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HomeMy WebLinkAboutPACIFIC TRAFFIC CONTROL (PACIFIC HOLDCO SERVICES, LLC) (2) Ii;SUR*CE NOT REQUIRED N-2025-115-01 WORK IVAY PROCEED C.1'fY CLE0 L 0 3 2015 FIRST AMENDMENT TO AGREEMENT WITH PACIFIC HOLDCO SERVICES LLC DBA PACIFIC TRAFFIC CONTROL,LLC TO PROVIDE TRAFFIC CONTROL SERVICES FOR THE 2025 SANTA ANA FUN RUN THIS FIRST AMENDMENT to the above-referenced agreement is entered into on June 25,2025,by and between Pacific Holdco Services,LLC,a Delaware limited liability company dba Pacific Traffic Control LLC ("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 No. N-2025-115 ("Agreement") dated May 8, 2025, for Contractor to provide traffic control services for the 2025 Santa Ana Fun Run("Event"). B. The parties wish to amend the Agreement to increase the overall compensation due under this Agreement to provide compensation for the increased services provided by Contractor to City. The Parties therefore agree: 1. Section 2.a., Compensation, is hereby amended to increase the amount owed to Contractor by an additional$1,571.30 for increased services provided by Contractor to City during the Event, attached hereto as Exhibit B-1. The total amount to be expended under the terms of this Agreement shall not exceed$25,540.30. 2. Except as modified by this First Amendment,all terms and conditions of the Agreement, shall remain in full force and effect. IN WITNESS WHEREOF,the parties hereto have executed this First Amendment to the Agreement on the date and year first written ab AT CITX §4NTA ANA fl e'r rr nP*T ennifer 71varo Nunez City C City Manager APPROVED AS TO FORM CONTRACTOR SONIA R.CARVALHO City Attorney r� ��✓���� fob Mc1�2�2 By. ice/ _usa aun / Jonathan T.MartinezU Bob McLeese Assistant City Attorney CEO RECOMMENDED FOR APPROVAL k54b��F— HAWK SCOTT Executive Director, Parks,Recreation,&Community Services Agency Exhibit D-1 to first AmcndmenL (N-2025-T15) Pacific Invoice TrafficMq Control Date Invoice#!~ Terms 2840 Lugo St. Los Angeles,CA.90023 5/31/2025 INV33353 Bill To: Work Performed: _ City of Santa Ana Parks, Recreation&Community City of Santa Ana Parks, Recreation&Community Service Agency 1 Service Agency 20 Civic Center Plaza 2nd Floor f United States Santa Ana CA 92701 United States Due Date P.O.Number Requestor I RA# Ship Via 5/31/2025 �. Quantity Description Price Each Amount 1 Water Tucks 4hr Refills and 0.5 Overtime $1,571.30 I Subtotal $1,571.30 SalesTax(%) $0.00 Total $1,571.30 Payments/Credits $0.00 Balance Due $1,571.30 Please make all checks payable to:Pacific Traffic Control,2840 Lugo St.,Los Angeles, CA 90023 For Credit Card Payments a 3.4%Transaction Fee will be added Please call(323)981-0600 or email accounting directly for a payment link/CC Auth Form To remit payment via:ACH/EFT/Direct Deposit or Wire Transfer,Please call or email accounting directly for our bank information. Office(T)323-981-0600(F)323-981-0779 1 Email:accounting@PatificTC.com ACC CERTIFICATE OF LIABILITY INSURANCE 13ATE(MMa7DrrYyYI 05/06/2025 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 rights to the certificate holder In lieu of such endorsement(s). PRODUCER C ONTACT Daniel Benson AssuredPartners Northeast,LLC. NE (914)761-9000 F No t: A1C,No: (914)761-3749 445 Hamilton Avenue Daniel.Benson assured artners.comkith Floor � pGCOVERAGE NAIC X White Plains NY 10601 URERA: Travelers Indemnity Company of Connecticut 256$2 INSURED INSURER B: Travelers Property Casualty Company of Arne nca 25674 Pacific Traffic Control,LLC INSURER C: Admiral insurance Company 24856 2840 Lugo Street INSURER D: INSURER e: Las Angeles CA 90023 INSURER F: COVERAGES CERTIFICATE NUMBER: CL2541445612 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, 1N513 POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVO POLICY NUMBER MMIDDIYYYY (MM1ODPfYYY) LIMITS X COMMERCIAL GENERAL LIABILITY 11000,000 ENCE g CLAIMS-A.IADE OCCUR EACH OCCURRPREMISES Ea accurrence S 300,000 MEO EXP(Arty one person) $ 5.000 A Y Y Y-630-5Y374343-TCT-25 04114/2025 04/14/2026 1 000 000 PERSONAL£ADV INJURY $ GEN'L AGGREGATE LIMITAPPLIESPER: GENERAL AGGREGATE g 2,000,00() POLICY JEPROtrT r7 LOC PRODUCTS-CDMPfOPAGG g 2,000,000 OTHER: S AUTOMOBILE LIABILITY COM31NED SINGLE LIMIT ANYAUTO Ea accident S 1,000,000 BODILY INJURY(Per personl S A OWNED SCHEDULED Y Y BA-5Y317895-25-14-G 04/14/2025 0411412026 BODILY INJURY(Per accident) $ HIRED AUTOSNON-OWNEDPROPERTY DAMAGE AUTOS ONLY At1T05 ONLYLY Per accident $ Auros ONLY Auros $ UMBRELLALIAB X OCCUR 5,000,000 EACH OCCURRENCE 5 B EXCESS Lraa CLA:14ts-MADE CUP-9X37058$-25-14 04/14/2025 04/14/2028 AGGREGATE g 5,000,000 DEC RETENTION g WORKERS COMPENSATION S PER OTH. AND EMPLOYERS'LIABILITY Y!N STATUTE ER ANY PROPRIETOPJPARTNEFUEXECUTIVE OFFICERW MBEREXCLUDED? ❑ N!A N/A E.L.EACH ACCIDENT g. (Mandatory in NH) If yes,describe under E.L.DISEASE-EA Eh1PLOYEE S DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLiCYLIMIT S Commercial Cyber and E&O Liability General Aggregate $1,000.000 C E000002533-12 04114t2025 04114,'2026 Each Occurrence $1,000,000 DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES IACORD 141,Additional Remarks Schedule,may be attached it more space is required) The City of Santa Ana,its City Council,officers,officials,employees,agents,and volunteers are included as Additional Insureds.Additional Insured status is granted with respects to General Liability on a Primary&Non-Contributory basis,when required by written contract,per farm CGD269 04116(copy attached),Additional insured status is granted for Auto Liability,per form CAT353 02115(copy attached). Waiver of Subrogation applies to General Liability and Auto Liability, Tr an I 1 n Digitally signed by APPROVED 7u Tran Nguyen Date-2025.0s.12 ey To Tram Ngul yen at 7:21 aril,May 12.2025 Nguyen 07,22:27-a7GG _-- CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN City of Santa Ana Attention:Parks,Recreation,and Community Service ACCORDANCE WITH THE POLICY PROVISIONS. 20 Civic Center Plaza, CA 92701.M-23 AUTHORIZED REPRESENTATIVE Santa Ana CA 92701 y� 1 a0 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD COMMERCIAL GENERAL LIABILITY POLICY NUMBER: Y-530-SY374343-TCT-25 ISSUE (DATE; 05-06-25 THIS. ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - STATE OR GOVERNMENTAL AGENCY OR SUBDIVISION OR POLITICAL SUBDIVISION PERMITS OR AUTHORIZATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Stato Or Governmental Agency Or Subdivision Or Political Subdivision: THE CITY OF SANA ANA, ITS CITY COUNCIL BEACH, OFFICERS, OFFICIALS, EMPLOYEES, AGENTS, AND VOLUNTEERS, PROVISIONS The following is added to SECTION II - WHO IS AN 2. This insurance does not apply to: INSURED: a. "Bodily injury," "property damage", "personal Any state or governmental agency or subdivision or injury" or "advertising injury" arising out of political subdivision shown in the Schedule is an operations performed for the federal insured, subject to the following provisions: government, state or municipality; or 1. This insurance applies only with respect to la, "Bodily injury" or"property damage" included operations performed by you or an your behalf for within the "products-completed operations which the state or governmental agency or subdivision or political subdivision has issued a hazard". permit or authorization. DG D2 60 0416 2016The Travelers Indemnity Company.All rights roserved. Page 1 of 1 includes copyrighted matwfal of Insuranco Services Office,Inc„with its permisslon. COMMERCIAL GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY COVERAGE FORM Various provisions in this policy restrict coverage.Read (1) The "bodily injury" or"property damage" is the entire policy carefully to determine rights, duties and caused by an"occurrence" that takes place what is and is not cowered. in the"coverage territory"; Throughout this policy the words "you" and "your" refer (2) The "bodily injury' or "property damage" to the Named Insured shown In the declarations, and occurs during the policy period; and any other person or organization qualifying as a Named (3) prior the olio Insured under this policy. The words "we", "us" and to policy period, no insured listed 'bur"refer to the company providing this insurance. under Paragraph 1. of Section II --Who !s An Insured and no "employee" authorized The word "insured" means any person or organization by you to give or receive notice of an qualifying as such under Section it -- Who Is An "occurrence" or claim knew that the"bodily Insured. injury" or"property damage" had occurred, Other words and phrases that appear in quotation in whole or in part. If such a listed insured marks have special meaning, Refer to Section V -- or authorized"employee" knew, prior to the Definitions. policy period, that the "bodily Injury" or "properly damage" occurred, then any SECTION I--COVERAG ES continuation, change or resumption of such COVERAGE A--BODILY INJURY AND PROPERTY "bodily injury" or"property damage" during [DAMAGE LIABILITY or after the policy period will be deemed to 1. Insuring Agreement have been known prior to the policy period. a. We will pay those sums that the Insured c. "Bodily Injury" or "property damage" which becomes legally obligated to pay as damages occurs during the policy period and was not, because of "bodily injury" or"property damage" prior to the policy period, known to have to which this insurance applies. We will have occurred by any insured listed under Paragraph the right and duty to defend the Insured against 1� of Section II Who Is An Insured or any any "suit" seeking those damages. However, "employee" authorized by you to give or receive we will have no duty to defend the insured notice of an "occurrence"or claim,Includes any against any"salt" seeking damages for"bodily continuation, change or resumption of that "bodily injury" or "property damage" to which this ily Injury" or "property damage'" after the insurance does not apply. We may, at our end of the policy period. discretion, investigate any "occurrence" and d. "Bodily Injury" or "property damage" will be .settle any claim or"suit"that may result. But; deemed to have been known to have occurred (1) The amount we will pay for damages is at the earliest time when any insured listed limited as described In Section III -- Limits under Paragraph 1. of Section II —Who Is An Of Insurance;and Insured or any"employee" authorized by you to give or receive notice of an "occurrence" or (2) Our right and duty to defend end when we claim: have used up the applicable limit of insurance in the payment of judgments or (1) Reports all, or any part, of the "bodily settlements under Coverages A or B or injury" or "property damage" to us or any medical expenses under Coverage C. other Insurer; No other obligation or liability to pay sums or (2) Receives a written or verbal demand or perform acts or services is covered unless claim for damages because of the "bodily explicitly provided for under Supplementary injury"or"property damage"; or Payments. (3) Becomes aware by any other means that b. This insurance applies to "bodily Injury" and "bodily injury" or "property damage" has „properly damage"only if; occurred or has begun to occur. CG T'I 00 0219 @ 2017The Travelers Indemnity Company.All rights reserved, Page I of 21 includes copyrighted material of Insurance services Office,Inc.with its permission. j I COMMERCIAL GENERAL LIABILITY e. Damages because of "bodily injury' include (3) Any statute, ordinance or regulation relating damages claimed by any person or organization to the sale, gift, distribution or use of for care, loss of services or death resuiting at alcoholic beverages, any time from the"bodily injury". This exclusion applies only if you are In the 2. Exclusions business of manufacturing, distributing, selling, This insurance does not appiyto: serving or furnishing alcoholic beverages. For a, Expected Cr Intended Injury the purposes of this exclusion, permitting a person to bring alcoholic beverages on your "Bodily injury"or"property damage"expected or premises, for consumption on your premises, intended from the standpoint of the Insured, whether or not a fee is charged or a license is This mcluslon does not apply to"bodily Injury" required for such activity, is not by Itself or "property damage" resulting from the use of considered the business of selling, serving or reasonable force to protect persons or property. furnishing alcoholic beverages. b. Contractual Liability d. Workers'Compensation And Similar Laws "Bodily Injury" or "property damage" for which Any obligation of the insured under a workers' the Insured is obligated to pay damages by compensation, disability benefits or reason of the assumption of liability In a unemployment compensation law or any similar contract or agreement. This exclusion does not lays, apply to liability for damages: e. Employer's Liability (1) That the insured would have in the absence "Bodily injury, to.