.e. in Section A. - Coverages.
Paragraph (6) of this exclusion does not
k. Damage To Property
apply to "property damage" included in the
"Property damage" to:
"products -completed operations hazard".
(1) Property you own, rent or occupy,
1. Damage To Your Product
including any costs or expenses
"Property damage" to "your product'
incurred by you, or any other person,
arising out of it or any part of it.
organization or entity, for repair,
m. Damage To Your Work
replacement, enhancement,
restoration or maintenance of such
"Property damage" to "your work" arising
property for any reason, including
out of it or any part of it and included in the
prevention of injury to a person or
"products -completed operations hazard".
damage to another's property;
This exclusion does not apply if the
(2) Premises you sell, give away or
damaged work or the work out of which
abandon, if the "property damage" arises
the damage arises was performed on your
out of any part of those premises;
behalf by a subcontractor.
(3) Property loaned to you;
n. Damage To Impaired Property Or
(4) Personal property in the care, custody
Property Not Physically Injured
or control of the insured;
"Property damage" to "Impaired property"
(5) That particular part of real property an
or property that has not been physically
which you or any contractors or
Injured, arising out of-,
subcontractors working directly or
(1) A defect, deficiency, inadequacy or
indirectly on your behalf are performing
dangerous condition in "your producf'
operations, if the "property damage"
or "Your work'; or
arises out of those operations; or
(2) A delay or failure by you or anyone
(6) That particular part of any property
acting on your behalf to perform a
that must be restored, repaired or
contract or agreement in accordance
replaced because "your work" was
with its terms.
incorrectly performed on it.
This exclusion does not apply to the loss
of use of other property arising out of
sudden and accidental physical injury to
"your product" or "your work" after it has
been put to its intended use.
Form SS 00 08 04 05 Page 7 of 24
BUSINESS LIABILITY COVERAGE FORM
o. Recall Of Products, Work Or Impaired
(c) Title of any literary or artistic work;
Property
(8) Arising out of an offense committed by
Damages claimed for any loss, cost or
an insured whose business is:
expense incurred by you or others for the
(a) Advertising, broadcasting,
loss of use, withdrawal, recall, inspection,
publishing or telecasting;
repair, replacement, adjustment, removal
(b) Designing or determining content
or disposal of:
of web sites for others; or
(1) "Your product';
(c) An Internet search, access,
(2) "Your work'; or
content or service provider.
(3) "Impaired property";
However, this exclusion does not
if such product, work or property is
apply to Paragraphs a., b. and c.
withdrawn or recalled from the market or
under the definition of "personal and
from use by any person or organization
advertising injury" in Section G. —
because of a known or suspected defect,
Liability And Medical Expenses
deficiency, inadequacy or dangerous
Definitions.
condition in it.
For the purposes of this exclusion,
p. Personal And Advertising Injury
placing an "advertisement" for or
"Personal and advertising injury":
linking to others on your web site, by
(1) Arising out of oral, written or electronic
itself, is not considered the business
publication of material, if done by or at
of advertising, broadcasting,
the direction of the insured with
publishing or telecasting;
knowledge of its falsity;
(9) Arising out of an electronic chat room
(2) Arising out of oral, written or electronic
or bulletin board the insured hosts,
publication of material whose first
owns, or over which the insured
exercises control;
publication took place before the
beginning of the policy period;
(10) Arising out of the unauthorized use of
(3) Arising out of a criminal act committed
another's name or product in your e-mail
by or at the direction of the insured;
address, domain name or metatags, or
any other similar tactics to mislead
(4) Arising out of any breach of contract,
another's potential customers;
except an implied contract to use
(11) Arising out of the violation of a
another's "advertising idea" in your
persons right of privacy created by
"advertisement" ;
any state or federal act.
(5) Arising out of the failure of goods,
However, this exclusion does not
products or services to conform with
apply to liability for damages that the
any statement of quality or
insured would have in the absence of
performance made in your
such state or federal act;
"advertisement";
(6) Arising out of the wrong description of
(12) Arising out of:
the price of goods, products or services;
(a) An "advertisement" for others on
(7) Arising out of any violation of any
your web site;
intellectual property rights such as
(b) Placing a link to a web site of
copyright, patent, trademark, trade
others on your web site;
name, trade secret, service mark or
(c) Content from a web site of others
other designation of origin or
displayed within a frame or border
authenticity.
on your web site. Content includes
However, this exclusion does not
information, code, sounds, text,
apply to infringement, in your
graphics or images; or
"advertisement", of
(d) Computer code, software or
(a) Copyright;
programming used to enable:
(b) Slogan, unless the slogan is also
(i) Yourweb site; or
a trademark, trade name, service
(it) The presentation or functionality
mark or other designation of origin
of an "advertisement' or other
or authenticity; or
content on your web site;
Page 8 of 24 Form SS 00 08 04 05
BUSINESS LIABILITY COVERAGE FORM
(13) Arising out of a violation of any anti-
(a) May be awarded or incurred by
trust law;
reason of any claim or suit
(14) Arising out of the fluctuation in price or
alleging actual or threatened injury
value of any stocks, bonds or other
or damage of any nature or kind to
securities; or
persons or property which would
(16) Arising out of discrimination or
not have occurred In whole or in
"asbestos
humiliation committed by or at the
pa rt but for the hazard";
direction of any "executive officer",
(b) Arise out of any request, demand,
director, stockholder, partner or
order or statutory or regulatory
member of the insured.
requirement that any insured or
q. Electronic Data
others test for, monitor, clean up,
remove, encapsulate, contain,
Damages arising out of the loss of, loss of
treat, detoxify or neutralize or in
use of, damage to, corruption of, inability
any way respond to or assess the
to access, or inability to manipulate
effects of an "asbestos hazard"; or
"electronic data!",
(c) Arise out of any claim or suit for
r. Employment -Related Practices
damages because of testing far,
"Bodily injury' or "personal and advertising
monitoring, cleaning up, removing,
injury" to:
encapsulating, containing, treating,
(1) A person arising out of any:
detoxifying or neutralizing or in any
way responding to or assessing the
(a) Refusal to employ that person;
effects of an "asbestos hazard".
(b) Termination of that person's
t Violation Of Statutes That Govern E -
employment; or
Mails, Fax, Phone Calls Or Other
(c) Employment-related practices,
Methods Of Sending Material Or
poiWies, acts or omissions, such as
information
coercion, demotion, evaluation,
"Bodily injury", "property damage", or
reassignment, discipline,
personal and advertising injury" arising
defamation, harassment, humiliation
directly or Indirectly out of any action or
or discrimination directed at that
omission that violates or is alleged to
person; or
violate:
(2) The spouse, child, parent, brother or
(1) The Telephone Consumer Protection
sister of that person as a
Act (TCPA), including any amendment
consequence of "bodily injury" or
of or addition to such law;
"personal and advertising injury" to the
(2) The CAN -SPAM Act of 2003, including
person at whom any of the
employment-related practices
any amendment of or addition to such
described in Paragraphs (a), (b); or (c)
law; or
above is directed.
