Loading...
HomeMy WebLinkAboutMARISCA N. SECUNDO (2)<ANLt Or FILE N-2021-195-01 .vnf,,i N;A.Y PROCELL UNfit INSURANCE EXPIRES FIRST AMENDMENT TO R , a9qa :LERK OF COUNCIL REt'Ktr7CTION SERVICES AGREEMENT WITH MARICSA N. SECUNDO DATE: THIS FIRST AMENDMENT TO AGREEMENT is entered into this 29s' day of November 2021, by and between Maricsa N. Secundo (erroneously referred to as Maricca N. Secundo in the original Agreement), �tO+IliemSandanl/ an individual ("Provider"), and the City of Santa Ana, a charter city and municipal corporation duly �GC-tlE.nandt;;� organized and existing under the Constitution and laws of the State of California ("City')_ Provider and City are also referred to herein as "Parties" or individually as a "Party." DEC 0 2 2021 RECITALS A. On September 30, 2021, the City entered into Agreement No. N-2021-195 ("Agreement") with Maricsa N. Secundo, an individual, to provide Danza Folklorico classes in its recreation class program- B. Agreement No. N-2021-195 is currently in full force and effect until September 30, 2022 C. The Parties desire to amend the substitution term of the Agreement. THE PARTIES THEREFORE AGREE: 1. Section 13, ASSIGNMENT/SUBSTITUTES, is amended to read: a. Assignment. The experience, knowledge, capability and reputation of Provider were a substantial inducement for City to enter into this Agreement. Therefore, Provider may not assign, transfer, delegate, or subcontract any interest herein without the prior written consent of the City and any such assignment, transfer, delegation or subcontract without the City's prior written consent shall be considered null and void. b. Substitutes. In the event Provider is not able to teach a class due to illness or some other cause beyond Provider's reasonable control, Provider must procure, at its sole expense, a qualified substitute instructor to teach the class at its regular time and place. Provider shall ensure that substitute instructors are at least twenty-one (21) years of age and comply with the City's insurance and live scan requirements contained herein. Evidence of compliance with City's insurance and live scan requirements shall be provided upon request. Provider must immediately notify the City of the substitute instructor's name, qualifications, address and phone number. If Provider cannot procure a qualified substitute and the City is unable to assist in this regard, then the class shall be canceled and a make-up class must be added to the session. Provider must notify participants as soon as possible of any class cancellation and make-up class. Provider must personally teach at least seventy- five percent (75%) of its offered classes. 2. Except as hereinabove modified, the terms and conditions of said Agreement remain unchanged and in full force and effect. [signatures on nextpagel Page 1 of 2 IN WUNESS WHEREOF, the Parties hereto have executed this First Amendment to the Agreement the date and year first above written. ATTEST; Daisy Gomez Clerk of the Council APPROVED AS TO FORM: Sonia R. Carvalho, City Attorney don Salvatierra Deputy City Attorney RECOMMENDED FOR APPROVAL: isa udloff cutive Director of Parks, Recreation and Community Services Agency CITY OF SANTA ANA VV4�'4 stine Ridge City Manager Mancsa N. Secundo Page 2 of 2 nelly rlB,,d by Tod Pierson TOYI Pierson Lag1er 2021 Style PRODUCER Maguire Insurance Agenq, Inc FWI 1 Dole 1, Ste IN 0e1a grtwyd, PA 19004-1401 610.611.7900 Mad.. Entrance 7143 Fulton Way Strum, a 9066D CERTIFICATE OF LIABILITY INSURANCE THIS CERTIFICATION IS ISSUED W17 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 CERIFICATION 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, INSR LTR ADWL INSRD - TYPE OF INSURANCE POLICY NUMBER POUCYEFFECHVE DATE(MM/DO/TYYY) POUCYEXPIKADON DATE(MM/DD/YYYY) - LIMITS A X GENERALUARILIT9 - X COMMERCIALGENEMLUADILIIY CLAIMSMADE OCCUR X PR OFESSIONALLIABILIW GEN-LAGGREGATELIM17APPLIESPER: X POLICY PROJECT 1 LOC PHPK2330195-000 09/27/2021. 09/27/2022 EACHOCCURENCE - S1,000,000 PREMISES Ea occur[en[a $100,000' MEO UP [Any one person) _ $2,500 PERSONAL &AOV INJURY $1,000.000 GENERALAGGREGATE - $3pgq,000 PRODUCTS—COMP/OP AEG $3,000�00E AUTOMOBILE LIABILITY ANYAUTO ALLDWNEDAUTDS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS COMBINED SINGLE UNIT (EAacddent) BODRYINIURY (Per porsonI 000ILY INJURY - (Pereaidant). PROPERTY DAMAGE (PLPaccldent) GAMGEUABIUTY ANYAUTO AUTO ONLY—EAACODENT OTHER VAN EAACC. AUTO ONLY: AEG _WRIKEI EXCESS/ UMBRELLA LIABILITY OCCUR ❑ CWM5MAOE DEDUCTIBLE - RETENTION - EACH OCCURENCE AGGREGATE .��... S COMPENSATION AND EMPLOYERS' LIABILITY YN` AON ICEN/MRMBER%CLUpEW XECUTIVE (Mandatory In AN, 6 If Far dessdboyu der SPECIAL P OVISIONEheIOw 10 VAlu ER - E.L. EACH ACCIDENT EL. DISEASE —EA AMPLOYEE E.L. DISEASE —POLICY LIMIT OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES E%C SION9 A00E0 BY ENDORSEMENT/ SPECIAL PROVISIONS Misunderstand and agreed that the f4llwin5 entity Is added as an additional Insured butonlywitb mspact(s) to the.,mothers of the named Insured sorept that liability mankind from the additional Insured's sole negligence, LICK IrMAIC nULucn LAIVLaLIAIIUIV SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EKPIMHON DATE MY of Sane Ana Risk Management UivHlon THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE N Clvle Canter Plasa CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR Santa Ana, CA92Y02� LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES, Y T RENEWE06A�ssPPRWE I�r - 74le P �wmiSvAhs:G ACORD 25 (2009/01) 0 1988-2009 ACORD CORPORATION WNW The ACORD name and logo are registered marks of ACORD rsMLPna,vgcnmTClmaai POLICY CHANGE DOCUMENT POLICY NO: CHANGE # 2 CHANGE EFFECTIVE: 09/27/2021 PHPK2330395-000 Philadelphia Indemnity Insurance Company PRODUCER: Maguire Insurance Agency, Inc. FWI NAMED INSURED: Maritsa Secundo MAILING ADDRESS 7143 Fulton Way Stanton, CA 90680- POLICY PERIOD: FROM 09/2712021 TO 09/27/2022 at 12:01 A.M. Standard Time at your mailing address shown above. DESCRIPTION: In consideration of the premium reflected, the policy is amended as indicated below: Added 1 Additional Insured. Total Annual Total Prorate Additional/Return Premium $0.00 Additional/Return Premium $0.00 Total Annual Total Prorate Additional/Return Additional/Return Tax/Surcharge/Fee $0.00 Tax/Surcharge/Fee $0,00 A4&APPR( WPr t flCUIEVh'�SMPpIMD4Y: P , lir � oo,G 7aec+ao,e a Page 1 of 1 mnau�a•,a n .da�o ACORD 25 (2009/01) IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the pollcy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endarsement(s). If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require _ an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). - DISCLAIMER This Certificate of Insurance does not constitute a contract between the Issuing insurer(s), authorized representative or producer, and .the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. •.,,. RfIkMaaµmmill71v4m zo kMMD6N7eo BY. ff- iarc[ i�lvWarc , nui<rnanae���un��aiane ;� COMMERCIAL GENERAL LIABILITY CG 00 01 04 13 Various provisions In this policy restrict