- of the contract or agreement,or (2) Assumed in a contract or agreement that is (1) An "employee" of the insured arising out of an "Insured contract", provided that the and in the course of; "bodily injury"' or "property damage" occurs (a) Employment by the Insured; or subsequent to the execution of the contract (b) performing duties related to the or agreement. Solely for the purposes of conduct of the insured's business;or liability assumed In an "Insured contract'", (2) The spouse, child,parent, brother or sister reasonable attorneys fees and necessary of that "employee" as a consequence of litigation expenses Incurred by or for a party paragraph(1)above, other than an insured will be deemed to be damages because of "bodily injury" or This exclusion applies whether the insured may "property damage",provided that: be liable as an employer or in any other capacity (a) Liability to such party for, or for the and to any obligation to share damages with or cost of, that party's defense has also repay someone else who must pay damages been assumed in the same "Insured because of the IrtJury, contract"; and This exclusion does not apply to liability (b) Such attorneys' fees and litigation assumed by the insured under an "insured expenses are for defense of that party contract . against a civil or alternative dispute f• Pollution resolution proceeding in which (1) "Bodily injury„ or"property damage'arising damages to which this insurance out of the actual, alleged or threatened applies are alleged, discharge, dispersal, seepage, migration, c. Liquor Liability release or escape of"Pollutants": "Bodily injury" or "property damage" for which (a) At or from any premises, site or any insured may be held liable by reason of: location WHO Is or was at any time owned or occupied by, or rented or (1) Causing or contributing to the intoxication loaned to, any insured. However, this of any pecan; subparagraph does not apply to: (7) The furnishing of alcoholic beverages to a (i) "Bodily injury' if sustained within a person under the legal drinking age or building and caused by smoke, under the influence of alcohol; fumes, vapor or soot produced by or originating from equipment that i Page 2 of 21 0 2017 The Travelers indemnity Company.All rights reserved. CG"T1 pp 0219 Includes copyrlghW material of insurance Services Office,Inc.with Its permission. COMMERCIAL GENERAL LIABILITY Is used to heat, cool or dehumidify to perform the normal electrical, the building, or produced by or hydraulic or mechanical functions originating from equipment that is necessary for the operation of used to heat water for personal "mobile equipment" or its parts, if use by the building's occupants or such fuels, lubricants or other their guests; operating fluids escape from a (ii) "Bodily injury" or "property vehicle part designed to hold, store damage" for which you may be or receive them. This exception held liable, if you are a contractor does not apply if the "bodily Injury" and the owner or lessee of such or"property damage" arises out of premises,site or location has been the intentional discharge, dispersal added to your policy as an or release of the fuels, lubricants additional insured with respect to or other operating fluids, or if such your ongoing operations performed fuels, lubricants or other operating for that additional insured at that fluids are brought on or to the premises,site or location and such premises, site or location with the premises, site or location is not intent that they be discharged, and never was owned or occupied dispersed or released as part of by, or rented or loaned to, any the operations being perforated by insured, other than that additional such insured, contractor or Insured;or subcontractor; (111) "Bodily Injury' or "property damage" arising out of heat, (ll) 'Bodily injury' or "property smoke or fumes from a "hostile damage" sustained within a fire"; building and caused by the release of gases, fumes or vapors from (b) At or from any premises, site or materials brought into that building location which is or was at any time in connection with operations being used by or for any insured or others for performed by you or on your behalf the handling, storage, disposal, by a contractor or subcontractor;or processing or treatment of waste, (c) If such "pollutants" are or were at any (Ill) "Bodily injury' or "property time transported, handled, stored, damage" arising out of heat, treated, disposed of, or processed as smoke or fumes from a "hostile waste by or for; fire!';or (1) Any insured,or (a) At or from any premises, site or (11) Any person or organization for location on which any insured or any whom you may be legally contractors or subcontractors working responsible; directly or indirectly on any Insured's behalf are or were 'at any time (d) At or from any premises, site or performing operations to test for, location on which any insured or any monitor, clean up, remove, contain, contractors or subcontractors working treat, detoxify or neutralize, or in any j directly or indirectly on any insured's way respond to, or assess the effects behalf are performing operations if the of,"pollutants". "pollutants" are brought on or to the premises, site or location in connection (2) Any loss, cost or expense arising out of with such operations by such insured, any. contractor or subcontractor. However, (a) Request, demand, order or statutory or this subparagraph does not apply to: {i) "Bodily injury" " regulatory requirement that any insured y ! ry or property or others test for, monitor, clean up, damage" arising out of the escape remove, contain, treat, detoxify or of fuels, lubricants or other neutralize, or in any way respond to,or operating fluids which are needed assess the effects of,"pollutants",or CG T1 00 0219 0 2017 The Travelers Indemnity Company.Ail rights reserved, Page 3 of 21 Includes copyrighted maternal of Insurance Services t5ffice,Inc.with its permission, I I COMMERCIAL GENERAL LIABILITY (b) Claim or suit by or on behalf of any (b) The operation of any of the machinery governmental authority or any other or equipment listed in Paragraph f.(2) person or organization because of or f.(3) of the definition of "mobile testing for, monitoring, cleaning up, equipment"; or removing, containing, treating, (g) An aircraft that is: detoxifying or neutralizing, or in an way responding to, or assessing the (a) Chartered with a pilot to any insured; effects of,"pollutants", (b) Not owned by any insured;and g. Aircraft,Auto Or Watercraft: (c) Not being used to carry any person or „Bodily injury" or "property damage" arising out property for a charge. of the ownership, maintenance, use or h, Mobile Equipment entrustment to others of any aircraft, "auto" or "Bodily Injury" or"property damage" arising out watercraft owned or operated by or rented or of: loaned to any insured, Use includes operation and"loading or unloading". (1) The transportation of "mobile equipment" This exclusion applies even if the claims by an "auto" owned or operated by or against any insured allege negligence or other rented or loaned to any insured,or wrongdoing in the supervision, hiring, (2) The use of"mobile equipment" in, or while employment, training or monitoring of others by in practice for, or while being prepared for, that insured, if the "occurrence" which caused any prearranged racing, speed, demolition, the"bodily injury"or"property damage"involved or stunting activity. the ownership, maintenance, use or i. war entrustment to others of any aircraft, "auto" or "Bodily Injury"or"property damage" arising out watercraft that is owned or operated by or of rented or loaned to any insured. This exclusion does not apply to: (1) War, including undedared or civil war; (2) Warlike action by a military farce, including (1) A watercraft while ashore an premises you oven or rent, action in hindering or defending against an actual or 6pected attack, by any (2) A watercraft you do not own that is: government, sovereign or other authority (a) 50 feet long or less,and using military personnel or other agents;or (b) Not being used to carry any person or (3) Insurrection, rebellion, revolution, usurped property for a charge; power, or action taken by governmental (3) Parking an "auto" on, or on the ways next authority In hindering or defending against to, premises you own or rent, provided the any of these. "auto" is not owned by or rented or loaned J. damage To Property to you or the Insured; "Property damage"to; (4) Liability assumed under any "insured (1) Property you own, rent, or occupy, contract"for the ownership,maintenance or Including any costs or expenses Incurred use of aircraft or watercraft; by you, or any other person,organization or (5) "Bodily injury" or"property damage" arising entity, for repair, replacement, out of: enhancement, restoration or maintenance (a) The operation of machinery or of such property For any reason, including equipment that Is attached to, or part preventlon of injury to a person or damage of, a land vehicle that would qualify as to another's property; I "mobile equipment" underthedefinition (2) Premises you sell,give away or abandon, if � of "mobile equipment"' if such land the "property damage" arises out of any vehicle were not subject to a part of those premises; compulsory or financial responsibility (3) Property loaned to you; law, or other motor vehicle insurance law, where it is licensed or principally ( ) Personal property in the care, custody or garaged; or control of the insured; I I i Page 4 of 21 0 2017 The Travelers indemnity Company.All rights reserved. CG T1 pp 021 g Includes copyrighted material of insurance Services office,Inc.w11.17 Its permisslan. I i COMMERCIAL GENERAL LIABILITY (5) That particular part of real property on accidental physical injury to "your product" or which r you or any contractors or "your work" after it has been put to its intended subcontractors working directly or indirectly use, on your behalf are performing operations, if n. Recall of Products"Work Or Impaired the "property damage" arises out of those Property operations, or Damages claimed for any loss, cost or expense (6) That particular part of any property that Incurred by you or others for the loss of use, must be restored, repaired or replaced withdrawal, recall, inspection, repair, because "your work" was incorrectly replacement, adjustment, removal or disposal performed on it. of: Paragraphs(`l), (3) and(4) of this exclusion do ('I) "Your product'; not apply to "premises damage". A separate (2) "Your work";or limit of insurance applies to"premises damage" as described in Paragraph 6. of section III -- (3) "Impaired property"; Limits Of Insurance, If such product, work, or property is withdrawn Paragraph(2)of this exclusion does not apply if or recalled from the market or from use by any the premises are "your work" and were never person or organfzatlon because of a known or occupied,rented or held for rental by you, suspected defect, deficiency, inadequacy or Paragraphs (3), (4), (5) and (6) of this dangerous condition in it. exclusion do not apply to liability assumed o• Personal And Advertising Injury under a sidetrack agreement, "Eodily Injury" arising out of "personal and Paragraph (6) of this exclusion does not apply advertising injury'. to"property damage" included fn the"products- p. Electronic Data completed operations hazard". Damages arising out of the loss of, loss of use k. Damage To Your Product of,damage to,corruption of, inability to access, "Property damage"to "your product" arising out or inability to manipulate"electronic data". of It or any part of it. However, this exclusion does not apply to 1, Damage To Your Work liability for damages because of"bodily Injury". "Property damage"to"your work" arising out of q. Unsolicited Communication it or any part of it and included in the"products- ""i"Bodily njury or property damage!'ge" arising out completed operations hazard of any actual or alleged violation of any law that This exclusion does not apply if the damaged restricts or prohibits the sending, transmitting work or the work out of which the damage or distributing of"unsolicited communication". arises was performed on your behalf by a subcontractor. r. Access Or Disclosure Of Confidential Or m, Damage To Impaired Property Or Property Personal Information Not Physically Injured "Bodily Injury„ or"property damage" arising out "Property damage" to "impaired property" or of any access to or disclosure of any person's or organization's confidential or personal property that has not been physically inured, information. arising out of: (1) A defect, deficiency, Inadequacy or s' Asbestos dangerous condition in "your product" or (1) "Bodily injury„or"property damage"arising "your work";or out of the actual or alleged presence or (2) A delay or failure by you or anyone acting actual, alleged or threatened dispersal of on your behalf to perform a contract or asbestos, asbestos fibers or products agreement in accordance with its terms, containing asbestos, provided that the This exclusion does not apply to the Ions of use "bodily injury' or "property damage" Is caused or contributed to by the hazardous of other property arising out of sudden and properties of asbestos. j i GG T1 QO 0219 @ 2017 The Travelers Indemnity Company.All rights reserved. page 5 of 21 Includes copyrighted material of Insurance sarvlces office,Inc,with its permission. COMMERCIAL GENERAL LIABILITY (2) "Bodily injury' or"property damage"arising employment-related practices described in out of the actual or alleged presence or Paragraph(a), (b), or(c) above Is directed. actual, alleged or threatened dispersal of This exclusion applies whether the insured may any solid, liquid, gaseous or thermal irritant be liable as an employer or in any other capacity or contaminant, including smoke, vapors, and to any obligation to share damages with or soot, fumes, acids, alkalis, chemicals and repay someone else who must pay damages waste, and that are part of any claim or because of the"bodily injury" "suit" which also alleges any"bodily injury' Exclusions c, through rt. do not apply to "premises or "property damage" described in darnage". A separate limit of Insurance applies to Paragraph(1)above. "premises damage' as described in Paragraph6. of (3) Any loss, cost or expense arising out of section III—Limits Of Insurance. any: COVERAGE B--PERSONAL AND ADVERTISING (a) Request, demand, order or statutory or INJURY LIABILITY regulatory requirement that any insured 1. Insuring Agreement or others test for, monitor, clean up, a, We will pay those sums that the Insured remove, contain, treat, detoxify or becomes legally obligated to pay as damages neutralize, or In any way respond to, or because of "personal and advertising injury" to assess the effects of, asbestos, which this insurance applies. We will have the asbestos fibers or.products containing right and duty to defend the insured against any asbestos; or "suit"seeking those damages. However,we will (b) Claim or suit by or on behalf of any have no duty to defend the insured against any governmental authority or any other "suit" seeking damages for "personal and person or organization because of advertising injury"to which this insurance does testing for, monitoring, cleaning up, not apply. We may, at our discretion, removing, containing, treating, Investigate any offense and settle any claim or detoxifying or neutralizing, or in any "suit"that may result. But; way responding to, or assessing the (1) The amount we will pay for damages is effects of, asbestos,asbestos fibers or limited as described in Section III --Limits products containing asbestos. Of Insurance; and It. Employment-Related Practices (2) Our right and duty to defend end when we „Bodily injury"to: have used up the applicable limit of (1) A person arising out of any: insurance In the payment of judgments or (a) Refusal to employ that