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Home My WebLink AboutCertificateSHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. INSURER(S) AFFORDING COVERAGE INSURER F : INSURER E : INSURER D : INSURER C : INSURER B : INSURER A : NAIC # NAME:CONTACT (A/C, No):FAX E-MAILADDRESS: PRODUCER (A/C, No, Ext):PHONE INSURED REVISION NUMBER:CERTIFICATE NUMBER:COVERAGES 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). 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. OTHER: (Per accident) (Ea accident) $ $ N / A SUBR WVD ADDL INSD 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 THISCERTIFICATE 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. $ $ $ $PROPERTY DAMAGE BODILY INJURY (Per accident) BODILY INJURY (Per person) COMBINED SINGLE LIMIT AUTOS ONLY AUTOSAUTOS ONLY NON-OWNED SCHEDULEDOWNED ANY AUTO AUTOMOBILE LIABILITY Y / N WORKERS COMPENSATION AND EMPLOYERS' LIABILITY OFFICER/MEMBER EXCLUDED?(Mandatory in NH) DESCRIPTION OF OPERATIONS belowIf yes, describe under ANY PROPRIETOR/PARTNER/EXECUTIVE $ $ $ E.L. DISEASE - POLICY LIMIT E.L. DISEASE - EA EMPLOYEE E.L. EACH ACCIDENT EROTH-STATUTEPER LIMITS(MM/DD/YYYY)POLICY EXP(MM/DD/YYYY)POLICY EFFPOLICY NUMBERTYPE OF INSURANCELTRINSR DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) EXCESS LIAB UMBRELLA LIAB $EACH OCCURRENCE $AGGREGATE $ OCCUR CLAIMS-MADE DED RETENTION $ $PRODUCTS - COMP/OP AGG $GENERAL AGGREGATE $PERSONAL & ADV INJURY $MED EXP (Any one person) $EACH OCCURRENCE DAMAGE TO RENTED $PREMISES (Ea occurrence) COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO-JECT LOC CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) CANCELLATION AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. CERTIFICATE HOLDER The ACORD name and logo are registered marks of ACORD HIREDAUTOS ONLY 11/19/2024 Parker Smith &Feek Insurance LLC2233112thAveNEBellevueWA98004 425-709-3600 License#:PC-1719201 Ohio Security Insurance Company 24082 BRINELE-01 The Ohio Casualty Insurance Company 24074BrinkElectricLLC8223BroadwayEverett,WA 98203 779303016 A X 1,000,000 X 1,000,000 15,000 1,000,000 2,000,000 X X Y Y BKS2556741164 7/12/2024 7/12/2025 2,000,000 A 1,000,000 X Y Y BAS2556741164 7/12/2024 7/12/2025 B X 4,000,000 X Y USO2556741164 7/12/2024Y 7/12/2025 4,000,000 X 10,000 A XBKS25567411647/12/2024 7/12/2025 1,000,000 1,000,000 1,000,000 Certificate Holder and all other parties required by the contract are included as Additional Insured on the General Liability,Automobile Liability and ExcessLiabilityPolicies,if required by written contract or agreement,subject to the policy terms and conditions.This Insurance is Primary &Non-Contributory on the General Liability,Automobile Liability and Excess Liability Policies,if required by written contract oragreement,subject to the policy terms and conditions.A Waiver of Subrogation is provided in favor of the Certificate Holder and all other parties required by the contract on the General Liability,Automobile LiabilityandExcessLiabilityPolicies,if required by written contract or agreement,subject to the policy terms and conditions.Project:Hazen High School Site Work for Portable Classrooms 2024. City of Renton1055SouthGrady WayRenton,WA 98057 THIS CERTIFICATE SUPERSEDES PREVIOUSLY ISSUED CERTIFICATE SUMMARY OF COVERAGE PARTS AND CHARGES This policy consists of this Common Policy Declarations page, Common Policy Conditions, Coverage Parts (which consist of coverage forms and other applicable forms and endorsements, if any, issued to form a part of them) and any other forms and endorsements issued to be part of this policy. COVERAGE PART CHARGES Business Auto Total Charges for all of the above coverage parts: Coverage for Terrorism resulting from Nuclear, Biological or Chemical Acts is Excluded Note: This is not a bill POLICY FORMS AND ENDORSEMENTS This section lists the Forms and Endorsements for your policy. Refer to these documents as needed for detailed information concerning your coverage. FORM NUMBER TITLE STATE(S) APPLICABLE AC 00 31 01 14 Changes In Your Policy WA AC 01 15 08 17 Washington Changes WA Named Insured Is: Limited Liability Company Named Insured Business Is: Electrical Contractor In return for the payment of the premium, and subject to all the terms of this policy, we agree with you to provide the insurance as stated in this policy. Coverage Is Provided In: Ohio Security Insurance Company, a stock company Domiciled in New Hampshire 175 Berkeley Street, Boston, MA 02116 Common Policy Declarations Policy Number: BAS (25) 56 74 11 64 Policy Period: From 07/12/2024 To 07/12/2025 12:01 am Standard Time at Insured Mailing Location Named Insured Agent BRINK ELECTRIC LLC 12104 NE 141st St Kirkland, WA 98034 (907) 562-2225 PARKER, SMITH & FEEK INSURANCE, LLC 3700 Centerpoint Dr Ste 102 Anchorage, AK 99503 To report a claim, call your Agent or 1-844-325-2467 DS 70 21 11 16 Issue Date 07/03/2024 Authorized Representative 07/03/2024 56741164 N0196212 EC Insured Copy Coverage Is Provided In: Ohio Security Insurance Company, a stock company Domiciled in New Hampshire 175 Berkeley Street, Boston, MA 02116 Common Policy Declarations Policy Number: BAS (25) 56 74 11 64 Policy Period: From 07/12/2024 To 07/12/2025 12:01 am Standard Time at Insured Mailing Location Named Insured Agent BRINK ELECTRIC LLC (907) 562-2225 PARKER, SMITH & FEEK INSURANCE, LLC To report a claim, call your Agent or 1-844-325-2467 DS 70 21 11 16 POLICY FORMS AND ENDORSEMENTS - continued FORM NUMBER TITLE STATE(S) APPLICABLE AC 84 59 06 14 State Application Of Terrorism Exclusion Endorsements Involving Nuclear, Biological Or Chemical Terrorism WA AC 85 01 06 18 Business Auto Coverage Enhancement Endorsement WA AC 85 85 01 21 Peer To Peer Vehicle Sharing Program Exclusion WA AC 86 31 04 23 Washington Amendment Of Concealment, Misrepresentation Or Fraud Condition WA CA 00 01 03 06 Business Auto Coverage Form WA CA 21 34 01 08 Washington Underinsured Motorists Coverage WA CA 23 45 11 16 Public or Livery Passenger Conveyance and On - Demand Delivery Services Exclusion WA CA 23 85 01 06 Exclusion of Terrorism Involving Nuclear, Biological or Chemical Terrorism WA CA 23 87 01 06 Exclusion of Terrorism Involving Nuclear, Biological or Chemical Terrorism Above Minimum Statutory Limits WA CA 23 89 01 06 Alaska Exclusion of Terrorism Involving Nuclear, Biological or Chemical Terrorism Above Minimum Statutory Limits WA CA 23 93 01 06 Washington Exclusion of Terrorism Involving Nuclear, Biological or Chemical Terrorism WA CA 23 94 03 06 Silica or Silica-Related Dust Exclusion for Covered Autos Exposure WA CA 85 47 12 93 Temporary Substitute Auto - Physical Damage Insurance WA CA 85 53 12 93 Recreational Trailers and Boat Trailers WA CA 87 57 08 13 Punitive or Exemplary Damages Exclusion WA CA 99 03 03 06 Auto Medical Payments Coverage WA IL 01 23 11 13 Washington Changes - Defense Costs WA IL 01 46 08 10 Washington Common Policy Conditions WA IL 01 98 09 08 Nuclear Energy Liability Exclusion Endorsement (Broad Form)WA In witness whereof, we have caused this policy to be signed by our authorized officers. Damon Hart Secretary Hamid Mirza President 07/03/2024 56741164 N0196212 EC Insured Copy 29266of5674116400291423556741164 POLSVCS 235 002914 29 266INSURED COPY PAGE OF Ohio Security Insurance Company BRINK ELECTRIC LLC (907) 562-2225 12104 NE 141st St PARKER, SMITH & FEEK INSURANCE, Kirkland, WA 98034 LLC 3700 Centerpoint Dr Ste 102 Anchorage, AK 99503-5800 BKS(25) 56 74 11 64 From 07/12/2024 To 07/12/2025 Coverage Is Provided