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DOWNEY VENDORS INC 2A
City of Santa Ana Clerk of the Council S AGREEMENT TERMINATION 05 Please complete this form when the attached agreement is no longer in effect. Return form to the Clerk of the Council Office (M -30). Call 647 -6520 if you have any questions. ----------------------- _______________--------------- ______ ____________ ____--------------- The agreement with 1 n er! VQs p-� �} No. was completed on 30 -Q d and final payment has been made. W-1009 -697 Department: (/y J 1 N- 2008 - 0 V -001 Phone /Ext.: f Signature: Date: j D Revised 12 -07 -07 INSURANCE ON FILE N-2008A97 WORK MAt PROCEED UNTILlNSURANCE EXPIRES ~-4-oq CLERK OF COUNCIL DATE: ~- 30 -c:>~ FIRST AMENDMENT TO O . LTG (y~ VENDING SERVICES AGREEMENT P"~` Galta~'a~ THIS FIRST AMENDMENT TO AGREEMENT is entered into on June 30, 2008, by and between Downey Vendors, Inc., a California corporation ("Contractor") and the City of Santa Ana, a charter city and municipal corporation organized and existing under the Constitution and laws of the State of California ("City"). RECITALS: A. The parties entered into Agreement/(-2006-106, dated October 24, 2006, (hereinafter "said Agreement") by which Contractor has provided vending services for certain Ciry facilities. B. In accordance with the terms and conditions of said Agreement, the parties wish to increase the sales prices of certain vending items and extend the term of said Agreement for an additional one-year period. WHEREFORE, in consideration of the covenants contained in said Agreement, and subject to all the terms and conditions of said Agreement, except those amended in this First Amendment to Agreement, the parties agree as follows: 1. Pursuant to Section l.c., SCOPE OF SERVICES, Contractor has requested, and received City's approval to increase prices on certain vending items, as set forth in Exhibit A-1, attached to this First Amendment to Agreement. 2. Section 3, TERM, shall be amended to extend the term for an additional one-year period, through June 30, 2009. 3. Except as herein amended, all terms and conditions of said Agreement shall remain in full force and effect. IN WITNESS WHEREOF, the parties hereto have executed this First Amendment to Consultant Agreement on the date and year first written above. ATTEST: CITY OF SANTA ANA ~~ PATRIC[A .HEAL Clerk of the Council DAVID N. RE M City Manager Additional signatures on next page APPROVED AS TO FORM: JOSEPH W.FLETCHER City Attorney By: La a Sheedy Assistant City Attorney DOWNEY VENDORS, INC. A /~a iD ~ (y~7A~Cca2 (Title) ESieN!QC ///cc ~2ESi.-~~ EXHIBIT A-1 VENDING PRICE LIST SCOPE OF SERVICES Contractor shall install, service and maintain vending equipment in City Hall, Library, Police Administration and the City Yard. Maintenance coverage shall be available 24-hours per day, 7 days per week. Periodic inspections by supervisory personnel will insure all vending equipment is being properly maintained and serviced. Contractor shall refund 100% of money lost to customer in vending machines. PRICE LIST SNACKS CANDY $0.75-.85 LARGE CANDY 1.50 BIG GRAB CHIPS, BAKED CHIPS .85 BAG -BIG COOKIES, GRANOLA, NUTS .90 MICROWAVE POPCORN 1.00 PASTRIES 1.25 SANDWICHES 2.50 BURRITOS, TUNA KITS, LUNCH BUCKETS $1.00 - $1.50 ICE CREAM BEVERAGES BOTTLE SODA (20 oz) $1.25 CAN SODA (12 oz) .75 1.00 WATER 50 1 BOTTLE JUICE (] 6 oz) . 30 COFFEE -SMALL 50 LARGE . 50 1 GATORADE BOTTLE (20 oz) . ENERGY DRINK 2,50 Darc lMmlDgYYYY1 g~QBD,~ CERTIFICATE OF LIABILITY INSURANCE o7/za/zoos PROWLER (925)688-0733 FAX (925)688-0737 -. pNLY ANDICONFERS NO RIGHTS UPON THE CERTIFICATEION Westport & Associates Insurance Services, ]:nc. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR i License #0884505 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 1390 Willow Pass Ad. , #930 INSURERS AFFORDING COVERAGE NAIL # Concord, CA 94320-3233 .INSURED Downey Vendors, Inc. /Eagle Vending, Inc. i~u~e. Travelers Indemn Company of CT DBA: aka: Premier Vending Group INSURER C: 6814 Suva Street INSURER D: Be71 Gardens, CA 90201 IIBURER E: J nw,r_ THE POLICIES OF INSURANCE LISTED SELOW HAVE BEEN WSUED TO THE INSURED NAMED A ANY REQUIREMENT, TERMOR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT W RH F MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN Ei SUBJECT POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAI~EFFECTIYE TER TYPE OFINSURANCE POLICY NUMBER GENEIUL LIABILRY 66D1430C7S208 02/09/2008 X COMmERgw GENERAL LIABILRY . q-plrytS MApE a OCIX1R A GEML AGGREGATE LR7R APPLIES PER: POLCY JE~CT LOC AuroMDBItE LuBILm BA3395C09508 :02/09/2008 ANY AU70 '}I-~ „~.. ALL OWNED AUTOS _.. A X scNEnuLED wTas ~\~ X HIRED AUTOS - X NONa`M~ED AUTOS GARAGE QIIBIDTY ' ANY AUTO EXCESSNMBRELU LtABILRY OCWR ~ CLAIMS fAVOE A DEDUCrreIE - X RETENOON b 10,00 VJORKERS COMPENSATON AND ENrLOrees~-uAelurr OVE FORTHE POLICY PERIDV trvulwu ~~~~•~~•^•••~~•°•°°° :SPELT TD WHICH THIS CERTIFICATE MAY BE ISSUED OR 70 ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH LIMBS EARN OCCURRENCE 'S 1,000 OO DAMAGE TO RENTED E 100,00 MEO EXP IArry one Parson) b $ OO PERSONAL dADV DUURY E 1000 DO GENERAL AGGREGATE $ Z pOO,OO PRODUCTS-COMPrUP AGG $ 2,000,00 51NGLE DNR b ~~tl~ 1 OOO,OD BOgLY INJURY E (Per Person) BODILY INJURY E (Per ecdeanU PROPERTY DAMAGE E {Per eorieent) AUTO ONLY-EA