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Insurance Certificate
.4CQDATE(MM/DD/YYYV) C � CERTIFICATE OF LIABILITY INSURANCE 3/20/2015 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). PRODUCER CONTACT NAME: Arthur J. Gallagher&Co. PHONE 925-299-1112 FAx 925-299-0328 Insurance Brokers of CA.Inc.LIC#0726293 (A/C No_Fxu• IA/C-NOT. EMAIL 3697 Mt. Diablo Blvd, Suite 300 A DRESS• Lafayette CA 94549 INSURER(S)AFFORDING COVERAGE NAIC it INSURER A:Zurich American Insurance Company 16535 INSURED FBDVANG-01 INSURER B:American Guarantee and Liability In 26247 FBD Vanguard Construction, Inc. INSURER C: dba:Vanguard Construction INSURER D 651 Enterprise Ct. Livermore CA 94550-5200 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 1922517375 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR AUDL UBrr POLICY EFF POLICY EXP LIMITS LTR TYPE OF INSURANCE INSD WV0 POLICY NUMBER (MM/DD/YYYY) (MM/DO/VYVY) A X COMMERCIAL GENERAL LIABILITY GLA011286700 3/25/2015 2/1/2016 EACH OCCURRENCE $2,000,000 DAMAGE TO RENTED CLAIMS-MADE X OCCUR PREMISES(Ea occurrence) $300,000 X XCU Included MED EXP(Any one person) $10,000 X Conlractural Lia PERSONAL&ADV INJURY $2,000,000 GENt AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $4,000,000 POLICY X JE° LOC PRODUCTS-COMP/OP AGG $4,000,000 OTHER: Deductible $$5,000 A AUTOMOBILE LIABILITY GLA011286700 3/25/2015 2/1/2016 COMBINED SINGLE LIMI(- $1,000,000 (Ea accident) X ANY AUTO BODILY INJURY(Per person) $ AUT OWNED SCHEDULED BODILY INJURY(Per accident) $ X HIRED AUTOS X NON OWNED PROPERTY DAMAGE $ _ AUTOS (Per accident) form CA 0001 03 06 $ B UMBRELLA LIAB X OCCUR AUC011291600 3/25/2015 2/1/2016 EACH OCCURRENCE $25,000,000 X EXCESS LIAB CLAIMS-MADE AGGREGATE $25,000,000 DED X RETENTIONS° $ A WORKERS COMPENSATION WC489238205 2/1/2015 2/1/2016 X PERTUTE OTTH- AND EMPLOYERS'LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE © E.L.EACH ACCIDENT $1,000,000 OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $1,000,000 It yes,describe urder DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached,I more space is required) VG986 Project:VERBS Safe Route to School- Project No. 12-PW-199, Federal Project No. RPSTPLE-5035 (024) City of Gilroy are included as additional insured for General Liability per form U-GL-1175-F CW(04/13)attached(primary wording included) and for Auto Liability per form CA 20 48 10 13 attached (primary wording included). Waiver of Subrogation applies for General Liability per form CG 24 04 05 09 attached,for Auto Liability per form CA 04 44 10 13 attached and for Workers Compensation per form WC 04 03 06 4-84 attached. The above Additional Insured, Primary Wording and Waiver of Subrogation Endorsements are only valid if required in a written contract. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Gilroy Putlic Works Department ACCORDANCE WITH THE POLICY PROVISIONS. 7351 Rosanna Street Gilroy CA 95020 USA AUTHORIZED REPRESENTATIVE (),,,,.:,. ).),,k-j;A,,:—.,„., \� ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD FBD Vanguard Construction, Inc. POLICY NUMBER: GLA011286700 COMMERCIAL AUTO CA20481013 • THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED INSURED FOR COVERED AUTOS. LIABILITY COVERAGE This endorsement modifies insurance provided under the following. AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by this endorsement. This endorsement identifies person(s) or organization(s)who are "insureds"for Covered Autos Liability Coverage under the Who Is An Insured provision of the Coverage Form. This endorsement does not alter coverage provided in the Coverage Form. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Named Insured: FBD Vanguard Construction, Inc. Endorsement Effective Date: 3/2 5/2 015 SCHEDULE Name Of Person(s)Or Organization(s): ANY PERSON OR ORGANIZATION TO WHOM OR WHICH YOU ARE REQUIRED TO PROVIDE ADDITIONAL INSURED STATUS OR ADDITIONAL INSURED STATUS ON A PRIMARY, NON- CONTRIBUTORY BASIS, IN A WRITTEN CONTRACT OR WRITTEN AGREEMENT EXECUTED PRIOR TO THE LOSS, EXCEPT WHERE SUCH CONTRACT OR AGREEMENT IS PROHIBITED BY LAW Information required to complete this Schedule, if not shown above, will be shown in the Declarations. Each person or organization shown in the Schedule is an "insured"for Covered Autos Liability Coverage, but only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured provision contained in Paragraph A.1. of Section II — Covered Autos Liability Coverage in the Business Auto and Motor Carrier Coverage Forms and Paragraph D.2. of Section I — Covered Autos Coverages of the Auto Dealers Coverage Form. CA 20 48 10 13 ©Insurance Services Office, Inc., 2011 Page 1 of 1 Wolters Kluwer Financial Services I Uniform FormsTM FBD Vanguard Construction, Inc. POLICY NUMBER: GLA011286700 COMMERCIAL AUTO CA 04 44 10 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (WAIVER OF SUBROGATION) This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Named Insured: Endorsement Effective Date: SCHEDULE Name(s)Of Person(s)Or Organization(s): ALL PERSONS AND/OR ORGANIZATIONS THAT ARE REQUIRED BY WRITTEN CONTRACT OR AGREEMENT WITH THE INSURED, EXECUTED PRIOR TO THE ACCIDENT OR LOSS, THAT WAIVER OF SUBROGATION BE PROVIDED UNDER THIS POLICY. Information required to complete this Schedule, if not shown above,will be shown in the Declarations. The Transfer Of Rights Of Recovery Against Others To Us condition does not apply to the person(s) or organization(s) shown in the Schedule, but only to the extent that subrogation is waived prior to the "accident" or the "loss" under a contract with that person or organization. CA 04 44 10 13 CO Insurance Services Office, Inc.,2011 Page 1 of 1 Wolters Kluwer Financial Services Uniform FormsTM Additional Insured —Automatic — Owners, Lessees Or ZURICH Contractors Policy No. Eff. Date of Pol. Exp. Date of Pol. Eff. Date of End. Producer No Add'I.Prem Return Prem. GLA011286700 3/25/15 2/1/16 3/25/15 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. Named Insured: FBD Vanguard Construction, Inc. Address(including ZIP Code): 651 Enterprise Court, Building H Livermore, CA 94550 This endorsement modifies insurance provided under the Commercial General Liability Coverage Part A. Section II—Who Is An Insured is amended to include as an additional insured any person or organization whom you are required to add as an additional insured on this policy under a written contract or written agreement. Such person or organization is an additional insured only with respect to liability for "bodily injury", "property damage"or"personal and advertising injury"caused, in whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf, in the performance of your ongoing operations or "your work" as included in the "products-completed operations hazard",which is the subject of the written contract or written agreement. However,the insurance afforded to such additional insured: 1. Only applies to the extent permitted by law; and 2. Will not be broader than that which you are required by the written contract or written agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds, the following additional exclusion applies: This insurance does not apply to "Bodily injury", "property damage" or"personal and advertising injury"arising out of the rendering of, or failure to render, any professional architectural, engineering or surveying services including: a. The preparing, approving or failing to prepare or approve maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or b. Supervisory, inspection, architectural or engineering activities. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by that insured, if the"occurrence"which caused the "bodily injury" or "property damage", or the offense which caused the "personal and advertising injury", involved the rendering of or the failure to render any professional architectural, engineering or surveying services. U-GL-1175-F CW(04/13) Page 1 of 2 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. C. The following is added to Paragraph 2. Duties In The Event Of Occurrence, Offense, Claim Or Suit of Section IV— Commercial General Liability Conditions: The additional insured must see to it that 1. We are notified as soon as practicable of an"occurrence"or offense that may result in a claim; 2. We receive written notice of a claim or"suit"as soon as practicable; and 3. A request for defense and indemnity of the claim or "suit" will promptly be brought against any policy issued by another insurer under which the additional insured may be an insured in any capacity. This provision does not apply to insurance on which the additional insured is a Named Insured if the written contract or written agreement requires that this coverage be primary and non-contributory. D. For the purposes of the coverage provided by this endorsement: 1. The following is added to the Other Insurance Condition of Section IV — Commercial General Liability Conditions: Primary and Noncontributory insurance This insurance is primary to and will not seek contribution from any other insurance available to an additional insured provided that: a. The additional insured is a Named Insured under such other insurance; and b. You are required by written contract or written agreement that this insurance be primary and not seek contribution from any other insurance available to the additional insured. 2. The following paragraph is added to Paragraph 4.b.of the Other Insurance Condition of Section IV—Commercial General Liability Conditions: This insurance is excess over: Any of the other insurance, whether primary, excess, contingent or on any other basis, available to an additional insured, in which the additional insured on our policy is also covered as an additional insured on another policy providing coverage for the same "occurrence", offense, claim or"suit". This provision does not apply to any policy in which the additional insured is a Named Insured on such other policy and where our policy is required by a written contract or written agreement to provide coverage to the additional insured on a primary and non- contributory basis. E. This endorsement does not apply to an additional insured which has been added to this policy by an endorsement showing the additional insured in a Schedule of additional insureds, and which endorsement applies specifically to that identified additional insured. F. With respect to the insurance afforded to the additional insureds under this endorsement, the following is added to Section III— Limits Of Insurance: The most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the written contract or written agreement referenced in Paragraph A.of this endorsement; or 2. Available under the applicable Limits of Insurance shown in the Declarations, whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. All other terms and conditions of this policy remain unchanged. U-GL-1175-F CW(04/13) Page 2of2 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. FBD Vanguard Construction, Inc. POLICY NUMBER: GLA011286700 COMMERCIAL GENERAL LIABILITY CG 24 04 05 09 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Person Or Organization: ANY PERSON OR ORGANIZATION THAT REQUIRES YOU TO WAIVE YOUR RIGHTS OF RECOVERY, IN A WRITTEN CONTRACT OR AGREEMENT WITH THE NAMED INSURED THAT IS EXECUTED PRIOR TO THE ACCIDENT OR LOSS. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV—Conditions: We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the "products- completed operations hazard". This waiver applies only to the person or organization shown in the Schedule above. CG 24 04 05 09 © Insurance Services Office, Inc., 2008 Page 1 of 1 Wolters Kluwer Financial Services I Uniform FormsTM WORKERS' COMPENSATION AND EMPLOYERS' LIABILITY INSURANCE POLICY WC 04 03 06 (Ed. 4-84) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT- CALIFORNIA This endorsement changes the policy to which it is attached effective on the inception date of the policy unless a different date is indicated below. (The following"attaching clause' need be completed only when this endorsement is issued subsequent to preparation of the policy.) This endorsement, effective on 2/1/2015 to 2/1/2016 at 12:01 A.M. standard time, forms a part of (DATE) Policy No. WC489238205 Endorsement No. of the Zurich American Insurance Company (NAME OF INSURANCE COMPANY) issued to FED Vanguard Construction, Inc. Premium (if any) $ Authorized Representative We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. The additional premium for this endorsement shall be 0.0% of the California workers' compensation premium otherwise due on such remuneration. Schedule Person or Organization Job Description ALL PERSONS AND/OR ORGANIZATIONS THAT ARE REQUIRED BY WRITTEN CONTRACT OR AGREEMENT WITH THE INSURED, EXECUTED PRIOR TO THE ACCIDENT OR LOSS, THAT WAIVER OF SUBROGATION BE PROVIDED UNDER THIS POLICY FOR WORK PERFORMED BY YOU FOR THAT PERSON OR ORGANIZATION. WC 252(4-84) WC 04 03 06(Fd 4-84) Page 1 of 1 A� DATE(MM/DD/VYVY) CERTIFICATE OF LIABILITY INSURANCE 1/29/2015 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). PRODUCER CONTACT NAME: Arthur J. Gallagher&Co. PHONE 925-299-1 112 FAX 925-299-0328 Insurance Brokers of CA.Inc.LIC#0726293 (A/c ro�,n) (A/C. 3697 Mt. Diablo Blvd, Suite 300 ADDRESS Lafayette CA 94549 INSURER(S)AFFORDING COVERAGE NAIC INSURER A:National Fire Insurance Co of Hartf 20478 INSURED FBDVANG-01 INSURER B:American Casualty Company of Readin 20427 FBD Vanguard Construction, Inc. INSURER c:Fireman's Fund Insurance Company 21873 dba: Vanguard Construction INSURER o:Zurich American Insurance Company 16535 651 Enterprise Ct. Livermore CA 94550-5200 INSURER E: INSURER F COVERAGES CERTIFICATE NUMBER: 1718874239 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR AUUL SUtSK POLICY EFF POLICY EXP TYPE OF INSURANCE LTR !NISEI WVD POLICY NUMBER (MM/DD/VYVY) (MM/DD/VYVY) LIMITS A X COMMERCIAL GENERAL LIABILITY 4014291109 3/25/2014 3/25/2015 EACH OCCURRENCE $2,000,000 DAMAGE l O RENT ED CLAIMS-MADE X OCCUR PREMISES(Ea occurrence) $100,000 _ X )(CU Included MED EXP(Any one person) $5,000 X Contraclural Lia PERSONAL 8 ADV INJURY $2,000,000 GENL AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $4,000,000 POLICY X JET° LOC PRODUCTS-COMP/OP AGG $4,000,000 OTHER: Deductible $$5,000 B AUTOMOBILE LIABILITY 4013610249 3/25/2014 3/25/2015 C:OMBINEV SINGLE LIMIT $ (Ea accident) 1,000,000 X ANY AUTO BODILY INJURY(Per person) S AUTOS NED SCTO ULED BODILY INJURY(Per accident) $ X HIRED AUTOS X NON-OWNED PROPERI Y DAMAGE AUTOS (Per accident) form CA 0001 03 06 $ C UMBRELLA LIAB X OCCUR SSE24402497 3/25/2014 3/25/2015 EACH OCCURRENCE $10,000,000 X EXCESS LIAB CLAIMS-MADE AGGREGATE $10,000,000 _ DED X RETENTIONS° _ $ D WORKERS COMPENSATION WC489238205 2/1/2015 2/1/2016 X PER OTIi- ANDEMPLOYERS'LIABILITY Y/N STATUTE ER ANYPROPRIETOR/PARTNER/EXECUTIVE (� N/A EL EACH ACCIDENT $1,000,000 OFFICER/MEMBER EXCLUDED? ` I (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $1,000,000 II yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached it more space is required) City of Gilroy is included as additional insured for General Liability per form G-140331-D 01/13 attached(Primary Wording Included).Waiver of Subrogation applies for General Liability per form G-18652-J 07-12 attached.The above Additional Insured, Primary Wording and Waiver of Subrogation Endorsements are only valid if requested by written contract.VG986 Project: VERBS Safe Route to School- Project No. 12-PW-199, Federal Project No RPSTPLE-5035(024) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELL ED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Gilroy Putlic Works Department ACCORDANCE WITH THE POLICY PROVISIONS. 7351 Rosanna Street Gilroy CA 95020 USA AUTHORIZED REPRESENTATIVE _ CI 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD G-140331-D WA (Ed 01/13) • BLANKET ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - WITH PRODUCTS-COMPLETED OPERATIONS COVERAGE It is understood and agreed that this endorsement amends the COMMERCIAL GENERAL LIABILITY COVERAGE PART as follows: SCHEDULE(OPTIONAL) Name of Additional Insured Persons Or Organizations (As required by"written contract" per Paragraph A. below ) Locations of Covered Operations (As per the"written contract," provided the location is within the"coverage territory" of this Coverage Part.) A. Section II-Who Is An Insured is amended to include as an additional insured: 1. Any person or organization whom you are required by "written contract" to add as an additional insured on this Coverage Part; and 2. The particular person or organization, if any, scheduled above B. The insurance provided to the additional insured is limited as follows: 1. The person or organization is an additional insured only with respect to liability for "bodily injury," "property damage," or"personal and advertising injury" caused in whole or in part by: a. Your acts or omissions, or the acts or omissions of those acting on your behalf, in the performance of your ongoing operations specified in the"written contract"; or b. "Your work" that is specified in the "written contract" but only for "bodily injury" or "property damage" included in the"products-completed operations hazard," and only if: (1) The "written contract" requires you to provide the additional insured such coverage;and (2) This Coverage Part provides such coverage. 2. If the "written contract"specifically requires you to provide additional insurance coverage via the 10/01 edition of CG2010 (aka CG 20 10 10 01), or via the 10/01 edition of CG2037 (aka CG 20 37 10 01),or via the 11/85 edition of CG2010 (aka CG 20 10 11 85), then in paragraph B.1. above, the words'caused in whole or in part by'are replaced by the words 'arising out of' 3. We will not provide the additional insured any broader coverage or any higher limit of insurance than: a. The maximum permitted by law; b. That required by the "written contract"; c. That described in B.1. above; or d. That afforded to you under this policy, whichever is less. G-140331-D (Ed. 01/13) Page 1 of 2 Copyright,CNA All Rights Reserved. CNA G-140331-D 1/13) (Ed 01/13) 4. Notwithstanding anything to the contrary in Condition 4. Other Insurance (Section IV), this insurance is excess of all other insurance available to the additional insured whether on a primary, excess, contingent or any other basis. But if required by the "written contract" to be primary and non-contributory, this insurance will be primary and non-contributory relative to insurance on which the additional insured is a Named Insured. 5. The insurance provided 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. C. SECTION IV—COMMERCIAL GENERAL LIABILITY CONDITIONS is amended as follows: 1. The Duties In The Event of Occurrence, Offense, Claim or Suit condition is amended to add the following additional conditions applicable to the additional insured: An additional insured under this endorsement will as soon as practicable: (1) Give us written notice of an "occurrence" or an offense which may result in a claim or"suit" under this insurance, and of any claim or"suit"that does result; (2) Except as provided in Paragraph B.4. of this endorsement, agree to make available any other insurance the additional insured has for a loss we cover under this Coverage Part; (3) Send us copies of all legal papers received, and otherwise cooperate with us in the investigation, defense, or settlement of the claim or"suit"; and (4) Tender the defense and indemnity of any claim or "suit" to any other insurer or self insurer whose policy or program applies to a loss we cover under this Coverage Part. But if the"written contract" requires this insurance to be primary and non-contributory, this provision(4) does not apply to insurance on which the additional insured is a Named Insured. We have no duty to defend or indemnify an additional insured under this endorsement until we receive from the additional insured written notice of a claim or"suit." D. Only for the purpose of the insurance provided by this endorsement,SECTION V—DEFINITIONS is amended to add the following definition: "Written contract" means a written contract or written agreement that requires you to make a person or organization an additional insured on this Coverage Part, provided the contract or agreement: 1. Is currently in effect or becomes effective during the term of this policy; 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 the additional insured seeks coverage under this Coverage Part. All other terms and conditions of the Policy remain unchanged. Material used with permission of ISO Properties, Inc. G-140331-D (Ed. 01/13) Page 2 of 2 Copyright,CNA All Rights Reserved. G-18652-J cNA (Ed. 07-12) CONTRACTORS'GENERAL LIABILITY EXTENSION ENDORSEMENT It is understood and agreed that this endorsement amends the COMMERCIAL GENERAL LIABILITY COVERAGE PART as follows. The changes this endorsement makes do not apply with respect to any coverage that has been excluded or amended by another endorsement attached to this policy. SCHEDULE Coverage is summarized below. For particulars and limitations affecting each coverage, please refer to the corresponding policy provisions in the body of this endorsement. 1. Additional Insureds Seven additional insured extensions. 2. Bodily Injury—Expanded Definition 3. Broad Knowledge of Occurrence/ Notice of Occurrence 4. Broad Named Insured 5. Broadened Liability Coverage For Damage To "Your Product"And "Your Work" Limit: $100,000. 6. Contractual Liability—Railroads Expanded definition of"insured contract." 7. Contractual Liability For Personal And Advertising Injury 8. Electronic Data Liability Loss of Electronic Data Limit: $100,000. 9. Expanded Personal And Advertising Injury - Discrimination Or Humiliation 10. Expected Or Intended Injury Reasonable force —"bodily injury" or"property damage." 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 Coverage for your interest in such terminated or ended organizations. 15. Legal Liability/Alienated Premises/Borrowed Equipment Coverage Extended perils. Default limit increased to$500,000 for Damage to Premises Rented To You. $25,000 limit for"property damage"to borrowed tools or equipment at a jobsite. 16. Liberalization Clause 17. Liquor Liability Coverage Extension 18. Medical Payments Limits increased to $15,000. Reporting increased to three years from the date of accident. 19. Non-owned Aircraft Coverage 20. Non-owned Watercraft Increased to 75 feet. 21. Primary And Non-Contributory To Other Insurance 22. Property Damage - Elevators 23. Supplementary Payments Cost of bail bonds increased to $5,000. Daily loss of earnings increased to $1,000. 24. Unintentional Failure To Disclose Hazards 25. Waiver of Subrogation -Blanket Waiver of subrogation where required by written contract or written agreement. 26. Wrap-Up Extension G-18652-J (Ed. 07-12) Page 1 of 12 Copyright.CNA All Rights Reserved. PDF created with pdfFactory Pro trial version G-18652-J CNA (Ed. 07-12) 1. ADDITIONAL INSURED 2. With respect to the insurance afforded to these additional insureds, this insurance SECTION II —WHO IS AN INSURED is amended does not apply to any "occurrence" which to include as an insured any person or organization takes place after the equipment lease (called additional insured) described in paragraphs expires. A.through G. below whom you are required to add as an additional insured on this policy under a D. Lessor- Land written contract or written agreement, provided the An owner or other interest from whom land has written contract or written agreement: been leased by you but only with respect to i. Is currently in effect or becomes effective liability arising out of the ownership, during the term of this policy; and maintenance or use of that specific part of the land leased to you and subject to the following ii. Was executed prior to the "bodily injury," additional exclusions: "property damage" or "personal injury and advertising injury" for which the additional This insurance does not apply to: insured seeks coverage. 1. Any "occurrence" which takes place after However, we will not provide the additional you cease to lease that land; or insured any broader coverage or any higher 2. Structural alterations, new construction or limit of insurance than the least that is: demolition operations performed by or on a. The maximum permitted by law; behalf of such additional insured. b. Required in the written contract or written E. Lessor- Premises agreement; A manager or lessor of premises but only with c. Afforded to you under this policy; or respect to liability arising out of the ownership, maintenance or use of that specific part of the d. Described in the applicable paragraphs A. premises leased to you and subject to the through G. below. following additional exclusions: A. Controlling Interest This insurance does not apply to: Any persons or organizations with a controlling 1. Any "occurrence" which takes place after interest in you but only with respect to their you cease to be a tenant in that premises; liability arising out of: or 1. Their financial control of you; or 2. Structural alterations, new construction or 2.. Premises they own, maintain or control demolition operations performed by or on while you lease or occupy these premises. behalf of such additional insured. This insurance does not apply to structural F. Mortgagee, Assignee or Receiver alterations, new construction and demolition A mortgagee, assignee or receiver but only with operations performed by or for such additional respect to their liability as mortgagee, assignee, insured. or receiver and arising out of the ownership, B. Co-owner of Insured Premises maintenance, or use of a premises by you. A co-owner of a premises co-owned by you and This insurance does not apply to structural covered under this insurance but only with alterations, new construction or demolition respect to the co owner's liability as co-owner operations performed by or for such additional of such premises. insured. C. Lessor- Equipment G. State or Governmental Agency or Subdivision or Political Subdivisions 1. Any person or organization from whom you lease equipment, but only with respect to A stale or governmental agency or subdivision liability for "bodily injury," "property or political subdivision subject to the following damage" or "personal and advertising provisions. injury" caused, in whole or in part, by your 1. This insurance applies only with respect to maintenance, operation or use of the following hazards for which the state or equipment leased to you by such person or governmental agency or subdivision or organization. political subdivision has issued a permit or G-18652-J (Ed. 07-12) Page 2 of 12 Copyright:CNA All Rights Reserved. PDF created with pdfFactory Pro trial version G-18652-J C'NA (Ed. 07-12) • authorization in connection with premises A. BROAD KNOWLEDGE OF OCCURRENCE you own, rent, or control and to which this insurance applies: You must give us or our authorized representative notice of an "occurrence," a. The existence, maintenance, repair, offense, claim, or "suit" only when the construction, erection, or removal of "occurrence," offense, claim or "suit" is known advertising signs, awnings, canopies, to: cellar entrances, coal holes, driveways, manholes, marquees, hoistaway (1) You, if you are an individual; openings, sidewalk vaults, street (2) A partner, if you are a partnership; banners, or decorations and similar exposures; or (3) An executive officer or the employee designated by you to give such notice, if b. The construction, erection, or removal you are a corporation; or of elevators; or (4) A manager, if you are a limited liability c. The ownership, maintenance or use of company. any elevators covered by this insurance B. NOTICE OF OCCURRENCE 2. This insurance applies only with respect to Your rights under this Coverage Part will not be operations performed by you or on your prejudiced if you fail to give us notice of an behalf for which the state or governmental "occurrence," offense, claim or"suit" and that agency or subdivision or political failure is solely due to your reasonable belief subdivision has issued a permit or that the"bodily injury" or "property damage" is authorization. not covered under this Coverage Part. However, you shall give written notice of this 3. This insurance does not apply to: "occurrence," offense, claim or"suit" to us as a. "Bodily injury," "property damage" or soon as you are aware that this insurance may "personal and advertising injury" arising apply to such "occurrence,"offense claim or out of operations performed for the "suit '' federal government, state or 4. BROAD NAMED INSURED municipality; or A. Any subsidiary or affiliate organization, other b. "Bodily injury" or "property damage" than a partnership, joint venture or limited included within the "products- liability company, in which a Named Insured completed operations hazard." specifically shown in the Declarations has A governmental permit which requires you to management control, directly or through one or add the governmental entity as an additional more subsidiary organizations, at the time of insured will trigger this Provision 1. as if the loss will qualify as a Named Insured but only if permit were a written contract. there is no other similar insurance available to such organization, nor similar insurance which 2. BODILY INJURY— EXPANDED DEFINITION would be available but for exhaustion of its SECTION V DEFINITIONS, the definition of limits. For the purpose of this provision, similar insurance means general liability or equivalent "bodily injury" is changed to read: insurance, no matter whether its coverage is "Bodily injury" means bodily injury, sickness or broader or narrower than that provided by this disease sustained by a person, including death, insurance. But if the only other similar humiliation, shock, mental anguish or mental injury insurance is for a "consolidated (wrap-up) by that person al any time which results as a program," then a subsidiary that qualifies as a consequence of the bodily injury, sickness or Named Insured on such project-specific disease. insurance can still qualify as a Named Insured on this insurance, but not for projects covered 3. BROAD KNOWLEDGE OF OCCURRENCE/ by the"consolidated (wrap-up) program." NOTICE OF OCCURRENCE [Please see Item 26.C.of this endorsement for Condition 2. Duties in The Event of Occurrence, the definition of"consolidated (wrap-up) Offense, Claim or Suit of SECTION IV— program."] COMMERCIAL GENERAL LIABILITY CONDITIONS is amended to add the following provisions. G-18652-J (Ed 07-12) Page 3 of 12 Copyright:CNA All Rights Reserved. PDF created with pdfFactory Pro trial version G-18652-J CNA (Ed. 07-12) B. This endorsement does not apply to any (1) Fire; organization for which coverage is excluded by another endorsement attached to this policy. (2) Smoke; C. Only for the purpose of this endorsement: (3) Collapse; or 1. Management control means: (4) Explosion. a. Ownership interest representing more I. Damage to Your Work than 50% of the voting, appointment, or "Property damage"to"your work" arising out of designation power for the subsidiary it, or any part of it and included in the organization's governing body; or "products-completed operations hazard." b. Having the right, pursuant to a written This exclusion does not apply: contract, or pursuant to the by-laws, charter, operating agreement, or similar (1) If the damaged work or the work out of document of a specifically shown which the damage arises was Named Insured or controlled subsidiary performed on your behalf by a organization to select, appoint, or subcontractor; or designate a majority of the subsidiary (2) If the cause of loss to the damaged organization's governing body. Such work arises as a result of: contract or document must have been created prior to the time of loss; or (a) Fire; c. Having the right, pursuant to a written (b) Smoke; trust agreement, to protect, control the (c) Collapse; or use of, encumber or transfer and sell property held by a trust. (d) Explosion. 