(3) Any statute, ordinance or regulation,
This exclusion applies:
other than the TCPA or CAN -SPAM Act
of 2003, that prohibits or limits the
(1) Whether the insured may be liable as
sending, transmitting, communicating or
an employer or in any other capacity;
distribution of material or information.
and
Damage To Promises Rented To You —
(2) To any obligation to share damages
Exception For Damage By Fire, Lightning
with or repay someone else who must
or Explosion
pay damages because of the injury.
Exclusions c. through h. and k. through o. do
9. Asbestos
not apply to damage by fire, lightning or
(1) "Bodily injury", "property damage" or
explosion to premises rented to you or
"Personal! and advertising Injury"'
temporarily occupied by you with permission of
arising out of the "asbestos hazard".
the owner. A separate Limit of Insurance
(2) Any damages, judgments, settlements,
applies to this coverage as described in
loss, costs or expenses that
Section D. - Liability And Medical Expenses
Limits Of Insurance.
Form SS 00 08 04 05 Page 9 of 24
BUSINESS LIABILITY COVERAGE FORM
2. Applicable To Medical Expenses Coverage
We will not pay expenses for "bodily injury":
a. Any Insured
To any insured, except "volunteer workers".
b. Hired Person
To a person hired to do work for or on behalf
of any insured or a tenant of any insured.
c. Injury On Normally Occupied Premises
To a person injured on that part of
premises you own or rent that the person
normally occupies.
d. Workers' Compensation And Similar
Laws
To a person, whether or not an
"employee" of any insured, if benefits for
the "bodily injury" are payable or must be
provided under a workers' compensation
or disability benefits law or a similar law.
e. Athletics Activities
To a person injured while practicing,
instructing or participating in any physical
exercises or games, sports or athletic
contests.
f. Products -Completed Operations Hazard
Included with the "products -completed
operations hazard".
g. Business Liability Exclusions
Excluded under Business Liability Coverage.
C. WHO IS AN INSURED
1. If you are designated in the Declarations as:
a. An individual, you and your spouse are
insureds, but only with respect to the
conduct of a business of which you are the
sole owner.
b. A partnership or joint venture, you are an
insured. Your members, your partners, and
their spouses are also insureds, but only with
respect to the conduct of your business.
c. A limited liability company, you are an
insured. Your members are also insureds,
but only with respect to the conduct of your
business. Your managers are insureds, but
only with respect to their duties as your
managers.
d. An organization other than a partnership,
joint venture or limited liability company, you
are an insured. Your "executive officers" and
directors are insureds, but only with respect
to their duties as your officers or directors.
Your stockholders are also insureds, but only
with respect to their liability as stockholders.
e. A trust, you are an insured. Your trustees
are also insureds, but only with respect to
their duties as trustees.
2. Each of the following is also an insured:
a. Employees And Volunteer Workers
Your "volunteer workers" only while
performing duties related to the conduct of
your business, or your "employees", other
than either your "executive officers" (if you
are an organization other than a
partnership, joint venture or limited liability
company) or your managers (if you are a
limited liability company), but only for acts
within the scope of their employment by
you or while performing duties related to
the conduct of your business.
However, none of these "employees" or
"volunteer workers" are insureds for:
(1) "Bodily injury" or "personal and
advertising injury":
(a) To you, to your partners or
members (if you are a partnership
or joint venture), to your members
(if you are a limited liability
company), or to a co -"employee"
while in the course of his or her
employment or performing duties
related to the conduct of your
business, or to your other
"volunteer workers" while
performing duties related to the
conduct of your business;
(b) To the spouse, child, parent,
brother or sister of that co -
"employee" or that "volunteer
worker" as a consequence of
Paragraph (1)(a) above;
(c) For which there is any obligation
to share damages with or repay
someone else who must pay
damages because of the injury
described in Paragraphs (1)(a) or
(b) above; or
(d) Arising out of his or her providing
or failing to provide professional
health care services.
If you are not in the business of
providing professional health care
services, Paragraph (d) does not apply
to any nurse, emergency medical
technician or paramedic employed by
you to provide such services.
(2) "Property damage" to property:
(a) Owned, occupied or used by,
Page 10 of 24 Form SS 00 08 04 05
(b) Rented to, in the care, custody or
control of, or over which physical
control is being exercised for any
purpose by you, any of your
"employees", "volunteer workers",
any partner or member (if you are
a partnership or joint venture), or
any member (if you are a limited
liability company).
b. Real Estate Manager
Any person (other than your "employee" or
"volunteer worker"), or any organization
while acting as your real estate manager.
c. Temporary Custodians Of Your
Property
Any person or organization having proper
temporary custody of your property if you
die, but only:
(1) With respect to liability arising out of the
maintenance or use of that property; and
(2) Until your legal representative has
been appointed.
d. Legal Representative If You Die
Your legal representative if you die, but
only with respect to duties as such. That
representative will have all your rights and
duties under this insurance.
e. Unnamed Subsidiary
Any subsidiary and subsidiary thereof, of
yours which is a legally incorporated entity
of which you own a financial interest of
more than 50% of the voting stock on the
effective date of this Coverage Part.
The insurance afforded herein for any
subsidiary not shown in the Declarations
as a named insured does not apply to
injury or damage with respect to which an
Insured under this insurance is also an
insured under another policy or would be
an insured under such policy but for its
termination or upon the exhaustion of its
limits of insurance.
3. Newly Acquired Or Formed Organization
Any organization you newly acquire or form,
other than a partnership, joint venture or
limited liability company, and over which you
maintain financial interest of more than 50% of
the voting stock, will qualify as a Named
Insured if there is no other similar insurance
available to that organization. However:
a. Coverage under this provision is afforded
only until the 180th day after you acquire
or form the organization or the end of the
policy period, whichever is earlier; and
BUSINESS LIABILITY COVERAGE FORM
b. Coverage under this provision does not
apply to:
(1) "Bodily injury" or "property damage"
that occurred; or
(2) "Personal and advertising injury"
arising out of an offense committed
before you acquired or formed the
organization.
4. Operator Of Mobile Equipment
With respect to "mobile equipment' registered in
your name under any motor vehicle registration
law, any person is an insured while driving such
equipment along a public highway with your
permission. Any other person or organization
responsible for the conduct of such person is
also an insured, but only with respect to liability
arising out of the operation of the equipment, and
only if no other insurance of any kind is available
to that person or organization for this liability.
However, no person or organization is an insured
with respect to:
a. "Bodily injury" to a co -"employee" of the
person driving the equipment; or
b. "Property damage" to property owned by,
rented to, in the charge of or occupied by
you or the employer of any person who is
an insured under this provision.
5. Operator of Nonowned Watercraft
With respect to watercraft you do not own that
is less than 51 feet long and is not being used
to carry persons for a charge, any person is an
insured while operating such watercraft with
your permission. Any other person or
organization responsible for the conduct of
such person is also an insured, but only with
respect to liability arising out of the operation
of the watercraft, and only if no other
insurance of any kind is available to that
person or organization for this liability.
