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HomeMy WebLinkAbout17-18 COI - Joe Bernasconi; RE Limelite.pdfANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? INSR ADDL SUBR LTR INSD WVD PRODUCER CONTACT NAME: FAXPHONE (A/C, No):(A/C, No, Ext): E-MAIL ADDRESS: INSURER A : INSURED INSURER B : INSURER C : INSURER D : INSURER E : INSURER F : POLICY NUMBER POLICY EFF POLICY EXPTYPE OF INSURANCE LIMITS(MM/DD/YYYY)(MM/DD/YYYY) AUTOMOBILE LIABILITY UMBRELLA LIAB EXCESS LIAB WORKERS COMPENSATION AND EMPLOYERS' LIABILITY DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) AUTHORIZED REPRESENTATIVE EACH OCCURRENCE $ DAMAGE TO RENTEDCLAIMS-MADE OCCUR $PREMISES (Ea occurrence) MED EXP (Any one person)$ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER:GENERAL AGGREGATE $ PRO-POLICY LOC PRODUCTS - COMP/OP AGGJECT OTHER:$ COMBINED SINGLE LIMIT $(Ea accident) ANY AUTO BODILY INJURY (Per person)$ OWNED SCHEDULED BODILY INJURY (Per accident)$AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $AUTOS ONLY AUTOS ONLY (Per accident) $ OCCUR EACH OCCURRENCE CLAIMS-MADE AGGREGATE $ DED RETENTION $ PER OTH- STATUTE ER E.L. EACH ACCIDENT E.L. DISEASE - EA EMPLOYEE $ If yes, describe under E.L. DISEASE - POLICY LIMITDESCRIPTION OF OPERATIONS below INSURER(S) AFFORDING COVERAGE NAIC # COMMERCIAL GENERAL LIABILITY Y / N N / A (Mandatory in NH) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 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. 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). COVERAGES CERTIFICATE NUMBER:REVISION NUMBER: CERTIFICATE HOLDER CANCELLATION © 1988-2015 ACORD CORPORATION. All rights reserved.ACORD 25 (2016/03) CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) $ $ $ $ $ The ACORD name and logo are registered marks of ACORD KSMITH3 04/05/2018 BIGMOUN-08 A UMB102797100 A CPP116345800 A CPP116674500 A CPP116674500 B G46781855001 1,000,000 1,000,000 1,000,000 10,000 5,000,000 5,000,000 2,000,000 1,000,000 2,000,000 10,000 100,000 1,000,000 WA STOP GAP 1,000,000 1,000,000 X X X X X X X X X X 07/01/2017 07/01/2018 07/01/2017 07/01/2018 07/01/2017 07/01/2018 07/01/2017 07/01/2018 07/01/2017 07/01/2018 RE: Limelite Project Location: 16202 114th Ave SE, Renton, WA. Joe Bernasconi, their employees and Coterra Engineering PLLC are included as Additional Insured per the attached form(s)/endorsement(s). Hub International Northwest LLC 12100 NE 195th Street, Suite 200 Bothell, WA 98011 (425) 485-8489(425) 489-4500 Joe Bernasconi P.O. Box 1343 Renton, WA 98057 Big Mountain Enterprises, LLC PO Box 1001 Enumclaw, WA 98022 Western National Assurance Company Westchester Surplus Lines Insurance Co. 24465 10172 X X X now.info@hubinternational.com X X X DED: $2,500; OCC/AGG 2,000,000POLLUTION COMMERCIAL GENERAL LIABILITY WN GL 89 07 15 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WN GL 89 07 15 Page 1 of 2 Includes copyrighted material of Insurance Services Office, Inc., with its permission. ADDITIONAL INSURED – CONTRACTORS – OPERATIONS AND COMPLETED OPERATIONS – WITH ADDITIONAL INSURED REQUIREMENT IN CONSTRUCTION CONTRACT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART 1. Additional Insured – Operations A. Operations Performed For An Additional Insured Section II – Who Is An Insured is amended to include as an additional insured any per- son or organization, if you and such person or organization have agreed in writing in a contract or agreement that such person or organization be included as an additional in- sured on your policy, but only with respect to liability for “bodily injury”, “property damage” or “personal and advertising injury” arising out of your ongoing operations for the addi- tional insured. B. Limitations The Operations Performed for Additional In- sured coverage is limited as follows: (1) This insurance does not apply to “bodily injury” or “property damage” occurring af- ter: a.All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or re- pairs) to be performed by or on be- half of the additional insured(s) at the location of the covered opera- tions has been completed; or b.That portion of “your work” out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcon- tractor engaged in performing opera- tions for a principal as a part of the same project. 