coverage. (2) The "bodily injury" or "property damage" Read the entire policy carefully to determine rights, occurs during the policy period; and duties and what Is and is not covered. (3) Prior to the policy period, no insured listed Throughout this policy the words "you" and "your" under Paragraph 1. of Section II — Who Is refer to the Named Insured shown in the Declarations, An Insured and no "employee" authorized and any other person or organization qualifying as a by you to give or receive notice of an Named Insured under this policy. The words "we", "occurrence" or clai n, knew that the "bodily "us" and "cur" refer to the company providing this injury" or "properly damage" had occurred, insurance. in whole or in part. If such a listed insured The word "insured" means any poison or organization or authorized "employee" knew, prior to the "pricy period, that the 'bodily injury qualifying as such under Section II — Who Is An 'property damage" occurred, then. any Insured. continuation, change or resumption of such Other words and phrases that appear In quotation "bodily injury" or "property damage" during marks have special meaning. Refer to Section V or after the policy period will be deemed to —Definitions. have been known prior to the policy period. SECfIONI— COVERAGES c. "Bodily Injury" or "property damage" which COVERAGE A- BODILY INJURY AND PROPERTY occurs during the policy period and was not, DAMAGE LIABILITY prior to the policy period, known to have occurred by any insured listed under 1. Insuring Agreement Paragraph 1. of Section II — Who Is An Insured a. We will pay those sums that the Insured or any "employee" authorized by you to give or becomes legally obligated to pay as damages receive notice of an "occurrence" or claim, because of"bodily Injury" or "property damage" includes any continuation, change or to which this Insurance applies. We will have resumption of that "bodily Injury" or "property the right and duty to defend the insured against damage" after the end of the policy period. any "suit" seeking those damages. However, d. "Bodily injury" or "property damage" will be we will have no duty to defend the insured deemed to have been known to have occurred against any "suit" seeking damages for "bodily at the earliest time when any Insured listed Injury" or 'property damage" to which this under Paragraph 1. of Section II — Who Is An insurance does not apply. We may, at our 'occurrence' Insured or any "employee" authorized by you to discretion, investigate any and give or receive notice of an "occurrence" or settle any claim or "suit' that may result. But: claim: (1) The amount we will pay for damages is (1) Reports all, or any part, of the "bodily Injury" limited as described in Section 10 — Limits or "property damage" to us or any other Of Insurance; and insurer; (2) Our right and duty to defend ends when we (2) Receives a written or verbal demand or have used up the applicable limit of claim for damages because of the "bodily Insurance In the payment of judgments or injury' or "property damage"; or settlements under Coverages A or B or medical expenses under Coverage C. (3) Becomes aware by any other means that No other obligation or liability to pay sums or "bodily injury" or "property damage" has occurred or has begun to occur. perform acts or services is covered unless explicitly provided for under Supplementary e. Damages because of "bodily injury" Include Payments — Coverages A and B. damages claimed by any person or b. This insurance applies to "bodily injury" and or death rresultingtion at any time from the h dfor care, loss ofilly Injury". "property damage" only If: (1) The "bodily injury" or "property damage" is caused by an "occurrence" that takes place in the "coverage territory"; „ W h4rvgmmd0ivldon .r"� NE•nErvrvi MegfNOD61". fl6NMv,"p<nc,RClmul Pltl" CG 00 01 0413 © Insurance Services Office, Inc., 2012 ,� 2, Exclusions This Insurance does not apply to: a. Expected Or Intended Injury "Bodily injury" or "property damage" expected or Intended from the standpoint of the insured. This exclusion does not apply to "bodily injury" resulting from the use of reasonable force to protect persons or property. b. Contractual Liability "Bodily Injury" or "property damage" 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: (1) That the Insured would have in the absence of the contractor agreement; or (2) Assumed in a contract or agreement that Is an "insured contract", provided the "bodily Injury" or "property damage" occurs subsequent to the execution of the contract or agreement. Solely for the purposes of liability assumed in an "insured contract", reasonable attorneys' fees and necessary litigation expenses Incurred by or for a patty other than an insured are deemed to be damages because of "bodily Injury" or "property damage", provided: (a) liability to such party for, or for the cost of, that party's defense has also been assumed in the same "insured contract"; and (b) Such attorneys' fees and litigation expenses are for defense of that party against a civil or alternative dispute resolution proceeding in which damages to which this Insurance applies are alleged. c. Liquor Liability "Bodily Injury" or "property damage" for which any Insured may be held liable by reason of.- (1) Causing or contributing to the intoxication of any person; (2) The furnishing of alcoholic beverages to a person under the legal drinking age or under the Influence of alcohol; or (3) Any statute, ordinance or regulation relating to the sale; gift, distribution or use of alcoholic beverages. This exclusion applies even If the claims against any insured allege negligence or other wrongdoing in: (a) The supervision, hiring, employment, training or monitoring of, others by that insured; or (b) Providing or failing to provide transportation with respect to any person that may be under the influence of alcohol; If the "occurrence" which caused the "bodily Injury" or "property damage", Involved that which Is described In Paragraph (1), (2) or (3) above, However, this exclusion applies only if you are In the business of manufacturing, distributing, selling, serving or furnishing alcoholic beverages. For the purposes of this exclusion, permitting a person to bring alcoholic beverages on your premises, for consumption on your premises, whether or not a fee is charged or a license is required for such activity, Is not by Itself considered the business of selling, serving or furnishing alcoholic beverages. d. Workers' Compensation And Similar Laws Any obligation of the Insured under a workers' compensation, disability benefits or unemployment compensation law or any similar law. e. Employer's Liability "Bodily injury" to: (1) An "employee" of the Insured arising out of and In the course of: (a) Employment by the insured; or (b) Performing duties related to the conduct of the Insured's business; or (2) The spouse, child, parent, brother or sister of that "employee" as a consequence of Paragraph (1) above. This exclusion applies whether the Insured may be liable as an employer or