However, no person or organization is an
insured with respect to:
a. "Bodily injury" to a co -"employee" of the
person operating the watercraft; or
b. "Property damage" to property owned by,
rented to, in the charge of or occupied by
you or the employer of any person who is
an insured under this provision.
S. Additional Insureds When Required By
Written Contract, Written Agreement Or
Permit
The person(s) or organization(s) identified in
Paragraphs a. through f. below are additional
insureds when you have agreed, in a written
Form SS 00 08 04 05 Page 11 of 24
BUSINESS LIABILITY COVERAGE FORM
contract, written agreement or because of a
(e) Any failure to make such
permit issued by a state or political
inspections, adjustments, tests or
subdivision, that such person or organization
servicing as the vendor has
be added as an additional insured on your
agreed to make or normally
policy, provided the injury or damage occurs
undertakes to make in the usual
subsequent to the execution of the contract or
course of business, in connection
agreement, or the issuance of the permit.
with the distribution or sale of the
A person or organization is an additional
products;
insured under this provision only for that
Ifl Demonstration, installation,
period of time required by the contract,
servicing or repair operations,
agreement or permit.
except such operations performed
However, no such person or organization is an
at the vendors premises in
connection with the sale of the
additional insured under this provision if such
product;
person or organization is included as an
additional insured by an endorsement issued
(g) Products which, after distribution
by us and made a part of this Coverage Part,
or sale by you, have been labeled
including all persons or organizations added
or relabeled or used as a
as additional insureds under the specific
container, part or ingredient of any
additional insured coverage grants in Section
other thing or substance by or for
F. — Optional Additional Insured Coverages.
the vendor; or
a. Vendors
(h) "Bodily injury" or "property
damage" arising out of the sole
Any person(s) or organization(s) (referred to
negligence of the vendor for its
below as vendor), but only with respect to
own acts or omissions or those of
"bodily injury" or "property damage" arising
its employees or anyone else
out of "your products" which are distributed
acting on its behalf. However, this
or sold in the regular course of the vendors
exclusion does not apply to:
business and only if this Coverage Part
provides coverage for "bodily injury" or
(t) The exceptions contained in
"property damage" included within the
Subparagraphs (d) or (f); or
"products -completed operations hazard".
(ii) Such inspections, adjustments,
(1) The insurance afforded to the vendor
tests or servicing as the vendor
is subject to the following additional
has agreed to make or normally
exclusions:
undertakes to make in the usual
This insurance does not apply to:
course of business, in
connection with the distribution
(a) "Bodily injury" or "property
or sale of the products.
damage" for which the vendor is
(2) This insurance does not apply to any
obligated to pay damages by
insured person or organization from
reason of the assumption of
whom you have acquired such products,
liability in a contract or agreement.
or any ingredient, part or container,
This exclusion does not apply to
entering into, accompanying or
liability for damages that the
containing such products.
vendor would have in the absence
of the contract or agreement;
b. Lessors Of Equipment
(b) Any express warranty
(1) Any person or organization from
unauthorized by you;
whom you lease equipment; but only
with respect to their liability for "bodily
(c) Any physical or chemical change
injury", "property damage" or
in the product made intentionally
"personal and advertising injury"
by the vendor;
caused, in whole or in part, by your
(d) Repackaging, except when
maintenance, operation or use of
unpacked solely for the purpose of
equipment leased to you by such
inspection, demonstration, testing,
person or organization.
or the substitution of parts under
instructions from the manufacturer,
and then repackaged in the
original container;
Page 12 of 24 Form SS 00 08 04 05
BUSINESS LIABILITY COVERAGE FORM
(2)
With respect to the insurance afforded
e. Permits Issued By State Or Political
to these additional insureds, this
Subdivisions
insurance does not apply to any
"occurrence"
(1) Any state or political subdivision, but
which takes place after
only with respect to operations
you cease to lease that equipment.
performed by you or on your behalf for
c. Lessors
Of Land Or Premises
which the state or political subdivision
(1)
Any person or organization from
has issued a permit.
whom you lease land or premises, but
(2) With respect to the insurance afforded
only with respect to liability arising out
to these additional insureds, this
of the ownership, maintenance or use
insurance does not apply to:
of that part of the land or premises
(a) "Bodily injury", "property damage"
leased to you.
or "personal and advertising
(2)
With respect to the insurance afforded
injury" arising out of operations
to these additional insureds, this
performed for the state or
insurance does not apply to:
municipality; or
(a) Any "occurrence" which takes
(b) "Bodily injury" or "property damage"
place after you cease to lease that
included within the "products -
land or be a tenant in that
completed operations hazard".
premises; or
f. Any Other Party
(b) Structural alterations, new
(1) Any other person or organization who
construction or demolition
is not an insured under Paragraphs a.
operations performed by or on
through e. above, but only with
behalf of such person or
organization.
respect to liability for "bodily injury",
"properly
damage" or "personal and
d. Architects, Engineers Or Surveyors
advertising injury" caused, in whole or
(1)
Any architect, engineer, or surveyor, but
in part, by your acts or omissions or
only with respect to liability for "bodily
the acts or omissions of those acting
injury", "property damage" or "personal
on your behalf:
and advertising injury" caused, in whole
(a) In the performance of your
or in part, by your acts or omissions or
ongoing operations;
the acts or omissions of those acting on
(b) In connection with your premises
your behalf:
owned by or rented to you; or
(a) in connection with your premises;
(c) In connection with "your work" and
or
included within the "products -
(b) In the performance of your
completed operations hazard", but
ongoing operations performed by
only if
you or on your behalf.
(i) The written contract or written
(2)
With respect to the insurance afforded
P
agreement requires you to
to these additional insureds, the
provide such coverage to
following additional exclusion applies:
such additional insured; and
This insurance does not apply to
(1I) This Coverage Part provides
"bodily injury", "property damage" or
coverage for "bodily injury" or
"personal and advertising injury"
"properly damage" included
arising out of the rendering of or the
within the "products -
failure to render any professional
completed operations hazard".
services by or for you, including:
(2) With respect to the insurance afforded
(a) The preparing, approving, or
to these additional insureds, this
failure to prepare or approve,
insurance does not apply to;
maps, shop drawings, opinions,
"Bodily injury", "property damage" or
reports, surveys, field orders,
"personal and advertising injury"
change orders, designs or
drawings and specifications; or
arising out of the rendering of, or the
failure to render, any professional
(b) Supervisory, inspection,
architectural, engineering or surveying
architectural or engineering
services, including:
activities.
Form SS 00 08 04 05 Page 13 of 24
BUSINESS LIABILITY COVERAGE FORM
(a) The preparing, approving, or
failure to prepare or approve,
maps, shop drawings, opinions,
reports, surveys, field orders,
change orders, designs or
drawings and specifications; or
(b) Supervisory, inspection,
architectural or engineering
activities.
The limits of insurance that apply to additional
insureds are described in Section D. — Limits
Of Insurance.
How this insurance applies when other
insurance is available to an additional insured
is described in the Other Insurance Condition
in Section E. — Liability And Medical Expenses
General Conditions.
