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HomeMy WebLinkAboutCOISHOULD 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 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.
$
$
$
$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 below
If 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
HIRED
AUTOS ONLY
06/07/21X
65548986
65548986
X
1,000,00006/07/22
WA#877030
7015073515
WA Stop Gap
A
15,000
PO Box 5
35289
1,000,000
ATTN: Risk Manager
06/07/22
X
X
06/07/21
10000
X
X
X
This insurance is primary and non-contributory with a waiver of subrogation per the attached.
X
the Certificate holder is additional insured per the attached:
Project: Watershed Apartments; 617 Williams Ave. S. Renton, WA. 98057
Seattle, WA 98101
2,000,000
McKee Enterprises, LLC
X
7014983991
1325 Fourth Avenue, Suite 2100
06/07/22
City of Renton
AssuredPartners of Wash. Ins. Agency, LLC CA Lic 0K61066
AssuredPartners of Washington, LLC
1,000,000
matt.benoit@assuredpartners.com
X
X
5,000,000
100,000
06/07/21
5,000,000
Enumclaw, WA 98022
X
1-206-343-2323
A
A
Renton, WA 98057
X
7015073546
1055 South Grady Way
206-343-4174
Matt Benoit
2,000,000
CONTINENTAL INS CO
05/20/2022
X
ashleywhite
USA
CNA PARAMOUNT
Contractors'General Liability Extension Endorsement
It is understood and agreed that this endorsement amends the COMMERCIAL GENERAL LIABILITY COVERAGE PART
as follows. If any other endorsement attached to this policy amends any provision also amended by this endorsement,
then that other endorsement controls with respect to such provision,and the changes made by this endorsement with
respect to such provision do not apply.
TABLE OF CONTENTS
1.Additional Insureds
2.Additional Insured -Primary And Non-Contributory To Additional Insured's Insurance
3.Bodily Injury –Expanded Definition
4.Broad Knowledge of Occurrence/Notice of Occurrence
5.Broad Named Insured
6.Broadened Liability Coverage For Damage To Your Product And Your Work
7.Contractual Liability -Railroads
8.Electronic Data Liability
9.Estates,Legal Representatives and Spouses
10.Expected Or Intended Injury –Exception for Reasonable Force
11.General Aggregate Limits of Insurance –Per Project
12.In Rem Actions
13.Incidental Health Care Malpractice Coverage
14.Joint Ventures/Partnership/Limited Liability Companies
15.Legal Liability –Damage To Premises /Alienated Premises /Property In The Named Insured's Care,
Custody or Control
16.Liquor Liability
17.Medical Payments
18.Non-owned Aircraft Coverage
19.Non-owned Watercraft
20.Personal And Advertising Injury –Discrimination or Humiliation
21.Personal And Advertising Injury -Contractual Liability
22.Property Damage -Elevators
23.Supplementary Payments
24.Unintentional Failure To Disclose Hazards
25.Waiver of Subrogation –Blanket
26.Wrap-Up Extension:OCIP CCIP,or Consolidated (Wrap-Up)Insurance Programs
CNA74705XX (1-15)
Page 1of17 Endorsement No:
CONTINENTAL CASUALTY COMPANY
Copyright CNA All Rights Reserved. Includes copyrightedmaterial of Insurance Services Office, Inc.,with its permission.
CNA PARAMOUNT
Contractors'General Liability Extension Endorsement
1.ADDITIONAL INSUREDS
a.WHO IS AN INSURED is amended to include as an Insured any person or organization described in paragraphs
A.through H.below whom a Named Insured is required to add as an additional insured on this Coverage Part
under a written contract or written agreement,provided such contract or agreement:
(1)is currently in effect or becomes effective during the term of this Coverage Part;and
(2)was executed prior to:
(a)the bodily injury or property damage;or
(b)the offense that caused the personal and advertising injury,
for which such additional insured seeks coverage.
b.However,subject always to the terms and conditions of this policy,including the limits of insurance,the Insurer
will not provide such additional insured with:
(1)a higher limit of insurance than required by such contract or agreement;or
(2)coverage broader than required by such contract or agreement,and in no event broader than that described
by the applicable paragraph A.through H.below.
Any coverage granted by this endorsement shall apply only to the extent permissible by law.