in any other capacity and to any obligation to share damages with or repay someone else who must pay damages because of the Injury. This exclusion does not apply to liability assumed by the insured under an "Insured contract". win &Apgm na 1 fi`ftkW flEY1fl4Eu6Nexwm ," mm,quiralAi"e .', Page 2 of 16 © Insurance Services office, Inc., 2012 f, Pollution (d) At or from any premises, site or location (1) "Bodily injury" or "property damage" arising on which any insured or any contractors subcontractors working directly or out of the actual, alleged or threatened behalf are indirectly on any ins re in discharge, dispersal, seepage, migration, If thed's performingoperationst release or escape of "pollutants": e brought tosthe premises, site (a) At or from any premises, site or location or location In connection with such which is or was at any time owned or operations by such insured, contractor occupied by, or rented or loaned to, any or subcontractor. However, this Insured. However, this subparagraph subparagraph does not apply to: does not apply to: (i)"Bodily injury" or 'property damage" (1) "Bodily injury" if sustained within a arising out of the escape of fuels, building and caused by smoke, lubricants or other operating Fluids fumes, vapor or soot produced by or which are needed to perform the originating from equipment that is normal electrical, hydraulic or used to heat, cool or dehumidify the mechanical functions necessary for building, or equipment that is used to the operation of "mobile equipment" heat water for personal use, by the or Its parts, if such fuels, lubricants building's occupants or their guests; or other operating fluids escape from (11) "Bodily injury" or "property damage" a vehicle part designed to hold, store for which you may be hold liable, if or receive them. This exception does you are a contractor and the owner not apply If the "bodily injury" or or lessee of such premises, site or "property damage" arises out of the location has been added to your Intentional discharge, dispersal or policy as an additional insured with release of the fuels, lubricants or respect to your ongoing operations other operating fluids, or if such performed for that additional insured fuels, lubricants or other operating at that premises, site or location and fluids are brought on or to the such premises, site or location is not premises, site or location with the and never was owned or occupied Intent that they be discharged, by, or rented or loaned to, any dispersed or released as part of the Insured, other than that additional operations being performed by such insured; or, insured, contractor or subcontractor; (111) "Bodily injury" or "property damage" (11) "Bodily Injury" or "property damage" arising out of heat, smoke or fumes sustained within a building and from a "hostile fire"; caused by the release of gases, (b) At or from any premises, site or location fumes or vapors from materials brought into that building in which is or was at any time used by or connection with operations being for any insured or others for the performed you or your behalf handling, storage, disposal, processing by a contractor or subcontractor; or or treatment of waste; (iii) "Bodily injury" ora "property damage" (c) Which are or were at any time arising out of heat, smoke or fumes transported, handled, stored, treated, from a "hostile fire". disposed of, or processed as waste by or for; (a) At or from any premises, site or location on which any insured or any contractors O Any insured; or or subcontractors working directly or (11) Any person or organization for whom indirectly on any Insured's behalf are you may be legally responsible; or performing operations if the operations are to test for, monitor, clean up, remove, contain, treat, detoxify or neutralize, or in any way respond to, or assess the effects of, "pollutants". %Ak Mwwvp mlIXNYon 4Rwn &ArrewenRr.:, CG 00 01 0413 © Insurance Services Office, Inc., 2012 , U. � �, .. (2) Any loss, cost or expense arising out of any: (a) Request, demand, order or statutory or regulatory requirement that any insured or others test for, monitor; clean up, remove, contain, treat, detoxify or neutralize, or in any way respond to, or assess the effects of, "pollutants'; or (b) Claim or suit by or on behalf of a governmental authority for damages because of testing for, monitoring, cleaning up, removing, containing, treating, detoxifying or neutralizing, or in any way responding to, or assessing the effects of, "pollutants". However, this paragraph does not apply to liability for damages because of "property damage" that the Insured would have in the absence of such request, demand, order or statutory or regulatory requirement, or such claim or "suit" by or on behalf of a governmental authority. g. Afrcraft, 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 26 feet long; and (b) Not being used to carry persons or property 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; or (5) "Bodily Injury" or "property damage" arising out of: (a) The operation of machinery or equipment that is attached to, or part of, a land vehicle that would qualify under the definition of "mobile equipment" if It were not subject to a compulsory or financial responsibility law or other motor vehicle insurance law where It is licensed or principally garaged; or (b) The operation of any of the machinery or equipment listed in Paragraph f.(2) or f.(3) of the definition of "mobile equipment". 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 for, or while being prepared for, any prearranged racing, speed, demolition, or stunting activity. f. War "Bodily Injury" or "property damage", 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. J. Damage To Property "Property damage" to: (1) Property you own, rent, or occupy, including any costs or expenses Incurred by you, or any other person, organization or entity, for repair, replacement, enhancement, restoration or maintenance of such property for any reason, including prevention of injury to a person or damage to another's property; (2) Premises you sell, give away or abandon, if the "property damage" arises out of any part of those premises; (3) Property loaned to you; Page 4 of 16 ©Insurance Services Office, Inc., 2012 8, 1 �+��!, Rh,Muyymnm"'41 " I,= Rt�tEw &mAPPROVrUr. R4kManagn,n, CAIralPlde (4) Personal property in the care, custody or control of the insured; (5) That particular part of real property on which you or any contractors or subcontractors working directly or indirectly on your behalf are performing operations, If the "property damage" arises out of those operations; or (6) That particular part of any property that must be restored, repaired or replaced because "your work" was Incorrectly performed on It. Paragraphs (1), (3) and (4) of this exclusion do not apply to "property damage" (other than damage by fire) to premises, including the contents of such premises, rented to you for a period of seven or fewer consecutive days. A separate limit of insurance applies to Damage To Premises Rented To