ACCDENT 8 DTNER THAN EA ACC E AUTO ONLY: AGG. E EACH OCWRRENCE E S OOO OO AGGREGATE E E 5,000,000 a s I X WC STATU- OTH- EL EACN ACCIDENT f 1,000 000 EL DISEASE-EA EMPLO E 1 000 O00 E.L DViEASE-POLICY LIMB f 1 000,000 tM NOF OPERATIDNEI LOCATNI IVEHICLEb IE%CL SN)N$ADDED BY ENppRSEMENTi BPEGUN.rNOna,una o~ Santa Ana, its officers, employees, agents, representatives & volunteers are na as tional insured as respects to general liability subject to the conditions, limitations itions, limitations and exclsuions of the policy. Davs notice for non-ssayRlent of premium. i City of Santa Ana 20 Civic Center Plaza, N-30 Santa Ana, CA 92702 ACORD 25 (20D1f08) 9NW LO ANY OF TN! ABOVE DESCRIBED POLN:IEE BE CANCELLED BEFORE THE E1D'IRATION DATE THERlOF, THE IESUIN6INEURBR WILL tNq•J,YOR TO MAIL *3O DAYS YJftITTEN NOTLE TO THE CFRTIFIWTE HOLDlR NAMCO TO THE LEFT. BUT FAILURE TO MAIL BUCM NOTICE SHALL WPOSE NO WDOATN)N OR LIABILITY OF AMY xNO UPON TN RER, RS AOEHiE OR REPREEENTATNES. AUTHORD'ED REPRESS ~~ e 1988 IMPORTANT If the cerfificate holder Is an ADDITIONAL INSURED, the policy{ies} must be endorsed. A statement on this cerfificate does not confer rights to the certificate holder in lieu of such erxtorsement(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 endorsemerd(s). DISCLAIMER The Certificate of Insurance qn the reverse side of this form does not constitute a conNact between the issuing insurer(s), authorized representative or producer, and the certificate hoder, nor does it afflrmalively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. ACORD 25 (2007/08) ;. POLICY NUMBER: I-660-3430C.752-TIL-OB_ COMMERCIAL GENERAL. LIABILITY ISSUE DA"fl: o2-i2-o8 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED -- YOUR EQUIPMENT ON THEIR PREMISES This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. SCHEDULE Name of Person or Organization (Additicnal Insured): See certificate for complete description of Additional Insured. (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.} B. PROVISIONS 1. WHO IS AN INSURED (SECTION Il) is amended to include as an insured the person or organ- ization designated in the Schedule above, but only with respect to such insured's hability_ arising out of the maintenance, operation or use of any equipment you own, while such egwpment is located on premises awned, maintained or used by the designated Person or organization subject to the following additional previsions. 2. This insurance does not apply to: (a} Any "occurrence" which takes place after your equipment has been removed from such premrses; ar of lh rson or (b} "Bodily Injury" or ......~...~~6nn Jodi CG T3 47 07 Sti arising out of the sole negkgence a pe de_ _._-------... ..--------- Page 1 of t ACDBa, CERTIFICATE OF LIABILITY INSURANCE I DATE (MM/OOfYYYY) 07/24/2008 PRODUC~R t925)688-0733 FAX (925)688-0737 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Westport & Associates Insurance Services, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE license #OB84505 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 1390 Willow Pass Rd., #930 Concord, CA 94520-5253 INSURERS AFFORDING COVERAGE NAIC# INSURED Downey Vendors, Inc. / Eagle Vending, Inc. INSURER A: Travelers Indemn Company of CT DBA: aka: Premier Vending Group INSURER B: 6814 Suva Street INSURER c: Bell Gardens, CA 90201 INSURER 0: INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. I.t{~ ~~l!'! TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE PQ~.fo:::Y, EXPIRATION LIMITS ~NERAl LIABILITY 660143OC75208 02/09/2008 02/09/2009 EACH OCCURRENCE , 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED , 100,OO( l CLAIMS MADE "0 OCCUR MED EXP (Anyone person) , 5,000/ A PERSCNAL &. AOV INJURY $ 1,000,000 GENERAl AGGREGATE $ 2,000,OOC ~'~ AGG~nE,UMrT APf~~t, PER: PRODUCTS - COMPfOP AGG , 2,OOO,OOC POLICY j~T LOC ~TOMOBILE lIABIUTY BA3395C09508 02/09/2008 02/09/2009 COMBINED SINGLE LIMIT (EaaCCldent) , l,OOO,OO( - ANY AUTO - ALL OWNED AUTOS BODILY INJURY $ ~ SCHEDULED AUTOS (Per person} A ~ HIRED AUTOS BODILY INJURY , ~ NON-DWNED AUTOS l.'( RM (Per accident) ,..,...... :.../ - PROPERTY DAMAGE , (Per accident) ==rGE LIABILITY /~ ~~?'"t,: .-l- AUTO ONLY. EA ACCIDENT $ ANY AUTO OTHER THAN EAACC , I AUTO QNl Y AGG $ . r~C :J~SSIUMBRELLA LIABILITY CUP3619Y73608 02/09/2008 02/09/2009 EACH OCCURRENCE $ 5,000,OO~ OCCUR D CLAIMS MADE AGGREGATE . A $ 5,OOO,OO~ ~ ~EDUCTI8LE . X RETENTION . lO,OO( $ WORKERS COMPENSATION AND IACRUB121Sl86708 04/01/2008 04/01/2009 x-l T'X~~T ~~U~ I IOJ,!;'- EMPLOYERS' LIABILITY ~L..: EACH ACCIDENT ____ :-'- _ ..-.