2. Governing body means the Board of B. The following paragraph is added to SECTION Directors of a corporation. III—LIMITS OF INSURANCE: 3. Loss means: Subject to 5. above, $100,000 is the most we will pay under Coverage A for the sum of a. The occurring of the "bodily injury" or damages arising out of any one"occurrence" "property damage"; or because of"property damage"to "your product" b. The committing of the offense that and"your work"that is caused by fire, smoke, caused the "personal and advertising collapse or explosion and is included within the injury." "product-completed operations hazard." This sublimit does not apply to"property damage" to D. The insurance provided by this policy applies to "your work" if the damaged work or the work out Named Insureds when trading under their own of which the damage arises was performed on names, or under such trading names or doing- your behalf by a subcontractor. business-as (DBA) names as any should choose to employ. C. This Provision 5. Broadened Liability 5. BROADENED LIABILITY COVERAGE FOR Coverage For Damage To "Your Product" And "Your Work" does not apply if an DAMAGE TO "YOUR PRODUCT" AND "YOUR endorsement of the same name is attached to WORK" this policy. A. Under SECTION I — COVERAGE A— BODILY 6. CONTRACTUAL LIABILITY —RAILROADS INJURY AND PROPERTY DAMAGE LIABILITY, Paragraph 2. Exclusions is With respect to operations performed within 50 feet amended to delete exclusions k. and I. and of railroad property, the definition of"insured replace them with the following: contract" in SECTION V DEFINITIONS is replaced by the following: [This insurance does not apply to:] "Insured Contract" means: k. Damage to Your Product a. A contract for a lease of premises. However, "Property damage"to"your product" arising that portion of the contract for a lease of out of it, or any part of it except when premises that indemnifies any person or caused by or resulting from: organization for damage by fire to premises while rented to you or temporarily occupied by G-18652-J (Ed 07-12) Page 4 of 12 Copyright:CNA All Rights Reserved. PDF created with pdfFactory Pro trial version CNA G-18652-J • (Ed. 07-1212 ) you with permission of the owner is not an exclusion p. Electronic Data and replace it "insured contract"; with the following: b. A sidetrack agreement; [This insurance does not apply to:I c. Any easement or license agreement; p. Electronic Data d. An obligation, as required by ordinance, to Damages arising out of the loss of, loss of use indemnify a municipality, except in connection of, damage to, corruption of, inability to access, with work for a municipality; or inability to manipulate "electronic data" that does not result from physical injury to tangible e. An elevator maintenance agreement; property. f. That part of any other contract or agreement pertaining to However, this exclusion does not apply to g your business (including an liability for damages because of"bodily injury." indemnification of a municipality in connection with work performed for a municipality) under B. The following paragraph is added to SECTION which you assume the tort liability of another III —LIMITS OF INSURANCE: party to pay for "bodily injury" or "property Subject to 5. above, $100,000 is the most we damage" to a third person or organization. Tort will pay under Coverage A for all damages liability means a liability that would be imposed arising out of any one"occurrence" because of by law in the absence of any contract or "property damage"that results from physical agreement. injury to tangible property and arises out of Paragraph f. does not include that part of any "electronic data." contract or agreement: C. The following definition is added to the (1) That indemnifies an architect, engineer or SECTION V— DEFINITIONS: surveyor for injury or damage arising out of: "Electronic data" means information, facts or (a) Preparing, approving or failing to programs stored as or on, created or used on, prepare or approve maps, shop or transmitted to or from computer software drawings, opinions, reports, surveys, (including systems and applications software), field orders, change orders or drawings hard or floppy disks, CD-ROMS, tapes, drives, and specifications; or cells, data processing devices or any other (b) Giving directions or instructions, or media which are used with electronically controlled equipment. failing to give them, if that is the primary cause of the injury or damage; D. For the purposes of the coverage provided by (2) Under which the insured, if an architect, this endorsement, the definition of "property damage" in SECTION V — DEFINITIONS is engineer or surveyor, assumes liability for replaced by the following: an injury or damage arising out of the insured's rendering or failure to render 17. "Property damage" means: professional services, including those listed in (1) above and supervisory, inspection, a. Physical injury to tangible property, architectural or engineering activities. including all resulting loss of use of that property. All such loss of use shall be 7. CONTRACTUAL LIABILITY FOR PERSONAL deemed to occur at the time of the AND ADVERTISING INJURY physical injury that caused it; Under SECTION I— COVERAGE B—PERSONAL b. Loss of use of tangible property that is AND ADVERTISING INJURY LIABILITY, not physically injured. All such loss of Paragraph 2. Exclusions is amended to delete use shall be deemed to occur at the exclusion e. Contractual Liability time of the "occurrence" that caused it; This provision 7. does not apply to any person or or organization who otherwise qualifies as an c. Loss of, loss of use of, damage to, additional insured on this Coverage Part. corruption of, inability to access, or 8. ELECTRONIC DATA LIABILITY inability to properly manipulate "electronic data," resulting from A. Under SECTION I — COVERAGE A— BODILY physical injury to tangible property. All INJURY AND PROPERTY DAMAGE, such loss of "electronic data" shall be Paragraph 2. Exclusions is amended to delete G-18652-J (Ed 07-12) Page 5 of 12 Copyright:CNA All Rights Reserved. PDF created with pdfFactory Pro trial version G-18652-J CNA (Ed. 07-12) deemed to occur at the time of the This provision 9. does not apply to any person "occurrence" that caused it. or organization who otherwise qualifies as an For the purposes of this insurance, additional insured on this Coverage Part. "electronic data" is not tangible property. 10. EXPECTED OR INTENDED INJURY E. If Electronic Data Liability is provided at a Under SECTION I—COVERAGE A— BODILY higher limit by another endorsement attached INJURY AND PROPERTY DAMAGE to this policy, then the $100,000 limit provided LIABILITY, Paragraph 2. Exclusions is by this Provision 8. Electronic Data Liability is amended to delete exclusion a. Expected or part of, and not in addition to, that higher limit. Intended Injury and replace it with the 9. EXPANDED PERSONAL AND ADVERTISING following: INJURY -DISCRIMINATION OR HUMILIATION [This insurance does not apply to:] A. SECTION V — DEFINITIONS is amended to a. Expected or Intended Injury add the following to the definition of "Personal and advertising injury": "Bodily injury" or "property damage" expected or intended from the standpoint of h. Discrimination or humiliation that results in the insured_ This exclusion does not apply injury to the feelings or reputation of a to"bodily injury" or"property damage" natural person, but only if such resulting from the use of reasonable force discrimination or humiliation is: to protect persons or property. (1) Not done intentionally by or at the 11. GENERAL AGGREGATE LIMITS OF direction of: INSURANCE -PER PROJECT (a) The insured; or A. For each construction project away from (b) Any "executive officer," director, premises you own or rent, a separate stockholder, partner, member or Construction Project General Aggregate manager (if you are a limited Limit, equal to the amount of the General liability company) of the insured; Aggregate Limit, is the most we will pay for and the sum of. (2) Not directly or indirectly related to the 1. All damages under Coverage A, except damages because of "bodily injury" or employment, prospective employment, past employment or termination of "property damage" included in the "products-completed operations employment of any person or persons hazard"; and by any insured. B. Under SECTION I — COVERAGE B — 2. All medical expenses under Coverage PERSONAL AND ADVERTISING INJURY C, LIABILITY, Paragraph 2. Exclusions is that arise from "occurrences" or amended to add the following additional accidents which can be attributed solely exclusions: to ongoing operations at that construction project. Such payments [This insurance does not apply to.] shall not reduce the General Aggregate Discrimination Relating To Room, Limit shown in the Declarations, nor the Dwelling or Premises Construction Project Aggregate Limit of any other construction project. "Personal or advertising injury" caused by discrimination directly or indirectly related B. All: to the sale, rental, lease or sub-lease or prospective sale, rental, lease or sub lease 1. Damages under Coverage B, regardless of the number of locations or construction of any room, dwelling or premises by or at projects involved; the direction of any insured. Fines Or Penalties 2. Damages under Coverage A, caused by "occurrences" which cannot be attributed Fines or penalties levied or imposed by a solely to ongoing operations at a single governmental entity because of construction project, except damages discrimination. because of "bodily injury" or "property G-18652-J (Ed. 07-12) Page 6 of 12 Copyright,CNA All Rights Reserved. PDF created with pdfFactory Pro trial version G-18652-J cWA (Ed. 07-12) damage" included in the "products- Paragraphs 1.b.(1) and 1.b.(2) with the completed operations hazard"; and following. 3. Medical expenses under Coverage C b. This insurance applies to "bodily injury" caused by accidents which cannot be only if you are not in the business of attributed solely to ongoing operations at a providing professional health care services, single construction project, and only if. will reduce the General Aggregate Limit shown (1) The "bodily injury" is caused by an in the Declarations. "occurrence" that takes place in the C. The limits shown in the Declarations for Each "coverage territory." For the purpose of this insurance: Occurrence, for Damage To Premises Rented To You and for Medical Expense continue to (a) "Bodily injury" caused by a "health apply, but will be subject to either the care incident" will be considered Construction Project Aggregate Limit or the caused by an "occurrence"; and General Aggregate Limit, depending on whether the "occurrence" can be attributed (b) All acts, errors or omissions that solely to ongoing operations at a particular are logically connected by any construction project. common fact, circumstance, situation, transaction, event, advice D. When coverage for liability arising out of the or decision will be considered to "products-completed operations hazard" is constitute a single"occurrence"; provided, any payments for damages because of "bodily injury" or "property damage" included (2) The "bodily injury" occurs during the in the "products-completed operations hazard," policy period. All "bodily injury" arising regardless of the number of locations involved from an "occurrence" will be deemed to will reduce the Products-Completed Operations have occurred at the time of the first Aggregate Limit shown in the Declarations act, error, or omission that is part of the "occurrence"; and E. If a single construction project away from B. With respect only to the insurance provided by premises owned by or rented to the insured has this Provision 13., Exclusion 2.e. Employer's been abandoned and then restarted, or if the Liability of SECTION I — COVERAGE A — authorized contracting parties deviate from BODILY INJURY AND PROPERTY DAMAGE, plans, blueprints, designs, specifications or timetables, the project will still be deemed to be is amended to append the following. the same construction project. Only for "bodily injury" not covered by other F. The provisions of SECTION III — LIMITS OF liability insurance (including state sanctioned INSURANCE not otherwise modified by this self insurance) available to the insured (or endorsement shall continue to apply as which would be available but for exhaustion of stipulated. its limits), this exclusion does not apply to "bodily injury" that arises out of a "health care 12. IN REM ACTIONS incident." Any action in rem against any vessel owned or C. SECTION V — DEFINITIONS is amended to operated by or for you, or chartered by or for you add the following new definition: will be treated in the same manner as though the 'Health care incident" means a negligent act, action were in personam against you error or omission by your "employees" or In rem is a term used to designate actions instituted "volunteer workers" working on your behalf in against the thing, as distinct from actions against the rendering of or failure to render professional the person, which are said to be in personam health care services in any of the following 13. INCIDENTAL HEALTH CARE MALPRACTICE capacities, or the related furnishing of food, COVERAGE beverages, medical supplies or appliances: A. With respect only to "bodily injury" that arises a. Physician; out of a "health care incident," COVERAGE A— b. Nurse; BODILY INJURY AND PROPERTY DAMAGE c. Emergency medical technician; LIABILITY OF SECTION I — COVERAGES is amended to replace Insuring Agreement d. Paramedic; e. Chiropractor; G-18652-J (Ed. 07-12) Page 7 of 12 Copyright CNA All Rights Reserved. PDF created with pdfFactory Pro trial version G-18652-J 'CNA (Ed 07-12) • f. Dentist; employment by you or while performing g. Athletic trainer; duties related to the conduct of your business; and h. Audiologist; b. "bodily injury" to a "volunteer worker" i. Physical therapist; while performing duties related to the j. Psychologist; conduct of your business; when such "bodily injury" arises out of a k. Speech therapist; "health care incident." I. Other allied health professional; or 2. Your "volunteer workers" are insureds with m. Provider of first aid or Good Samaritan respect to: services rendered in an emergency and for a. "bodily injury" to a co-"volunteer which no payment is demanded or worker" while performing duties related received. to the conduct of your business; and D. SECTION I — COVERAGE A — BODILY b. "bodily injury" to an "employee"while in INJURY AND PROPERTY DAMAGE, the course of the "employee's" Paragraph 2. Exclusions is amended to add the employment by you or while performing following additional exclusions. These new duties related to the conduct of your exclusions apply only to this Incidental Health business; Care Malpractice Coverage: when such "bodily injury" arises out of a [This insurance does not apply to.] "health care incident." Dishonesty or Crime 3. Paragraphs 2.a. (1)(a), (b) and (c) of Any dishonest, criminal or malicious act, error SECTION II — WHO IS AN INSURED do or omission. not apply to "bodily injury" for which insurance is provided this Provision 13. Clinical Trials/Product Testing 4. Paragraph 2.a.(1)(d) of SECTION II — Acts, errors or omissions that occur in the WHO IS AN INSURED is deleted. course of human clinical trials or product testing. G. With respect to the insurance provided by this Provision 13., the following is added to Medicare/Medicaid Fraud Paragraph 4.b.(1) of SECTION IV — Medicare or Medicaid fraud or abuse. COMMERCIAL GENERAL LIABILITY CONDITIONS: Services Excluded by Endorsement To the extent this insurance applies, it is excess Any "health care incident"for which coverage is over any of the other insurance (including excluded by endorsement. qualified self insurance), whether primary, E. SECTION V — DEFINITIONS is amended to excess, contingent or on any other basis, except for insurance purchased specifically by add the following subparagraph to Paragraph f. you to be excess of this policy. of the definition of"insured contract": Paragraph f. does not include that part of any 14. JOINT VENTURES / PARTNERSHIP / LIMITED contract or agreement: LIABILITY COMPANIES (4) Under which you assume another's tort A. The following is added to SECTION II — WHO IS AN INSURED: liability for "bodily injury" arising out of the rendering of or failure to render 4. You are an insured when you had an professional health care services. interest in a joint venture, partnership or F. SECTION II — WHO IS AN INSURED is limited liability company which terminated amended to add the following provisions: or ended prior to or during this policy period, but only to the extent of your 1. Your "employees" are insureds with respect interest in such joint venture, partnership or to: limited liability company. This coverage a. "bodily injury" to a co-"employee" while does not apply: in the course of the co-"employee's" G-18652-J (Ed. 07-12) Page 8 of 12 Copyright,CNA All Rights Reserved. PDF created with pdfFactory Pro trial version G-18652-J ' WA (Ed. 07-12) a. Prior to the termination date of any joint (6) That particular part of any property that venture, partnership or limited liability must be restored, repaired or replaced company; because "your work" was incorrectly b. If there is other valid and collectible performed on it. insurance purchased specifically to Paragraph (2) of this exclusion does not insure the partnership, joint venture or apply if the premises are "your work." limited liability company; or Paragraphs (3) and (4) of this exclusion do c. To a joint venture, partnership or not apply to "property damage" to tools or limited liability company which is or equipment loaned to you A separate limit was insured under a "consolidated of insurance applies to such tools or (wrap-up) insurance program." equipment that are damaged while being [Please see Item 26.C. of this endorsement used in your operations. for the definition of "consolidated (wrap-up) Paragraphs(1), (3) and (4) of this exclusion program."] do not apply to "property damage" (other B. The last paragraph of SECTION II — WHO IS than damage by fire) to premises rented to AN INSURED is deleted and replaced by the You or temporarily occupied by you with the permission of the owner, or to the contents following: of premises rented to you for a period of 7 Except as provided under the Contractors' or fewer consecutive days. A separate limit General Liability Extension Endorsement or by of insurance applies to Damage To the attachment of another endorsement (if any), Premises Rented To You as described in no person or organization is an insured with SECTION III—LIMITS OF INSURANCE. respect to the conduct of any current or past partnership, joint venture or limited liability Paragraphs (3), (4), (5) and (6) of this exclusion do not apply to liability assumed company that is not shown as a Named Insured under a sidetrack agreement. in the Declarations. Paragraph (6) of this exclusion does not 15. LEGAL LIABILITY/ALIENATED PREMISES/ apply to "property damage" included in the BORROWED EQUIPMENT "products-completed operations hazard " A. Under SECTION I — COVERAGE A— BODILY B. Under SECTION I — COVERAGE A — BODILY INJURY AND PROPERTY DAMAGE, INJURY AND PROPERTY DAMAGE the last Paragraph 2. Exclusions is amended to delete paragraph of Paragraph 2. Exclusions is exclusion j. Damage to Property in its entirety deleted and replaced by the following. and replace it with the following: [This insurance does not apply to:] Exclusions c. through n. do not apply to damage by fire to premises while rented to you j. Damage to Property or temporarily occupied by you with permission "Property damage"to of the owner nor to the contents of premises p Y g rented to you for a period of 7 or fewer (1) Property you own, rent, or occupy; consecutive days. (2) Premises you sell, give away or A separate limit of insurance applies to this abandon, if the "property damage" coverage as described in SECTION III — arises out of any part of those LIMITS OF INSURANCE. premises; C. The following paragraph is added to SECTION (3) Property loaned to you; III— LIMITS OF INSURANCE: (4) Personal property in the care, custody Subject to 5. above, $25,000 is the most we will or control of the insured; pay under Coverage A for damages arising out of any one "occurrence" because of "property (5) That particular part of real property on damage" to tools or equipment loaned to you which you or any contractors or by others that occurs while the equipment is subcontractors working directly or being used to perform operations. indirectly on your behalf are performing operations, if the "property damage" D. Paragraph 6. Damage To Premises Rented To arises out of those operations; or You Limit of SECTION III — LIMITS OF INSURANCE is replaced by the following: G-18652-J (Ed. 07-12) Page 9 of 12 Copyright,CNA All Rights Reserved. PDF created with pdfFactory Pro trial version G-18652-J CNA (Ed. 07-12) 6. Subject to Paragraph 5. above, (the Each SECTION — I — COVERAGE C for all Occurrence Limit), the Damage To medical expenses because of "bodily Premises Rented To You Limit is the most injury" sustained by any one person. The we will pay under SECTION — I — Medical Expense Limit is the greater of: COVERAGE A for damages because of "property damage" to any one premises (1) $15,000; or while rented to you or temporarily occupied (2) The amount shown in the Declarations by you with the permission of the owner, for Medical Expense Limit. including contents of such premises rented to you for a period of 7 or fewer B. Paragraph 1.a.(3)(b) of SECTION I — consecutive days. The Damage To COVERAGE C MEDICAL PAYMENTS, is Premises Rented To You Limit is the replaced by the following: greater of: (b) The expenses are incurred and reported to a. $500,000; or us within three years of the date of the accident; and b. The Damage To Premises Rented To You Limit shown in the Declarations. This paragraph B. does not apply to medical expenses incurred in the state of Missouri. E. Paragraph 4.b.(1)(a)(ii) of SECTION IV — COMMERCIAL GENERAL LIABILITY 19. NON-OWNED AIRCRAFT CONDITIONS is deleted and replaced by the Under SECTION I—COVERAGE A— BODILY following: INJURY AND PROPERTY DAMAGE LIABILITY. (ii) That is property insurance for premises Paragraph 2. Exclusions is amended such that rented to you, for premises temporarily exclusion g.Aircraft, Auto or Watercraft does not occupied by you with the permission of the apply to an aircraft you do not own, provided that: owner; or for personal property of others in 1. The pilot in command holds a currently your care, custody or control; effective certificate issued by the duly F. This Provision 15. does not apply if Damage To constituted authority of the United States of Premises Rented To You Liability under America or Canada, designating that person as SECTION — I — COVERAGE A is excluded by a commercial or airline transport pilot; endorsement. 2. The aircraft is rented to you with a trained, paid 16. LIBERALIZATION CLAUSE crew; and If we adopt a change in our forms or rules which 3. The aircraft does not transport persons or cargo would broaden coverage for contractors under this for a charge. endorsement without an additional premium 20. NON-OWNED WATERCRAFT charge, your policy will automatically provide the additional coverage as of the date the revision is Under SECTION I—COVERAGE A— BODILY effective in your state. INJURY AND PROPERTY DAMAGE LIABILITY, Paragraph 2. Exclusions is amended to delete 17. LIQUOR LIABILITY subparagraph (2)of exclusion g. Aircraft, Auto or Under SECTION I—COVERAGE A— BODILY Watercraft and replace it with the following. INJURY AND PROPERTY DAMAGE, Paragraph 2. [This exclusion does not apply to:] Exclusions is amended to delete exclusion c. Liquor Liability. (2) A watercraft you do not own that is. This provision 17. does not apply to any person or (a) Less than 75 feet long; and organization who otherwise qualifies as an additional insured on this Coverage Part. (b) Not being used to carry persons or property for a charge. 18. MEDICAL PAYMENTS 21. PRIMARY AND NON-CONTRIBUTORY TO A. Paragraph 7. Medical Expense Limit, of OTHER INSURANCE SECTION III — LIMITS OF INSURANCE is With respect to any person or organization that is deleted and replaced by the following: an additional insured under this Coverage Part, the 7. Subject to Paragraph 5. above (the Each following is added to Paragraph 4. of SECTION IV Occurrence Limit), the Medical Expense —COMMERCIAL GENERAL LIABILITY Limit is the most we will pay under CONDITIONS: G-18652-J (Ed. 07-12) Page 10 of 12 Copyright:CNA All Rights Reserved. PDF created with pdfFactory Pro trial version G-18652-J ti WA (Ed. 07-12) If you have agreed in writing in a contract or 25. WAIVER OF SUBGROGATION -BLANKET agreement that this insurance is primary and non Under SECTION IV—COMMERCIAL GENERAL contributory relative to an additional insured's own LIABILITY CONDITIONS, The Transfer Of Rights insurance, then this insurance is primary and we Of Recovery Against Others To Us Condition is will not seek contribution from that other insurance. For the purpose of this Provision 21., the additional amended by the addition of the following: insured's own insurance means insurance on which We waive any right of recovery we may have the additional insured is a Named Insured. against any person or organization because of This Provision 21. does not apply in situations payments we make for injury or damage arising out where the endorsement on this policy affording of: coverage to the additional insured specifies that 1. Your ongoing operations; or this insurance is excess over any other insurance available to that additional insured. 2. "Your work" included in the "products completed operations hazard." 22. PROPERTY DAMAGE—ELEVATORS However, this waiver applies only when you have A. Under SECTION I — COVERAGE A — BODILY agreed in writing to waive such rights of recovery in INJURY AND PROPERTY DAMAGE, a contract or agreement, and only if the contract or Paragraph 2. Exclusions is amended such that agreement: exclusion k. Damage to Your Product, and subparagraph (3), (4) and (6) of exclusion j. 1. Is in effect or becomes effective during the Damage to Property do not apply "property term of this policy; and damage"that results from the use of elevators. 2. Was executed prior to loss. B. With respect only to the coverage provided by 26. WRAP-UP EXTENSION: OWNER CONTROLLED this endorsement, Condition 4. Other INSURANCE PROGRAM, CONTRACTOR Insurance in SECTION IV — COMMERCIAL CONTROLLED INSURANCE PROGRAM OR GENERAL LIABILITY CONDITIONS is CONSOLIDATED (WRAP-UP) INSURANCE amended to add the following subparagraph PROGRAMS b.(1)(a)(v): Note: The following provision does not apply to any 4. Other Insurance public construction project in the state of b. Excess Insurance Oklahoma, nor to any construction project in the state of Alaska, that is not permitted to be insured (1) This insurance is excess over: under a"consolidated (wrap-up)insurance (a) Any of the other insurance, program" by applicable state statute or regulation: whether primary, excess, If the endorsement EXCLUSION — contingent or on any other CONSTRUCTION WRAP-UP or another basis: exclusionary endorsement pertaining to Owner (v) That is Property insurance Controlled Insurance Programs(O.C.I.P.) or covering property of others Contractor Controlled Insurance Programs damaged from the use of (C.C.I.P.) is attached to this policy, then the elevators. following changes apply: 23. SUPPLEMENTARY PAYMENTS A. The following wording is added to the endorsement: A. Under Section I — Supplementary Payments —Coverages A and B, Paragraph 1.b., the limit With respect to a"consolidated (wrap-up) of $250 shown for the cost of bail bonds is insurance program" project in which you are or replaced by $5,000. were involved, this exclusion does not apply to those sums you become legally obligated to B. In Paragraph 1.d., the limit of $250 shown for pay as damages because of: daily loss of earnings is replaced by$1,000 1. "Bodily injury," "property damage," or 24. UNINTENTIONAL FAILURE TO DISCLOSE "personal or advertising injury" that occurs HAZARDS during your ongoing operations at the If unintentionally you should fail to disclose all project, or during such operations of existing hazards at the inception date of your anyone acting on your behalf; nor policy, we will not deny coverage under this 2. "Bodily injury" or "property damage" Coverage Part because of such failure included within the "products-completed G-18652-J (Ed. 07-12) Page 11 of 12 Copyright:CNA All Rights Reserved. PDF created with pdfFactory Pro trial version G-18652-J r•CNA (Ed. 07-12) operations hazard" that arises out of those involved in the project, such as an Owner portions of the project that are not Controlled Insurance Program (O.C.I.P.)or "residential structures." Contractor Controlled Insurance Program B. SECTION IV — COMMERCIAL GENERAL (C.C.I.P.). LIABILITY CONDITIONS is amended to add "Residential structure" means any structure the following subparagraph 4.b.(1)(c) to where 30% or more of the square foot area is Condition 4. Other Insurance: used or is intended to be used for human [This insurance is excess over:] residency including but not limited to single or multifamily housing, apartments, (c) Any of the other insurance whether primary, condominiums, townhouses, co-operatives or excess, contingent or any other basis that is planned unit developments and also includes insurance available to you as a result of their common areas and/or appurtenant your being a participant in a "consolidated structures (including pools, hot tubs, detached (wrap-up) insurance program," but only as garages, guest houses or any similar respects your involvement in that structures). When there is no individual "consolidated (wrap-up) insurance ownership of units, residential structure does program." not include military housing, college/university C. SECTION V — DEFINITIONS is amended to housing or dormitories, long term care facilities, hotels, or motels. Residential structure also add the following definition: does not include hospitals or prisons. "Consolidated (wrap-up) insurance program" This provision 26. does not apply to any person means a construction, erection or demolition or organization who otherwise qualifies as an project for which the prime contractor/project additional insured on this Coverage Part. manager or owner of the construction project has secured general liability insurance covering some or all of the contractors or subcontractors 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. Material used with permission of ISO Properties, Inc G-18652-J (Ed. 07-12) Page 12 of 12 Copyright:CNA All Rights Reserved. PDF created with pdfFactory Pro trial version 3/21/2014 1:39:31 PM PST (GMT-8) FROM: 100005-TO: 14088460429 Page: 2 of 16 ACc 1® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/D0/YYYY)3/21/2014 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). g CONTACT PRODUCER Arthur J. Galla her&Co. Insurance Brokers NAME: of California, Inc. PHONE FAX 3697 Mt. Diablo Blvd., Suite 300 wC.No.EMI 925-299-1112 (A/C.No) 925-299-0328 Lafayette, CA 94549 A ADD ADDRESS INSURER(S)AFFORDING COVERAGE NAIC N www.ajg.com 0726293 INSURER A: National Fire Ins. Co.of Hartford 20478 INSURED INSURER: American Casualty Company of Reading, PA 20427 FBD Vanguard Construction, Inc. dba:Vanguard Construction ,INSURER: Fireman's Fund Insurance Company 21873 651 Enterprise Ct. INSURER D: Zurich American Insurance Co. 16535 Livermore, CA 94550-5200 INSURER: INSURER F COVERAGES CERTIFICATE NUMBER: 19561238 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADOL SUBR POLICY EFF POLICY EXP LTR INSO WVD POLICY NUMBER (MM/DO/YYYY) (MM/DD/YYYY) LIMITS A , COMMERCIAL GENERAL LIABILITY 4014291109 3/25/2014 3/25/2015 EACH OCCURRENCE $ 2,000,000 CLAIMS-MADE / OCCUR DAMAGE TO RENTED 100,000 PREMISES(Ea ocwn•ence) $ 1 XCU Included MED EXP(Any one person) $ 5,000 ./ Contractural Liab PERSONAL&ADV INJURY •$ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ 4,000,000 POLICY[ 1 PRO I I 4,000,000 JECT I 'LOG PRODUCTS-COMP/OP AGG $ I OTHER. Deductible $ $5,000 B AUTOMOBILE LIABLITY 4013610249 3/25/2014 3/25/2015 COMBINED SINGLE LIMIT '$ form CA 0001 03 06 (Ea accident) 1,000,000 J ANY AUTO BODILY INJURY(Per person) •$ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ _ AUTOS ^_ AUTOS J HIRED AUTOS I NON-OWNED PROPERTY DAMAGE •$ AUTOS (Per accident) , $ C UMBRELLA LAB J OCCUR SSE24402497 3/25/2014 3/25/2015 EACH OCCURRENCE -$ 10,000,000 / EXCESS LIAR CLAIMS-MADE AGGREGATE $ 10,000,000 DEC /I RETENTION$0 $ D WORKERS COMPENSATION WC489238204 2/1/2014 2/1/2015 , IPERTUTE 1 ER AND EMPLOYERS'LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED' n N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E .DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) City of Gilroy is included as additional insured for General Liability per form G-140331-D 01/13 attached(Primary Wording Included).Waiver of Subrogation applies for General Liability per form G-18652-J 07-12 attached. The above Additional Insured, Primary Wording and Waiver of Subrogation Endorsements are only valid if requested by written contract. VG986 Project:VERBS Safe Route to School-Project No 12-PW-199,Federal Project No RPSTPLE-5035(024) CERTIFICATE HOLDER CANCELLATION City of Gilroy SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Gilro Department THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 7351 Rosanna Street Gilroy CA 95020 AUTHORIZED REPRESENTATNE �• /d�°' yG'4.O I Jamie Yaudes ✓f ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD CERT NO.: 19561236 CLIENT CODE: 1997-02-03 15:55:28.803 Jame Yaudes 3/21/2014 1:37.37 PM Page 1 of 15 3/21/2014 1:39:31 PM PST (GMT-8) FROM: 100005-TO: 14088460429 Page: 3 of 16 rtsu vanguard uons[rucuon, inc. dba-Vanguard Construction G-18652-J C'NA (Ed. 07-12) 4014291109 3/21/2014 CONTRACTORS'GENERAL LIABILITY EXTENSION ENDORSEMENT It is understood and agreed that this endorsement amends the COMMERCIAL GENERAL LIABILITY COVERAGE PART as follows. The changes this endorsement makes do not apply with respect to any coverage that has been excluded or amended by another endorsement attached to this policy. SCHEDULE Coverage is summarized below. For particulars and limitations affecting each coverage, please refer to the corresponding policy provisions in the body of this endorsement. 1. Additional Insureds Seven additional insured extensions. 2. Bodily Injury— Expanded Definition 3. Broad Knowledge of Occurrence/Notice of Occurrence 4. Broad Named Insured 5. Broadened Liability Coverage For Damage To "Your Product"And "Your Work" Limit: $100,000. 6. Contractual Liability—Railroads Expanded definition of"insured contract." 7. Contractual Liability For Personal And Advertising Injury 8. Electronic Data Liability Loss of Electronic Data Limit: $100,000. 9. Expanded Personal And Advertising Injury - Discrimination Or Humiliation 10. Expected Or Intended Injury Reasonable force—"bodily injury"or"property damage." 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 Coverage for your interest in such terminated or ended organizations. 15. Legal Liability/Alienated Premises/Borrowed Equipment Coverage Extended perils. Default limit increased to$500,000 for Damage to Premises Rented To You. $25,000 limit for"property damage" to borrowed tools or equipment at a jobsite. 16. Liberalization Clause 17. Liquor Liability Coverage Extension 18. Medical Payments Limits increased to$15,000. Reporting increased to three years from the date of accident. 19. Non-owned Aircraft Coverage 20. Non-owned Watercraft Increased to 75 feet. 21. Primary And Non-Contributory To Other Insurance 22. Property Damage- Elevators 23. Supplementary Payments Cost of bail bonds increased to$5,000. Daily loss of earnings increased to$1,000. 24. Unintentional Failure To Disclose Hazards 25. Waiver of Subrogation - Blanket Waiver of subrogation where required by written contract or written agreement. 26. Wrap-Up Extension G-18652-J (Ed. 07-12) Page 1 of 12 Copyright,CNA All Rights Reserved, cREIF created with, 6iAlFactory3 Rr trral3versio Awmcedffactoryicom 2 of 15 3/21/2014 1:39:31 PM PST (GMT-8) FROM: 100005-TO: 14088460429 Page: 4 of 16 • G-18652-J CNA (Ed. 07-12) 1. ADDITIONAL INSURED 2. With respect to the insurance afforded to these additional insureds, this insurance SECTION II—WHO IS AN INSURED is amended does not apply to any "occurrence" which to include as an insured any person or organization takes place after the equipment lease (called additional insured) described in paragraphs expires. A. through G. below whom you are required to add as an additional insured on this policy under a D. Lessor- Land written contract or written agreement, provided the An owner or other interest from whom land has written contract or written agreement: been leased by you but only with respect to i. Is currently in effect or becomes effective liability arising out of the ownership, during the term of this policy; and maintenance or use of that specific part of the land leased to you and subject to the following ii. Was executed prior to the "bodily injury," additional exclusions: "property damage" or "personal injury and advertising injury" for which the additional This insurance does not apply to: insured seeks coverage. 