You as described in Section III — Limits Of Insurance. Paragraph (2) of this exclusion does not apply If the premises are "your work" and were never occupied, rented or held for rental by you. Paragraphs (3), (4), (6) and (6) of this exclusion do not apply to liability assumed under a sidetrack agreement. Paragraph (6) of this exclusion does not apply to "property damage" Included in the "products - completed operations hazard". k. Damage To Your Product "Property damage" to "your product" arising out of It or any part of it. 1. Damage To Your Work "Property damage" to "your work" arising out of it or any part of It and Included in the "products - completed operations hazard". This exclusion does not apply if the damaged work or the work out of which the damage arises was performed on your behalf by a subcontractor. m. Damage To Impaired Property Or Property Not Physically Injured "Property damage" to "impaired property' or property that has not been physically Injured, arising out of: (1) A defect, deficiency, inadequacy or dangerous condition in "your product' or "your work"; or (2) A delay or failure by you or anyone acting on your behalf to perform a contract or agreement in accordance with its terms. 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. n. Recall Of Products, Work Or Impaired Property Damages claimed for any loss, cost or expense incurred by you or others for the loss of use, withdrawal, recall, inspection, repair, replacement, adjustment, removal or disposal of: (1) "Your product"; (2) "Your work"; or (3) "Impaired property"; If such product, work, or property is withdrawn or recalled from the market or from use by any person or organization because of a known or suspected defect, deficiency, Inadequacy or dangerous condition In It. o. Personal And Advertising Injury "Bodily injury" arising out of "personal and advertising injury". p. Electronic Data Damages arising out of the loss of, loss of use of, damage to, corruption of, Inability to access, or inability to manipulate electronic data. However, this exclusion does not apply to liability for damages because of "bodily injury". As used in this exclusion, electronic data means Information, facts or programs stored as or on, created or used on, or transmitted to or from computer software, including systems and applications software, hard or floppy disks, CD- ROMs, tapes, drives, cells, data processing devices or any other media which are used with electronically controlled equipment. cl. Recording And Distribution Of Material Or Information In Violation Of Law "Bodily injury" or "property damage" arising directly or indirectly out of any action or omission that violates or is alleged to violate: (1) The Telephone Consumer Protection Act (TCPA), Including any amendment of or addition to such law; (2) The CAN-SPAM Act of 2003, Including any amendment of or addition to such law; (3) The Fair Credit Reporting Act (FORA), and any amendment of or addition to such law, including the Fair and Accurate Credit Transactions Act (FACTA); or . MuugmuutUMdai t j ■yy■ `` ^� RENf.WFU6,.ryAPYRNFbeM: � +jllllt' �) "%r! p<CWOtt iti "^ 'Rux Ma,upen,en, ClnieilAide N CG 00 01 0413 0 Insurance Services Office, Inc., 2012 , y. � .. " (4) Any federal, state or local statute, ordinance or regulation, other than the TCPA, CAN-SPAM Act of 2003 or FCRA and their amendments and additions, that addresses, prohibits, or limits the printing, dissemination, disposal, collecting, recording, sending, transmitting, communicating or distribution of material or Information. Exclusions c. through n. do not apply to damage by fire to premises while rented to you or temporarily occupied by you with permission of the owner. A separate limit of Insurance applies to this coverage as described. in Section III - Limits Of Insurance. COVERAGE B — PERSONAL AND ADVERTISING INJURY LIABILITY 1. Insuring Agreement a. We will pay those sums that the insured becomes legally obligated to pay as damages because of "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 "personal and advertising injury" to which this Insurance does not apply. We may, at our discretion, investigate any 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 III — Limits Of Insurance; and (2) Our right and duty to defend end when we have used up the applicable limit of Insurance in the payment of judgments or settlements under Coverages A or B or medical expenses under Coverage C. No other obligation or liability to pay sums or perform acts or services is covered unless explicitly provided for under Supplementary Payments — Coverages A and B. b. This Insurance applies 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. 2. Exclusions This Insurance does not apply to: a. Knowing Violation Of Rights Of Another "Personal and advertising Injury" caused by or at the direction of the Insured with the knowledge that the act would violate the rights of another and would Inflict "personal and advertising Injury". b. Material Published With Knowledge Of Falsity "Personal and advertising Injury" arising out of oral or written publication, in any manner, of material, if done by or at the direction of r the insured with knowledge of its falsity. c. Material Published Prior To Policy Period "Personal and advertising Injury" arising out of oral or written publication, in any manner, of material whose first publication took place before the beginning of the policy period, d. Criminal Acts "Personal and advertising injury" arising out of a criminal act committed by or at the direction of the insured. e. Contractual Liability "Personal and advertising injury" for which the insured has assumed liability in a contract or ' agreement. This exclusion does not apply to liability for damages that the Insured would have in the absence of the contract or agreement. f. Breach Of Contract "Personal and advertising injury" arising out of a breach of contract, except an Implied contract to use another's advertising Idea In your "advertisement". g. Quality Or Performance Of Goods — Failure To Conform To Statements "Personal and advertising injury" arising out of the failure of goods, products or services to conform with any statement of quality or performance made in your "advertisement". h. Wrong Description Of Prices "Personal and advertising Injury" arising out of the wrong description of the price of goods, products or services stated In your "advertisement". wekMn.gcna�toolaun r seneumanrrxwEoer: � ?axl ploxeac Page 6 of 16 © Insurance Services Office, Inc., 2012 `' t. Infringement of Copyright, Patent, Trademark Or Trade Secret "Personal and advertising Injury" arising out of the Infringement of copyright, patent, trademark, trade secret or other Intellectual property rights. Under this exclusion, such other intellectual property rights do not include the use of another's advertising idea in your "advertisement". However, this exclusion does not apply to infringement, in your "advertisement", of copyright, trade dress or slogan. j, Insureds In Media And Internet Type Businesses "Personal and