-h!!OQ,~o! A ANY PROPRIETQRlPARTNERlEXECUTIVl? OFFICERlMEMBER EXCLUDED? E l DISEASE - EA EMPLOYEE $ 1,000,000 If yes, desaibeunder E.l. DISEASE POLICY LIMIT , 1,000,001 SPECIAL PROVISIONS below OTliER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS ity of Santa Ana, its officers, employees, agents, representatives & volunteers are named as I;1dditional insured as respects to general liability subject to the conditions, limitations \:onditions, limitations and exclsuions of the policy. '10 Days notice for non-payment of premium. City of Santa Ana 20 Civic Center Plaza, M-30 Santa Ana, CA 92702 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAil *30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAilURE TO MAil SUCH NOTICE SHAll IMPOSE NO OBLIGATION OR LIABILITY NSURER,ITS AGENTS OR REPRESENTATlVES. VE ACORD 25 (2001/08) IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(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 The Certificate of Insurance on the reverse side of this form 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 aiter the coverage afforded by the policies listed thereon. ACORD 25 (2001/08) POLICY NUMBER: 1-660-1430C752-TIL-08 COMMERCIAL GENERAL LIABILITY ISSUE DATE:': 02-12-08 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED -- YOUR EQUIPMENT ON THEIR PREMISES This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. SCHEDULE Name of Person or Organization (Additional Insured): See certificate for complete description of Additional Insured, (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) B. PROVISIONS 1. WHO IS AN INSURED (SECTION II) is amended to include as an insured the person or organ- ization designated in the Schedule above, but only with respect to such insured's liability arising out of the maintenance, operation or use of any equipment you own, while such equipment is located on premises owned, maintained or used by the designated person or organizatIOn subject to the following additional provisions. 2. This insurance does not apply to: (a) Any "occurrence" which takes place after your equipment has been removed from such premises; or (b) "Bodily Injury" or "property damage" arising out of the sole negligence of the person or organization designated in the Schedule. CG T3 47 07 86 Page 1 of 1 ~CORD," CERTIFICATE OF LIABILITY INSURANCE \ DATE (MM/DDfYYYYl 01/30/2009 PRODUCER (925)688-0733 FAX (925)688-0737 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Westport & Associates Insurance Services, Ine. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR License #OB84505 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, 1390 Willow Pass Rd., #930 N -:J-OcJt;,-Ocn Concord, CA 94520-5253 INSURERS AFFORDING COVERAGE NAIC# INSURED Downey Vendors, Ine. / Eagle Vending, Inc. INSURER A Travelers Indemn Company of CT DBA: aka: Premier vending Group INSURER B 6814 Suva Street A .XDl- Qd-6 INSURER C Bell Gardens, CA 90201 " " OdS!\ INSURER D: INSURER E: COVERAGES - 0.;1 P, THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS II~~ ~P.'1:i TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLlCY EXPIRATION LIMITS GENERAL LIABILITY 6601430C75209 02/09/2009 02/09/2010 EACH OCCURRENCE $ 1,000,001 ~ COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED .., $ 100,000 \ CLAIMS MADE 0 OCCUR MED EXP (Anyone person) $ 5,001 A PERSONAL & ADV INJURY $ 1,000,000 f-- 2,000,001 GENERAL AGGREGATE , f-- 2,000,001 GEN'l AGGREGATE LIMIT APPLIES PER PRODUCTS - COMPIOP AGG $ h ,nPRO. n POLICY JECT LOC ~TOMOBllE LIABILITY BA3395C09509 02/09/2009 02/09/2010 COMBINED SINGLE LIMIT (Eaaccident) $ 1,000,001 - ANY AUTO ALL OWNED AUTOS ., ~ BODILY INJURY X $ SCHEDULED AUTOS ,.O~ (Per person) A rx HIRED AUTOS ..., ~ ~. BODILY INJURY ex " (Per accident) $ NON-OWNED AUTOS , f- t....) I- /, ,L~ PROPERTY DAMAGE $ .,J ~- - ." (Per accident} GARAGE LIABILITY oiL' j) ::,.'~",'\'~ AUTO ONLY - EA ACCIDENT $ ~ ANY AUTO ~~ ,~' [) .~" . EA Ace $ ~'I> :'c"\" OTHER THAN 1// AUTO ONLY AGG $ :=JESS/UMBRELLA LIABILITY CUP3619Y ~~ L~/09/2009 02/09/2010 EACH OCCURRENCE $ 5,000,001 OCCUR 0 CLAIMS MADE AGGREGATE $ A $ 5,000,001 g DEDUCTIBLE $ X RETENTION $ 1O,00( , WORKERS COMPENSATION AND IACRUB1215L86708 04/01/2008 04/01/2009 I WC STATU-_ I \OJ,tI- EMPL.OYERS' L.IABlLlTY 1,000,001 A ANY PROPRIETOR/PARTNERIEXECUTIVE E.l EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? E L DISEASE - EA EMPLOYEE $ 1,000,000 If yes, describe under EL DISEASE - POLICY LIMIT 1,000,000 SPECIAL PROVISIONS below $ OTHER DESCR1PTlfN OF OPERATIONS {lOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS ity 0 Santa Ana, its officers, employees, agents, representatives & volunteers are named as "dditional insured as respects to general liability subject to the conditions, 1 imitations Fonditions, limitations and exclsuions of the policy. bl0 Days notice for non-payment of premium. s City of Santa Ana 20 Civic Center Plaza, M-30 Santa Ana, CA 92702 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WIL.L ENDEAVOR TO MAIL. *30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAil SUCH NOTICE SHALL IMPOSE NO OBLlGA liON OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORl REPRESENTA nVE 'C.r/loL<."... If? -/It. @ACORDCORPORATION1988 ACORD 25 (2001108) IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(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 The Certificate of Insurance on the reverse side of this form 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. ACORD 25 (2001/08) POLICY NUMBER: I_660_1430C752-TIL-09 COMMERCIAL GENERAL LIABILITY ISSUE DATE: 12-31-08 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - MANAGERS OR LESSORS OF PREMISES This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE 1. Designation of Premises (Part Leased to You): 2. Name of Person or Organization (Additional Insured): CITY OF SANTA ANA 20 CIVIC CENTER, 8TH FLOOR SANTA ANA CA 92702 3. Additional Premium: 160 (If no entry appears above, the information required to complete this endorsement will be shown in the Declara- tions as applicable to this endorsement.) WHO IS AN INSURED (Section