No person or organization is an insured with
respect to the conduct of any current or past
partnership, joint venture or limited liability
company that is not shown as a Named Insured in
the Declarations.
D. LIABILITY AND MEDICAL EXPENSES
LIMITS OF INSURANCE
1. The Most We Will Pay
The Limits of Insurance shown in the
Declarations and the rules below fix the most
we will pay regardless of the number of:
a. Insureds;
b. Claims made or"suits" brought; or
c. Persons or organizations making claims or
bringing "suits".
2. Aggregate Limits
The most we will pay for:
a. Damages because of "bodily injury" and
"property damage" included in the
"products -completed operations hazard" is
the Products -Completed Operations
Aggregate Limit shown in the
Declarations.
b. Damages because of all other "bodily
injury", "property damage" or "personal
and advertising injury", including medical
expenses, is the General Aggregate Limit
shown in the Declarations.
This General Aggregate Limit applies
separately to each of your "locations"
owned by or rented to you.
"Location" means premises involving the
same or connecting lots, or premises
whose connection is interrupted only by a
street, roadway or right-of-way of a
railroad.
This General Aggregate limit does not
apply to "property damage" to premises
while rented to you or temporarily
occupied by you with permission of the
owner, arising out of fire, lightning or
explosion.
3. Each Occurrence Limit
Subject to 2.a. or 2.b above, whichever
applies, the most we will pay for the sum of all
damages because of all "bodily injury",
"property damage" and medical expenses
arising out of any one "occurrence" is the
Liability and Medical Expenses Limit shown in
the Declarations.
The most we will pay for all medical expenses
because of "bodily injury" sustained by any
one person is the Medical Expenses Limit
shown in the Declarations.
4. Personal And Advertising Injury Limit
Subject to 2.b. above, the most we will pay for
the sum of all damages because of all
"personal and advertising injury" sustained by
any one person or organization is the Personal
and Advertising Injury Limit shown in the
Declarations.
5. Damage To Premises Rented To You Limit
The Damage To Premises Rented To You
Limit is the most we will pay under Business
Liability Coverage for damages because of
"property damage" to any one premises, while
rented to you, or in the case of damage by fire,
lightning or explosion, while rented to you or
temporarily occupied by you with permission of
the owner.
In the case of damage by fire, lightning or
explosion, the Damage to Premises Rented To
You Limit applies to all damage proximately
caused by the same event, whether such
damage results from fire, lightning or explosion
or any combination of these.
6. How Limits Apply To Additional Insureds
The most we will pay on behalf of a person or
organization who is an additional insured
under this Coverage Part is the lesser of:
a. The limits of insurance specified in a
written contract, written agreement or
permit issued by a state or political
subdivision; or
b. The Limits of Insurance shown in the
Declarations.
Such amount shall be a part of and not in
addition to the Limits of Insurance shown in
the Declarations and described in this Section.
Page 14 of 24 Form SS 00 08 04 05
BUSINESS LIABILITY COVERAGE FORM
if more than one limit of insurance under this
(1) Immediately send us copies of any
policy and, any endorsements attached thereto
demands, notices, summonses or
applies to any claim or "'suit', the most we will pay
legal papers received in connection
under this policy and the endorsements is the
with the claim or "suit";
single highest limit of liability of all coverages
(2) Authorize us to obtain records and
applicable to such claim or "suit". However, this
other information;
paragraph does not apply to the Medical Expenses
(3) Cooperate with us in the investigation,
limit set forth In Paragraph 3. above.
settlement of the claim or defense
The Limits of Insurance of this Coverage Part apply
against the "suit"; and
separately to each consecutive annual period and to
(4) Assist us, upon our request, in the
any remaining period of less than 12 months, starting
enforcement of any right against any
with the beginning of the policy period shown in the
person or organization that may be
Declarabons, unless the policy period Is extended
liable to the insured because of injury
after issuance for an additional period of less than 12
or damage to which this insurance
months. In that case, e additional period will be
th
may also apply.
deemed part of the last preceding period for purposes
of determining the Limits of Insurance.
d. Obligations At The Insured's Own Cost
E. LIABILITY AND MEDICAL EXPENSES
No insured will, except at that insured's own
GENERAL CONDITIONS
cost voluntarily make a payment assume
any obligation, or incur any expense, other
1. Bankruptcy
than for first aid, without our consent.
Bankruptcy or insolvency of the insured or of
e. Additional Insured's Other Insurance
the insured's estate will not relieve us of our
If we cover a claim or "suit" under this
obligations under this Coverage Part.
Coverage Part that may also be covered
2. Duties In The Event Of Occurrence,
by other insurance available to an
Offense, Claim Or Suit
additional Insured, such additional insured
a. Notice Of Occurrence Or Offense
must submit such claim or "suit" to the
other insurer for defense and indemnity.
You or any additional insured must see to
it that we are notified as soon as
However, this provision does not apply to
practicable of an "occurrence" or an
the extent that you have agreed in a
offense which may result in a claim. To
written contract, written agreement or
the extent possible, notice should include:
permit that this insurance is primary and
(11) How, when and where the "occurrence'
non-contributory with the additional
insured's own insurance,
or offense took place;
L Knowledge Of An Occurrence, Offense,
(2) The names and addresses of any
Claim Or Suit
Injured persons and witnesses; and
Paragraphs a. and b. apply to you or to
(3) The nature and location of any injury
any additional Insured only when such
or damage arising out of the
"occurrence", offense, claim or "suit" is
"occurrence" or offense.
known to:
b. Notice Of Claim
(1) You or any additional insured that is
If a claim is made or "suit" is brought
an individual;
against any insured, you or any additional
(2) Any partner, if you or an additional
insured must:
insured is a partnership;
(1) Immediately record the specifics of the
(3) Any manager, if you or an additional
claim or "suit" and the date received;
insured is a limited liability company;
and
(4) Any "executive officer' or insurance
(2) Notify us as soon as practicable.
manager, if you or an additional
You or any additional insured must see to
insured is a corporation;
It that we receive a written notice of the
(5) Any trustee, if you or an additional
claim or "suit" as soon as practicable.
insured is a trust; or
c. Assistance And Cooperation Of The
(6) Any elected or appointed official, if you
Insured
or an additional insured is a political
You and any other involved insured must:
subdivision or public entity.
Form SS 00 08 04 05 Page 15 of 24
BUSINESS LIABILITY COVERAGE FORM
This Paragraph f. applies separately to
you and any additional insured.
3. Financial Responsibility Laws
a. When this policy is certified as proof of
financial responsibility for the future under
the provisions of any motor vehicle
financial responsibility law, the insurance
provided by the policy for "bodily injury"
liability and "property damage" liability will
comply with the provisions of the law to
the extent of the coverage and limits of
insurance required by that law.
b. With respect to "mobile equipment' to
which this insurance applies, we will
provide any liability, uninsured motorists,
underinsured motorists, no-fault or other
coverage required by any motor vehicle
law. We will provide the required limits for
those coverages.
4. Legal Action Against Us
No person or organization has a right under
this Coverage Form:
a. To join us as a party or otherwise bring us
into a "suit" asking for damages from an
insured; or
b. To sue us on this Coverage Form unless
all of its terms have been fully complied
with.
