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HomeMy WebLinkAboutMAD SCIENCE (THE JAY PARTICLE LLC) INSURANCE ON FILE N-2024-225 WORK MAY PROCEED UNTIL INSURANCE EXPIRES 4 cA N 2,1I c CITY CLERK '"" ' DATE: JUL 08 LO24 l � _..... sep`^\ June 18,2024 The Jay Particle LLC dba Mad Science("Speaker/Performer") 3501 W. Moore Ave, Ste.J Santa Ana,CA 92704 (714)668-9174 MadscienceWOC(a7,gmail.com Re: Speaker/Performer Engagement Agreement This letter represents your agreement with the City of Santa Ana ("City") as entered into on the above date for the engagement described below: 1. Event Description: As further described in Exhibit A,attached hereto, Speaker/Performer shall provide science shows on the dates below at the times and locations listed below. 2. Date(s): Wednesday,July 17, 2024 Wednesday,July 31, 2024 Wednesday, September 18,2024 3. Event Time(s): 6:00 p.m.—7:00 p.m. 4. Location: Newhope Library, 122 N.Newhope Street, Santa Ana,CA 92703 5. Compensation: The total amount shall not exceed $1,335.00 under this Agreement (payable by check within 30 calendar days of event); Speaker/Performer must provide IRS form W-9 before payment can be made. 6. Provided by City: advertising the event and setting up space for patrons attending. 7. Provided by Speaker/Performer: Insurance requirements as detailed in Exhibit B and all other equipment and materials necessary. 8. City Contact Person(for coordinating purposes only): Maria Sepulveda x5265 9. Independent Contractor: Speaker/Performer shall, during the entire term of this Agreement,be construed to be an independent contractor and not an employee of the City. This Agreement is not intended nor shall it be construed to create an employer-employee relationship,a joint venture relationship,or to allow the City to exercise discretion or control over the professional manner in which Speaker/Performer performs the services that are the subject matter of this Agreement; however, the services to be provided by Speaker/Performer shall be provided in a manner consistent with all applicable standards and regulations. Speaker/Performer shall pay all salaries and wages, employer's social security taxes, unemployment insurance and similar taxes relating to employees and shall be responsible for all applicable withholding taxes. 10. Indemnification: Speaker/Performer,his or her agents,or employees(if applicable) agrees to and shall indemnify, defend,and hold harmless the City,its officers,agents,employees,consultants,special counsel,and representatives from and against all loss, expenses,or liability(including costs and attorney's fees)arising from the negligence or willful misconduct of Speaker/Performer, his or her agents,or employees. 11. Release: Speaker/Performer accepts any City-provided equipment used in connection with the performance in their "as-is" condition, with all faults. Speaker/Performer fully releases, waives and discharges forever any and all Speaker Agreement—The Jay Particle LLC dba Mad Science Page 2 claims,demands,rights,and causes of action of any kind or nature against,and covenants not to sue,City,its elected officials,officers, employees,agents and volunteers,and all persons acting on behalf of,by,through or under each of them, under any present or future laws,statutes,or regulations for any claim or event relating to the condition of the City-provided equipment or Speaker/Performer's use thereof. 12. The City shall have the right and royalty-free license to simulcast or produce and show a tape-delayed broadcast of Speaker/Performer's presentation to the City community or general public, through webcast or any other means. This license shall be non-exclusive and the copyright shall remain with the Speaker/Performer. Copies of Speaker/Performer's presentation may be maintained by the City, and Speaker/Performer consents to use of such recordings. 13. Speaker/Performer is solely responsible for payment of royalty fees,performance fees, or similar fees that may be required by unions or similar organizations. Speaker/Performer shall indemnify the City against any liability or damages, including attorney's fees, that may arise as a result of violation by Speaker/Performer of copyright laws. 14. Speaker/Performer shall not discriminate because of race, color, creed, religion, sex, marital status, sexual orientation, age, national origin, ancestry, disability, or any other basis protected by applicable law in connection with any activities related to this Agreement. 15. This Agreement shall in all respects shall be interpreted,enforced,and governed exclusively by and under the laws of the state of California. Both parties agree that Orange County, California, shall be the venue for any action or proceeding that may be brought or arise out of, in connection with or by reason of this Agreement. 16. This Agreement represents the complete and exclusive statement between the City and Speaker/Performer regarding the subject matter herein and supersedes any and all other agreements, oral or written, between the parties. This Agreement may not be modified except by written instrument signed by the City and by an authorized representative of Speaker/Performer. CITY OF ANTA A SPEAKER/PERFORMER u4.4 afis JM l,L p ±a.zonai,33ron Alvaro Nufiez Karla Lopez Van Meter Acting City Manager Owner AT ST: APPROVED AS TO FORM: sANN • By: en r L. • B on Salvatierra Ci Ier Deputy City Attorney RECOMMENDED FOR APPROVAL B.art 13 SS POT Brian Sternberg Library Services Director Library Services EXHIBIT A Exhibit A SCOPE OF SERVICES VENDOR INFORMATION: The Jay Particle, LLC, DBA Mad Science The Jay Particle,LLC,DBA Mad Science 3501 W. Moore Ave, Ste. J Santa Ana, CA 92704 Telephone: (714) 668-9174 Email: madsciencewoc(c gmail.com EVENT(S): Themed Science Shows LOCATIONS: All Library facilities including but not limited to facilities listed below. • Newhope Library, 122 N.Newhope Street, Santa Ana CA 92703 TERM: July 17, 2024 through September 18, 2024 COMPENSATION: Not to exceed $1335.00 DESCRIPTION: This vendor will provide science shows on Wednesday, July 17 & 31, 2024 (6:00 pm-7:00 pm), and Wednesday, September 18`h,2024 at the Newhope Library located at 122 N. Newhope Street, Santa Ana, CA 92703. The total amount for this agreement shall not exceed $1335.00. The City will be responsible for setting up the space for the patrons attending, and advertising the program. Vendor will be responsible for providing all equipment,materials, supplies and personnel necessary to perform the act. City staff will be present at all times during the performance. EXHIBIT B EXHIBIT B Speaker/Performer shall procure and maintain for the duration of the Agreement insurance against claims for injuries to persons or damages to property which may arise from or in connection with services,products,and materials supplied to City. Total cost of such insurance shall be borne by Speaker/Performer. a. Minimum Scope and Limit of Insurance (1) Commercial General Liability (CGL). Insurance Services Office ("ISO") Form CG 00 01 covering CGL on an "occurrence" basis, including products and completed operations, property damage, bodily injury and personal & advertising injury with limits no less than $1,000,000 per occurrence and $2,000,000 aggregate. Required policy limits can be met with primary and umbrella/excess insurance policies. (2) Automobile Liability(AL). ISO Form CA 00 01 covering Code 1 (any auto), with combined single limits of$1,000,000. (3) Workers' Compensation. As required by the State of California, with statutory limits, and employer's liability insurance with a limit of no less than $1,000,000 per accident, per employee,per policy for bodily injury or disease. This requirement can be waived if Speaker/Performer has no employees. (4) Sexual Abuse or Molestation Liability (SAML). If the CGL policy referenced above is not endorsed to include affirmative coverage for sexual abuse or molestation, Speaker/Performer shall obtain and maintain a policy covering sexual abuse and molestation with a limit of no less than$1,000,000 per occurrence or claim. (5) Broader Coverage. If the Speaker/Performer maintains broader coverage and/or higher limits than the minimums shown above, the City requires and shall be entitled to the broader coverage and/or the higher limits maintained by the Speaker/Performer. Any available insurance proceeds in excess of the specified minimum limits of insurance and coverage shall be available to the City. b. Other Insurance Provisions The above required insurance policies are to contain or be endorsed to contain the following provisions: (1) Additional Insured Status. The City, its officers, officials, employees, and volunteers are to be covered as additional insureds on the policies required above, with respect to liability arising out