2.Additional Insured – Completed Operations A. Additional Insured – Completed Opera- tions Section II – Who Is An Insured is amended to include as an additional insured any per- son or organization, if you and such person or organization have agreed in writing in a contract or agreement that such person or organization be included as an additional in- sured on your policy, but only with respect to “bodily injury” or “property damage”, arising out of “your work” performed for the addi- tional insured and included in the “products- completed operations hazard”. B. Limitations The Additional Insured – Completed Opera- tions coverage is limited as follows: (1) A person or organization’s status as an insured under Additional Insured – Com- pleted Operations continues only for the period of time required by any written contract or agreement. (2) The insurance provided to the additional insured does not apply to “bodily injury”, “property damage” or “personal and ad- vertising injury” arising out of “your work” for which a consolidated (wrap-up) in- surance program has been provided by the prime contractor-project manager or owner of the construction project in which you are involved. Policy #CPP116674500 WN GL 89 07 15 Page 2 of 2 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 3. Primary and Noncontributory The following is added to the Other Insurance Condition and supersedes any provision to the contrary: Primary And Noncontributory Insurance This insurance is primary to and will not seek contribution from any other insurance avail a- ble to an additional insured under your policy provided that: (1) The additional insured is a Named In- sured under such other insurance; and (2) You have agreed in writing in a contract or agreement that this insurance would be primary and would not seek contribu- tion from any other insurance available to the additional insured. 4. Other Provisions Applicable to Additional Insured – Operations and Additional Insured – Completed Operations A. The Amendment of Insured Contract Defini- tion (Endorsement CG 24 26) does not apply to an additional insured. B. The coverage provided under Paragraph f. of the definition of “insured contract” under Section V – Definitions does not apply to an additional insured under this endorsement unless required by a written contract or agreement. C. The insurance afforded to such additional i n- sured only applies to the extent permitted by law; and If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. D. With respect to the insurance afforded to these additional insureds, the following is added to Section III – Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is: (1) The minimum amount required by the contract or agreement; or (2) The Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. E. With respect to the insurance afforded to these additional insureds, the following addi- tional exclusion applies: This insurance does not apply to: (1) "Bodily injury", "property damage" or "personal and advertising injury" arising out of the rendering of, or the failure to render, any professional architectural, engineering or surveying services, in- cluding: a. The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or draw- ings and specifications; or b. Supervisory, inspection, architectural or engineering activities. This exclusion applies even if the claims against an additional insured allege neg- ligence or other wrongdoing in the su- pervision, hiring, employment, training or monitoring of others by that insured, if the “occurrence” which caused the “bodi- ly injury” or “property damage”, or the of- fense which caused the “personal and advertising injury”, involved the rendering of or failure to render any professional services by you with respect to your providing engineering, architectural or surveying services in your capacity as an engineer, architect or surveyor. SUMMARY OF COVERAGES PAGE THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY WN GL 39 0715Includes copyrighted material of the Insurance Service Office, Inc., with its permission.Page 3of 10(5)That particular part of real property on which you or any contractors or subcontractors working directly or indirectly on your behalf (6)That particular part of any property that must be restored, repaired or replaced because Paragraphs (1), (3)and (4)of this exclusion do not fire, lightning, explosion or sprinkler leakage) to premises, including the contents of such premises, rented to you for a period of sevenor fewer consecutive days. A separate limit of insurance applies to Damage To Premises Rented To You as described in SECTION IIILIMITS OF INSURANCE. However, the provisions of this paragraph do not apply if coverage for Damage To Premises Rented To You is excluded by en-dorsement.Paragraph (2)of this exclusion does not apply if the d, rented or held for rental by you.Paragraphs (3)and (4) of this exclusion do not apply to the use of elevators.Paragraphs (3), (4), (5)and (6)of this exclusion do not apply to liability assumed under a sidetrack