A person or organization may sue us to recover
on an agreed settlement or on a final judgment
against an insured; but we will not be liable for
damages that are not payable under the terms of
this insurance or that are in excess of the
applicable limit of insurance. An agreed
settlement means a settlement and release of
liability signed by us, the insured and the
claimant or the claimant's legal representative.
5. Separation Of Insureds
Except with respect to the Limits of Insurance,
and any rights or duties specifically assigned
in this policy to the first Named Insured, this
insurance applies:
a. As if each Named Insured were the only
Named Insured; and
b. Separately to each insured against whom
a claim is made or "suit" is brought.
S. Representations
a. When You Accept This Policy
By accepting this policy, you agree:
(1) The statements in the Declarations
are accurate and complete;
(2) Those statements are based upon
representations you made to us; and
(3) We have issued this policy in reliance
upon your representations.
b. Unintentional Failure To Disclose
Hazards
If unintentionally you should fail to disclose
all hazards relating to the conduct of your
business at the inception date of this
Coverage Part, we shall not deny any
coverage under this Coverage Part
because of such failure.
7. Other Insurance
If other valid and collectible insurance is
available for a loss we cover under this
Coverage Part, our obligations are limited as
follows:
a. Primary Insurance
This insurance is primary except when b.
below applies. If other insurance is also
primary, we will share with all that other
insurance by the method described in c.
below.
b. Excess Insurance
This insurance is excess over any of the
other insurance, whether primary, excess,
contingent or on any other basis:
(1) Your Work
That is Fire, Extended Coverage,
Builder's Risk, Installation Risk or
similar coverage for "your work';
(2) Premises Rented To You
That is fire, lightning or explosion
insurance for premises rented to you
or temporarily occupied by you with
permission of the owner;
(3) Tenant Liability
That is insurance purchased by you to
cover your liability as a tenant for
"property damage" to premises rented
to you or temporarily occupied by you
with permission of the owner;
(4) Aircraft, Auto Or Watercraft
If the loss arises out of the maintenance
or use of aircraft, "autos" or watercraft to
the extent not subject to Exclusion g. of
Section A. — Coverages.
(5) Property Damage To Borrowed
Equipment Or Use Of Elevators
If the loss arises out of "property
damage" to borrowed equipment or
the use of elevators to the extent not
subject to Exclusion k. of Section A. —
Coverages.
Page 16 of 24 Form SS 00 08 04 06
(6) When You Are Added As An
Additional Insured To Other
Insurance
That is other insurance available to
you covering liability for damages
arising out of the premises or
operations, or products and completed
operations, for which you have been
added as an additional insured by that
insurance; or
(7) When You Add Others As An
Additional Insured To This
Insurance
That is other insurance available to an
additional insured.
However, the following provisions
apply to other insurance available to
any person or organization who is an
additional insured under this Coverage
Part:
(a) Primary Insurance When
Required By Contract
This insurance is primary if you
have agreed in a written contract,
written agreement or permit that
this insurance be primary. If other
insurance is also primary, we will
share with all that other insurance
by the method described in c.
below.
(b) Primary And Non -Contributory
To Other Insurance When
Required By Contract
If you have agreed in a written
contract, written agreement or
permit that this insurance is
primary and non-contributory with
the additional insured's own
insurance, this insurance is
primary and we will not seek
contribution from that other
insurance.
Paragraphs (a) and (b) do not apply to
other insurance to which the additional
insured has been added as an
additional insured.
When this insurance is excess, we will
have no duty under this Coverage Part to
defend the insured against any "suit" if any
other insurer has a duty to defend the
insured against that "suit". If no other
insurer defends, we will undertake to do
so, but we will be entitled to the insured's
rights against all those other insurers.
BUSINESS LIABILITY COVERAGE FORM
When this insurance is excess over other
insurance, we will pay only our share of
the amount of the loss, if any, that
exceeds the sum of:
(1) The total amount that all such other
insurance would pay for the loss in the
absence of this insurance; and
(2) The total of all deductible and self-
insured amounts under all that other
insurance.
We will share the remaining loss, if any, with
any other insurance that is not described in
this Excess Insurance provision and was not
bought specifically to apply in excess of the
Limits of Insurance shown in the
Declarations of this Coverage Part.
c. Method Of Sharing
If all the other insurance permits
contribution by equal shares, we will follow
this method also. Under this approach,
each insurer contributes equal amounts
until it has paid its applicable limit of
insurance or none of the loss remains,
whichever comes first.
If any of the other insurance does not permit
contribution by equal shares, we will
contribute by limits. Under this method, each
insurer's share is based on the ratio of its
applicable limit of insurance to the total
applicable limits of insurance of all insurers.
8. Transfer Of Rights Of Recovery Against
Others To Us
a. Transfer Of Rights Of Recovery
If the insured has rights to recover all or
part of any payment, including
Supplementary Payments, we have made
under this Coverage Part, those rights are
transferred to us. The insured must do
nothing after loss to impair them. At our
request, the insured will bring "suit" or
transfer those rights to us and help us
enforce them. This condition does not
apply to Medical Expenses Coverage.
b. Waiver Of Rights Of Recovery (Waiver
Of Subrogation)
If the Insured has waived any rights of
recovery against any person or
organization for all or part of any payment,
including Supplementary Payments, we
have made under this Coverage Part, we
also waive that right, provided the insured
waived their rights of recovery against
such person or organization in a contract,
agreement or permit that was executed
prior to the injury or damage.
Form SS 00 08 04 05 Page 17 of 24
BUSINESS LIABILITY COVERAGE FORM
F. OPTIONAL ADDITIONAL INSURED
COVERAGES
If listed or shown as applicable in the Declarations,
one or more of the following Optional Additional
Insured Coverages also apply. When any of these
Optional Additional Insured Coverages apply,
Paragraph 6. (Additional insureds When Required
by Written Contract, Written Agreement or Permit)
of Section C., Who Is An Insured, does not apply
to the person or organization shown in the
Declarations. These coverages are subject to the
terms and conditions applicable to Business
Liability Coverage in this policy, except as
provided below:
1. Additional Insured - Designated Person Or
Organization
WHO IS AN INSURED under Section C. is
amended to include as an additional insured
the person(s) or organization(s) shown in the
Declarations, but only with respect to liability
for "bodily injury", "property damage" or
"personal and advertising injury" caused, in
whole or in part, by your acts or omissions or
the acts or omissions of those acting on your
behalf.
a. In the performance of your ongoing
operations; or
b. In connection with your premises owned
by or rented to you.
2. Additional Insured - Managers Or Lessors
Of Promises
a. WHO IS AN INSURED under Section C. Is
amended to include as an additional insured
the person(s) or organization(s) shown in the
Declarations as an Additional Insured -
Designated Person Or Organization; but only
with respect to liability arising out of the
ownership, maintenance or use of that part of
the premises leased to you and shown in the
Declarations.
b. With respect to the insurance afforded to
these additional Insureds, the following
additional exclusions apply:
This insurance does not apply to:
(1) Any "occurrence" which takes place
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
person or organization.