A.Controlling Interest
Any person or organization with a controlling interest in a Named Insured,but only with respect to such person or
organization's liability for bodily injury,property damage or personal and advertising injury arising out of:
1.such person or organization's financial control of a Named Insured;or
2.premises such person or organization owns,maintains or controls while a Named Insured leases or
occupies such premises;
provided that the coverage granted by this paragraph does not apply to structural alterations,new construction or
demolition operations performed by,on behalf of,or for such additional insured.
B.Co-owner of Insured Premises
A co-owner of a premises co-owned by a Named Insured and covered under this insurance but only with respect
to such co-owner's liability for bodily injury,property damage or personal and advertising injury as co-owner
of such premises.
C.Lessor of Equipment
Any person or organization from whom a Named Insured leases equipment,but only with respect to liability for
bodily injury,property damage or personal and advertising injury caused,in whole or in part,by the Named
Insured's maintenance,operation or use of such equipment,provided that the occurrence giving rise to such
bodily injury,property damage or the offense giving rise to such personal and advertising injury takes place
prior to the termination of such lease.
D.Lessor of Land
Any person or organization from whom a Named Insured leases land but only with respect to liability for bodily
injury,property damage or personal and advertising injury arising out of the ownership,maintenance or use
of such land,provided that the occurrence giving rise to such bodily injury,property damage or the offense
giving rise to such personal and advertising injury takes place prior to the termination of such lease.The
CNA74705XX (1-15)
Page 2of17 Endorsement No:
CONTINENTAL CASUALTY COMPANY
Copyright CNA All Rights Reserved. Includes copyrightedmaterial of Insurance Services Office, Inc.,with its permission.
CNA PARAMOUNT
Contractors'General Liability Extension Endorsement
coverage granted by this paragraph does not apply to structural alterations,new construction or demolition
operations performed by,on behalf of,or for such additional insured.
E.Lessor of Premises
An owner or lessor of premises leased to the Named Insured,or such owner or lessor's real estate manager,but
only with respect to liability for bodily injury,property damage or personal and advertising injury arising out of
the ownership,maintenance or use of such part of the premises leased to the Named Insured,and provided that
the occurrence giving rise to such bodily injury or property damage,or the offense giving rise to such personal
and advertising injury,takes place prior to the termination of such lease.The coverage granted by this
paragraph does not apply to structural alterations,new construction or demolition operations performed by,on
behalf of,or for such additional insured.
F. Mortgagee,Assignee or Receiver
A mortgagee,assignee or receiver of premises but only with respect to such mortgagee,assignee or receiver's
liability for bodily injury,property damage or personal and advertising injury arising out of the Named
Insured's ownership,maintenance,or use of a premises by a Named Insured.
The coverage granted by this paragraph does not apply to structural alterations,new construction or demolition
operations performed by,on behalf of,or for such additional insured.
G.State or Governmental Agency or Subdivision or Political Subdivisions –Permits
A state or governmental agency or subdivision or political subdivision that has issued a permit or authorization but
only with respect to such state or governmental agency or subdivision or political subdivision's liability for bodily
injury,property damage or personal and advertising injury arising out of:
1.the following hazards in connection with premises a Named Insured owns,rents,or controls 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,hoistaway openings,sidewalk
vaults,street banners,or decorations and similar exposures;or
b.the construction,erection,or removal of elevators;or
c.the ownership,maintenance or use of any elevators covered by this insurance;or
2.the permitted or authorized operations performed by a Named Insured or on a Named Insured's behalf.
The coverage granted by this paragraph does not apply to:
a.Bodily injury,property damage or personal and advertising injury arising out of operations performed
for the state or governmental agency or subdivision or political subdivision;or
b.Bodily injury or property damage included within the products-completed operations hazard.
With respect to this provision's requirement that additional insured status must be requested under a written
contract or agreement,the Insurer will treat as a written contract any governmental permit that requires the
Named Insured to add the governmental entity as an additional insured.
H.Trade Show Event Lessor
1.With respect to a Named Insured's participation in a trade show event as an exhibitor,presenter or displayer,
any person or organization whom the Named Insured is required to include as an additional insured,but only
with respect to such person or organization's liability for bodily injury,property damage or personal and
advertising injury caused by:
CNA74705XX (1-15)
Page 3of17 Endorsement No:
CONTINENTAL CASUALTY COMPANY
Copyright CNA All Rights Reserved. Includes copyrightedmaterial of Insurance Services Office, Inc.,with its permission.