advertising Injury" committed by an Insured whose business Is: (1) Advertising, broadcasting, publishing or telecasting; (2) Designing or determining content of web sites for others; or (3) An Internet search, access, content or service provider. However, this exclusion does not apply to Paragraphs 14.a., b. and c. of "personal and advertising Injury" under the Definitions section. For the purposes of this exclusion, the placing of frames, borders or links, or advertising, for you or others anywhere on the Internet, is not by itself, considered the business of advertising, broadcasting, publishing or telecasting. k. Electronic Chatrooms Or Bulletin Boards "Personal -and advertising Injury" arising out of an electronic chatroom or bulletin board the insured hosts, owns, or over which the insured exercises control. I. Unauthorized Use Of Another's Name Or Product "Personal and advertising injury" arising out of the unauthorized use of another's name or product in your e-mail address, domain name or metatag, or any other similar tactics to mislead another's potential customers. m. Pollution "Personal and advertising Injury" arising out of the actual, alleged or threatened discharge, dispersal, seepage, migration, release or escape of "pollutants" at any time. n. Pollution -related Any loss, cost or expense arising out of any (1) Request, demand, order or statutory or regulatory requirement that any insured or others test for, monitor, clean up, remove, contain, treat, detoxify or neutralize, or In any way respond to, or assess the effects of, "pollutants"; or (2) Claim or suit by or on behalf of a governmental authority for damages because of testing for, monitoring, cleaning up, removing, containing, treating, detoxifying or neutralizing, or in any way responding to, or assessing the effects of, .,pollutants". o. War "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. p. Recording And Distribution Of Material Or Information In Violation Of Law "Personal and advertising Injury" arising directly or indirectly out of any action or omission that violates or is alleged to violate: (1) The Telephone Consumer Protection Act (TCPA), including any amendment of or addition to such law; (2) The CAN-SPAM Act of 2003, Including any amendment of or addition to such law; (3) The Fair Credit Reporting Act (FCRA), and any amendment of or addition to such law, Including the Fair and Accurate Credit Transactions Act (FACTA); or (4) Any federal, state or local statute, ordinance or regulation, other than the TCPA, CAN-SPAM Act of 2003 or FCRA and their amendments and additions, that addresses, prohibits, or limits the printing, dissemination, disposal, collecting, recording, sending, transmitting, communicating or distribution of material or Information. j �n W,� RhVA4ngM�nxvWm �NeAENEn6/UPNuvmel: Pa 7 '� �' IlkltMana9en"„I CIMciINJ" CG 00 01 0413 © insurance Services Office, Inc., 2012 COVERAGE C — MEDICAL PAYMENTS 1. 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: (a) The accident takes place In the coverage territory' and during the policy period; (b) The expenses are Incurred and reported to us within one year of the date of the accident; and (c) 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. 2. Exclusions 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 low, 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 within the "products -completed operations hazard". g. Coverage A Exclusions Excluded under Coverage A. SUPPLEMENTARY PAYMENTS — COVERAGES A AND B 1. We will pay, with respect to any claim we Investigate or settle, or any "suit" against an Insured we defend: a. All expenses we Incur. b. Up to $250 for cost of ball bonds required because of accidents or traffic law violations arising out of the use of any vehicle to which the Bodily Injury Liability Coverage applies. We do not have to furnish these bonds. c. The cost of bonds to release attachments, but only for bond amounts within the applicable limit of insurance. We do not have to furnish these bonds. d. All reasonable expenses incurred by the Insured at our request to assist us in the Investigation or defense of the claim or "suit", including actual loss of earnings up to $250 a day because of time off from work. e. All court costs taxed against the Insured In the "suit'. However, these payments do not include attorneys' fees or attorneys' expenses taxed against the Insured. f. 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. Page 8 of 16 © Insurance Services Office, Inc., 2012 wanmrga,�iunw"n 'as1�i`r,' FenEwm6Arrwov®av; -'�"'" Pi9,Ma,w9cniangnic�l/tidc V V VV V, V�1 I M g. 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. These payments will not reduce the limits of insurance. 2. 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: a. 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'; b, This insurance applies to such liability assumed by the insured; c. 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' d. The allegations in the "suit" and the information we know about the "occurrence" are such that no confilct appears to exist between the interests of the insured and the interests of the Indemnitee; e. The Indemnitee and the insured ask us to conduct and control the defense of that indemnitee against such "suit" and agree that we can assign the same counsel to defend the insured and the Indemnitee; and f. The Indomnitee: (1) Agrees in writing to: (a) Cooperate with us in the Investigation, settlement or defense of the "suit"; (b) Immediately send us copies of any demands, notices, summonses or legal papers received In connection with the "suit"; (c) Notify any other Insurer whose coverage Is available to the indemnitee; and (d) Cooperate with us with respect to coordinating other applicable insurance available to the Indemnitee; and (2) Provides us with written authorization to: (a) Obtain records and other information related to the "suit"; and (b) Conduct and control the defense of the Indemnitee in such "suit". 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 2.b.(2) of Section I — Coverage A — Bodily Injury And Property Damage Liability, 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 we have used up the applicable limit of Insurance in the payment of judgments or settlements or the conditions set forth above, or the terms of the agreement described in Paragraph f. above, are no longer met. SECTION 11-- 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. w,kn+,w�„In,uNwa� f 1 •yeily�'� IkwGT�o6Mvrtwmev; � I 76TG PkRJOrt a,. liul, M:mu"en,e,rt GnlalAitle CG 00 01 0413 © Insurance Services Office, Inc., 2012 2. Each of the following is also an Insured: a. 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 Iiability 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), to a cc -"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 'volunteer worker' as a consequence of Paragraph (1)(a) above; (c) For which there is any obligation to share damages with or repay someone also who must pay damages because of the injury described In Paragraph (1)(a) or (b) above; or (d) Arising out of his or her providing or failing to provide professional health care services. (2) "Property damage" to property: (a) Owned, occupied or used by; (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. Any person (other than your "employee" or "volunteer worker'), or any organization while acting as your real estate manager. c. 