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HomeMy WebLinkAboutCity of Renton and Renton School District Project Honey Dew Elementary [232950] COI 5-8-20231 of 34 (SS003) CERTIFICATE HOLDER © 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) AUTHORIZED REPRESENTATIVE CANCELLATION DATE (MM/DD/YYYY)CERTIFICATE OF LIABILITY INSURANCE LOCJECTPRO-POLICY GEN'L AGGREGATE LIMIT APPLIES PER: OCCURCLAIMS-MADE COMMERCIAL GENERAL LIABILITY GENERAL LIABILITY PREMISES (Ea occurrence)$DAMAGE TO RENTED EACH OCCURRENCE $ MED EXP (Any one person)$ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ PRODUCTS - COMP/OP AGG $ $RETENTIONDED CLAIMS-MADE OCCUR $ AGGREGATE $ EACH OCCURRENCE $UMBRELLA LIAB EXCESS LIAB DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) INSRLTR TYPE OF INSURANCE POLICY NUMBER POLICY EFF(MM/DD/YYYY)POLICY EXP(MM/DD/YYYY)LIMITS WC STATU-TORY LIMITS OTH-ER E.L. EACH ACCIDENT E.L. DISEASE - EA EMPLOYEE E.L. DISEASE - POLICY LIMIT $ $ $ ANY PROPRIETOR/PARTNER/EXECUTIVE If yes, describe underDESCRIPTION OF OPERATIONS below (Mandatory in NH)OFFICER/MEMBER EXCLUDED? WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED HIRED AUTOS NON-OWNEDAUTOSAUTOS AUTOS COMBINED SINGLE LIMIT BODILY INJURY (Per person) BODILY INJURY (Per accident) PROPERTY DAMAGE $ $ $ $ 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. INSR ADDL WVD SUBR N / A $ $ (Ea accident) (Per accident) 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 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). The ACORD name and logo are registered marks of ACORD COVERAGES CERTIFICATE NUMBER:REVISION NUMBER: INSURED PHONE(A/C, No, Ext): PRODUCER ADDRESS:E-MAIL FAX(A/C, No): CONTACTNAME: NAIC # INSURER A : INSURER B : INSURER C : INSURER D : INSURER E : INSURER F : INSURER(S) AFFORDING COVERAGE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORETHE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 05/08/2023 Parker, Smith & Feek Insurance, LLC. 2233 112th Avenue NE Bellevue, WA 98004 425-709-3600 425-709-7460 Ohio Security Insurance Company Reynolds General Contracting, Inc. 15333 NE 90th St. Suite 130 Redmond, WA 98052 The Ohio Casualty Insurance Co. A X 1,000,000 8 X 8 8 PD Ded $250 8 Per Claim 8 BKS56734039 06/02/2023 06/02/2024 1,000,000 15,000 1,000,000 2,000,000 2,000,000 A 1,000,000 8 X X BAS56734039 06/02/2023 06/02/2024 B 8 10,000,000 8 X X 10,000,000 8 10,000 SIR USO56734039 06/02/2023 06/02/2024 A 806/02/2023 06/02/2024 1,000,000 BKS56734039 ** WA STOP GAP 2,000,000 1,000,000 RE: Project Name: Honey Dew Elementary School - Safety Upgrades; Location: 800 Union Ave. NE, Renton, WA 98059. City of Renton and Renton School District #403, its directors, officers and employees are included as Additional Insured with respect to General Liability, Auto Liability and Umbrella Liability per the attached endorsements\forms. Coverage is Primary and Non-Contributory with respect to General Liability, Auto Liability and Umbrella Liability per the attached endorsements\forms. Waiver of Subrogation applies with respect to General Liability, Auto Liability and ... (See Attached Description) City of Renton and Renton School District 300 SW 7th Street Renton, WA 98057 2 of 34 (SS003) DESCRIPTIONS (Continued from Page ) 1 Umbrella Liability per the attached endorsements\forms. 30 days Notice of Cancellation applies per the attached endorsement\form. CANCELS AND REPLACES PREVIOUSLY ISSUED CERTIFICATE. 