II) is amended to include as an insured the person or organization shown in the Schedule but only with respect to liability arising out of the ownership, maintenance or use of that part of the premises leased to you and shown in the Schedule and 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 demoli- tion operations performed by or on behalf of the person or organization shown in the Schedule. CG 20 11 01 96 Copyright, Insurance Services Office, Inc., 1994 Page 1 of 1 ACORD CERTIFICATE OF LIABILITY INSURANCE °ATE(MM,DD/YYYY) 04/08/2009 PRODUCER 925.688.0733 FAX 925.688.0737 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Westport & Associates Insurance Services, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE License #0684505 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW 1390 Wi 11 ow Pass Rd . , #930 ~/~ ~Q ~, ~ 9, . I Concord, CA 94520-5253 INSURERS AFFORDING COVERAGE NAIC # INSURED Downey Vendors, Inc. /Eagle Vending, Inc. INSURERA: Travelers Indemn Company of CT DBA: aka: Premier Vending Group INSURER B: 6814 Suva Street INSURER C: Bell Gardens, CA 90201 INSURER D: INSURER E: vv Y CRMV CJ i nt rvu~lts yr Irv~uwvrvGt us l tD 6ELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR DD' NSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MM/DD/YYYY POLICY EXPIRATION DATE MMlDDIYYYY LIMITS GENERAL LIABILITY 6601430075209 02/09/2009 02/U9/201U EACH OCCURRENCE $ 1 ~ QQQ ~ QQ X COMMERCIAL GENERAL LIABILITY PREMISES Ea occur ante $ 100, 000 CLAIMS MADE ~ OCCUR MED EXP (Any one person) $ 5 ~ QQQ A PERSONAL & ADV INJURY $ 1 QQQ QQQ ~ ~ GENERAL AGGREGATE $ 2 QQQ QQQ GEN'L AGGREGATE LIMIT APPLIES PER: PRO- PRODUCTS -COMP/OP AGG ~ ~ $ 2 , QQQ ~ QQQ POLICY JECT LOC AUT OMOBILE LIABILITY BA3395C09509 02/09/2009 02/09/2010 X ANY AUTO COMBINED SINGLE LIMIT (Ea accident) $ 1 000 00 , , ALL OWNED AUTOS - 1 ~©~1~ A X SCHEDULED AUTOS pp v ~Pi~ Ll-x ~~~ A BODILY INJURY (Per person) $ X HIRED AUTOS ~ '~~ X NON-OWNED AUTOS ~-. ,~ "` BODILY INJURY (Per accident) $ - -,~_.- ' ' , t s aura 5~:: a,.u C J . L ~,1?;f IiLL ~LLlv'~~ PROPERTY DAMAGE (per accident) $ Iyt~~;~ GAR AGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS I UMBRELLA LIABILITY CUP3619Y73609 02/09/2009 02/U9/201U EACH OCCURRENCE $ 5 ~ QQQ ~ QQQ OCCUR ~J CLAIMS MADE AGGREGATE $ A $ 5,000,000 DEDUCTIBLE $ X RETENTION $ lO, OO WORKERS COMPENSATION AND EMPLOYERS' LIABILITY IACRU61215 L86709 04 Ol / /2009 04/01/2010 $ Y ~ N TORY LIMITS ER A OFFICER/MEMBER EXCLUDED? ECUTIVE^ E.L. EACH ACCIDENT $ 1 ~ QQQ ~ ~~~ (Mandatory in NH) If yes, describe under E.L. DISEASE - EA EMPLOYEE $ 1, QQQ ~ QQ SPECIAL PROVISIONS below E.L. DISEASE -POLICY LIMIT $ 1 ~ QQQ ~ QQQ OTHER DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES /EXCLUSIONS ADDED BY ENDORSEMENT 1 SPECIAL PROVISIONS ity of Santa Ana, its officers, employees, agents, representatives & volunteers are named as dditional insured as respects to general liability subject to the conditions, limitations onditions, limitations and exclsuions of the policy. ~10 Da s notice for non- a ment of remium. r_FRTIFICeTt= unl nco . _ --_-. _ _ -_ _ _ _ City of Santa Ana 20 Civic Center Plaza, M-30 Santa Ana, CA 92702 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ° 3O DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR TION. 1 ne rr,wKU name ana logo are registered marks of ACORD IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(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. ACORDM CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYY,r) 01/28/2010 PRODUCER (925)934-0505 FAX (925)977-1591 Insurance Associates of Northern CA 1550 Parkside Drive, Suite 120 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Walnut Creek, CA 94596 INSURERS AFFORDING COVERAGE NAIC # INSURED Downey Vendors, Inc. INSURER A: Travelers Indemnity Company 6814 Suva Street N-2006-106 INSURER B Bell Gardens, CA 90201 N.2008~~ INSURER C: N-200$-OJ7-00'I INSURER D: INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED NOTWITHSTANDING . ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR DD' TYpE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS GENERAL LIABILITY I6601430C752TIL10 02/09/2010 02/09/2011 EACH OCCURRENCE $ 1 ~ 000 ~ o0 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ loo' ooo CLAIMS MADE a OCCUR MED EXP A ( ny one person) $ 5 , 00 A PERSONAL 8 ADV INJUiZY $ 1 oOO OO , , GENERAL AGGREGATE $ 2 OOO OO GEN'L AGGREGATE LIMIT APPLIES PER: PRO- PRODUCTS -COMP/OP AGG , , $ 2 ,ooo , OO POLICY JECT LOC AU TOMOBILE LIABILITY BA3395C09510SEL 02/09/2010 02/09/2011 ANY AUTO COMBINED SINGLE LIMIT (Ea accident) $ 1 000 00 , , ALL OWNED AUTOS A X SCHEDULED AUTOS T ~ r BODILY INJURY (Per person) $ APPRO VEll C l o i~ (~ S ~ X HIRED AUTOS X NON-OWNED AUTOS BODILY INJURY (Per accident) $ / ~ ' ~ ~ LaUT' t tt Sheerly PROPERTY DAMAGE (per accident) $ GARAGE LIABILITY ~SSISY.IIC C Ly /AtTOTTIey AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: qGG $ EXCESSlUMBRELLA LIABILITY ISMCUP3619Y736TIL10 02/09/2010 02/09/2011 EACH OCCURRENCE $ 5 ,ooo, 00 X OCCUR ~ CLAIMS MADE AGGREGATE $ 5 ,ooo , OO A $ DEDUCTIBLE $ X RETENTION $ lO,OO $ WORKERS COMPENSATION AND IACRUB1215 L86710 04/01/2010 04/01/2011 X we sTATU- oTH- EMPLOYERS' LIABILITY A ANY PROPRIETORlPARTNER,~EXFCUTIVE OFFICER/MEM°ER S E.L. EACH ACCIDENT - $ 1, ooo, ooo EX^!