1. Any "occurrence" which takes place after However, we will not provide the additional you cease to lease that land; or insured any broader coverage or any higher 2. Structural alterations, new construction or limit of insurance than the least that is: demolition operations performed by or on a. The maximum permitted by law; behalf of such additional insured. b. Required in the written contract or written E. Lessor - Premises agreement; A manager or lessor of premises but only with c. Afforded to you under this policy; or respect to liability arising out of the ownership, maintenance or use of that specific part of the d. Described in the applicable paragraphs A. premises leased to you and subject to the through G. below. following additional exclusions: A. Controlling Interest This insurance does not apply to: Any persons or organizations with a controlling 1. Any "occurrence" which takes place after interest in you but only with respect to their you cease to be a tenant in that premises; liability arising out of: or 1. Their financial control of you; or 2. Structural alterations, new construction or 2. Premises they own, maintain or control demolition operations performed by or on while you lease or occupy these premises. behalf of such additional insured. This insurance does not apply to structural F. Mortgagee, Assignee or Receiver alterations, new construction and demolition A mortgagee, assignee or receiver but only with operations performed by or for such additional respect to their liability as mortgagee, assignee, insured. or receiver and arising out of the ownership, B. Co-owner of Insured Premises maintenance, or use of a premises by you. A co-owner of a premises co-owned by you and This insurance does not apply to structural covered under this insurance but only with alterations, new construction or demolition respect to the co-owner's liability as co-owner operations performed by or for such additional of such premises. insured. C. Lessor-Equipment G. State or Governmental Agency or Subdivision or Political Subdivisions 1. Any person or organization from whom you lease equipment, but only with respect to A state or governmental agency or subdivision liability for "bodily injury," "property or political subdivision subject to the following damage" or "personal and advertising provisions: injury" caused, in whole or in part, by your 1. This insurance applies only with respect to maintenance, operation or use of the following hazards for which the state or equipment leased to you by such person or governmental agency or subdivision or organization. political subdivision has issued a permit or G-18652-J (Ed. 07-12) Page 2 of 12 Copyright,CNA All Rights Reserved. °RDE created with, i.r 4Faet y3 Pros tria63verrionvivwwpdffac tort/ Gm 3 of 15 3/21/2014 1:39:31 PM PST (GMT-8) FROM: 100005-TO: 14088460429 Page: 5 of 16 G-18652-J NA (Ed. 07-12) authorization in connection with premises A. BROAD KNOWLEDGE OF OCCURRENCE you own, rent, or control and to which this insurance applies: You must give us or our authorized representative notice of an "occurrence," a. The existence, maintenance, repair, offense, claim, or "suit" only when the construction, erection, or removal of "occurrence," offense, claim or "suit" is known advertising signs, awnings, canopies, to: cellar entrances, coal holes, driveways, manholes, marquees, hoistaway (1) You, if you are an individual; openings, sidewalk vaults, street (2) A partner, if you are a partnership; banners, or decorations and similar exposures; or (3) An executive officer or the employee designated by you to give such notice, if b. The construction, erection, or removal you are a corporation; or of elevators; or (4) A manager, if you are a limited liability c. The ownership, maintenance or use of company. any elevators covered by this insurance. B. NOTICE OF OCCURRENCE 2. This insurance applies only with respect to Your rights under this Coverage Part will not be operations performed by you or on your prejudiced if you fail to give us notice of an behalf for which the state or governmental "occurrence,"offense, claim or"suit" and that agency or subdivision or political failure is solely due to your reasonable belief subdivision has issued a permit or that the"bodily injury" or"property damage" is authorization. not covered under this Coverage Part. However, you shall give written notice of this 3. This insurance does not apply to: "occurrence,"offense, claim or"suit" to us as a. "Bodily injury," "property damage" or soon as you are aware that this insurance may apply to such "occurrence,"offense claim or "personal and advertising injury" arising "suit." out of operations performed for the federal government, state or 4. BROAD NAMED INSURED municipality; or A. Any subsidiary or affiliate organization, other b. "Bodily injury" or "property damage" than a partnership, joint venture or limited included within the "products- liability company, in which a Named Insured completed operations hazard." specifically shown in the Declarations has A governmental permit which requires you to management control, directly or through one or add the governmental entity as an additional more subsidiary organizations, at the time of insured will trigger this Provision 1. as if the loss will qualify as a Named Insured but only if permit were a written contract. there is no other similar insurance available to such organization, nor similar insurance which 2. BODILY INJURY—EXPANDED DEFINITION would be available but for exhaustion of its SECTION V— DEFINITIONS, the definition of limits. For the purpose of this provision, similar "bodily injury" is changed to read: insurance means general liability or equivalent insurance, no matter whether its coverage is "Bodily injury" means bodily injury, sickness or broader or narrower than that provided by this disease sustained by a person, including death, insurance. But if the only other similar humiliation, shock, mental anguish or mental injury insurance is for a "consolidated (wrap-up) by that person at any time which results as a program," then a subsidiary that qualifies as a consequence of the bodily injury, sickness or Named Insured on such project-specific disease. insurance can still qualify as a Named Insured 3. BROAD KNOWLEDGE OF OCCURRENCE/ on this insurance, but not for projects covered NOTICE OF OCCURRENCE by the"consolidated (wrap-up)program." [Please see Item 26.C. of this endorsement for Condition 2. Duties in The Event of Occurrence, the definition of"consolidated (wrap-up) Offense, Claim or Suit of SECTION IV— program."] COMMERCIAL GENERAL LIABILITY CONDITIONS is amended to add the following provisions: G-18652-J (Ed. 07-12) Page 3 of 12 Copyright,CNA All Rights Reserved. cPQF.created with, G r4Faotory3 Pre triahverrionUv v .ddffactorV cGrfl 4 L5 3/21/2014 1:39:31 PM PST (GMT-8) FROM: 100005-TO: 14088460429 Page: 6 of 16 G-18652-J CNA (Ed. 07-12) B. This endorsement does not apply to any (1) Fire; organization for which coverage is excluded by (2) Smoke; another endorsement attached to this policy. C. Only for the purpose of this endorsement: (3) Collapse; or 1. Management control means: (4) Explosion. a. Ownership interest representing more I. Damage to Your Work than 50% of the voting, appointment, or "Property damage"to"your work"arising out of designation power for the subsidiary it, or any part of it and included in the organization's governing body; or "products-completed operations hazard." b. Having the right, pursuant to a written This exclusion does not apply: contract, or pursuant to the by-laws, charter, operating agreement, or similar (1) If the damaged work or the work out of document of a specifically shown which the damage arises was Named Insured or controlled subsidiary performed on your behalf by a organization to select, appoint, or subcontractor; or designate a majority of the subsidiary (2) If the cause of loss to the damaged organization's governing body. Such work arises as a result of contract or document must have been created prior to the time of loss; or (a) Fire; c. Having the right, pursuant to a written (b) Smoke; trust agreement, to protect, control the (c) Collapse; or use of, encumber or transfer and sell property held by a trust. (d) Explosion. 2. Governing body means the Board of B. The following paragraph is added to SECTION Directors of a corporation. III —LIMITS OF INSURANCE: 3. Loss means: Subject to 5.above, $100,000 is the most we will pay under Coverage A for the sum of a. The occurring of the "bodily injury" or damages arising out of any one"occurrence" "property damage"; or because of"property damage"to"your product" b. The committing of the offense that and "your work"that is caused by fire, smoke, caused the "personal and advertising collapse or explosion and is included within the injury." "product-completed operations hazard." This sublimit does not apply to"property damage"to D. The insurance provided by this policy applies to "your work" if the damaged work or the work out Named Insureds when trading under their own of which the damage arises was performed on names, or under such trading names or doing- your behalf by a subcontractor. business-as (DBA) names as any should choose to employ. C. This Provision 5. Broadened Liability Coverage For Damage To "Your Product" 5. BROADENED LIABILITY COVERAGE FOR And "Your Work" does not apply if an DAMAGE TO "YOUR PRODUCT" AND "YOUR endorsement of the same name is attached to WORK" this policy. A. Under SECTION I — COVERAGE A— BODILY 6. CONTRACTUAL LIABILITY—RAILROADS INJURY AND PROPERTY DAMAGE LIABILITY, Paragraph 2. Exclusions is With respect to operations performed within 50 feet amended to delete exclusions k. and I. and of railroad property, the definition of"insured replace them with the following: contract" in SECTION V—DEFINITIONS is replaced by the following: [This insurance does not apply to:] "Insured Contract" means: k. Damage to Your Product a. A contract for a lease of premises. However, "Property damage" to"your product"arising that portion of the contract for a lease of out of it, or any part of it except when premises that indemnifies any person or caused by or resulting from: organization for damage by fire to premises while rented to you or temporarily occupied by G-18652-J (Ed. 07-12) Page 4 of 12 Copyright,CNA All Rights Reserved. cROE created with a.r4Factory3 PrcE traat3version.v vs, rodffactnrvico as 5 of 15 3/21/2014 1:39:31 PM PST (GMT-8) FROM: 100005-TO: 14088460429 Page: 7 of 16 G-18652-J CNA (Ed. 07-12) you with permission of the owner is not an exclusion p. Electronic Data and replace it "insured contract"; with the following: b. A sidetrack agreement; [This insurance does not apply to:] c. Any easement or license agreement; p. Electronic Data d. An obligation, as required by ordinance, to Damages arising out of the loss of, loss of use indemnify a municipality, except in connection of, damage to, corruption of, inability to access, with work for a municipality; or inability to manipulate "electronic data" that does not result from physical injury to tangible e. An elevator maintenance agreement; property. f. That part of any other contract or agreement However, this exclusion does not apply to pertaining to your business (including an liability for damages because of"bodily injury." indemnification of a municipality in connection with work performed for a municipality) under B. The following paragraph is added to SECTION which you assume the tort liability of another III —LIMITS OF INSURANCE: party to pay for "bodily injury" or "property Subject to 5. above, $100,000 is the most we damage" to a third person or organization. Tort will pay under Coverage A for all damages liability means a liability that would be imposed arising out of any one"occurrence" because of by law in the absence of any contract or "property damage" that results from physical agreement. injury to tangible property and arises out of Paragraph f. does not include that part of any "electronic data." contract or agreement: C. The following definition is added to the (1) That indemnifies an architect, engineer or SECTION V—DEFINITIONS: surveyor for injury or damage arising out of: "Electronic data" means information, facts or (a) Preparing, approving or failing to programs stored as or on, created or used on, prepare or approve maps, shop or transmitted to or from computer software drawings, opinions, reports, surveys, (including systems and applications software), field orders, change orders or drawings hard or floppy disks, CD-ROMS, tapes, drives, and specifications; or cells, data processing devices or any other (b) Giving directions or instructions, or media which are used with electronically controlled equipment. failing to give them, if that is the primary cause of the injury or damage; D. For the purposes of the coverage provided by (2) Under which the insured, if an architect, this endorsement, the definition of "property damage" in SECTION V — DEFINITIONS is engineer or surveyor, assumes liability for an injury or damage arising out of the replaced by the following: insured's rendering or failure to render 17. "Property damage" means: professional services, including those listed a. Physical injury to tangible property, in (1) above and supervisory, inspection, architectural or engineering activities. including all resulting loss of use of that property. All such loss of use shall be 7. CONTRACTUAL LIABILITY FOR PERSONAL deemed to occur at the time of the AND ADVERTISING INJURY physical injury that caused it; Under SECTION I —COVERAGE B—PERSONAL b. Loss of use of tangible property that is AND ADVERTISING INJURY LIABILITY, not physically injured. All such loss of Paragraph 2. Exclusions is amended to delete use shall be deemed to occur at the exclusion e. Contractual Liability. time of the "occurrence" that caused it; This provision 7. does not apply to any person or or organization who otherwise qualifies as an c. Loss of, loss of use of, damage to, additional insured on this Coverage Part. corruption of, inability to access, or 8. ELECTRONIC DATA LIABILITY inability to properly manipulate "electronic data," resulting from A. Under SECTION I — COVERAGE A— BODILY physical injury to tangible property. All INJURY AND PROPERTY DAMAGE, such loss of "electronic data" shall be Paragraph 2. Exclusions is amended to delete G-18652-J (Ed. 07-12) Page 5 of 12 Copyright,CNA All Rights Reserved. SRO created with, r..rifFaotauy3Pfcr:traa63version umvwradffactorweGaa 3/21/2014 1:39:31 PM PST (GMT-8) FROM: 100005-TO: 14088460429 Page: 8 of 16 G-18652-J CNA (Ed. 07-12) deemed to occur at the time of the This provision 9. does not apply to any person "occurrence" that caused it. or organization who otherwise qualifies as an For the purposes of this insurance, additional insured on this Coverage Part. "electronic data" is not tangible property. 10. EXPECTED OR INTENDED INJURY E. If Electronic Data Liability is provided at a Under SECTION I —COVERAGE A—BODILY higher limit by another endorsement attached INJURY AND PROPERTY DAMAGE to this policy, then the $100,000 limit provided LIABILITY, Paragraph 2. Exclusions is by this Provision 8. Electronic Data Liability is amended to delete exclusion a. Expected or part of, and not in addition to, that higher limit. Intended Injury and replace it with the 9. EXPANDED PERSONAL AND ADVERTISING following: INJURY -DISCRIMINATION OR HUMILIATION [This insurance does not apply to:] A. SECTION V — DEFINITIONS is amended to a. Expected or Intended Injury add the following to the definition of "Personal and advertising injury": "Bodily injury"or"property damage" expected or intended from the standpoint of h. Discrimination or humiliation that results in the insured. This exclusion does not apply injury to the feelings or reputation of a to"bodily injury"or"property damage" natural person, but only if such resulting from the use of reasonable force discrimination or humiliation is: to protect persons or property. (1) Not done intentionally by or at the 11. GENERAL AGGREGATE LIMITS OF direction of: INSURANCE -PER PROJECT (a) The insured; or A. For each construction project away from (b) Any "executive officer," director, premises you own or rent, a separate stockholder, partner, member or Construction Project General Aggregate manager (if are a limited Limit, equal to the amount of the General liability company) of the insured; Aggregate Limit, is the most we will pay for the sum of and (2) Not directly or indirectly related to the 1. All damages under Coverage A, except damages because of "bodily injury" or employment, prospective employment, "property damage" included in the past employment or termination of "products-completed employment of any person or persons azy d"; and operations by any insured. hazard"; and B. Under SECTION I — COVERAGE B — 2. All medical expenses under Coverage PERSONAL AND ADVERTISING INJURY C, LIABILITY, Paragraph 2. Exclusions is that arise from "occurrences" or amended to add the following additional accidents which can be attributed solely exclusions: to ongoing operations at that construction project. Such payments [This insurance does not apply to:] shall not reduce the General Aggregate Discrimination Relating To Room, Limit shown in the Declarations, nor the Dwelling or Premises Construction Project Aggregate Limit of "Personal or advertising injury"caused by any other construction project. discrimination directly or indirectly related B. All: to the sale, rental, lease or sub-lease or 1. Damages under Coverage B, regardless of prospective sale, rental, lease or sub-lease the number of locations or construction of any room, dwelling or premises by or at projects involved; the direction of any insured. Fines Or Penalties 2. Damages under Coverage A, caused by occurrences" which cannot be attributed Fines or penalties levied or imposed by a solely to ongoing operations at a single governmental entity because of construction project, except damages discrimination. because of "bodily injury" or "property G-18652-J (Ed. 07-12) Page 6 of 12 Copyright,CNA All Rights Reserved. °PDF created wit p iFaetorg3 Pro trial3verriovUvovsmpciffac#orV cGm 7 of 15 3/21/2014 1:39:31 PM PST (GMT-8) FROM: 100005-TO: 14088460429 Page: 9 of 16 G-18652-J iNA (Ed. 07-12) damage" included in the "products- Paragraphs 1.b.(1) and 1.b.(2) with the completed operations hazard"; and following: 3. Medical expenses under Coverage C b. This insurance applies to "bodily injury" caused by accidents which cannot be only if you are not in the business of attributed solely to ongoing operations at a providing professional health care services, single construction project, and only if: will reduce the General Aggregate Limit shown (1) The "bodily injury" is caused by an in the Declarations. "occurrence" that takes place in the C. The limits shown in the Declarations for Each "coverage territory." For the purpose of this insurance: Occurrence, for Damage To Premises Rented To You and for Medical Expense continue to (a) "Bodily injury" caused by a "health apply, but will be subject to either the care incident" will be considered Construction Project Aggregate Limit or the caused by an "occurrence"; and General Aggregate Limit, depending on whether the "occurrence" can be attributed (b) All acts, errors or omissions that solely to ongoing operations at a particular are logically connected by any construction project. common fact, circumstance, situation, transaction, event, advice D. When coverage for liability arising out of the or decision will be considered to "products-completed operations hazard" is constitute a single "occurrence"; provided, any payments for damages because (2) The "bodily injury" occurs during the of "bodily injury" or'"property damage" included in the "products-completed operations hazard," policy period. All "bodily injury" arising regardless of the number of locations involved from an "occurrence"will be deemed to will reduce the Products-Completed Operations have occurred at the time of the first Aggregate Limit shown in the Declarations. act, error, or omission that is part of the "occurrence"; and E. If a single construction project away from premises owned by or rented to the insured has B. With respect only to the insurance provided by been abandoned and then restarted, or if the this Provision 13., Exclusion 2.e. Employer's authorized contracting parties deviate from Liability of SECTION I — COVERAGE A — plans, blueprints, designs, specifications or BODILY INJURY AND PROPERTY DAMAGE, timetables, the project will still be deemed to be is amended to append the following: the same construction project. Only for "bodily injury" not covered by other F. The provisions of SECTION III — LIMITS OF liability insurance (including state-sanctioned INSURANCE not otherwise modified by this self insurance) available to the insured (or endorsement shall continue to apply as which would be available but for exhaustion of stipulated. its limits), this exclusion does not apply to "bodily injury" that arises out of a "health care 12. IN REM ACTIONS incident." Any action in rem against any vessel owned or C. SECTION V — DEFINITIONS is amended to operated by or for you, or chartered by or for you add the following new definition: will be treated in the same manner as though the "Health care incident" means a negligent act, action were in personam against you. error or omission by your "employees" or In rem is a term used to designate actions instituted "volunteer workers" working on your behalf in against the thing, as distinct from actions against the rendering of or failure to render professional • the person, which are said to be in personam. health care services in any of the following 13. INCIDENTAL HEALTH CARE MALPRACTICE capacities, or the related furnishing of food, COVERAGE beverages, medical supplies or appliances: A. With respect only to "bodily injury" that arises a. Physician; out of a "health care incident," COVERAGE A— b. Nurse; BODILY INJURY AND PROPERTY DAMAGE LIABILITY OF SECTION I — COVERAGES is c. Emergency medical technician; amended to replace Insuring Agreement d. Paramedic; e. Chiropractor; G-18652-J (Ed. 07-12) Page 7 of 12 Copyright,CNA All Rights Reserved. cROF created with, G.PiFaeto y3 Pra traal3verriorwv w.pdffac tory GGm 8 of IS 3/21/2014 1:39:31 PM PST (GMT-8) FROM: 100005-TO: 14088460429 Page: 10 of 16 G-18652-J CNA (Ed. 07-12) f. Dentist; employment by you or while performing g. Athletic trainer; duties related to the conduct of your• business; and h. Audiologist; b. "bodily injury" to a "volunteer worker" i. Physical therapist; while performing duties related to the j. Psychologist; conduct of your business; k. Speech therapist; when such "bodily injury"arises out of a p p "health care incident." I. Other allied health professional; or 2. Your "volunteer workers" are insureds with m. Provider of first aid or Good Samaritan respect to: services rendered in an emergency and for a. "bodily injury" to a co-"volunteer which no payment is demanded or worker" while performing duties related received. to the conduct of your business; and D. SECTION I — COVERAGE A — BODILY b. "bodily injury" to an "employee"while in INJURY AND PROPERTY DAMAGE, the course of the "employee's" Paragraph 2. Exclusions is amended to add the employment by you or while performing following additional exclusions. These new duties related to the conduct of your exclusions apply only to this Incidental Health business; Care Malpractice Coverage: when such"bodily injury" arises out of a [This insurance does not apply to:] "health care incident." Dishonesty or Crime 3. Paragraphs 2.a. (1)(a), (b) and (c) of Any dishonest, criminal or malicious act, error SECTION II — WHO IS AN INSURED do or omission. not apply to "bodily injury" for which insurance is provided this Provision 13. Clinical Trials/ Product Testing 4. Paragraph 2.a.(1)(d) of SECTION II — Acts, errors or omissions that occur in the WHO IS AN INSURED is deleted. course of human clinical trials or product testing. G. With respect to the insurance provided by this Provision 13., the following is added to Medicare/Medicaid Fraud Paragraph 4.b.(1) of SECTION IV - Medicare or Medicaid fraud or abuse. COMMERCIAL GENERAL LIABILITY CONDITIONS: Services Excluded by Endorsement To the extent this insurance applies, it is excess Any"health care incident"for which coverage is over any of the other insurance (including excluded by endorsement. qualified self insurance), whether primary, E. SECTION V — DEFINITIONS is amended to excess, contingent or on any other basis, add the following subparagraph to Paragraph f. except for insurance purchased specifically by of the definition of"insured contract": you to be excess of this policy. Paragraph f. does not include that part of any 14. JOINT VENTURES / PARTNERSHIP / LIMITED contract or agreement: LIABILITY COMPANIES (4) Under which you assume another's tort A. The following is added to SECTION II — WHO liability for "bodily injury" arising out of the IS AN INSURED: rendering of or failure to render 4. You are an insured when you had an professional health care services. interest in a joint venture, partnership or F. SECTION II — WHO IS AN INSURED is limited liability company which terminated amended to add the following provisions: or ended prior to or during this policy period, but only to the extent of your 1. Your"employees" are insureds with respect interest in such joint venture, partnership or to: limited liability company. This coverage a. "bodily injury" to a co-"employee" while does not apply: in the course of the co-"employee's" G-18652-J (Ed. 07-12) Page 8 of 12 Copyright,CNA All Rights Reserved. :POF created vutth s IF actory3 Prec tri al 3versionwommdd ffactorVf€ 1 9 of 15 3/21/2014 1:39:31 PM PST (GMT-8) FROM: 100005-TO: 14088460429 Page: 11 of 16 G-18652-J CNA (Ed. 07-12) a. Prior to the termination date of any joint (6) That particular part of any property that venture, partnership or limited liability must be restored, repaired or replaced company; because "your work" was incorrectly b. If there is other valid and collectible performed on it. insurance purchased specifically to Paragraph (2) of this exclusion does not insure the partnership, joint venture or apply if the premises are"your work." limited liability company; or Paragraphs (3) and (4) of this exclusion do c. To a joint venture, partnership or not apply to "property damage" to tools or limited liability company which is or equipment loaned to you. A separate limit was insured under a "consolidated of insurance applies to such tools or (wrap-up) insurance program." equipment that are damaged while being [Please see Item 26.C. of this endorsement used in your operations. for the definition of"consolidated (wrap-up) Paragraphs (1), (3) and (4) of this exclusion program."] do not apply to "property damage" (other B. The last paragraph of SECTION II — WHO IS than damage by fire) to premises rented to AN INSURED is deleted and replaced by the you or temporarily occupied by you with the following: permission of the owner, or to the contents of premises rented to you for a period of 7 Except as provided under the Contractors' or fewer consecutive days. A separate limit General Liability Extension Endorsement or by of insurance applies to Damage To the attachment of another endorsement (if any), Premises Rented To You as described in no person or organization is an insured with SECTION III —LIMITS OF INSURANCE. respect to the conduct of any current or past partnership, joint venture or limited liability Paragraphs (3), (4), (5) and (6) of this company that is not shown as a Named Insured unde a s do act agre to nobility assumed in the Declarations. under a sidetrack agreement. Paragraph (6) of this exclusion does not 15. LEGAL LIABILITY/ALIENATED PREMISES/ apply to "property damage' included in the BORROWED EQUIPMENT "products-completed operations hazard." A. Under SECTION I — COVERAGE A— BODILY B. Under SECTION I — COVERAGE A— BODILY INJURY AND PROPERTY DAMAGE, INJURY AND PROPERTY DAMAGE the last Paragraph 2. Exclusions is amended to delete paragraph of Paragraph 2. Exclusions is exclusion j. Damage to Property in its entirety deleted and replaced by the following. and replace it with the following: [This insurance does not apply to:] Exclusions c. through n. do not apply to damage by fire to premises while rented to you j. Damage to Property or temporarily occupied by you with permission of the owner nor to the contents of premises "Property damage" to: rented to you for a period of 7 or fewer (1) Property you own, rent, or occupy; consecutive days. (2) Premises you sell, give away or A separate limit of insurance applies to this abandon, if the "property damage" coverage as described in SECTION III — arises out of any part of those LIMITS OF INSURANCE. premises; C. The following paragraph is added to SECTION (3) Property loaned to you; III —LIMITS OF INSURANCE: (4) Personal property in the care, custody Subject to 5. above, $25,000 is the most we will or control of the insured; pay under Coverage A for damages arising out of any one "occurrence" because of "property (5) That particular part of real property on damage" to tools or equipment loaned to you which you or any contractors or by others that occurs while the equipment is subcontractors working directly or being used to perform operations. indirectly on your behalf are performing operations, if the "property damage" D. Paragraph 6. Damage To Premises Rented To arises out of those operations; or You Limit of SECTION III — LIMITS OF INSURANCE is replaced by the following: G-18652-J (Ed. 07-12) Page 9 of 12 Copyright,CNA All Rights Reserved. °PDF created with, a,r iFaot�y3 PrG:tria63versiov w nk.pdffac;tor>J�c� a 10 of 15 3/21/2014 1:39:31 PM PST (GMT-8) FROM: 100005-TO: 14088460429 Page: 12 of 16 G-18652-J CNA (Ed. 07-12) 6. Subject to Paragraph 5. above, (the Each SECTION — I — COVERAGE C for all Occurrence Limit), the Damage To medical expenses because of "bodily Premises Rented To You Limit is the most injury" sustained by any one person. The we will pay under SECTION — I — Medical Expense Limit is the greater of: COVERAGE A for damages because of "property damage" to any one premises (1) $15,000; or while rented to you or temporarily occupied (2) The amount shown in the Declarations by you with the permission of the owner, for Medical Expense Limit. including contents of such premises rented to you for a period of 7 or fewer B. Paragraph 1.a.(3)(b) of SECTION I — consecutive days. The Damage To COVERAGE C MEDICAL PAYMENTS, is Premises Rented To You Limit is the replaced by the following: greater of: (b) The expenses are incurred and reported to a. $500,000; or us within three years of the date of the accident; and b. The Damage To Premises Rented To You Limit shown in the Declarations. This paragraph B. does not apply to medical expenses incurred in the state of Missouri. E. Paragraph 4.b.(1)(a)(ii) of SECTION IV — COMMERCIAL GENERAL LIABILITY 19. NON-OWNED AIRCRAFT CONDITIONS is deleted and replaced by the Under SECTION I—COVERAGE A—BODILY following: INJURY AND PROPERTY DAMAGE LIABILITY. (ii) That is property insurance for premises Paragraph 2. Exclusions is amended such that rented to you, for premises temporarily exclusion g. Aircraft,Auto or Watercraft does not occupied by you with the permission of the apply to an aircraft you do not own, provided that: owner; or for personal property of others in 1. The pilot in command holds a currently your care, custody or control; effective certificate issued by the duly F. This Provision 15. does not apply if Damage To constituted authority of the United States of Premises Rented To You Liability under America or Canada, designating that person as SECTION — I — COVERAGE A is excluded by a commercial or airline transport pilot; . endorsement. 2. The aircraft is rented to you with a trained, paid 16. LIBERALIZATION CLAUSE crew; and If we adopt a change in our forms or rules which 3. The aircraft does not transport persons or cargo would broaden coverage for contractors under this for a charge. endorsement without an additional premium 20. NON-OWNED WATERCRAFT charge, your policy will automatically provide the additional coverage as of the date the revision is Under SECTION I—COVERAGE A—BODILY effective in your state. INJURY AND PROPERTY DAMAGE LIABILITY, Paragraph 2. Exclusions is amended to delete 17. LIQUOR LIABILITY subparagraph (2) of exclusion g.Aircraft,Auto or Under SECTION I —COVERAGE A—BODILY Watercraft and replace it with the following. INJURY AND PROPERTY DAMAGE, Paragraph 2. [This exclusion does not apply to:] Exclusions is amended to delete exclusion c. Liquor Liability. (2) A watercraft you do not own that is: This provision 17. does not apply to any person or (a) Less than 75 feet long; and organization who otherwise qualifies as an (b) Not being used to carry persons or property additional insured on this Coverage Part. for a charge. 18. MEDICAL PAYMENTS 21. PRIMARY AND NON-CONTRIBUTORY TO A. Paragraph 7. Medical Expense Limit, of OTHER INSURANCE SECTION III — LIMITS OF INSURANCE is With respect to any person or organization that is deleted and replaced by the following: an additional insured under this Coverage Part, the 7. Subject to Paragraph 5. above (the Each following is added to Paragraph 4. of SECTION IV Occurrence Limit), the Medical Expense —COMMERCIAL GENERAL LIABILITY Limit is the most we will pay under CONDITIONS: G-18652-J (Ed. 07-12) Page 10 of 12 Copyright,CNA All Rights Reserved. °ROE created with. a,s ifFaetor-y3 Prcc traa63verzior .w v pdffacoryicGm 11 of 15 3/21/2014 1:39:31 PM PST (GMT-8) FROM: 100005-TO: 14088460429 Page: 13 of 16 G-18652-J CNA (Ed. 07-12) If you have agreed in writing in a contract or 25. WAIVER OF SUBGROGATION - BLANKET agreement that this insurance is primary and non Under SECTION IV—COMMERCIAL GENERAL contributory relative to an additional insured's own LIABILITY CONDITIONS, The Transfer Of Rights insurance, then this insurance is primary and we Of Recovery Against Others To Us Condition is will not seek contribution from that other insurance. amended by the addition of the following: For the purpose of this Provision 21., the additional insured's own insurance means insurance on which We waive any right of recovery we may have the additional insured is a Named Insured. against any person or organization because of This Provision 21. does not apply in situations payments we make for injury or damage arising out where the endorsement on this policy affording of: coverage to the additional insured specifies that 1. Your ongoing operations; or this insurance is excess over any other insurance available to that additional insured. 2. "Your work" included in the "products completed operations hazard." • 22. PROPERTY DAMAGE—ELEVATORS However, this waiver applies only when you have A. Under SECTION I — COVERAGE A — BODILY agreed in writing to waive such rights of recovery in INJURY AND PROPERTY DAMAGE, a contract or agreement, and only if the contract or Paragraph 2. Exclusions is amended such that agreement: exclusion k. Damage to Your Product, and subparagraph (3), (4) and (6) of exclusion j. 1. Is in effect or becomes effective during the Damage to Property do not apply "property term of this policy; and damage" that results from the use of elevators. 2. Was executed prior to loss. B. With respect only to the coverage provided by 26. WRAP-UP EXTENSION: OWNER CONTROLLED this endorsement, Condition 4. Other INSURANCE PROGRAM, CONTRACTOR Insurance in SECTION IV — COMMERCIAL CONTROLLED INSURANCE PROGRAM OR GENERAL LIABILITY CONDITIONS is CONSOLIDATED (WRAP-UP) INSURANCE amended to add the following subparagraph PROGRAMS b.