agreement.Paragraph (4)of this exclusion does not apply to being used to perform operations at the jobsite. Subject to Paragraph 2. of SECTION III LIMITS OF INSURANCE, the rules below fix the most we this provision:(1)number of persons or organizations who sustain (2)$50,000 annual aggregate; and(3)We will pay only for damages in excess of $2,500 as a result of a-gardless of the number of persons or organiza--or any part of any deductible amount, if applica-ble, to effect settlement of any claim oUpon notice of our payment of a deductible amount, you shall promptly reimburse us for the part of the deductible amount we paid.Paragraph (6)of this exclusion does not apply to -com-pleted operationborrowed equipment is excess over any other valid and collectible property insurance (including any de-ductible portion thereof) available to theinsured whether primary, excess, contingent or on any other basis.C.Damage To Premises Rented To YouItem 2. Exclusions,the last paragraph is replaced by the following:Exclusions c.throughn. do not apply to damage by fire, lightning, explosion or sprinkler leakage to premises while rented to you or temporarily occupied by you with permission of the owner. A separate limit of insurance applies to this coverage as de-scribed in Paragraph 6.of SECTION III LIMITS OF INSURANCE.COVERAGE B PERSONALAND ADVERTISING INJURY LIABILITYD.Personal And Advertising InjuryItem 2. Exclusionsis amended by replacing Sub-paragraphs b. and c.with the following:b.Material Published With Knowledge Of Falsityoral, written, televised, videotaped or electronic publication, in any manner,of material, if done by or at the direction of the insured with knowledge of its falsity.c.Material Published Prior To Policy Periodout of oral, written, televised, videotaped or electronic publication, in any manner, of material whose first publication took place before the beginning of the policy period.WN GL 39 0715Includes copyrighted material of the Insurance Service Office, Inc., with its permission.Page 4of 10SUPPLEMENTARY PAYMENTS COVERAGES A AND BE.Supplementary Payments Coverages A and BItem 1.is amended by replacing Subparagraphs b.and d.with the following:b.Up to $5,000 for cost of bail bonds required be-cause of accidents or traffic law violations aris-ing out of the use of any vehicle towhich the Bodily Injury Liability Coverage applies. We do not have to furnish these bonds.d.All reasonable expenses incurred by the insured at our request to assist us in the investigation or loss of earnings up to $500 a day because of time off from work.SECTION II WHO IS AN INSUREDAMENDMENTS A.Employee Bodily Injury To A Co-EmployeeParagraph 2. a. (1)is replaced by the following:(1)"Bodily injury" or "personal and advertising injury":(a)Toyou, to your partners or members (if you are a partnership or joint venture), to your members (if you are a limited liability com-pany), or to your other "volunteer workers" while performing duties related to the con-duct of your business;(b)For which there is any obligation to share damages with or repay someone else who must pay damages because of the injury described in Paragraph (1) (a)above; or(c)Arising out of his or her providing or failing to provide professional health care services. B.Newly Acquired OrganizationsParagraph 3.a. is replaced by the following:a.Coverage under this provision is afforded only until the 180thday after you acquire or form the organization or the end of the policy period, whichever is earlier;The followingare added:C.Blanket Additional Insured Vendors As Re-quired By Contract1.Section II Who Is An Insuredis amended to include as an additional insured any person(s) or organization(s) (referred to throughout this endorsement as vendor) with whomyou have agreed in a written contract, executed prior to loss, to name as an additional insured, but only with respect to "bodily injury" or "property damage" arising out of "your products" which are distributed or sold in the regular course of the vendor's business. However, a.The insurance afforded to such vendor only appliestothe extent permitted by law; andb.If coverage provided to the vendor is required by a contract or agreement, the insurance afforded to such vendor will not be broader than that which you are required by the contract or agreement to provide for such vendor. 