_UD -D? If yes, describe under E.L. DISEASE - EA EMPLOYEE $ 1 , OOO , OO SPECIAL PROVISIONS below E.L. DISEASE -POLICY LIMIT $ 1 ,ooo 00 OTHER , DESCRIPTION OF OPERATIONS /LOCATIONS /VEHICLES /EXCLUSIONS ADDED BY ENDORSEMENT /SPECIAL PROVISIONS ertTficate holder is included as additional insur d e as respects to General Liability subject to the onditions, limitations and exclusions of the policy. r10 Day for payment non-payment of premium f.C~T~r1A ~~~ .,~• wow City of Santa Ana 20 Civic Center Plaza, M-30 Santa Ana, CA 92702 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ~' 3O DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INS AUTHORIZED REPRESENTATIVE ITS AGENTS OR REPRESENTATIVES. rrie Lazaro/CHERNE ©ACORD CORPORATION 1988 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. XTEND ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART GENERAL DESCRIPTION OF COVERAGE -This endorsement broadens coverage, The following listing is a general coverage description only. Limitations and exclusions may apply to these coverages. Read alf the PRO- VISIONS of this endorsement carefully to determine rights, duties, and what is and is not covered. A. Broadened Named Insured 8. Damage To Premises Rented To You Extension • Perils of fire, explosion, lightning, smoke, water • Limit increased to $300,000 C. Blanket Waiver of Subrogation D. Blanket Additional Insured -Managers or Lessors of Premises E. Blanket Additional Insured - Lessor of Leased Equipment F. Incidental Medical Malpractice G. Personal injury-Assumed by Contract H. Extension of Coverage -Bodily Injury PROVISIONS A. BROADENED NAMED INSURED 1. The Named Insured in Item 1. of the Declara- tions is as follows: The person or organization named in Item 1. of the Declarations and any organization, other than a partnership or joint venture, over which you maintain ownership or majority in- terest on the effective date of the policy. However, coverage for any such organization wilt cease as of the date during the policy pe- riod that you no longer maintain ownership of, or majority interest in, such organization. 2. WMO IS AN INSURED (Section II) Item 4.a. is deleted and replaced by the following: a. Coverage under this provision is afforded only until the 180th day after you acquire or form the organization or the end of the policy period, whichever is earlier, unless reported in writing to us within 180 days. 3. This Provision A. does not apply to any per- son or organization for which coverage is ex- cluded by endorsement. I. Injury to Co-Employees and Co-Volunteer Workers J. Aircraft Chartered with Crew K. Non-Owned Watercraft -increased from 25 feet to 50 feet L. Increased Supplementary Payments • Cost for bail bonds increased to $2,500 • Loss of earnings increased to $500 per day M. Knowledge and Notice of Occurrence or Offense N. UnintentionalOmission O. Reasonable Force -Bodily Injury or Property Damage B. DAMAGE TO PREMISES RENTED TO YOU EXTENSION 1. The last paragraph of COVERAGE A. BOD- fLY INJURY AND PROPERTY DAMAGE LI- ABILITY (Section I -Coverages} is deleted and replaced by the following: Exclusions c. through n. do not apply to dam- age to premises while rented to you, or tem- porarily occupied by you with permission of the owner, caused by: a. Fire; b. Explosion; c. Lightning; d. Smoke resulting from such fire, explosion, or lightning; or e. Water. A separate limit of insurance applies to this coverage as described in LIMITS OF INSUR- ANCE (Section III). 2. This insurance does not apply to damage to premises while rented to you, or temporarily CG D1 86 11 03 Copyright, The Travelers indemnity Company, 2003 Page 1 of 5 COMMERCIAL GENERAL LIABILITY occupied by you with permission of the COVERAGE A. BODILY INJURY AND owner, caused by: PROPERTY DAMAGE LIABILITY {Section I - a. Rupture, bursting, or operation of pres- Coverages) is excluded by endorsement. sure relief devices; C. BLANKET WAIVER OF SUBROGATION b. Rupture or bursting due to expansion or swelling of the contents of any building or structure, caused by or resulting from wa- ter; c. Explosion of steam boilers, steam pipes, steam engines, or steam turbines. 3. Part 6. of LIMITS OF INSURANCE (Section III) is deleted and replaced by the following: Subject to 5. above, the Damage To Prem- ises Rented To You Limit is the most we will pay under COVERAGE A. for damages be- cause of "property damage" to any one prem- ises while rented to you, or temporarily occu- pied by you with permission of the owner, caused by fire, explosion, lightning, smoke resulting from such fire, explosion, or light- ning, or water. The Damage To Premises Rented To You Limit will apply to all damage proximately caused by the same "occur- rence", whether such damage results from fire, explosion, lightning, smoke resulting from such fire, explosion, or lightning, or water, or any combination of any of these. The Damage To Premises Rented To You Limit will be the higher of: a. $300,000; or b. The amount shown on the Declarations for Damage To Premises Rented To You Limit. 