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. 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 Coverage Part, 3. Any organization you newly acquire or form, other than a partnership, jolntventure or limited liability company, and over which you maintain ownership or majority interest, 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 90th day after you acquire or form the organization or the and of the policy period, whichever is earlier; b. Coverage A does not apply to "bodily injury" or "property damage" that occurred before you acquired or formed the organization; and c. Coverage B does not apply to 'personal and advertising injury" arising out of an offense committed before you acquired or formed the organization. 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. SECTION III — LIMITS OF INSURANCE 1. 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. The General Aggregate Limit is the most we will pay for the sum of: a. Medical expenses under Coverage C; b. Damages under Coverage A, except damages because of "bodily Injury" or "property damage" Included in the "products -completed operations hazard"; and c. Damages under Coverage B. o,< RMtM11•mgenNlahiY". ROV4111-w..9 ClviG11 N"" Page 10 of 16 © Insurance Services Office, Inc., 2012 3. The Products -Completed Operations Aggregate Limit is the most we will pay under Coverage A for damages because of "bodily injury" and "property damage" included in the "products -completed operations hazard". 4. Subject to Paragraph 2, above, the Personal And Advertising Injury Limit is the most we will pay under Coverage B for the sum of all damages because of all "personal and advertising Injury" sustained by any one person or organization. 5. Subject to Paragraph 2. or 3. above, whichever applies, the Each Occurrence Limit Is the most we will pay for the sum of: a. Damages under Coverage A; and b. Medical expenses under Coverage C because of all "bodily injury" and "property damage" arising out of any one "occurrence". 6. Subject to Paragraph 5. above, the Damage To Premises Rented To You Limit Is the most we will pay under Coverage A for damages because of "property damage" to any one premises, while rented to you, or in the case of damage by Ore, while rented to you or temporarily occupied by you with permission of the owner. 7. Subject to Paragraph 5. above, the Medical Expense Limit is the most we will pay under Coverage C for all medical expenses because of "bodily Injury" sustained by any one person. The Limits of Insurance of this Coverage Part apply separately to each consecutive annual period and to any remaining period of less than 12 months, starting with the beginning of the policy period shown in the Declarations, unless the policy period is extended after issuance for an additional period of less than 12 months. In that case, the additional period will be deemed part of the last preceding period for purposes of determining the Limits of Insurance. SECTION IV— COMMERCIAL GENERAL LIABILITY CONDITIONS 1. Bankruptcy Bankruptcy or insolvency of the Insured or of the insured's estate will not relieve us of our obligations under this Coverage Part. 2. Duties In The Event Of Occurrence, Offense, Claim Or Suit a. You must see to It that we are notified as soon as practicable of an "occurrence" or an offense which may result In a claim. To the extent possible, notice should include: (1) How, when and where the "occurrence" or offense took place; (2) The names and addresses of any Injured persons and witnesses; and (3) The nature and location of any injury or damage arising out of the "occurrence" or offense. b. If a claim Is made or "suit" is brought against any insured, you must: (1) Immediately record the specifics of the claim or "suit' and the date received; and (2) Notify us as soon as practicable. You must see to It that we receive written notice of the claim or "suit" as soon as practicable. c. You and any other involved insured must: (1) Immediately send us copies of any demands, notices, summonses or legal papers received in connection with the claim or "suit"; (2) Authorize us to obtain records and other information; (3) Cooperate with us in the investigation or settlement of the claim or defense against the "suit"; and (4) Assist us, upon our request, in the enforcement of any right against any person or organization which may be liable to the Insured because of injury or damage to which this Insurance may also apply. d. No insured will, except at that Insured's own cost, voluntarily make a payment, assume any obligation, or incur any expense, other than for first aid, without our consent. 3. Legal Action Against Us No person or organization has a right under this Coverage Part: 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 Part 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 Coverage Part 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. CG 00 01 0413 © Insurance Services Office, Inc., 2012 WA NktnEmcvreo6M&/AVPP ntDM1iYan xwEnxr fthkhlmaya,mKlMml Nde 4. Otherinsurance If other valid and collectible insurance is available to the insured for a loss we cover under Coverages A or B of this Coverage Part, our obligations are limited as follows; a. Primary Insurance This insurance Is primary except when Paragraph b. below applies. If this Insurance is primary, our obligations are not affected unless any of the other insurance is also primary. Then, we will share with all that other Insurance by the method described in Paragraph c. below. . b. Excess Insurance (1) This Insurance is excess over: (a) Any of the other insurance, whether primary, excess, contingent or on any other basis: (1) That is Fire, Extended Coverage, Builder's Risk, Installation Risk or similar coverage for "your work'; (II) That Is Fire insurance for premises rented to you or temporarily occupied by you with permission of the owner; (111) 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; or (iv) 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 I — Coverage A — Bodily Injury And Property Damage Liability. (b) Any other primary Insurance available to you covering liability for damages arising out of the premises or operations, or the products and completed operations, for which you have been added as an additional Insured. (2) When this insurance is excess, we will have no duty under Coverages A or B 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. (3) 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: (a) The total amount that all such other Insurance would pay for the loss in the absence of this Insurance; and (b) The total of all deductible and self - Insured amounts under all that other Insurance. (4) 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 of 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. 