of work or operations performed by or on behalf of the Speaker/Performer including materials, parts, or equipment furnished in connectionwith such work or operations. (2) Waiver of Subrogation. Speaker/Performer's insurance company(ies) agree(s) to waive all rights of subrogation against the City, its City Council, its officers, officials, employees, agents, and volunteers for losses paid under the terms of any policy which arise from work performed by Speaker/Performer under this Agreement. (3) Primary Coverage. For any claims related to this Agreement, Speaker/Performer's insurance coverage shall be primary and any insurance maintained by City, its City Council, its officers, officials, employees, agents, or volunteers shall not contribute with it. (4) Severability. A severability of interest provision must apply for all the additional insured, ensuring that Speaker/Performer's insurance shall apply separately to each insured against whom a claim is made or suit is brought, except with respect to the insurer's limits of liability. (5) Cancellation. Insurance policy(ies)herein shall provide that coverage shall not be canceled, suspended, voided, reduced in coverage or in limits, non-renewed by the carrier, or materially changed except after thirty (30) days prior written notice has been given to City. Ten (10) days prior written notice shall be provided to City for policy cancellation or non-renewal due to non-payment. (6) Certificate Holder. The Certificate Holder on each evidence of insurance certificate shall be: City of Santa Ana, Attn: (name of department staff responsible for Agreement), 20 Civic Center Plaza M-XX (responsible staffs department mailbox), Santa Ana, CA 92701. The name and location of event should be included in the description of operations section of each certificate. c. Acceptability of Insurers. Insurance is to be placed with insurers authorized to conduct business in the state with a current A.M. Best's rating of no less than A:VII, unless otherwise acceptable to the City. d. Verification of Coverage. Speaker/Performer shall furnish the City with original Certificates of Insurance including all required amendatory endorsements(or copies of the applicable policy language effecting coverage requiredby this clause) and a copy of the Declarations and Endorsement Page of the CGL policy listing allpolicy endorsements to City before work begins. However, failure to obtain the required documents prior to the work beginning shall not waive the Speaker/Performer's obligation to provide them. The City reserves the right to require complete,certified copies of all required insurance policies,including endorsements required by these specifications, at any time. e. Special Events Coverage. Special events coverage is available and can by purchased by Speaker/Performer. Use this link to learn more: www.2sparta.com f. Special Risks or Circumstances. City reserves the right to modify these requirements, including limits, based on the nature of therisk, prior experience, insurer, coverage, or other special circumstances. 1 Final Audit Report 2024-06-26 Created: 2024-06-26 By: Ella Sepulveda(msepulveda@santa-ana.org) Status: Signed Transaction ID: CBJCHBCAABAA5zn1Y2gaUzgqM4y8QsIR18D_kXxJjsKA "1 " History fi Document created by Ella Sepulveda (msepulveda@santa-ana.org) 2024-06-26-0:40:21 AM GMT L�. Document emailed to madsciencewoc@gmail.com for signature 2024-06-26-0:40:27 AM GMT n Email viewed by madsciencewoc@gmail.com 2024-06-26-6:31:50 PM GMT 6o Signer madsciencewoc@gmail.com entered name at signing as Karla Lopez Van Meter 2024-06-26-6:33:18 PM GMT ba Document e-signed by Karla Lopez Van Meter(madsciencewoc@gmail.com) Signature Date:2024-06-26-6:33:20 PM GMT-Time Source:server ® Agreement completed. 2024-06-26-6:33:20 PM GMT Q Adobe Acrobat Sign ____......IN THEJAYP-01 PREVOMA A�ORO CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) 5/15/2024 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer ri hts to the certificate holder in lieu of sur n an ement s PRODUCER `ONT• ' I � I I y signed by Hylant-Toledo IH2N x 811 Madison Ave. No,Ext):( )724-1990 INC,No): Toledo,OH 43604 ngie AAI .Cindy.Bleir Hy nt.com An � SI, orRedo NAIL# INSU.=RA:Philgielphia Indemnity Ins Co 18058 INSURED �NSUR caau 01241 • n 29424 The Acle LLC dba Mad Science of West ange L�VJLCoun 3501r ve. INSURER D: 7 ^Jl 7SantA 4eve _ INSURE F •4/ •O✓ _O / 'oo' 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 CONTRACTOR 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 SUER POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR INSD WVD IMM/DD/YYYYI IMM/DD/YYYYI A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S 2,000,000 CLAIMS-MADE n OCCUR X X PHPK2645846 1/27/2024 1/27/2025 DAMAGESO a occu Dnce) $ 300,000 MED EXP(Any one person) S 15,000 PERSONAL&ADV INJURY $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S 4,000,000 POLICY X JECT X LOC PRODUCTS-COMP/OP AGG $ 4,000,000 X Abuse/Molestation$1 MIU$2MIL OTHER: A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 (Ea accident) $ - ANY AUTO PHPK2645846 1/27/2024 1/27/2025 BODILY INJURY(Per person) $ OWNED -SCHEDULED - _ AUTOS ONLY AUTOS BODILY INJURY(Per accident), $ X AUTOS ONLY X NON-OWNED ONLYY PROPERTY accidentDAMAGE $ S A X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1,000,000 EXCESS LIAB CLAIMS-MADE PHUB897330 1/27/2024 1/27/2025 AGGREGATE $ 1,000,000 DED X RETENTIONS 10,000 $ B WORKERS COMPENSATION X PER OTH- AND EMPLOYERS'LIABILITY STAIIJTF ER ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N X 45WECAV7H87 1/27/2024 1/27/2025 E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S A Property-Commercial PHPK2645846 1/27/2024 1/27/2025 BPP/DED$1,000 20,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) City of Santa Ana its officers,agents and employees are included as an Additional Insured for General Liability,on a Primary and Non-Contributory basis, when required by written agreement,subject to policy provisions.Automobile:The Jay Particle,LLC dba Mad Science of West Orange County does not own any vehicles to insured that would require this type of policy.Hired&Non-Owned Auto is provided on the General Liability.A Waiver of Subrogation applies on the General Liability and Workers Compensation policy in favor of the Additional Insured. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREO\ f City of Santa Ana ACCORDANCE WITH THE POLICY PR( 20 Civic Center Plaza o„.9L,4".,. RialcManagetnvttDfvisian Santa Ana,CA 92701 c.'';ty� ��'+ REVIEWED&APPROVmBY: • AUTHORIZED REPRESENTATIVE I (I-AGW`Ot.O r.„. 4.4. 7 7/ �' Risk Management^ ` Specialist I ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Philadelphia Indemnity Insurance Company PI-GLD-VS (05/17) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. GENERAL LIABILITY DELUXE ENDORSEMENT SCHOOLS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE It is understood and agreed that the following extensions only apply in the event that no other specific coverage for the indicated loss exposure is provided under this policy. If such specific coverage applies, the terms, conditions and limits of that coverage are the sole and exclusive coverage applicable under this policy, unless otherwise noted on this endorsement. The following is a summary of the Limits of Insurance and additional coverages provided by this endorsement. For complete details on specific coverages, consult the policy contract wording. Coverage Applicable Limit of Insurance Page# Damage to Premises Rented to You $300,000 2 Extended Property Damage included 2 Non-Owned Watercraft Less than 58 feet 2 Supplementary Payments—Bail Bonds $2,500 2 Supplementary Payment—Loss of Earnings $500 per day 2 Medical Payments $15,000 3 Medical Payments—Extended Reporting Period 3 years 3 Employee Indemnification Defense Coverage for Employee $25,000 3 Additional Insured—Medical Directors and Administrators Included 3 Additional Insured—Managers and Supervisors Included 3 Additional Insured—Broadened Named Insured Included 3 Additional Insured—Funding Source Included 3 Additional Insured—Managers or Lessors of Premises Included 4 Additional Insured—By Contract, Agreement or Permit Included 4 Additional Insured—Broad Form Vendors Included 4 General Aggregate—Per Campus Included 5 Duties in the Event of Occurrence, Claim or Suit Included 6 Other Insurance—Primary Additional Insured Included 6 Other Insurance—You Are An Additional Insured On Included 7 Another Person's Or Organization's Policy Unintentional Failure to Disclose Hazards Included 8 Liberalization Included 8 Bodily Injury—includes Mental Anguish Included 8 Personal and Advertising Injury—includes Abuse of Included 8 Process, Discrimination Transfer of Rights of Recovery Against Others To Us Clarification 9 Science Laboratory"Occurrence" $50,000 