person; settlements under Coverages A or B or (b) Termination of that person's medical expenses under Coverage C. employment; or No other obligation or liability to pay sums or (c) Employment-related practice, policy, perform acts or services is covered unless act or omission, such as coercion, explicitly provided for under Supplementary demotion, evaluation, reassignment, payments. discipline, failure to promote or b. This insurance applies to "personal and advance, harassment, humiliation, advertising injury" caused by an offense arising discrimination, libel, slander, violation out of your business but only if the offense was of the person's right of privacy, committed in the"coverage territory' during the malicious prosecution or false arrest, policy period, detention or imprisonment applied to or 2. Exclusions directed at that person, regardless of This insurance does not apply whether such practice, policy, act or ranceto: omission occurs, is applied or is A. Knowing Violation Of Rights Of Another committed before, during or after the it Personal and advertising injury' caused by or time of that person's employment; or at the direction of the insured with the (2) The spouse, child, parent, brother or sister knowledge that the act would violate the rights of that personas a consequence of "bodily of another and would inflict "personal and injury" to that person at whom any of the advertising injury'. Page 6 of 21 a 2017 The Travelers Indemnity Company.All rights reserved. CC T1 pp 021 g Includes copyrighted material of Insurance services Office,ine.wlih Its permisslon, COMMERCIAL GENERAL LIABILITY This exclusion does not apply to "personal against a civil or alternative dispute injury"caused by malicious prosecution. resolution proceeding in which b. Material Published With Knowledge Of damages to which this insurance Falsity applies are alleged. "Personal and advertising Injury' arising out of f. Breach Of Contract oral or written publication, including publication "Advertising injury' arising out of a breach of by electronic means,of material, If done by or at contract, the direction of the insured with knowledge of g, Quality Or Performance Of Goods—Failure its falsity. To Conform To Statements c. Material Published Or Used Prior To Policy "Advertising injury" arising out of the failure of Period goods, products or services to conform with (1) "Personal and advertising injury'arising out any statement of quality or performance made of oral or written publication, including in your"advertisement". publication by electronic means, of material h. Wrong Description Of Prices whose first publication'took place before the beginning of the policy period;or "Advertising injury" arising out of the wrong (2) "Advertising injury" arising out of description of the price of goods, products or infringement of copyright, "t€tle"or"slogan" services stated in your"advertisement" in your "advertisement" whose first I. Intellectual Property infringement in your "advertisement" was "Personal and advertising injury" arising out of committed before the beginning of the any actual or alleged infringement or violation of policy period, any of the following rights or laws, or any other d. Criminal A "personal and advertising injury' alleged in any "Personal and advertising injury"arising out of a claim or "suit" that also alleges any such criminal act committed by or at the direction of infringement or violation: the Insured. (1) Copyright; e. Contractual Liability (2) Patent; "Personal and advertising injury" for which the (3) Trade dress; insured has assumed liability in a contract or (4) Trade name; agreement. This exclusion does not apply to ( ) Trademark; liability for damages: (1) That the Insured would have in the absence (6) Trade secret;or of the contract or agreement; or ( Other intellectual property rights or laws. (2) Because of "personal injury" assumed by This exclusion does not apply to: you in a contract or agreement that is an (1) "Advertising injury'arising out of any actual "insured contract", provided that the or alleged Infringement or violat€on of "personal injury' is caused by an offense another's copyright, "titie" or "slogan" in committed subsequent to the execution of your"advertlsemenf;or the contract or agreement, Solely for the purposes of liability assumed by you in an (2) Any other "personal and advertising injury" "insured contract", reasonable attorneys' alleged in any claim or "suit" that also fees and necessary litigation expenses alleges any such infringement or violation incurred by or for a party other than an of another's copyright, "title' or"slogan" in insured will be deemed to be damages your"advertisemenft because of"personal injury",provided that: J. Insureds In Media And Internet Type (a) Uabillty to such party for, or for the Businesses cost of, that party's defense has also "Personal and advertising Injury" caused by an been assumed dby you in the same offense committed by an insured whose Insured contract';and business is: (b) Such attorneys' fees and litigation expenses'are for defense of that party (1) Advertising, "broadcasting"or publishing; CG T1 00 02 19 (D 2017 The Travelers Indemnity Company.All rights reserved, Page 7 of 21 Includes copyrighted material of Insurance Services Office,Inc.with its permission. COMMERCIAL-GENERAL LIABILITY (2) Designing or determining content of neutralizing, or In anyway responding to,or websites for others;or assessing the effects of, "pollutants". (3) An Internet search, access, content or o. War service provider, "Personal and advertising injury„ arising out of: However, this exclusion does not apply to (1) War, including undeclared or civil war; Paragraphs a,(1),(2) and(3) of the definition of "personal injury", (2) Warlike action by a military force, including For the purposes of this exclusion; action in hindering or defending against an actual or expected attack, by any (1) Creating and producing correspondence government, sovereign or other authority written in the conduct of your business, us€ng military personnel or other agents;or bulletins, financial or annual reports, or (3) Insurrection, rebellion, revolution, usurped newsletters about your goods, products or power, or action taken by governmental services will not be considered the authority in hindering or defending against business of publishing;and any of these (2) The placing of frames, borders or links, or p, Unsolicited Communication advertising, for you or others anywhere on the Internet will not, by itself, be considered "Personal and advertising Injury" arising out of the lousiness of advertising, "broadcasting" any actual or alleged violation of any law that or publishing. restricts or prohibits the sending, transmitting or distributing of"unsolicited communication". k. Electronic Chatroams Or Bulletin Boards g. Access Or Disclosure Of Confidential Or "Personal and advertising injury" arising out of Personal Information an electronic chatroom or bulletin board the "Personal and advertising injury" arising out of Insured hosts or owns, or over which the any access to or disclosure of any person's or Insured exercises control, organization's confidential or personal 1. Unauthorized Use Of Anoth&s Name Or information, Product r. Asbestos "Personal and advertising injury" arising out of (1) "personal and advertising injury,arising out the unauthorized use of another's name or of the actual or alleged presence or actual, product In your e-mail address, domain name or alleged or threatened dispersal of asbestos, metatag, or any other similar tactics to mislead asbestos fibers or products containing anothers potential customers, asbestos, provided that the "p ersonal personal and m. Pollution advertising injury" is caused or contributed "Personal and advertising injury" arising out of to by the hazardous properties of asbestos. the actual, alleged or threatened discharge, (2) "personal and advertising injury"arising out dispersal, seepage, migration, release or of the actual or alleged presence or actual, escape of"pollutants"at any time. alleged or threatened dispersal of any solid, n, pollution-Related liquid, gaseous or thermal irritant or contaminant, including smoke, vapors, Any loss,cost or expense arising out of any: soot, fumes, acids, alkalis, chemicals and (1) Request, demand, order or statutory or waste, and that are part of any claim or regulatory requirement that any insured or "suit"which also alleges any„personal and others test for, monitor, clean up, remove, advertising Injury" described In paragraph contain, treat, detoxify or neutralize, or In (1) above. any way respond to, or assess the effects (3) Any loss, cost or expense- arising out of of, "pollutants";or any; (2) Claim or suit by or on behalf of any (a) Request, demand,order or statutory or governmental authority or any other person regulatory requirement that any insured or organization because of testing for, or others test for, monitor, clean up, monitoring, cleaning up, removing, remove, contain, treat, detoxify or containing, treating, detoxifying or neutralize, or In any way respond to,or Page 8 of 21 0 2017 The Travelers Indemnity Company.All rights reserved. CG T I Oq 02 19 includes copyrighted material of Insurance Services Office,Inc.with its permission. COMMERCIAL GENERAL LIABILITY assess the effects of, asbestos, (3) Because of your operations; asbestos fibers or products containing provided that; asbestos;or (b) Claim or suit by or on behalf of any (a) The accident takes place in the "coverage governmental authority or any other territory' and during the policy period; person or, organization because of (b) The expenses are Incurred and reported to testing for, monitoring, cleaning up, us within one year of the date of the removing, containing, treating, accident;and detoxifying or neutralizing, or in any (c) The injured person submits to examination, way responding to, or assessing the at our expense, by physicians of our choice effects of,asbestos,asbestos fibers or as often as we reasonably require, products containing asbestos. b. We will make these payments regardless of s. Employment-Related Practices fault. These payments will not exceed the "Personal injury"to: applicable limit of Insurance. We will pay (1) A person arising out of any., reasonable expenses for: (a) Refusal to employ that person; (1) First aid administered at the time of an accident; (b) Termination of that person's (2) Necessary medical, surgical, X-ray and employment;or dental services, including prosthetic (c) Employment-related practice, policy, devices; and act or omission, such as coercion, (3) Necessary ambulance, hospital, demotion, evaluation, reassignment, professional nursing and funeral services, discipline, failure to promote or advance, harassment, humillation, 2. Exclusions discrimination, libel, slander, violation We will not pay expenses for"bodily injury": of the person's right of. privacy, a. Any Insured malicious prosecution or false arrest, To any Insured,except"volunteer workers", detention or Imprisonment applied to or directed at that person, regardless of b. Wired Person whether such practice, policy, act or To a person hired to do work for or on behalf of omission occurs, is applied or is any insured or a tenant of any Insured, commltted before, during or after the c. injury On Normally Occupied premises tdme of that person's employment;or To a person injured on that park of premises (2) The spouse, child, parent, brother or sister you own or rent that the person normally of that person as a consequence of occupies. "personal Injury" to that person at whom any of the employment-related practices d. Workers'Compensatlon And Similar Laws described in Paragraph (a), (b), or (c) To a person, whether or not an "employee" of above is directed, any insured, If benefits for the"bodily injury"are This exclusion applies whether the insured may payable or must be provided under a workers' be liable:as an employer or in any other capacity compensation or disability benefits law or a and to any obligation to share damages with or similar law. repay someone else who must pay damages e. Athletics Activities because of the"personal injury". To a person injured while practicing, Instructing COVE=RAGI~C-+II MEDICAL PAYMENTS or participating in any physical exercises or 1. Insuring Agreement games, sports,or athletic contests. a. We will pay medical expenses as described f. Products-Completed Operations Hazard below for"bodily injury"caused by an accident: Included within the "products-completed (1) On premises you own or rent; operations hazard". (2) On ways next to premises you own or rent; g. Coverage A Exclusions or Excluded under Coverage A. CG T1 00 02 19 0 2017 The Travelers indemnity company.All rights reserved. Page 9 of 21 Includes copyrighted material of Insurance Services office,Inc,with its permission. COMMERCIAL GENERAL LIABILITY SUPP EMENTARY PAYMENTS assumed by the Insured in the same "Insured 1. We will pay, with respect to any claim we contract"; investigate or settle, or any"suit" against an insured d. The allegations in the"suit" and the Information we defend: we know about the"occurrence" or offense are a. All expenses we Incur. such that no conflict appears to exist between the Interests of the insured and the interests of b. Up to$2,500 for the cost of bail bonds required the indemnitee; because of accidents or traffic law violations e. The Indemnitee and the Insured ask us to arising out of the use of any vehicle to which conduct and control the defense of that the Bodily Injury Gabil€ty Coverage applies, We Indemnitee against such "suit" and agree that do not have to furnish these bonds, we can assign the same counsel to defend the c. The cost of bonds to release attachments, but insured and the indemnitee; and only for bond amounts within the applicable limit f. The Indemnitee: of insurance. We do not have to furnish these (1) Agrees in writing to: bonds, (a) Cooperate with us In the investigation, d. All reasonable expenses incurred by the settlement or defense of the"suit"; Insured at our request to assist us in the (b) Immediately send us copies of any investigation or defense of the claim or "suit", demands,notices,summonses or legal including actual loss of earnings up to $500 a papers received in connection with the day because of time off from work. "suit'; e. All court costs taxed against the insured in the (c) Notify any other insurer whose "suit". However, these payments do not include coverage is available to the indemnitee; attorneys' fees or attorneys' expenses taxed and againstthe insured. (d) Cooperate with us with respect to f. Prejudgment interest awarded against the coordinating other applicable insurance Insured on that part of the judgment we pay, If available to the Indemnitee;and we make an offer to pay the applicable limit of (2) Provides us with written authorization to: insurance„ we will not pay any prejudgment interest based on that period of time after the (a) Obtain records and other information offer. related to the"suit";and g. Al Interest on the full amount of any judgment (b) Conduct and control the defense of the that accrues after entry of the judgment and indemnitee in such"sult". before we have paid, offered to pay, or So long as the above condltions are met, attorneys' deposited in court the part of the judgment that fees incurred by us in the defense of that is within the applicable Cu-nit of insurance. Indemnitee, necessary litigation expenses Incurred These payments will not reduce the limits of by us and necessary litigation expenses incurred by insurance the indemnitee at our request will be paid as 2. If we defend an Insured against a "suit" and an Supplementary Payments. Notwithstanding the Indemnitee of the insured is also named as a provisions of Paragraph 2.b.