5. Premium Audit a. We will compute all premiums for this Coverage Part In accordance with our rules and rates. b. Premium shown in this Coverage Part as advance premium is a deposit premium only. At the close of each audit period we will compute the earned premium for that period and send notice to the first, Named Insured. The due date for audit and retrospective premiums is the date shown as the due date on the bill. If the sum of the advance and audit premiums paid for the policy period is greater than the earned premium, we will return the excess to the first Named Insured. c. The first Named Insured must keep records of the Information we need for premium computation, and send us copies at such times as we may request. 6. Representations By accepting this policy, you agree: a. The statements in the Declarations are accurate and complete; w Mu+gnmdUi,idoR ' i'+�9� Rk�/IEWEp&APPdWPb 9'P RekM gtim"gMalXde Page 12 of 16 © Insurance Services Office, Inc„ 2012 —> , . V ; .1 ,, . b. Those statements are based upon representations you made to us; and c. We have issued this policy in reliance upon 3. your representations. 7. Separation Of Insureds Except with respect to the Limits of Insurance, and any rights or duties specifically assigned in this Coverage Part 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 claim Is made or "suit" is brought. 8. Transfer Of Rights Of Recovery Against Others To Us If the insured has rights to recover all or part of any payment 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. 9. When We Do Not Renew If we decide not to renew this Coverage Part, we will mall or deliver to the first Named Insured shown in the Declarations written notice of the nonrenewal not less than 30 days before the expiration date. If notice Is mailed, proof of mailing will be sufficient proof of notice. SECTION V — DEFINITIONS 1. "Advertisement" means a notice that is broadcast or published to the general public or specific market segments about your goods, products or services for the purpose of attracting customers or supporters. For the purposes of this definition: a. Notices that are published include material placed on the Internet or on similar electronic means of communication; and b. Regarding web sites, only that part of a web site that is about your goods, products or services for the purposes of attracting customers or supporters is considered an advertisement. 2. "Auto" means: a. A land motor vehicle, trailer or semitrailer designed for travel on public roads, including any attached machinery or equipment; or b. Any other land vehicle that Is subject to a compulsory or financial responsibility law or other motor vehicle Insurance law where it is licensed or principally garaged. CG 00 Of 0413 4. However, "auto" does not include "mobile equipment". "Bodily injury" means bodily Injury, sickness or disease sustained by a person, including death resulting from any of these at any time. "Coverage territory" means: a. The United States of America (including its territories and possessions), Puerto Rico and Canada; b. International waters or airspace, but only if the Injury or damage occurs in the course of travel or transportation between any places Included in Paragraph a. above; or c. All other parts of the world if the injury or damage arises out of: (1) Goods or products made or sold by you in the territory described in Paragraph a. above; (2) The activities of a person whose home Is in the territory described in Paragraph a. above, but is away for a short time on your business; or (3) "Personal and advertising injury" offenses that take place through the Internet or similar electronic means of communication; provided the Insured's responsibility to pay damages is determined in a "suit" on the merits, in the territory described in Paragraph a, above or In a settlement we agree to. 5. "Employee" Includes a "leased worker". "Employee" does not Include a "temporary worker", 6. "Executive officer" means a person holding any of the officer positions created by your charter, constitution, bylaws or any other similar governing document. 7. "Hostile fire" means one which becomes uncontrollable or breaks out from where it was Intended to be. 8. 'Impaired property' means tangible property, other than "your product" or "your work", that cannot be used or is less useful because: a. It Incorporates "your product" or "your work" that is known or thought to be defective, deficient, inadequate or dangerous; or b. You have failed to fulfill the terms of a contract or agreement; If such property can be restored to use by the repair, replacement, adjustment or removal of "your product" or "your work" or your fulfilling the terms of the contract or agreement. ©Insurance Services Office, Inc., 2012 MA00— tMan , REvtvHsvS+ryAvrernt�sflr. /JSG YCf!lJJiI ,' RisaM nnpennrt 0-1-11A,h t ...W., ... �. ,.. 9, "Insured contract" means; a. A contract for a lease of promises. However, that portion of the contract for a lease of premises that Indemnifies any person or organization for damage by fire to premises while rented to you or temporarily occupied by you with permission of the owner is not an "insured contract"; b. A sidetrack agreement; c. Any easement or license agreement, except in connection with construction or demolition operations on or within 50 feet of a railroad; d. An obligation, as required by ordinance, to indemnify a municipality, except In connection with work for a municipality; e. An elevator maintenance agreement; f. That part of any other contract or agreement pertaining to your business (including an Indemnification of a municipality in connection with work performed for a municipality) under which you assume the tort liability of another party to pay for "bodily Injury" or "property damage" to a third person or organization. Tort liability means a liability that would be Imposed by law in the absence of any contract or agreement. Paragraph f, does not include that part of any contract or agreement: (1) That indemnifies a railroad for "bodily injury" or "property damage" arising out of construction or demolition operations, within 50 feet of any railroad property and affecting any railroad bridge or trestle, tracks, road -beds, tunnel, underpass or crossing; (2) 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 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 (3) 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 (2) above and supervisory, inspection, architectural or engineering activities. 10."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". 11.1oading 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". 12."