9 Medical Incident Liability—Nurse and Athletic Trainer Included Risk Ma sgementDivislon " , REVIEWED&APPROVED BY: PI-GLD-VS (05/17) A :e Acwtd.a Page 1 of 9 ® g Risk Arlanagement Specialist Includes copyrighted material of Insurance Services Office, Inc., with its p,/ Philadelphia Indemnity Insurance Company PI-GLD-VS (05/17) A. Damage to Premises Rented to You 1. If damage by fire to premises rented to you is not otherwise excluded from this Coverage Part, the word"fire" is changed to"fire, lightning, explosion, smoke, or leakage from automatic fire protective systems"where it appears in: a. The last paragraph of SECTION I—COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, Subsection 2. Exclusions; b. SECTION III - LIMITS OF INSURANCE, Paragraph 6.; c. SECTION V—DEFINITIONS, Paragraph 9.a. 2. If damage by fire to premises rented to you is not otherwise excluded from this Coverage Part, the words"Fire insurance" are changed to"insurance for fire, lightning, explosion, smoke, or leakage from automatic fire protective systems"where it appears in: a. SECTION IV-COMMERCIAL GENERAL LIABILITY CONDITIONS, Subsection 4. Other Insurance, Paragraph b. Excess Insurance 3. The Damage To Premises Rented To You Limit section of the Declarations is amended to the greater of: a. $300,000; or b. The amount shown in the Declarations as the Damage to Premises Rented to You Limit. This is the most we will pay for all damage proximately caused by the same event, whether such damage results from fire, lightning, explosion, smoke, or leaks from automatic fire protective systems or any combination thereof. B. Extended "Property Damage" SECTION I -COVERAGES. COVERAGE A, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, Subsection 2. Exclusions, Paragraph a. is deleted and replaced by the following: 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"or"property damage" resulting from the use of reasonable force to protect persons or property. C. Non-Owned Watercraft SECTION I—COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, Subsection 2. Exclusions, Paragraph g. (2) is amended to read as follows: (2) A watercraft you do not own that is: (a) Less than 58 feet long; and (b) Not being used to carry persons or property for a charge; This provision applies to any person, who with your consent, either uses or is responsible for the use of a watercraft. This insurance is excess over any other valid and collectible insurance available to the insured whether primary, excess or contingent. D. Supplementary Payments Risk Management Div isian Under the SUPPLEMENTARY PAYMENTS -COVERAGE A AND B provision, I int Ren ® EWED&APPRov8Y: PI-GLD-VS (05/17) ' Page 2 of 9 • Risk Management Specialist Includes copyrighted material of Insurance Services Office, Inc., with its p./ Philadelphia Indemnity Insurance Company PI-GLD-VS (05/17) are amended as follows: 1. The limit for the cost of bail bonds is changed from $250 to$2,500; and 2. The limit for loss of earnings is changed from $250 a day to$500 a day. E. Medical Payments -Limit Increased to $15,000, Extended Reporting Period If COVERAGE C MEDICAL PAYMENTS is not otherwise excluded from this Coverage Part: 1. The Medical Expense Limit is changed subject to all of the terms of SECTION III -LIMITS OF INSURANCE to the greater of: a. $15,000; or b. The Medical Expense Limit shown in the Declarations of this Coverage Part. 2. SECTION I —COVERAGE, COVERAGE C MEDICAL PAYMENTS, Subsection 1. Insuring Agreement, the second part of Paragraph a. is amended to read: provided that: (2) The expenses are incurred and reported to us within three years of the date of the accident; F. Employee Indemnification Defense Coverage Under the SUPPLEMENTARY PAYMENTS -COVERAGES A AND B provision, the following is added: 3. We will pay, on your behalf, defense costs incurred by an "employee" in a criminal proceeding. The most we will pay for any"employee"who is alleged to be directly involved in a criminal proceeding is$25,000 regardless of the numbers of"employees", claims or"suits" brought or persons or organizations making claims or bringing "suits". G. SECTION II -WHO IS AN INSURED is amended as follows: 1. If coverage for newly acquired or formed organizations is not otherwise excluded from this Coverage Part, Paragraph 3.a. is changed to read: a. Coverage under this provision is afforded until the end of the policy period. 2. Each of the following is also an insured: a. Medical Directors and Administrators -Your medical directors and administrators, but only while acting within the scope of and during the course of their duties as such. b. Managers and Supervisors -If you are an organization other than a partnership or joint venture, your managers and supervisors are also insureds, but only with respect to their duties as your managers and supervisors. c. Broadened Named Insured -Any organization and subsidiary thereof which you control and actively manage on the effective date of this Coverage Part. However, coverage does not apply to any organization or subsidiary not named in the Declarations as Named Insured, if they are also insured under another similar policy, but for its termination or the exhaustion of its limits of insurance. d. Funding Source-Any person or organization with respect to their liability Risk MaragenattDivision (1)Their financial control of you; or _ REVIEWED&APPROVED BY: PI-GLD-VS (05/17) AU F_' #s. €Auvih Page 3 of 9 ® g Risk Management Specialist Includes copyrighted material of Insurance Services Office, Inc., with its p,/ Philadelphia Indemnity Insurance Company PI-GLD-VS (05/17) (2) Premises they own, maintain or control while you lease or occupy these premises. This insurance does not apply to structural alterations, new construction and demolition operations performed by or for that person or organization. e. Managers or Lessors of Premises -Any person or organization with respect to their liability arising out of the ownership, maintenance or use of that part of the premises leased to you subject to the following additional exclusions: This insurance does not apply to: (1) Any"occurrence"which takes place after you cease to be a tenant in that premises. (2) Structural alterations, new construction or demolition operations performed by or on behalf of that person or organization. f. By Contract, Agreement or Permit -Any person or organization with whom you agreed, because of a written contract or agreement or permit, to provide insurance such as is afforded under this policy, but only with respect to your operations, "your work"or facilities owned or used by you. (1) This provision does not apply: (a) Unless the written contract or agreement has been executed or permit has been issued prior to the"bodily injury," "property damage," "personal and advertising injury": (b) To any person or organization included as an insured under g. Broad Form Vendors below; or (c) To any person or organization included as an insured by an endorsement issued by us and made a part of this Coverage Part. (2) When an engineer, architect or surveyor becomes an insured under this Coverage Part,the following additional exclusion applies: (a) "Bodily injury", "property damage", "personal and advertising injury" arising out of the rendering of or the failure to render any professional services by or for you, including: (i) The preparing, approving, or failing to approve maps, drawings, opinions, reports, surveys, change orders, designs or specifications; and (ii) Supervisory, inspection, or engineering services. (3) When a lessor of leased equipment becomes an insured under this Coverage Part,the following additional exclusions apply: (a)To any"occurrence" which takes place after the equipment lease expires; or (b)To"bodily injury" or"property damage" arising out of the sole negligence of the lessor. (4) When owners or other interests from whom land has been leased become an insured under this Coverage Part, the following additional exclusions apply: (a) Any"occurrence" which takes place after you cease to lease that land; or (b) Structural alterations, new construction or demolition operations performed by or on behalf of the owners or other interests from whom land has been leased. g. Broad Form Vendors -Any person or organization with whom you agreed, because of a written contract or agreement to provide insurance, 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, subject to the following additional exclusions. (1) The insurance afforded the vendor 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 / testing or substitution of parts under instructions from the manufact' Risk ManagementD[visinn repackaged in the original container; ii REVIEIVEQ 6i ApPROV®SY: PI-GLD-VS (05/17) '1' A.g:SAuvula Page 4 of 9 ® Risk Management Specialist Includes