4. Under DEFINITIONS (Section V), Paragraph a. of the definition of "insured contract" is amended so that it does not include that por- tion of the contract for a lease of premises that indemnifies any person or organization for damage to premises while rented to you, or temporarily occupied by you with permis- sion of the owner, caused by: a. Fire; b. Explosion; c. Lightning; d. Smoke resulting from such fire, explosion, or lightning; or e. Water. We waive any right of recovery we may have against any person or organization because of payments we make for injury or damage arising out of premises owned or occupied by or rented or loaned to you; ongoing operations performed by you or on your behalf, done under a contract with that person or organization; "your work"; or "your products". We waive this right where you have agreed to do so as part of a written contract, executed by you prior to loss. D. BLANKET ADDITIONAL INSURED - MANAG- ERS OR LESSORS OF PREMISES WHO IS AN INSURED (Section II) is amended to include as an insured any person or organization (referred to below as "additional insured") with whom you have agreed in a written contract, exe- cuted prior to loss, to name as an additional in- sured, but only with respect to liability arising out of the ownership, maintenance or use of that part of any premises leased to you, subject to the fol- lowing provisions: 1. Limits of Insurance. The limits of insurance afforded to the additional insured shall be the limits which you agreed to provide, or the lim- its shown on the Declarations, whichever is less. 2. The insurance afforded to the additional in- sured does not apply to: a. Any "occurrence" that takes place after you cease to be a tenant in that premises; b. Any premises for which coverage is ex- cluded by endorsement; or c. Structural alterations, new construction or demolition operations performed by or on behalf of such additional insured. 3. The insurance afforded to the additional in- sured is excess over any valid and collectible insurance available to such additional in- sured, unless you have agreed in a written contract for this insurance to apply on a pri- mary or contributory basis. E. BLANKET ADDITIONAL INSURED -LESSOR OF LEASED EQUIPMENT WHO IS AN INSURED (Section If) is amended to 5. This Provision B. does not apply if coverage include as an insured any person or organization for Damage To Premises Rented To You of (referred to below as "additional insured") with Page 2 of 5 Gopyright, The Travelers Indemnity Gompany, 2003 CG D1 ti6 11 03 COMMERCIAL GENERAL LIABILITY whom you have agreed in a written contract, exe- cuted prior to loss, to name as an additional in- sured, but only with respect to their liability arising out of the maintenance, operation or use by you of equipment leased to you by such additional in- sured, subject to the following provisions: 1. Limits of Insurance. The limits of insurance afforded to the additional insured shall be the limits which you agreed to provide, or the lim- its shown on the Declarations, whichever is less. 2. The insurance afforded to the additional in- sured does not apply to: a. Any "occurrence" tha# takes place after the equipment lease expires; or b. "Bodily injury" or "property damage" aris- ing out of the sole negligence of such ad- ditional insured. 4. for which no remuneration is demanded or received. Paragraph 2.a.(1)(d) of WHO IS AN IN- SURED (Section II) does not apply to any registered nurse, licensed practical nurse, emergency medical technician or paramedic employed by you, but only while performing the services described in paragraph 2. above and while acting within the Scope of their em- ployment by you. Any "employees" rendering "Good Samaritan services" will be deemed to be acting within the scope of #heir employ- ment by you. The following exclusion is added to paragraph 2. Exclusions of COVERAGE A. -BODILY INJURY AND PROPERTY DAMAGE LIABIL- ITY (Section 1-Coverages): (This insurance does not apply to:) Liability arising out of the willful violation of a penal statute or ordinance relating to the sale of pharmaceuticals by or with the knowledge or consent of the insured. For the purposes of determining the applica- ble limits of insurance, any act or omission, together with all related acts or omissions in the furnishing of the services described in paragraph 2. above to any one person, will be considered one "occurrence". 3. The insurance afforded to the additional in- sured is excess over any valid and collectible insurance available to such additional in- sured, unless you have agreed in a written contract for this insurance to apply on a pri- 5• many or contributory basis. F. INCIDENTAL MEDICAL MALPRACTICE 1. The definition of "bodily injury" in DEFINI- TIONS (Section V) is amended to include "!n- cidental Medical Malpractice Injury". 2. The following definition is added to DEFINI- TIONS (Section V): "Incidental medical malpractice injury" means bodily injury, mental anguish, sickness or dis- ease sustained by a person, including death resulting from any of these at any time, aris- ing out of the rendering of, or failure to ren- der, the following services: a. Medical, surgical, dental, laboratory, x-ray or nursing service or treatment, advice or instruction, or the related furnishing of food or beverages; b. The furnishing or dispensing of drugs or medical, dental, or surgical supplies or appliances; or c. First aid, d. "Good Samaritan services". As used in this Provision F., "Good Samaritan ser- vices" are those medico! services ren- dered or provided in an emergency and 6. This Provision F. does not apply if you are in the business or occupation of providing any of the services described in paragraph 2. above. 