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, maintained primarily to provide mobility to 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 Paragraph 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; If. Vehicles not described in Paragraph a., b., c. or d. above maintained primarily for purposes other than the transportation of persons or cargo. t . p°' `` _ Reneums vsv S ;y� tit" ' "Yort 7�tcraam flkkML,wnemrntClnlmlNflu Page 14 of 16 © Insurance Services Office, Inc., 2012 However, self-propelled vehicles with the following types of permanently attached equipment are not "mobile equipment" but will be considered "autos": (1) Equipment 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. However, "mobile equipment" does not include any land vehicles that are subject to a compulsory or financial responsibility law or other motor vehicle insurance law where it is licensed or principally garaged. Land vehicles subject to a compulsory or financial responsibility law or other motor vehicle Insurance law are considered "autos". 13."Occurrence" means an accident, including continuous or repeated exposure to substantially the same general harmful conditions. 14."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; c. The wrongful eviction from, wrongful entry into, or invasion of the right of private occupancy of a room, dwelling or premises that a person occupies, committed by or on behalf of Its owner, landlord or lessor; d. Oral or written publication, in any manner, of material that slanders or libels a person or organization or disparages a person's or organization's goods, products or services; e. Oral or written publication, In any manner, of material that violates a person's right of privacy; f. The use of another's advertising idea in your "advertisement"; or g. Infringing upon another's copyright, trade dress or slogan in your "advertisement". 15."Pollutants" mean 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. 16."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 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. Work that may need service, maintenance, correction, repair or replacement, but which is otherwise complete, will be treated as completed. 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; (2) The existence of tools, uninstalled equipment or abandoned or unused materials; or (3) Products or operations for which the classification, listed in the Declarations or in a policy Schedule, states that products - completed operations are subject to the General Aggregate Limit. 17."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 the "occurrence" that caused It. For the purposes of this Insurance. elactrnnin data Is not tangible property. 7oTt P&woa Cloiu9Ai,l" a ' sI�M"rs !°e 1`•..;RENEWEUGMPRCIVEPBV: t �Rh4Mmn"an,l CG 00 01 0413 0 Insurance Services Office, Inc., 2012 , ..e. — �. ,. As used In this definition, electronic data means Information, facts or programs stored as or on, created or used on, or transmitted to or from computer software, including systems and applications software, hard or floppy disks, CO- ROMs, tapes, drives, cells, data processing devices or any other media which are used with electronically controlled equipment. 18."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. 19."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. 20."Volunteer worker" means a person who Is not your "employee", and who donates his or her work and acts at the direction of and within the scope of duties determined by you, and is not paid a fee, salary or other compensation by you or anyone else for their work performed for you. 21. "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. 22. "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 16 of 16 © Insurance Services Office, Inc., 2012 fta�neam&AMmweoev: � "lagi %idmdaa RY4M„u"erm"Cirnc"IFVae. vv VV V, Vl ,V Maricsa Secundo 7143 Fulton Way Stanton, CA. 90680 mixxasecundo@gmaii.com 714 781-9017 April 29, 2021 City of Santa Ana Risk Management Division 20 Civic Center Plaza, Santa Ana, CA 92702 Re: Professional Liability and Auto Insurance Requirement and Release of Liability. Dear City of Santa Ana Risk Management Division: I, Maritsa Secundo, Dance instructor, hereby release the City of Automobile Liability. do not use/drive any vehicle during the course and scope of my agreement with the City. Additionally, I am not a licensed professional and will not employ a licensed professional during the course of my contract. During the term June 1, 2021 through May 31, 2022, Danza Folklorico, El Salvador Park, 1825 W Civic Center Drive, Santa Ana, CA. Sincerely, Maritsa Secundo Dance Instructor .. wok Mnugeroalf MOM RENEWFO6MPROVt3]NY %OSC&MOO Y—� `R61aMmeyrmu[CleiiralPfde '' 01 Date: 9/24/2021 City of Santa Ana Risk Management Division 20 Civic Center Plaza Santa Ana, CA 92702 Re: Auto Insurance Requirement Dear City of Santa Ana Risk Management Division: [Maritsa Secundo] has intent to enter into an agreement with the City of Santa Ana. Throughout the course of this agreement, [Maritsa Secundo] attests to the following: 1. [Maritsa Secundo], will not use/drive any vehicle during the Course and scope of the services provided in the agreement/contract: 2. [Maritsa Secundo] will not use any owned/rented/leased vehicles during the course and scope of the services provided in the agreement/contract. 3. [Maritsa Secundo] consultants/independent contractors/employees utilize their personal vehicles/non-company owned, borrowed, or rented/leased vehicles for transportation to and from work and if applicable carry their own automobile insurance. By signing below, I, Maricsa Secundo attest that I possess the legal authority to enter intoan agreement with the City of Santa Ana as well as the legal authority to attest to the statements above. If at any time it is found that [company name] is not adhering to any/all statements in this document and has not provided the minimum Auto liability insurance coverage of $1 million per occurrence, the contract will be considered null and void and the company will be held fully liable for any and all damages. Signature Maricsa Secundo] Dance Instructor Contact Phone:? 1478 1.9017 Emall Address: mlJxasecundo@gmall.com fiF w�.yi WdiMaAFnRotaivldcn { j RtYte &AFFROV ft ?1'�ii 's1I � 7axl �<cr.ar -�Rul<lAnna9eninn 4alulAide S; CITYonSANTAANA Rist< MANAGEMENT. a'usto a 4HUMAN RESOURCES ' Managing Risk mrwgh Positive Ci1anga � r WORKERS' COMPENSATION DECLARATION I Maricsa Secundo (Namell-Irtle) following declaration: I certify on behalf of Maricsa Secundo of my contract for hereby affirm under penalty of perjury, the that during the term (Consultant/Company Name) Dance services with the City of Santa Ana, (Type of service provided) 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 Section 3700 of the Labor Code, I shall forthwith comply with the provisions and provide proof of workers' compensation coverage immediately. Date: April 29, 2021 Print Name: Maricsa Secundo Print Title: Dance Instructor Signature: Telephone: i71 ) 781-9017 WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT 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 SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES, 1 a M,rrgarenl0l�Wn y.� F�AEu2o&MPpavmOv: 9oxt �fawolo "'" -----'"'" '"" '" IIISI<M:IIIdJ2111[III CIIYICAI/L'(1C �� l: jRlsk Mgmtjlnsurance Requlrementsj WC Declaration 08152019