In: Common Policy Declarations Named Insured & Mailing Address Agent Mailing Address & Phone No. Policy Number: Policy Period: 12:01 am Standard Time at Insured Mailing Location Issue Date Authorized Representative To report a claim, call your Agent or 1-800-366-6446 DS 70 21 11 16 LIMITED LIABILITY COMPANY ELECTRICAL CONTRACTOR Named Insured Is: Named Insured Business Is: In return for the payment of the premium, and subject to all the terms of this policy, we agree with you to provide the insurance as stated in this policy. - CUSTOM PROTECTORSUMMARY OF COVERAGE PARTS AND CHARGES This policy consists of this Common Policy Declarations page, Common Policy Conditions, Coverage Parts (which consist of coverage forms and other applicable forms and endorsements, if any, issued to form a part of them) and any other forms and endorsements issued to be part of this policy. COVERAGE PART CHARGES Commercial Property Commercial Inland Marine Commercial General Liability Total Charges for all of the above coverage parts: Certified Acts of Terrorism Coverage: Note: This is not a bill IMPORTANT MESSAGES .This policy is auditable. Please refer to the conditions of the policy for details or contact your agent. 30266of56741164 POLSVCS 235 002914 30 266INSUREDCOPYPAGEOF Ohio Security Insurance Company BRINK ELECTRIC LLC (907)562-2225 12104 NE 141st St PARKER,SMITH &FEEK INSURANCE, Kirkland,WA 98034 LLC 3700 Centerpoint Dr Ste 102 Anchorage,AK 99503-5800 BKS (25)56 74 11 64 From 07/12/2024 To 07/12/2025 1-844-325-2467 Coverage Is Provided In: Common Policy Declarations Named Insured Agent Policy Number: Policy Period: 12:01 am Standard Time at Insured Mailing Location In witness whereof,we have caused this policy to be signed by our authorized officers. Damon Hart Hamid Mirza Secretary President To report a claim,call your Agent or DS 70 21 11 16 SUMMARY OF LOCATIONS This policy provides coverage for the following under one or more coverage parts.Please refer to the individual Coverage Declarations Schedules,or,the individual Coverage Forms for locations or territory definition for that specific Coverage Part. 0001 12104 NE 141st St,Kirkland,WA 98034-1411 0002 8223 Broadway Ste 103,Everett,WA 98203-6874 POLICY FORMS AND ENDORSEMENTS This section lists the Forms and Endorsements for your policy.Refer to these documents as needed for detailed information concerning your coverage. FORM NUMBER TITLE CG 00 01 04 13 Commercial General Liability Coverage Form -Occurrence CG 01 81 05 08 Washington Changes CG 01 97 12 07 Washington Changes -Employment-Related Practices Exclusion CG 04 42 11 03 Stop Gap -Employers Liability Coverage Endorsement -Washington CG 04 50 05 08 Washington Changes -Who Is An Insured CG 21 06 12 23 Exclusion -Access Or Disclosure Of Confidential Or Personal Material Or Information CG 21 70 01 15 Cap on Losses from Certified Acts of Terrorism 31266of5674116400291423556741164 POLSVCS 235 002914 31 266INSUREDCOPYPAGEOF Ohio Security Insurance Company BRINK ELECTRIC LLC (907)562-2225 12104 NE 141st St PARKER,SMITH &FEEK INSURANCE, Kirkland,WA 98034 LLC 3700 Centerpoint Dr Ste 102 Anchorage,AK 99503-5800 BKS (25)56 74 11 64 From 07/12/2024 To 07/12/2025 1-844-325-2467 Coverage Is Provided In: Common Policy Declarations Named Insured Agent Policy Number: Policy Period: 12:01 am Standard Time at Insured Mailing Location To report a claim,call your Agent or DS 70 21 11 16 POLICY FORMS AND ENDORSEMENTS -CONTINUED This section lists all of the Forms and Endorsements for your policy.Refer to these documents as needed for detailed information concerning your coverage. FORM NUMBER TITLE CG 21 76 01 15 Exclusion of Punitive Damages Related to a Certified Act of Terrorism CG 21 86 12 04 Exclusion -Exterior Insulation and Finish Systems CG 21 96 03 05 Silica or Silica-Related Dust Exclusion CG 22 79 04 13 Exclusion -Contractors -Professional Liability CG 24 26 04 13 Amendment of Insured Contract Definition CG 26 77 12 04 Washington -Fungi or Bacteria Exclusion CG 32 21 01 15 Washington Conditional Exclusion of Terrorism Involving Nuclear,Biological or Chemical Terrorism (Relating to Disposition of Federal Terrorism Risk Insurance Act) CG 40 35 12 23 Exclusion -Cyber Incident CG 80 61 05 11 Amendment of Cancellation Provisions CG 84 94 12 08 Exclusion -Consolidated Insurance Programs Wrap-Up CG 84 99 08 09 Non-Cumulation Liability Limits Same Occurrence CG 85 83 04 13 Blanket Additional Insured Contractors -Products -Completed Operations CG 88 10 04 13 Commercial General Liability Extension CG 88 60 12 08 Each Location General Aggregate Limit CG 88 67 12 08 Property Damage -Borrowed Equipment -$100,000 Limit CG 88 70 12 08 Construction Project(s)-General Aggregate Limit (Per Project) CG 88 77 12 08 Medical Expense At Your Request Endorsement CG 88 80 12 08 Property Damage -Customers’Goods ($100,000 Limit) CG 89 27 10 09 Washington Exclusion -Asbestos CG 91 98 06 15 Disclosure and Notice Concerning Fully Earned and Minimun Premium Endorsements CG 93 41 08 20 Voluntary Loss Coverage No Duty To Defend CG 93 74 03 22 Exclusion -PFC/PFAS 32266of56741164 POLSVCS 235 002914 32 266INSUREDCOPYPAGEOF Ohio Security Insurance Company BRINK ELECTRIC LLC (907)562-2225 12104 NE 141st St PARKER,SMITH &FEEK INSURANCE, Kirkland,WA 98034 LLC 3700 Centerpoint Dr Ste 102 Anchorage,AK 99503-5800 BKS (25)56 74 11 64 From 07/12/2024 To 07/12/2025 1-844-325-2467 Coverage Is Provided In: Common Policy Declarations Named Insured Agent Policy Number: Policy Period: 12:01 am Standard Time at Insured Mailing Location To report a claim,call your Agent or DS 70 21 11 16 POLICY FORMS AND ENDORSEMENTS -CONTINUED This section lists all of the Forms and Endorsements for your policy.Refer to these documents as needed for detailed information concerning your coverage. FORM NUMBER TITLE CG 93 81 11 22 Exclusion -Biometric Information Privacy Claim CG 94 39 05 24 Washington Amendment Of Representations Condition CL 01 03 03 10 Common Policy Conditions -Washington CL 04 65 01 01 Loss Payable Endorsement -Washington CL 06 00 01 15 Certified Terrorism Loss CL 07 00 10 06 Virus or Bacteria Exclusion CL 08 11 09 18 Cannabis Items and Activities Exclusion CL 16 50 08 06 Conditional Nuclear,Biological,and Chemical Terrorism Exclusion CM 76 13 07 13 Waiver of Theft Deductible CM 89 15 06 20 Variable Deductible Endorsement CM 89 19 06 20 Valuation Of Equipment Leased Or Rented From Others CM 89 21 08 20 Replacement Cost Removed On Equipment Older Than Six (6)Years Of Age CM 89 65 08 21 Cyber Incident Exclusion CM 89 68 05 21 Amendatory Endorsement -Washington CP 00 10 10 12 Building and Personal Property Coverage Form CP 00 30 10 12 Business Income (And Extra Expense)Coverage Form CP 00 90 07 88 Commercial Property Conditions CP 01 26 10 12 Washington Changes CP 01 40 07 06 Exclusion of Loss Due to Virus or Bacteria CP 01 60 03 21 Washington Changes -Domestic Abuse CP 01 79 10 12 Washington Changes -Excluded Causes of Loss CP 10 30 10 12 Causes of Loss -Special Form CP 10 34 10 12 Exclusion of Loss Due To By-Products of Production or Processing Operations (Rental Properties) 33266of5674116400291423556741164 POLSVCS 235 002914 33 266INSUREDCOPYPAGEOF Ohio Security Insurance Company BRINK ELECTRIC LLC (907)562-2225 12104 NE 141st St PARKER,SMITH &FEEK INSURANCE, Kirkland,WA 98034 LLC 3700 Centerpoint Dr Ste 102 Anchorage,AK 99503-5800 BKS (25)56 74 11 64 From 07/12/2024 To 07/12/2025 1-844-325-2467 Coverage Is Provided In: Common Policy Declarations Named Insured Agent