2.With respect to the insurance afforded to these vendors, the following additional exclusions apply:a.The insurance afforded the vendor does not apply to: (1)"Bodily injury" or "property damage" for which the vendor is obligated to pay damages by reason of the assumption of liability in a contract or agreement. This exclusion does not apply to liability for damages that the vendor would have in the absence of the contract or agreement;(2)Any express warranty unauthorized by you;(3)Any physical or chemical change in the product made intentionally by the vendor;(4)Repackaging, except when unpacked solely for the purpose of inspection, demonstration, testing, or the substitution of parts under instructions from the manufacturer, and then repackaged in the original container; WN GL 39 0715Includes copyrighted material of the Insurance Service Office, Inc., with its permission.Page 5of 10(5)Any failure to make such inspections, adjustments, tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business, in connection with the distribution or sale of the products;(6)Demonstration, installation, servicing or repair operations, except such operations performed at the vendor's premises in connection with the sale of the product;(7)Products which, after distribution or sale by you, have been labeled or relabeled or used as a container, part or ingredient of any other thing or substance by or for the vendor; or(8)"Bodily injury or "property damage" arising out of the sole negligence of the vendor for its own acts or omissions or those of its employees or anyone else acting on its behalf. However, this exclusion does not apply to:(i)The exceptions contained in Subparagraphs (4)or (6);or(ii)Such inspections, adjustments, tests or servicing as the vendor has agreed to make or normally undertakes tomake in the usual course of business, in connection with the distribution or sale of the products. 3.This ProvisionC.does not apply: a.To any insured person or organization from whom you have acquired such products, or any ingredient, part or container, entering into, accompanying or containing such products; b.To any vendor for which coverage as an additional insured specifically is scheduled by endorsement; or c.When liability included within the "products-completed operations hazard" has been ex-cluded for such product either by the provi-sions of the coverage part or by endorse-ment. 4.With respect to the insurance afforded to these vendors, the following is added to Section III Limits Of Insurance: If coverage provided to the vendor is required by a contract or agreement, the most we will pay on behalf of the vendoris: a.The minimum amount required by the contract or agreement; orb.TheLimits of Insurance shown in the Declarations;whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations.5.With respect to the insurance afforded to these additional insureds, thefollowing additional exclusionapplies:This insurance does not apply to:a."Bodily injury", "property damage" or "personal and advertising injury" arising out of the rendering of, or the failure to render, any professional architectural, engineering or surveying services, including:(1)The preparing, approving,or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or(2)Supervisory, inspection, architectural or engineering activities.This exclusion applies even if the claims against an additional insured allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by that insured, if the offense whrendering of or failure to render any professional services by you with respect to your providing engineering, architectural or surveying services in your capacity as an engineer, architect or surveyor.WN GL 39 0715Includes copyrighted material of the Insurance Service Office, Inc., with its permission.Page 6of 10D.Blanket Additional Insured Lessor Of Leased Equipment1.Section II Who Is An Insured is amended to include as an additional insured any person(s)or organization(s)from whom you lease equipment when you and such person(s)or organization(s)have agreed in writing in a contract or agreement, executed prior to loss, that such person(s)or organization(s)be added as an additional insured on your policy. Such person(s)or organization(s)is an insured only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by your maintenance, operation or use of equipment leased to you by such person(s)ororganization(s). However, the insurance afforded to such additional insured:a.Only applies to the extent permitted by law; andb.Will not be broader than that which you are required by the contract or agreement to provide for such additional insured. A person's or organization's status as an addi-tional insured under this endorsement ends when their contract or agreement with youfor such leased equipment ends. 2.With respect to the insurance afforded to these additional insureds, this insurance does not ap-ply to any "occurrence" which takes place after the equipment lease expires. 