CNA PARAMOUNT
Contractors'General Liability Extension Endorsement
a.the Named Insured's acts or omissions;or
b.the acts or omissions of those acting on the Named Insured's behalf,
in the performance of the Named Insured's ongoing operations at the trade show event premises during the
trade show event.
2.The coverage granted by this paragraph does not apply to bodily injury or property damage included within
the products-completed operations hazard.
2.ADDITIONAL INSURED -PRIMARY AND NON-CONTRIBUTORY TO ADDITIONAL INSURED'S INSURANCE
The Other Insurance Condition in the COMMERCIAL GENERAL LIABILITY CONDITIONS Section is amended to
add the following paragraph:
If the Named Insured has agreed in writing in a contract or agreement that this insurance is primary and non-
contributory relative to an additional insured's own insurance,then this insurance is primary,and the Insurer will not
seek contribution from that other insurance.For the purpose of this Provision 2.,the additional insured's own
insurance means insurance on which the additional insured is a named insured.Otherwise,and notwithstanding
anything to the contrary elsewhere in this Condition,the insurance provided to such person or organization is excess
of any other insurance available to such person or organization.
3.BODILY INJURY –EXPANDED DEFINITION
Under DEFINITIONS,the definition of bodily injury is deleted and replaced by the following:
Bodily injury means physical injury,sickness or disease sustained by a person,including death,humiliation,shock,
mental anguish or mental injury sustained by that person at any time which results as a consequence of the physical
injury,sickness or disease.
4.BROAD KNOWLEDGE OF OCCURRENCE/NOTICE OF OCCURRENCE
Under CONDITIONS,the condition entitled Duties in The Event of Occurrence,Offense,Claim or Suit is amended
to add the following provisions:
A.BROAD KNOWLEDGE OF OCCURRENCE
The Named Insured must give the Insurer or the Insurer's authorized representative notice of an occurrence,
offense or claim only when the occurrence,offense or claim is known to a natural person Named Insured,to a
partner,executive officer,manager or member of a Named Insured,or an employee designated by any of the
above to give such notice.
B.NOTICE OF OCCURRENCE
The Named Insured's rights under this Coverage Part will not be prejudiced if the Named Insured fails to give
the Insurer notice of an occurrence,offense or claim and that failure is solely due to the Named Insured's
reasonable belief that the bodily injury or property damage is not covered under this Coverage Part.However,
the Named Insured shall give written notice of such occurrence,offense or claim to the Insurer as soon as the
Named Insured is aware that this insurance may apply to such occurrence,offense or claim.
5.BROAD NAMED INSURED
WHO IS AN INSURED is amended to delete its Paragraph 3.in its entirety and replace it with the following:
3.Pursuant to the limitations described in Paragraph 4.below,any organization in which a Named Insured has
management control:
a.on the effective date of this Coverage Part;or
CNA74705XX (1-15)
Page 4of17 Endorsement No:
CONTINENTAL CASUALTY COMPANY
Copyright CNA All Rights Reserved. Includes copyrightedmaterial of Insurance Services Office, Inc.,with its permission.
CNA PARAMOUNT
Contractors'General Liability Extension Endorsement
claims arising solely out of their capacity or status as such and,in the case of a spouse,where such claim seeks
damages from marital community property,jointly held property or property transferred from such natural person
Insured to such spouse.No coverage is provided for any act,error or omission of an estate,heir,legal
representative,or spouse outside the scope of such person's capacity or status as such,provided however that the
spouse of a natural person Named Insured and the spouses of members or partners of joint venture or partnership
Named Insureds are Insureds with respect to such spouses'acts,errors or omissions in the conduct of the Named
Insured's business.
10.EXPECTED OR INTENDED INJURY –EXCEPTION FOR REASONABLE FORCE
Under COVERAGES,Coverage A –Bodily Injury and Property Damage Liability,the paragraph entitled
Exclusions is amended to delete the exclusion entitled Expected or Intended Injury and replace it with the following:
This insurance does not apply to:
Expected or Intended Injury
Bodily injury or property damage expected or intended from the standpoint of the Insured.This exclusion does not
apply to bodily injury or property damage resulting from the use of reasonable force to protect persons or property.