(1)(a)(v): 4. Other Insurance Note: The following provision does not apply to any public construction project in the state of b. Excess Insurance Oklahoma, nor to any construction project in the state of Alaska, that is not permitted to be insured (1) This insurance is excess over: under a "consolidated (wrap-up) insurance (a) Any of the other insurance, program" by applicable state statute or regulation: whether primary, excess, If the endorsement EXCLUSION— contingent or on any other CONSTRUCTION WRAP-UP or another basis: exclusionary endorsement pertaining to Owner (v) That is Property insurance Controlled Insurance Programs (O.C.I.P.) or covering property of others Contractor Controlled Insurance Programs damaged from the use of (C.C.I.P.) is attached to this policy, then the elevators. following changes apply: 23. SUPPLEMENTARY PAYMENTS A. The following wording is added to the endorsement: A. Under Section I — Supplementary Payments With respect to a "consolidated (wrap-up) —Coverages A and B, Paragraph 1.b., the limit insurance program" project in which you are or of $250 shown for the cost of bail bonds is replaced by$5,000: were involved, this exclusion does not apply to those sums you become legally obligated to B. In Paragraph 1.d., the limit of $250 shown for pay as damages because of: daily loss of earnings is replaced by$1,000. 1. "Bodily injury," "property damage," or 24. UNINTENTIONAL FAILURE TO DISCLOSE "personal or advertising injury" that occurs HAZARDS during your ongoing operations at the If unintentionally you should fail to disclose all project, or during such operations of anyone acting on your behalf; nor existing hazards at the inception date of your policy, we will not deny coverage under this 2. "Bodily injury" or "property damage" Coverage Part because of such failure. included within the "products-completed G-18652-J (Ed. 07-12) Page 11 of 12 Copyright,CNA All Rights Reserved. cPDF.created %ail. 6.41Factory3 Pre traahverrion. .ndffadortvfccar 12 of 15 3/21/2014 1:39:31 PM PST (GMT-8) FROM: 100005-TO: 14088460429 Page: 14 of 16 • G-18652-J C'NA (Ed. 07-12) • operations hazard" that arises out of those involved in the project, such as an Owner portions of the project that are not Controlled Insurance Program (O.C.I.P.) or "residential structures." Contractor Controlled Insurance Program B. SECTION IV — COMMERCIAL GENERAL (C.C.I.P.). LIABILITY CONDITIONS is amended to add "Residential structure" means any structure the following subparagraph 4.b.(1)(c) to where 30% or more of the square foot area is Condition 4. Other Insurance: used or is intended to be used for human [This insurance is excess over:) residency including but not limited to single or multifamily housing, apartments, (c) Any of the other insurance whether primary, condominiums, townhouses, co-operatives or excess, contingent or any other basis that is planned unit developments and also includes insurance available to you as a result of their common areas and/or appurtenant your being a participant in a "consolidated structures (including pools, hot tubs, detached (wrap-up) insurance program," but only as garages, guest houses or any similar respects your involvement in that structures). When there is no individual "consolidated (wrap-up) insurance ownership of units, residential structure does program." not include military housing, college/university C. SECTION V — DEFINITIONS is amended to housing or dormitories, long term care facilities, hotels, or motels. Residential structure also add the following definition: does not include hospitals or prisons. "Consolidated (wrap-up) insurance program" This provision 26. does not apply to any person means a construction, erection or demolition or organization who otherwise qualifies as an project for which the prime contractor/project additional insured on this Coverage Part. manager or owner of the construction project has secured general liability insurance covering some or all of the contractors or subcontractors 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. Material used with permission of ISO Properties, Inc G-18652-J (Ed. 07-12) Page 12 of 12 Copyright,CNA All Rights Reserved. cPD created with 6,0 1Factty3 F r tria63veresimnuv vwpdfiactoryTco m 13 of 15 3/21/2014 1:39:31 PM PST (GMT-8) FROM: 100005-TO: 14088460429 Page: 15 of 16 3/21/2014 • 4014291109 G-140331-D CNAFBD Vanguard Construction, Inc. (Ed. 01/13) dba: Vanguard Construction BLANKET ADDITIONAL INSURED -OWNERS, LESSEES OR CONTRACTORS — WITH PRODUCTS-COMPLETED OPERATIONS COVERAGE It is understood and agreed that this endorsement amends the COMMERCIAL GENERAL LIABILITY COVERAGE PART as follows: SCHEDULE (OPTIONAL) Name of Additional Insured Persons Or Organizations (As required by"written contract" per Paragraph A. below.) Locations of Covered Operations (As per the "written contract," provided the location is within the"coverage territory"of this Coverage Part.) A. Section II -Who Is An Insured is amended to include as an additional insured: 1. Any person or organization whom you are required by "written contract" to add as an additional insured on this Coverage Part; and 2. The particular person or organization, if any, scheduled above. B. The insurance provided to the additional insured is limited as follows: 1. The person or organization is an additional insured only with respect to liability for "bodily injury," "property damage,"or"personal and advertising injury"caused in whole or in part by: a. Your acts or omissions, or the acts or omissions of those acting on your behalf, in the performance of your ongoing operations specified in the"written contract"; or b. "Your work" that is specified in the "written contract" but only for "bodily injury" or "property damage" included in the"products-completed operations hazard,"and only if: (1) The"written contract"requires you to provide the additional insured such coverage; and (2) This Coverage Part provides such coverage. 2. If the "written contract"specifically requires you to provide additional insurance coverage via the 10/01 edition of CG2010 (aka CG 20 10 10 01), or via the 10/01 edition of CG2037(aka CG 20 37 10 01), or via the 11/85 edition of CG2010 (aka CG 20 10 11 85), then in paragraph B.1. above, the words'caused in whole or in part by are replaced by the words'arising out of. 3. We will not provide the additional insured any broader coverage or any higher limit of insurance than: a. The maximum permitted by law; b. That required by the "written contract"; c. That described in B.1. above; or d. That afforded to you under this policy, whichever is less. G-140331-D (Ed. 01/13) Page 1 of 2 Copyright,CNA All Rights Reserved CERT NO.: 19561236 CLIENT CODE: 1997-02-03 15:55:28.803 Jame Taudes 3/21/2014 1:37'.37 PM Page 14 of 15 3/21/2014 1:39:31 PM PST (GMT-8) FROM: 100005-TO: 14088460429 Page: 16 of 16 G-140331-D CNA (Ed. 01/13) 4. Notwithstanding anything to the contrary in Condition 4. Other Insurance (Section IV), this insurance is excess of all other insurance available to the additional insured whether on a primary, excess, contingent or any other basis. But if required by the "written contract" to be primary and non-contributory, this insurance will be primary and non-contributory relative to insurance on which the additional insured is a Named Insured. 5. The insurance provided 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. C. SECTION IV—COMMERCIAL GENERAL LIABILITY CONDITIONS is amended as follows: 1. The Duties In The Event of Occurrence, Offense, Claim or Suit condition is amended to add the following additional conditions applicable to the additional insured: An additional insured under this endorsement will as soon as practicable: (1) Give us written notice of an "occurrence" or an offense which may result in a claim or "suit" under this insurance, and of any claim or"suit"that does result; (2) Except as provided in Paragraph B.4. of this endorsement, agree to make available any other insurance the additional insured has for a loss we cover under this Coverage Part; (3) Send us copies of all legal papers received, and otherwise cooperate with us in the investigation, defense, or settlement of the claim or"suit"; and (4) Tender the defense and indemnity of any claim or"suit" to any other insurer or self insurer whose policy or program applies to a loss we cover under this Coverage Part. But if the "written contract"requires this insurance to be primary and non-contributory, this provision(4) does not apply to insurance on which the additional insured is a Named Insured. We have no duty to defend or indemnify an additional insured under this endorsement until we receive from the additional insured written notice of a claim or"suit." D. Only for the purpose of the insurance provided by this endorsement,SECTION V—DEFINITIONS is amended to add the following definition: "Written contract" means a written contract or written agreement that requires you to make a person or organization an additional insured on this Coverage Part, provided the contract or agreement: 1. Is currently in effect or becomes effective during the term of this policy; 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 the additional insured seeks coverage under this Coverage Part. All other terms and conditions of the Policy remain unchanged. Material used with permission of ISO Properties, Inc. G-140331-D (Ed. 01/13) Page 2 of 2 Copyright,CNA All Rights Reserved. CERT NO.: 19561238 CLIENT CODE: 1997-02-03 15:55:28.803 Jame Yaudes 3/21/2014 1:37:37 PM Page 15 of 15 1/31/2014 9:09:42 AM PST (GMT-8) FROM: 100005-TO: 14088460429 Page: 1 of 16 From: Arthur J. Gallagher&Co. Insurance Brokers of California, Inc. FAX DOCUMENT 3697 Mt. Diablo Blvd., Suite 300 Lafayette, CA 94549 Certificate of Insurance Delivery by ecertsonline TM 925-627-8227 0726293 www ajg.corn From: Jamie Yaudes To Subject: ACORD 25(05/10)Certificate of Liability FBD Vanguard Construction,Inc. City of Gilroy Putlic Works Department Date: 1/31/2014 7351 Rosanna Street Gilroy CA 95020 Delivery Via: FAX 14088460429 No. of Pages: 16 THIS MESSAGE IS INTENDED FOR THE USE OF THE INDIVIDUAL OR ENTITY TO WHICH IT IS ADDRESSED AND MAY CONTAIN INFORMATION THAT IS PRIVILEGED,CONFIDENTIAL AND EXEMPT FROM DISCLOSURE UNDER APPLICABLE LAW.IF'THE READER OF THE MESSAGE IS NOT THE INTENDED RECIPIENT,OR THE EMPLOYEE OR AGENT RESPONSIBLE FOR DELIVERING THE MESSAGE TO THE INTENDED RECIPIENT,YOU ARE HEREBY NOTIFIED THAT ANY DISSEMINATION,DISTRIBUTION OR COPYING OF THIS COMMUNICATION IS STRICTLY PROHIBITED.IF YOU HAVE RECEIVED THIS COMMUNICATION IN ERROR,PLEASE NOTIFY US IMEDIATELY BYTELEPHONE,AND RETURN THE ORIGINAL MESSAGE TO US AT THE ABOVE ADDRESS VIA REGULAR POSTAL SERVICE. ©2002 Certificate of Insurance Delivered by ecertsonlineTM Insurance Visions,Inc.All rights reserved. 1/31/2014 9:09:42 AM PST (GMT-8) FROM: 100005-TO: 14088460429 Page: 2 of 16 •/^,' ® DATE(MM/DO/YYYY) AR° CERTIFICATE OF LIABILITY INSURANCE 1,31/214 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). PRODUCER Arthur J. Gallagher&Co. Insurance Brokers CONTACT NAME: of California, PHONE(A/C.NO EMI' 925-299-1112 FAX(ac.No) 925-299-0328 3697 Mt. Diablo to Blvd., Suite 300 Lafayette, CA 94549 E-MAIL ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC N www.ajg.corn 0726293 rISURERA: National Fire Ins.Co.of Hartford 20478 INSURED INSURER B: Continental Casualty Insurance Company 20443 FBD Vanguard Construction, Inc. INSURER : Fireman's Fund Insurance Company 21873 dba: Vanguard Construction Y 651 Enterprise Ct. INSURER: Zurich American Insurance Co 16535 Livermore, CA 94550-5200 INSURER _INSURER F COVERAGES CERTIFICATE NUMBER: 19122717 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUER POLICY EFF POLICY EXP W PY LIMITS LTR INSR VD POLICY NUMBER (MM/DD/NYYY) (MMIDDYYY) A GENERAL LIABILITY 4014291109 3/25/2013 3/25/2014 EACH OCCURRENCE $ 2,000,000 DAMAGE TO RENTED 100,000 I COMMERCIAL GENERAL LIABILITY PREMISES(Ea occurrence) $ CLAIMS-MADE e OCCUR MED EXP(Any one person) $ 5,000 XCU Included PERSONAL 8 ADV INJURY $ 2,000,000 I Contractural Liab GENERAL AGGREGATE $ 4,000,000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OP AGG $ 4,000,000 —7 n EC POLICY T n LOC Deductible $ $5,000 B AUTOMOBILE LIABILrrY 4013610249 3/25/2013 3/25/2014 COMBINED t SINGLE LIMIT $ 1,000,000 I ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS , AUTOS BODILY INJURY(Per accident) $ NON-OWNED PROPERTY DAMAGE ./ HIRED AUTOS , AUTOS _Per accident) $ 1 form CA 0001 03 06 $ UMBRELLA LIAR / OCCUR EACH OCCURRENCE $ 10,000,000 C _ SSE48706600 3/25/2013 3/25/2014 i EXCESS LIAR CLAIMS-MADE AGGREGATE $ 10,000,000 DED I ,/I RETENTION$0 $ — $ D WORKERS COMPENSATION WC489238204 2/1/2014 2/1/2015 AV MS EMPLOYERS'LIABILITY Y/N �/ TORY LIMITS I ER ANY PROPRIETOR/PARTNER/EXECUTIVE r�'I E L EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? I I N/A (Mandatory in NH) E .DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E DISEASE.POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) City of Gilroy is included as additional insured for General Liability per form G-140331-C31 10/10 attached(Primary Wording Included).Waiver of Subrogation applies for General Liability per form G-18652-J 07-12 attached. The above Additional Insured, Primary Wording and Waiver of Subrogation Endorsements are only valid if requested by written contract. VG986 Project VERBS Safe Route to School-Project No 12-PW-199.Federal Project No.RPSTPLE-5035(024) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Gilroy THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN PUtlic Works Department ACCORDANCE WITH THE POLICY PROVISIONS. 7351 Rosanna Street Gilroy CA 95020 AUTHORIZED REPRESENTATIVE � :Lt rte'o Jamie Yaudes ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD CERT NO.. 19122717 CLIENT CODE: 1997-02-03 15:55:28.803 Jamie Yaudes 1/31/2014 9:06:36 AN Page 1 of 15 1/31/2014 9:09:42 AM PST (GMT-8) FROM: 100005-TO: 14088460429 Page: 3 of 16 . 4014291109 1/31/2014 FBD Vanguard Construction, Inc. C'NA G-140331-C31 Ed. 10/10) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - WITH PRODUCTS-COMPLETED OPERATIONS COVERAGE This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE(OPTIONAL) Name of Additional Insured Persons Or Organizations tTvreg groby"written contract"per Paragraph A. below.) Putlic Works Department 7351 Rosanna Street Gilroy CA 95020 Locations of Covered Operations (As per the"written contract", provided the location is within the"coverage territory"of this Coverage Part.) A. Section II-Who Is An Insured is amended to 2. We will not provide the additional insured any include as an additional insured: broader coverage or any higher limit of 1.Any person or organization whom you are insurance than the least that is: required by"written contract"to add as an Y" a. Required by the"written contract"; additional insured on this Coverage Part;and b. Described in B.1. above;or 2.The particular person or organization, If any, scheduled above. c. Afforded to you under this policy. B. The insurance provided to the additional insured is 3. This insurance is excess of all other insurance limited as follows: available to the additional insured whether on a 1. The person or organization is an additional primary, excess, contingent or any other basis. insured only with respect to liability for"bodily But if required by the"written contract",this insurance will be primary and non-contributory injury","property damage", or'personal and advertising injury"caused in whole or in part by: insured is insurance ns on which the additional insured is a Named Insured. a. Your acts or omissions; or 4. The insurance provided to the additional insured b. The acts or omissions of those acting on does not apply to"bodily injury","property your behalf damage",or"personal and advertising injury in the performance of your ongoing operations arising out of: specified in the"written contract";or a. The rendering of,or the failure to render, c. "Your work"that is specified in the"written any professional architectural, engineering, contract"but only for"bodily injury"or or surveying services, including: "property damage"included in the (1) The preparing, approving,or failing to "products-completed operations hazard", prepare or approve maps, shop and only if: drawings,opinions,reports,surveys, (1)The"written contract''requires you to field orders,change orders or drawings provide the additional insured such and specifications; and coverage; and (2) Supervisory,inspection, architectural or (2)This Coverage Part provides such • engineering activities; or coverage. b. Any premises or work for which the additional insured is specifically listed as an G-140331-C31 Includes copyrighted material of Insurance Services Office,Inc.,with its permission Page 1 of 2 (Ed. 10/10) cRDF.created with NIFactory3 Pr«:tria63versionumvr, .pdffactorapeo 2 of 15 1/31/2014 9:09:42 AM PST (GMT-8) FROM: 100005-TO: 14088460429 Page: 4 of 16 CNAG-140331-C31 Ed. 10/10) additional insured on another endorsement We have no duty to defend or pay on behalf of attached to this Coverage Part. an additional insured under this endorsement C. SECTION iV—COMMERCIAL GENERAL until we receive from the additional insured LIABILITY CONDITIONS is amended as follows: written notice of a claim or"suit". 1. The Duties In The Event of Occurrence, 2. With respect only to the insurance provided by Offense,Claim or Suit condition is amended to this endorsement, the first sentence of add the following additional conditions Paragraph 4.a.of the Other Insurance Condition applicable to the additional insured: is deleted and replaced with the following: An additional insured under this endorsement 4. Other insurance will as soon as practicable: a. Primary Insurance (1) Give us written notice of an"occurrence"or This insurance is primary and non- an offense which may result in a claim or contributory except when rendered "suit"under this insurance,and of any claim excess by endorsement G-140331-C31, or"suit"that does result; or when Paragraph b.below applies. (2) Except as provided in Paragraph 9.3 of this D. Only for the purpose of the insurance provided by endorsement,agree to make available any this endorsement,SECTION V—DEFINITIONS is other insurance the additional insured has • amended to add the following definition: for a loss we cover under this Coverage Part; "Written contract"means a written contract or written agreement that requires you to make a (3) Send us copies of all legal papers received, person or organization an additional insured on this and otherwise cooperate with us in the Coverage Part,provided the contract or agreement: investigation, defense, or settlement of the 1. Is currently in effect or becomes effective during claim or"suit";and the term of this policy; and (4) Tender the defense and indemnity of any 2.Was executed prior to: • claim or"suit"to any other insurer or self insurer whose policy or program applies to a a.The"bodily injury'or"property damage"; or loss we cover under this Coverage Part. b The offense that caused the"personal and But if the"written contract"requires this advertising injury" insurance to be primary and non- for which the additional insured seeks coverage contributory, this provision (4)does not under this Coverage Part. apply to insurance on which the additional insured is a Named Insured. • G-140331-C31 Includes copyrighted material of Insurance Services Office,Inc.,with its permission Page 2 of 2 (Ed. 10/10) cPDF.created Haig pdtFaotory3 Pra tri a63versionAtam.pe factorype ryi 3 of 15 1/31/2014 9:09:42 AM PST (GMT-8) FROM: 100005-TO: 14088460429 Page: 5 of 16 rtsu vanguara construction, Inc. dba: Vanguard Construction G-18652-J CNA (Ed. 07-12) 4014291109 1/31/2014 CONTRACTORS'GENERAL LIABILITY EXTENSION ENDORSEMENT It is understood and agreed that this endorsement amends the COMMERCIAL GENERAL LIABILITY COVERAGE PART as follows. The changes this endorsement makes do not apply with respect to any coverage that has been excluded or amended by another endorsement attached to this policy. SCHEDULE Coverage is summarized below. For particulars and limitations affecting each coverage, please refer to the corresponding policy provisions in the body of this endorsement. 1. Additional Insureds Seven additional insured extensions. 2. Bodily Injury—Expanded Definition 3. Broad Knowledge of Occurrence/Notice of Occurrence 4. Broad Named Insured 5. Broadened Liability Coverage For Damage To "Your Product"And "Your Work" Limit: $100,000. 6. Contractual Liability—Railroads Expanded definition of"insured contract." 7. Contractual Liability For Personal And Advertising Injury 8. Electronic Data Liability Loss of Electronic Data Limit: $100,000. 9. Expanded Personal And Advertising Injury - Discrimination Or Humiliation 10. Expected Or Intended Injury Reasonable force—"bodily injury"or"property damage." 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 Coverage for your interest in such terminated or ended organizations. 15. Legal Liability/Alienated Premises/Borrowed Equipment Coverage Extended perils. Default limit increased to$500,000 for Damage to Premises Rented To You. $25,000 limit for"property damage" to borrowed tools or equipment at a jobsite. 16. Liberalization Clause 17. Liquor Liability Coverage Extension 18. Medical Payments Limits increased to$15,000. Reporting increased to three years from the date of accident. 19. Non-owned Aircraft Coverage 20. Non-owned Watercraft Increased to 75 feet. 21. Primary And Non-Contributory To Other Insurance 22. Property Damage- Elevators 23. Supplementary Payments Cost of bail bonds increased to$5,000. Daily loss of earnings increased to$1,000. 24. Unintentional Failure To Disclose Hazards 25. Waiver of Subrogation - Blanket Waiver of subrogation where required by written contract or written agreement. 26. Wrap-Up Extension G-18652-J (Ed. 07-12) Page 1 of 12 Copyright,CNA All Rights Reserved. cPDE created withr G,.stFaotor-q3 Rise triat3versionwom .pdffactora' Gm a of 5 1/31/2014 9:09:42 AM PST (GMT-8) FROM: 100005-TO: 14088460429 Page: 6 of 16 G-18652-J CNA (Ed. 07-12) 1. ADDITIONAL INSURED 2. With respect to the insurance afforded to these additional insureds, this insurance SECTION II —WHO IS AN INSURED is amended does not apply to any "occurrence" which to include as an insured any person or organization takes place after the equipment lease (called additional insured) described in paragraphs expires. A. through G. below whom you are required to add as an additional insured on this policy under a D. Lessor - Land written contract or written agreement, provided the An owner or other interest from whom land has written contract or written agreement: been leased by you but only with respect to i. Is currently in effect or becomes effective liability arising out of the ownership, during the term of this policy; and maintenance or use of that specific part of the land leased to you and subject to the following ii. Was executed prior to the "bodily injury," additional exclusions: "property damage" or "personal injury and advertising injury" for which the additional This insurance does not apply to: insured seeks coverage. 1. Any "occurrence" which takes place after However, we will not provide the additional you cease to lease that land; or insured any broader coverage or any higher 2. Structural alterations, new construction or limit of insurance than the least that is: demolition operations performed by or on a. The maximum permitted by law; behalf of such additional insured. b. Required in the written contract or written E. Lessor- Premises agreement; A manager or lessor of premises but only with c. Afforded to you under this policy; or respect to liability arising out of the ownership, maintenance or use of that specific part of the d. Described in the applicable paragraphs A. premises leased to you and subject to the through G. below. following additional exclusions: A. Controlling Interest This insurance does not apply to: Any persons or organizations with a controlling 1. Any "occurrence" which takes place after interest in you but only with respect to their you cease to be a tenant in that premises; liability arising out of: or 1. Their financial control of you; or 2. Structural alterations, new construction or 2. Premises they own, maintain or control demolition operations performed by or on while you lease or occupy these premises. behalf of such additional insured. This insurance does not apply to structural F. Mortgagee,Assignee or Receiver alterations, new construction and demolition A mortgagee, assignee or receiver but only with operations performed by or for such additional respect to their liability as mortgagee, assignee, insured. or receiver and arising out of the ownership, B. Co-owner of Insured Premises maintenance, or use of a premises by you. A co-owner of a premises co-owned by you and This insurance does not apply to structural covered under this insurance but only with alterations, new construction or demolition respect to the co-owner's liability as co-owner operations performed by or for such additional of such premises. insured. C. Lessor-Equipment G. State or Governmental Agency or Subdivision or Political Subdivisions 1. Any person or organization from whom you A state or governmental agency or subdivision lease equipment, but only with respect to or political subdivision subject to the following liability for "bodily injury," "property damage" or "personal and advertising provisions: injury" caused, in whole or in part, by your 1. This insurance applies only with respect to maintenance, operation or use of the following hazards for which the state or equipment leased to you by such person or governmental agency or subdivision or organization. political subdivision has issued a permit or G-18652-J (Ed. 07-12) Page 2 of 12 Copyright,CNA All Rights Reserved. cPOE created with i.e Factory,Pre tri at 3versicr peomedffactoryieorn 5 of 15 1/31/2014 9:09:42 AM PST (GMT-8) FROM: 100005-TO: 14088460429 Page: 7 of 16 G-18652-J CNA (Ed. 07-12) authorization in connection with premises A. BROAD KNOWLEDGE OF OCCURRENCE you own, rent, or control and to which this insurance applies: You must give us or our authorized representative notice of an "occurrence," a. The existence, maintenance, repair, offense, claim, or "suit" only when the construction, erection, or removal of "occurrence," offense, claim or "suit" is known advertising signs, awnings, canopies, to: cellar entrances, coal holes, driveways, manholes, marquees, hoistaway (1) You, if you are an individual; openings, sidewalk vaults, street (2) A partner, if you are a partnership; banners, or decorations and similar exposures; or (3) An executive officer or the employee designated by you to give such notice, if b. The construction, erection, or removal you are a corporation; or of elevators; or (4) A manager, if you are a limited liability c. The ownership, maintenance or use of company. any elevators covered by this nsurance. B. NOTICE OF OCCURRENCE 2. This insurance applies only with respect to Your rights under this Coverage Part will not be operations performed by you or on your prejudiced if you fail to give us notice of an behalf for which the state or governmental "occurrence,"offense, claim or"suit" and that agency or subdivision or political failure is solely due to your reasonable belief subdivision has issued a permit or that the "bodily injury" or"property damage" is authorization. not covered under this Coverage Part. However, you shall give written notice of this 3. This insurance does not apply to: "occurrence,"offense, claim or"suit" to us as a. "Bodily injury," "property damage" or soon as you are aware that this insurance may "personal and advertising injury" arising apply to such "occurrence,"offense claim or out of operations performed for the "suit." federal government, state or 4. BROAD NAMED INSURED municipality; or A. Any subsidiary or affiliate organization, other b. "Bodily injury" or "property damage" than a partnership, joint venture or limited included within the "products- liability company, in which a Named Insured completed operations hazard." specifically shown in the Declarations has A governmental permit which requires you to management control, directly or through one or add the governmental entity as an additional more subsidiary organizations, at the time of insured will trigger this Provision 1. as if the loss will qualify as a Named Insured but only if permit were a written contract. there is no other similar insurance available to such organization, nor similar insurance which 2. BODILY INJURY—EXPANDED DEFINITION would be available but for exhaustion of its SECTION V—DEFINITIONS, the definition of limits. For the purpose of this provision, similar "bodily injury" is changed to read: insurance means general liability or equivalent insurance, no matter whether its coverage is "Bodily injury" means bodily injury, sickness or broader or narrower than that provided by this disease sustained by a person, including death, insurance. But if the only other similar humiliation, shock, mental anguish or mental injury insurance is for a "consolidated (wrap-up) by that person at any time which results as a program," then a subsidiary that qualifies as a consequence of the bodily injury, sickness or Named Insured on such project-specific disease. insurance can still qualify as a Named Insured on this insurance, but not for projects covered 3. BROAD KNOWLEDGE OF OCCURRENCE/ by the"consolidated (wrap-up) program." NOTICE OF OCCURRENCE [Please see Item 26.C. of this endorsement for Condition 2. Duties in The Event of Occurrence, the definition of"consolidated (wrap-up) Offense, Claim or Suit of SECTION IV— program.") COMMERCIAL GENERAL LIABILITY CONDITIONS is amended to add the following provisions: G-18652-J (Ed. 07-12) Page 3of12 Copyright,CNA All Rights Reserved cPDF created with pdfFactar-y3 Pria traal3version.ww n.pdffacztorvieom 6 of 15 1/31/2014 9:09:42 AM PST (GMT-8) FROM: 100005-TO: 14088460429 Page: 8 of 16 • G-18652-J CNA (Ed. 07-12) (Ed. 07-12) B. This endorsement does not apply to any (1) Fire; organization for which coverage is excluded by (2) Smoke; another endorsement attached to this policy. C. Only for the purpose of this endorsement: (3) Collapse; or 1. Management control means: (4) Explosion. a. Ownership interest representing more I. Damage to Your Work than 50% of the voting, appointment, or "Property damage"to"your work"arising out of designation power for the subsidiary it, or any part of it and included in the organization's governing body; or "products-completed operations hazard." b. Having the right, pursuant to a written This exclusion does not apply: contract, or pursuant to the by-laws, charter, operating agreement, or similar (1) If the damaged work or the work out of document of a specifically shown which the damage arises was Named Insured or controlled subsidiary performed on your behalf by a organization to select, appoint, or subcontractor; or designate a majority of the subsidiary (2) If the cause of loss to the damaged organization's governing body. Such work arises as a result of contract or document must have been created prior to the time of loss; or (a) Fire; c. Having the right, pursuant to a written (b) Smoke; trust agreement, to protect, control the (c) Collapse; or use of, encumber or transfer and sell property held by a trust, (d) Explosion. 2. Governing body means the Board of B. The following paragraph is added to SECTION Directors of a corporation. III —LIMITS OF INSURANCE: 3. Loss means: Subject to 5. above, $100,000 is the most we will pay under Coverage A for the sum of a. The occurring of the "bodily injury" or damages arising out of any one"occurrence" "property damage"; or because of"property damage" to "your product" b. The committing of the offense that and "your work"that is caused by fire, smoke, caused the "personal and advertising collapse or explosion and is included within the injury." "product-completed operations hazard." This sublimit does not apply to"property damage" to D. The insurance provided by this policy applies to "your work" if the damaged work or the work out Named Insureds when trading under their own of which the damage arises was performed on names, or under such trading names or doing- your behalf by a subcontractor. business-as (DBA) names as any should choose to employ. C. This Provision 5. Broadened Liability Coverage For Damage To "Your Product" 5. BROADENED LIABILITY COVERAGE FOR And "Your Work" does not apply if an DAMAGE TO "YOUR PRODUCT" AND "YOUR endorsement of the same name is attached to WORK" this policy. A. Under SECTION I — COVERAGE A— BODILY 6. CONTRACTUAL LIABILITY— RAILROADS INJURY AND PROPERTY DAMAGE LIABILITY, Paragraph 2. Exclusions is With respect to operations performed within 50 feet amended to delete exclusions k. and I. and of railroad property, the definition of"insured replace them with the following: contract" in SECTION V—DEFINITIONS is replaced by the following: [This insurance does not apply to:] "Insured Contract"means: k. Damage to Your Product a. A contract for a lease of premises. However, "Property damage" to"your product"arising that portion of the contract for a lease of out of it, or any part of it except when premises that indemnifies any person or caused by or resulting from: organization for damage by fire to premises while rented to you or temporarily occupied by G-18652-J (Ed. 07-12) Page 4 of 12 Copyright,CNA All Rights Reserved. oPOF created wait u4Fa©tory3Preb:trial3version.v vr, .tedffiaatorypeorn 7 of 15 1/31/2014 9:09:42 AM PST (GMT-8) FROM: 100005-TO: 14088460429 Page: 9 of 16 G-18652-J CNA (Ed. 07-12) (Ed. 07-12) you with permission of the owner is not an exclusion p. Electronic Data and replace it "insured contract"; with the following: b. A sidetrack agreement; [This insurance does not apply to:] c. Any easement or license agreement; p. Electronic Data d. An obligation, as required by ordinance, to Damages arising out of the loss of, loss of use indemnify a municipality, except in connection of, damage to, corruption of, inability to access, with work for a municipality; or inability to manipulate "electronic data" that does not result from physical injury to tangible e. An elevator maintenance agreement; property. f. That part of any other contract or agreement However, this exclusion does not apply to pertaining to your business (including an liability for damages because of"bodily injury." indemnification of a municipality in connection with work performed for a municipality) under B. The following paragraph is added to SECTION which you assume the tort liability of another III —LIMITS OF INSURANCE: party to pay for "bodily injury" or "property Subject to 5. above, $100,000 is the most we damage" to a third person or organization. Tort will pay under Coverage A for all damages liability means a liability that would be imposed by law in the absence of any contract or arising out of any one"occurrence" because of agreement. "property damage" that results from physical injury to tangible property and arises out of Paragraph f. does not include that part of any "electronic data." contract or agreement: C. The following definition is added to the (1) That indemnifies an architect, engineer or SECTION V—DEFINITIONS: surveyor for injury or damage arising out of: "Electronic data" means information, facts or (a) Preparing, approving or failing to programs stored as or on, created or used on, prepare or approve maps, shop or transmitted to or from computer software drawings, opinions, reports, surveys, (including systems and applications software), field orders, change orders or drawings hard or floppy disks, CD-ROMS, tapes, drives, and specifications; or cells, data processing devices or any other (b) Giving directions or instructions, or media which are used with electronically controlled equipment. failing to give them, if that is the primary cause of the injury or damage; D. For the purposes of the coverage provided by (2) Under which the insured, if an architect, this endorsement, the definition of "property damage" in SECTION V — DEFINITIONS is engineer or surveyor, assumes liability for replaced by the following: an injury or damage arising out of the insured's rendering or failure to render 17. "Property damage" means: professional services, including those listed a. Physical injury to tangible property, in (1) above and supervisory, inspection, architectural or engineering activities. including all resulting loss of use of that property. All such loss of use shall be 7. CONTRACTUAL LIABILITY FOR PERSONAL deemed to occur at the time of the AND ADVERTISING INJURY physical injury that caused it; Under SECTION I —COVERAGE B—PERSONAL b. Loss of use of tangible property that is AND ADVERTISING INJURY LIABILITY, not physically injured. All such loss of Paragraph 2. Exclusions is amended to delete use shall be deemed to occur at the exclusion e. Contractual Liability. time of the "occurrence" that caused it; This provision 7. does not apply to any person or or organization who otherwise qualifies as an c. Loss of, loss of use of, damage to, additional insured on this Coverage Part. corruption of, inability to access, or 8. ELECTRONIC DATA LIABILITY inability to properly manipulate "electronic data," resulting from A. Under SECTION I — COVERAGE A— BODILY physical injury to tangible property. All INJURY AND PROPERTY DAMAGE, such loss of "electronic data" shall be Paragraph 2. Exclusions is amended to delete G-18652-J (Ed. 07-12) Page 5 of 12 Copyright,CNA All Rights Reserved. cPOF created wit4 pd>fFaoter-q3 Pr&trial 3verrior movpdffactorvl€ m 5 0: 15 1/31/2014 9:09:42 AM PST (GMT-8) FROM: 100005-TO: 14088460429 Page: 10 of 16 G-18652-J CNA (Ed. 07-12) deemed to occur at the time of the This provision 9. does not apply to any person "occurrence"that caused it. or organization who otherwise qualifies as an For the purposes of this insurance, additional insured on this Coverage Part. "electronic data" is not tangible property. 