Policy Number: Policy Period: 12:01 am Standard Time at Insured Mailing Location To report a claim,call your Agent or DS 70 21 11 16 POLICY FORMS AND ENDORSEMENTS -CONTINUED This section lists all of the Forms and Endorsements for your policy.Refer to these documents as needed for detailed information concerning your coverage. FORM NUMBER TITLE CP 12 20 10 12 Loss Payable Provisions -Washington Endorsement CP 88 04 03 10 Removal Permit CP 88 44 02 15 Equipment Breakdown Coverage Endorsement CP 90 55 12 12 Business Income And Extra Expense Changes -Actual Loss Sustained In A Twelve-Month Period CP 90 59 12 12 Identity Theft Administrative Services and Expense Coverage CP 91 00 10 14 Contractors Custom Protector Endorsement CP 91 42 01 15 Custom Protector Plus Endorsement CP 92 12 12 20 Cyber Incident Exclusion CP 92 23 09 23 Washington -Amendment Of Concealment,Misrepresentation Or Fraud Condition IL 01 23 11 13 Washington Changes -Defense Costs IL 01 46 08 10 Washington Common Policy Conditions IL 01 98 09 08 Nuclear Energy Liability Exclusion Endorsement (Broad Form) IL 09 35 07 02 Exclusion of Certain Computer-Related Losses IL 09 52 01 15 Cap On Losses From Certified Acts Of Terrorism IL 09 96 01 07 Conditional Exclusion of Terrorism Involving Nuclear,Biological or Chemical Terrorism (Relating to Dispostion of Federal Terrorism Risk Insurance Act) IL 88 56 03 22 Actual Cash Value -Washington IM 70 00 04 04 Contractors’Equipment Coverage IM 70 37 01 12 Equipment Borrowed From Others IM 71 00 06 04 Installation Floater Coverage IM 79 02 05 04 Loss Payable Schedule 51266of5674116400291423556741164 POLSVCS 235 002914 51 266INSUREDCOPYPAGEOF Ohio Security Insurance Company Commercial General Liability Declarations BKS (25)56 74 11 64 From 07/12/2024 To 07/12/2025 1-844-325-2467 DS 70 22 01 08 Coverage Is Provided In:Policy Number: Policy Period: 12:01 am Standard Time at Insured Mailing Location To report a claim,call your Agent or OccurrenceBasis: BRINK ELECTRIC LLC (907)562-2225 PARKER,SMITH &FEEK INSURANCE, LLC Named Insured Agent SUMMARY OF LIMITS AND CHARGES Commercial DESCRIPTION LIMIT General Liability Limits of Insurance Each Occurrence Limit 1,000,000 Damage To Premises Rented To You Limit (Any One Premises)1,000,000 Medical Expense Limit (Any One Person)15,000 Personal and Advertising Injury Limit 1,000,000 General Aggregate Limit (Other than Products -Completed Operations)2,000,000 Products -Completed Operations Aggregate Limit 2,000,000 Explanation of DESCRIPTION PREMIUM Charges General Liability Schedule Totals 24,191.00 Certified Acts of Terrorism Coverage 145.00 Total Advance Charges:$24,336.00 Note:This is not a bill 1776of5674116400291523556741164 POLSVCS 235 002915 17 76INSURED COPY PAGE OF The Ohio Casualty Insurance Company Commercial Umbrella Policy Declarations Basis: Occurrence USO (25) 56 74 11 64 To report a claim, call your Agent or 1-844-325-2467 DS 70 22 01 08 Coverage Is Provided In:Policy Number: Issue Date Authorized Representative BRINK ELECTRIC LLC (907) 562-2225 8223 Broadway Ste 103 PARKER, SMITH & FEEK INSURANCE, Everett, WA 98203 LLC 3700 Centerpoint Dr Ste 102 Anchorage, AK 99503-5800 LIMITED LIABILITY COMPANY ELECTRICAL CONTRACTOR (ITEM 1) NAMED INSURED & MAILING ADDRESS AGENT MAILING ADDRESS & PHONE NO. Named Insured Is: Named Insured Business Is: From 07/12/2024 TO 07/12/2025 12:01 AM Standard Time at Insured Mailing Location (ITEM 2) POLICY PERIOD (ITEM 3) PREMIUM CHARGES Explanation of DESCRIPTION PREMIUM Charges Commercial Umbrella Certified Acts of Terrorism Coverage Total Advance Charges Note: This is not a bill XBASIS OF PREMIUM: NON-AUDITABLE( ) AUDITABLE( ) 0% IN THE EVENT OF CANCELLATION BY THE NAMED INSURED, THE COMPANY WILL RECEIVE AND RETAIN NO LESS THAN ( ) OF THE POLICY PREMIUM AS THE MINIMUM RETAINED PREMIUM PLUS CERTIFIED ACTS OF TERRORISM COVERAGE AND ANY APPLICABLE TAXES AND SURCHARGES. (ITEM 4) LIMITS OF INSURANCE DESCRIPTION LIMIT $4,000,000 $4,000,000 $4,000,000 $10,000 EACH OCCURRENCE AGGREGATE (WHERE APPLICABLE) PRODUCTS-COMPLETED OPERATIONS AGGREGATE SELF-INSURED RETENTION 1876of56741164 POLSVCS 235 002915 18 76INSUREDCOPYPAGEOF The Ohio Casualty Insurance Company USO (25)56 74 11 64 To report a claim,call your Agent or 1-844-325-2467 DS 70 23 01 08 Coverage Is Provided In:Policy Number: (ITEM 5)SCHEDULE OF UNDERLYING INSURANCE: CARRIER,POLICY NUMBER AND PERIOD TYPE OF COVERAGE LIMITS OF INSURANCE OHIO SECURITY INSURANCE GENERAL $1,000,000 EACH OCCURRENCE COMPANY LIABILITY LIMIT $1,000,000 PERSONAL AND BKS(25)56741164 ADVERTISING INJURY 07/12/2024 -07/12/2025 LIMIT $2,000,000 GENERAL AGGREGATE LIMIT $2,000,000 PRODUCTS -COMPLETED OPERATIONS AGGREGATE LIMIT OHIO SECURITY INSURANCE OWNED AND HIRED $1,000,000 COMBINED SINGLE COMPANY AND/OR NONOWNED LIMIT AUTO LIABILITY BAS(25)56741164 07/12/2024 -07/12/2025 OHIO SECURITY INSURANCE STOP GAP $1,000,000 BODILY INJURY EACH COMPANY LIABILITY ACCIDENT LIMIT $2,000,000 BODILY INJURY BY BKS(25)56741164 DISEASE AGGREGATE 07/12/2024 -07/12/2025 LIMIT $1,000,000 BODILY INJURY BY DISEASE EACH EMPLOYEE LIMIT 1976of5674116400291523556741164 POLSVCS 235 002915 19 76INSUREDCOPYPAGEOF The Ohio Casualty Insurance Company USO (25)56 74 11 64 To report a claim,call your Agent or 1-844-325-2467 DS 70 23 01 08 Coverage Is Provided In:Policy Number: In witness whereof,we have caused this policy to be signed by our authorized officers. Damon Hart Hamid Mirza Secretary President POLICY FORMS AND ENDORSEMENTS This section lists all the Forms and Endorsements for your policy.Refer to these documents as needed for detailed information concerning your coverage. FORM NUMBER TITLE CNI90 11 07 18 Reporting A Commercial Claim 24 Hours A Day CU 60 02 04 21 Commercial Umbrella Coverage Form CU 60 39 04 21 Cap On Losses From Certified Acts Of Terrorism CU 60 40 04 21 Underlying Coverage Requirement For Certified Acts Of Terrorism CU 61 02 04 21 Exclusion -Aircraft Products And Grounding Liability CU 61 29 04 21 Personal And Advertising Injury -Following Form CU 61 50 04 21 Contractors Limitation Endorsement CU 64 00 04 21 Exclusion -Exterior Insulation And Finish Systems CU 64 30 04 21 Washington Exclusion -Fungi or Bacteria CU 64 95 04 21 Waiver Of Transfer Of Rights Of Recovery Against Others -Following Form CU 65 08 04 21 Exclusion Of Punitive Damages Related To A Certified Act Of Terrorism CU 88 27 04 21 Washington Exclusion -Employment Related Practices CU 88 65 04 21 Damage To Your Work Performed By Subcontractors On Your Behalf -Following Form CU 88 80 04 21 Exclusion -Silica Or Silica-Related Dust 2076of56741164 POLSVCS 235 002915 20 76INSUREDCOPYPAGEOF The Ohio Casualty Insurance Company USO (25)56 74 11 64 To report a claim,call your Agent or 1-844-325-2467 DS 70 23 01 08 Coverage Is Provided In:Policy Number: POLICY FORMS AND ENDORSEMENTS -continued This section lists all the Forms and Endorsements for your policy.Refer to these documents as needed for detailed information concerning your coverage. FORM NUMBER TITLE CU 89 31 04 21 Washington Conditional Exclusion Of Terrorism Involving Nuclear,Biological Or Chemical Terrorism (Relating To Disposition Of Federal Terrorism Risk Insurance Act) CU 89 40 04 21 Crisis Management Coverage CU 89 41 04 21 Washington Changes -Defense Costs CU 89 44 04 21 Exclusion -Contractors Errors Or Omissions CU 89 45 12 23 Exclusion -Access Or Disclosure Of Confidential Or Personal Information And Data-Related Liability -With Limited Bodily Injury Exception CU 90 63 04 21 Tracking General Aggregate Limit CU 90 83 04 21 Amendment Of Other Insurance -Blanket CU 91 12 04 21 Washington Changes -Cancellation and Nonrenewal CU 91 27 04 21 Washington Changes -Amendment of Pollution Exclusion CU 91 37 04 21 Washington Amendment of Pollution Exclusion CU 91 41 04 21 Washington Changes -Concealment,Misrepresentation or Fraud CU 91 94 03 22 Exclusion -PFC/PFAS CU 92 21 11 22 Exclusion -Biometric Information Privacy Claim CU 92 49 12 23 Exclusion -Cyber Incident 2017Liberty Mutual Insurance AC 85 01 06 18 Page 7 of 7IncludescopyrightedmaterialofInsuranceServicesOfficeInc.,with its Permission. 