11.GENERAL AGGREGATE LIMITS OF INSURANCE -PER PROJECT
A.For each construction project away from premises the Named Insured owns or rents,a separate Construction
Project General Aggregate Limit,equal to the amount of the General Aggregate Limit shown in the Declarations,
is the most the Insurer will pay for the sum of:
1.All damages under Coverage A,except damages because of bodily injury or property damage included in
the products-completed operations hazard;and
2.All medical expenses under Coverage C,
that arise from occurrences or accidents which can be attributed solely to ongoing operations at that construction
project.Such payments shall not reduce the General Aggregate Limit shown in the Declarations,nor the
Construction Project General Aggregate Limit of any other construction project.
B.All:
1.Damages under Coverage B,regardless of the number of locations or construction projects involved;
2.Damages under Coverage A,caused by occurrences which cannot be attributed solely to ongoing
operations at a single construction project,except damages because of bodily injury or property damage
included in the products-completed operations hazard;and
3.Medical expenses under Coverage C caused by accidents which cannot be attributed solely to ongoing
operations at a single construction project,
will reduce the General Aggregate Limit shown in the Declarations.
C.The limits shown in the Declarations for Each Occurrence,for Damage To Premises Rented To You and for
Medical Expense continue to apply,but will be subject to either the Construction Project General Aggregate Limit
or the General Aggregate Limit shown in the Declarations,depending on whether the occurrence can be
attributed solely to ongoing operations at a particular construction project.
D.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 shown in the Declarations,regardless of
the number of projects involved.
CNA74705XX (1-15)
Page 8of17 Endorsement No:
CONTINENTAL CASUALTY COMPANY
Copyright CNA All Rights Reserved. Includes copyrightedmaterial of Insurance Services Office, Inc.,with its permission.
CNA PARAMOUNT
Contractors'General Liability Extension Endorsement
E.If a single construction project away from premises owned by or rented to the Insured has been 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.
F.The provisions of LIMITS OF INSURANCE not otherwise modified by this endorsement shall continue to apply as
stipulated.
12.IN REM ACTIONS
A quasi in rem action against any vessel owned or operated by or for the Named Insured,or chartered by or for the
Named Insured, will be treated in the same manner as though the action were in personam against the Named
Insured.
13.INCIDENTAL HEALTH CARE MALPRACTICE COVERAGE
Solely with respect to bodily injury that arises out of a health care incident:
A.Under COVERAGES,Coverage A –Bodily Injury and Property Damage Liability,the paragraph entitled
Insuring Agreement is amended to replace Paragraphs 1.b.(1)and 1.b.(2)with the following:
b.This insurance applies to bodily injury provided that the professional health care services are incidental to
the Named Insured's primary business purpose,and only if:
(1)such bodily injury is caused by an occurrence that takes place in the coverage territory.
(2)the bodily injury first occurs during the policy period. All bodily injury arising from an occurrence will
be deemed to have occurred at the time of the first act,error,or omission that is part of the occurrence;
and
B.Under COVERAGES,Coverage A –Bodily Injury and Property Damage Liability,the paragraph entitled
Exclusions is amended to:
i.add the following to the Employers Liability exclusion:
This exclusion applies only if the bodily injury arising from a health care incident is covered by other
liability insurance available to the Insured (or which would have been available but for exhaustion of its
limits).
ii.delete the exclusion entitled Contractual Liability and replace it with the following:
This insurance does not apply to:
Contractual Liability
the Insured's actual or alleged liability under any oral or written contract or agreement,including but not
limited to express warranties or guarantees.
iii.add the following additional exclusions:
This insurance does not apply to:
Discrimination
any actual or alleged discrimination,humiliation or harassment,including but not limited to claims based on
an individual's race,creed,color,age,gender,national origin, religion, disability,marital status or sexual
orientation.
Dishonesty or Crime
Any actual or alleged dishonest,criminal or malicious act,error or omission.
Medicare/Medicaid Fraud
CNA74705XX (1-15)
Page 9of17 Endorsement No:
CONTINENTAL CASUALTY COMPANY
Copyright CNA All Rights Reserved. Includes copyrightedmaterial of Insurance Services Office, Inc.,with its permission.