3.With respect to the insurance afforded to these additional insureds, the following is added to Section III Limits Of Insurance:If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is: a.The minimum amount required by the contract or agreement; orb.The Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations.4.With respect to the insuranceafforded to these additional insureds, the following additional exclusion applies:This insurance does not apply to:a."Bodily injury", "property damage" or "personal and advertising injury" arising out of the rendering of, or the failure to render, any professional architectural, engineering or surveying services, including:(1)The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or(2)Supervisory, inspection, architectural or engineering activities.This exclusion applies even if the claims against an additional insured allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by thatinsured, if the bodily render any professional services by you with respect to your providing engineering, architectural or surveying services in your capacity as an engineer, architect or surveyor. E.Blanket Additional Insured Managers Or Les-sors Of Premises1.Section II Who Is An Insured is amended to include as an additional insured any person(s)or organization(s)with whom you have agreed in a written contract, executed prior to loss, to name as an additional insured, but only with respect to liability arising out of the ownership, maintenance or use of that part of the premises leased to you, subject to the following additional exclusions: This insurance does not apply to: a.Any "occurrence" which takes place after you cease to be a tenant in that premises. b.Structural alterations, new construction or demolition operations performed by or on behalf of such additional insured. WN GL 39 0715Includes copyrighted material of the Insurance Service Office, Inc., with its permission.Page 7of 10However:a.The insurance afforded to such additional insured only applies to the extent permitted by law; andb.If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. 2.With respect to the insurance afforded to these additional insureds, the following is added to Section III Limits Of Insurance:If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is:a.The minimum amount required by the contract or agreement; orb.The Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations.3.With respect to the insurance afforded to these additional insureds, the following additional exclusion applies:This insurance does not apply to:a."Bodily injury", "property damage" or "personal and advertising injury" arising out of the rendering of, or the failure to render, any professional architectural, engineering or surveying services, including:(1)The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or(2)Supervisory, inspection, architectural or engineering activities.This exclusion applies even if the claims against an additional insured allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by that insured, if the bodily render any professional services by you with respect to your providing engineering, architectural or surveying services in your capacity as an engineer, architect or surveyor. F.Blanket Additional Insured State Or Governmental Agency Or Subdivision Or Politi-cal Subdivision Permits Or AuthorizationsSection II Who Is An Insuredis amended to in-clude as an additional insured any state or governmental agency or subdivision or political subdivision with whom you have agreed in a written contract, executed prior to loss, to name as an additional insured, subject to the following provisions:1.This insurance applies only with respect to op-erations performed by you or on your behalf for which the state or governmental agency or sub-division or political subdivision has issued a permit or authorization. However: a.The insurance afforded to such additional insured only applies to the extent permitted by law; andb.If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. 2.This insurance does not apply to:a."Bodily injury", "property damage" or "per-sonal and advertising injury" arising out of operations performed forthe federal govern-ment, state or municipality; orb."Bodily injury" or "property damage" in-cluded within the "products-completed op-erations hazard". 