21.AMENDED DUTIES IN THE EVENT OF ACCIDENT,CLAIM,SUIT,OR LOSS SECTION IV -BUSINESS AUTO CONDITIONS,Paragraph A.2.a.is replaced in its entirety by the follow- ing: a.In the event of "accident",claim,"suit"or "loss",you must promptly notify us when it is known to: (1)You,if you are an individual; (2)A partner,if you are a partnership; (3)Member,if you are a limited liability company; (4)An executive officer or the "employee"designated by the Named Insured to give such notice,if you are a corporation. To the extent possible,notice to us should include: (a)How,when and where the "accident"or "loss"took place; (b)The "insureds"name and address;and (c)The names and addresses of any injured persons and witnesses. 22.WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US SECTION IV -BUSINESS AUTO CONDITIONS,Paragraph A.5.Transfer Of Rights Of Recovery Against Others To Us,is amended by the addition of the following: If the person or organization has in a written agreement waived those rights before an "accident"or "loss",our rights are waived also. 23.HIRED AUTO COVERAGE TERRITORY SECTION IV -BUSINESS AUTO CONDITIONS,Paragraph B.7.Policy Period,Coverage Territory,is amended by the addition of the following: f.For "autos"hired 30 days or less,the coverage territory is anywhere in the world,provided that the "insured’s"responsibility to pay for damages is determined in a "suit",on the merits,in the United States,the territories and possessions of the United States of America,Puerto Rico or Canada or in a settlement we agree to. This extension of coverage does not apply to an "auto"hired,leased,rented or borrowed with a driver. 24.PRIMARY AND NON-CONTRIBUTING IF REQUIRED BY WRITTEN CONTRACT OR WRITTEN AGREE- MENT The following is added to SECTION IV -BUSINESS AUTO CONDITIONS,General Conditions,B.5.Other Insurance and supersedes any provision to the contrary: This Coverage Form’s Covered Autos Liability Coverage is primary to and will not seek contribution from any other insurance available to an "insured"under your policy provided that: 1.Such "insured"is a Named Insured under such other insurance;and 2.You have agreed in a written contract or written agreement that this insurance would be primary and would not seek contribution from any other insurance available to such "insured". SECTION V -DEFINITIONS is amended as follows: 25.BODILY INJURY REDEFINED Under SECTION V -DEFINITIONS,Definition C.is replaced by the following: "Bodily injury"means physical injury,sickness or disease sustained by a person,including mental anguish,mental injury,shock,fright or death resulting from any of these at any time. 07/03/2024 56741164 N0196212 EC Insured Copy 2017Liberty Mutual Insurance AC 85 01 06 18 Page 7 of 7IncludescopyrightedmaterialofInsuranceServicesOfficeInc.,with its Permission. 21.AMENDED DUTIES IN THE EVENT OF ACCIDENT,CLAIM,SUIT,OR LOSS SECTION IV -BUSINESS AUTO CONDITIONS,Paragraph A.2.a.is replaced in its entirety by the follow- ing: a.In the event of "accident",claim,"suit"or "loss",you must promptly notify us when it is known to: (1)You,if you are an individual; (2)A partner,if you are a partnership; (3)Member,if you are a limited liability company; (4)An executive officer or the "employee"designated by the Named Insured to give such notice,if you are a corporation. To the extent possible,notice to us should include: (a)How,when and where the "accident"or "loss"took place; (b)The "insureds"name and address;and (c)The names and addresses of any injured persons and witnesses. 22.WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US SECTION IV -BUSINESS AUTO CONDITIONS,Paragraph A.5.Transfer Of Rights Of Recovery Against Others To Us,is amended by the addition of the following: If the person or organization has in a written agreement waived those rights before an "accident"or "loss",our rights are waived also. 23.HIRED AUTO COVERAGE TERRITORY SECTION IV -BUSINESS AUTO CONDITIONS,Paragraph B.7.Policy Period,Coverage Territory,is amended by the addition of the following: f.For "autos"hired 30 days or less,the coverage territory is anywhere in the world,provided that the "insured’s"responsibility to pay for damages is determined in a "suit",on the merits,in the United States,the territories and possessions of the United States of America,Puerto Rico or Canada or in a settlement we agree to. This extension of coverage does not apply to an "auto"hired,leased,rented or borrowed with a driver. 24.PRIMARY AND NON-CONTRIBUTING IF REQUIRED BY WRITTEN CONTRACT OR WRITTEN AGREE- MENT The following is added to SECTION IV -BUSINESS AUTO CONDITIONS,General Conditions,B.5.Other Insurance and supersedes any provision to the contrary: This Coverage Form’s Covered Autos Liability Coverage is primary to and will not seek contribution from any other insurance available to an "insured"under your policy provided that: 1.Such "insured"is a Named Insured under such other insurance;and 2.You have agreed in a written contract or written agreement that this insurance would be primary and would not seek contribution from any other insurance available to such "insured". SECTION V -DEFINITIONS is amended as follows: 25.BODILY INJURY REDEFINED Under SECTION V -DEFINITIONS,Definition C.is replaced by the following: "Bodily injury"means physical injury,sickness or disease sustained by a person,including mental anguish,mental injury,shock,fright or death resulting from any of these at any time. 07/03/2024 56741164 N0196212 EC Insured Copy 105272of56741164001840235 106272of 94266ofCOMMERCIAL GENERAL LIABILITY CG 85 83 04 13 THIS ENDORSEMENT CHANGES THE POLICY.PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED CONTRACTORS -PRODUCTS/COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART 95266of56741164002166235 96266ofCOMMERCIAL GENERAL LIABILITY CG 88 10 04 13 THIS ENDORSEMENT CHANGES THE POLICY.PLEASE READ IT CAREFULLY. COMMERCIAL GENERAL LIABILITY EXTENSION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART 97266of56741164002166235 98266of 99266of56741164002166235 100266of 101266of56741164002166235 102266of 103266of56741164002166235 106266ofCOMMERCIAL GENERAL LIABILITY CG 88 70 12 08 THIS ENDORSEMENT CHANGES THE POLICY.PLEASE READ IT CAREFULLY. CONSTRUCTION PROJECT(S)-GENERAL AGGREGATE LIMIT (PER PROJECT) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART Includes copyrighted material of ISO Properties,Inc.,with its permission.CG 88 70 12 08 Page 1 of 1 A.For all sums which the insured becomes legally obligated to pay as damages caused by "occurrences" under Section I -Coverage A -Bodily Injury And Property Damage Liability,and for all medical ex- penses caused by accidents under Section I -Coverage C Medical Payments,which can be attributed only to ongoing operations at a single construction project away from premises owned by or rented to you: 1.A separate Construction Project General Aggregate Limit applies to each construction project,and that limit is equal to the amount of the General Aggregate Limit shown in the Declarations . 