CNA PARAMOUNT
Contractors'General Liability Extension Endorsement
B.Solely for the purpose of the coverage provided by this PROPERTY DAMAGE –ELEVATORS Provision,the
Other Insurance conditions is amended to add the following paragraph:
This insurance is excess over any of the other insurance,whether primary,excess,contingent or on any other
basis that is Property insurance covering property of others damaged from the use of elevators.
23.SUPPLEMENTARY PAYMENTS
The section entitled SUPPLEMENTARY PAYMENTS –COVERAGES A AND B is amended as follows:
A.Paragraph 1.b.is amended to delete the $250 limit shown for the cost of bail bonds and replace it with a $5,000.
limit;and
B.Paragraph 1.d.is amended to delete the limit of $250 shown for daily loss of earnings and replace it with a
$1,000.limit.
24.UNINTENTIONAL FAILURE TO DISCLOSE HAZARDS
If the Named Insured unintentionally fails to disclose all existing hazards at the inception date of the Named
Insured's Coverage Part,the Insurer will not deny coverage under this Coverage Part because of such failure.
25.WAIVER OF SUBROGATION -BLANKET
Under CONDITIONS,the condition entitled Transfer Of Rights Of Recovery Against Others To Us is amended to
add the following:
The Insurer waives any right of recovery the Insurer may have against any person or organization because of
payments the Insurer makes for injury or damage arising out of:
1.the Named Insured's ongoing operations;or
2.your work included in the products-completed operations hazard.
However,this waiver applies only when the Named Insured has agreed in writing to waive such rights of recovery in
a written contract or written agreement,and only if such contract or agreement:
1.is in effect or becomes effective during the term of this Coverage Part;and
2.was executed prior to the bodily injury,property damage or personal and advertising injury giving rise to the
claim.
26.WRAP-UP EXTENSION:OCIP,CCIP,OR CONSOLIDATED (WRAP-UP)INSURANCE PROGRAMS
Note:The following provision does not apply to any public construction project in the state of Oklahoma,nor to any
construction project in the state of Alaska,that is not permitted to be insured under a consolidated (wrap-up)
insurance program by applicable state statute or regulation.
If the endorsement EXCLUSION –CONSTRUCTION WRAP-UP is attached to this policy,or another exclusionary
endorsement pertaining to Owner Controlled Insurance Programs (O.C.I.P.)or Contractor Controlled Insurance
Programs (C.C.I.P.)is attached,then the following changes apply:
A.The following wording is added to the above-referenced endorsement:
With respect to a consolidated (wrap-up)insurance program project in which the Named Insured is or was
involved,this exclusion does not apply to those sums the Named Insured become legally obligated to pay as
damages because of:
1.Bodily injury,property damage,or personal or advertising injury that occurs during the Named Insured's
ongoing operations at the project,or during such operations of anyone acting on the Named Insured's
behalf;nor
CNA74705XX (1-15)
Page 16 of 17 Endorsement No:
CONTINENTAL CASUALTY COMPANY
Copyright CNA All Rights Reserved. Includes copyrightedmaterial of Insurance Services Office, Inc.,with its permission.
Blanket Additional Insured - Owners, Lessees or
Contractors - with Products-Completed
Operations Coverage Endorsement
CNA75079XX (1-15) Policy No:
Page 1 of 2 Endorsement No:
Effective Date:
Insured Name:
Copyright CNA All Rights Reserved. Includes copyrighted material of Insurance Services Office, Inc., with its permission.
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
It is understood and agreed as follows:
I. The WHO IS AN INSURED section is amended to add as an Insured any person or organization whom the
Named Insured is required by written contract to add as an additional insured on this coverage part, including
any such person or organization, if any, specifically set forth on the Schedule attachment to this endorsement.
However, such person or organization is an Insured only with respect to such person or organization’s liability
for:
A. unless paragraph B. below applies,
1. bodily injury, property damage, or personal and advertising injury caused in whole or in part by the
acts or omissions by or on behalf of the Named Insured and in the performance of such Named
Insured’s ongoing operations as specified in such written contract; or
2. bodily injury or property damage caused in whole or in part by your work and included in the
products-completed operations hazard, and only if
a. the written contract requires the Named Insured to provide the additional insured such coverage;
and
b. this coverage part provides such coverage.