copyrighted material of Insurance Services Office, Inc., with its p,/ Philadelphia Indemnity Insurance Company PI-GLD-VS (05/17) (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 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. (2) This provision 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. (3) This provision does not apply to any vendor included as an insured by an endorsement issued by us and made a part of this Coverage Part. (4) This provision does not apply if"bodily injury" or"property damage" included within the "products-completed operations hazard" is excluded either by the provisions of the Coverage Part or by endorsement. H. Per Campus—General Aggregate SECTION III—LIMITS OF INSURANCE is amended to include the following provisions: 1. For all sums which the insured becomes legally obligated to pay as damages caused by "occurrences" under SECTION I—COVERAGE, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, and for all medical expenses caused by accidents under SECTION I—COVERAGE, COVERAGE C MEDICAL PAYMENTS which can be attributed only to operations at a single designated"campus" shown in the Declarations: a. A separate Per Campus General Aggregate Limit is applicable to each single designated "campus" shown in the Declarations and that limit is equal to the amount of the General Aggregate Limit shown in the Declarations. b. The Per Campus General Aggregate Limit is the most we will pay for the sum of all damages under COVERAGE A, except damages because of"bodily injury" or"property damage" included in the"products-completed operations hazard," and for medical expenses under COVERAGE C regardless of the number of: (1) Insureds; (2) Claims made or"suits" brought; or (3) Persons or organizations making claims or bringing "suits." c. Any payments made under COVERAGE A for damages or under COVERAGE C for medical expenses shall reduce the Per Campus General Aggregate Limit for that designated "campus." Such payments shall not reduce the General Aggregate Limit shown in the Declarations nor shall they reduce any other Per Campus General Aggregate Limit for any other designated "campus" shown in the Declarations. d. The limits shown in the Declarations for Each Occurrence, Fire Damage and Medical Expense continue to apply. However, instead of being subject to the General Aggregate Limit shown in the Declarations, such limits will be subject to the applicable Per Campus General Aggregate Limit. / os e�.ti,r Risk Management Division j c.," REVIEWED&APPROVED BY: PI-GLD-VS (05/17) A Acwk�a Page 5 of 9 Risk Management Specialist Includes copyrighted material of Insurance Services Office, Inc., with its p/ Philadelphia Indemnity Insurance Company PI-GLD-VS (05/17) 2. For all sums which the insured becomes legally obligated to pay as damages caused by "occurrences" under SECTION I—COVERAGE, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABIITY, and for all medical expenses caused by accidents under SECTION I—COVERAGE, COVERAGE C MEDICAL PAYMENTS which cannot be attributed only to operations at a single designated "campus" shown in the Declarations: a. Any payments made under COVERAGE A for damages or under COVERAGE C for medical expenses shall reduce the amount available under the General Aggregate Limit or the Products-Completed Operations Aggregate Limit, whichever is applicable; and b. Such payments shall not reduce any separate designated "campus" General Aggregate Limit. 3. When coverage for liability arising out of the"products-completed operations hazard" is provided, any payment for damages because of"bodily injury" or"property damage" included in the "products-completed operations hazard"will reduce the Products-Completed Operations Aggregate Limit, and not reduce the General Aggregate Limit nor the Per Campus General Aggregate Limit. 4. SECTION V—DEFINITIONS is amended by adding the following: "Campus" is defined as premises involving the same or connecting lots, or premises whose connection is interrupted only by a street, roadway, waterway or right-of-way of a railroad. 5. The provisions of SECTION III—LIMITS OF INSURANCE not otherwise modified by the above shall continue to apply as stipulated. I. Duties in the Event of Occurrence, Claim or Suit 1. The requirement in Paragraph 2.a. of SECTION IV-COMMERCIAL GENERAL LIABILITY CONDITIONS that you must see to it that we are notified as soon as practicable of an"occurrence" or an offense, applies only when the"occurrence" or offense is known to: a. You, if you are an individual; b.A partner, if you are a partnership; or c. An executive officer or insurance manager, if you are a corporation. 2. The requirement in Paragraph 2.b. of SECTION IV—COMMERCIAL GENERAL LIABILITY CONDITIONS that you must see to it that we receive notice of a claim or"suit" as soon as practicable will not be considered breached unless the breach occurs after such claim or"suit" is known to: a. You, if you are an individual; b. A partner, if you are a partnership; or c. An executive officer or insurance manager, if you are a corporation. J. Other Insurance—Primary Additional Insured 1. If the written contract or agreement or permit requires this insurance to be primary for any person or organization with whom you agree to include in SECTION II -WHO IS AN INSURED, then SECTION IV—COMMERCIAL GENERAL LIABILITY CONDITIONS, Subsection 4. Other Insurance is replaced by the following: If other valid and collectible insurance is available for a loss we cover under COVERAGE A of this Coverage Part, our obligations are limited as follows: nn�--''__ Division f„onANRs 1��Division a. Primary Insurance-This insurance is primary. We will not seek contributio =' REVIEWED&APPROVED ar PI-GLD-VS (05/17) A Acw�a Page 6 of 9 Risk Management Specialist Includes copyrighted material of Insurance Services Office, Inc., with its p,/ Philadelphia Indemnity Insurance Company PI-GLD-VS (05/17) insurance available to the person or organization with whom you agree to include in SECTION II -WHO IS AN INSURED, except when 2. below applies. b. Excess Insurance-This insurance is excess over any of the other insurance whether primary, excess, contingent or any other basis: (1)That is Fire, Extended Coverage, Builder's Risk, Installation Risk or similar coverage for "your work"; (2)That is Fire, lightning or explosion insurance for premises rented to you; or temporarily occupied by you with permission of the owner; or (3) If the loss arises out of the maintenance or use of aircraft, "autos" or watercraft to the extent not subject to SECTION I—COVERAGE, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, Subsection 2. Exclusions, Paragraph g. When this insurance is excess, we will have no duty under Coverages A or B to defend any claim or"suit"that any other insurer has a duty to defend. 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. 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 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 or the other insurance does not permit contribution by equal shares, we will contribute by limits. Under this method, each insurer's contribution is based on the ratio of its applicable limits of insurance of all insurers. 2. This provision only applies with respect to your operations, "your work" or facilities owned or used by you. K. Other Insurance—You Are An Additional Insured On Another Person's Or Organization's Policy If you are an insured under SECTION II -WHO IS AN INSURED, then SECTION IV—COMMERCIAL GENERAL LIABILITY CONDITIONS, Subsection 4. OTHER INSURANCE, Paragraph b. Excess Insurance is replaced by the following: This insurance is excess over any other insurance, whether primary, excess, contingent or on any other basis: 1. That is Fire, Extended Coverage, Builders Risk, Installation Risk or similar coverage for"your work"; 2. That is Fire, lightning or explosion insurance for premises rented to you or temp you with permission of the owner; Risk MwttgmnmtDivision paitF /' REVIEWED&APPROVED BY: PI-GLD-VS (05/17) A :e AG€41 do Page 7 of 9 Risk Management Specialist Includes copyrighted material of Insurance Services Office, Inc., with its p,/ Philadelphia Indemnity Insurance Company PI-GLD-VS (05/17) 3. If the loss arises out of the maintenance or use of aircraft, "autos" or watercraft to the extent not subject to SECTION I—COVERAGE, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, Subsection 2. Exclusions, Paragraph g.; or 4. When any of the Named Insureds, under this Coverage Part, are additional insureds under a commercial general liability policy or similar insurance of another party. When this insurance is excess, we will have no duty under Coverages A or B to defend any claim or "suit" that any other insurer has a duty to defend. 