3 of 34 (SS003) 4 of 34 (SS003) 5 of 34 (SS003) 6 of 34 (SS003) 7 of 34 (SS003) 8 of 34 (SS003) 9 of 34 (SS003) 10 of 34 (SS003) 11 of 34 (SS003) COMMERCIAL 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 A. Paragraph 2. under Section II – Who Is An Insured is amended to include as an insured any person or organization whom you have agreed to add as an additional insured in a written contract or written agreement. Such person or organization is an additional insured but only with respect to liability for “bodily injury” or “property damage”: 1. Caused by “your work” performed for that additional insured that is the subject of the written contract or written agreement; and 2. Included in the “products-completed operations hazard”. However: a) The insurance afforded to such additional insured only applies to the extent permitted by law; and b) 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 The insurance provided by this endorsement applies only if the written contract or written agreement is signed prior to the “bodily injury” or “property damage”. We have no duty to defend an additional insured under this endorsement until we receive written notice of a “suit” by the additional insured as required in Paragraph b. of Condition 2. Duties In The Event Of Occurrence, Offense, Claim Or Suit under Section IV – Commercial General Liability Conditions. B. With respect to the insurance provided by this endorsement, the following are added to Paragraph 2. Exclusions under Section I – Coverage A – Bodily Injury And Property Damage Liability: This insurance does not apply to: 1. “Bodily injury” or “property damage” that occurs prior to you commencing operations at the location where such “bodily injury” or “property damage” occurs. 2. “Bodily injury” or “property damage” arising out of the rendering of, or the failure to render, any professional architectural, engineering or surveying services including: a. The preparing, approving or failure to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawing and specifications; and b. Supervisory, inspection, architectural or engineering activities. © 2013 Liberty Mutual Insurance CG 85 83 04 13 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 2 12 of 34 (SS003) C. With respect to the insurance afforded by this endorsement, exclusion l. Damage To Your Work of Paragraph 2. Exclusions under Section I – Coverage A – Bodily Injury And Property Damage Liability is replaced by the following: l. Damage To Your Work “Property damage” to “your work” arising out of it or any part of it and included in the “products- completed operations hazard”. D. With respect to the insurance afforded to these additional insureds, the following is added to Section II – 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 the amount of insurance: 1. Required by contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the Declaration. whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. E. With respect to the insurance afforded by this endorsement, Section IV – Commercial General Liability Conditions is amended as follows: 1. The following is added to Paragraph 2. Duties In The Event Of Occurrence, Offense, Claims Or Suit: An additional insured under this endorsement will as soon as practicable: a. Give written notice of an “occurrence” or an offense that may result in a claim or “suit” under this insurance to us; b. Tender the defense and indemnity of any claim or “suit” to all insurers whom also have insurance available to the additional insured; and c. Agree to make available any other insurance which the additional insured has for a loss we cover under this Coverage Part. d. We have no duty to defend or indemnify an additional insured under this endorsement until we receive written notice of a “suit” by the additional insured. 