2.The Construction Project General Aggregate Limit is the most we will pay for the sum of all damages under Coverage A,except damages because of "bodily injury"or "property damage" included in the "products-completed operations hazard",and for medical expenses under Cov- erage C regardless of the number of: a.Insureds; b.Claims made or "suits"brought;or c.Persons or organizations making claims or bringing "suits". 3.Any payments made under Coverage A for damages or under Coverage C for medical expenses shall reduce the Construction Project General Aggregate Limit for that construction project.Such payments shall not reduce the General Aggregate Limit shown in the Declarations nor shall they reduce any other Construction Project General Aggregate Limit for any other construction project. 4.The limits shown in the Declarations for Each Occurrence,Fire Damage and Medical Expense continue to apply.However,instead of being subject to the General Aggregate Limit shown in the Declarations,such limits will be subject to the applicable Construction Project General Aggregate Limit. B.For all sums which the insured becomes legally obligated to pay as damages caused by "occurrences" under Section I -Coverage A -Bodily Injury And Property Damage Liability,and for all medical ex- penses caused by accidents under Section I -Coverage C Medical Payments,which cannot be attrib- uted only to ongoing operations at a single construction project away from premises owned by or rented to you: 1.Any payments made under Coverage A for damages or under Coverage C for medical expenses shall reduce the amount available under the General Aggregate Limit or the Products-Completed Operations Aggregate Limit,whichever is applicable;and 2.Such payments shall not reduce any Construction Project General Aggregate Limit. C.When coverage for liability arising out of the "products-completed operations hazard"is provided,any payments for damages because of "bodily injury"or "property damage"included in the "products- completed operations hazard"will reduce the Products-Completed Operations Aggregate Limit,and not reduce the General Aggregate Limit nor the Construction Project General Aggregate Limit. D.If the applicable construction project has been abandoned,delayed,or abandoned and then restarted, or if the authorized contracting parties deviate from plans,blueprints,designs,specifications or timetables,the project will still be deemed to be the same construction project. E.The provisions of Section III -Limits Of Insurance not otherwise modified by this endorsement shall continue to apply. 107272of56741164001840235 108272of 110272of 53102of56741164001583235 CU 90 83 04 21 © 2020 Liberty Mutual Insurance Page 1 of 1 Includes copyrighted material of Insurance Services Office, Inc., with its permission. COMMERCIAL UMBRELLA CU 90 83 04 21 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. AMENDMENT OF OTHER INSURANCE – BLANKET This endorsement modifies insurance provided under the following: COMMERCIAL UMBRELLA COVERAGE FORM Condition 12. of Section VI – Conditions is replaced by the following: 12. Other Insurance This insurance is excess over, and will not share or contribute with any "other insurance" whether primary, excess, contingent, or on any other basis. This insurance, however, will not seek contribution from any "other insurance" available to an additional insured provided that: a. The additional insured is a "named insured" on such "other insurance"; b. You have agreed in a written contract or agreement that this insurance would not seek contribution from any "other insurance" available; c. "Underlying insurance" includes the person or organization as an additional insured; and d. "Underlying insurance" provides coverage to the person or organization on a primary and noncontributory basis. CU 64 95 04 21 © 2020 Liberty Mutual Insurance Page 1 of 1 Includes copyrighted material of Insurance Services Office, Inc., with its permission. COMMERCIAL UMBRELLA CU 64 95 04 21 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS – FOLLOWING FORM This endorsement modifies insurance provided under the following: COMMERCIAL UMBRELLA COVERAGE FORM The following is added to Condition 16. Transfer Of Rights Of Recovery Against Others To Us under Section VI – Conditions: We have the right to recover our payments from anyone liable for an injury or damage covered by this policy. To the extent that right has been waived in "underlying insurance", we will waive any right of recovery we may have against a person or organization because of payments we make under this policy. Any such waiver, however, will not be any broader than that provided by such "underlying insurance". 2017Liberty Mutual Insurance AC 85 01 06 18 Page 2 of 7IncludescopyrightedmaterialofInsuranceServicesOfficeInc.,with its Permission. SECTION II -LIABILITY COVERAGE is amended as follows: 2.NEWLY FORMED OR ACQUIRED SUBSIDIARIES SECTION II - LIABILITY COVERAGE, Paragraph A.1. - Who Is An Insured is amended to include the following as an "insured": d.Any legally incorporated subsidiary of which you own more than 50 percent interest during the policy period. Coverage is afforded only for 90 days from the date of acquisition or formation. However, "insured" does not include any organization that: (1)Is a partnership or joint venture; or (2)Is an "insured" under any other automobile policy except a policy written specifically to apply in excess of this policy; or (3)Has exhausted its Limit of Insurance or had its policy terminated under any other automobile policy. Coverage under this provision d. does not apply to "bodily injury" or "property damage" that occurred before you acquired or formed the organization. 3.EMPLOYEES AS INSUREDS SECTION II -LIABILITY COVERAGE,Paragraph A.1.Who Is An Insured is amended to include the following as an "insured": e.Any "employee"of yours while using a covered "auto"you do not own,hire or borrow but only for acts within the scope of their employment by you.Insurance provided by this endorsement is excess over any other insurance available to any "employee". f.Any "employee"of yours while operating an "auto"hired or borrowed under a written contract or agreement in that "employee’s"name,with your permission,while performing duties related to the conduct of your business and within the scope of their employment.Insurance provided by this endorsement is excess over any other insurance available to the "employee". 4.ADDITIONAL INSURED BY CONTRACT,AGREEMENT OR PERMIT SECTION II -LIABILITY COVERAGE,Paragraph A.1.Who Is An Insured is amended to include the following as an "insured": g.Any person or organization with respect to the operation,maintenance or use of a covered "auto", provided that you and such person or organization have agreed in a written contract,written agreement,or permit issued to you by governmental or public authority,to add such person,or organization,or governmental or public authority to this policy as an "insured". However,such person or organization is an "insured": (1)Only with respect to the operation,maintenance or use of a covered "auto"; (2)Only for "bodily injury"or "property damage"caused by an "accident"which takes place after you executed the written contract or written agreement,or the permit has been issued to you; and (3)Only for the duration of that contract,agreement or permit. The "insured"is required to submit a claim to any other insurer to which coverage could apply for defense and indemnity.Unless the "insured"has agreed in writing to primary noncontributory wording per enhancement number 24,this policy is excess over any other collectible insurance. 