(2) of Section I party to the "suit", we will defend that indemnitee If all of Coverages — Coverage A — Bodily Iryury AndProperty Damage Liability or Paragraph U. of the following conditions are n,et! Section I — Coverages -- Coverage S Personal a. The "suit" against the indemnitee seeks And Advertising Injury Liability, such payments will damages for which the insured has assumed not be deemed to be damages for "bodily injury", the liability of the indemnitee in a contract or "property damage" or"personal injury", and will not agreement that is an"Insured contract"; reduce the limits of insurance. b. This insurance applies to such liability assumed Our obligation to defend an Insured's indemnitee by the insured; and to pay for attorneys' fees and necessary c. The obligation to defend, or the cost of the litigation expenses as Supplementary Payments defense of, that Indemnitee, has also been ends when: i Page 10 of 21 0 2017 The Travelers Indemnity Company.All rights reserved, CG T1 00 0219 Includes copyrighted material of Insurince Services Office,Inc,with its permission, COMMERCIAL GrENERAL LIABILITY a. We have used up the applicable limit of workers" while performing duties Insurance In the payment of Judgments, related to the conduct of your settlements or medical expenses; or business; b. The conditions set forth above, or the terms of (b) To the spouse,child, parent, brother or the agreement described in Paragraph f, above, sister of that co-"employee" or are no longer met, "volunteer worker" as a consequence SECTION lI—WHO IS AN INSURED of Paragraph(1)(a)above, 1. If you are designated in the Declarations as; (c) For which there is any obligation to a. An individual, you and your spouse are share damages with or repay someone insureds, but only with respect to the conduct else who must pay damages because of a business of which you are the sole owner, of the injury described in paragraph b. A partnership or joint venture, (1)(a)or(b) above; or p p j you are an (d) Arising out of his or her providing insured, Your members, your partners, and p vrciing or their spouses are also insureds, but only with failing to provide professional health respect to the conduct of your business, care services. c. A limited liability company, you are an insured. Unless you are in the business or Your members are also insureds, but only with occupation of providing professional health respect to the conduct of your business. Your care services, Paragraphs (1)(a), (b), (c) managers are insureds,but only with respect to and(d) above do not apply to"bodily injury" their duties as your managers. arising out of providing or failing to provide d. An organization other than a first aid or "Good Samaritan services" by g partnership, joint any of your employees or volunteer venture or limited liability company, you are an workers", other than an employed or insured. Your"executive officers" and directors volunteer doctor. Any such "employees" or are Insureds, but only with respect to their "volunteer workers" providing or failing to duties as your officers or directors. Your provide first aid or "Good Samaritan stockholders are also insureds, but only with services" during their work hours for you respect to their liability as stockholders, w€II be deemed to be acting within the e. A trust, you are an Insured. Your trustees are scope of their employment by you or also Insureds, but only with respect to their performing duties related to the conduct of duties as trustees, your business. 2. Each of the following is also an insured; (2) "Property damage"to property; a. Your "volunteer workers" only while performing (a) Owned,occupied or used by, duties related to the conduct of your business, (b) Rented to, in the care, custody or or your "employees", other than either your control of, or over which physical "executive officers" (if you are an organization control is being exercised for any other than a partnership,joint venture or limited purpose by; liability company) or your managers(if you are a you, ally of your "employees" "volunteer limited liability company), but only for acts workers",any partner or member(if you are within the scope of their employment by you or a partnership or joint venture), or any while performing duties related to the conduct member (if you area limited liability tof your business. 'However, none of I�these company), employees or volunteer workers are insureds for. b. Any person (other than your "employee" or (1) 'Bodily injury"or"personal injury"; "volunteer worker"), or any organization, while acting as your real estate manager. (a) To you,to your partners or members (€f c, Any person or organization having proper you are a partnership or joint venture), temporary custody of your property if you die, to your members (if you are a limited but only liability company), to a co-"employee" while in the course of his or her (1) With respect to liability arising out of the employment or performing duties maintenance or use of that property;and related to the conduct of your (2) Until your legal representative has been business, or to your other "volunteer appointed, i CG T1 00 0219 0 2017 The Travelers Indemnity Company.All rights reserved, page 11 of 21 Includes copyrighted material of Insurince Services Office,Inc.with its permission. COMMERCIAL GENERAL LIABILITY d. Your legal representative if you dle, but only b. Arises out of the ownership, maintenance or with respect to duties as such, That use of that part of any premises leased to you. representative will have all your rights and The insurance provided to such premises owner, duties under this Coverage Part, manager or lessor Is subject to the following e. Any person or organization that, with your provisions; express or implied consent, either uses or is a, The limits of insurance provided to such responsible for the use of a watercraft that you premises owner, manager or lessor will be the do not own that is: minimum limits that you agreed to provide in the (1) 50 feet Tong or less;and written contract or agreement, or the limits (2) Not being used to carry any person or shown in the Declarations,whichever are less. propertyfor a charge, b. The insurance provided to such premises 3. Any organization you newly acquire or form, other owner, manager or lessor does not apply to: than a partnership, joint venture or limited liability (1) Any "bodily Injury" or "property damage', company, and of which you are the sole owner or in that occurs, or "personal and advertising which you maintain an ownership interest of more injury" caused by an offense that is than 50%,will qualify as a Named Insured if there is committed, after you cease to be a tenant In no other similar insurance available to that that premises; or organization. However: (2) Structural alterations, new construction or a. Coverage under this provision is afforded only demolition operations performed by or on until the 180th day after you acquire or form the behalf of such premises owner, manager or organization or the end of the policy period, lessor. whichever is earlier; 5, Any person or organization that Is an equipment b. Coverage A does not apply to "bodily injury" or lessor and that you have agreed in a written contract "property damage" that occurred before you or agreement to include as an additional Insured on acquired or formed the organization; and this Coverage Part is an insured, but only with c. Coverage B does not apply to "personal and respect to liability for "bodily injury", "property advertising injury" arising out of an offense damage", or"personal and advertising lnjury'that: committed before you acquired or formed the a. Is "bodily injury' or "property damage" that organization. occurs, or is "personal and advertising injury" For the purposes of Paragraph 1. of Section II — caused by an offense that is committed, Who Is An Insured, each such organization will be subsequent to the signing of that contract or deemed to be designated in the Declarations as; agreemenE; and a. An organization, other than a partnership, joint b• Is caused, In whole or in part; by your acts or venture or limited[lability company;or omissions In the maintenance, operation or use of equipment leased to you by such equipment b. A trust; lessor, as indicated in its name or the documents that The Insurance provided to such equipment lessor is govern its structure, subject to the following provisions: 4. Any person or organization that is a premises a. The Iimlts of Insurance provided to such owner,manager or lessor and that you have agreed equipment lessor will be the minimum limits that in a written contract or agreement to include as an You agreed to provide in the written contract or agreement, or the limits shown in the additional insured an this Coverage Part Is an Declarations, whichever are less. insured, but only with respect to liability for"bodily injury', "property damage" or "personal and h. The Insurance provided to such equipment advertising injury'that: lessor does not apply to any "bodily Injury' or "property damage" that occurs, or "personal a. Is "bodily injury" or "property damage" that and advertising injury" caused by an offense occurs, or is "personal and advertising injury' that is comrnlmd, after the equipment lease caused by an offense that is committed, expires, subsequent to the signing of that contract or No person or organization is an insured with respect to agreement; and the conduct of any current or past partnership, joint Page 12 of 21 0 2047 The Travelers Indemnity Cannany.All rights reserved. CG T1 00 0219 Includes copyrighted material of Insurance Services office,Inc,with its permission. I COMMERCIAL GENERAL LIABILITY venture or limited liability company that is not shown as a. The amount shown for the Damage. To a Named Insured In the Declarations. This paragraph Premises Rented To You Limit in the does not apply to any such partnership.Joint venture or Declarations of this Coverage Part; or limited liability company that otherwise qualifies as an b. $300,000 if no amount is shown for the Insured under Section II—Who Is An Insured, Damage To Premises Rented To You Limit in SECTION III—LIMITS OF INSURANCE the Declarations of this Coverage Part. 1. The Limits of Insurance shown in the Declarations y. Subject to paragraph S. above, the Medical and the rules below fix the most we will pay Expense Limit is the most we will pay under regardless of the number of; Coverage C for all medical expenses because of a. lnsureds; "bodily lnjury" sustained by anyone person, The Limits of Insurance of this Coverage Part apply b, Claims made or"suits"brought; or separately to each consecutive annual period and to any c. Persons or organizations making claims or remaining period of less than 12 months, starting with bringing"suits". the beginning of the policy period shown in the 2. The General Aggregate Limit is the most we will pay Declarations, unless the policy period is extended after for the sum of. Issuance for an additional period of less than 12 months, In that case, the additional period will be a. Medical expenses under Coverage C; deemed part of the last preceding period for purposes of b. Damages under Coverage A, except damages determining the Limits of Insurance. because of"bodily injury"or"property damage" SECTION 1V—COMMERCIAL GENERAL LIABILITY included in the "products-completed operations CONDITIONS hazard'",and 1. Bankruptcy c, Damages under Coverage B. Bankruptcy or insolvency of the insured or of the 3. The Products-Completed Operations Aggregate insured's estate will not relieve us of our obligations Limit Is the most we will pay under Coverage A for under this Coverage Part, damages because of "bodily injury' and "properly damage included in the "products-completed Z. Duties In Event Of Occurrence,Offense, The operations hazard". Claim Or TSuit The 4. Subject to Paragraph 2. above, the Personal And a. You must see to it that we are notified as soon Advertising Injury Limit is the most we will pay as practicable of an "occurrence" or an offense under Coverage B for the sum of all damages which may result in a claim. To the extent because of all "personal Injury" and "advertising possible, notice should Include, injury'sustained by any one person or organization. M How, when and where the "occurrence"or S. Subject to Paragraph 2. or 3. above, whichever offense took place; applies, the Each Occurrence Limit is the most we (2) The names and addresses of any injured will pay for the sum of, persons and witnesses;and a. Damages under CoverageA;and (3) The nature and location of any injury or b, Medical expenses under Coverage C; damage arising out of the "occurrence" or offense, because of all"bodily injury" and"property damage" b. If a claim is made or "suit" is brought against arising out of any one"occurrence", g g any insured,you must; For the purposes of determining the applicable Each [occurrence Limit, all related acts or (1) Immediately record the specifics of the omisslons committed