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 insureds. When this insurance is excess or 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. L. Unintentional Failure To Disclose Hazards It is agreed that, based on our reliance on your representations as to existing hazards, if you should unintentionally fail to disclose all such hazards prior to the beginning of the policy period of this Coverage Part, we shall not deny coverage under this Coverage Part because of such failure. M. Liberalization If we revise this endorsement to provide more coverage without additional premium charge, we will automatically provide the additional coverage to all endorsement holders as of the day the revision is effective in your state. N. Bodily Injury - Mental Anguish SECTION V—DEFINITIONS, Paragraph 3. is changed to read: "Bodily Injury": a. Means bodily injury, sickness or disease sustained by a person, and includes mental anguish resulting from any of these; and b. Except for mental anguish, includes death resulting from the foregoing (item a. above)at any time. O. Personal and Advertising Injury—Abuse of Process. Discrimination If COVERAGE B PERSONAL AND ADVERTISING INJURY LIABILITY COVERAGE is not otherwise excluded from this Coverage Part, the definition of"personal and advertising injury" is amended as follows: 1. SECTION V—DEFINITIONS, Paragraph 14. b. is revised to read: b. Malicious prosecution or abuse of process: 2. SECTION V—DEFINITIONS, Paragraph 14. is amended to include the followi o�,ti a Risk MRnag nentD(visian st REVIEVIED&APPROVED BY: PI-GLD-VS (05/17) l ca Awe Acevedo Page 8 of 9 • Risk Management Specialist Includes copyrighted material of Insurance Services Office, Inc., with its p,/ Philadelphia Indemnity Insurance Company PI-GLD-VS (05/17) "Personal Injury" also means discrimination based on race, color, religion, sex, age or national origin, except when: a. Done intentionally by or at the direction of, or with the knowledge or consent of: (1)Any insured; or (2)Any executive officer, director, stockholder, partner or member of the insured; or b. Directly or indirectly related to the employment, former or prospective employment, termination of employment, or application for employment of any person or persons by an insured; or c. Directly or indirectly related to the sale, rental, lease or sublease or prospective sales, rental, lease or sub-lease of any room, dwelling or premises by or at the direction of any insured; or d. Insurance for such discrimination is prohibited by or held in violation of law, public policy, legislation, court decision or administrative ruling. The above does not apply to fines or penalties imposed because of discrimination. P. Transfer of Rights of Recovery Against Others To Us As a clarification, the following is added to SECTION IV—COMMERCIAL GENERAL LIABILITY CONDITIONS, Subsection 8. Transfer of Rights of Recovery Against Others To Us: Therefore, the insured can waive the insurer's Rights of Recovery prior to the occurrence of a loss, provided the waiver is made in a written contract. Q. Science Laboratory "Occurrence" SECTION I—COVERAGE, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, Subsection 2. Exclusions, Paragraph f. does not apply to any"bodily injury" or"physical damage" arising out of a fire or"occurrence" in any of your science laboratories while teaching is being conducted in that laboratory, subject to a $50,000 per policy limit. R. Medical Incident Liability-Nurse and Athletic Trainer 1. SECTION II —WHO IS AN INSURED, Subparagraph 2.a. (1) (d) is deleted and replaced by the following: (d)Arising out of his or her providing or failing to provide professional medical services. This paragraph does not apply to a registered or practical nurse or athletic trainer, while acting within the scope of his or her duties for the Named Insured and arising out of a"medical incident". 2. SECTION V—DEFINITIONS, 13. is deleted and replaced by the following: "Occurrence" means an accident, including continuous or repeated exposure to substantially the same general harmful conditions, and "medical incident". 3. The following definition is added to SECTION V—DEFINITIONS: "Medical Incident" means any act or omission in the furnishing or failure to furnish professional medical services by the insured or any person acting under the personal direction, control, or supervision of the insured. Any such act or omission together with all related acts or omissions in the furnishing of such services to any one person shall be considered one"medical incident". "Medical incident"does not include any actual, alleged or threatened emotional, physical, or sexual abuse of any patient or professional medical services recipient. J ate. f Riak Management Division. REVIEWED&APPROVED By: PI-GLD-VS (05/17) od o' A A oat, Page 9 of 9 Risk Management Specialist Includes copyrighted material of Insurance Services Office, Inc., with its p,/ POLICY NUMBER: PHPK2645846 COMMERCIAL GENERAL LIABILITY CG 20 10 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Location(s) Of Covered Operations a t y of Sant a Ana, i t s off i cer s, agent s and errpl oyees Information required to complete this Schedule, if not shown above,will be shown in the Declarations. A. Section II — Who Is An Insured is amended to B. With respect to the insurance afforded to these include as an additional insured the person(s) or additional insureds, the following additional organization(s) shown in the Schedule, but only exclusions apply: with respect to liability for "bodily injury", "property This insurance does not apply "bodily damage" or "personal and advertising injury" pp y to injury" or "property damage"occurring after: caused, in whole or in part, by: 1. All work, including materials, parts or 1. Your acts or omissions; or equipment furnished in connection with such 2. The acts or omissions of those acting on your work, on the project (other than service, behalf; maintenance or repairs) to be performed by or in the performance of your ongoing operations for on behalf of the additional insured(s) at the the additional insured(s) at the location(s) location of the covered operations has been designated above. completed; or However: 2. That portion of "your work" out of which the 1. The insurance afforded to such additional injury or damage arises has been put to its intended use by any person or organization insured only applies to the extent permitted by other than another contractor or subcontractor law; and engaged in performing operations for a 2. If coverage provided to the additional insured is principal as a part of the same project. required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. Risk Management Division fREVIEWED&APPROVED BY:� Aavek ® Risk Management Specialist CG 20 10 04 13 ©Insurance Services Office, Inc., 2012 Page 1 of 2 C. With respect to the insurance afforded to these 2. Available under the applicable Limits of additional insureds, the following is added to Insurance shown in the Declarations; Section III —Limits Of Insurance: whichever is less. If coverage provided to the additional insured is This endorsement shall not increase the required by a contract or agreement, the most we applicable Limits of Insurance shown in the will pay on behalf of the additional insured is the Declarations. amount of insurance: 1. Required by the contract or agreement; or Risk Management Division i` RENnEwED&APPROVED BY: �htoll f�.' A Auv44 112MMENI Risk Management Specialist Page 2 of 2 © Insurance Services Office, Inc., 2012 CG 20 10 04 13 PI-GL-005 (07/12) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED PRIMARY AND NON-CONTRIBUTORY INSURANCE This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Effective Date: 01/27/2024 Name of Person or Organization (Additional Insured): City of Santa Ana, its officers, agents and employees SECTION II—WHO IS AN INSURED is amended to include as an additional insured the person(s) or organization(s) shown in the endorsement Schedule, but only with respect to liability for"bodily injury," "property damage"or"personal and advertising injury" arising out of or relating to your negligence in the performance of"your work"for such person(s)or organization(s) that occurs on or after the effective date shown in the endorsement Schedule. This insurance is primary to and non-contributory with any other insurance maintained by the person or organization (Additional Insured), except for loss resulting from the sole negligence of that person or organization. This condition applies even if other valid and collectible insurance is available to the Additional Insured for a loss or"occurrence"we cover for this Additional Insured. The Additional Insured's limits of insurance do not increase our limits of insurance, as described in SECTION III—LIMITS OF INSURANCE. All other