2. Paragraph 4. of Section IV – Commercial General Liability Conditions is amended as follows: a. The following is added to Paragraph a. Primary Insurance: If an additional insured's policy has an Other Insurance provision making its policy excess, and you have agreed in a written contract or written agreement to provide the additional insured coverage on a primary and noncontributory basis, this policy shall be primary and we will not seek contribution from the additional insured's policy for damages we cover. b. The following is added to Paragraph b. Excess Insurance: When a written contract or written agreement, other than a premises lease, facilities rental contract or agreement, an equipment rental or lease contract or agreement, or permit issued by a state or political subdivision between you and an additional insured does not require this insurance to be primary or primary and non-contributory, this insurance is excess over any other insurance for which the additional insured is designated as a Named Insured. Regardless of the written agreement between you and an additional insured, this insurance is excess over any other insurance whether primary, excess, contingent or on any other basis for which the additional insured has been added as an additional insured on other policies. © 2013 Liberty Mutual Insurance CG 85 83 04 13 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 2 of 2 13 of 34 (SS003) 14 of 34 (SS003) 15 of 34 (SS003) 16 of 34 (SS003) 17 of 34 (SS003) 18 of 34 (SS003) 19 of 34 (SS003) 20 of 34 (SS003) 21 of 34 (SS003) 22 of 34 (SS003) 23 of 34 (SS003)31 78of56734039003573235COMMERCIAL AUTO AC 85 01 06 18 THIS ENDORSEMENT CHANGES THE POLICY. PLEASEREAD IT CAREFULLY. BUSINESS AUTO COVERAGE ENHANCEMENT ENDORSEMENT 2017Liberty Mutual InsuranceAC 85 01 06 18 Page 1 of 7Includes copyrighted material of Insurance Services Office Inc.,with its Permission. This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGEFORM 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. 24 of 34 (SS003)32 78of2017Liberty Mutual InsuranceAC 85 01 06 18 Page 2 of 7Includes copyrighted material of Insurance Services Office Inc.,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 specificall y 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. 25 of 34 (SS003)33 78of567340390035732352017Liberty Mutual InsuranceAC 85 01 06 18 Page 3 of 7Includes copyrighted material of Insurance Services Office Inc.,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 smallestof: (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. 26 of 34 (SS003)34 78of2017Liberty Mutual InsuranceAC 85 01 06 18 Page 4 of 7Includes copyrighted material of Insurance Services Office Inc.,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. 27 of 34 (SS003)35 78of567340390035732352017Liberty Mutual InsuranceAC 85 01 06 18 Page 5 of 7Includes copyrighted material of Insurance Services Office Inc.,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 / LEASEGAP 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". 28 of 34 (SS003)36 78of2017Liberty Mutual InsuranceAC 85 01 06 18 Page 6 of 7Includes copyrighted material of Insurance Services Office Inc.,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. 17. 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. PARKEDAUTO 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 whileitis: 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. 29 of 34 (SS003)37 78of567340390035732352017Liberty Mutual InsuranceAC 85 01 06 18 Page 7 of 7Includes copyrighted material of Insurance Services Office Inc.,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. 