in providing or failing to claim or"suit and the date received;and provide first aid or "Good Samaritan services" to (2) Notify us as soon as practicable, any one person will be deemed to be one You must see to it that we receive written notice "occurrence", of the claim or"suit"as soon as practicable, 6. Subject to paragraph S. above, the Damage To c. You and any other involved insured must; Premises Rented To You Limit is the most we will {1) Immediately send us copies cal an pay under Coverage A for damages because of demands, notices, summonses or le y"premises damags" to any one premises, The: gal Damage To Premises Rented To You Limit will be; papers received in connection with the claim or"suit"; CG T1 00 02 19 (r 2017 The Travelers Indemnity Company.All rights reserved, Page t3 of 21 Includes copyrighted material of Insurance Services Office,Inc.with its permisslon. i I COMMERCIAL GENERAL LIABILITY (2) Authorize us to obtain records and other 010 An exeeutive'officer or director of information; any other organization; or (3) Cooperate with us in the investigation or Ov) A trustee of any trust; settlement of the claim or defense against that Is the"suit"; and your partner, joint venture (4) Assist us, upon our request, in the member, manager or trustee;or enforcement of any right against any (b) Any employee authorized by such person or organization which may be liable partnership, joint venture, limited to the insured because of Injury or damage liability company, trust or other to which this insurance may also apply. organization to give notice of an d. No insured will, except at that insured's own occurrence"or offense. cost, voluntarily make a payment, assume any (3) Notice to us of such "occurrence" or obligation, or incur any expense, other than for offense will be deerned to be given as soon first aid,without our consent. as practicable if It is given In good faith as soon as practicable to your workers' e. The following provisions apply to Paragraph a. compensation Insurer. This applies only if above, but only for purposes of the Insurance you subsequently give notice to us of the provided under this Coverage Part to you or any "occurrence" or offense as soon as insured listed in Paragraph 1.or-2.of Section 11 practicable after any of the parsons —Who Is An Insured: described in Paragraph e.(1) or(2) above discovers that the "occurrence" or offense (1) Notice to us of such "occurrence" or may result in sums to which the insurance offense must be given as soon as provided under this Coverage Part may practicable only after the "occurrence" or apply, offense is known to you (if you are an However,If this policy includes an endorsement Individual), any of your partners or that provides Ilmited coverage for"bodily injury" members who is an individual (if you are a or "property damage" or pollution costs arising partnership or joint venture), any of your out of a discharge, release or escape of managers who is an individual (if you area "pollutants" which contains a requirement that limited liability company), any of your q "executive offices" or directors (if you are the discharge,release or escape of"pollutants" an organization other than a partnership, must be reported to us within a specific number joint venture, or limited liability company), of days after its abrupt commencement, this any of yotar trustees who is an individual (if Paragraph e, does not affect that requirement. you are a trust) or any "employee" 3. Legal Action Against Us authorized by you to give notice of an No person or organization has a right under this 'occurrence"or offense. Coverage Part: (2) If you are a partnership, joint venture, a. 'To join us as a party or otherwise bring us into limited liability company or trust, and none a"suit"asking for damages from an insured;or of your partners, joint venture members, b. To sue us on this Coverage Part unless all of managers or trustees are individuals, notice its terms have been fully complied with, to us of such"occurrence"or offense must A person or organization may sue us to recover on be given as soon as practicable only after an agreed settiernent or on a final judgment against the"occurrence"or offense is(mown by: an insured; but we will not be liable for damages (a) Any individual who is: that are not payable under the terms of this Coverage Part or that are in excess of the (i) A partner or member of any applicable limit of insurance. An agreed settlement partnership or joint venture; means a settlement and release of liability signed by (i€) A manager of any limited liability us, the insured, and the claimant or the claimant's company; legal representative, I Page 14 of 21 0 M17 The Travelers Indemnity company.AN rights reserved. CG T1 00 0219 Includes copyrighted material of Insurance Services office,Inc,with its permission, COMMERCIAL.GENERAL LIABILITY 4. Other Insurance (ii) That Is Insurance for "premises If valid and collectible other insurance is available to dama,gdl; the insured for a loss we cover under Coverages A (111) If the loss arises out of the or 8 of this Coverage Part, our obligations are maintenance or use of aircraft, limited as described in Paragraphs a.and b. below, "autos" or watercraft to the extent As used anywhere in this Coverage part, other not subject to any exclusion in this Insurance means insurance, or the funding of Coverage Part that applies to losses, that Is provided by, through or on behalf of; aircraft,"autos"or watercraft; (I) Another Insurance company; (Iv) That is insurance available to a (i!) Us or any of our affiliated insurance companies, premises owner, manager orlessor that qualifies as an insured except when the Non cumulation of Each graph 4. of Section It-- under Paragraph Limit provision of Paragraph 5. of und and Is ra insured, except when Section III -� Limits Of Insurance or the Non Paragraph d. below applies;or cumulation of Personal and Advertising Injury (v) That !s insurance available to an Limit provision of Paragraph 4, of Section III — equipment lessor that qualifies as Limits of Insurance applies because the Insured under Paragraph 5. of Amendment — Non Cumulation Of Each an an Insured tion II -- Who Is An insured, Occurrence Limit Of Liability And Non except when paragraph d. below Cumulation Of Personal And Advertising Injury applies. Limit endorsement is Included In this polity, (III)Any risk retention group; or (b) Any of the other insurance, whether primary, excess, contingent or on any (iv)Any self-insurance method or program, in other basis, that is available to the which case the insured will be deemed to be insured when the Insured is an the provider of other insurance, additional insured, or is any other Other Insurance does not include umbrella Insured that does not qualify as a insurance, or excess Insurance, that was bought named insured, under such other specifically to apply In excess of the Limits of insurance. Insurance shown in the Declarations of this (2) When this insurance is excess, we will Coverage Part. have no duty under Coverages A or B to As used anywhere in this Coverage Part, other defend the insured against any"suit" if any Insurer means a provider of other Insurance. As other insurer has a duty to defend the used in Paragraph c below, insurer means a insured against that "suit", If no other providerof insurance. insurer defends,we will undertake to do so, but we will be entitled to the Insured's rights a. Primary Insurance against all those other Insurers. This insurance is primary except when (3) When this insurance is excess over other Paragraph b, below applies. if this insurance is insurance,we will pay only our share of the primary, our obligations are not affected Linless amount of the loss, if any,that exceeds the any of the other insurance is also primary. sum of, Then,we will share with all that other insurance (a) The total amount that all such other by the method described in Paragraph c, below, Insurance would pay for the loss in the except when Paragraph d. below applies, absence of this insurance;and b. Excess Insurance (b) The total of all deductible and self- insured amounts under all that other Insurance. (a) Any of the other insurance, whether (4) We will share the remaining loss, If any, primary, excess, contingent or on any with any other insurance that is not other basis: described in this Excess Insurance (1) That is Fire, Extended coverage, provision and was not bought specificallyto Builder's Risk, Installation Risk or apply in excess of the Limits of Insurance similar coverage for"your work'; shown in the Declarations of this Coverage Part. CG T1 UO 02 19 2017 The Travelers Indemnity Company.All rights reserved. Page 15 of 21 Includes copyrighted material of Insuraiica Services Office,Inc.with its permission. COMMERCIAL GENERAL LIABILITY C. Method Of Sharing a. The statements in the Declarations are If all of the other insurance permits contribution accurate and complete; by equal shares,we will follow this method also, b. Those statements are based upon Under this approach each insurer contributes representations you made to us;and equal amounts until it has paid its applicable c. We have issued this policy in reliance upon limit of insurance or none of the loss remains, your representations. whichever comes first. If any of the other insurance does not permit The unintentional omission of, or unintentional error contribution by equal shares, we will contribute in, any information provided by you which we relied upon in issuing this policy will not prejudice your by limits. Under this method, each Insurer's rights under this insurance. However,this provision share is based on the ratio of its applicable limit does not affect our right to collect additional of insurance to the total applicable limits of premium or to exercise our rights of cancellation or insurance of all insurers. nonrenewal In accordance with applicable insurance d. Primary And Non-Contributory Insurance if laws or regulations, Required By Written Contract 7. Separation Of Insureds If you specifically agree in a written contract or Except with respect to the Limits of Insurance, and agreement that the insurance afforded to an any rights or duties specifically assigned in this insured under this Coverage Dart must apply on Coverage Part to the first Named Insured, this a primary basis, or a primary and non- insurance applies; contributory basis, this insurance is primary to a, As if each Named Insured were the onl other Insurance that Is available to such insured y which covers such insured as a named insured, Named Insured; and and we will not share with that other Insurance, b. Separately to each Insured against whom claim provided that: Is made or"suit"is brought. (1) The"bodily injury"or"property damage"for 8, Transfer Of Rights Of Recovery Against Others which coverage is sought occurs;and To Us (2) The "personal and advertising injury" for If the Insured has rights to recover all or part of any which coverage is sought is caused by an payment we have made under this Coverage Dart, offense that Is committed; those rights are transferred to us. The insured must subsequent to the signing of that contract or do nothing after loss to Impair them.At our request, agreement by you, the insured will bring "suit" or transfer those rights S. Premium Audit to us and help us enforce them, a. We will compute all premiums for this Coverage g' When We Do Not Renew Part in accordance with our rules and rates, If we decide not to renew this Coverage Part, we will mail or deliver to the first Named Insured shown in b. Premium shown in this Coverage part as the Declarations written notice of the nonrenewal advance premium is a deposit premium only.At not less than 30 days before the expiration date, the close of each audit period we will compute the earned premium for that period and send if native is mailed, proof of mailing will be sufficient notice to the:first Named Insured.The due date proof of notice, for audit and retrospective premiums is the date SECTION V—DEFINITIONS shown as the due date on the bill, If the sum of 1. "Advertisement" means a notice that is broadcast or the advance and audit premiums paid for the published to the general public or specific market policy period Is greater than the earned segments about your goods, products or services premium, we will return the excess to the first for the purpose of attracting customers or Named Insured. supporters.For the purposes of this definition: c. The first Named insured must keep records of a. Notices that are published include material the Information we need for premium placed on the Internet or on similar electronic computation, and send us copies at such times means of communication;and as we may request. b. Regarding websites, only that part of a website 6. Representations that is about your goods, products or services By accepting this policy,you agree: for the purposes of attracting customers or supporters is considered an advertisement, Page 16 of 21 0 2017 The Travelers indemnity company.AN rights reserved. CG T1 00 0219 Includes copyrighted material of Insurance Services Office,inc,with Its permission, COMMERCIAL GENERAL LIABILITY 2. "Advertising injury', b. In, by or with any other electronic means of a. Means injury caused by one or more of the communication, such as the Internet, if that following offenses: material is part of: (1) Oral or written publication, including (1) Radio or television programming being publication by electronic means,of material transmitted; In your "advertisement" that slanders or libels a person or organization or (2) Other entertainment, educational, disparages a person's or organization's instructional, music car news programming goods, products or services, provided that being transmitted; or the claim is made or the"suit"is brought by (3) Advertising transmitted with any of such a person or organization that claims to have programming. been slandered or libeled, or that claims to have had its goods, products or services s. "Coverage territory"means: disparaged; a. The United States of America (including its (2) Oral or written publication, Including territories and possessions), Puerto Rico and publication by electronic means, of material Canada; In your"advertisement"that: b. International waters or airspace, but only if the: (a) Appropriates a person's name, voice, injury or damage occurs in the course of travel photograph or likeness;or or transportation between any places included (b) Unreasonably places a person in a in Paragraph a. above;or false light;or c. All other parts of the world if the Injury or (3) infringement of copyright, „title" or "slogan" damage arises out of: in your "advertisement", provided that the (1) Goods or products made or sold by year in claim is made or the"suit" is brought by a the territory described in Paragraph a. person or organization that claims above; ownership of such copyright, "tJtle" or "slogan" (2) The activities of a person whose home is in b. Includes "bodily injury" caused by one or more the territory described in Paragraph a. of the offenses described in Paragraph a. above, but is away for a short time can your above business;or 3. "Auto'means: (3) "Personal and advertising injury" offenses that take place through the Internet or a. A land motor vehicle, trailer or semitrailer similar electronic means of communication; designed for travel on public roads, including provided the insuredts responsibility to pa any attached machinery or equipment; or damages is determined in a "suit" on the merits in b. Any other land vehicle that is subject to a the territory described in Paragraph a.above, or in a compulsory or financial responsibility law, or settlement we agree to, other motor vehicle insurance law, where it is licensed or principally garaged. 