3. Additional Insured - Grantor Of Franchise
WHO IS AN INSURED under Section C. is
amended to include as an additional insured
the person(s) or organization(s) shown In the
Declarations as an Additional Insured -
Grantor Of Franchise, but only with respect to
their liability as grantor of franchise to you.
4. Additional Insured - Lessor Of Leased
Equipment
a. WHO IS AN INSURED under Section C. is
amended to include as an additional
insured the person(s) or organization(s)
shown in the Declarations as an Additional
Insured — Lessor of Leased Equipment,
but only with respect to liability for "bodily
injury", "property damage" or "personal
and advertising injury" caused, in whole or
in part, by your maintenance, operation or
use of equipment leased to you by such
person(s) or organization(s).
b. With respect to the insurance afforded to
these additional insureds, this insurance
does not apply to any "occurrence" which
takes place after you cease to lease that
equipment.
5. Additional Insured - Owners Or Other
Interests From Whom Land Has Been
Leased
a. WHO IS AN INSURED under Section C. is
amended to include as an additional
insured the person(s) or organization(s)
shown in the Declarations as an Additional
Insured — Owners Or Other Interests From
Whom Land Has Been Leased, but only
with respect to liability arising out of the
ownership, maintenance or use of that part
of the land leased to you and shown in the
Declarations.
b. With respect to the insurance afforded to
these additional insureds, the following
additional exclusions apply:
This insurance does not apply to:
(1) Any "occurrence" that takes place
after you cease to lease that land; or
(2) Structural alterations, new
construction or demolition operations
performed by or on behalf of such
person or organization.
S. Additional Insured - State Or Political
Subdivision — Permits
a. WHO IS AN INSURED under Section C. is
amended to include as an additional
insured the state or political subdivision
shown in the Declarations as an Additional
Page 18 of 24 Form SS 00 08 04 05
Insured — State Or Political Subdivision -
Permits, but only with respect to
operations performed by you or on your
behalf for which the state or political
subdivision has issued a permit.
b. With respect to the insurance afforded to
these additional insureds, the following
additional exclusions apply:
This insurance does not apply to:
(1) "Bodily injury", "property damage" or
"Personal and advertising injury"
arising out of operations performed for
the state or municipality; or
(2) "Bodily injury" or "property damage"
included in the "product -completed
operations" hazard.
7. Additional Insured —Vendors
a. WHO IS AN INSURED under Section C. is
amended to include as an additional
insured the person(s) or organization(s)
(referred to below as vendor) shown in the
Declarations as an Additional Insured -
Vendor, but only with respect to "bodily
injury" or "property damage" arising out of
"your products" which are distributed or
sold in the regular course of the vendor's
business and only if this Coverage Part
provides coverage for "bodily injury" or
"property damage" included within the
"products -completed operations hazard".
b. The insurance afforded to the vendor is
subject to the following additional exclusions:
(1) This insurance does not apply to:
(a) "Bodily injury" or "property
damage" for which the vendor is
obligated to pay damages by
reason of the assumption of
liability in a contract or agreement.
This exclusion does not apply to
liability for damages that the
vendor would have in the absence
of the contract or agreement;
(b) Any express warranty
unauthorized by you;
(c) Any physical or chemical change
in the product made intentionally
by the vendor;
(d) Repackaging, unless 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;
BUSINESS LIABILITY COVERAGE FORM
(e) Any failure to make such
inspections, adjustments, tests or
servicing as the vendor 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 vendor's premises in
connection with the sale of the
product;
(g) Products which, after distribution
or sale by you, have been labeled
or relabeled or used as a
container, part or ingredient of any
other thing or substance by or for
the vendor; or
(h) "Bodily injury" or "property
damage" arising out of the sole
negligence of the vendor 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:
(t) The exceptions contained in
Subparagraphs (d) or (f); or
(ii) Such inspections,
adjustments, tests or servicing
as the vendor 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.
(2) This insurance does not apply to any
insured person or organization from
whom you have acquired such
products, or any ingredient, part or
container, entering into,
accompanying or containing such
products.
8. Additional Insured — Controlling Interest
WHO IS AN INSURED under Section C. is
amended to include as an additional insured
the person(s) or organization(s) shown in the
Declarations as an Additional Insured —
Controlling Interest, but only with respect to
their liability arising out of:
a. Their financial control of you; or
b. Premises they own, maintain or control
while you lease or occupy these premises.
Form SS 00 08 04 05 Page 19 of 24
BUSINESS LIABILITY COVERAGE FORM
This insurance does not apply to structural
alterations, new construction and demolition
operations performed by or for that person or
organization.
9. Additional Insured — Owners, Lessees Or
Contractors — Scheduled Person Or
Organization
a. WHO IS AN INSURED under Section C. is
amended to include as an additional
insured the person(s) or organization(s)
shown in the Declarations as an Additional
Insured — Owner, Lessees Or Contractors,
but only with respect to liability for "bodily
injury", "property damage" or "personal
and advertising injury" caused, in whole or
in part, by your acts or omissions or the
acts or omissions of those acting on your
behalf:
(1) In the performance of your ongoing
operations for the additional
insured(s); or
(2) In connection with "your worts"
performed for that additional insured
and included within the "products -
completed operations hazard", but
only if this Coverage Part provides
coverage for "bodily injury" or
"property damage" included within the
"products -completed operations
hazard".
b. With respect to the insurance afforded to
these additional insureds, this insurance
does not apply to "bodily injury", "property
damage" or "personal an advertising
injury" arising out of the rendering of, or
the failure to render, any professional
architectural, engineering or surveying
services, including:
(1) The preparing, approving, or failure to
prepare or approve, maps, shop
drawings, opinions, reports, surveys,
field orders, change orders, designs or
drawings and specifications; or
(2) Supervisory, inspection, architectural
or engineering activities.
10. Additional Insured — Co -Owner Of Insured
Premises
WHO IS AN INSURED under Section C. is
amended to include as an additional insured
the person(s) or Organization(s) shown in the
Declarations as an Additional Insured — Co -
Owner Of Insured Premises, but only with
respect to their liability as co-owner of the
premises shown in the Declarations.
The limits of insurance that apply to additional
insureds are described in Section D. — Limits Of
Insurance.
How this insurance applies when other insurance
is available to an additional insured is described in
the Other Insurance Condition in Section E. —
Liability And Medical Expenses General
Conditions.
G. LIABILITY AND MEDICAL EXPENSES
DEFINITIONS
1. "Advertisement" means the widespread public
dissemination of information or images that
has the purpose of inducing the sale of goods,
products or services through:
a. (1)
Radio;
(2)
Television;
(3)
Billboard;
(4)
Magazine;
(5)
Newspaper;
b. The Internet, but only that part of a web
site that is about goods, products or
services for the purposes of inducing the
sale of goods, products or services; or
c. Any other publication that is given
widespread public distribution.
However, "advertisement" does not include:
a. The design, printed material, information
or images contained in, on or upon the
packaging or labeling of any goods or
products; or
b. An interactive conversation between or
among persons through a computer network.