B. bodily injury, property damage, or personal and advertising injury arising out of your work described in
such written contract, but only if:
1. this coverage part provides coverage for bodily injury or property damage included within the
products completed operations hazard; and
2. the written contract specifically requires the Named Insured to provide additional insured coverage
under the 11-85 or 10-01 edition of CG2010 or the 10-01 edition of CG2037.
II. Subject always to the terms and conditions of this policy, including the limits of insurance, the Insurer will not
provide such additional insured with:
A. coverage broader than required by the written contract; or
B. a higher limit of insurance than required by the written contract.
III. The insurance granted by this endorsement to the additional insured does not apply to bodily injury, property
damage, or personal and advertising injury arising out of:
A. 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; and
2. supervisory, inspection, architectural or engineering activities; or
B. any premises or work for which the additional insured is specifically listed as an additional insured on another
endorsement attached to this coverage part.
IV. Notwithstanding anything to the contrary in the section entitled COMMERCIAL GENERAL LIABILITY
CONDITIONS, the Condition entitled Other Insurance, this insurance is excess of all other insurance available
to the additional insured whether on a primary, excess, contingent or any other basis. However, if this insurance
Blanket Additional Insured - Owners, Lessees or
Contractors - with Products-Completed
Operations Coverage Endorsement
CNA75079XX (1-15) Policy No:
Page 2 of 2 Endorsement No:
Effective Date:
Insured Name:
Copyright CNA All Rights Reserved. Includes copyrighted material of Insurance Services Office, Inc., with its permission.
is required by written contract to be primary and non-contributory, this insurance will be primary and non-
contributory relative solely to insurance on which the additional insured is a named insured.
V. Solely with respect to the insurance granted by this endorsement, the section entitled COMMERCIAL GENERAL
LIABILITY CONDITIONS is amended as follows:
The Condition entitled Duties In The Event of Occurrence, Offense, Claim or Suit is amended with the
addition of the following:
Any additional insured pursuant to this endorsement will as soon as practicable:
1. give the Insurer written notice of any claim, or any occurrence or offense which may result in a claim;
2. except as provided in Paragraph IV. of this endorsement, agree to make available any other insurance
the additional insured has for any loss covered under this coverage part;
3. send the Insurer copies of all legal papers received, and otherwise cooperate with the Insurer in the
investigation, defense, or settlement of the claim; and
4. tender the defense and indemnity of any claim to any other insurer or self insurer whose policy or
program applies to a loss that the Insurer covers under this coverage part. However, if the written
contract requires this insurance to be primary and non-contributory, this paragraph (4) does not apply to
insurance on which the additional insured is a named insured.
The Insurer has no duty to defend or indemnify an additional insured under this endorsement until the Insurer
receives written notice of a claim from the additional insured.
VI. Solely with respect to the insurance granted by this endorsement, the section entitled DEFINITIONS is amended
to add the following definition:
Written contract means a written contract or written agreement that requires the Named Insured to make a
person or organization an additional insured on this coverage part, provided the contract or agreement:
A. is currently in effect or becomes effective during the term of this policy; and
B. was executed prior to:
1. the bodily injury or property damage; or
2. the offense that caused the personal and advertising injury
for which the additional insured seeks coverage.
Any coverage granted by this endorsement shall apply solely to the extent permissible by law.
All other terms and conditions of the Policy remain unchanged.
This endorsement, which forms a part of and is for attachment to the Policy issued by the designated Insurers, takes
effect on the effective date of said Policy at the hour stated in said Policy, unless another effective date is shown
below, and expires concurrently with said Policy.
Form No: CNA63359XX (04-2012)
© Copyright CNA All Rights Reserved. Includes copyrighted material of the
Insurance Services Office, Inc., used with its permission.
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
This endorsement modifies insurance provided under the following:
BUSINESS AUTO COVERAGE FORM
I.LIABILITY COVERAGE
A.Who Is An Insured
The following is added to Section II, Paragraph A.1., Who Is An Insured:
1.a. Any incorporated entity of which the Named Insured owns a majority of the voting stock on the
date of inception of this Coverage Form; provided that,
b.The insurance afforded by this provision A.1. does not apply to any such entity that is an
insured under any other liability “policy” providing auto coverage.