7. "Electronic data" means information, facts or However, "auto" does not Include "mobile programs stared as or on, created or used on, or equipment", transmitted to or from computer software (including systems and applications software), hard or floppy �. "Bodily Injury'means: disks, Ca-ROMs, tapes, drives, cells, data a. Physical harm, including sickness or disease, processing devices or any other media which are sustained by a person;or used with electronically controlled equipment. b. Mental anguish, injury or illness, or emotional 8, "Employe&' includes a "leased worker", "Employee" distress, resulting at any time frorn such does not include a"temporary worker". physical harm,sickness or disease. 9. "Executive officer" means a person holding any of 5. "Broadcasting" means transmitting any audio or the officer positions created by your charter, visual material for any purpose: constitution, bylaws or any other similar governing a. By radio or television;or document. CG T1 00 U219 0 2017 The Travelers Indemnity company.All rights reserved. Page 17 of 21 Includes copyrighted material of insurance services Me,Inc,with Its permission, i I COMMERCIAL GENERAL LIABILITY 10. "Good Samaritan services" means any emergency tracks, roadbeds, tunnel, underpass or medical services for which no compensation is crossing; demanded or received, (2) 'rhat indemnifies an architect, engineer or 11. "Hostile fire" means a fire which becomes surveyor for injury or damage arising out of: uncontrollable or breaks out from where it was (a) Preparing, approving, or failing to intended to be, prepare or approve, maps, shop 12. "Impaired properly" means tangible property, other drawings, opinions, reports, surveys, than "your product" or "your work", that cannot be field orders,change orders or drawings used or is less useful because; and specifications;or a. It incorporates "your product" or "your work" (b) Giving directions or Instructions, or that is known or thought to be defective, failing to give them, if that is the deficient, inadequate or dangerous;or primary cause of the injury or damage; b, You have failed to fulfill the terms of a contract or or agreement; (3) Under which the insured, if an architect, if such property can be restored to use by the engineer or surveyor, assumes liability for repair, replacement, adjustment or removal of ,your an Injury or damage arising out of the product"or"your work"or your fulfilling the terms of insured's rendering or failure to render the contractor agreement. professional services, including those listed In Paragraph (2) above and supervisory, 13. "Insured contract" means; Inspection, architectural or engineering a. A contract for a lease of premises. However, activities. that portion of the contract for a lease of 14. "Leased worker"means a person leased to you by a premises that indemnifies any person or labor leasing firm under an agreement between you organization for "premises damage" is not an and the labor leasing firm,to perform duties related "Insured contract'; to the conduct of your business, "Leased worker, b. A sidetrack agreement; does not include a"temporary worker', c. Any easement or license agreement, except in 15. "Loading or unloading" means the handling of connection with construction or demolition property, operations on or within 50 feet of a railroad; a. After it Is moved from the place where it is d. An obligation, as required by ordinance, to accepted for movement into or onto an aircraft, Indemnify a municipality, except in connection watercraft or"auto,,; with work for a municipality; b. While it Is in or on an aircraft, watercraft or e. An elevator maintenance agreement; "auto';or f That part of any other contract or agreement c. While it is being moved from an aircraft, pertaining to your business (Including an watercraft or "auto" to the place where it is Indemnification of a municipality in connection finally delivered; with work performed for a municipality) under but "loading or unloading" does not Include the which you assume the tort liability of another movement of property by means of a mechanical party to pay for "bodily Injury", "property device, other than a hand truck,that is not attached damage" or "personal injury' to a third person to the aircraft,watercraft or"auto", or organization. Tort liability means a liability „ that would be Imposed by law in the absence of 18• Mobile equipment means any of the following any contract or agreement. types of land vehicles, including any attached machinery or equipment: Paragraph L does not include that part of any a, Bulldozers, farm machinery, forklifts and other contractor agreement; vehicles designed for use principally off public (1) That indemnifies a railroad for "bodily roads; injury' or "property damage" arising out of b. Vehicles maiiltalned for use solely on or next to construction or demolition operations, premises you own or rent; within 50 Feet of any railroad property and affecting any railroad bridge or trestle, c. Vehicles that travel on crawler treads; Page 9 0 2017 The Travelers Indemnity Company.All rights reserved. CG T1 00 0219 Includes copyrighted material of Insurance Services Office,Inc,with its permission, COMMERCIAL GENERAL LiA131LITY d, Vehicles, whether self-propelled or not, b. An act or amisslon committed in providing or maintained primarily to provide mobility to failing to provide first aid or "Good Samaritan permanently mounted: services" to a person, unless you are in the (1) Power cranes, shovels, loaders, diggers or business or occupation of providing drills; or professional health care services, (2) Road ' construction or resurfacing 18. "Personal and advertising injury' means "personal equipment such as graders, scrapers or injury" or"advertising injury% rollers; 19. "Personal injury"; a. Vehicles not described in Paragraph a., b., c. or d. above that are not self propelled and are a• Means injury, other than "advertising injury,, maintained primarily to provide mobility to caused by one or more of the following permanently attached equipment of the offenses: following types; (1) false arrest,detention or Imprisonment; (1)- Air compressors, pumps and generators, including spraying, welding, building (2) Malicious prosecution; cleaning, geophysical exploration, lighting (3) The wrongful eviction from, wrongful entry and well servicing equipment;or Into, or invasion of the right of private (2) Cherry pickers and similar devices used to occupancy of a room, dwelling or premises raise or lower workers; that a person occupies, provided that the f. Vehicles not described in Paragraph a„ b., c. wrongful eviction,wrongful entry or invasion or d. above maintained primarily for purposes of the right of private occupancy is other than the transportation of persons or committed by or on behalf of the owner, cargo, landlord or lessor of that room, dwelling or However, self-propelled vehicles with the premises; following types of permanently attached (4) Oral or written publication, including equipment are not "mobile equipment" but will publication by electronic means,of material be considered"autos": that slanders or libels a person or (1) Equipment designed primarily for: organization or disparages a person's or (a) Snow removal; organization's goods,products or services, provided that the claim is made or the"suit" (b) Road maintenance, but not is brought by a person or organization that construction or resurfacing;or claims to have been slandered or libeled,or (c) Street cleaning; that claims to have had its goods, products (2) Cherry pickers and similar devices or services disparaged;or mounted on automobile or truck chassis (5) Oral or written publication, including and used to raise or lower workers;and publication by electronic means, of material (3) Air compressors, pumps and generators, that: including spraying, welding, building , cleaning, geophysical (a) Appropriates a person s name, voice, g exploration, lighting photograph or likeness; or and well servicing equipment. However, "mobile equipment" does not include any (b) Unreasonably places a person in a land vehicle that is subject to a compulsory or false light. financial responsibility law, or other motor vehicle b. Includes "bodily Injury" caused by one or more insurance law, where it is licensed or principally of the offenses described in Paragraph a. garaged. Such land vehicles are considered above. "autos". 20. "Pollutants"' mean any solid, liquid, gaseous or 17. "Occurrence"means: thermal irritant or contaminant, including smoke, a. An accident, Including continuous or repeated vapor, soot, fumes, acids, alkalis, chemicals and exposure to substantially the same general waste. Waste includes materials to be recycled, harmful conditions;or reconditioned or reclaimed. CG T1 00 02 19 0 2017 The Travelers Indemnity Company.All rights reserved. page 19 of 21 Includes copyrighted material of Insurance Services Office,Inc,with Its permission. COMMERCIAL GENERAL LIABILITY 21. "Premises damage"means; contract calls for work at more than a. With respect to the first paragraph of the one Jab site. exceptions in Exclusion J. of Section I -- (c) When that part of the work done at a Coverage A Bodily Injury And Property job site has been put to its intended Damage Liability, "property damage" to any use by any person or organization other premises while rented to you for a period of than another contractor or seven or fewer consecutive days, including the subcontractor working on the same contents of such premises;or project. b. With respect to the exception to Exclusions c, Work that may need service, maintenance, through n. In the last paragraph of Paragraph 2. correction,repair or replacement, but which of Section I — Coverage A — Bodily Injury And is otherwise complete, will be treated as Property Damage Liability, "property damage"to completed. any premises while rented to you for a period of more than seven consecutive days, or while b• Does not include "bodily injury' or "property temporarily occupied by you with permission of damage"arising out of: the owner, caused by: (1) The transportation of property, unless the (1) Fire; injury or damage arises out of a condition in (2) Explosion; or on a vehicle not owned or operated by you, and that condition was created by the (3) Lightning; "loading or unloading" of that vehicle by any (4) Smoke resulting from fire, explosion or insured; lightning;or (2) The existence of tools, uninstalled . (5) Water. equipment or abandoned or unused But "premises damage" under this paragraph materials;or b. does not include "property damage" to any {3) Products or operations for which the premises caused by: classification, listed in the Declarations or (1) Rupture, bursting, or operation of pressure in a policy Schedule, states that products- relief devices; completed operations are subject to the General Aggregate Limit. (2) Rupture or bursting due to expansion or' 23, "Property damage"means: swelling of the contents of any building or structure caused by or resulting from water; a• Physical injury to tangible property, including all or resulting loss of use of that property. All such loss of use will be deemed to occur at the time of (3) Explosion of steam boilers, steam pipes, the physical injury that caused it;or steam engines or steam turbines. b. Loss of use of tangible property that is not 22. "Products-completed operations hazard": physically Injured. All such loss of use will be a. Includes all "bodily injury" and "property deemed to occur at the time of the"occurrence" damage" occurring away from premises you that caused it, own or rent and arising out of "your product" or For the purposes of this insurance, "electronic data" "your work" except: is not tangible property. (1) Products that are still in your physical 24. "Slogan"; possession;or a. Means a phrase that others use for the purpose (2) Work that has not yet been completed or of attracting attention in heir advertising. abandoned, However, "your work" will be b. Goes not Include a phrase used as, ar in, the deemed completed at the earliest of the name of; following times: (7) Any person or organization, ether than you; (a) When all of the work called for in your or cantwact has been completed. (2) Any business, or any of the premises, (b) When all of the work to be done at the goods, products, services or work, of any Job site has been completed if your person or organization,other than you. Page 20 of 21 Q 2017 The Travelers Indemnity Company.All rights reserved. CG T1 000219 Includes copyrighted material of Insurance services Office,Inc.with its permission. I COMMERCIAL GENERAL LIABILITY 25. "Suit" means a civil proceeding in which damages (a) You; because of "bodily injury", "property damage" or (b) Others trading under your name; or "personal and advertising injury" to which this Insurance applies are alleged."Suit" Includes: (c) A person or organization whose a. An arbitration proceeding in which such business or assets you have acquired; and damages are