BEAN SPROUTS, LLC (2) - Laserfiche WebLink

Home Browse Search

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ENDORSEMENT - CALIFORNIA Policy Number: 59 WEC AC9055 Endorsement Number: Effective Date: 07/03/20 Effective hour is the same as stated on the Information Page of the policy. Named Insured and Address: BAY SPROUTS LLC 655 S MAIN ST STE 200-317 ORANGE CA 92868 The insurance afforded by Part Two (Employers' Liability C. The "Exclusions" section is modified as follows (all Insurance) by reason of designation of California in Item 3 other exclusions in the "Exclusions" section remain of the Information Page is subject to the following as is): provisions: 1. Exclusion 1 is amended to read as follows: A. "How This Insurance Applies," is amended to read 1. liability assumed under a contract. as follows: 2. Exclusion 2 is deleted. A. How This Insurance Applies 3. Exclusion 7 is amended to read as follows: This employers' liability insurance applies to bodily 7. damages arising out of coercion, criticism, injury by accident or bodily injury by disease. demotion, evaluation, reassignment, Bodily injury means a physical injury, including discipline, defamation, harassment, resulting death. humiliation, discrimination against or 1. The bodily injury must arise out of and in the termination of any employee, termination of course of the injured employee's employment employment, or any personnel practices, by you. policies, acts or omissions. 2. The employment must be necessary or 4. The following exclusions are added: incidental to your work in California. 1. bodily injury to any member of the flying crew 3. Bodily injury by accident must occur during of any aircraft. the policy period. 2. bodily injury to an employee when you are 4. Bodily injury by disease must be caused or deprived of statutory or common law aggravated by the conditions of your defenses or are subject to penalty because employment. The employee's last day of last of your failure to secure your obligations exposure to the conditions causing or under the workers' compensation law(s) aggravating such bodily injury by disease applicable to you or otherwise fail to comply must occur during the policy period. with that law. 5. If you are sued, the original suit and any 3. liability arising from California Labor Code related legal actions for damages for bodily Section 2810.3 which relates to labor injury by accident or by disease must be contracting. brought in the United States of America, its territories or possessions, or Canada. Countersigned by cF RAMmWmentDMsian REVIEWED & APPROVED BY. - Form WC 04 03 60 B Printed in U.S.A. -' W Process Date: 05/25/20