30 of 34 (SS003) <=O€>?@ABCD EFCFGH IJKFBGJLA  0.   0  r  rIJLHFhAK LPfDB?NeCAh jGCAB?GH PQ IJKFBGJLA TABg?LAK VQQ?LA IJLc_i?Ce ?CK MABj?KK?PJc              1  1  1       ) 3       1 MGBGNBGfe ?K BAfHGLAh ?J ?CK AJC?BACD @D CeA QPHHPi| ?JNx IJ CeA AgAJC PQ wGLL?hAJCw_ LHG?j_ wKF?Cw PB wHPKKw_ DPF jFKC fBPjfCHD JPC?QD FK ieAJ ?C ?K zJPiJ CPx tv ]PF_ ?Q DPF GBA GJ ?Jh?g?hFGHy tv \ fGBCJAB_ ?Q DPF GBA G fGBCJABKe?fy t'v EAj@AB_ ?Q DPF GBA G H?j?CAh H?G@?H?CD LPjfGJDy t(v \J AoALFC?gA PQQ?LAB PB CeA wAjfHPDAAw hAK?NJGCAh @D CeA UGjAh IJKFBAh CP N?gA KFLe JPC?LA_ ?Q DPF GBA G LPBfPBGC?PJc RP CeA AoCAJC fPKK?@HA_ JPC?LA CP FK KePFHh ?JLHFhAx tv SPi_ ieAJ GJh ieABA CeA wGLL?hAJCw PB wHPKKw CPPz fHGLAy t*v ReA w?JKFBAhKw JGjA GJh GhhBAKKy GJh t v ReA JGjAK GJh GhhBAKKAK PQ GJD ?JpFBAh fABKPJK GJh i?CJAKKAKc  4      2     2          ) 3       1 MGBGNBGfe . &#$&  "7!$   %&, "#$! !7&$  $1 ?K GjAJhAh @D CeA Ghh?C?PJ PQ CeA QPHHPi?JNx IQ CeA fABKPJ PB PBNGJ?mGC?PJ eGK ?J G iB?CCAJ GNBAAjAJC iG?gAh CePKA B?NeCK @AQPBA GJ wGLL?hAJCw PB wHPKKw_ PFB B?NeCK GBA iG?gAh GHKPc '      2        ) 3       1 MGBGNBGfe 3r +" , &"1 %& &&"!&,1 ?K GjAJhAh @D CeA Ghh?C?PJ PQ CeA QPHHPi?JNx bPB wGFCPKw e?BAh ƒ= hGDK PB HAKK_ CeA LPgABGNA CABB?CPBD ?K GJDieABA ?J CeA iPBHh_ fBPg?hAh CeGC CeA w?JKFBAhnKw BAKfPJK?@?H?CD CP fGD QPB hGjGNAK ?K hACABj?JAh ?J G wKF?Cw_ PJ CeA jAB?CK_ ?J CeA aJ?CAh TCGCAK_ CeA CABB?CPB?AK GJh fPKKAKK?PJK PQ CeA aJ?CAh TCGCAK PQ \jAB?LG_ MFABCP Z?LP PB WGJGhG PB ?J G KACCHAjAJC iA GNBAA CPc Re?K AoCAJK?PJ PQ LPgABGNA hPAK JPC GffHD CP GJ wGFCPw e?BAh_ HAGKAh_ BAJCAh PB @PBBPiAh i?Ce G hB?gABc (      )  3 2    3 4      4   2 )  ReA QPHHPi?JN ?K GhhAh CP     ) 3       1 2#&+ #"!"#$1 3. !7& #$&# GJh KFfABKAhAK GJD fBPg?K?PJ CP CeA LPJCBGBDx Re?K WPgABGNA bPBjnK WPgABAh \FCPK >?G@?H?CD WPgABGNA ?K fB?jGBD CP GJh i?HH JPC KAAz LPJCB?@FC?PJ QBPj GJD PCeAB ?JKFBGJLA GgG?HG@HA CP GJ w?JKFBAhw FJhAB DPFB fPH?LD fBPg?hAh CeGCx TFLe w?JKFBAhw ?K G UGjAh IJKFBAh FJhAB KFLe PCeAB ?JKFBGJLAy GJh ]PF eGgA GNBAAh ?J G iB?CCAJ LPJCBGLC PB iB?CCAJ GNBAAjAJC CeGC Ce?K ?JKFBGJLA iPFHh @A fB?jGBD GJh iPFHh JPC KAAz LPJCB?@FC?PJ QBPj GJD PCeAB ?JKFBGJLA GgG?HG@HA CP KFLe w?JKFBAhwc     )     ?K GjAJhAh GK QPHHPiKx . 3         aJhAB     )     1 YAQ?J?C?PJ ?K BAfHGLAh @D CeA QPHHPi?JNx w`Ph?HD ?JpFBDw jAGJK feDK?LGH ?JpFBD_ K?LzJAKK PB h?KAGKA KFKCG?JAh @D G fABKPJ_ ?JLHFh?JN jAJCGH GJNF?Ke_ jAJCGH ?JpFBD_ KePLz_ QB?NeC PB hAGCe BAKFHC?JN QBPj GJD PQ CeAKA GC GJD C?jAc 04/10/2022 56734039 POLSVCS EC Insured Copy 31 of 34 (SS003) 32 of 34 (SS003)53 100of567340390012872352020Liberty Mutual InsuranceCU 60 02 04 21 Includes copyrighted material of Insurance Services Office, Inc.,with its permission.Page 3 of 21 (d)Arising out of his or her providing or failing to provide professional health care services. However, Paragraphs (1)(a), (1)(b),and (1)(c)do not apply to the extent "underlying insurance" provides coverage for such person(s). Coverage for such persons under this policy, will be no broader than that provided by "underlying insurance". Coverage provided by this policy for "bodily injury" to a co-"employee" or "volunteer worker" will not apply if the injured co-"employee’s" or "volunteer worker’s" remedy for such injury is provided under a workers’ compensation law or any similar law. (2)"Property damage" to property: (a)Owned, occupied, or used by; (b)Rented to, in the care, custody or control of, or over which physical control is being exercised for any purpose by; you, any of your "employees", "volunteer