claimed and to which the Insured must submit or does submit with our consent; (2) Containers (other than vehicles), materials, or parts or equipment furnished in connection with such goods or products. b. Any other alternative dispute resolution p, Includes: proceeding in which such darnages are claimed and to which the insured submits with our (1) Warranties or representations made at any consent, time with respect to the fitness, quality, 26. "Temporary worker" means a durability, performance or use of "your p i7+ person who is furnished to you to substitute for a permanent product"; and "employee on leave or to meet seasonal or short- (2) The providing of or failure to provide term workload conditions, warnings or instructions, 27. "Title"means a name of a literary or artistic work. c. Does not Include vending machines or other 28. "Unsolicited communication" means any property rented to or located for the use of communication, in any form, that the recipient of others but not sold. such communication did not specifically request to 31• "Your work': receive. a. Means: 29, "Volunteer worker" means a.person who is not your (1) Work or operations performed by you or on "employer;'. and who donates his or her work and your behalf;and acts at the direction of and within the scope of (2) Materials, parts or equipment furnished in duties determined by you, and is nut paid a fee, connection with such work or operations, salary or other compensation by you or anyone else for their work performed for you, b. Includes; 30, „Your product": (1) Warranties or representations made at any time with respect to the fitness, quality, a. Means: durability, performance or use of "your (1) Any goods or products, other than real work"; and property, manufactured, sold, handled, (2) The providing of or failure to provide distributed or disposed of by: warnings or instructions, CG T1 00 02 19 0 2017 The Travelers Indemnity company.All rights reserved, page 21 of 21 Includes copyrighted material of In$urance Services office,Inc.with its permission. COMMERCIAL AUTO THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BUSINESS AUTO EXTENSION ENDORSEMENT EMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM GENERAL DESCRIPTION OF COVERAGE--This endorsement broadens coverage. However, coverage for any injury, damage or medical expenses described in any of the provisions of this endorsement may be excluded or limited by another endorsement to the Coverage mart, and these coverage broadening provisions do not apply to the extent that coverage is excluded or limited by such an endorsement. The following listing is a general cover- age description only. Limitations and exclusions may apply to these coverages. Dead all the provisions of this en- dorsement and the rest of your policy carefully to determine rights, duties, and what is and is not covered. A. BROAD FORM NAMED INSURED H. HIRED AUTO PHYSICAL DAMAGE -- LOSS OF B. BLANKET ADDITIONAL INSURED USE—INCREASED LIMIT C. EMPLOYEE HIRED AUTO} I. PHYSICAL DAMAGE — TRANSPORTATION EXPENSES—INCREASED LIMIT D. EMPLOYEES A5 INSURED EXPENSES PERSONAL PROPERTY E. SUPPLEMENTARY PAYMENTS INCREASED K. AIRBAGS LIMITS L. NOTICE AND KNOWLEDGE OF ACCIDENT OR F. HIRED AUTO -- LIMITED WORLDWIDE COV- LOSS ERAOiE-»INDEMNITY BASIS M. BLANKET WAIVER OF SUBROGATION G. WAIVER OF Di=DUOyTISLF?—GLASS N. UNINTENTIONAL ERRORS OR OMISSIONS PROVISIONS A, BROAD FORM NAMED INSURED this insurance applies and only to the extent that The following is added to Paragraph A.1,. Who Is person or organization qualifies as an "insured" An Insured, of SECTION II COVERED AUTOS under the Who Is An Insured provision contained LIABILITY COVERAGE: in Section 11. Any organization you newly acquire or form dur- C. EMPLOYEE HIRED AUTO ing the policy period over which you maintain +1• The following is added to Paragraph A.1., 50% or more ownership interest and that is not Who Is An Insured, of SECTION 11 — COV- separately insured for Business Auto Coverage, ERED AUTOS LIABILITY COVERAGE: Coverage under this provislon is afforded only un- An "employee" of yours is an "insured" while til the 180th day after you acquire or form the or- operating an "auto" hired or rented under a ganixation or the end of the policy period, which- contract or agreement in an "employee's" ever is earlier. name, with your permission. while performing duties related to the conduct of your busk B. BLANKET ADDITIONAL INSURED ness. The following is added to Paragraph c. In A.1„ 2. The following replaces Paragraph b. in B.S., Who Is An Insured, of SECTION 11 — COVERrzD Other Insurance, of SECTION 1V .- BUsl- AUTOS LIABILITY COVERAGE: NESS AUTO CONDITIONS: Any person or organization who is required under b. For Hired.Auto Physical Damage Cover- s written contract or agreement between you and age, the following are deemed to be cov- j that person or organization, that is signed and Bred "autos"you own: executed by you before the "bodily Injury" or (1) Any covered "auto" you lease, hire, "property damage" occurs and that is in effect rent or borrow;and during the policy period, to be named as an add[- (,2) Any covered "auto" hired or rented b tional insured is an "insured" for Covered Autos y Liability Coverage, but only for damages to which your "employee' tinder a contract In "employee's"employees„ name, with your CA T3 53 02 15 02016 The Travelers Indemnity Company.Ali rights reserved. Page 1 of 4 Includes copyrighted materlsI of Insurance Services office,Inc.wlih Its permission. COMMERCIAL AUTO permission, while performing duties (a) With respect to any claim made or "suit" related to the conduct of your busi- brought outside the United States of ness, America, the territories and possessions However, any "auto" that is leased, hired, of the United States of America, Puerto rented or borrowed with a driver is not a Rico and Canada: covered "auto". (1) You must arrange to defend the "In- D. EMPLOYEES AS INSURED cured"against, and investigate or set- The following is added to Paragraph A.1., Who is tle any such claim or "suit" and keep An Insured, of SECTION II-- COVERED AUTOS us advised of all proceedings and ac- LIABILITY COVERAGE: tions. Any "employee" of yours is an "Insured" while us- (III) Neither you nor any other involved ing a covered "auto"you don't own, hire or borrow "insured" wlfl make any settlement in your business or your personal affairs. without our consent. E. SUPPLEMENTARY PAYMENTS -- INCREASED (iii)We may, at our discretion, participate LIMITS in defending the "insured" against, or 7. The fallowing replaces Paragraph A.2.a.(2), '"in the settlement of, any claim or suit", of SECTION II — COVERED AUTOS LIABIL- ITY COVERAGE; (iv)We will reimburse the "insured" for sums that the "Insured" legally must (2) Up to $3,000 for cost of bail bands (in- pay as damages Because of "bodily cluding bonds for related traffic law viola- Injury" or "properly damage" to which tions) required because of an "accident" this insurance applies, that the "in- we cover. We do not have to furnish sated" pays with our consent, but these bonds. only up to the limit described in Para- 2. The fallowing replaces Paragraph A.2.a.(4), graph C., Limits Of Insurance, of of SECTION 11 — COVERED AUTOS LIABIL- SECTION II — COVERED AUTOS ITY COVERAGE; LIABIOTY COVERAGE, (4) All reasonable expenses incurred by the (v) We will reimburse the "Insured" for "insured" at our request, including actual the reasonable expenses incurred loss of earnings up to $500 a day be- with our consent for your Investiga- cause of time off from work. tion of such claims and your defense of the "insured" against any such F. WIRED AUTO — LIMITED WORLDWIDE COV- "suit", but only up to and included ERAG£—INDEMNITY BASIS within the limit described in Para- The following replaces Subparagraph (5) In Para- graph C., Limits Of Insurance, of graph 8.7.., policy Period, Coverage Territory, SECTION 11 — COVERED AUTOS of SECTION IV — BUSINESS AUTO CONDI. LIABILITY COVERAGE, and not in TIONS; addition to such limit, Our duty to (5) Anywhere in the world, except any country or make such payments ends when we jurisdiction while any trade sanction, em- have used up the applicable limit of bargo, or similar regulation Imposed by the insurance in payments for damages, United States of America applies to and pro- settlements or defense expenses. j I hibits the transaction of business with or (b) This insurance is excess over any valid within such country or jurisdiction, for Cov- and collectible other insurance available ered Autos Liability Coverage for any covered to the "insured" whether primary, excess, "auto" that you lease, hire, rent or borrow contingent or on any other basis. without a driver for a period of 30 days or less (c) This insurance is not a substitute for re- and that is not an "auto"you lease, hire, rent quired or compulsory insurance In any or borrow from any of your "employees", country outside the United States, its ter. partners (if you are a partnership), members ritories and possessions, Puerto Rico and (if you are a limited liability company) or Canada, members of their households. Page 2 of 4 0 2016 The Travelers Indomnity Company.All rights resorved, CA T3 53 02 15 Includes copyrighted material of Insurance Servlces Office,Inc.with its permission. COMMERCIAL.AUTO You agree to maintain all required or (2) In or on your covered "auto". compulsory insurance In any such coun- This coverage applies only in the event of a total try up to the minimum limits required by theft of your covered "auto". local law, Your failure to comply with compulsory insurance requirements will No deductibles apply to this Personal Property not invalidate the coverage afforded by coverage, this policy, but we will only be liable to the K. AIRBAGS same extent we would have been liable The following is added to Paragraph 13.3., Exclu. had you complied with the compulsory in- sions, of SECTION III — PHYSICAL DAMAGE surance requirements. COVERAGE: (d) It is understood that we are not an admit- Exclusion 3.a. does not apply to "loss" to one or ted or authorized insurer outside the more airbags in a covered "auto" you own that In.; United States of America, Its territorlles flate, due to a cause other than a cause of "loss" and possessions, Puerto Rico and Can- set forth in Paragraphs A.1.b. and A.1.c., but ada. We assume no responsibility for the only: furnishing of certificates of insurance, or a. If that "auto" is a covered "auto" for Compre- for compliance in any way with the laws hensive Coverage under this policy; of other countries relating to insurance. b. The airbags are not covered under any war. G. WAIVER OF DEDUCTIBLE—GLASS ranty; and The following is added to Paragraph D., Deducti- c, The airbags were not intentionally inflated. ble, of SECTION III — PHYSICAL DAMAGE We will pay up to a maximum of $1,000 for any COVERAGE: one "loss". No deductible for a covered "auto" will apply to L. NOTICE AND KNOWLEDGE OF ACCIDENT OR glass damage if the glass is repaired rather than LOSS replaced. The following is added to Paragraph A.2.a., of H. HIRED AUTO PHYSICAL DAMAGE — LOSS OF SECTION IV—BUSINESS AUTO CONDITIONS: USE—INCREASE© LIMIT Your duty to give us or our authorized representa. The following replaces the last sentence of Para- Cive prompt notice of the "accident" or "loss' air graph A.4.11b., Loss Of Use Expenses, of SEC. plies only when the "accident" or "loss" is known TIQN III—PHYSICAL DAMAGE COVERAGE: Ca. However, the most we will pay for any expenses (a) You (if you are an individual); for loss of use is $65 per day, to a maximum of (b) A partner(if you are a partnership); $750 for any one"accident". I. PHYSICAL DAMAGE — TRANSPORTATION (c) A member (if you are a limited liability com- pany) EXPENSES—INCREASED LIMIT (d) An executive officer, director or insurance The following replaces the first sentence in Para- manager (if you are a corporation or other or- graph AA.a., Transportation Expenses, of ga,nization); or SECTION Ill — PHYSICAL DAMAGE COVER- (e) Any"employee" authorized by you to give no- AGE, tice of the "accident"or"loss". We will pay up to $50 per day to a maximum of M. BLANKET WAIVER OF SUBROGATION $1,500 for temporary transportation expense in- The following replaces Paragraph A.5., Transfer curred by you because of the total theft of a cov- Of Rights Of Recovery Against Others To Us, ered"auto" of the private passenger type. of SECTION IV — BUSINESS AUTO CONDI- J. PERSONAL PROPERTY TIONS : The following is added to Paragraph A.4., Cover- S. Transfer Of Rights Of Recovery Against age Extensions, of SECTION 111 — PHYSICAL Others To Us DAMAGE COVERAGE: We waive any right of recovery we may have Personal Property against any person or organization to the ex- tent required of you by a written contract We will pay up to $400 for loss to wearing ap- signed and executed prior to any "accident" parel and other personal property which is; or"loss", provided that the"accident" or "loss" (1) Owned by an"Insured". and arises out of operations contemplated by CA T3 S3 0215 0 2015 Tha'Travelers indemnity Company.All rights reserved. Page 3 of 4 Includes copyrighted material of Insurance Services office,Inc.with Its permis*n. COMMERCIAL AUTO such contract. The waiver applies only to the The unintentional omission of, or unintentional person or organization designated in such error in, any Information given by you shall not contract. prejudice your rights under this insurance. How. N. UNINTENTIONAL.ERRORS OR OMISSIONS ever this provision does not affect our right to col- The following Is added to paragraph B.Z., Con- lect additional premium or exercise our right of cealment, Misrepresentation, Or Fraud, of cancellation or non-renewal SECTION IV•—BUSINESS AUTO CONDITIONS., i i i Page 4 of 4 02016 The Travelers Indamnity Compa ny.Alf rights reserved. CA T3 53 0215 Includes oopydghted material of Insurance Services office,Inc.with Its permission. COMMERCIAL GENERAL LIABILITY POLICYNUMSER: x-6 3 0-6=64703-TCT-23 ISSUEDATE: 04-21-23 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. TOTAL AGGREGATE LIMIT AND DESIGNATED PROJECT AND LOCATION AGGREGATE LIMITS This endorsement modifies insurance provided under the faiiowing: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE--LIMITS OF INSURANCE AND DESIGNATED PROJECTS AND LOCATIONS LIMITS OF INSURANCE Total Aggregate Limit $ 10,000,000 (Other Than Products-Completed Operations) Designated Project Aggregate Limit $ 7 000,000 (Other Than Products-Completed Operations) Designated Location Aggregate Limit $ 1,000,000 (Other Than Products-Completed Operations) General Aggregate Limit $ 2,000,000 (Other Than Products-Completed Operations) Designated Projects: AS REQUIRED 8Y 'WRITTEN CONTRACT EXECUTED F OIR TO A" TOSS Designated Locations: ALL AOCA'TXONS LISTED ON LOCATION SCH19D LS IL TO 03 04 PROVISIONS a. Insureds; 1. The General Aggregate Limit (other Than b, Claims made or"suits" brought; Products-Completed Operations) shown in the c. Persons or organizations making claims Declarations is replaced by the Limits of or bringing"suits":or Insurance shown in the Schedule -- Limits Of d< "Projects"or"locations". Insurance And Designated Projects And Locations. 