5.SUPPLEMENTARY PAYMENTS SECTION II -LIABILITY COVERAGE,Coverage Extensions,2.a.Supplementary Payments,Paragraphs (2)and (4)are replaced by the following: (2)Up to $3,000 for cost of bail bonds (including bonds for related traffic violations )required because of an "accident"we cover.We do not have to furnish these bonds. (4)All reasonable expenses incurred by the "insured"at our request,including actual loss of earnings up to $500 a day because of time off from work. 07/03/2024 56741164 N0196212 EC Insured Copy COMMERCIAL AUTO AC 85 01 06 18 THIS ENDORSEMENT CHANGES THE POLICY.PLEASE READ IT CAREFULLY. BUSINESS AUTO COVERAGE ENHANCEMENT ENDORSEMENT 2017Liberty Mutual Insurance AC 85 01 06 18 Page 1 of 7IncludescopyrightedmaterialofInsuranceServicesOfficeInc.,with its Permission. This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM With respect to coverage afforded by this endorsement,the provisions of the policy apply unless modified by the endorsement. If the policy to which this endorsement is attached also contains a Business Auto Coverage Enhancement Endorsement with a specific state named in the title,this endorsement does not apply to vehicles garaged in that specified state. COVERAGE INDEX SUBJECT PROVISION NUMBER ACCIDENTAL AIRBAG DEPLOYMENT 13 ADDITIONAL INSURED BY CONTRACT,AGREEMENT OR PERMIT 4 AMENDED DUTIES IN THE EVENT OF ACCIDENT,CLAIM,SUIT OR LOSS 21 AMENDED FELLOW EMPLOYEE EXCLUSION 6 AUDIO,VISUAL AND DATA ELECTRONIC EQUIPMENT COVERAGE 15 BODILY INJURY REDEFINED 25 EMPLOYEES AS INSUREDS (Including Employee Hired Auto)3 EXTRA EXPENSE -BROADENED COVERAGE 11 GLASS REPAIR -WAIVER OF DEDUCTIBLE 17 HIRED AUTO COVERAGE TERRITORY 23 HIRED AUTO PHYSICAL DAMAGE (Including Employee Hired Auto)7 LOAN /LEASE GAP (Coverage Not Available In New York)16 NEWLY FORMED OR ACQUIRED SUBSIDIARIES 2 PARKED AUTO COLLISION COVERAGE (WAIVER OF DEDUCTIBLE)18 PERSONAL EFFECTSCOVERAGE 12 PHYSICAL DAMAGE -ADDITIONAL TRANSPORTATION EXPENSE COVERAGE 9 PHYSICAL DAMAGE DEDUCTIBLE -VEHICLE TRACKING SYSTEM 14 PRIMARY AND NON-CONTRIBUTORY -WRITTEN CONTRACT OR WRITTEN AGREEMENT 24 RENTAL REIMBURSEMENT 10 SUPPLEMENTARY PAYMENTS 5 TOWING AND LABOR 8 TRAILERS -INCREASED LOAD CAPACITY 1 TWO OR MORE DEDUCTIBLES 19 UNINTENTIONAL FAILURE TO DISCLOSE HAZARDS 20 WAIVER OF TRANSFER OF RIGHTS OF RECOVERYAGAINST OTHERS TO US 22 SECTION I -COVERED AUTOS is amended as follows: 1.TRAILERS -INCREASED LOAD CAPACITY The following replaces Paragraph C.1.Certain Trailers,Mobile Equipment And Temporary Substitute Autos of SECTION I -COVERED AUTOS: "Trailers"with a load capacity of 3,000 pounds or less designed primarily for travel on public roads. 07/03/2024 56741164 N0196212 EC Insured Copy 2017Liberty Mutual Insurance AC 85 01 06 18 Page 2 of 7IncludescopyrightedmaterialofInsuranceServicesOfficeInc.,with its Permission. SECTION II -LIABILITY COVERAGE is amended as follows: 2.NEWLY FORMED OR ACQUIRED SUBSIDIARIES SECTION II - LIABILITY COVERAGE, Paragraph A.1. - Who Is An Insured is amended to include the following as an "insured": d.Any legally incorporated subsidiary of which you own more than 50 percent interest during the policy period. Coverage is afforded only for 90 days from the date of acquisition or formation. However, "insured" does not include any organization that: (1)Is a partnership or joint venture; or (2)Is an "insured" under any other automobile policy except a policy written specifically to apply in excess of this policy; or (3)Has exhausted its Limit of Insurance or had its policy terminated under any other automobile policy. Coverage under this provision d. does not apply to "bodily injury" or "property damage" that occurred before you acquired or formed the organization. 3.EMPLOYEES AS INSUREDS SECTION II -LIABILITY COVERAGE,Paragraph A.1.Who Is An Insured is amended to include the following as an "insured": e.Any "employee"of yours while using a covered "auto"you do not own,hire or borrow but only for acts within the scope of their employment by you.Insurance provided by this endorsement is excess over any other insurance available to any "employee". f.Any "employee"of yours while operating an "auto"hired or borrowed under a written contract or agreement in that "employee’s"name,with your permission,while performing duties related to the conduct of your business and within the scope of their employment.Insurance provided by this endorsement is excess over any other insurance available to the "employee". 4.ADDITIONAL INSURED BY CONTRACT,AGREEMENT OR PERMIT SECTION II -LIABILITY COVERAGE,Paragraph A.1.Who Is An Insured is amended to include the following as an "insured": g.Any person or organization with respect to the operation,maintenance or use of a covered "auto", provided that you and such person or organization have agreed in a written contract,written agreement,or permit issued to you by governmental or public authority,to add such person,or organization,or governmental or public authority to this policy as an "insured". However,such person or organization is an "insured": (1)Only with respect to the operation,maintenance or use of a covered "auto"; (2)Only for "bodily injury"or "property damage"caused by an "accident"which takes place after you executed the written contract or written agreement,or the permit has been issued to you; and (3)Only for the duration of that contract,agreement or permit. The "insured"is required to submit a claim to any other insurer to which coverage could apply for defense and indemnity.Unless the "insured"has agreed in writing to primary noncontributory wording per enhancement number 24,this policy is excess over any other collectible insurance. 5.SUPPLEMENTARY PAYMENTS SECTION II -LIABILITY COVERAGE,Coverage Extensions,2.a.Supplementary Payments,Paragraphs (2)and (4)are replaced by the following: (2)Up to $3,000 for cost of bail bonds (including bonds for related traffic violations )required because of an "accident"we cover.We do not have to furnish these bonds. (4)All reasonable expenses incurred by the "insured"at our request,including actual loss of earnings up to $500 a day because of time off from work. 07/03/2024 56741164 N0196212 EC Insured Copy 2017Liberty Mutual Insurance AC 85 01 06 18 Page 3 of 7IncludescopyrightedmaterialofInsuranceServicesOfficeInc.,with its Permission. 