terms, conditions, and exclusions under the policy are applicable to this endorsement and remain unchanged. Risk%augementDivision �.: REVIEWED&APPROVED BY: Page 2 of 6 A4,p AcwuLo iEEIZEMEIA Includes copyrighted material of Insurance Services Office, Inc., with its p Risk Management specialist POLICY NUMBER: PHPK2645846 COMMERCIAL GENERAL LIABILITY CG 24 04 05 09 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Person Or Organization: G t y of Sant a Ana, i t s off i cer s, agent s and errpl oyees Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV—Conditions: We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the "products- completed operations hazard". This waiver applies only to the person or organization shown in the Schedule above. Risk ManagementDivisiun REVIEWED&APPROVE By: .. Aov Risk Management Specialist f CG 24 04 05 09 ©Insurance Services Office, Inc., 2008 Page 1 of 1 0 Philadelphia Indemnity Insurance Company PI-GLD-VS (05/17) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. GENERAL LIABILITY DELUXE ENDORSEMENT SCHOOLS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE It is understood and agreed that the following extensions only apply in the event that no other specific coverage for the indicated loss exposure is provided under this policy. If such specific coverage applies, the terms, conditions and limits of that coverage are the sole and exclusive coverage applicable under this policy, unless otherwise noted on this endorsement. The following is a summary of the Limits of Insurance and additional coverages provided by this endorsement. For complete details on specific coverages, consult the policy contract wording. Coverage Applicable Limit of Insurance Page# Damage to Premises Rented to You $300,000 2 Extended Property Damage included 2 Non-Owned Watercraft Less than 58 feet 2 Supplementary Payments—Bail Bonds $2,500 2 Supplementary Payment—Loss of Earnings $500 per day 2 Medical Payments $15,000 3 Medical Payments—Extended Reporting Period 3 years 3 Employee Indemnification Defense Coverage for Employee $25,000 3 Additional Insured—Medical Directors and Administrators Included 3 Additional Insured—Managers and Supervisors Included 3 Additional Insured—Broadened Named Insured Included 3 Additional Insured—Funding Source Included 3 Additional Insured—Managers or Lessors of Premises Included 4 Additional Insured—By Contract,Agreement or Permit Included 4 Additional Insured—Broad Form Vendors Included 4 General Aggregate—Per Campus Included 5 Duties in the Event of Occurrence, Claim or Suit Included 6 Other Insurance—Primary Additional Insured Included 6 Other Insurance—You Are An Additional Insured On Included 7 Another Person's Or Organization's Policy Unintentional Failure to Disclose Hazards Included 8 Liberalization Included 8 Bodily Injury—includes Mental Anguish Included 8 Personal and Advertising Injury—includes Abuse of Included 8 Process, Discrimination Transfer of Rights of Recovery Against Others To Us Clarification 9 Science Laboratory"Occurrence" $50,000 9 Medical Incident Liability—Nurse and Athletic Trainer Included \ f ou,N,^1.HCF Risk Management Division = REVIEWED&APPROVED BY: PI-GLD-VS (05/17) , A o A Auvda ® Page e 1 of 9 Risk Management Specialist Includes copyrighted material of Insurance Services Office, Inc., with its p/ `` Philadelphia Indemnity Insurance Company PI-GLD-VS(05/17) A. Damage to Premises Rented to You 1. If damage by fire to premises rented to you is not otherwise excluded from this Coverage Part, the word "fire" is changed to"fire, lightning, explosion, smoke, or leakage from automatic fire protective systems"where it appears in: a. The last paragraph of SECTION I—COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, Subsection 2. Exclusions; b. SECTION III - LIMITS OF INSURANCE, Paragraph 6.; c. SECTION V—DEFINITIONS, Paragraph 9.a. 2. If damage by fire to premises rented to you is not otherwise excluded from this Coverage Part, the words"Fire insurance" are changed to"insurance for fire, lightning, explosion, smoke, or leakage from automatic fire protective systems"where it appears in: a. SECTION IV- COMMERCIAL GENERAL LIABILITY CONDITIONS, Subsection 4. Other Insurance, Paragraph b. Excess Insurance 3. The Damage To Premises Rented To You Limit section of the Declarations is amended to the greater of: a. $300,000; or b. The amount shown in the Declarations as the Damage to Premises Rented to You Limit. This is the most we will pay for all damage proximately caused by the same event, whether such damage results from fire, lightning, explosion, smoke, or leaks from automatic fire protective systems or any combination thereof. B. Extended "Property Damage" SECTION I -COVERAGES. COVERAGE A, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, Subsection 2. Exclusions, Paragraph a. is deleted and replaced by the following: 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" or"property damage" resulting from the use of reasonable force to protect persons or property. C. Non-Owned Watercraft SECTION I —COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, Subsection 2. Exclusions, Paragraph g. (2) is amended to read as follows: (2) A watercraft you do not own that is: (a) Less than 58 feet long; and (b) Not being used to carry persons or property for a charge; This provision applies to any person, who with your consent, either uses or is responsible for the use of a watercraft. This insurance is excess over any other valid and collectible insurance available to the insured whether primary, excess or contingent. D. Supplementary Payments / Risk Ms agemerttDivisian Under the SUPPLEMENTARY PAYMENTS-COVERAGE A AND B provision, I ,? ID REVIEWEQ&APPROVED 8Y: PI GLD VS (05/17) �`' A Aa'a. Page 2 of 9 Risk Management Specialist Includes copyrighted material of Insurance Services Office, Inc., with its p/ Philadelphia Indemnity Insurance Company PI-GLD-VS (05/17) are amended as follows: 1. The limit for the cost of bail bonds is changed from $250 to$2,500; and 2. The limit for loss of earnings is changed from $250 a day to$500 a day. E. Medical Payments -Limit Increased to $15,000, Extended Reporting Period If COVERAGE C MEDICAL PAYMENTS is not otherwise excluded from this Coverage Part: 1. The Medical Expense Limit is changed subject to all of the terms of SECTION III- LIMITS OF INSURANCE to the greater of: a. $15,000; or b. The Medical Expense Limit shown in the Declarations of this Coverage Part. 2. SECTION I—COVERAGE, COVERAGE C MEDICAL PAYMENTS, Subsection 1. Insuring Agreement, the second part of Paragraph a. is amended to read: provided that: (2) The expenses are incurred and reported to us within three years of the date of the accident; F. Employee Indemnification Defense Coverage Under the SUPPLEMENTARY PAYMENTS -COVERAGES A AND B provision, the following is added: 3. We will pay, on your behalf, defense costs incurred by an "employee" in a criminal proceeding. The most we will pay for any"employee"who is alleged to be directly involved in a criminal proceeding is $25,000 regardless of the numbers of"employees", claims or"suits" brought or persons or organizations making claims or bringing "suits". G. SECTION II -WHO IS AN INSURED is amended as follows: 1. If coverage for newly acquired or formed organizations is not otherwise excluded from this Coverage Part, Paragraph 3.a. is changed to read: a. Coverage under this provision is afforded until the end of the policy period. 2. Each of the following is also an insured: a. Medical Directors and Administrators -Your medical directors and administrators, but only while acting within the scope of and during the course of their duties as such. b. Managers and Supervisors - If you are an organization other than a partnership or joint venture, your managers and supervisors are also insureds, but only with respect to their duties as your managers and supervisors. c. Broadened Named Insured -Any organization and subsidiary thereof which you control and actively manage on the effective date of this Coverage Part. However, coverage does not apply to any organization or subsidiary not named in the Declarations as Named Insured, if they are also insured under another similar policy, but for its termination or the exhaustion of its limits of insurance. d. FundingSource-Anyperson or organization with respect to their liability 9 p Y; x;akMarugemenEDtvi9ton (1)Their financial control of you; or q,. ; REVIEWED&APPROVED BY: PI-GLD-VS (05/17) 9 L' '=' A Aaved. Page 3 of 9 Risk Management Specialist Includes copyrighted material of Insurance Services Office, Inc., with its p,/ Philadelphia Indemnity Insurance Company PI-GLD-VS (05/17) (2) Premises they own, maintain or control while you lease or occupy these premises. This insurance does not apply to structural