3. The following replaces Paragraph 2. of SECTION III—LIMITS OF INSURANCE: 2. The following replaces Paragraph 'I. of 2. a. The Total Aggregate Limit shown in the SECTION III—LIMITS OF INSURANCE; Schedule Limits Of Insurance And 1. The Limits of insurance shown in the Designated Projects And Locations Is Declarations or the Schedule — Limits Of the most we will pay for the sum of all Insurance And Designated Projects And amounts under the. Designated Project Locations, whichever apply, and the rules Aggregate Limit, all amounts under the below fix the most we will pay regardless of Designated Location Aggregate Limit the number of: and all amounts under the General Aggregate Limit. This includes; CG D4 68 0219 0 2017 The Travelers Company.All rights reserved. Page 1 of 3 Includes copyrighted material of Insurance Services Office,Inc.with Its permission. g COMMERCIAL GENERAL LIABILITY (1) Damages under Coverage A, except (b) The Designated Project Aggre- damages because of "bodily Injury" gate Limit for the applicable or"property damage" included in the "project". "products-completed operations Such payments will not reduce the hazard'; General Aggregate Limit described (2) Damages under Coverage B; and in Paragraph 2.d. below, the (3) Medical expenses under Coverage Designated project Aggregate Limit C. for any other "project" or the Designated Location Aggregate b. Subject to the Total Aggregate Limit Limit, described in Paragraph 2.a, above, the Designated Project Aggregate Limit c, Subject to the Total Aggregate Limit shown in the Schedule — Limits Of described in Paragraph 2.a. above, the Insurance And Designated Projects And Designated Location Aggregate Limit Locations applies and is further subject shown in the Schedule — Limits Of to all of the following provisions: Insurance And Designated Projects And (h) The Designated Project Aggregate Locations applies and is further subject Limit is the most we will pay for the to all of the fallowing provisions; sum of: (1) The Designated Location Aggregate Limit is the most we will pay for the (a) Damages under Coverage A sum of: because of "bodily injury" and "property damage" caused by (a) Damages under Coverage A "occurrences";and because of "bodily injury" and "property damage" caused by (b) Medical expenses under "occurrence$".and Coverage C for "bodily injury" ' caused by accidents; (b) Medical expenses under that can be attributed only to Coverage C far "bodily injury" caused by accidents; operations at a single"project", that can be attributed only to (2) The Designated Project Aggregate operations at a single"location", Limit applies separately to each "project". (2) The Designated Location Aggregate Limit applies separately to each (3) The Designated Project Aggregate "location". Limit does not apply to damages (3) The Designated Location Aggregate because of "bodily injury" or Limit does not apply to damages „property damage" included in the because of "bodily Injury" or "products-completed operations "property damage" Included in the hazard". Instead, the Products- "products-completed operations Completed Operations Aggregate hazard". Instead, the Products- limit described in Paragraph 3. Completed Operations Aggregate below applies to such damages, Limit described in Paragraph 3. (4) The Designated Project Aggregate below applies to such damages. Limit does not apply to damages (4) The Designated Location Aggregate under Coverage 13. Instead, the Limit does not apply to damages General Aggregate Limit described under Coverage B, Instead, the in Paragraph 2.d. below applies to General Aggregate limit described such damages. In Paragraph 2.d. below applies to such damages. (5) Any payments made for damages or (5) Any payments made for damages or medical expenses to which the medical expenses to which the Designated Project Aggregate. Limit Designated Loc ation Agg regate Limit applies will reduce: applies wilt reduce: (a) The Total Aggregate Limit, and (a) The Total Aggregate Limit; and Page 2 of 3 0 2017 The Travelers Company.All rights reserved. ECG D4 68 0219 Includes copyrighted material or Insurance services Office,Inc,with Its permission. COMMERCIAL GENERAL LIABILITY (b) The Designated Location Aggre- 4. The following' replaces Paragraph 3. of gate Limit for the applicable SECTION iiI—LIMITS OF INSURANCE; "location", 3. The Products-Completed Operations Aggre_ Such payments will not reduce the gate Limit shown in the Declarations Is the General Aggregate Limit described most we will pay under Coverage A for in Paragraph 2,d. below, the damages because of "bodily injury" or Designated Project Aggregate Limit "property damage"included In the "products- or the Designated Location completed operations hazard". Any Aggregate Limit for any other payments made for such damages will not "location". reduce the Total Aggregate Limit, the d. Subject to the Total Aggregate Limit General Aggregate Limit, the Designated described in Paragraph 2.a. above, the Project Aggregate Limit for any "project" or General Aggregate Limit shown In the the Designated Location Aggregate Limit for Schedule — Umits Of insurance And any"location". Designated Projects And Locations 5. The following is added to the DEFINITIONS applies and is further subject to all of the Section, but only for purposes of the Designated following provisions: Location and Designated Project shown in the (1) The General Aggregate Limit is the Schedule--Limits Of Insurance And Designated most we wll I pay for the sum of: Projects And Locations: (a) Damages under Coverage A "Location"means any designated location shown because of "bodily injury" and in the: Schedule -- Limits Of Insurance And "property damage" caused by Designated Projects And Locations that is owned „occurrences", and medical by or rented to you. For the purposes of expenses under Coverage C for determining the applicable aggregate limit of "bodily injury" caused by Insurance, each "location" that includes a accidents, that cannot be premises Involving the same or connecting lots, attributed only to operations at a or premises whose connection Is interrupted only single "project" or a single by a street, roadway or waterway, or by a right- "location", and of-way of a railroad, will be considered a single (b) Damages under Coverage B. "location", (2) The General Aggregate Limit does "Project"means any designated project sh own in not apply to damages for "bodily the Schedule -- Limits Of Insurance And injury" or "property damage" Designated Projects And Locations that is away Included in the "products-completed from premises awned by or rented to you and at operations hazard". Instead, the which you are performing operations pursuant to Products-Completed Operations a contract or agreement. For the purposes of- Aggregate Limit described In determining the applicable aggregate limit of Paragraph 3, below applies to such insurance, each "project" that includes a damages, premises involving the same or connecting lots, (3) Any payments made for damages or or premises whose connection is interrupted only medical expenses to which the by a street, roadway or waterway, or by a right- General Aggregate Limit applies will off-way of a railroad. will be considered a single reduce: "" ," project . (a) The Total Aggregate Limit, and (b) The General Aggregate Limit. Such payments will not reduce the Designated Project Aggregate Limit for any "project" or the Designated j Location Aggregate Limit for any "location". CG D4 fib 0219 @ 2017 The Traveters Company.All rights reserved, Page 3 of 3 Includes copyrighted material of Insurance Services Office, Inc.with its permission. I CERTIFICATE OF LIABILITY INSURANCE DATE jM!l D°IYVYY) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT APFIRNfATIVELY.OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAOR AFFORDED BY THE POLICIES BELOW. THIS 0ERTIFICAT5 OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATiV90R.PRODUCER,AND THE OERTIFICATE HOLDER, IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED,the pollcy(les)must have ADDITIONAL INSURED provisions or b-endorsed. if SUEIRCOATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement, A statement on this oertlNcate does not canter rlyhts to the certificate holder in lieu of Stich end orsemenft PRODUOR CONTATrNAME Marsh Afllnily Marsh Affinity AIC No Ex 600.743.3130 FAX No; a dlvlslon of Marsh USA LLC, UMAIL DRE95; AOPToIalSourou$marsh.cam PO BOX 14404 DosMolres,tA00308.9990 INSURERS AFFORDING COVERAGE NAIOII INSURER A:- NU lnauronco 0ornlinny 19309 INSURED INSURER B ADP TotalSource DE IV,Inc. INSURER C; 6900 Windward Parkway MISURERD; Alpharetta,GA 30006 1.0r: INSURER r;: Pu(:tnn Services Holdlw,U.C. INSURER N: 2940 Lugo St, Las Angalos,CA 90D27 COVERAGES CERTIFICATE NUMOER; REVISIONNIJMSER; THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED 8Y THE POLICIES DESCREED HEEiIwIN IS SUBJECT TO ALL THE TERM$ EXCLUSIONS AND CONDITIONS OP SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN RECUCED BY PAID CLAIMS. INSR TYPEOPINSURANCE ADD 9 BR POLICY NUMBER LTR INBD Y4Vt}_ _ tMMlOoIYYYY) {k15 D LIMITS 00MMERGIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS-MADE r OCCUR OAEAi1ETOREUsDaaos $ MEO EXP(Any ofla parson) $ PERSONAL&,ADV INJURY B t3EN'LAGOREOATE LIMIT APPLIESPER GENERALAGCREGATE $ POLICY ❑� LOC PRWUCTS,COMPIOP AGt3 S OTHER! AUTOMOBILE LIABILITY C DdDS INGLELIMIT ANYAUTO a I $OWNED 5CIIEUULED DQDILY INJURY(Per parson) $ AUTOS ONLY AUTOS BODILY INJURY(Pei acaldent) $ A RED ONLY AUUTOS QNL.Y $ f'ROAERTYDAMAQE Par aocident UM ORRLLA LIAR OCCUR EACH OCCURRENCE $ WORSSLIAO CLAIM&MADE AGGREGATE $ DED RETENTION$ $ Wi RKNRS COMPENSATION ANDLruIPLOYERS'LIABILITY YIN 3TA UTE H ANYP OPRIETORIPARTNEJEXECUTNE L,FAgHACCIDENI' $ 2000,000 OFFiCER7MEM13ER E39GLUOEO7 N NIA x WC 069306914 CA 07/01/2024 0710W1 21i I� iNfandat6ry fn NHi .L.DISEASE.EA EMPLOYEE $ 2,000,00i? ff sas,d�rdbs ender QT�SCRI ION OF OPMaRATIONS be Low L.MEASE-POLICY LIMIT $ 2,000 000 DESCRIPTION Of OPERATfONS1 LOOATIGNB I VEHICLES{ACl7RD 10,Additl0nal Remarks Sahadu o,maybe attaahed If mare space is raqulred) All workslte nmpfayees working Tar Parllla SerVIGas Holden,LLC,pail under AUP TOTALSOURCE,INC,'s payroll,are eevared under the above statadppoollay,ProprlolotiPalnor/gamaWye OlrtcerlMarnhor are not excluded as Longg as tiny mein the ADPTS payroll Or have coVioted the SEI Panlclpatlatl Addendum,WAIVER OF SORROGATION IN FAVOR OF CErrrIFIGAYE HOLDER A9 RESPECTS Gri4P PERrORMEO BY j Pacifk:Saivloes Hnldao,LLC,AS REQUIRED BY WRITTEN CONFRACT. I CFRTIFIGATE HOLDER CANCELLATION filly of Santa Ana —�—— 211 Parks,RecraaHan,and Community Se vice SHOUILD ANY OF THE ABOVE DESCRIElEO POLICIES BE CANCELLED BEFORE 29CvicCenter 2701 THE EXPIRATION DATE THEREOF, NOTICE VILL BE DELIVERED IN Santa Ana,CA 92'I01 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZER REPRESENTATIVE AGORD26(2018103) C)1088-2016 ACO. D.CORPQ ION: All rights reserved. The AGORI]1`101"o Wid logo are registered marks of At bRD I BLANKET WAIVER OF OUR RIONT TO RECOVER FROM OTHERS ENDORSEMENT This endorsement changes the policy to which it Is attached effective on the Inception date.of the policy unless a different date is indicated below. (The following "attaching clause" need be completed only when this endorsement is Iseued subsequent to preparation of the policy). This endorsement, effective 07/0112024 12,01 AM forms a part of Policy No. WC 069365914 CA Issued to ADP TotalSource DE IV, Inc. 5800 Windward Parkway Al haretta, GA 30005 L18I : Pacific Services I-Holdco, LLC, 2840 Lugo St. Los Angeles, CA 90023 By AIU Insurance Company We have a right to recover our payments from anyone liable for an injury covered by this policy, We will not enforce our right against any person or organization with whom you have a written contract that requires you to obtain this agreement from us, as regards any work you perform for such parson or organization. The additional premium for this endorsement shall he—/o of the total estimated workers compensation premium for this policy, ANY PERSON OR ORGANIZATION TO WHOM YOU EECOME OBLIGATED TO WAIVE YOUR RIGHTS OF RECOVERY AGAINST,UNDER ANY CONTRACT OR AGREEMENT YOU ENTER INTO PIRIOR TO THE OCCURRENCE OF LOSS i i WC 04 03 61 Countersigned by (Ed.d 1/90) Authojizefd Representative COMMERCIAL GENERAL INABILITY POLICY NUMBER: Y-630-5'Y374343,TCTw25 ISSUE DATE: 05-O6-25 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (WAIVER OF SUBROGATION) This endorsement modifles insurance provided under the following: COMMERCIAL.GENERAL LIABILITY COVERAGE PART ELECTRONIC DATA LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAGE PART DESIGNATED SITES POLLUTION LIABILITY LIMITED COVERAGE PART DESIGNATED SITES PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART RAILROAD PROTECTIVE LIABILITY COVERAGE PART UNDERGROUND STORAGE TANK POLICY DESIGNATED TANKS SCHEDULE Name Of Person(s) Or Organization(s): CITY OF SANTA AN,1<s.. 20 CIVIC CENTRR PLAZA, CA 92701, M^23 S.ANTA AID, CA 92741 City of Santa Ana, its Council officers, officials,employees, agents, and volunteers 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 Part. Such waiver by Qs_app(ies_anly to the extent tit Rights Of Recovery Against Others To Us of the Insured has waived its tight of recovery against Section IV--Conditions: such person(s) or organization(s) prior to loss, This We walve any right of recovery against the person(s) endorsement applies only to the person(s) or or organlzatlon(s) shown In the schedule above organizatlon(s)shown In the Schedule above, because of payments we make under this Coverage CG 24 04 12 19 0 Insurance Services Office, Inc., 2018 Page 1 of 1 i