2. "Advertising idea" means any idea for an
"advertisement".
3. "Asbestos hazard" means an exposure or
threat of exposure to the actual or alleged
properties of asbestos and includes the mere
presence of asbestos in any form.
4. "Auto" means a land motor vehicle; trailer or
semi -trailer designed for travel on public
roads, including any attached machinery or
equipment. But "auto" does not include
"mobile equipment".
5. "Bodily injury" means physical:
a. Injury;
b. Sickness; or
c. Disease
sustained by a person and, if arising out of the
above, mental anguish or death at any time.
6. "Coverage territory" means:
Page 20 of 24 Form SS 00 08 04 05
BUSINESS LIABILITY COVERAGE FORM
a. The United States of America (including its
b.
You have failed to fulfill the terms of a
territories and possessions), Puerto Rico
contract or agreement;
and Canada;
if such property can be restored to use by:
b. International waters or airspace, but only if
a.
The repair, replacement, adjustment or
the injury or damage occurs in the course
removal of "your product" or "your work";
of travel or transportation between any
or
places included in a. above;
b.
Your fulfilling the terms of the contract or
c. All other parts of the world if the injury or
agreement.
damage arises out of:
12. "Insured contract" means:
(1) Goods or products made or sold by you
a.
A contract for a lease of premises.
in the territory described in a. above;
However, that portion of the contract for a
(2) The activities of a person whose home
lease of premises that indemnifies any
is in the territory described in a.
person or organization for damage by fire,
above, but is away for a short time on
lightning or explosion to premises while
your business; or
rented to you or temporarily occupied by
(3) "Personal and advertising injury"
you with permission of the owner is
offenses that take place through the
subject to the Damage To Premises
Internet or similar electronic means of
Rented To You limit described in Section
communication
D. — Liability and Medical Expenses Limits
provided the insured's responsibility to pay
of Insurance.
damages is determined in the United States of
b.
A sidetrack agreement;
America (including its territories and
c.
Any easement or license agreement,
possessions), Puerto Rico or Canada, in a
including an easement or license
"suit" on the merits according to the
agreement in connection with construction
substantive law in such territory, or in a
or demolition operations on or within 50
settlement we agree to.
feet of a railroad;
7. "Electronic data" means information, facts or
d.
Any obligation, as required by ordinance,
programs:
to indemnify a municipality, except in
a. Stored as or on;
connection with work for a municipality;
b. Created or used on; or
e.
An elevator maintenance agreement; or
c. Transmitted to or from
f.
That part of any other contract or
computer software, including systems and
agreement pertaining to your business
applications software, hard or floppy disks,
(including an indemnification of a
CD-ROMS, tapes, drives, cells, data
municipality in connection with work
processing devices or any other media which
performed for a municipality) under which
are used with electronically controlled
you assume the tort liability of another
equipment.
party to pay for "bodily injury" or "property
8. "Employee" includes a "leased worker".
damage" to a third person or organization,
"bodily "property
"Employee" does not include a "temporary
provided the injury" or
worker".
damage" is caused, in whole or in part, by
you or by those acting on your behalf.
9. "Executive officer" means a person holding
Tort liability means a liability that would be
any of the officer positions created by your
imposed by law in the absence of any
charter, constitution, by-laws or any other
contract or agreement.
similar governing document.
Paragraph f. includes that part of any
10. "Hostile fire" means one which becomes
contract or agreement that indemnifies a
uncontrollable or breaks out from where it was
railroad for "bodily injury" or "property
intended to be.
damage" arising out of construction or
11. "Impaired property" means tangible property,
demolition operations within 50 feet of any
other than "your product" or "your work", that
railroad property and affecting any railroad
cannot be used or is less useful because:
bridge or trestle, tracks, road -beds, tunnel,
a. It incorporates "your product" or'your work"
underpass or crossing.
that is known or thought to be defective,
However, Paragraph f. does not include
deficient, inadequate or dangerous; or
that part of any contract or agreement:
Form SS 00 08 04 05 Page 21 of 24
BUSINESS LIABILITY COVERAGE FORM
(1) That indemnifies an architect,
engineer or surveyor for injury or
damage arising out of:
(a) Preparing, approving or failing to
prepare or approve maps, shop
drawings, opinions, reports,
surveys, field orders, change
orders, designs or drawings and
specifications; or
(b) Giving directions or instructions,
or failing to give them, if that is the
primary cause of the injury or
damage; or
(2) Under which the insured, if an
architect, engineer or surveyor,
assumes liability for an injury or
damage arising out of the insured's
rendering or failure to render
professional services, including those
listed in (1) above and supervisory,
inspection, architectural or
engineering activities.
13. "Leased worker" means a person leased to
you by a labor leasing firm under an
agreement between you and the labor leasing
firm, to perform duties related to the conduct of
your business. "Leased worker" does not
include a,"temporary worker".
14. "Loading or unloading" means the handling of
property:
a. After it is moved from the place where it is
accepted for movement into or onto an
aircraft, watercraft or "auto";
b. While it is in or on an aircraft, watercraft or
"auto"; or
c. While it is being moved from an aircraft,
watercraft or "auto" to the place where it is
finally delivered;
but "loading or unloading" does not include the
movement of property by means of a mechanical
device, other than a hand truck, that is not
attached to the aircraft, watercraft or "auto".
15. "Mobile equipment" means any of the following
types of land vehicles, including any attached
machinery or equipment:
a. Bulldozers, farm machinery, forklifts and
other vehicles designed for use principally
off public roads;
b. Vehicles maintained for use solely on or
next to premises you own or rent;
c. Vehicles that travel on crawler treads;
d. Vehicles, whether self-propelled or not, on
which are permanently mounted:
(1) Power cranes, shovels, loaders,
diggers or drills; or
(2) Road construction or resurfacing
equipment such as graders, scrapers
or rollers;
e. Vehicles not described in a., b., c., or d.
above that are not self-propelled and are
maintained primarily to provide mobility to
permanently attached equipment of the
following types:
(1) Air compressors, pumps and
generators, including spraying,
welding, building cleaning,
geophysical exploration, lighting and
well servicing equipment; or
(2) Cherry pickers and similar devices
used to raise or lower workers;
Vehicles not described in a., b., c., or d.
above maintained primarily for purposes
other than the transportation of persons or
cargo.
However, self-propelled vehicles with the
following types of permanently attached
equipment are not "mobile equipment' but
will be considered "autos":
(1) Equipment, of at least 1,000 pounds
gross vehicle weight, designed
primarily for:
(a) Snow removal;
(b) Road maintenance, but not
construction or resurfacing; or
(c) Street cleaning;
(2) Cherry pickers and similar devices
mounted on automobile or truck
chassis and used to raise or lower
workers; and
(3) Air compressors, pumps and
generators, including spraying,
welding, building cleaning,
geophysical exploration, lighting and
well servicing equipment.
16. "Occurrence" means an accident, including
continuous or repeated exposure to substantially
the same general harmful conditions.