3.With respect to the insurance afforded to these additional insureds, the following is added to Section III Limits Of Insurance:If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is: a.The minimum amount required by the contract or agreement; orb.The Limits of Insurance shown in the Declarations;whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations.WN GL 39 0715Includes copyrighted material of the Insurance Service Office, Inc., with its permission.Page 8of 104.With respect to the insurance afforded to these additional insureds, the following additional exclusion applies:This insurance does not apply to:a."Bodily injury", "property damage" or "personal and advertising injury" arising out of the rendering of, or the failure to render, any professional architectural, engineering or surveying services, including:(1)The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or(2)Supervisory, inspection, architectural or engineering activities.This exclusion applies even if the claims against an additional insured allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by that insured, if the bodily render any professional services by you with respect to your providing engineering, architectural or surveying services in your capacity as an engineer, architect or surveyor. G.Blanket Additional Insured State Or Governmental Agency Or Subdivision Or Politi-cal Subdivision Permits Or Authorizations Re-lating To PremisesSection II Who Is An Insuredis amended to in-clude as an additional insured any state or governmental agency or subdivision or political subdivision with whom you have agreed in a written contract, executed prior to loss, to name as an additional insured, subject tothe following provision:1.This insurance applies only with respect to the following hazards for which the state or governmental agency or subdivision or political subdivision has issued a permit or authorization in connection with premises you own, rent or control and to which this insurance applies:a.The existence, maintenance, repair, construction, erection or removal of advertising signs, awnings, canopies, cellar entrances, coal holes, driveways, manholes, marquees, hoist away openings, sidewalkvaults, street banners or decorations and similar exposures; orb.The construction, erection or removal of elevators; orc.The ownership, maintenance or use of any elevators covered by this insurance. However, a.The insurance afforded to such additional insured only applies to the extent permitted by law; andb.If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. 2.With respect to the insurance afforded to these additional insureds, the following is added to Section III Limits Of Insurance:If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is: a.The minimum amount required by the contract or agreement; orb.The Limits of Insurance shown in the Declarations;whichever is less.This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. 3.With respect to the insurance afforded to these additional insureds, the following additional exclusion applies:This insurance does not apply to:a."Bodily injury", "property damage" or "personal and advertising injury" arising out of the rendering of, or the failure to render, any professional architectural, engineering or surveying services, including:(1)The preparing, approving, or failing to prepare or approve,maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or(2)Supervisory, inspection, architectural or engineering activities. POLICY NUMBER: COMMERCIAL GENERAL LIABILITY CG 25 03 05 09 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CG 25 03 05 09 © Insurance Services Office, Inc., 2008 Page 1 of 2 † DESIGNATED CONSTRUCTION PROJECT(S) GENERAL AGGREGATE LIMIT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Designated Construction Project(s): Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. For all sums which the insured becomes legally obligated to pay as damages caused by "occur- rences" under Section I – Coverage A, and for all medical expenses caused by accidents under Section I – Coverage C, which can be attributed only to ongoing operations at a single designated construction project shown in the Schedule above: 1.A separate Designated Construction Project General Aggregate Limit applies to each des- ignated construction project, and that limit is equal to the amount of the General Aggregate Limit shown in the Declarations. 2.The Designated Construction Project General Aggregate Limit is the most we will pay for the sum of all damages under Coverage A, ex- cept damages because of "bodily injury" or "property damage" included in the "products- completed operations hazard", and for medi- cal expenses under Coverage 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 Designated Con- struction Project General Aggregate Limit for that designated construction project. Such payments shall not reduce the General Ag- gregate Limit shown in the Declarations nor shall they reduce any other Designated Con- struction Project General Aggregate Limit for any other designated construction project shown in the Schedule above. 