10. EXPECTED OR INTENDED INJURY E. If Electronic Data Liability is provided at a Under SECTION I—COVERAGE A— BODILY higher limit by another endorsement attached INJURY AND PROPERTY DAMAGE to this policy, then the $100,000 limit provided LIABILITY, Paragraph 2. Exclusions is by this Provision 8. Electronic Data Liability is amended to delete exclusion a. Expected or part of, and not in addition to, that higher limit. Intended Injury and replace it with the 9. EXPANDED PERSONAL AND ADVERTISING following: INJURY -DISCRIMINATION OR HUMILIATION [This insurance does not apply to:] A. SECTION V — DEFINITIONS is amended to a. Expected or Intended Injury add the following to the definition of "Personal and advertising injury": "Bodily injury"or"property damage" expected or intended from the standpoint of h. Discrimination or humiliation that results in the insured. This exclusion does not apply injury to the feelings or reputation of a to"bodily injury"or"property damage" natural person, but only if such resulting from the use of reasonable force discrimination or humiliation is: to protect persons or property. (1) Not done intentionally by or at the 11. GENERAL AGGREGATE LIMITS OF direction of: INSURANCE -PER PROJECT (a) The insured; or A. For each construction project away from (b) Any "executive officer," director, premises you own or rent, a separate stockholder, partner, member or Construction Project General Aggregate manager (if art are a limited Limit, equal to the amount of the General liability company) of the insured; Aggregate Limit, is the most we will pay for the sum of and (2) Not directly or indirectly related to the 1. All damages under Coverage A, except damages because of "bodily injury" or employment, prospective employment, "property damage" included in the past employment or termination of "products-completed operations employment of any person or persons by any insured. hazard"; and B. Under SECTION I — COVERAGE B — 2. All medical expenses under Coverage PERSONAL AND ADVERTISING INJURY C, LIABILITY, Paragraph 2. Exclusions is that arise from "occurrences" or amended to add the following additional accidents which can be attributed solely exclusions: to ongoing operations at that construction project. Such payments [This insurance does not apply to:] shall not reduce the General Aggregate Discrimination Relating To Room, Limit shown in the Declarations, nor the Dwelling or Premises Construction Project Aggregate Limit of "Personal or advertising injury" caused by any other construction project. discrimination directly or indirectly related B. All: to the sale, rental, lease or sub-lease or 1. Damages under Coverage B, regardless of prospective sale, rental, lease or sub-lease the number of locations or construction of any room, dwelling or premises by or at projects involved; the direction of any insured. Fines Or Penalties 2. Damages under Coverage A, caused by occurrences" which cannot be attributed Fines or penalties levied or imposed by a solely to ongoing operations at a single governmental entity because of construction project, except damages discrimination. because of "bodily injury" or "property G-18652-J (Ed. 07-12) Page 6 of 12 Copyright,CNA All Rights Reserved. GREW.created with, (,,r lFaetary3 F re5 tria63versiorti,w .redffactorypeo as 9 of 1s 1/31/2014 9:09:42 AM PST (GMT-8) FROM: 100005-TO: 14088460429 Page: 11 of 16 G-18652-J CNA (Ed. 07-12) damage" included in the "products- Paragraphs 1.b.(1) and 1.b.(2) with the completed operations hazard"; and following: 3. Medical expenses under Coverage C b. This insurance applies to "bodily injury" caused by accidents which cannot be only if you are not in the business of attributed solely to ongoing operations at a providing professional health care services, single construction project, and only if: will reduce the General Aggregate Limit shown (1) The "bodily injury" is caused by an in the Declarations. "occurrence" that takes place in the C. The limits shown in the Declarations for Each "coverage territory." For the purpose of this insurance: Occurrence, for Damage To Premises Rented To You and for Medical Expense continue to (a) "Bodily injury" caused by a "health apply, but will be subject to either the care incident" will be considered Construction Project Aggregate Limit or the caused by an "occurrence"; and General Aggregate Limit, depending on (b) All acts, errors or omissions that whether the "occurrence" can be attributed solely to ongoing operations at a particular are logically connected by any construction project. common fact, circumstance, situation, transaction, event, advice D. When coverage for liability arising out of the or decision will be considered to "products-completed operations hazard" is constitute a single"occurrence"; provided, any payments for damages because (2) The "bodily injury" occurs during the of "bodily injury" or'"property damage" included in the "products-completed operations hazard," policy period. All "bodily injury" arising regardless of the number of locations involved from an "occurrence"will be deemed to will reduce the Products-Completed Operations have occurred at the time of the first Aggregate Limit shown in the Declarations. act, error, or omission that is part of the "occurrence"; and E. If a single construction project away from B. With respect only to the insurance provided by premises owned by or rented to the insured has this Provision 13., Exclusion 2.e. Employer's been abandoned and then restarted, or if the Liability of SECTION I — COVERAGE A — authorized contracting parties deviate from BODILY INJURY AND PROPERTY DAMAGE, plans, blueprints, designs, specifications or timetables, the project will still be deemed to be is amended to append the following: the same construction project. Only for "bodily injury" not covered by other F. The provisions of SECTION III — LIMITS OF liability insurance (including state-sanctioned INSURANCE not otherwise modified by this self insurance) available to the insured (or endorsement shall continue to apply as which would be available but for exhaustion of stipulated. its limits), this exclusion does not apply to "bodily injury" that arises out of a "health care 12. IN REM ACTIONS incident." Any action in rem against any vessel owned or C. SECTION V — DEFINITIONS is amended to operated by or for you, or chartered by or for you add the following new definition: will be treated in the same manner as though the "Health care incident" means a negligent act, action were in personam against you. error or omission by your "employees" or In rem is a term used to designate actions instituted "volunteer workers" working on your behalf in against the thing, as distinct from actions against the rendering of or failure to render professional the person, which are said to be in personam. health care services in any of the following 13. INCIDENTAL HEALTH CARE MALPRACTICE capacities, or the related furnishing of food, COVERAGE beverages, medical supplies or appliances: A. With respect only to "bodily injury" that arises a. Physician; out of a "health care incident," COVERAGE A— b. Nurse; BODILY INJURY AND PROPERTY DAMAGE c. Emergency medical technician; LIABILITY OF SECTION I — COVERAGES is amended to replace Insuring Agreement d. Paramedic; e. Chiropractor; G-18652-J (Ed. 07-12) Page 7 of 12 Copyright,CNA All Rights Reserved. cROF.created wits pd#Fa®tar--y3 f ra trial3versionwmvpdffactorwcorn 10 of 15 1/31/2014 9:09:42 AM PST (GMT-8) FROM: 100005-TO: 14088460429 Page: 12 of 16 G-18652-J CNA (Ed. 07-12) f. Dentist; employment by you or while performing g. Athletic trainer; duties related to the conduct of your business; and h. Audiologist; b. "bodily injury" to a "volunteer worker" i. Physical therapist; while performing duties related to the j. Psychologist; conduct of your business; k. Speech therapist; when such "bodily injury"arises out of a "health care incident." I. Other allied health professional; or 2. Your "volunteer workers" are insureds with m. Provider of first aid or Good Samaritan respect to: services rendered in an emergency and for a. "bodily injury" to a co-"volunteer which no payment is demanded or worker" while performing duties related received. to the conduct of your business; and D. SECTION I — COVERAGE A — BODILY b. "bodily injury" to an "employee"while in INJURY AND PROPERTY DAMAGE, the course of the "employee's" Paragraph 2. Exclusions is amended to add the employment by you or while performing following additional exclusions. These new duties related to the conduct of your exclusions apply only to this Incidental Health business; Care Malpractice Coverage: when such "bodily injury" arises out of a [This insurance does not apply to:] "health care incident." Dishonesty or Crime 3. Paragraphs 2.a. (1)(a), (b) and (c) of Any dishonest, criminal or malicious act, error SECTION II — WHO IS AN INSURED do or omission. not apply to "bodily injury" for which insurance is provided this Provision 13. Clinical Trials/ Product Testing 4. Paragraph 2.a.(1)(d) of SECTION II — Acts, errors or omissions that occur in the WHO IS AN INSURED is deleted. course of human clinical trials or product testing. G. With respect to the insurance provided by this Provision 13., the following is added to Medicare/Medicaid Fraud Paragraph 4.b.(1) of SECTION IV — Medicare or Medicaid fraud or abuse. COMMERCIAL GENERAL LIABILITY CONDITIONS: Services Excluded by Endorsement To the extent this insurance applies, it is excess Any"health care incident"for which coverage is over any of the other insurance (including excluded by endorsement. qualified self insurance), whether primary, E. SECTION V — DEFINITIONS is amended to excess, contingent or on any other basis, add the following subparagraph to Paragraph f. except for insurance purchased specifically by of the definition of"insured contract": you to be excess of this policy. Paragraph f. does not include that part of any 14. JOINT VENTURES / PARTNERSHIP / LIMITED contract or agreement: LIABILITY COMPANIES (4) Under which you assume another's tort A. The following is added to SECTION II — WHO liability for "bodily injury" arising out of the IS AN INSURED: rendering of or failure to render 4. You are an insured when you had an professional health care services. interest in a joint venture, partnership or F. SECTION II — WHO IS AN INSURED is limited liability company which terminated amended to add the following provisions: or ended prior to or during this policy period, but only to the extent of your 1. Your"employees" are insureds with respect interest in such joint venture, partnership or to: limited liability company. This coverage a. "bodily injury" to a co-"employee"while does not apply: in the course of the co-"employee's" G-18652-J (Ed. 07-12) Page 8 of 12 Copyright,CNA All Rights Reserved ,POF created With. G"D'Factor-y3 Pres trial3versionotwomfodffactorapeorn 11 of 15 1/31/2014 9:09:42 AM PST (GMT-8) FROM: 100005-TO: 14088460429 Page: 13 of 16 G-18652-J CNA (Ed. 07-12) a. Prior to the termination date of any joint (6) That particular part of any property that venture, partnership or limited liability must be restored, repaired or replaced company; because "your work" was incorrectly b. If there is other valid and collectible performed on it. insurance purchased specifically to Paragraph (2) of this exclusion does not insure the partnership, joint venture or apply if the premises are"your work." limited liability company; or Paragraphs (3) and (4) of this exclusion do c. To a joint venture, partnership or not apply to "property damage" to tools or limited liability company which is or equipment loaned to you. A separate limit was insured under a "consolidated of insurance applies to such tools or (wrap-up) insurance program." equipment that are damaged while being [Please see Item 26.C. of this endorsement used in your operations. for the definition of"consolidated (wrap-up) Paragraphs (1), (3) and (4) of this exclusion program."] do not apply to "property damage" (other B. The last paragraph of SECTION II — WHO IS than damage by fire) to premises rented to AN INSURED is deleted and replaced by the you or temporarily occupied by you with the following: permission of the owner, or to the contents of premises rented to you for a period of 7 Except as provided under the Contractors' or fewer consecutive days. A separate limit General Liability Extension Endorsement or by of insurance applies to Damage To the attachment of another endorsement(if any), Premises Rented To You as described in no person or organization is an insured with SECTION III— LIMITS OF INSURANCE. respect to the conduct of any current or past partnership, joint venture or limited liability Paragraphs (3), (4), (5) and (6) of this company that is not shown as a Named Insured exclusion do not apply to liability assumed in the Declarations. under a sidetrack agreement. 15. LEGAL LIABILITY/ALIENATED PREMISES/ Paragraph (6) of this exclusion does not BORROWED EQUIPMENT apply to "property damage" included in the "products-completed operations hazard." A. Under SECTION I — COVERAGE A— BODILY B. Under SECTION I — COVERAGE A— BODILY INJURY AND PROPERTY DAMAGE, INJURY AND PROPERTY DAMAGE the last Paragraph 2. Exclusions is amended to delete exclusion j. Damage to Property in its entirety paragraph of Paragraph 2. Exclusions is and replace it with the following: deleted and replaced by the following. [This insurance does not apply to:] Exclusions c. through n. do not apply to damage by fire to premises while rented to you j. Damage to Property or temporarily occupied by you with permission of the owner nor to the contents of premises "Property damage" to: rented to you for a period of 7 or fewer (1) Property you own, rent, or occupy; consecutive days. (2) Premises you sell, give away or A separate limit of insurance applies to this abandon, if the "property damage" coverage as described in SECTION III — arises out of any part of those LIMITS OF INSURANCE. premises; C. The following paragraph is added to SECTION (3) Property loaned to you; III —LIMITS OF INSURANCE: (4) Personal property in the care, custody Subject to 5. above, $25,000 is the most we will or control of the insured; pay under Coverage A for damages arising out of any one "occurrence" because of "property (5) That particular part of real property on damage" to tools or equipment loaned to you which you or any contractors or by others that occurs while the equipment is subcontractors working directly or being used to perform operations. indirectly on your behalf are performing operations, if the "property damage" D. Paragraph 6. Damage To Premises Rented To arises out of those operations; or You Limit of SECTION III — LIMITS OF INSURANCE is replaced by the following: G-18652-J (Ed. 07-12) Page 9 of 12 Copyright,CNA All Rights Reserved. (PDF created with pd1Factory3 Pixt trial 3versionuv►wwv.pdffaotorapeom 12 of 15 1/31/2014 9:09:42 AM PST (GMT-8) FROM: 100005-TO: 14088460429 Page: 14 of 16 • G-18652-J CNA (Ed. 07-12) 6. Subject to Paragraph 5. above, (the Each SECTION — I — COVERAGE C for all Occurrence Limit), the Damage To medical expenses because of "bodily Premises Rented To You Limit is the most injury" sustained by any one person. The we will pay under SECTION — I — Medical Expense Limit is the greater of: COVERAGE A for damages because of "property damage" to any one premises (1) $15,000; or while rented to you or temporarily occupied (2) The amount shown in the Declarations by you with the permission of the owner, for Medical Expense Limit. including contents of such premises rented to you for a period of 7 or fewer B. Paragraph 1.a.(3)(b) of SECTION I — consecutive days. The Damage To COVERAGE C MEDICAL PAYMENTS, is Premises Rented To You Limit is the replaced by the following: greater of: (b) The expenses are incurred and reported to a. $500,000; or us within three years of the date of the accident; and b. The Damage To Premises Rented To You Limit shown in the Declarations. This paragraph B. does not apply to medical expenses incurred in the state of Missouri. E. Paragraph 4.b.(1)(a)(ii) of SECTION IV - 19. NON-OWNED AIRCRAFT COMMERCIAL GENERAL LIABILITY CONDITIONS is deleted and replaced by the Under SECTION I—COVERAGE A—BODILY following: INJURY AND PROPERTY DAMAGE LIABILITY. (ii) That is property insurance for premises Paragraph 2. Exclusions is amended such that rented to you, for premises temporarily exclusion g.Aircraft,Auto or Watercraft does not occupied by you with the permission of the apply to an aircraft you do not own, provided that: owner; or for personal property of others in 1. The pilot in command holds a currently your care, custody or control; effective certificate issued by the duly F. This Provision 15. does not apply if Damage To constituted authority of the United States of Premises Rented To You Liability under America or Canada, designating that person as SECTION — I — COVERAGE A is excluded by a commercial or airline transport pilot; endorsement. 2. The aircraft is rented to you with a trained, paid 16. LIBERALIZATION CLAUSE crew; and If we adopt a change in our forms or rules which 3. The aircraft does not transport persons or cargo would broaden coverage for contractors under this for a charge. endorsement without an additional premium 20. NON-OWNED WATERCRAFT charge, your policy will automatically provide the additional coverage as of the date the revision is Under SECTION I—COVERAGE A— BODILY effective in your state. INJURY AND PROPERTY DAMAGE LIABILITY, Paragraph 2. Exclusions is amended to delete 17. LIQUOR LIABILITY subparagraph (2) of exclusion g.Aircraft, Auto or Under SECTION I -COVERAGE A-BODILY Watercraft and replace it with the following. INJURY AND PROPERTY DAMAGE, Paragraph 2. [This exclusion does not apply to:) Exclusions is amended to delete exclusion c. Liquor Liability. (2) A watercraft you do not own that is: This provision 17. does not apply to any person or (a) Less than 75 feet long; and organization who otherwise qualifies as an additional insured on this Coverage Part. (b) Not being used to carry persons or property for a charge. 18. MEDICAL PAYMENTS 21. PRIMARY AND NON-CONTRIBUTORY TO A. Paragraph 7. Medical Expense Limit, of OTHER INSURANCE SECTION III — LIMITS OF INSURANCE is With respect to any person or organization that is deleted and replaced by the following: an additional insured under this Coverage Part, the 7. Subject to Paragraph 5. above (the Each following is added to Paragraph 4. of SECTION IV Occurrence Limit), the Medical Expense —COMMERCIAL GENERAL LIABILITY Limit is the most we will pay under CONDITIONS: G-18652-J (Ed. 07-12) Page 10 of 12 Copyright,CNA All Rights Reserved. cROF created with, i,.r IFaot y3 PPrG traa63verrior w .pdf#aotorapcom 13 of S 1/31/2014 9:09:42 AM PST (GMT-8) FROM: 100005-TO: 14088460429 Page: 15 of 16 G-18652-J CNA (Ed. 07-12) If you have agreed in writing in a contract or 25. WAIVER OF SUBGROGATION - BLANKET agreement that this insurance is primary and non Under SECTION IV—COMMERCIAL GENERAL contributory relative to an additional insured's own LIABILITY CONDITIONS, The Transfer Of Rights insurance, then this insurance is primary and we Of Recovery Against Others To Us Condition is will not seek contribution from that other insurance. amended by the addition of the following: For the purpose of this Provision 21., the additional insured's own insurance means insurance on which We waive any right of recovery we may have the additional insured is a Named Insured. against any person or organization because of This Provision 21. does not apply in situations payments we make for injury or damage arising out where the endorsement on this policy affording of: coverage to the additional insured specifies that 1. Your ongoing operations; or this insurance is excess over any other insurance available to that additional insured. 2. "Your work" included in the "products completed operations hazard." 22. PROPERTY DAMAGE—ELEVATORS However, this waiver applies only when you have A. Under SECTION I — COVERAGE A — BODILY agreed in writing to waive such rights of recovery in INJURY AND PROPERTY DAMAGE, a contract or agreement, and only if the contract or Paragraph 2. Exclusions is amended such that agreement: exclusion k. Damage to Your Product, and subparagraph (3), (4) and (6) of exclusion j. 1. Is in effect or becomes effective during the Damage to Property do not apply "property term of this policy; and damage"that results from the use of elevators. 2. Was executed prior to loss. B. With respect only to the coverage provided by 26. WRAP-UP EXTENSION: OWNER CONTROLLED this endorsement, Condition 4. Other INSURANCE PROGRAM, CONTRACTOR Insurance in SECTION IV — COMMERCIAL CONTROLLED INSURANCE PROGRAM OR GENERAL LIABILITY CONDITIONS is CONSOLIDATED (WRAP-UP) INSURANCE amended to add the following subparagraph PROGRAMS b.(1)(a)(v): Note: The following provision does not apply to any 4. Other Insurance public construction project in the state of b. Excess Insurance Oklahoma, nor to any construction project in the state of Alaska, that is not permitted to be insured (1) This insurance is excess over: under a "consolidated (wrap-up) insurance (a) Any of the other insurance, program" by applicable state statute or regulation: whether primary, excess, If the endorsement EXCLUSION— contingent or on any other CONSTRUCTION WRAP-UP or another basis: exclusionary endorsement pertaining to Owner (v) That is Property insurance Controlled Insurance Programs (O.C.I.P.) or covering property of others Contractor Controlled Insurance Programs damaged from the use of (C.C.I.P.) is attached to this policy, then the elevators. following changes apply: 23. SUPPLEMENTARY PAYMENTS A. The following wording is added to the endorsement: A. Under Section I — Supplementary Payments With respect to a "consolidated (wrap-up) —Coverages A and B, Paragraph 1.b., the limit insurance program" project in which you are or of $250 shown for the cost of bail bonds is were involved, this exclusion does not apply to replaced by$5,000. those sums you become legally obligated to B. In Paragraph 1.d., the limit of $250 shown for pay as damages because of: daily loss of earnings is replaced by$1,000. 1. "Bodily injury," "property damage," or 24. UNINTENTIONAL FAILURE TO DISCLOSE "personal or advertising injury" that occurs HAZARDS during your ongoing operations at the If unintentionally you should fail to disclose all project, or during such operations of existing hazards at the inception date of your anyone acting on your behalf; nor policy, we will not deny coverage under this 2. "Bodily injury" or "property damage" Coverage Part because of such failure. included within the "products-completed G-18652-J (Ed. 07-12) Page 11 of 12 Copyright,CNA All Rights Reserved °ROF created with,pdiFaotor-y3 6 ' :tr4 a63versior,iwwr, .pd ffacicrapeom 14 of 15 3/22/2013 11:34:35 AM PST (GMT-8) FROM: 100005-TO: 14088460429 Page: 2 of 16 A` RD® CERTIFICATE OF LIABILITY INSURANCE DATE/22/ D/YYYY) 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). PRODUCER Arthur J. Gallagher&Co. Insurance Brokers CONTACT NAME: of California, Inc. 3697 Mt. Diablo Blvd., Suite 300 PHONE(A/C.No.E<0 925-299-1112 I FAX(A/C-No): 925-299-0328 Lafayette, CA 94549 E-MAIL ADDRESS INSURER(S)AFFORDING COVERAGE NAIC Al www.ajg.corn 0726293 INSURER National Fire Ins Co of Hartford 20478 INSURED INSURERS: Continental Casualty Insurance Company 20443 FBD Vanguard Construction, Inc. dba: Vanguard Construction INSURER : Fireman's Fund Insurance Company 21873 651 Enterprise Ct. INSURER0: Zurich American Insurance Co. 16535 Livermore, CA 94550-5200 INSURER E: INSURER' _ COVERAGES CERTIFICATE NUMBER: 15807748 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUER POLICY EFF POLICY EXP W M/ LIMITS LTR INSR VD POLICY NUMBER (MMIDD/YYYY) (MDD/YYYY) A GENERALLIABILITY 4014291109 3/25/2013 3/25/2014 EACH OCCURRENCE $ 2,000,000 DAMAGE TO RENTED 100,000 J COMMERCIAL GENERAL LIABILITY PREMISES(Ea occurrence) $ CLAIMS-MADE e OCCUR MED EXP(Any one person) $ 5,000 1 XCU Included PERSONAL&ADV INJURY $ 2,000,000 I Contractural Liab GENERAL AGGREGATE $ 4,000,000 GEN'L AGGREGATE LIMIT APPLIES PER. PRODUCTS••COMP/OP AGG $ 4,000,000 -I POLICY 171 PRO- n LOC Deductible $ $5,000 JECi B I AUTOMOBILE LIABILITY 4013610249 3/25/2013 3/25/2014 '(EO aBBI dEED1)INGLE LIMIT $ 1,000,000 J ANY AUTO BODILY INJURY(Per person) $ ALL OWNED 'SCHEDULED BODILY INJURY(Per accident) $ AUTOS _ AUTOS – NON-OWNED PROPERTY DAMAGE J HIRED AUTOS 1 AUTOS (Per accident) $ _ 1 form CA 0001 03 06 $ - $ C UMBRELLA LIAE / OCCUR SSE48706600 3/25/2013 3/25/2014 ,EACH OCCURRENCE $ 10,000,000 J EXCESS LIAE CLAIMS-MADE AGGREGATE $ 10,000,000 DED I J I RETENTION$0 $ — o WORKERS COMPENSATION Y/N WC489238203 2/1/2014 2/1/2015 I we STATUS IS I. EMPLOYERS'LIABILITY TORY LIMITS ANY PROPRIETOR/PARTNER/EXECUTIVE I E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 It yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE•POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach AC ORD 101,Additional Remarks Schedule,it more space is required) City of Gilroy is included as additional insured for General Liability perform G-140331-C31 10/10 attached(Primary Wording Included).Waiver of Subrogation applies for General Liability per form G-18652-J 07-12 attached. The above Additional Insured, Primary Wording and Waiver of Subrogation Endorsements are only valid if requested by written contract. VG986 Project:VERBS Safe Route to School-Proiect No 12-PW-199,Federal Project No RPSTPLE-5035(024) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Gilroy THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Putlic Works Department ACCORDANCE WITH THE POLICY PROVISIONS. 7351 Rosanna Street Gilroy CA 95020 AUTHORIZED REPRESENTATIVE _ Jamie Yaudes ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD CERT riO.: 15807746 CLIEPIT CODE: 1991-02-03 15:55:28.603 Jamie Yaudes 3/22/2013 11:30:06 AM Page 1 of 15 3/22/2013 11:34:35 AM PST (GMT-8) FROM: 100005-TO: 14088460429 Page: 3 of 16 4014291109 3/22/2013 FBD Vanguard Construction, Inc. CF'IA G-140331-C31 Ed. 10/10) . C THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS -WITH PRODUCTS-COMPLETED OPERATIONS COVERAGE This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE(OPTIONAL) Name of Additional Insured Persons Or Organizations (44 yreoqu j doby"written contract"per Paragraph A. below.) Putlic Works Department 7351 Rosanna Street Gilroy CA 95020 • Locations of Covered Operations (As per the"written contract", provided the location is within the"coverage territory"of this Coverage Part.) A. Section II-Who Is An Insured is amended to 2. We will not provide the additional insured any include as an additional insured: broader coverage or any higher limit of 1.Any person or organization whom you are insurance than the least that is: required by written contract"to add as an y" " a. Required by the"written contract"; additional insured on this Coverage Part;and b. Described in B.1.above;or 2.The particular person or organization, if any, scheduled above. c. Afforded to you under this policy. B. The insurance provided to the additional insured is 3. This insurance is excess of all other insurance limited as follows: available to the additional insured whether on a 1. The person or organization is an additional primary,excess, contingent or any other basis. insured only with respect to liability for"bodily But if required by the"written contract", this • injury", only damage", liability 'personal and insurance will be primary and non-contributory I ry","p p y g p relative to insurance on which the additional advertising injury"caused in whole or in part by: insured is a Named Insured. a. Your acts or omissions; or 4. The insurance provided to the additional insured b. The acts or omissions of those acting on does not apply to"bodily injury","property your behalf damage", or"personal and advertising injury in the performance of your ongoing operations arising out of: specified in the"written contract"; or a. The rendering of, or the failure to render, c. "Your work"that is specified in the"written any professional architectural,engineering, contract"but only for"bodily injury"or or surveying services, including: "property damage"included in the (1) The preparing, approving,or failing to "products-completed operations hazard", prepare or approve maps, shop and only if: drawings,opinions, reports,surveys, (1)The"written contract"requires you to field orders,change orders or drawings provide the additional insured such and specifications; and coverage;and (2) Supervisory, inspection,architectural or (2)This Coverage Part provides such engineering activities;or coverage. b. Any premises or work for which the additional insured is specifically listed as an G-140331-C31 Includes copyrighted material of Insurance Services Office,Inc.,with its permission Page 1 of 2 (Ed. 10/10) cRDE created with G,r#Fa©to y3 Pt--tria63verasioriuwww.pdffacfimry.aame 2 of 15 3/22/2013 11:34:35 AM PST (GMT-8) FROM: 100005-TO: 14088460429 Page: 4 of 16 CNA G-140331-C31 Ed. 10/10) additional insured on another endorsement We have no duty to defend or pay on behalf of • attached to this Coverage Part. an additional insured under this endorsement C. SECTION IV—COMMERCIAL GENERAL until we receive from the additional insured LIABILITY CONDITIONS is amended as follows: written notice of a claim or"suit'. 1. The Duties In The Event of Occurrence, 2. With respect only to the insurance provided by Offense,Claim or Suit condition is amended to this endorsement,the first sentence of add the following additional conditions Paragraph 4.a.of the Other Insurance Condition applicable to the additional insured: is deleted and replaced with the following: An additional insured under this endorsement 4. Other Insurance will as soon as practicable: a. Primary Insurance (1) Give us written notice of an"occurrence"or This insurance is primary and non- an offense which may result in a claim or contributory except when rendered "suit" under this insurance, and of any claim excess by endorsement G-140331-C31, or"suit"that does result; or when Paragraph b. below applies. (2) Except as provided in Paragraph B.3 of this D. Only for the purpose of the insurance provided by endorsement,agree to make available any this endorsement,SECTION V—DEFINITIONS is other insurance the additional insured has amended to add the following definition: for a loss we cover under this Coverage Part; "Written contract"means a written contract or written agreement that requires you to make a • (3) Send us copies of all legal papers received, person or organization an additional insured on this and otherwise cooperate with us in the .Coverage Part, provided the contract or agreement: investigation, defense, or settlement of the 1. Is currently in effect or becomes effective during claim or"suit";and the term of this policy; and (4) Tender the defense and indemnity of any 2.Was executed prior to: • claim or"suit"to any other insurer or self insurer whose policy or program applies to a a.The"bodily injury"or"properly damage"; or loss we cover under this Coverage Part. b The offense that caused the"personal and But if the"written contract"requires this advertising injury" insurance to be primary and non- for which the additional insured seeks coverage contributory,this provision (4)does not under this Coverage Part. apply to insurance on which the additional insured is a Named Insured. • • G-140331-C31 Includes copyrighted material of Insurance Services Office,Inc.,with its permission Page 2 of 2 (Ed. 10/10) • cPOF created with u..5tFaotor-y3 Preb trial3verasionmvev .zedffactora,t.CaMe 3 of 15 3/22/2013 11:34:35 AM PST (GMT-8) FROM: 100005-TO: 14088460429 Page: 5 of 16 rrsu vanguaro construction, Inc. dba: Vanguard Construction G-18652-J CNA (Ed. 07-12) 4014291109 3/22/2013 CONTRACTORS'GENERAL LIABILITY EXTENSION ENDORSEMENT It is understood and agreed that this endorsement amends the COMMERCIAL GENERAL LIABILITY COVERAGE PART as follows. The changes this endorsement makes do not apply with respect to any coverage that has been excluded or amended by another endorsement attached to this policy. SCHEDULE Coverage is summarized below. For particulars and limitations affecting each coverage, please refer to the corresponding policy provisions in the body of this endorsement. 