alterations, new construction and demolition operations performed by or for that person or organization. e. Managers or Lessors of Premises -Any person or organization with respect to their liability arising out of the ownership, maintenance or use of that part of the premises leased to you subject to the following additional exclusions: This insurance does not apply to: (1) Any"occurrence"which takes place after you cease to be a tenant in that premises. (2) Structural alterations, new construction or demolition operations performed by or on behalf of that person or organization. f. By Contract, Agreement or Permit -Any person or organization with whom you agreed, because of a written contract or agreement or permit, to provide insurance such as is afforded under this policy, but only with respect to your operations, "your work"or facilities owned or used by you. (1) This provision does not apply: (a) Unless the written contract or agreement has been executed or permit has been issued prior to the"bodily injury,""property damage,""personal and advertising injury": (b) To any person or organization included as an insured under g. Broad Form Vendors below; or (c) To any person or organization included as an insured by an endorsement issued by us and made a part of this Coverage Part. (2) When an engineer, architect or surveyor becomes an insured under this Coverage Part, the following additional exclusion applies: (a) "Bodily injury", "property damage", "personal and advertising injury"arising out of the rendering of or the failure to render any professional services by or for you, including: (i) The preparing, approving, or failing to approve maps, drawings, opinions, reports, surveys, change orders, designs or specifications; and (ii) Supervisory, inspection, or engineering services. (3) When a lessor of leased equipment becomes an insured under this Coverage Part,the following additional exclusions apply: (a) To any"occurrence"which takes place after the equipment lease expires; or (b) To"bodily injury" or"property damage" arising out of the sole negligence of the lessor. (4) When owners or other interests from whom land has been leased become an insured under this Coverage Part, the following additional exclusions apply: (a) Any"occurrence"which takes place after you cease to lease that land; or (b) Structural alterations, new construction or demolition operations performed by or on behalf of the owners or other interests from whom land has been leased. g. Broad Form Vendors -Any person or organization with whom you agreed, because of a written contract or agreement to provide insurance, 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, subject to the following additional exclusions. (1) The insurance afforded the vendor 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' testing or substitution of parts under instructions from the manufact; _ Risk MRnag tttDivision repackaged in the original container; :�� ®REVIEWED&APPROV8Y: ,, PI-GLD-VS (05/17) t�l�l1A �cwtsdo Page 4 of 9 ® Risk Management Specialist Includes copyrighted material of Insurance Services Office, Inc., with its pl✓ Philadelphia Indemnity Insurance Company PI-GLD-VS (05/17) (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 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. (2) This provision 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. (3) This provision does not apply to any vendor included as an insured by an endorsement issued by us and made a part of this Coverage Part. (4) This provision does not apply if"bodily injury" or"property damage" included within the "products-completed operations hazard" is excluded either by the provisions of the Coverage Part or by endorsement. H. Per Campus —General Aggregate SECTION III —LIMITS OF INSURANCE is amended to include the following provisions: 1. For all sums which the insured becomes legally obligated to pay as damages caused by "occurrences" under SECTION I—COVERAGE, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, and for all medical expenses caused by accidents under SECTION I —COVERAGE, COVERAGE C MEDICAL PAYMENTS which can be attributed only to operations at a single designated"campus" shown in the Declarations: a. A separate Per Campus General Aggregate Limit is applicable to each single designated "campus" shown in the Declarations and that limit is equal to the amount of the General Aggregate Limit shown in the Declarations. b. The Per Campus General Aggregate Limit is the most we will pay for the sum of all damages under COVERAGE A, except damages because of"bodily injury" or"property damage" included in the"products-completed operations hazard," and for medical expenses under COVERAGE C regardless of the number of: (1) Insureds; (2) Claims made or"suits" brought; or (3) Persons or organizations making claims or bringing "suits." c. Any payments made under COVERAGE A for damages or under COVERAGE C for medical expenses shall reduce the Per Campus General Aggregate Limit for that designated "campus." Such payments shall not reduce the General Aggregate Limit shown in the Declarations nor shall they reduce any other Per Campus General Aggregate Limit for any other designated"campus" shown in the Declarations. d. The limits shown in the Declarations for Each Occurrence, Fire Damage and Medical Expense continue to apply. However, instead of being subject to the General Aggregate Limit shown in the Declarations, such limits will be subject to the applicable Per Campus General Aggregate Limit. Risk Manage nentDivision fli REVIEWED&APPROVED BY: PI-GLD-VS (05/17) A+�:4A1wu(a Page 5 of 9 �4- Risk Management Specialist Includes copyrighted material of Insurance Services Office, Inc., with its p/ Philadelphia Indemnity Insurance Company PI-GLD-VS (05/17) 2. For all sums which the insured becomes legally obligated to pay as damages caused by "occurrences" under SECTION I—COVERAGE, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABIITY, and for all medical expenses caused by accidents under SECTION I—COVERAGE, COVERAGE C MEDICAL PAYMENTS which cannot be attributed only to operations at a single designated "campus" shown in the Declarations: a. Any payments made under COVERAGE A for damages or under COVERAGE C for medical expenses shall reduce the amount available under the General Aggregate Limit or the Products-Completed Operations Aggregate Limit, whichever is applicable; and b. Such payments shall not reduce any separate designated "campus" General Aggregate Limit. 3. When coverage for liability arising out of the"products-completed operations hazard" is provided, any payment for damages because of"bodily injury" or"property damage" included in the "products-completed operations hazard"will reduce the Products-Completed Operations Aggregate Limit, and not reduce the General Aggregate Limit nor the Per Campus General Aggregate Limit. 4. SECTION V—DEFINITIONS is amended by adding the following: "Campus" is defined as premises involving the same or connecting lots, or premises whose connection is interrupted only by a street, roadway, waterway or right-of-way of a railroad. 5. The provisions of SECTION III—LIMITS OF INSURANCE not otherwise modified by the above shall continue to apply as stipulated. I. Duties in the Event of Occurrence, Claim or Suit 1. The requirement in Paragraph 2.a. of SECTION IV-COMMERCIAL GENERAL LIABILITY CONDITIONS that you must see to it that we are notified as soon as practicable of an "occurrence" or an offense, applies only when the"occurrence" or offense is known to: a. You, if you are an individual; b.A partner, if you are a partnership; or c.An executive officer or insurance manager, if you are a corporation. 2. The requirement in Paragraph 2.b. of SECTION IV—COMMERCIAL GENERAL LIABILITY CONDITIONS that you must see to it that we receive notice of a claim or"suit" as soon as practicable will not be considered breached unless the breach occurs after such claim or"suit" is known to: a. You, if you are an individual; b. A partner, if you are a partnership; or c. An executive officer or insurance manager, if you are a corporation. J. Other Insurance—Primary Additional Insured 1. If the written contract or agreement or permit requires this insurance to be primary for any person or organization with whom you agree to include in SECTION II -WHO IS AN INSURED, then SECTION IV—COMMERCIAL GENERAL LIABILITY CONDITIONS, Subsection 4. Other Insurance is replaced by the following: If other valid and collectible insurance is available for a loss we cover under COVERAGE A of this Coverage Part, our obligations are limited as follows: / o a.oR, f Risk MranagemcntDivision a. Primary Insurance-This insurance is primary. We will not seek contnbutio i;` REVIEWED&APPROVED BY: PI-GLD-VS (05/17) A Acwtda Page 6 of 9 --- , Risk Management Specialist Includes copyrighted material of Insurance Services Office, Inc., with its pa/ Philadelphia Indemnity Insurance Company PI-GLD-VS (05/17) insurance available to the person or organization with whom you agree to include in SECTION II -WHO IS AN INSURED, except when 2. below applies. b. Excess Insurance-This insurance is excess over any of the other insurance whether primary, excess, contingent or any other basis: (1)That is Fire, Extended Coverage, Builder's Risk, Installation Risk or similar coverage for "your work"; (2) That is Fire, lightning or explosion insurance for premises rented to you; or temporarily occupied by you with permission of the owner; or (3) If the loss arises out of the maintenance or use of aircraft, "autos" or watercraft to the extent not subject to SECTION I—COVERAGE, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, Subsection 2. Exclusions, Paragraph g. When this insurance is excess, we will have no duty under Coverages A or B to defend any claim or"suit"that any other insurer has a duty to defend. 