7. The insurance provided by this Provision F. shall be excess over any other valid and col- lectible insurance available to the insured, whether primary, excess, contingent or on any other basis, except for insurance pur- chased specifically by you to be excess of this policy. G. PERSONAL INJURY -ASSUMED BY CON- TRACT 1. The Contractual Liability Exclusion in Part 2., Exclusions of COVERAGE B. PER- SONAL AND ADVERTISING INJURY LIABIL- ITY (Section I -Coverages) is deleted and replaced by the following: (This insurance does not apply to:} Contractual Liability "Advertising injury" for which the insured has assumed liability in a contract or agreement. This exclusion does not apply to liability for CG D1 86 11 03 Copyright, The Travelers Indemnity Company, 2003 Pa e 3 of 5 9 COMMERCIAL GENERAL LIABILITY damages that the insured would have in the 3. Subparagraphs 2.a.(1)(a), (b) and (c) and absence of the contract of agreement. 3.a. of WMO IS AN INSURED (Section II) do 2. Subparagraph f. of the de#inition of "insured not apply to "bodily injury" for which insurance contract" {DEFINITIONS -Section V) is de- is provided by paragraph 1. or 2. above. feted and replaced by the following: J. AIRCRAFT CHARTERED WITH CREW f. That part of any other contract or agree- ment pertaining to your business (includ- ing an indemnification of a municipality in connection with work perforrned for a municipality) under which you assume the tort liability of another party to pay for "bodily injury," "property damage" or "per- sonal injury" to a third party ar organiza- tion. Tort liability means a liability that would be imposed by law in the absence of any contract or agreement. 3. This Provision G. does not apply if COVER- AGE B. PERSONAL AND ADVERTISING IN- JURY LIABILITY is excluded by endorse- ment, H. EXTENSION OF COVERAGE -BODILY IN- JURY The definition of "bodily injury" (DEFINITIONS - Section V) is deleted and replaced by the follow- i ng: "Bodily injury" means bodily injury, mental an- guish, mental injury, shock, fright, disability, hu- miliation, sickness or disease sustained by a per- son, including death resulting from any of these at any time. t. INJURY TO CO-EMPLOYEES AND CO- VOLUNTEER WORKERS 1, Your "employees" are insureds with respect to "bodily injury" to a co-"employee" in the course of the co-"employee's" employment by you, or to your "volunteer workers" while per- forming duties related to the conduct of your business, provided that this coverage for your "employees" does not apply to acts outside the scope of their employment by you or while performing duties unrelated to the conduct of your business. 2. Your "volunteer workers" are insureds with respect to "bodily injury" to a co"volunteer worker" while performing duties related to the conduct of your business, or to your "employ- ees" in the course of the "employee's" em- ployment by you, provided that this coverage for your "volunteer workers" does not apply while performing duties unrelated to the con- duct of your business. 1. The following is added to the exceptions con- tained in the Aircraft, Auto Or Watercraft Exclusion in Part 2., Exclusions of COVER- AGE A. BODILY INJURY AND PROPERTY DAMAGE LIABILITY {Section I -Coverages): (This exclusion does not apply to:) Aircraft chartered with crew to any insured. 2. This Provision J. does not apply if the char- tered aircraft is owned by any insured. 3. The insurance provided by this Provision J. shall be excess aver any other valid and col- lectible insurance available to the insured, whether primary, excess, contingent or on any other basis, except for insurance pur- chased specifically by you to be excess of this policy. K. NON-OWNED WATERCRAFT 1. The exception contained in Subparagraph (2) of the Aircraft, Auto Or Watercraft Exclu- sion in Part 2., Exclusions of COVERAGE A. BODILY INJURY AND PROPERTY DAMAGE LIABILITY (Section I -Coverages) is deleted and replaced by the following: (2) A watercraft you do not own that is: (a) Fifty feet long or less; and (b) Not being used to carry persons or property for a charge; 2. This Provision K. applies to any person who, with your expressed or implied consent, either uses or is responsible for the use of a water- craft. 3. The insurance provided by this Provision K. shall be excess over any other valid and col- lectible insurance available to the insured, whether primary, excess, contingent or on any other basis, except for insurance pur- chased specifically by you to be excess of this policy. L. INCREASED SUPPLEMENTARY PAYMENTS Parts b. and d. of SUPPLEMENTARY PAY- MENTS - COVERAGES A AND B (Section t - Coverages) are amended as follows: 1. fn Part b. the amount we will pay for the cost of bail bonds is increased to $2500. Page 4 of 5 Copyright, The Travelers Indemnity Company, 2003 CG D1 86 11 03 COMMERCIAL GENERAL LIABILITY 2. In Part d. the amount we will pay for toss of earnings is increased to $500 a day. M. KNOWLEDGE AND NOTICE OF 000UR- RENCE OR OFFENSE 1. The following is added to COMMERCIAL GENERAL LIABILITY CONDITIONS (Section IV), paragraph 2. (Duties In The Event of Oc- currence, Offense, Claim or Suit): Notice of an "occurrence" or of an offense which may result in a claim under this insur- ance shall be given as soon as practicable af- ter knowledge of the "occurrence" or offense has been reported to any insured listed under Paragraph 1. of Section II -Who Is An In- sured or an "employee" (such as an insur- ance, loss control or risk manager or adminis- trator) designated by you to give such notice. Knowledge by other "employee(s)" of an "oc- currence" or of an offense does not imply that you also have such knowledge. 