1. Additional Insureds Seven additional insured extensions. 2. Bodily Injury- Expanded Definition 3. Broad Knowledge of Occurrence!Notice of Occurrence 4. Broad Named Insured 5. Broadened Liability Coverage For Damage To "Your Product"And "Your Work" Limit: $100,000. 6. Contractual Liability—Railroads Expanded definition of"insured contract." 7. Contractual Liability For Personal And Advertising Injury 8. Electronic Data Liability Loss of Electronic Data Limit: $100,000. 9. Expanded Personal And Advertising Injury - Discrimination Or Humiliation 10. Expected Or Intended Injury Reasonable force-"bodily injury"or"property damage." 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 Coverage for your interest in such terminated or ended organizations. 15. Legal Liability/Alienated Premises/Borrowed Equipment Coverage Extended perils. Default limit increased to$500,000 for Damage to Premises Rented To You. $25,000 limit for"property damage" to borrowed tools or equipment at a jobsite. 16. Liberalization Clause 17. Liquor Liability Coverage Extension 18. Medical Payments Limits increased to$15,000. Reporting increased to three years from the date of accident. 19. Non-owned Aircraft Coverage 20. Non-owned Watercraft Increased to 75 feet. 21. Primary And Non-Contributory To Other Insurance 22. Property Damage- Elevators 23. Supplementary Payments Cost of bail bonds increased to$5,000. Daily loss of earnings increased to$1,000. 24. Unintentional Failure To Disclose Hazards 25. Waiver of Subrogation - Blanket Waiver of subrogation where required by written contract or written agreement. 26. Wrap-Up Extension G-18652-J (Ed. 07-12) Page 1 of 12 Copyright,CNA All Rights Reserved. cPOF created wirtit pdfFa©tor-y3 PrG traai3verriorw iww.pdffactory.00r1ae 4 of 15 3/22/2013 11:34:35 AM PST (GMT-8) FROM: 100005-TO: 14088460429 Page: b of 16 G-18652-J CNA (Ed. 07-12) 1. ADDITIONAL INSURED 2. With respect to the insurance afforded to these additional insureds, this insurance ,SECTION II —WHO IS AN INSURED is amended does not apply to any "occurrence" which to include as an insured any person or organization takes place after the equipment lease (called additional insured) described in paragraphs expires. A.through G. below whom you are required to add as an additional insured on this policy under a D. Lessor - Land written contract or written agreement, provided the An owner or other interest from whom land has written contract or written agreement: been leased by you but only with respect to i. Is currently in effect or becomes effective liability arising out of the ownership, during the term of this policy; and maintenance or use of that specific part of the land leased to you and subject to the following ii. Was executed prior to the "bodily injury," additional exclusions: "property damage" or "personal injury and advertising injury" for which the additional This insurance does not apply to: insured seeks coverage. 1. Any "occurrence" which takes place after However, we will not provide the additional you cease to lease that land; or insured any broader coverage or any higher 2. Structural alterations, new construction or limit of insurance than the least that is: demolition operations performed by or on a. The maximum permitted by law; behalf of such additional insured. b. Required in the written contract or written E. Lessor- Premises agreement; A manager or lessor of premises but only with c. Afforded to you under this policy; or respect to liability arising out of the ownership, maintenance or use of that specific part of the d. Described in the applicable paragraphs A. premises leased to you and subject to the through G. below. following additional exclusions: A. Controlling Interest This insurance does not apply to: Any persons or organizations with a controlling 1. Any "occurrence" which takes place after interest in you but only with respect to their you cease to be a tenant in that premises; liability arising out of: or 1. Their financial control of you; or 2. Structural alterations, new construction or 2. Premises they own, maintain or control demolition operations performed by or on while you lease or occupy these premises. behalf of such additional insured. This insurance does not apply to structural F. Mortgagee,Assignee or Receiver alterations, new construction and demolition A mortgagee, assignee or receiver but only with operations performed by or for such additional respect to their liability as mortgagee, assignee, insured. or receiver and arising out of the ownership, B. Co-owner of Insured Premises maintenance, or use of a premises by you. A co-owner of a premises co-owned by you and This insurance does not apply to structural covered under this insurance but only with alterations, new construction or demolition respect to the co-owner's liability as co-owner operations performed by or for such additional of such premises. insured. C. Lessor -Equipment G. State or Governmental Agency or Subdivision or Political Subdivisions 1. Any person or organization from whom you A state or governmental agency or subdivision lease equipment, but only with respect to liability for "bodily injury," "property or political subdivision subject to the following damage" or "personal and advertising provisions: injury" caused, in whole or in part, by your 1. This insurance applies only with respect to maintenance, operation or use of the following hazards for which the state or equipment leased to you by such person or governmental agency or subdivision or organization. political subdivision has issued a permit or G-18652-J (Ed. 07-12) Page 2 of 12 Copyright,CNA All Rights Reserved. cROF created with i,r4Factory3Pra:traa63versio mmt.p ffactorr.eofine 5 of 15 3/22/2013 11:34:35 AM PST (GMT-8) FROM: 100005-TO: 14088460429 Page: / of 16 G-18652-J CNA (Ed. 07-12) authorization in connection with premises A. BROAD KNOWLEDGE OF OCCURRENCE you own, rent, or control and to which this You must give us or our authorized insurance applies: representative notice of an "occurrence," a. The existence, maintenance, repair, offense, claim, or "suit" only when the construction, erection, or removal of "occurrence," offense, claim or "suit" is known advertising signs, awnings, canopies, to: cellar entrances, coal holes, driveways, manholes, marquees, hoistaway (1) You, if you are an individual; openings, sidewalk vaults, street (2) A partner, if you are a partnership; banners, or decorations and similar exposures; or (3) An executive officer or the employee designated by you to give such notice, if b. The construction, erection, or removal you are a corporation; or of elevators; or (4) A manager, if you are a limited liability c. The ownership, maintenance or use of company. any elevators covered by this B. NOTICE OF OCCURRENCE insurance. 2. This insurance applies only with respect to Your rights under this Coverage Part will not be operations performed by you or on your prejudiced if you fail to give us notice of an behalf for which the state or governmental "occurrence,"offense, claim or"suit" and that agency or subdivision or political failure is solely due to your reasonable belief subdivision has issued a permit or that the "bodily injury" or"property damage" is authorization. not covered under this Coverage Part. However, you shall give written notice of this 3. This insurance does not apply to: "occurrence,"offense, claim or"suit"to us as a. "Bodily injury," "property damage" or soon as you are aware that this insurance may "personal and advertising injury" arising apply to such "occurrence,"offense claim or out of operations performed for the "suit." federal government, state or 4. BROAD NAMED INSURED municipality; or A. Any subsidiary or affiliate organization, other b. "Bodily injury" or "property damage" than a partnership, joint venture or limited included within the "products- liability company, in which a Named Insured completed operations hazard." specifically shown in the Declarations has A governmental permit which requires you to management control, directly or through one or add the governmental entity as an additional more subsidiary organizations, at the time of insured will trigger this Provision 1. as if the loss will qualify as a Named Insured but only if permit were a written contract. there is no other similar insurance available to such organization, nor similar insurance which 2. BODILY INJURY—EXPANDED DEFINITION would be available but for exhaustion of its SECTION V—DEFINITIONS, the definition of limits. For the purpose of this provision, similar insurance means general liability or equivalent "bodily injury" is changed to read: insurance, no matter whether its coverage is "Bodily injury" means bodily injury, sickness or broader or narrower than that provided by this disease sustained by a person, including death, insurance. But if the only other similar humiliation, shock, mental anguish or mental injury insurance is for a "consolidated (wrap-up) by that person at any time which results as a program," then a subsidiary that qualifies as a consequence of the bodily injury, sickness or Named Insured on such project-specific disease. insurance can still qualify as a Named Insured 3. BROAD KNOWLEDGE OF OCCURRENCE/ on this insurance, but not for projects covered NOTICE OF OCCURRENCE by the"consolidated (wrap-up) program." [Please see Item 26.C. of this endorsement for Condition 2. Duties in The Event of Occurrence, the definition of"consolidated (wrap-up) Offense, Claim or Suit of SECTION IV— program.") COMMERCIAL GENERAL LIABILITY CONDITIONS is amended to add the following provisions: G-18652-J (Ed. 07-12) Page 3 of 12 Copyright,CNAAII Rights Reserved. cPOF.created with=pdiFaotory3 Rrr :traa63versio wwww.adffa(tor&Qome 6 of 15 3/22/2013 11:34:35 AM PST (GMT-8) FROM: 100005-TO: 14088460429 Page: 8 of 16 G-18652-J CNA (Ed. 07-12) B. This endorsement does not apply to any (1) Fire; organization for which coverage is excluded by (2) Smoke; . another endorsement attached to this policy. C. Only for the purpose of this endorsement: (3) Collapse; or 1. Management control means: (4) Explosion. a. Ownership interest representing more I. Damage to Your Work than 50% of the voting, appointment, or "Property damage"to"your work"arising out of designation power for the subsidiary it, or any part of it and included in the organization's governing body; or "products-completed operations hazard." b. Having the right, pursuant to a written This exclusion does not apply: contract, or pursuant to the by-laws, charter, operating agreement, or similar (1) If the damaged work or the work out of document of a specifically shown which the damage arises was Named Insured or controlled subsidiary performed on your behalf by a organization to select, appoint, or subcontractor; or designate a majority of the subsidiary (2) If the cause of loss to the damaged organization's governing body. Such work arises as a result of: contract or document must have been created prior to the time of loss; or (a) Fire; c. Having the right, pursuant to a written (b) Smoke; trust agreement, to protect, control the (c) Collapse; or use of, encumber or transfer and sell property held by a trust. (d) Explosion. 2. Governing body means the Board of B. The following paragraph is added to SECTION Directors of a corporation. III —LIMITS OF INSURANCE: 3. Loss means: Subject to 5. above, $100,000 is the most we will pay under Coverage A for the sum of a. The occurring of the "bodily injury" or damages arising out of any one"occurrence" "property damage"; or because of"property damage"to"your product" b. The committing of the offense that and "your work"that is caused by fire, smoke, caused the "personal and advertising collapse or explosion and is included within the injury." "product-completed operations hazard." This sublimit does not apply to"property damage"to D. The insurance provided by this policy applies to "your work" if the damaged work or the work out Named Insureds when trading under their own of which the damage arises was performed on names, or under such trading names or doing- your behalf by a subcontractor. business-as (DBA) names as any should choose to employ. C. This Provision 5. Broadened Liability 5. BROADENED LIABILITY COVERAGE FOR Coverage For Damage To "Your Product" And "Your Work" does not apply if an DAMAGE TO "YOUR PRODUCT" AND "YOUR endorsement of the same name is attached to WORK" this policy. A. Under SECTION I — COVERAGE A— BODILY 6. CONTRACTUAL LIABILITY—RAILROADS INJURY AND PROPERTY DAMAGE LIABILITY, Paragraph 2. Exclusions is With respect to operations performed within 50 feet amended to delete exclusions k. and I. and of railroad property, the definition of"insured replace them with the following: contract" in SECTION V—DEFINITIONS is replaced by the following: [This insurance does not apply to:] "Insured Contract" means: k. Damage to Your Product a. A contract for a lease of premises. However, "Property damage"to"your product"arising that portion of the contract for a lease of out of it, or any part of it except when premises that indemnifies any person or caused by or resulting from: organization for damage by fire to premises while rented to you or temporarily occupied by G-18652-J (Ed. 07-12) Page 4 of 12 Copyright,CNA All Rights Reserved. cROF created with pdifFaotor-y3 Pra tria63verrioEuwvwpdf#actorai.com 7 of 15 3/22/2013 11:34:35 AM PST (GMT-8) FROM: 100005-TO: 14088460429 Page: 9 of 16 G-18652-J CNA (Ed. 07-12) you with permission of the owner is not an exclusion p. Electronic Data and replace it "insured contract"; with the following: `b. A sidetrack agreement; [This insurance does not apply to:] c. Any easement or license agreement; p. Electronic Data d. An obligation, as required by ordinance, to Damages arising out of the loss of, loss of use indemnify a municipality, except in connection of, damage to, corruption of, inability to access, with work for a municipality; or inability to manipulate "electronic data" that e. An elevator maintenance agreement; does not result from physical injury to tangible property. f. That part of any other contract or agreement However, this exclusion does not apply to pertaining to your business (including an liability for damages because of"bodily injury." indemnification of a municipality in connection with work performed for a municipality) under B. The following paragraph is added to SECTION which you assume the tort liability of another III —LIMITS OF INSURANCE: party to pay for "bodily injury" or "property Subject to 5. above, $100,000 is the most we damage" to a third person or organization. Tort will pay under Coverage A for all damages liability means a liability that would be imposed arising out of any one"occurrence" because of by law in the absence of any contract or "property damage" that results from physical agreement. injury to tangible property and arises out of Paragraph f. does not include that part of any "electronic data." contract or agreement: C. The following definition is added to the (1) That indemnifies an architect, engineer or SECTION V—DEFINITIONS: surveyor for injury or damage arising out of: "Electronic data" means information, facts or (a) Preparing, approving or failing to programs stored as or on, created or used on, prepare or approve maps, shop or transmitted to or from computer software drawings, opinions, reports, surveys, (including systems and applications software), field orders, change orders or drawings hard or floppy disks, CD-ROMS, tapes, drives, and specifications; or cells, data processing devices or any other (b) Giving directions or instructions, or media which are used with electronically controlled equipment. failing to give them, if that is the primary cause of the injury or damage; D. For the purposes of the coverage provided by (2) Under which the insured, if an architect, this endorsement, the definition of "property engineer or surveyor, assumes liability for damage" in SECTION V — DEFINITIONS is an injury or damage arising out of the replaced by the following: insured's rendering or failure to render 17. "Property damage" means: professional services, including those listed a. Physical injury to tangible property, in (1) above and supervisory, inspection, architectural or engineering activities. including all resulting loss of use of that property. All such loss of use shall be 7. CONTRACTUAL LIABILITY FOR PERSONAL deemed to occur at the time of the AND ADVERTISING INJURY physical injury that caused it; Under SECTION I —COVERAGE B—PERSONAL b. Loss of use of tangible property that is AND ADVERTISING INJURY LIABILITY, not physically injured. All such loss of Paragraph 2. Exclusions is amended to delete use shall be deemed to occur at the exclusion e. Contractual Liability. time of the "occurrence" that caused it; This provision 7. does not apply to any person or or organization who otherwise qualifies as an c. Loss of, loss of use of, damage to, additional insured on this Coverage Part. corruption of, inability to access, or 8. ELECTRONIC DATA LIABILITY inability to properly manipulate "electronic data," resulting from A. Under SECTION I — COVERAGE A— BODILY physical injury to tangible property. All INJURY AND PROPERTY DAMAGE, such loss of "electronic data" shall be Paragraph 2. Exclusions is amended to delete G-18652-J (Ed. 07-12) Page 5 of 12 Copyright,CNA All Rights Reserved. cROF.created with, #Faetory3 Pre triat3versio wwv.pdf#actorr.eame a of 15 3/22/2013 11:34:35 AM PST (GMT-8) FROM: 100005-TO: 14088460429 Page: 10 of 16 G-18652-J CNA (Ed. 07-12) deemed to occur at the time of the This provision 9. does not apply to any person "occurrence"that caused it. or organization who otherwise qualifies as an For the purposes of this insurance, additional insured on this Coverage Part. "electronic data" is not tangible property. 10. EXPECTED OR INTENDED INJURY E. If Electronic Data Liability is provided at a Under SECTION I —COVERAGE A— BODILY higher limit by another endorsement attached INJURY AND PROPERTY DAMAGE to this policy, then the $100,000 limit provided LIABILITY, Paragraph 2. Exclusions is by this Provision 8. Electronic Data Liability is amended to delete exclusion a. Expected or part of, and not in addition to, that higher limit. Intended Injury and replace it with the 9. EXPANDED PERSONAL AND ADVERTISING following: INJURY-DISCRIMINATION OR HUMILIATION [This insurance does not apply to:] A. SECTION V — DEFINITIONS is amended to a. Expected or Intended Injury add the following to the definition of "Personal "Bodily injury"or"property damage" and advertising injury": expected or intended from the standpoint of h. Discrimination or humiliation that results in the insured. This exclusion does not apply injury to the feelings or reputation of a to"bodily injury"or"property damage" natural person, but only if such resulting from the use of reasonable force discrimination or humiliation is: to protect persons or property. (1) Not done intentionally by or at the 11. GENERAL AGGREGATE LIMITS OF direction of: INSURANCE -PER PROJECT (a) The insured; or A. For each construction project away from premises you own or rent, a separate (b) Any "executive officer," director, stockholder, partner, member or Construction Project General Aggregate (if are a limited Limit, equal to the amount of the General manager liability (if you u a the insured; Aggregate Limit, is the most we will pay for the sum of: and (2) Not directly or indirectly related to the 1. All damages under Coverage A, except damages because of "bodily injury" or employment, prospective employment, "property damage" included in the past employment or termination of "products-completed operations employment of any person or persons hazard"; and by any insured. B. Under SECTION I — COVERAGE B — 2. All medical expenses under Coverage C' PERSONAL AND ADVERTISING INJURY LIABILITY, Paragraph 2. Exclusions is that arise from "occurrences" or amended to add the following additional accidents which can be attributed solely exclusions: to ongoing operations at that [This insurance does not apply to:] construction project. Such payments shall not reduce the General Aggregate Discrimination Relating To Room, Limit shown in the Declarations, nor the Dwelling or Premises Construction Project Aggregate Limit of "Personal or advertising injury"caused by any other construction project. discrimination directly or indirectly related B. All: to the sale, rental, lease or sub-lease or 1. Damages under Coverage B, regardless of prospective sale, rental, lease or sub-lease the number of locations or construction of any room, dwelling or premises by or at projects involved; the direction of any insured. Fines Or Penalties 2. Damages under Coverage A, caused by occurrences" which cannot be attributed Fines or penalties levied or imposed by a solely to ongoing operations at a single governmental entity because of construction project, except damages discrimination. because of "bodily injury" or "property G-18652-J (Ed. 07-12) Page 6 of 12 Copyright,CNA Ali Rights Reserved. cREIF.created with,pdtFaot r-y3 Pr&trial3version.www.pdffactorv.com 9 of 15 3/22/2013 11:34:35 AM PST (GMT-8) FROM: 100005-TO: 14088460429 Page: 11 of lb G-18652-J CNA (Ed. 07-12) • damage" included in the "products- Paragraphs 1.b.(1) and 1.b.(2) with the completed operations hazard"; and following: 3. Medical expenses under Coverage C b. This insurance applies to "bodily injury" caused by accidents which cannot be only if you are not in the business of attributed solely to ongoing operations at a providing professional health care services, single construction project, and only if: will reduce the General Aggregate Limit shown (1) The "bodily injury" is caused by an in the Declarations. "occurrence" that takes place in the C. The limits shown in the Declarations for Each "coverage territory." For the purpose of this insurance: Occurrence, for Damage To Premises Rented To You and for Medical Expense continue to (a) "Bodily injury" caused by a "health apply, but will be subject to either the care incident" will be considered Construction Project Aggregate Limit or the caused by an "occurrence"; and General Aggregate Limit, depending on (b) All acts, errors or omissions that whether the "occurrence" can be attributed solely to ongoing operations at a particular are logically connected by any construction project. common fact, circumstance, situation, transaction, event, advice D. When coverage for liability arising out of the or decision will be considered to "products-completed operations hazard" is constitute a single"occurrence"; provided, any payments for damages because , of "bodily injury" or"property damage" included (2) The "bodily injury' occurs during the in the "products-completed operations hazard," policy period. All "bodily injury" arising regardless of the number of locations involved from an "occurrence"will be deemed to will reduce the Products-Completed Operations have occurred at the time of the first Aggregate Limit shown in the Declarations. act, error, or omission that is part of the "occurrence"; and E. If a single construction project away from B. With respect only to the insurance provided by premises owned by or rented to the insured has this Provision 13., Exclusion 2.e. Employer's been abandoned and then restarted, or if the Liability of SECTION I — COVERAGE A — authorized contracting parties deviate from BODILY INJURY AND PROPERTY DAMAGE, plans, blueprints, designs, specifications or is amended to append the following: timetables, the project will still be deemed to be the same construction project. Only for "bodily injury" not covered by other F. The provisions of SECTION III — LIMITS OF liability insurance (including state-sanctioned INSURANCE not otherwise modified by this self insurance) available to the insured (or endorsement shall continue to apply as which would be available but for exhaustion of stipulated. its limits), this exclusion does not apply to "bodily injury" that arises out of a "health care 12. IN REM ACTIONS incident." Any action in rem against any vessel owned or C. SECTION V — DEFINITIONS is amended to operated by or for you, or chartered by or for you add the following new definition: will be treated in the same manner as though the "Health care incident" means a negligent act, action were in personam against you. error or omission by your "employees" or In rem is a term used to designate actions instituted "volunteer workers" working on your behalf in against the thing, as distinct from actions against the rendering of or failure to render professional the person, which are said to be in personam. health care services in any of the following 13. INCIDENTAL HEALTH CARE MALPRACTICE capacities, or the related furnishing of food, COVERAGE beverages, medical supplies or appliances: A. With respect only to "bodily injury" that arises a. Physician; out of a "health care incident," COVERAGE A— b. Nurse; BODILY INJURY AND PROPERTY DAMAGE LIABILITY OF SECTION I — COVERAGES is c. Emergency medical technician; amended to replace Insuring Agreement d. Paramedic; e. Chiropractor; G-18652-J (Ed. 07-12) Page 7 of 12 Copyright,CNA All Rights Reserved. cFaCiF created with G,r#Faotkr-y3 Pio trial3versionuwur . ditactorv.CoMP 10 of 15 3/22/2013 11:34:35 AM PST (GMT-8) FROM: 100005-TO: 14088460429 Page: 12 of 16 G-18652-J CNA (Ed. 07-12) f. Dentist; employment by you or while performing g. Athletic trainer; duties related to the conduct of your business; and h. Audiologist; b. "bodily injury" to a "volunteer worker" i. Physical therapist; while performing duties related to the j. Psychologist; conduct of your business; k. Speech therapist; when such "bodily injury"arises out of a p p "health care incident." I. Other allied health professional; or 2. Your "volunteer workers" are insureds with m. Provider of first aid or Good Samaritan respect to: services rendered in an emergency and for a. "bodily injury" to a co-"volunteer which no payment is demanded or worker" while performing duties related received. to the conduct of your business; and D. SECTION I — COVERAGE A — BODILY b. "bodily injury" to an "employee"while in INJURY AND PROPERTY DAMAGE, the course of the "employee's" Paragraph 2. Exclusions is amended to add the employment by you or while performing following additional exclusions. These new duties related to the conduct of your exclusions apply only to this Incidental Health business; Care Malpractice Coverage: when such "bodily injury" arises out of a [This insurance does not apply to:] "health care incident." Dishonesty or Crime 3. Paragraphs 2.a. (1)(a), (b) and (c) of Any dishonest, criminal or malicious act, error SECTION II — WHO IS AN INSURED do or omission. not apply to "bodily injury" for which insurance is provided this Provision 13. Clinical Trials/ Product Testing 4. Paragraph 2.a.(1)(d) of SECTION H — Acts, errors or omissions that occur in the WHO IS AN INSURED is deleted. course of human clinical trials or product testing. G. With respect to the insurance provided by this Provision 13., the following is added to Medicare/Medicaid Fraud Paragraph 4.b.(1) of SECTION IV — Medicare or Medicaid fraud or abuse. COMMERCIAL GENERAL LIABILITY CONDITIONS: Services Excluded by Endorsement To the extent this insurance applies, it is excess Any"health care incident"for which coverage is over any of the other insurance (including excluded by endorsement. qualified self insurance), whether primary, E. SECTION V — DEFINITIONS is amended to excess, contingent or on any other basis, add the following subparagraph to Paragraph f. except for insurance purchased specifically by of the definition of"insured contract": you to be excess of this policy. Paragraph f. does not include that part of any 14. JOINT VENTURES / PARTNERSHIP / LIMITED contract or agreement: LIABILITY COMPANIES (4) Under which you assume another's tort A. The following is added to SECTION II — WHO IS AN INSURED: liability for "bodily injury" arising out of the rendering of or failure to render 4. You are an insured when you had an professional health care services. interest in a joint venture, partnership or F. SECTION II — WHO IS AN INSURED is limited liability company which terminated amended to add the following provisions: or ended prior to or during this policy period, but only to the extent of your 1. Your"employees" are insureds with respect interest in such joint venture, partnership or to: limited liability company. This coverage a. "bodily injury" to a co-"employee" while does not apply: in the course of the co-"employee's" G-18652-J (Ed. 07-12) Page 8 of 12 Copyright,CNA All Rights Reserved. cPO created with,polFaotor-g3 Pte,tria63verrionuuww.remiffac wry.wale 11 of 15 3/22/2013 11:34:35 AM PST (GMT-8) FROM: 100005-TO: 14088460429 Page: 13 of 16 G-18652-J CNA (Ed. 07-12) • a. Prior to the termination date of any joint (6) That particular part of any property that venture, partnership or limited liability must be restored, repaired or replaced company; because "your work" was incorrectly b. If there is other valid and collectible performed on it. insurance purchased specifically to Paragraph (2) of this exclusion does not insure the partnership, joint venture or apply if the premises are"your work." limited liability company; or Paragraphs (3) and (4) of this exclusion do c. To a joint venture, partnership or not apply to "property damage" to tools or limited liability company which is or equipment loaned to you. A separate limit was insured under a "consolidated of insurance applies to such tools or (wrap-up) insurance program." equipment that are damaged while being [Please see Item 26.C. of this endorsement used in your operations. for the definition of"consolidated (wrap-up) Paragraphs (1), (3) and (4) of this exclusion program."] do not apply to "property damage" (other B. The last paragraph of SECTION II — WHO IS than damage by fire) to premises rented to AN INSURED is deleted and replaced by the you or temporarily occupied by you with the following: permission of the owner, or to the contents of premises rented to you for a period of 7 Except as provided under the Contractors' or fewer consecutive days. A separate limit General Liability Extension Endorsement or by of insurance applies to Damage To the attachment of another endorsement (if any), Premises Rented To You as described in no person or organization is an insured with SECTION III—LIMITS OF INSURANCE. respect to the conduct of any current or past partnership, joint venture or limited liability Paragraphs (3), (4), (5) and (6) of this exclusion do not apply to liability assumed company that is not shown as a Named Insured under a sidetrack agreement. in the Declarations. 15. Paragraph (6) of this exclusion does not 5. LEGAL LIABILITY/ALIENATED PREMISES! BORROWED EQUIPMENT apply to "property damage" included in the "products-completed operations hazard." A. Under SECTION I — COVERAGE A— BODILY B. Under SECTION I — COVERAGE A— BODILY INJURY AND PROPERTY DAMAGE, INJURY AND PROPERTY DAMAGE the last Paragraph 2. Exclusions is amended to delete exclusion j. Damage to Property in its entirety paragraph and reof placed Paragraph 2. Exclusions is and replace it with the following: deleted and replaced by the following. [This insurance does not apply to:] Exclusions c. through n. do not apply to damage by fire to premises while rented to you j. Damage to Property or temporarily occupied by you with permission of the owner nor to the contents of premises "Property damage"to: rented to you for a period of 7 or fewer (1) Property you own, rent, or occupy; consecutive days. (2) Premises you sell, give away or A separate limit of insurance applies to this abandon, if the "property damage" coverage as described in SECTION III — arises out of any part of those LIMITS OF INSURANCE. premises; C. The following paragraph is added to SECTION (3) Property loaned to you; III —LIMITS OF INSURANCE: (4) Personal property in the care, custody Subject to 5. above, $25,000 is the most we will or control of the insured; pay under Coverage A for damages arising out of any one "occurrence" because of "property (5) That particular part of real property on damage" to tools or equipment loaned to you which you or any contractors or by others that occurs while the equipment is subcontractors working directly or being used to perform operations. indirectly on your behalf are performing operations, if the "property damage" D. Paragraph 6. Damage To Premises Rented To arises out of those operations; or You Limit of SECTION III — LIMITS OF INSURANCE is replaced by the following: G-18652-J (Ed. 07-12) Page 9 of 12 Copyright,CNA AD Rights Reserved. cPDE created wit G, Faet iy Pre tria63versi©n.www.pdf#actorv.00me 12 of 15 3/22/2013 11:34:35 AM PST (GMT-8) FROM: 100005-TO: 1408846U429 Page: 14 at 16 G-18652-J CNA (Ed. 07-12) 6. Subject to Paragraph 5. above, (the Each SECTION — I — COVERAGE C for all Occurrence Limit), the Damage To medical expenses because of "bodily Premises Rented To You Limit is the most injury" sustained by any one person. The we will pay under SECTION — I — Medical Expense Limit is the greater of: COVERAGE A for damages because of "property damage" to any one premises (1) $15,000; or while rented to you or temporarily occupied (2) The amount shown in the Declarations by you with the permission of the owner, for Medical Expense Limit. including contents of such premises rented to you for a period of 7 or fewer B. Paragraph 1.a.(3)(b) of SECTION I — consecutive days. The Damage To COVERAGE C MEDICAL PAYMENTS, is Premises Rented To You Limit is the replaced by the following: greater of: (b) The expenses are incurred and reported to a. $500,000; or us within three years of the date of the accident; and b. The Damage To Premises Rented To You Limit shown in the Declarations. This paragraph B. does not apply to medical expenses incurred in the state of Missouri. E. Paragraph 4.b.(1)(a)(ii) of SECTION IV — COMMERCIAL GENERAL LIABILITY 19. NON-OWNED AIRCRAFT CONDITIONS is deleted and replaced by the Under SECTION I—COVERAGE A—BODILY following: INJURY AND PROPERTY DAMAGE LIABILITY. (ii) That is property insurance for premises Paragraph 2. Exclusions is amended such that rented to you, for premises temporarily exclusion g. Aircraft, Auto or Watercraft does not occupied by you with the permission of the apply to an aircraft you do not own, provided that: owner; or for personal property of others in 1. The pilot in command holds a currently your care, custody or control; effective certificate issued by the duly F. This Provision 15. does not apply if Damage To constituted authority of the United States of Premises Rented To You Liability under America or Canada, designating that person as SECTION — I — COVERAGE A is excluded by a commercial or airline transport pilot; endorsement. 