6.AMENDED FELLOW EMPLOYEE EXCLUSION In those jurisdictions where,by law,fellow "employees"are not entitled to the protection afforded to the employer by the workers compensation exclusivity rule,or similar protection,the following provi- sion is added: SECTION II -LIABILITY,Exclusion B.5.Fellow Employee does not apply if the "bodily injury"results from the use of a covered "auto"you own or hire if you have workers compensation insurance in force for all of your "employees"at the time of "loss". This coverage is excess over any other collectible insurance. SECTION III -PHYSICAL DAMAGE COVERAGE is amended as follows: 7.HIRED AUTO PHYSICAL DAMAGE Paragraph A.4.Coverage Extensions of SECTION III -PHYSICAL DAMAGE COVERAGE,is amended by adding the following: If hired "autos"are covered "autos"for Liability Coverage,and if Comprehensive,Specified Causes of Loss or Collision coverage are provided under the Business Auto Coverage Form for any "auto"you own,then the Physical Damage coverages provided are extended to "autos": a.You hire,rent or borrow;or b.Your "employee"hires or rents under a written contract or agreement in that "employee’s"name, but only if the damage occurs while the vehicle is being used in the conduct of your business, subject to the following limit and deductible: a.The most we will pay for "loss"in any one "accident"or "loss"is the smallest of: (1)$50,000;or (2)The actual cash value of the damaged or stolen property as of the time of the "loss";or (3)The cost of repairing or replacing the damaged or stolen property with other property of like kind and quality,minus a deductible. b.The deductible will be equal to the largest deductible applicable to any owned "auto"for that coverage. c.Subject to the limit,deductible and excess provisions described in this provision,we will provide coverage equal to the broadest coverage applicable to any covered "auto"you own. d.Subject to a maximum of $1,000 per "accident",we will also cover the actual loss of use of the hired "auto"if it results from an "accident",you are legally liable and the lessor incurs an actual financial loss. e.This coverage extension does not apply to: (1)Any "auto"that is hired,rented or borrowed with a driver;or (2)Any "auto"that is hired,rented or borrowed from your "employee"or any member of your "employee’s"household. Coverage provided under this extension is excess over any other collectible insurance available at the time of "loss". 8.TOWING AND LABOR SECTION III -PHYSICAL DAMAGE COVERAGE,Paragraph A.2.Towing,is amended by the addition of the following: We will pay towing and labor costs incurred,up to the limits shown below,each time a covered "auto" classified and rated as a private passenger type,"light truck"or "medium truck"is disabled: a.For private passenger type vehicles,we will pay up to $75 per disablement. b.For "light trucks",we will pay up to $75 per disablement."Light trucks"are trucks that have a gross vehicle weight (GVW)of 10,000 pounds or less. c.For "medium trucks",we will pay up to $150 per disablement."Medium trucks"are trucks that have a gross vehicle weight (GVW)of 10,001 -20,000 pounds. However,the labor must be performed at the place of disablement. 07/03/2024 56741164 N0196212 EC Insured Copy 2017Liberty Mutual Insurance AC 85 01 06 18 Page 4 of 7IncludescopyrightedmaterialofInsuranceServicesOfficeInc.,with its Permission. 9.PHYSICAL DAMAGE -ADDITIONAL TRANSPORTATION EXPENSE COVERAGE Paragraph A.4.a.Coverage Extensions,Transportation Expenses of SECTION III -PHYSICAL DAMAGE COVERAGE,is amended to provide a limit of $50 per day and a maximum limit of $1,500. 10.RENTAL REIMBURSEMENT SECTION III -PHYSICAL DAMAGE COVERAGE,A.Coverage,is amended by adding the following: a.We will pay up to $75 per day for rental reimbursement expenses incurred by you for the rental of an "auto"because of "accident"or "loss",to an "auto"for which we also pay a "loss"under Comprehensive,Specified Causes of Loss or Collision Coverages.We will pay only for those ex- penses incurred after the first 24 hours following the "accident"or "loss"to the covered "auto." b.Rental Reimbursement requires the rental of a comparable or lessor vehicle,which in many cases may be substantially less than $75 per day,and will only be allowed for the period of time it should take to repair or replace the vehicle with reasonable speed and similar quality,up to a maximum of 30 days. c.We will also pay up to $500 for reasonable and necessary expenses incurred by you to remove and replace your tools and equipment from the covered "auto".This limit is excess over any other collectible insurance. d.This coverage does not apply unless you have a business necessity that other "autos"available for your use and operation cannot fill. e.If "loss"results from the total theft of a covered "auto"of the private passenger type,we will pay under this coverage only that amount of your rental reimbursement expenses which is not already provided under Paragraph 4.Coverage Extension. f.No deductible applies to this coverage. g.The insurance provided under this extension is excess over any other collectible insurance. If this policy also provides Rental Reimbursement Coverage you purchased,the coverage provided by this Enhancement Endorsement is in addition to the coverage you purchased. For the purposes of this endorsement provision,materials and equipment do not include "personal effects"as defined in provision 12.B. 11.EXTRA EXPENSE -BROADENED COVERAGE Under SECTION III -PHYSICAL DAMAGE COVERAGE,A.Coverage,we will pay for the expense of returning a stolen covered "auto"to you.The maximum amount we will pay is $1,000. 12.PERSONAL EFFECTSCOVERAGE A.SECTION III -PHYSICAL DAMAGE COVERAGE,A.Coverage,is amended by adding the following: If you have purchased Comprehensive Coverage on this policy for an "auto"you own and that "auto"is stolen,we will pay,without application of a deductible,up to $600 for "personal effects" stolen with the "auto." The insurance provided under this provision is excess over any other collectible insurance. B.SECTION V -DEFINITIONS is amended by adding the following: For the purposes of this provision,"personal effects"mean tangible property that is worn or carried by an "insured.""Personal effects"does not include tools,equipment,jewelry,money or securi- ties. 13.ACCIDENTAL AIRBAG DEPLOYMENT SECTION III -PHYSICAL DAMAGE COVERAGE,B.Exclusions is amended by adding the following: If you have purchased Comprehensive or Collision Coverage under this policy,the exclusion for "loss" relating to mechanical breakdown does not apply to the accidental discharge of an airbag. Any insurance we provide shall be excess over any other collectible insurance or reimbursement by manufacturer’s warranty.However,we agree to pay any deductible applicable to the other coverage or warranty. 07/03/2024 56741164 N0196212 EC Insured Copy 2017Liberty Mutual Insurance AC 85 01 06 18 Page 5 of 7IncludescopyrightedmaterialofInsuranceServicesOfficeInc.,with its Permission. 14.PHYSICAL DAMAGE DEDUCTIBLE -VEHICLE TRACKING SYSTEM SECTION III -PHYSICAL DAMAGE COVERAGE,D.Deductible,is amended by adding the following: Any Comprehensive Deductible shown in the Declarations will be reduced by 50%for any "loss" caused by theft if the vehicle is equipped with a vehicle tracking device such as a radio tracking device or a global position device and that device was the method of recovery of the vehicle. 15.AUDIO,VISUAL AND DATA ELECTRONIC EQUIPMENT COVERAGE SECTION III -PHYSICAL DAMAGE COVERAGE,B.Exclusions,Paragraph a.of the exception to exclu- sions 4.c.and 4.d.is deleted and replaced with the following: Exclusions 4.c.and 4.d.do not apply to: a.Electronic equipment that receives or transmits audio,visual or data signals,whether or not de- signed solely for the reproduction of sound,if the equipment is: (1)Permanently installed in the covered "auto"at the time of the "loss"or removable from a housing unit that is permanently installed in the covered "auto";and (2)Designed to be solely operated by use from the power from the "auto’s"electrical system;and (3)Physical damage coverages are provided for the covered "auto". If the "loss"occurs solely to audio,visual or data electronic equipment or accessories used with this equipment,then our obligation to pay for,repair,return or replace damaged or stolen property will be reduced by a $100 deductible. 