2.Any organization you newly acquire or form, other than a limited liability company, partnership or
joint venture, and over which you maintain majority ownership interest.
The insurance afforded by this provision A.2.:
a.Is effective on the acquisition or formation date, and is afforded only until the end of the policy
period of this Coverage Form, or the next anniversary of its inception date, whichever is earlier.
b.Does not apply to:
(1)Bodily injury or property damage caused by an accident that occurred before you acquired
or formed the organization; or
(2)Any such organization that is an insured under any other liability “policy” providing auto
coverage.
3.Any person or organization that you are required by a written contract to name as an additional
insured is an insured but only with respect to their legal liability for acts or omissions of a person,
who qualifies as an insured under SECTION II – WHO IS AN INSURED and for whom Liability
Coverage is afforded under this policy. If required by written contract, this insurance will be primary
and non-contributory to insurance on which the additional insured is a Named Insured.
4.An employee of yours is an insured while operating an auto hired or rented under a contract or
agreement in that employee's name, with your permission, while performing duties related to the
conduct of your business.
“Policy”, as used in this provision A. Who Is An Insured, includes those policies that were in force on
the inception date of this Coverage Form but:
1.Which are no longer in force; or
2.Whose limits have been exhausted.
B.Bail Bonds and Loss of Earnings
Section II, Paragraphs A.2. (2) and A.2. (4) are revised as follows:
1.In a.(2), the limit for the cost of bail bonds is changed from $2,000 to $5,000; and
CONTRACTORS EXTENDED COVERAGE ENDORSEMENT – BUSINESS AUTO PLUS
Form No: CNA63359XX (04-2012)
© Copyright CNA All Rights Reserved. Includes copyrighted material of the
Insurance Services Office, Inc., used with its permission.
2.In a.(4), the limit for the loss of earnings is changed from $250 to $500 a day.
C.Fellow Employee
Section II, Paragraph B.5 does not apply.
Such coverage as is afforded by this provision C. is excess over any other collectible insurance.
II.PHYSICAL DAMAGE COVERAGE
A.Glass Breakage – Hitting A Bird Or Animal – Falling Objects Or Missiles
The following is added to Section III, Paragraph A.3.:
With respect to any covered auto, any deductible shown in the Declarations will not apply to glass
breakage if such glass is repaired, in a manner acceptable to us, rather than replaced.
B.Transportation Expenses
Section III, Paragraph A.4.a. is revised, with respect to transportation expense incurred by you, to
provide:
a.$60 per day, in lieu of $20; subject to
b.$1,800 maximum, in lieu of $600.
C.Loss of Use Expenses
Section III, Paragraph A.4.b. is revised, with respect to loss of use expenses incurred by you, to
provide:
a.$1,000 maximum, in lieu of $600.
D.Hired “Autos”
The following is added to Section III. Paragraph A.:
5.Hired “Autos”
If Physical Damage coverage is provided under this policy, and such coverage does not extend to Hired
Autos, then Physical Damage coverage is extended to:
a.Any covered auto you lease, hire, rent or borrow without a driver; and
b.Any covered auto hired or rented by your employee without a driver, under a contract in that
individual employee's name, with your permission, while performing duties related to the
conduct of your business.
c.The most we will pay for any one accident or loss is the actual cash value, cost of repair, cost
of replacement or $75,000, whichever is less, minus a $500 deductible for each covered auto.
No deductible applies to loss caused by fire or lightning.
d.The physical damage coverage as is provided by this provision is equal to the physical damage
coverage(s) provided on your owned autos.
e.Such physical damage coverage for hired autos will:
(1)Include loss of use, provided it is the consequence of an accident for which the Named
Insured is legally liable, and as a result of which a monetary loss is sustained by the leasing
or rental concern.
(2)Such coverage as is provided by this provision will be subject to a limit of $750 per
accident.
E.Airbag Coverage
Form No: CNA63359XX (04-2012)
© Copyright CNA All Rights Reserved. Includes copyrighted material of the
Insurance Services Office, Inc., used with its permission.
The following is added to Section III, Paragraph B.3.:
The accidental discharge of an airbag shall not be considered mechanical breakdown.