2. The aircraft is rented to you with a trained, paid 16. LIBERALIZATION CLAUSE crew; and If we adopt a change in our forms or rules which 3. The aircraft does not transport persons or cargo would broaden coverage for contractors under this for a charge. endorsement without an additional premium 20. NON-OWNED WATERCRAFT charge, your policy will automatically provide the additional coverage as of the date the revision is Under SECTION I—COVERAGE A—BODILY effective in your state. INJURY AND PROPERTY DAMAGE LIABILITY, Paragraph 2. Exclusions is amended to delete 17. LIQUOR LIABILITY subparagraph (2) of exclusion g.Aircraft, Auto or Under SECTION I —COVERAGE A—BODILY Watercraft and replace it with the following. INJURY AND PROPERTY DAMAGE, Paragraph 2. [This exclusion does not apply to:] Exclusions is amended to delete exclusion c. Liquor Liability. (2) A watercraft you do not own that is: This provision 17. does not apply to any person or (a) Less than 75 feet long; and organization who otherwise qualifies as an (b) Not being used to carry persons or property additional insured on this Coverage Part. for a charge. 18. MEDICAL PAYMENTS 21. PRIMARY AND NON-CONTRIBUTORY TO A. Paragraph 7. Medical Expense Limit, of OTHER INSURANCE SECTION III — LIMITS OF INSURANCE is With respect to any person or organization that is deleted and replaced by the following: an additional insured under this Coverage Part, the 7. Subject to Paragraph 5. above (the Each following is added to Paragraph 4.of SECTION IV Occurrence Limit), the Medical Expense —COMMERCIAL GENERAL LIABILITY Limit is the most we will pay under CONDITIONS: G-18652-J (Ed. 07-12) Page 10 of 12 Copyright,CNA All Rights Reserved. cPDF.created with, a,stFaetor-q3 Pr&trhahverriorw` .pdffaCtOR& O e 13 of 15 3/22/2013 11:34:35 AM PST (GMT-8) FROM: 100005-TO: 14U8846842y Page: 15 or lb G-18652-J CNA (Ed. 07-12) If you have agreed in writing in a contract or 25. WAIVER OF SUBGROGATION - BLANKET agreement that this insurance is primary and non Under SECTION IV—COMMERCIAL GENERAL contributory relative to an additional insured's own LIABILITY CONDITIONS, The Transfer Of Rights insurance, then this insurance is primary and we will not seek contribution from that other insurance. Of Recovery Against Others To Us Condition is For the purpose of this Provision 21., the additional amended by the addition of the following: insured's own insurance means insurance on which We waive any right of recovery we may have the additional insured is a Named Insured. against any person or organization because of This Provision 21. does not apply in situations payments we make for injury or damage arising out where the endorsement on this policy affording of: coverage to the additional insured specifies that 1. Your ongoing operations; or this insurance is excess over any other insurance available to that additional insured. 2. "Your work" included in the "products completed operations hazard." 22. PROPERTY DAMAGE—ELEVATORS However, this waiver applies only when you have A. Under SECTION I — COVERAGE A — BODILY agreed in writing to waive such rights of recovery in INJURY AND PROPERTY DAMAGE, a contract or agreement, and only if the contract or Paragraph 2. Exclusions is amended such that agreement: exclusion k. Damage to Your Product, and subparagraph (3), (4) and (6) of exclusion j. 1. Is in effect or becomes effective during the Damage to Property do not apply "property term of this policy; and damage"that results from the use of elevators. 2. Was executed prior to loss. B. With respect only to the coverage provided by 26. WRAP-UP EXTENSION: OWNER CONTROLLED this endorsement, Condition 4. Other INSURANCE PROGRAM, CONTRACTOR Insurance in SECTION IV — COMMERCIAL CONTROLLED INSURANCE PROGRAM OR GENERAL LIABILITY CONDITIONS is CONSOLIDATED (WRAP-UP) INSURANCE amended to add the following subparagraph PROGRAMS b.(1)(a)(v): Note: The following provision does not apply to any 4. Other Insurance public construction project in the state of b. Excess Insurance Oklahoma, nor to any construction project in the state of Alaska, that is not permitted to be insured (1) This insurance is excess over: under a "consolidated (wrap-up) insurance (a) Any of the other insurance, program" by applicable state statute or regulation: whether primary, excess, If the endorsement EXCLUSION— contingent or on any other CONSTRUCTION WRAP-UP or another basis: exclusionary endorsement pertaining to Owner (v) That is Property insurance Controlled Insurance Programs (O.C.I.P.) or covering property of others Contractor Controlled Insurance Programs damaged from the use of (C.C.I.P.) is attached to this policy, then the elevators. following changes apply: 23. SUPPLEMENTARY PAYMENTS A. The following wording is added to the endorsement: A. Under Section I — Supplementary Payments With respect to a "consolidated (wrap-up) —Coverages A and B, Paragraph 1.b.,the limit of $250 shown for the cost of bail bonds is insurance program" project in which you are or replaced by$5,000: were involved, this exclusion does not apply to those sums you become legally obligated to B. In Paragraph 1.d., the limit of $250 shown for pay as damages because of: daily loss of earnings is replaced by $1,000. 1. "Bodily injury," "property damage," or 24. UNINTENTIONAL FAILURE TO DISCLOSE "personal or advertising injury" that occurs HAZARDS during your ongoing operations at the If unintentionally you should fail to disclose all project, or during such operations of existing hazards at the inception date of your anyone acting on your behalf; nor policy, we will not deny coverage under this 2. "Bodily injury" or "property damage" Coverage Part because of such failure. included within the "products-completed G-18652-J (Ed. 07-12) Page 11 of 12 Copyright,CNA All Rights Reserved. cPDF.created with u,.r#Faetor.y3 Pre:trial3verriov o Wm.pdffactt 1Q of 15 3/22/2013 11:34:35 AM PST (GMT-8) FROM: 100005-TO: 14088460429 Page: lb of lb G-18652-J CNA (Ed. 07-12) operations hazard" that arises out of those involved in the project, such as an Owner portions of the project that are not Controlled Insurance Program (O.C.I.P.) or "residential structures." Contractor Controlled Insurance Program B. SECTION IV — COMMERCIAL GENERAL (C.C.I.P.). LIABILITY CONDITIONS is amended to add "Residential structure" means any structure the following subparagraph 4.b.(1)(c) to where 30% or more of the square foot area is Condition 4. Other Insurance: used or is intended to be used for human [This insurance is excess over:) residency including but not limited to single or multifamily housing, apartments, (c) Any of the other insurance whether primary, condominiums, townhouses, co-operatives or excess, contingent or any other basis that is planned unit developments and also includes insurance available to you as a result of their common areas and/or appurtenant your being a participant in a "consolidated structures (including pools, hot tubs, detached (wrap-up) insurance program," but only as garages, guest houses or any similar respects your involvement in that structures). When there is no individual "consolidated (wrap-up) insurance ownership of units, residential structure does program." not include military housing, college/university C. SECTION V — DEFINITIONS is amended to housing or dormitories, long term care facilities, hotels, or motels. Residential structure also add the following definition: does not include hospitals or prisons. "Consolidated (wrap-up) insurance program" This provision 26.does not apply to any person means a construction, erection or demolition or organization who otherwise qualifies as an project for which the prime contractor/project additional insured on this Coverage Part. manager or owner of the construction project has secured general liability insurance covering some or all of the contractors or subcontractors 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. Material used with permission of ISO Properties, Inc G-18652-J (Ed. 07-12) Page 12 of 12 Copyright,CNA All Rights Reserved. cPflE created with,polFa©toty3 Pr tria63versiorwmm adffactory.caoee 15 of L5 1/31/2014 9:09:42 AM PST (GMT-8) FROM: 100005-TO: 14088460429 Page: 16 of 16 CNA (Ed. 07-12) (Ed. 07-12) operations hazard" that arises out of those involved in the project, such as an Owner portions of the project that are not Controlled Insurance Program (O.C.I.P.) or "residential structures." Contractor Controlled Insurance Program B. SECTION IV — COMMERCIAL GENERAL (C.C.I.P.). LIABILITY CONDITIONS is amended to add "Residential structure" means any structure the following subparagraph 4.b.(1)(c) to where 30% or more of the square foot area is Condition 4. Other Insurance: used or is intended to be used for human residency including but not limited to single or [This insurance is excess over:] multifamily housing, apartments, (c) Any of the other insurance whether primary, condominiums, townhouses, co-operatives or excess, contingent or any other basis that is planned unit developments and also includes insurance available to you as a result of their common areas and/or appurtenant your being a participant in a "consolidated structures (including pools, hot tubs, detached (wrap-up) insurance program," but only as garages, guest houses or any similar respects your involvement in that structures). When there is no individual "consolidated (wrap-up) insurance ownership of units, residential structure does program." not include military housing, college/university C. SECTION V — DEFINITIONS is amended to housing or dormitories, long term care facilities, hotels, or motels. Residential structure also add the following definition: does not include hospitals or prisons. "Consolidated (wrap-up) insurance program" This rovision 26. does not apply a construction, erection or demolition p PP I organization who otherwise qualifies to an y person or alifies as an project for which the prime contractor/project additional insured on this Coverage Part. manager or owner of the construction project has secured general liability insurance covering some or all of the contractors or subcontractors 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. Material used with permission of ISO Properties, Inc G-18652-J (Ed. 07-12) Page 12 of 12 Copyright,CNA All Rights Reserved. cROF.created with,pd#Faotot y3 Pra traa63versior►owwa .pe ffad:orvizor/1 15 of 15 3/22/2013 11:34:35 AM PST (GMT-8) FROM: 100005-TO: 14088460429 Page: 2 of 16 A` RD® CERTIFICATE OF LIABILITY INSURANCE DATE/22/ D/YYYY) 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). PRODUCER Arthur J. Gallagher&Co. Insurance Brokers CONTACT NAME: of California, Inc. 3697 Mt. Diablo Blvd., Suite 300 PHONE(A/C.No.E<0 925-299-1112 I FAX(A/C-No): 925-299-0328 Lafayette, CA 94549 E-MAIL ADDRESS INSURER(S)AFFORDING COVERAGE NAIC Al www.ajg.corn 0726293 INSURER National Fire Ins Co of Hartford 20478 INSURED INSURERS: Continental Casualty Insurance Company 20443 FBD Vanguard Construction, Inc. dba: Vanguard Construction INSURER : Fireman's Fund Insurance Company 21873 651 Enterprise Ct. INSURER0: Zurich American Insurance Co. 16535 Livermore, CA 94550-5200 INSURER E: INSURER' _ COVERAGES CERTIFICATE NUMBER: 15807748 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUER POLICY EFF POLICY EXP W M/ LIMITS LTR INSR VD POLICY NUMBER (MMIDD/YYYY) (MDD/YYYY) A GENERALLIABILITY 4014291109 3/25/2013 3/25/2014 EACH OCCURRENCE $ 2,000,000 DAMAGE TO RENTED 100,000 J COMMERCIAL GENERAL LIABILITY PREMISES(Ea occurrence) $ CLAIMS-MADE e OCCUR MED EXP(Any one person) $ 5,000 1 XCU Included PERSONAL&ADV INJURY $ 2,000,000 I Contractural Liab GENERAL AGGREGATE $ 4,000,000 GEN'L AGGREGATE LIMIT APPLIES PER. PRODUCTS••COMP/OP AGG $ 4,000,000 -I POLICY 171 PRO- n LOC Deductible $ $5,000 JECi B I AUTOMOBILE LIABILITY 4013610249 3/25/2013 3/25/2014 '(EO aBBI dEED1)INGLE LIMIT $ 1,000,000 J ANY AUTO BODILY INJURY(Per person) $ ALL OWNED 'SCHEDULED BODILY INJURY(Per accident) $ AUTOS _ AUTOS – NON-OWNED PROPERTY DAMAGE J HIRED AUTOS 1 AUTOS (Per accident) $ _ 1 form CA 0001 03 06 $ - $ C UMBRELLA LIAE / OCCUR SSE48706600 3/25/2013 3/25/2014 ,EACH OCCURRENCE $ 10,000,000 J EXCESS LIAE CLAIMS-MADE AGGREGATE $ 10,000,000 DED I J I RETENTION$0 $ — o WORKERS COMPENSATION Y/N WC489238203 2/1/2014 2/1/2015 I we STATUS IS I. EMPLOYERS'LIABILITY TORY LIMITS ANY PROPRIETOR/PARTNER/EXECUTIVE I E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 It yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE•POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach AC ORD 101,Additional Remarks Schedule,it more space is required) City of Gilroy is included as additional insured for General Liability perform G-140331-C31 10/10 attached(Primary Wording Included).Waiver of Subrogation applies for General Liability per form G-18652-J 07-12 attached. The above Additional Insured, Primary Wording and Waiver of Subrogation Endorsements are only valid if requested by written contract. VG986 Project:VERBS Safe Route to School-Proiect No 12-PW-199,Federal Project No RPSTPLE-5035(024) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Gilroy THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Putlic Works Department ACCORDANCE WITH THE POLICY PROVISIONS. 7351 Rosanna Street Gilroy CA 95020 AUTHORIZED REPRESENTATIVE _ Jamie Yaudes ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD CERT riO.: 15807746 CLIEPIT CODE: 1991-02-03 15:55:28.603 Jamie Yaudes 3/22/2013 11:30:06 AM Page 1 of 15 3/22/2013 11:34:35 AM PST (GMT-8) FROM: 100005-TO: 14088460429 Page: 3 of 16 4014291109 3/22/2013 FBD Vanguard Construction, Inc. CF'IA G-140331-C31 Ed. 10/10) . C THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS -WITH PRODUCTS-COMPLETED OPERATIONS COVERAGE This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE(OPTIONAL) Name of Additional Insured Persons Or Organizations (44 yreoqu j doby"written contract"per Paragraph A. below.) Putlic Works Department 7351 Rosanna Street Gilroy CA 95020 • Locations of Covered Operations (As per the"written contract", provided the location is within the"coverage territory"of this Coverage Part.) A. Section II-Who Is An Insured is amended to 2. We will not provide the additional insured any include as an additional insured: broader coverage or any higher limit of 1.Any person or organization whom you are insurance than the least that is: required by written contract"to add as an y" " a. Required by the"written contract"; additional insured on this Coverage Part;and b. Described in B.1.above;or 2.The particular person or organization, if any, scheduled above. c. Afforded to you under this policy. B. The insurance provided to the additional insured is 3. This insurance is excess of all other insurance limited as follows: available to the additional insured whether on a 1. The person or organization is an additional primary,excess, contingent or any other basis. insured only with respect to liability for"bodily But if required by the"written contract", this • injury", only damage", liability 'personal and insurance will be primary and non-contributory I ry","p p y g p relative to insurance on which the additional advertising injury"caused in whole or in part by: insured is a Named Insured. a. Your acts or omissions; or 4. The insurance provided to the additional insured b. The acts or omissions of those acting on does not apply to"bodily injury","property your behalf damage", or"personal and advertising injury in the performance of your ongoing operations arising out of: specified in the"written contract"; or a. The rendering of, or the failure to render, c. "Your work"that is specified in the"written any professional architectural,engineering, contract"but only for"bodily injury"or or surveying services, including: "property damage"included in the (1) The preparing, approving,or failing to "products-completed operations hazard", prepare or approve maps, shop and only if: drawings,opinions, reports,surveys, (1)The"written contract"requires you to field orders,change orders or drawings provide the additional insured such and specifications; and coverage;and (2) Supervisory, inspection,architectural or (2)This Coverage Part provides such engineering activities;or coverage. b. Any premises or work for which the additional insured is specifically listed as an G-140331-C31 Includes copyrighted material of Insurance Services Office,Inc.,with its permission Page 1 of 2 (Ed. 10/10) cRDE created with G,r#Fa©to y3 Pt--tria63verasioriuwww.pdffacfimry.aame 2 of 15 3/22/2013 11:34:35 AM PST (GMT-8) FROM: 100005-TO: 14088460429 Page: 4 of 16 CNA G-140331-C31 Ed. 10/10) additional insured on another endorsement We have no duty to defend or pay on behalf of • attached to this Coverage Part. an additional insured under this endorsement C. SECTION IV—COMMERCIAL GENERAL until we receive from the additional insured LIABILITY CONDITIONS is amended as follows: written notice of a claim or"suit'. 1. The Duties In The Event of Occurrence, 2. With respect only to the insurance provided by Offense,Claim or Suit condition is amended to this endorsement,the first sentence of add the following additional conditions Paragraph 4.a.of the Other Insurance Condition applicable to the additional insured: is deleted and replaced with the following: An additional insured under this endorsement 4. Other Insurance will as soon as practicable: a. Primary Insurance (1) Give us written notice of an"occurrence"or This insurance is primary and non- an offense which may result in a claim or contributory except when rendered "suit" under this insurance, and of any claim excess by endorsement G-140331-C31, or"suit"that does result; or when Paragraph b. below applies. (2) Except as provided in Paragraph B.3 of this D. Only for the purpose of the insurance provided by endorsement,agree to make available any this endorsement,SECTION V—DEFINITIONS is other insurance the additional insured has amended to add the following definition: for a loss we cover under this Coverage Part; "Written contract"means a written contract or written agreement that requires you to make a • (3) Send us copies of all legal papers received, person or organization an additional insured on this and otherwise cooperate with us in the .Coverage Part, provided the contract or agreement: investigation, defense, or settlement of the 1. Is currently in effect or becomes effective during claim or"suit";and the term of this policy; and (4) Tender the defense and indemnity of any 2.Was executed prior to: • claim or"suit"to any other insurer or self insurer whose policy or program applies to a a.The"bodily injury"or"properly damage"; or loss we cover under this Coverage Part. b The offense that caused the"personal and But if the"written contract"requires this advertising injury" insurance to be primary and non- for which the additional insured seeks coverage contributory,this provision (4)does not under this Coverage Part. apply to insurance on which the additional insured is a Named Insured. • • G-140331-C31 Includes copyrighted material of Insurance Services Office,Inc.,with its permission Page 2 of 2 (Ed. 10/10) • cPOF created with u..5tFaotor-y3 Preb trial3verasionmvev .zedffactora,t.CaMe 3 of 15 3/22/2013 11:34:35 AM PST (GMT-8) FROM: 100005-TO: 14088460429 Page: 5 of 16 rrsu vanguaro construction, Inc. dba: Vanguard Construction G-18652-J CNA (Ed. 07-12) 4014291109 3/22/2013 CONTRACTORS'GENERAL LIABILITY EXTENSION ENDORSEMENT It is understood and agreed that this endorsement amends the COMMERCIAL GENERAL LIABILITY COVERAGE PART as follows. The changes this endorsement makes do not apply with respect to any coverage that has been excluded or amended by another endorsement attached to this policy. SCHEDULE Coverage is summarized below. For particulars and limitations affecting each coverage, please refer to the corresponding policy provisions in the body of this endorsement. 1. Additional Insureds Seven additional insured extensions. 2. Bodily Injury- Expanded Definition 3. Broad Knowledge of Occurrence!Notice of Occurrence 4. Broad Named Insured 5. Broadened Liability Coverage For Damage To "Your Product"And "Your Work" Limit: $100,000. 6. Contractual Liability—Railroads Expanded definition of"insured contract." 7. Contractual Liability For Personal And Advertising Injury 8. Electronic Data Liability Loss of Electronic Data Limit: $100,000. 9. Expanded Personal And Advertising Injury - Discrimination Or Humiliation 10. Expected Or Intended Injury Reasonable force-"bodily injury"or"property damage." 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 Coverage for your interest in such terminated or ended organizations. 15. Legal Liability/Alienated Premises/Borrowed Equipment Coverage Extended perils. Default limit increased to$500,000 for Damage to Premises Rented To You. $25,000 limit for"property damage" to borrowed tools or equipment at a jobsite. 16. Liberalization Clause 17. Liquor Liability Coverage Extension 18. Medical Payments Limits increased to$15,000. Reporting increased to three years from the date of accident. 19. Non-owned Aircraft Coverage 20. Non-owned Watercraft Increased to 75 feet. 21. Primary And Non-Contributory To Other Insurance 22. Property Damage- Elevators 23. Supplementary Payments Cost of bail bonds increased to$5,000. Daily loss of earnings increased to$1,000. 24. Unintentional Failure To Disclose Hazards 25. Waiver of Subrogation - Blanket Waiver of subrogation where required by written contract or written agreement. 26. Wrap-Up Extension G-18652-J (Ed. 07-12) Page 1 of 12 Copyright,CNA All Rights Reserved. cPOF created wirtit pdfFa©tor-y3 PrG traai3verriorw iww.pdffactory.00r1ae 4 of 15 3/22/2013 11:34:35 AM PST (GMT-8) FROM: 100005-TO: 14088460429 Page: b of 16 G-18652-J CNA (Ed. 07-12) 1. ADDITIONAL INSURED 2. With respect to the insurance afforded to these additional insureds, this insurance ,SECTION II —WHO IS AN INSURED is amended does not apply to any "occurrence" which to include as an insured any person or organization takes place after the equipment lease (called additional insured) described in paragraphs expires. A.through G. below whom you are required to add as an additional insured on this policy under a D. Lessor - Land written contract or written agreement, provided the An owner or other interest from whom land has written contract or written agreement: been leased by you but only with respect to i. Is currently in effect or becomes effective liability arising out of the ownership, during the term of this policy; and maintenance or use of that specific part of the land leased to you and subject to the following ii. Was executed prior to the "bodily injury," additional exclusions: "property damage" or "personal injury and advertising injury" for which the additional This insurance does not apply to: insured seeks coverage. 1. Any "occurrence" which takes place after However, we will not provide the additional you cease to lease that land; or insured any broader coverage or any higher 2. Structural alterations, new construction or limit of insurance than the least that is: demolition operations performed by or on a. The maximum permitted by law; behalf of such additional insured. b. Required in the written contract or written E. Lessor- Premises agreement; A manager or lessor of premises but only with c. Afforded to you under this policy; or respect to liability arising out of the ownership, maintenance or use of that specific part of the d. Described in the applicable paragraphs A. premises leased to you and subject to the through G. below. following additional exclusions: A. Controlling Interest This insurance does not apply to: Any persons or organizations with a controlling 1. Any "occurrence" which takes place after interest in you but only with respect to their you cease to be a tenant in that premises; liability arising out of: or 1. Their financial control of you; or 2. Structural alterations, new construction or 2. Premises they own, maintain or control demolition operations performed by or on while you lease or occupy these premises. behalf of such additional insured. This insurance does not apply to structural F. Mortgagee,Assignee or Receiver alterations, new construction and demolition A mortgagee, assignee or receiver but only with operations performed by or for such additional respect to their liability as mortgagee, assignee, insured. or receiver and arising out of the ownership, B. Co-owner of Insured Premises maintenance, or use of a premises by you. A co-owner of a premises co-owned by you and This insurance does not apply to structural covered under this insurance but only with alterations, new construction or demolition respect to the co-owner's liability as co-owner operations performed by or for such additional of such premises. insured. C. Lessor -Equipment G. State or Governmental Agency or Subdivision or Political Subdivisions 1. Any person or organization from whom you A state or governmental agency or subdivision lease equipment, but only with respect to liability for "bodily injury," "property or political subdivision subject to the following damage" or "personal and advertising provisions: injury" caused, in whole or in part, by your 1. This insurance applies only with respect to maintenance, operation or use of the following hazards for which the state or equipment leased to you by such person or governmental agency or subdivision or organization. political subdivision has issued a permit or G-18652-J (Ed. 07-12) Page 2 of 12 Copyright,CNA All Rights Reserved. cROF created with i,r4Factory3Pra:traa63versio mmt.p ffactorr.eofine 5 of 15 3/22/2013 11:34:35 AM PST (GMT-8) FROM: 100005-TO: 14088460429 Page: / of 16 G-18652-J CNA (Ed. 07-12) authorization in connection with premises A. BROAD KNOWLEDGE OF OCCURRENCE you own, rent, or control and to which this You must give us or our authorized insurance applies: representative notice of an "occurrence," a. The existence, maintenance, repair, offense, claim, or "suit" only when the construction, erection, or removal of "occurrence," offense, claim or "suit" is known advertising signs, awnings, canopies, to: cellar entrances, coal holes, driveways, manholes, marquees, hoistaway (1) You, if you are an individual; openings, sidewalk vaults, street (2) A partner, if you are a partnership; banners, or decorations and similar exposures; or (3) An executive officer or the employee designated by you to give such notice, if b. The construction, erection, or removal you are a corporation; or of elevators; or (4) A manager, if you are a limited liability c. The ownership, maintenance or use of company. any elevators covered by this B. NOTICE OF OCCURRENCE insurance. 2. This insurance applies only with respect to Your rights under this Coverage Part will not be operations performed by you or on your prejudiced if you fail to give us notice of an behalf for which the state or governmental "occurrence,"offense, claim or"suit" and that agency or subdivision or political failure is solely due to your reasonable belief subdivision has issued a permit or that the "bodily injury" or"property damage" is authorization. not covered under this Coverage Part. However, you shall give written notice of this 3. This insurance does not apply to: "occurrence,"offense, claim or"suit"to us as a. "Bodily injury," "property damage" or soon as you are aware that this insurance may "personal and advertising injury" arising apply to such "occurrence,"offense claim or out of operations performed for the "suit." federal government, state or 4. BROAD NAMED INSURED municipality; or A. Any subsidiary or affiliate organization, other b. "Bodily injury" or "property damage" than a partnership, joint venture or limited included within the "products- liability company, in which a Named Insured completed operations hazard." specifically shown in the Declarations has A governmental permit which requires you to management control, directly or through one or add the governmental entity as an additional more subsidiary organizations, at the time of insured will trigger this Provision 1. as if the loss will qualify as a Named Insured but only if permit were a written contract. there is no other similar insurance available to such organization, nor similar insurance which 2. BODILY INJURY—EXPANDED DEFINITION would be available but for exhaustion of its SECTION V—DEFINITIONS, the definition of limits. For the purpose of this provision, similar insurance means general liability or equivalent "bodily injury" is changed to read: insurance, no matter whether its coverage is "Bodily injury" means bodily injury, sickness or broader or narrower than that provided by this disease sustained by a person, including death, insurance. But if the only other similar humiliation, shock, mental anguish or mental injury insurance is for a "consolidated (wrap-up) by that person at any time which results as a program," then a subsidiary that qualifies as a consequence of the bodily injury, sickness or Named Insured on such project-specific disease. insurance can still qualify as a Named Insured 3. BROAD KNOWLEDGE OF OCCURRENCE/ on this insurance, but not for projects covered NOTICE OF OCCURRENCE by the"consolidated (wrap-up) program." [Please see Item 26.C. of this endorsement for Condition 2. Duties in The Event of Occurrence, the definition of"consolidated (wrap-up) Offense, Claim or Suit of SECTION IV— program.") COMMERCIAL GENERAL LIABILITY CONDITIONS is amended to add the following provisions: G-18652-J (Ed. 07-12) Page 3 of 12 Copyright,CNAAII Rights Reserved. cPOF.created with=pdiFaotory3 Rrr :traa63versio wwww.adffa(tor&Qome 6 of 15 3/22/2013 11:34:35 AM PST (GMT-8) FROM: 100005-TO: 14088460429 Page: 8 of 16 G-18652-J CNA (Ed. 07-12) B. This endorsement does not apply to any (1) Fire; organization for which coverage is excluded by (2) Smoke; . another endorsement attached to this policy. C. Only for the purpose of this endorsement: (3) Collapse; or 1. Management control means: (4) Explosion. a. Ownership interest representing more I. Damage to Your Work than 50% of the voting, appointment, or "Property damage"to"your work"arising out of designation power for the subsidiary it, or any part of it and included in the organization's governing body; or "products-completed operations hazard." b. Having the right, pursuant to a written This exclusion does not apply: contract, or pursuant to the by-laws, charter, operating agreement, or similar (1) If the damaged work or the work out of document of a specifically shown which the damage arises was Named Insured or controlled subsidiary performed on your behalf by a organization to select, appoint, or subcontractor; or designate a majority of the subsidiary (2) If the cause of loss to the damaged organization's governing body. Such work arises as a result of: contract or document must have been created prior to the time of loss; or (a) Fire; c. Having the right, pursuant to a written (b) Smoke; trust agreement, to protect, control the (c) Collapse; or use of, encumber or transfer and sell property held by a trust. (d) Explosion. 2. Governing body means the Board of B. The following paragraph is added to SECTION Directors of a corporation. III —LIMITS OF INSURANCE: 3. Loss means: Subject to 5. above, $100,000 is the most we will pay under Coverage A for the sum of a. The occurring of the "bodily injury" or damages arising out of any one"occurrence" "property damage"; or because of"property damage"to"your product" b. The committing of the offense that and "your work"that is caused by fire, smoke, caused the "personal and advertising collapse or explosion and is included within the injury." "product-completed operations hazard." This sublimit does not apply to"property damage"to D. The insurance provided by this policy applies to "your work" if the damaged work or the work out Named Insureds when trading under their own of which the damage arises was performed on names, or under such trading names or doing- your behalf by a subcontractor. business-as (DBA) names as any should choose to employ. C. This Provision 5. Broadened Liability 5. BROADENED LIABILITY COVERAGE FOR Coverage For Damage To "Your Product" And "Your Work" does not apply if an DAMAGE TO "YOUR PRODUCT" AND "YOUR endorsement of the same name is attached to WORK" this policy. A. Under SECTION I — COVERAGE A— BODILY 6. CONTRACTUAL LIABILITY—RAILROADS INJURY AND PROPERTY DAMAGE LIABILITY, Paragraph 2. Exclusions is With respect to operations performed within 50 feet amended to delete exclusions k. and I. and of railroad property, the definition of"insured replace them with the following: contract" in SECTION V—DEFINITIONS is replaced by the following: [This insurance does not apply to:] "Insured Contract" means: k. Damage to Your Product a. A contract for a lease of premises. However, "Property damage"to"your product"arising that portion of the contract for a lease of out of it, or any part of it except when premises that indemnifies any person or caused by or resulting from: organization for damage by fire to premises while rented to you or temporarily occupied by G-18652-J (Ed. 07-12) Page 4 of 12 Copyright,CNA All Rights Reserved. cROF created with pdifFaotor-y3 Pra tria63verrioEuwvwpdf#actorai.com 7 of 15 3/22/2013 11:34:35 AM PST (GMT-8) FROM: 100005-TO: 14088460429 Page: 9 of 16 G-18652-J CNA (Ed. 07-12) you with permission of the owner is not an exclusion p. Electronic Data and replace it "insured contract"; with the following: `b. A sidetrack agreement; [This insurance does not apply to:] c. Any easement or license agreement; p. Electronic Data d. An obligation, as required by ordinance, to Damages arising out of the loss of, loss of use indemnify a municipality, except in connection of, damage to, corruption of, inability to access, with work for a municipality; or inability to manipulate "electronic data" that e. An elevator maintenance agreement; does not result from physical injury to tangible property. f. That part of any other contract or agreement However, this exclusion does not apply to pertaining to your business (including an liability for damages because of"bodily injury." indemnification of a municipality in connection with work performed for a municipality) under B. The following paragraph is added to SECTION which you assume the tort liability of another III —LIMITS OF INSURANCE: party to pay for "bodily injury" or "property Subject to 5. above, $100,000 is the most we damage" to a third person or organization. Tort will pay under Coverage A for all damages liability means a liability that would be imposed arising out of any one"occurrence" because of by law in the absence of any contract or "property damage" that results from physical agreement. injury to tangible property and arises out of Paragraph f. does not include that part of any "electronic data." contract or agreement: C. The following definition is added to the (1) That indemnifies an architect, engineer or SECTION V—DEFINITIONS: surveyor for injury or damage arising out of: "Electronic data" means information, facts or (a) Preparing, approving or failing to programs stored as or on, created or used on, prepare or approve maps, shop or transmitted to or from computer software drawings, opinions, reports, surveys, (including systems and applications software), field orders, change orders or drawings hard or floppy disks, CD-ROMS, tapes, drives, and specifications; or cells, data processing devices or any other (b) Giving directions or instructions, or media which are used with electronically controlled equipment. failing to give them, if that is the primary cause of the injury or damage; D. For the purposes of the coverage provided by (2) Under which the insured, if an architect, this endorsement, the definition of "property engineer or surveyor, assumes liability for damage" in SECTION V — DEFINITIONS is an injury or damage arising out of the replaced by the following: insured's rendering or failure to render 17. "Property damage" means: professional services, including those listed a. Physical injury to tangible property, in (1) above and supervisory, inspection, architectural or engineering activities. including all resulting loss of use of that property. All such loss of use shall be 7. CONTRACTUAL LIABILITY FOR PERSONAL deemed to occur at the time of the AND ADVERTISING INJURY physical injury that caused it; Under SECTION I —COVERAGE B—PERSONAL b. Loss of use of tangible property that is AND ADVERTISING INJURY LIABILITY, not physically injured. All such loss of Paragraph 2. Exclusions is amended to delete use shall be deemed to occur at the exclusion e. Contractual Liability. time of the "occurrence" that caused it; This provision 7. does not apply to any person or or organization who otherwise qualifies as an c. Loss of, loss of use of, damage to, additional insured on this Coverage Part. corruption of, inability to access, or 8. ELECTRONIC DATA LIABILITY inability to properly manipulate "electronic data," resulting from A. Under SECTION I — COVERAGE A— BODILY physical injury to tangible property. All INJURY AND PROPERTY DAMAGE, such loss of "electronic data" shall be Paragraph 2. Exclusions is amended to delete G-18652-J (Ed. 07-12) Page 5 of 12 Copyright,CNA All Rights Reserved. cROF.created with, #Faetory3 Pre triat3versio wwv.pdf#actorr.eame a of 15 3/22/2013 11:34:35 AM PST (GMT-8) FROM: 100005-TO: 14088460429 Page: 10 of 16 G-18652-J CNA (Ed. 07-12) deemed to occur at the time of the This provision 9. does not apply to any person "occurrence"that caused it. or organization who otherwise qualifies as an For the purposes of this insurance, additional insured on this Coverage Part. "electronic data" is not tangible property. 