4.The limits shown in the Declarations for Each Occurrence, Damage To Premises Rented To You and Medical Expense continue to apply. However, instead of being subject to the General Aggregate Limit shown in the Decla- rations, such limits will be subject to the appli- cable Designated Construction Project Gen- eral Aggregate Limit. Where required by written contract CPP116674500 Page 2 of 2 © Insurance Services Office, Inc., 2008 CG 25 03 05 09 † B. For all sums which the insured becomes legally obligated to pay as damages caused by "occur- rences" under Section I – Coverage A, and for all medical expenses caused by accidents under Section I – Coverage C, which cannot be attrib- uted only to ongoing operations at a single des- ignated construction project shown in the Sched- ule above: 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 Desig- nated Construction Project General Aggre- gate Limit. C. When coverage for liability arising out of the "products-completed operations hazard" is pro- vided, any payments for damages because of "bodily injury" or "property damage" included in the "products-completed operations hazard" will reduce the Products-completed Operations Ag- gregate Limit, and not reduce the General Ag- gregate Limit nor the Designated Construction Project General Aggregate Limit. D. If the applicable designated construction project has been abandoned, delayed, or abandoned and then restarted, or if the authorized contract- ing parties deviate from plans, blueprints, de- signs, specifications or timetables, the project will still be deemed to be the same construction pro- ject. E. The provisions of Section III – Limits Of Insur- ance not otherwise modified by this endorsement shall continue to apply as stipulated. SUMMARY OF COVERAGES PAGE THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY WN CA 27 06 16Includes copyrighted material of Insurance Services Office, with its permissionPage 3of 5D.Fellow Employee CoverageSECTION II COVERED AUTOS LIABILITY COVERAGE, B. Exclusions, 5. Fellow Employee, the following is added: Co-Employee Lawsuit Defense Cost Reimbursementor while performing duties related to the conduct of your business, or a suit seeking damages brought by the spouse, child, parent, brother or sister of that reimburse reasonable costs that you incur in the defense of such matters. Any reimbursement made pursuant to this sub-section will be in addition to the limits of liability set forth in the Declarations. SECTION III PHYSICAL DAMAGE COVERAGE AMENDMENTSA.Transportation Expense Limits AmendedSECTION III PHYSICAL DAMAGE COVERAGE, A. Coverage, 4. Coverage Extensions, a. Trans-portation Expensesis amended by replacing $20 per day/$600 maximum limit with $50 per day/$1000 maximum.B.Hired Auto Physical Damage Loss Of Use Expenses Limits AmendedSECTION III PHYSICAL DAMAGE COVERAGE, A. Coverage, 4. Coverage Extensions, b. Loss of Use Expensesis amended by replacing the $20 per day/$600 maximum limit with $50 per day/$750 maximum limit.C.Personal Effects CoverageSECTION lll PHYSICAL DAMAGE COVERAGE, A. Coverage, 4.Coverage Extensionsis amended by adding the following:c.Personal Effectseffects, which are:(1)(2)This coverage applies only in the event of the total this coverage D.Glass Repair Deductible WaiverSECTION III PHYSICAL DAMAGE COVERAGE, A. Coverage, 3. Glass BreakageHitting A Bird Or Animal Falling Objects Or Missiles, is amended by adding the following:No deductible will apply to glass breakage ifsuch glass is repaired, in a manner acceptable to us, rather than replaced.E.Hired Auto Physical DamageSECTION III PHYSICAL DAMAGE COVERAGE, A. Coverageis amended by adding the following:5.Hired Auto Physical DamageCoverage and if Comprehensive, Specified Causes of Loss, or Collision coverages are pro-you own, then the Physical Damage Coverages kind and use, subject to the following:a.$50,000 or the actual cash value or cost to repair or replace, whichever is less, minus a deductible;b.The deductible will be equal to the largest deductible applicable tfor that coverage. Any Comprehensive deductiby fire or lightening;c.Hired Auto Physical Damage coverage is excess over any other collectible insurance; andd.Subject to the above limit, deductible and excess provisions we will provide coverage equal to the broadest coverage applicable to If a limit for Hired Auto Physical Damage is indicated in the Declarations, then that limit replaces, and is not added to, the $50,000 limit indicated above.WN CA 27 06 16Includes copyrighted material of Insurance Services Office, with its permissionPage 