16.LOAN /LEASE GAP COVERAGE (Not Applicable In New York) A.Paragraph C.Limit Of Insurance of SECTION III -PHYSICAL DAMAGE COVERAGE is amended by adding the following: The most we will pay for a "total loss"to a covered "auto"owned by or leased to you in any one "accident"is the greater of the: 1.Balance due under the terms of the loan or lease to which the damaged covered "auto"is subject at the time of the "loss"less the amount of: a.Overdue payments and financial penalties associated with those payments as of the date of the "loss"; b.Financial penalties imposed under a lease due to high mileage,excessive use or abnormal wear and tear; c.Costs for extended warranties,Credit Life Insurance,Health,Accident or Disability Insur- ance purchased with the loan or lease; d.Transfer or rollover balances from previous loans or leases; e.Final payment due under a "Balloon Loan"; f.The dollar amount of any unrepaired damage which occurred prior to the "total loss"of a covered "auto"; g.Security deposits not refunded by a lessor; h.All refunds payable or paid to you as a result of the early termination of a lease agreement or as a result of the early termination of any warranty or extended service agreement on a covered "auto"; i.Any amount representing taxes; j.Loan or lease termination fees;or 2.The actual cash value of the damage or stolen property as of the time of the "loss". An adjustment for depreciation and physical condition will be made in determining the actual cash value at the time of the "loss".This adjustment is not applicable in Texas. B.Additional Conditions This coverage applies only to the original loan for which the covered "auto"that incurred the "loss"serves as collateral,or lease written on the covered "auto"that incurred the "loss". 07/03/2024 56741164 N0196212 EC Insured Copy 2017Liberty Mutual Insurance AC 85 01 06 18 Page 6 of 7IncludescopyrightedmaterialofInsuranceServicesOfficeInc.,with its Permission. C.SECTION V -DEFINITIONS is changed by adding the following: As used in this endorsement provision,the following definitions apply: "Total loss"means a "loss"in which the cost of repairs plus the salvage value exceeds the actual cash value. A "balloon loan"is one with periodic payments that are insufficient to repay the balance over the term of the loan,thereby requiring a large final payment. GLASS REPAIR -WAIVER OF DEDUCTIBLE Paragraph D.Deductible of SECTION III -PHYSICAL DAMAGE COVERAGE is amended by the addition of the following: No deductible applies to glass damage if the glass is repaired rather than replaced. 18.PARKED AUTO COLLISION COVERAGE (WAIVER OF DEDUCTIBLE) Paragraph D.Deductible of SECTION III - PHYSICAL DAMAGE COVERAGE is amended by the addition of the following: The deductible does not apply to "loss"caused by collision to such covered "auto"of the private passenger type or light weight truck with a gross vehicle weight of 10,000 lbs.or less as defined by the manufacturer as maximum loaded weight the "auto"is designed to carry while it is: a.In the charge of an "insured"; b.Legally parked;and c.Unoccupied. The "loss"must be reported to the police authorities within 24 hours of known damage. The total amount of the damage to the covered "auto"must exceed the deductible shown in the Declarations. This provision does not apply to any "loss"if the covered "auto"is in the charge of any person or organization engaged in the automobile business. 19.TWO OR MORE DEDUCTIBLES Under SECTION III -PHYSICAL DAMAGE COVERAGE,if two or more company policies or coverage forms apply to the same "accident",the following applies to Paragraph D.Deductible: a.If the applicable Business Auto deductible is the smaller (or smallest)deductible,it will be waived; or b.If the applicable Business Auto deductible is not the smaller (or smallest)deductible ,it will be reduced by the amount of the smaller (or smallest)deductible;or c.If the "loss"involves two or more Business Auto coverage forms or policies,the smaller (or smallest)deductible will be waived. For the purpose of this endorsement,company means any company that is part of the Liberty Mutual Group. SECTION IV -BUSINESS AUTO CONDITIONS is amended as follows: 20.UNINTENTIONAL FAILURE TO DISCLOSE HAZARDS SECTION IV-BUSINESS AUTO CONDITIONS,Paragraph B.2.is amended by adding the following: If you unintentionally fail to disclose any hazards,exposures or material facts existing as of the incep- tion date or renewal date of the Business Auto Coverage Form,the coverage afforded by this policy will not be prejudiced. However,you must report the undisclosed hazard of exposure as soon as practicable after its discovery, and we have the right to collect additional premium for any such hazard or exposure. 17. 07/03/2024 56741164 N0196212 EC Insured Copy 2017Liberty Mutual Insurance AC 85 01 06 18 Page 7 of 7IncludescopyrightedmaterialofInsuranceServicesOfficeInc.,with its Permission. 21.AMENDED DUTIES IN THE EVENT OF ACCIDENT,CLAIM,SUIT,OR LOSS SECTION IV -BUSINESS AUTO CONDITIONS,Paragraph A.2.a.is replaced in its entirety by the follow- ing: a.In the event of "accident",claim,"suit"or "loss",you must promptly notify us when it is known to: (1)You,if you are an individual; (2)A partner,if you are a partnership; (3)Member,if you are a limited liability company; (4)An executive officer or the "employee"designated by the Named Insured to give such notice,if you are a corporation. To the extent possible,notice to us should include: (a)How,when and where the "accident"or "loss"took place; (b)The "insureds"name and address;and (c)The names and addresses of any injured persons and witnesses. 22.WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US SECTION IV -BUSINESS AUTO CONDITIONS,Paragraph A.5.Transfer Of Rights Of Recovery Against Others To Us,is amended by the addition of the following: If the person or organization has in a written agreement waived those rights before an "accident"or "loss",our rights are waived also. 23.HIRED AUTO COVERAGE TERRITORY SECTION IV -BUSINESS AUTO CONDITIONS,Paragraph B.7.Policy Period,Coverage Territory,is amended by the addition of the following: f.For "autos"hired 30 days or less,the coverage territory is anywhere in the world,provided that the "insured’s"responsibility to pay for damages is determined in a "suit",on the merits,in the United States,the territories and possessions of the United States of America,Puerto Rico or Canada or in a settlement we agree to. This extension of coverage does not apply to an "auto"hired,leased,rented or borrowed with a driver. 24.PRIMARY AND NON-CONTRIBUTING IF REQUIRED BY WRITTEN CONTRACT OR WRITTEN AGREE- MENT The following is added to SECTION IV -BUSINESS AUTO CONDITIONS,General Conditions,B.5.Other Insurance and supersedes any provision to the contrary: This Coverage Form’s Covered Autos Liability Coverage is primary to and will not seek contribution from any other insurance available to an "insured"under your policy provided that: 1.Such "insured"is a Named Insured under such other insurance;and 2.You have agreed in a written contract or written agreement that this insurance would be primary and would not seek contribution from any other insurance available to such "insured". SECTION V -DEFINITIONS is amended as follows: 25.BODILY INJURY REDEFINED Under SECTION V -DEFINITIONS,Definition C.is replaced by the following: "Bodily injury"means physical injury,sickness or disease sustained by a person,including mental anguish,mental injury,shock,fright or death resulting from any of these at any time. 07/03/2024 56741164 N0196212 EC Insured Copy