2. Notice shall be deemed prompt if given in good faith as soon as practicable to your workers' compensation insurer. This applies only if you subsequently give notice to us as soon as practicable after any insured listed under Paragraph 1. of Section II -Who Is An Insured or an "employee" (such as an insur- ance, loss control or risk manager or adminis- trator) designated by you to give such notice discovers that the "occurrence", offense or claim may involve this policy. 3. However, this Provision M. does not apply as respects the specific number of days within which you are required to notify us in writing of the abrupt commencement of a discharge, release or escape of "pollutants" which causes "bodily injury" or "property damage" which may otherwise be covered under this policy. N. UNINTENTIONAL OMISSION The following is added to COMMERCIAL GEN- ERAL LIABILITY CONDITIONS (Section IV), paragraph 6. (Representations): The unintentional omission of, or unintentional error in, any information provided by you shall not prejudice your rights under this insurance. How- ever, this Provision N. does not affect our right to collect additional premium or to exercise our right of cancellation or nonrenewal in accordance with applicable state insurance laws, codes or regula- tions. O. REASONABLE FORCE -BODILY INJURY OR PROPERTY DAMAGE The Expected Or Intended Injury Exclusion in Part 2., Exclusions of COVERAGE A. BODILY INJURY AND PROPERTY DAMAGE LIABILITY (Section I -Coverages) is deleted and replaced by the following: (This insurance does not apply to:) Expected or Intended Injury or Damage "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 rea- sonable force to protect persons or property. CG D1 86 11 03 Copyright, The Travelers Indemnity Company, 2003 Page 5 of 5 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WEB XTEND LIABfLITY This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PROVESIONS Paragraph o. Personal And Advertising Injury, Part 2. Exclusions of SECTION I _ COVERAGES, COV- ERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY is deleted and replaced by the following: o. Personal Injury, Advertising Injury and Web Site Injury "Bodily injury" arising out of "personal injury", "ad- vertising injury" or "web site injury". COVERAGE B. PERSONAL AND ADVERTISING INJURY LIABILITY (SECTION I -COVERAGES) is deleted in its entirety and replaced by the following: COVERAGE B. PERSONAL INJURY, ADVERTIS- ING INJURY AND WEB SITE INJURY LIABILITY Insuring Agreement. a. We will pay those sums that the insured be- comes legally obligated to pay as damages because of "personal injury", "advertising in- jury" or "web site injury" to which this insur- ance applies. We will have the right and duty to defend the insured against any "suit" seek- ing those damages. However, we will have no duty to defend the insured against any "suit" seeking damages for "personal injury", "ad- vertising injury", or "web site injury" to which this insurance does not apply. We may at our discretion investigate any "occurrence" or of- fense and se#tle 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 Coverage A or B or medical expenses under Coverage C. No other obligation or liability to pay sums or per- form acts or services is covered unless explicitly provided for under Supplementary Payments - Coverages A and B. b. This insurance applies to: (1) "Personal injury" caused by an offense arising out of your business, excluding advertising, publishing, broadcasting or telecasting done by or for you; (2) "Advertising injury" caused by an offense committed in the course of advertising your goods, products or services; or (3) "Web site injury" caused by an offense committed in the course of the visual or audio presentation of material on "your web site" or in the numerical expression of computer code used to enable "your web site"; but only if the offense was committed in the "coverage territory" during the policy period. With respect to subparagraph b. (1) above, bulletins, financial or annual reports, or news- letters that are not published to the general public or specific market segments about your goods, products or services for the purpose of attracting customers or supporters will not be considered publishing. 2. Exclusions. This insurance does not apply to: a. Knowing Violation Of Rights Of Another "Personal injury", "advertising injury" or "web site 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 "persona! injury", "advertising injury" or "web site injury". b. Material Published With Knowledge Of Falsity "Personal injury", "advertising injury" or "web site injury" arising out of oral, written or elec- tronic publication of material, if done by or at the direction of the insured with knowledge of its falsity. CG D2 34 01 05 Copyright 2005 The St. Paul Travelers Companies, Inc. All rights reserved. Page 1 of 5