F.Electronic Equipment
Section III, Paragraphs B.4.c and B.4.d. are deleted and replaced by the following:
c.Physical Damage Coverage on a covered auto also applies to loss to any permanently installed
electronic equipment including its antennas and other accessories
d.A $100 per occurrence deductible applies to the coverage provided by this provision.
G.Diminution In Value
The following is added to Section III, Paragraph B.6.:
Subject to the following, the diminution in value exclusion does not apply to:
a.Any covered auto of the private passenger type you lease, hire, rent or borrow, without a driver
for a period of 30 days or less, while performing duties related to the conduct of your business;
and
b.Any covered auto of the private passenger type hired or rented by your employee without a
driver for a period of 30 days or less, under a contract in that individual employee's name, with
your permission, while performing duties related to the conduct of your business.
c.Such coverage as is provided by this provision is limited to a diminution in value loss arising
directly out of accidental damage and not as a result of the failure to make repairs; faulty or
incomplete maintenance or repairs; or the installation of substandard parts.
d.The most we will pay for loss to a covered auto in any one accident is the lesser of:
(1)$5,000; or
(2)20% of the auto's actual cash value (ACV).
III.Drive Other Car Coverage – Executive Officers
The following is added to Sections II and III:
1.Any auto you don't own, hire or borrow is a covered auto for Liability Coverage while being used by,
and for Physical Damage Coverage while in the care, custody or control of, any of your “executive
officers”, except:
a.An auto owned by that “executive officer” or a member of that person's household; or
b.An auto used by that “executive officer” while working in a business of selling, servicing, repairing
or parking autos.
Such Liability and/or Physical Damage Coverage as is afforded by this provision.
(1)Equal to the greatest of those coverages afforded any covered auto; and
(2)Excess over any other collectible insurance.
2.For purposes of this provision, “executive officer” means a person holding any of the officer positions
created by your charter, constitution, by-laws or any other similar governing document, and, while a
resident of the same household, includes that person's spouse.
Such “executive officers” are insureds while using a covered auto described in this provision.
IV.BUSINESS AUTO CONDITIONS
A.Duties In The Event Of Accident, Claim, Suit Or Loss
Form No: CNA63359XX (04-2012)
© Copyright CNA All Rights Reserved. Includes copyrighted material of the
Insurance Services Office, Inc., used with its permission.
The following is added to Section IV, Paragraph A.2.a.:
(4)Your employees may know of an accident or loss. This will not mean that you have such
knowledge, unless such accident or loss is known to you or if you are not an individual, to any
of your executive officers or partners or your insurance manager.
The following is added to Section IV, Paragraph A.2.b.:
(6)Your employees may know of documents received concerning a claim or suit. This will not
mean that you have such knowledge, unless receipt of such documents is known to you or if
you are not an individual, to any of your executive officers or partners or your insurance
manager.
B.Transfer Of Rights Of Recovery Against Others To Us
The following is added to Section IV, Paragraph A.5. Transfer Of Rights Of Recovery Against Others To
Us:
We waive any right of recovery we may have, because of payments we make for injury or damage,
against any person or organization for whom or which you are required by written contract or
agreement to obtain this waiver from us.
This injury or damage must arise out of your activities under a contract with that person or
organization.
You must agree to that requirement prior to an accident or loss.
C.Concealment, Misrepresentation or Fraud
The following is added to Section IV, Paragraph B.2.:
Your failure to disclose all hazards existing on the date of inception of this Coverage Form shall not
prejudice you with respect to the coverage afforded provided such failure or omission is not intentional.
D.Other Insurance
The following is added to Section IV, Paragraph B.5.:
Regardless of the provisions of Paragraphs 5.a. and 5.d. above, the coverage provided by this policy
shall be on a primary non-contributory basis. This provision is applicable only when required by a
written contract.
That written contract must have been entered into prior to Accident or Loss.
E.Policy Period, Coverage Territory
Section IV, Paragraph B. 7.(5).(a). is revised to provide:
a.45 days of coverage in lieu of 30 days.
V.DEFINITIONS
Section V. paragraph C. is deleted and replaced by the following:
Bodily injury means bodily injury, sickness or disease sustained by a person, including mental anguish,
mental injury or death resulting from any of these.