workers", any partner or member (if you are a partnership or joint venture), or any member (if you are a limited liability company). b.Any person or organization, other than the "named insured", who qualifies as an additional insured in the "underlying insurance". However, coverage under this policy will be no broader than that provided by "underlying insurance". The insurance afforded to such additional insured only applies to the extent permitted by law and the amount we will pay for damages is limited as described in Section III - Limits Of Insurance. c.Any person, other than your "employee" or "volunteer worker", or organization while acting as your real estate manager. d.Any person or organization having proper temporary custody of your property if you die, but only: (1)With respect to liability arising out of the maintenance or use of that property; and (2)Until your legal representative has been appointed. e.Your legal representative if you die, but only with respect to duties as such. That representative will have all your rights and duties under this policy. f.With respect to liability arising out of the maintenance, ownership, or use of an "auto", any person or organization qualifying as an insured in the "underlying insurance" which provides coverage for such "auto", but only to the extent provided in such "underlying insurance". No person or organization is an insured with respect to the conduct of any current or past partnership, joint venture, or limited liability company that is not a "named insured". SECTION III - LIMITS OF INSURANCE 1.The Limits of Insurance shown in (Item 4)of the Declarations and the rules below fix the most we will pay regardless of the number of: a.Insureds; b.Claims made or "suits" brought; c.Persons or organizations making claims or bringing "suits"; or d.Coverages provided under this policy. 2.The General Aggregate Limit is the most we will pay for all damages covered under Section I - Cov- erages except: a.Damages included in the "products-completed operations hazard"; and b.Damages caused by an "occurrence" and resulting from the ownership, maintenance, or use of a covered "auto". 3.The Products-Completed Operations Aggregate Limit is the most we will pay for all damages included in the "products-completed operations hazard". 33 of 34 (SS003)80 100ofper agent COMMERCIAL UMBRELLA CU 88 40 04 21 THIS ENDORSEMENT CHANGES THE POLICY. PLEASEREAD IT CAREFULLY. AMENDMENT OF OTHER INSURANCE - DESIGNATED PERSONS OR ORGANIZATIONS This endorsement modifies insurance provided under the following: COMMERCIAL UMBRELLA COVERAGE FORM 2020Liberty Mutual InsuranceCU 88 40 04 21 Includes copyrighted material of Insurance Services Office, Inc.,with its permission.Page 1 of 1 SCHEDULE Name Of Person Or Organization: (Information required to complete this Schedule, if not shown above, will be shown in the Declarations) 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. However, this insurance will not seek contribution from any "other insurance" available to an additional insured shown in the Schedule, 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. 34 of 34 (SS003)78 100ofCOMMERCIAL UMBRELLA CU 64 95 04 21 THIS ENDORSEMENT CHANGES THE POLICY. PLEASEREAD IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS - FOLLOWING FORM This endorsement modifies insurance provided under the following: COMMERCIAL UMBRELLA COVERAGEFORM 2020Liberty Mutual InsuranceCU 64 95 04 21 Includes copyrighted material of Insurance Services Office, Inc.,with its permission.Page 1 of 1 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".