4of 5F.Rental Reimbursement SECTION III PHYSICAL DAMAGE COVERAGE A. Coverage, is amended by adding the following:6.Rental ReimbursementThis coverage applies only the private passenger or light truck type as follows:a.We will pay for rental reimbursement expenses incurred by you for the rental of a -sengapplies in addition to the otherwise applica-ble amount of each coverage you have on a covered private passenger or light truck type coverage.b.We will pay only for those expenses incurred during the policy period beginning 24 hours -lowing number of days:(1)The number of days reasonably re-quired to repair or replace the covered private passenger or light truck type number of days is added to the number of days it takes to locate the covered private passenger or light truck type (2)30 days.c.Our paymentis limited to the lesser of the following amounts:(1)Necessary and actual expenses incurred, or(2)$50 per day, up to a maximum of $1,000.d.This coverage does not apply while there are spare or reserve private passenger or available to you for your operations.e.light truck type, we will pay under this cover-age only that amount of your rental reim-bursement expenses which is not already provided for under SECTION III PHYSICAL DAMAGE COVERAGE, A. Coverage, 4. Coverage Extensions.For the purposes of this Rental Reimbursement coverage, light truck is defined as a truck with a gross vehicle weight of 10,000 lbs. or less as defined by themanufacturer as the maximum loaded weight the auto is designed to carry.G.Accidental Airbag Deployment CoverageSECTION III PHYSICAL DAMAGE COVERAGE, A. Coverageis amended by adding the following:7.Accidental Airbag Deployment CoverageWe will pay to reset or replace factory installed discharge, other than discharge due to a collision loss.This coverage is applicable only if comprehen-This coverage is excess over any other collecti-ble insurance or reimbursement by manufac-H.Auto Loan/Lease Gap CoverageSECTION III PHYSICAL DAMAGE COVERAGE, Item A., Coverage, is amended by adding the following:8.Auto Loan/Lease Gap CoverageThis cdescribed or designated in the Schedule or in the Declarations as including physical damage coverage.Schedule or in the Declarations, we will pay any unpaid amount due on the lease or loan for a a.The amount paid under the Physical Damage Coverage Section on the policy; andb.Any:(1)Overdue lease/loan payments at the (2)Financial penalties imposed under a lease for excessive use, abnormal wear and tear or high mileage;(3)Security deposits not returned by the lessor;(4)Costs for extended warranties, Credit Life Insurance, Health, Accident or Disability Insurance purchased with the loan or lease; and(5)Carry-over balances from previous loans or leases. WN CA 27 06 16Includes copyrighted material of Insurance Services Office, with its permissionPage 5of 5SECTION IV BUSINESS AUTO CONDITIONSAMENDMENTSA.Duties In The Event Of Accident, Claim, Suit Or Loss AmendedSECTION IV BUSINESS AUTO CONDITIONS, A. Loss Conditions, 2. Duties In The Event Of Accident, Claim, Suit Or Loss, a.is amended by adding the following:(1)You, if you are an individual;(2)A partner, if you are a partnership;(3)An executive officer or insurance manager, if you are a corporation; or(4)A member or manager, if you are a limited liability company.But, this section does not amend the provisions relating to notification of police, protection or exami-nation of the property which was subject to the B.Blanket Waiver of SubrogationSection IV BUSINESS AUTO CONDITIONS, A. Loss Conditions, 5. Transfer of Rights of Recovery Against Others to Us,is amended by adding the following exception:However, we waive any right of recovery we may have against any person or organization to the extent required of you by a written contract signed operations contemplated by such contract. The waiver applies only to the person or organization designated in such contract. C.Unintentional Failure to Disclose HazardsSECTION IV BUSINESS AUTO CONDITIONS, B. General Conditions, 2. Concealment, Misrepre-sentation Or Fraud, is amended byaddingthe following paragraph:If you unintentionally fail to disclose any hazards existing at the inception date of the policy, or during the policy period in connection with any additional hazards, we will not deny coverage under this Cov-erage Part because of such failure.D.Employee Hired AutoSECTION IV BUSINESS AUTO CONDITIONS, B. General Conditions, 5. Other Insurance, paragraph b. is deleted and replace by the following:b.For Hired Auto Physical Damage Coverage, the you own:(1)borrow.(2)name, with your permission, while performing duties related to the conduct of your business.