17. "Personal and advertising injury" means injury,
including consequential "bodily injury", arising
out of one or more of the following offenses:
a. False arrest, detention or imprisonment;
b. Malicious prosecution;
Page 22 of 24 Form SS 00 08 04 06
c. The wrongful eviction from, wrongful entry
into, or invasion of the right of private
occupancy of a room, dwelling or
premises that the person occupies,
committed by or on behalf of its owner,
landlord or lessor,
d. Oral, written or electronic publication of
material that slanders or libels a person or
organization or disparages a person's or
organization's goods, products or services;
e. Oral, written or electronic publication of
material that violates a person's right of
privacy;
f. Copying, in your "advertisement", a
person's or organization's "advertising
idea" or style of "advertisement";
g. Infringement of copyright, slogan, or title of
any literary or artistic work, in your
"advertisement"; or
h. Discrimination or humiliation that results in
injury to the feelings or reputation of a
natural person.
18. "Pollutants" means any solid, liquid, gaseous or
thermal irritant or contaminant, including smoke,
vapor, soot, fumes, acids, alkalis, chemicals and
waste. Waste includes materials to be recycled,
reconditioned or reclaimed.
19. "Products -completed operations hazard";
a. Includes all "bodily injury" and "property
damage" occurring away from premises
you own or rent and arising out of "your
product" or "your work" except:
(1) Products that are still in your physical
possession; or
(2) Work that has not yet been completed
or abandoned. However, "your work"
will be deemed to be completed at the
earliest of the following times:
(a) When all of the work called for in
your contract has been completed.
(b) When all of the work to be done at
the job site has been completed if
your contract calls for work at
more than one job site.
(c) When that part of the work done at
a job site has been put to its
intended use by any person or
organization other than another
contractor or subcontractor
working on the same project.
BUSINESS LIABILITY COVERAGE FORM
Work that may need service, maintenance,
correction, repair or replacement, but
which is otherwise complete, will be
treated as completed.
The "bodily injury" or "property damage"
must occur away from premises you own
or rent, unless your business includes the
selling, handling or distribution of "your
product" for consumption on premises you
own or rent.
b. Does not include "bodily injury" or
"property damage" arising out of.,
(1) The transportation of property, unless
the injury or damage arises out of a
condition in or on a vehicle not owned
or operated by you, and that condition
was created by the "loading or
unloading" of that vehicle by any
insured; or
(2) The existence of tools, uninstalled
equipment or abandoned or unused
materials.
20. "Property damage" means:
a. Physical injury to tangible property,
including all resulting loss of use of that
property. All such loss of use shall be
deemed to occur at the time of the
physical injury that caused it; or
b. Loss of use of tangible property that is not
physically injured. All such loss of use
shall be deemed to occur at the time of
"occurrence" that caused it.
As used in this definition, "electronic data" is
not tangible property.
21. "Suit" means a civil proceeding in which
damages because of "bodily injury", "property
damage" or "personal and advertising injury"
to which this insurance applies are alleged.
"Suit" includes:
a. An arbitration proceeding in which such
damages are claimed and to which the
insured must submit or does submit with
our consent; or
b. Any other alternative dispute resolution
proceeding in which such damages are
claimed and to which the insured submits
with our consent.
22. "Temporary worker" means a person who is
furnished to you to substitute for a permanent
"employee" on leave or to meet seasonal or
short-term workload conditions.
23. "Volunteer worker" means a person who:
a. Is not your "employee'
Form SS 00 08 04 05 Page 23 of 24
BUSINESS LIABILITY COVERAGE FORM
b. Donates his or her work;
c. Acts at the direction of and within the
scope of duties determined by you; and
d. Is not paid a fee, salary or other
compensation by you or anyone else for
their work performed for you.
24. "Your product':
a. Means:
(1) Any goods or products, other than real
property, manufactured, sold, handled,
distributed or disposed of by:
(a) You;
(b) Others trading under your name;
or
(c) A person or organization whose
business or assets you have
acquired; and
(2) Containers (other than vehicles),
materials, parts or equipment
furnished in connection with such
goods or products.
b. Includes:
(1) Warranties or representations made at
any time with respect to the fitness,
quality, durability, performance or use
of "your product'; and
(2) The providing of or failure to provide
warnings or instructions.
c. Does not include vending machines or
other property rented to or located for the
use of others but not sold.
25. "Your work":
a. Means:
(1) Work or operations performed by you
or on your behalf; and
(2) Materials, parts or equipment
furnished in connection with such work
or operations.
b. Includes:
(1) Warranties or representations made at
any time with respect to the fitness,
quality, durability, performance or use
of "your work"; and
(2) The providing of or failure to provide
warnings or instructions.
Page 24 of 24 Form SS 00 06 04 05
City Of El Segundo
INTERDEPARTMENTAL CORRESPONDENCE
DATE: August 5, 1998
TO: Cindy Mortesen, City Clerk
FROM: Bret B. Bernard, AICD, Director Planning & Building Safety
BY: Tina Gall, CDBG Consultant#rodw)
SUBJECT: Insurance Requirements
In response to (the attached) correspondence dated July 27 and August 3, 1998 from Patti
Adlen of your office, please be advised that I, at my discretion, and under authority granted
to me, with the review and acknowledgment of the City Attorney, waive the Workers
Compensation and Errors and Omissiond Insurance requirements for Diana Cho and
Associates and, separately for Tina Gall, as stipulated in Section XXII, entitled, "insurance",
respectively, in the Professional Service Agreements for both consultants.
xc: Mark Hensley, City Attorney
Tim Grimmond, City Manager
Attachments: July 27, 1998 Memorandum from City Clerk
August 3, 1998 Memorandum from City Clerk
P:44db91cnpndlmemoel1nc8.5
CITY OF EL SEGUNDO
WORKERS' COMPENSATION DECLARATION
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE
IS UNLAWFUL AND SUBJECTS AN EMPLOYER TO CRIMINAL PENALTIES
AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000),
IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED
FOR IN LABOR CODE § 3706, INTEREST, AND ATTORNEY'S FEES.
I affirm under penalty of perjury under the laws of California one of the following declarations:
(__) I have and will maintain a certificate of consent of self -insure for workers' compensation, issued by the Director
of Industrial Relations as provided for by Labor Code § 3700 for the performance of the work set forth the agreement
with the City of EI Segundo,
Policy No.
(_) I have and will maintain workers' compensation insurance as required by Labor Code § 3700 for the performance
of the work for which the agreement with the City of EI Segundo is executed, My workers' compensation insurance
carrier and policy number are:
Carrier Policy Number Expiration Date
Name of Agent Phone #
1 certify that, in the performance of the work set forth in the agreement with the City of EI Segundo, I will not
employ any person in any manner so as to become subject to the workers' compensation laws of California, and
agree that, if I should become subject to the workers' compensation provisions of Labor Code § 3700 1 must
immediately comply with those provisions or the agreement will automatically become void,
Signature of Applicant s Date 8/14/2019
Print Name Tina Gan
Agreement for: Tiy m l i —&odA4qMD
Dated:'
Reviewed by:,,