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. 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 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 or the other insurance does not permit contribution by equal shares, we will contribute by limits. Under this method, each insurer's contribution is based on the ratio of its applicable limits of insurance of all insurers. 2. This provision only applies with respect to your operations, "your work" or facilities owned or used by you. K. Other Insurance—You Are An Additional Insured On Another Person's Or Organization's Policy If you are an insured under SECTION II -WHO IS AN INSURED,then SECTION IV—COMMERCIAL GENERAL LIABILITY CONDITIONS, Subsection 4. OTHER INSURANCE, Paragraph b. Excess Insurance is replaced by the following: This insurance is excess over any other insurance, whether primary, excess, contingent or on any other basis: 1. That is Fire, Extended Coverage, Builders Risk, Installation Risk or similar coverage for"your work"; 2. That is Fire, lightning or explosion insurance for premises rented to you or tem:\----' you with permission of the owner; Risk MntuagemattDivision REVIEWED&APPROVED 8Y: PI-GLD-VS (05/17) u�� rn'' A Aewtdo Page 7 of 9 Risk Management Specialist Includes copyrighted material of Insurance Services Office, Inc., with its p./ Philadelphia Indemnity Insurance Company PI-GLD-VS (05/17) 3. If the loss arises out of the maintenance or use of aircraft, "autos" or watercraft to the extent not subject to SECTION I —COVERAGE, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, Subsection 2. Exclusions, Paragraph g.; or 4. When any of the Named Insureds, under this Coverage Part, are additional insureds under a commercial general liability policy or similar insurance of another party. When this insurance is excess, we will have no duty under Coverages A or B to defend any claim or "suit"that any other insurer has a duty to defend. 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 insureds. When this insurance is excess or 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. L. Unintentional Failure To Disclose Hazards It is agreed that, based on our reliance on your representations as to existing hazards, if you should unintentionally fail to disclose all such hazards prior to the beginning of the policy period of this Coverage Part, we shall not deny coverage under this Coverage Part because of such failure. M. Liberalization If we revise this endorsement to provide more coverage without additional premium charge, we will automatically provide the additional coverage to all endorsement holders as of the day the revision is effective in your state. N. Bodily Iniury - Mental Anguish SECTION V—DEFINITIONS, Paragraph 3. is changed to read: "Bodily Injury": a. Means bodily injury, sickness or disease sustained by a person, and includes mental anguish resulting from any of these; and b. Except for mental anguish, includes death resulting from the foregoing (item a. above) at any time. O. Personal and Advertising Injury —Abuse of Process, Discrimination If COVERAGE B PERSONAL AND ADVERTISING INJURY LIABILITY COVERAGE is not otherwise excluded from this Coverage Part, the definition of"personal and advertising injury" is amended as follows: 1. SECTION V—DEFINITIONS, Paragraph 14. b. is revised to read: b. Malicious prosecution or abuse of process: 2. SECTION V—DEFINITIONS, Paragraph 14. is amended to include the followi\ Risk Management Division re& REVIEWED&APPROVED 8Y: PI-GLD-VS (05/17) y, AAaw Page 8 of 9 Risk Management Specialist Includes copyrighted material of Insurance Services Office, Inc., with its p,/ Philadelphia Indemnity Insurance Company PI-GLD-VS (05/17) "Personal Injury" also means discrimination based on race, color, religion, sex, age or national origin, except when: a. Done intentionally by or at the direction of, or with the knowledge or consent of: (1)Any insured; or (2)Any executive officer, director, stockholder, partner or member of the insured; or b. Directly or indirectly related to the employment, former or prospective employment, termination of employment, or application for employment of any person or persons by an insured; or c. Directly or indirectly related to the sale, rental, lease or sublease or prospective sales, rental, lease or sub-lease of any room, dwelling or premises by or at the direction of any insured; or d. Insurance for such discrimination is prohibited by or held in violation of law, public policy, legislation, court decision or administrative ruling. The above does not apply to fines or penalties imposed because of discrimination. P. Transfer of Rights of Recovery Against Others To Us As a clarification, the following is added to SECTION IV—COMMERCIAL GENERAL LIABILITY CONDITIONS, Subsection 8. Transfer of Rights of Recovery Against Others To Us: Therefore, the insured can waive the insurer's Rights of Recovery prior to the occurrence of a loss, provided the waiver is made in a written contract. Q. Science Laboratory "Occurrence" SECTION I—COVERAGE, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, Subsection 2. Exclusions, Paragraph f. does not apply to any"bodily injury" or"physical damage" arising out of a fire or"occurrence" in any of your science laboratories while teaching is being conducted in that laboratory, subject to a$50,000 per policy limit. R. Medical Incident Liability-Nurse and Athletic Trainer 1. SECTION II—WHO IS AN INSURED, Subparagraph 2.a. (1) (d) is deleted and replaced by the following: (d)Arising out of his or her providing or failing to provide professional medical services. This paragraph does not apply to a registered or practical nurse or athletic trainer, while acting within the scope of his or her duties for the Named Insured and arising out of a"medical incident". 2. SECTION V—DEFINITIONS, 13. is deleted and replaced by the following: "Occurrence" means an accident, including continuous or repeated exposure to substantially the same general harmful conditions, and"medical incident". 3. The following definition is added to SECTION V—DEFINITIONS: "Medical Incident" means any act or omission in the furnishing or failure to furnish professional medical services by the insured or any person acting under the personal direction, control, or supervision of the insured. Any such act or omission together with all related acts or omissions in the furnishing of such services to any one person shall be considered one"medical incident". "Medical incident" does not include any actual, alleged or threatened emotional, physical, or sexual abuse of any patient or professional medical services recipient. r —yes Risk Management Division REVIEWED&APPROVED BY: PI-GLD-VS (05/17) AAaaa. Page 9 of 9 �- Risk Management Specialist Includes copyrighted material of Insurance Services Office, Inc., with its p,✓ THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT - CALIFORNIA Policy Number: 45 WEC AV7H87 Endorsement Number: Effective Date: 01/27/24 Effective hour is the same as stated on the Information Page of the policy. Named Insured and Address: The Jay Particle, LLC 3501 W MOORE AVE STE J SANTA ANA CA 92704 We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. The additional premium for this endorsement shall be 2 % of the California workers' compensation premium otherwise due on such remuneration. SCHEDULE Person or Organization Job Description Any person or organization for whom you are required by written contract or agreement to obtain this waiver of rights from us Risk Management Divistvn Countersigned by REVIEWED&APPROVED BY: '' ,y tIu ` A Auu d. Risk Management Specialist Form WC 04 03 06 (1) Printed in U.S.A. Process Date: 12/18/23 Policy Expiration Date: 01/27/25