10. EXPECTED OR INTENDED INJURY E. If Electronic Data Liability is provided at a Under SECTION I —COVERAGE A— BODILY higher limit by another endorsement attached INJURY AND PROPERTY DAMAGE to this policy, then the $100,000 limit provided LIABILITY, Paragraph 2. Exclusions is by this Provision 8. Electronic Data Liability is amended to delete exclusion a. Expected or part of, and not in addition to, that higher limit. Intended Injury and replace it with the 9. EXPANDED PERSONAL AND ADVERTISING following: INJURY-DISCRIMINATION OR HUMILIATION [This insurance does not apply to:] A. SECTION V — DEFINITIONS is amended to a. Expected or Intended Injury add the following to the definition of "Personal "Bodily injury"or"property damage" and advertising injury": expected or intended from the standpoint of h. Discrimination or humiliation that results in the insured. This exclusion does not apply injury to the feelings or reputation of a to"bodily injury"or"property damage" natural person, but only if such resulting from the use of reasonable force discrimination or humiliation is: to protect persons or property. (1) Not done intentionally by or at the 11. GENERAL AGGREGATE LIMITS OF direction of: INSURANCE -PER PROJECT (a) The insured; or A. For each construction project away from premises you own or rent, a separate (b) Any "executive officer," director, stockholder, partner, member or Construction Project General Aggregate (if are a limited Limit, equal to the amount of the General manager liability (if you u a the insured; Aggregate Limit, is the most we will pay for the sum of: and (2) Not directly or indirectly related to the 1. All damages under Coverage A, except damages because of "bodily injury" or employment, prospective employment, "property damage" included in the past employment or termination of "products-completed operations employment of any person or persons hazard"; and by any insured. B. Under SECTION I — COVERAGE B — 2. All medical expenses under Coverage C' PERSONAL AND ADVERTISING INJURY LIABILITY, Paragraph 2. Exclusions is that arise from "occurrences" or amended to add the following additional accidents which can be attributed solely exclusions: to ongoing operations at that [This insurance does not apply to:] construction project. Such payments shall not reduce the General Aggregate Discrimination Relating To Room, Limit shown in the Declarations, nor the Dwelling or Premises Construction Project Aggregate Limit of "Personal or advertising injury"caused by any other construction project. discrimination directly or indirectly related B. All: to the sale, rental, lease or sub-lease or 1. Damages under Coverage B, regardless of prospective sale, rental, lease or sub-lease the number of locations or construction of any room, dwelling or premises by or at projects involved; the direction of any insured. Fines Or Penalties 2. Damages under Coverage A, caused by occurrences" which cannot be attributed Fines or penalties levied or imposed by a solely to ongoing operations at a single governmental entity because of construction project, except damages discrimination. because of "bodily injury" or "property G-18652-J (Ed. 07-12) Page 6 of 12 Copyright,CNA Ali Rights Reserved. cREIF.created with,pdtFaot r-y3 Pr&trial3version.www.pdffactorv.com 9 of 15 3/22/2013 11:34:35 AM PST (GMT-8) FROM: 100005-TO: 14088460429 Page: 11 of lb G-18652-J CNA (Ed. 07-12) • damage" included in the "products- Paragraphs 1.b.(1) and 1.b.(2) with the completed operations hazard"; and following: 3. Medical expenses under Coverage C b. This insurance applies to "bodily injury" caused by accidents which cannot be only if you are not in the business of attributed solely to ongoing operations at a providing professional health care services, single construction project, and only if: will reduce the General Aggregate Limit shown (1) The "bodily injury" is caused by an in the Declarations. "occurrence" that takes place in the C. The limits shown in the Declarations for Each "coverage territory." For the purpose of this insurance: Occurrence, for Damage To Premises Rented To You and for Medical Expense continue to (a) "Bodily injury" caused by a "health apply, but will be subject to either the care incident" will be considered Construction Project Aggregate Limit or the caused by an "occurrence"; and General Aggregate Limit, depending on (b) All acts, errors or omissions that whether the "occurrence" can be attributed solely to ongoing operations at a particular are logically connected by any construction project. common fact, circumstance, situation, transaction, event, advice D. When coverage for liability arising out of the or decision will be considered to "products-completed operations hazard" is constitute a single"occurrence"; provided, any payments for damages because , of "bodily injury" or"property damage" included (2) The "bodily injury' occurs during the in the "products-completed operations hazard," policy period. All "bodily injury" arising regardless of the number of locations involved from an "occurrence"will be deemed to will reduce the Products-Completed Operations have occurred at the time of the first Aggregate Limit shown in the Declarations. act, error, or omission that is part of the "occurrence"; and E. If a single construction project away from B. With respect only to the insurance provided by premises owned by or rented to the insured has this Provision 13., Exclusion 2.e. Employer's been abandoned and then restarted, or if the Liability of SECTION I — COVERAGE A — authorized contracting parties deviate from BODILY INJURY AND PROPERTY DAMAGE, plans, blueprints, designs, specifications or is amended to append the following: timetables, the project will still be deemed to be the same construction project. Only for "bodily injury" not covered by other F. The provisions of SECTION III — LIMITS OF liability insurance (including state-sanctioned INSURANCE not otherwise modified by this self insurance) available to the insured (or endorsement shall continue to apply as which would be available but for exhaustion of stipulated. its limits), this exclusion does not apply to "bodily injury" that arises out of a "health care 12. IN REM ACTIONS incident." Any action in rem against any vessel owned or C. SECTION V — DEFINITIONS is amended to operated by or for you, or chartered by or for you add the following new definition: will be treated in the same manner as though the "Health care incident" means a negligent act, action were in personam against you. error or omission by your "employees" or In rem is a term used to designate actions instituted "volunteer workers" working on your behalf in against the thing, as distinct from actions against the rendering of or failure to render professional the person, which are said to be in personam. health care services in any of the following 13. INCIDENTAL HEALTH CARE MALPRACTICE capacities, or the related furnishing of food, COVERAGE beverages, medical supplies or appliances: A. With respect only to "bodily injury" that arises a. Physician; out of a "health care incident," COVERAGE A— b. Nurse; BODILY INJURY AND PROPERTY DAMAGE LIABILITY OF SECTION I — COVERAGES is c. Emergency medical technician; amended to replace Insuring Agreement d. Paramedic; e. Chiropractor; G-18652-J (Ed. 07-12) Page 7 of 12 Copyright,CNA All Rights Reserved. cFaCiF created with G,r#Faotkr-y3 Pio trial3versionuwur . ditactorv.CoMP 10 of 15 3/22/2013 11:34:35 AM PST (GMT-8) FROM: 100005-TO: 14088460429 Page: 12 of 16 G-18652-J CNA (Ed. 07-12) f. Dentist; employment by you or while performing g. Athletic trainer; duties related to the conduct of your business; and h. Audiologist; b. "bodily injury" to a "volunteer worker" i. Physical therapist; while performing duties related to the j. Psychologist; conduct of your business; k. Speech therapist; when such "bodily injury"arises out of a p p "health care incident." I. Other allied health professional; or 2. Your "volunteer workers" are insureds with m. Provider of first aid or Good Samaritan respect to: services rendered in an emergency and for a. "bodily injury" to a co-"volunteer which no payment is demanded or worker" while performing duties related received. to the conduct of your business; and D. SECTION I — COVERAGE A — BODILY b. "bodily injury" to an "employee"while in INJURY AND PROPERTY DAMAGE, the course of the "employee's" Paragraph 2. Exclusions is amended to add the employment by you or while performing following additional exclusions. These new duties related to the conduct of your exclusions apply only to this Incidental Health business; Care Malpractice Coverage: when such "bodily injury" arises out of a [This insurance does not apply to:] "health care incident." Dishonesty or Crime 3. Paragraphs 2.a. (1)(a), (b) and (c) of Any dishonest, criminal or malicious act, error SECTION II — WHO IS AN INSURED do or omission. not apply to "bodily injury" for which insurance is provided this Provision 13. Clinical Trials/ Product Testing 4. Paragraph 2.a.(1)(d) of SECTION H — Acts, errors or omissions that occur in the WHO IS AN INSURED is deleted. course of human clinical trials or product testing. G. With respect to the insurance provided by this Provision 13., the following is added to Medicare/Medicaid Fraud Paragraph 4.b.(1) of SECTION IV — Medicare or Medicaid fraud or abuse. COMMERCIAL GENERAL LIABILITY CONDITIONS: Services Excluded by Endorsement To the extent this insurance applies, it is excess Any"health care incident"for which coverage is over any of the other insurance (including excluded by endorsement. qualified self insurance), whether primary, E. SECTION V — DEFINITIONS is amended to excess, contingent or on any other basis, add the following subparagraph to Paragraph f. except for insurance purchased specifically by of the definition of"insured contract": you to be excess of this policy. Paragraph f. does not include that part of any 14. JOINT VENTURES / PARTNERSHIP / LIMITED contract or agreement: LIABILITY COMPANIES (4) Under which you assume another's tort A. The following is added to SECTION II — WHO IS AN INSURED: liability for "bodily injury" arising out of the rendering of or failure to render 4. You are an insured when you had an professional health care services. interest in a joint venture, partnership or F. SECTION II — WHO IS AN INSURED is limited liability company which terminated amended to add the following provisions: or ended prior to or during this policy period, but only to the extent of your 1. Your"employees" are insureds with respect interest in such joint venture, partnership or to: limited liability company. This coverage a. "bodily injury" to a co-"employee" while does not apply: in the course of the co-"employee's" G-18652-J (Ed. 07-12) Page 8 of 12 Copyright,CNA All Rights Reserved. cPO created with,polFaotor-g3 Pte,tria63verrionuuww.remiffac wry.wale 11 of 15 3/22/2013 11:34:35 AM PST (GMT-8) FROM: 100005-TO: 14088460429 Page: 13 of 16 G-18652-J CNA (Ed. 07-12) • a. Prior to the termination date of any joint (6) That particular part of any property that venture, partnership or limited liability must be restored, repaired or replaced company; because "your work" was incorrectly b. If there is other valid and collectible performed on it. insurance purchased specifically to Paragraph (2) of this exclusion does not insure the partnership, joint venture or apply if the premises are"your work." limited liability company; or Paragraphs (3) and (4) of this exclusion do c. To a joint venture, partnership or not apply to "property damage" to tools or limited liability company which is or equipment loaned to you. A separate limit was insured under a "consolidated of insurance applies to such tools or (wrap-up) insurance program." equipment that are damaged while being [Please see Item 26.C. of this endorsement used in your operations. for the definition of"consolidated (wrap-up) Paragraphs (1), (3) and (4) of this exclusion program."] do not apply to "property damage" (other B. The last paragraph of SECTION II — WHO IS than damage by fire) to premises rented to AN INSURED is deleted and replaced by the you or temporarily occupied by you with the following: permission of the owner, or to the contents of premises rented to you for a period of 7 Except as provided under the Contractors' or fewer consecutive days. A separate limit General Liability Extension Endorsement or by of insurance applies to Damage To the attachment of another endorsement (if any), Premises Rented To You as described in no person or organization is an insured with SECTION III—LIMITS OF INSURANCE. respect to the conduct of any current or past partnership, joint venture or limited liability Paragraphs (3), (4), (5) and (6) of this exclusion do not apply to liability assumed company that is not shown as a Named Insured under a sidetrack agreement. in the Declarations. 15. Paragraph (6) of this exclusion does not 5. LEGAL LIABILITY/ALIENATED PREMISES! BORROWED EQUIPMENT apply to "property damage" included in the "products-completed operations hazard." A. Under SECTION I — COVERAGE A— BODILY B. Under SECTION I — COVERAGE A— BODILY INJURY AND PROPERTY DAMAGE, INJURY AND PROPERTY DAMAGE the last Paragraph 2. Exclusions is amended to delete exclusion j. Damage to Property in its entirety paragraph and reof placed Paragraph 2. Exclusions is and replace it with the following: deleted and replaced by the following. [This insurance does not apply to:] Exclusions c. through n. do not apply to damage by fire to premises while rented to you j. Damage to Property or temporarily occupied by you with permission of the owner nor to the contents of premises "Property damage"to: rented to you for a period of 7 or fewer (1) Property you own, rent, or occupy; consecutive days. (2) Premises you sell, give away or A separate limit of insurance applies to this abandon, if the "property damage" coverage as described in SECTION III — arises out of any part of those LIMITS OF INSURANCE. premises; C. The following paragraph is added to SECTION (3) Property loaned to you; III —LIMITS OF INSURANCE: (4) Personal property in the care, custody Subject to 5. above, $25,000 is the most we will or control of the insured; pay under Coverage A for damages arising out of any one "occurrence" because of "property (5) That particular part of real property on damage" to tools or equipment loaned to you which you or any contractors or by others that occurs while the equipment is subcontractors working directly or being used to perform operations. indirectly on your behalf are performing operations, if the "property damage" D. Paragraph 6. Damage To Premises Rented To arises out of those operations; or You Limit of SECTION III — LIMITS OF INSURANCE is replaced by the following: G-18652-J (Ed. 07-12) Page 9 of 12 Copyright,CNA AD Rights Reserved. cPDE created wit G, Faet iy Pre tria63versi©n.www.pdf#actorv.00me 12 of 15 3/22/2013 11:34:35 AM PST (GMT-8) FROM: 100005-TO: 1408846U429 Page: 14 at 16 G-18652-J CNA (Ed. 07-12) 6. Subject to Paragraph 5. above, (the Each SECTION — I — COVERAGE C for all Occurrence Limit), the Damage To medical expenses because of "bodily Premises Rented To You Limit is the most injury" sustained by any one person. The we will pay under SECTION — I — Medical Expense Limit is the greater of: COVERAGE A for damages because of "property damage" to any one premises (1) $15,000; or while rented to you or temporarily occupied (2) The amount shown in the Declarations by you with the permission of the owner, for Medical Expense Limit. including contents of such premises rented to you for a period of 7 or fewer B. Paragraph 1.a.(3)(b) of SECTION I — consecutive days. The Damage To COVERAGE C MEDICAL PAYMENTS, is Premises Rented To You Limit is the replaced by the following: greater of: (b) The expenses are incurred and reported to a. $500,000; or us within three years of the date of the accident; and b. The Damage To Premises Rented To You Limit shown in the Declarations. This paragraph B. does not apply to medical expenses incurred in the state of Missouri. E. Paragraph 4.b.(1)(a)(ii) of SECTION IV — COMMERCIAL GENERAL LIABILITY 19. NON-OWNED AIRCRAFT CONDITIONS is deleted and replaced by the Under SECTION I—COVERAGE A—BODILY following: INJURY AND PROPERTY DAMAGE LIABILITY. (ii) That is property insurance for premises Paragraph 2. Exclusions is amended such that rented to you, for premises temporarily exclusion g. Aircraft, Auto or Watercraft does not occupied by you with the permission of the apply to an aircraft you do not own, provided that: owner; or for personal property of others in 1. The pilot in command holds a currently your care, custody or control; effective certificate issued by the duly F. This Provision 15. does not apply if Damage To constituted authority of the United States of Premises Rented To You Liability under America or Canada, designating that person as SECTION — I — COVERAGE A is excluded by a commercial or airline transport pilot; endorsement. 2. The aircraft is rented to you with a trained, paid 16. LIBERALIZATION CLAUSE crew; and If we adopt a change in our forms or rules which 3. The aircraft does not transport persons or cargo would broaden coverage for contractors under this for a charge. endorsement without an additional premium 20. NON-OWNED WATERCRAFT charge, your policy will automatically provide the additional coverage as of the date the revision is Under SECTION I—COVERAGE A—BODILY effective in your state. INJURY AND PROPERTY DAMAGE LIABILITY, Paragraph 2. Exclusions is amended to delete 17. LIQUOR LIABILITY subparagraph (2) of exclusion g.Aircraft, Auto or Under SECTION I —COVERAGE A—BODILY Watercraft and replace it with the following. INJURY AND PROPERTY DAMAGE, Paragraph 2. [This exclusion does not apply to:] Exclusions is amended to delete exclusion c. Liquor Liability. (2) A watercraft you do not own that is: This provision 17. does not apply to any person or (a) Less than 75 feet long; and organization who otherwise qualifies as an (b) Not being used to carry persons or property additional insured on this Coverage Part. for a charge. 18. MEDICAL PAYMENTS 21. PRIMARY AND NON-CONTRIBUTORY TO A. Paragraph 7. Medical Expense Limit, of OTHER INSURANCE SECTION III — LIMITS OF INSURANCE is With respect to any person or organization that is deleted and replaced by the following: an additional insured under this Coverage Part, the 7. Subject to Paragraph 5. above (the Each following is added to Paragraph 4.of SECTION IV Occurrence Limit), the Medical Expense —COMMERCIAL GENERAL LIABILITY Limit is the most we will pay under CONDITIONS: G-18652-J (Ed. 07-12) Page 10 of 12 Copyright,CNA All Rights Reserved. cPDF.created with, a,stFaetor-q3 Pr&trhahverriorw` .pdffaCtOR& O e 13 of 15 3/22/2013 11:34:35 AM PST (GMT-8) FROM: 100005-TO: 14U8846842y Page: 15 or lb G-18652-J CNA (Ed. 07-12) If you have agreed in writing in a contract or 25. WAIVER OF SUBGROGATION - BLANKET agreement that this insurance is primary and non Under SECTION IV—COMMERCIAL GENERAL contributory relative to an additional insured's own LIABILITY CONDITIONS, The Transfer Of Rights insurance, then this insurance is primary and we will not seek contribution from that other insurance. Of Recovery Against Others To Us Condition is For the purpose of this Provision 21., the additional amended by the addition of the following: insured's own insurance means insurance on which We waive any right of recovery we may have the additional insured is a Named Insured. against any person or organization because of This Provision 21. does not apply in situations payments we make for injury or damage arising out where the endorsement on this policy affording of: coverage to the additional insured specifies that 1. Your ongoing operations; or this insurance is excess over any other insurance available to that additional insured. 2. "Your work" included in the "products completed operations hazard." 22. PROPERTY DAMAGE—ELEVATORS However, this waiver applies only when you have A. Under SECTION I — COVERAGE A — BODILY agreed in writing to waive such rights of recovery in INJURY AND PROPERTY DAMAGE, a contract or agreement, and only if the contract or Paragraph 2. Exclusions is amended such that agreement: exclusion k. Damage to Your Product, and subparagraph (3), (4) and (6) of exclusion j. 1. Is in effect or becomes effective during the Damage to Property do not apply "property term of this policy; and damage"that results from the use of elevators. 2. Was executed prior to loss. B. With respect only to the coverage provided by 26. WRAP-UP EXTENSION: OWNER CONTROLLED this endorsement, Condition 4. Other INSURANCE PROGRAM, CONTRACTOR Insurance in SECTION IV — COMMERCIAL CONTROLLED INSURANCE PROGRAM OR GENERAL LIABILITY CONDITIONS is CONSOLIDATED (WRAP-UP) INSURANCE amended to add the following subparagraph PROGRAMS b.(1)(a)(v): Note: The following provision does not apply to any 4. Other Insurance public construction project in the state of b. Excess Insurance Oklahoma, nor to any construction project in the state of Alaska, that is not permitted to be insured (1) This insurance is excess over: under a "consolidated (wrap-up) insurance (a) Any of the other insurance, program" by applicable state statute or regulation: whether primary, excess, If the endorsement EXCLUSION— contingent or on any other CONSTRUCTION WRAP-UP or another basis: exclusionary endorsement pertaining to Owner (v) That is Property insurance Controlled Insurance Programs (O.C.I.P.) or covering property of others Contractor Controlled Insurance Programs damaged from the use of (C.C.I.P.) is attached to this policy, then the elevators. following changes apply: 23. SUPPLEMENTARY PAYMENTS A. The following wording is added to the endorsement: A. Under Section I — Supplementary Payments With respect to a "consolidated (wrap-up) —Coverages A and B, Paragraph 1.b.,the limit of $250 shown for the cost of bail bonds is insurance program" project in which you are or replaced by$5,000: were involved, this exclusion does not apply to those sums you become legally obligated to B. In Paragraph 1.d., the limit of $250 shown for pay as damages because of: daily loss of earnings is replaced by $1,000. 1. "Bodily injury," "property damage," or 24. UNINTENTIONAL FAILURE TO DISCLOSE "personal or advertising injury" that occurs HAZARDS during your ongoing operations at the If unintentionally you should fail to disclose all project, or during such operations of existing hazards at the inception date of your anyone acting on your behalf; nor policy, we will not deny coverage under this 2. "Bodily injury" or "property damage" Coverage Part because of such failure. included within the "products-completed G-18652-J (Ed. 07-12) Page 11 of 12 Copyright,CNA All Rights Reserved. cPDF.created with u,.r#Faetor.y3 Pre:trial3verriov o Wm.pdffactt 1Q of 15 3/22/2013 11:34:35 AM PST (GMT-8) FROM: 100005-TO: 14088460429 Page: lb of lb G-18652-J CNA (Ed. 07-12) operations hazard" that arises out of those involved in the project, such as an Owner portions of the project that are not Controlled Insurance Program (O.C.I.P.) or "residential structures." Contractor Controlled Insurance Program B. SECTION IV — COMMERCIAL GENERAL (C.C.I.P.). LIABILITY CONDITIONS is amended to add "Residential structure" means any structure the following subparagraph 4.b.(1)(c) to where 30% or more of the square foot area is Condition 4. Other Insurance: used or is intended to be used for human [This insurance is excess over:) residency including but not limited to single or multifamily housing, apartments, (c) Any of the other insurance whether primary, condominiums, townhouses, co-operatives or excess, contingent or any other basis that is planned unit developments and also includes insurance available to you as a result of their common areas and/or appurtenant your being a participant in a "consolidated structures (including pools, hot tubs, detached (wrap-up) insurance program," but only as garages, guest houses or any similar respects your involvement in that structures). When there is no individual "consolidated (wrap-up) insurance ownership of units, residential structure does program." not include military housing, college/university C. SECTION V — DEFINITIONS is amended to housing or dormitories, long term care facilities, hotels, or motels. Residential structure also add the following definition: does not include hospitals or prisons. "Consolidated (wrap-up) insurance program" This provision 26.does not apply to any person means a construction, erection or demolition or organization who otherwise qualifies as an project for which the prime contractor/project additional insured on this Coverage Part. manager or owner of the construction project has secured general liability insurance covering some or all of the contractors or subcontractors 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. Material used with permission of ISO Properties, Inc G-18652-J (Ed. 07-12) Page 12 of 12 Copyright,CNA All Rights Reserved. cPflE created with,polFa©toty3 Pr tria63versiorwmm adffactory.caoee 15 of L5 2/1/2013 2:55:25 PM PST (GMT-8) FROM: 100005-TO: 14088460429 Page: 2 of 12 A`°RO® CERTIFICATE OF LIABILITY INSURANCE DATti1l20 sYYn '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). PRODUCER Arthur J. Gallagher&Co. Insurance Brokers CONTACT NAME: of California, Inc. 3697 Mt. Diablo Blvd., Suite 300 PHONE(A/C No.Exn• 925-299-1112 FAX(A/C,No) 925-299-0328 Lafayette, CA 94549 E-MAIL ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC N www.ajg.com 0726293 INSURER A: National Fire Ins Co of Hartford 20478 INSURED INSURER B: Valley Forge Insurance Company/ 20508 FBD Vanguard Construction, Inc. INSURER : Fireman's Fund Insurance Company 21873 dba:Vanguard Construction y 651 Enterprise Ct. INSURER: Zurich American Insurance Co 16535 Livermore, CA 94550-5200 INSURER E: _INSURER F: COVERAGES CERTIFICATE NUMBER: 15415036 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM.OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ILIP TYPE OF INSURANCE _NSR WVD POLICY NUMBER POLICY EFF POLICY EXP LIMITS (MMIDD/YYYY) (MMIDD/YYVY) A GENERAL LIABILITY 4014291109 3/25/2012 3/25/2013 EACH OCCURRENCE _$ 2,000,000 DAMAGE TO RENTED 100,000 / COMMERCIAL GENERAL LIABILITY PREMISES(Ea occurrence) $ CLAIMS-MADE e OCCUR MED EXP(Any one person) $ 5,000 / XCU Included PERSONAL&ADV INJURY $ 2,000,000 • Contractural Liab GENERAL AGGREGATE $ 4,000,000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OP AGG $ 4,000,000 n POLICY[71 PROT- n LOC Deductible $ $5,000 JEC B AUTOMOBILE LIABILITY 4013610249 3/25/2012 3/25/2013 (Ee aBcNdEEDtSINGLE LIMIT $ 1,000,000 / ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) AUTOS _AUTOS $ / HIRED AUTOS / NON-OWNED PROPERTY DAMAGE AUTOS (Per accident) _$ / form CA 0001 03 06 $ $ UMBRELLA LIAR C — I OCCUR SSE00024201725 3/25/2012 3/25/2013 EACH OCCURRENCE $ 10,000,000 / EXCESS LIAR CLAIMS-MADE I AGGREGATE $ 10,000,000 DED I /I RETENTION$0 $ $ $ D WORKERS COMPENSATION WC489238203 2/1/2013 2/1/2014 I WC STATU- I 147N+ AND EMPLOYERS'LIABILITY y/N /_ TORY LIMITS I l ANY PROPRIETOR/PARTNER/EXECUTIVE E.L EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? n N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach AC ORD 101,Additional Remarks Schedule,if more space is required) City of Gilroy is included as additional insured for General Liability per form G-140331-C31 10/10 attached(Primary Wording Included).Waiver of Subrogation applies for General Liability per form G-18652-I 07/09 attached. The above Additional Insured, Primary Wording and Waiver of Subrogation Endorsements are only valid if requested by written contract. VG986 Proiect:VERBS Safe Route to School-Proiect No 12-PW-199-Federal Proiect No.RPSTPLE-5035(024) CERTIFICATE HOLDER ,CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Gilroy THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Putlic Works Department ACCORDANCE WITH THE POLICY PROVISIONS. 7351 Rosanna Street Gilroy CA 95020 AUTHORIZED REPRESENTATIVE :2: �r1r'—tom I Jamie Yaudes ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD CERT NO.: 15415036 CLIENT CODE: 1997-02-03 15:55:28.803 Jamie Yaudes 2/1/2013 2.53:15 PM Page 1 of 11 2/1/2013 2:55:25 PM PST (GMT-8) FROM: 100005-TO: 14088460429 Page: 3 of 12 4014291109 2/1/2013 FBD Vanguard Construction, Inc. CNAG-140331-C31 Ed. 10/10) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS -WITH PRODUCTS-COMPLETED OPERATIONS COVERAGE This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE (OPTIONAL) Name of Additional Insured Persons Or Organizations tiyyrorit.aroyy"written contract"per Paragraph A. below.) Putlic Works Department 7351 Rosanna Street Gilroy CA 95020 Locations of Covered Operations (As per the"written contract", provided the location is within the"coverage territory"of this Coverage Part.) A. Section II-Who Is An Insured is amended to 2. We will not provide the additional insured any include as an additional insured: broader coverage or any higher limit of 1.Any person or organization whom you are insurance than the least that is: required by"written contract"to add as an a. Required by the"written contract", additional insured on this Coverage Part;and b. Described in B.1.above;or 2.The particular person or organization, if any, c. Afforded to you under this policy. scheduled above. B. The insurance provided to the additional insured is 3. This insurance is excess of all other insurance limited as follows: available to the additional insured whether on a 1. primary, excess, contingent or any other basis. . The person or organization is an additional insured only with respect to liability for"bodily But if required by the"written contract", this insurance will be primary and non-contributory • injury","property damage", or'personal and insured to insurance on which the additional advertising injury"caused in whole or in part by: i nsured is a Named Insured. a. Your acts or omissions; or 4. The insurance provided to the additional insured b. The acts or omissions of those acting on - does not apply to"bodily injury","property your behalf damage", or"personal and advertising injury in the performance of your ongoing operations arising out of: specified in the"written contract"; or a. The rendering of, or the failure to render, c. "Your work"that is specified in the"written any professional architectural, engineering, contract"but only for"bodily injury"or or surveying services, including: "property damage"included in the (1) The preparing, approving,or failing to "products-completed operations hazard", prepare or approve maps, shop and only if: drawings,opinions, reports,surveys, (1)The"written contract"requires you to field orders,change orders or drawings provide the additional insured such and specifications; and coverage;and (2) Supervisory, inspection,architectural or (2)This Coverage Part provides such engineering activities;or coverage. b. Any premises or work for which the additional insured is specifically listed as an G-140331-C31 Includes copyrighted material of Insurance Services Office,Inc.,with its permission Page 1 of 2 (Ed. 10/10) cPOF.created with pdtFactory3 Pr&tri a hversi onuvvvvvv.pd ffaetory n2 of 11 2/1/2013 2:55:25 PM PST (GMT-8) FROM: 100005-TO: 14088460429 Page: 4 of 12 • CNA G-140331-C31 Ed. 10/10) additional insured on another endorsement We have no duty to defend or pay on behalf of attached to this Coverage Part. an additional insured under this endorsement C. SECTION IV-COMMERCIAL GENERAL until we receive from the additional insured LIABILITY CONDITIONS is amended as follows: written notice of a claim or"suit". 1. The Duties In The Event of Occurrence, 2. With respect only to the insurance provided by • Offense,Claim or Suit condition is amended to this endorsement, the first sentence of add the following additional conditions Paragraph 4.a.of the Other Insurance Condition applicable to the additional insured: is deleted and replaced with the following: An additional insured under this endorsement 4. Other Insurance will as soon as practicable: a. Primary Insurance (1) Give us written notice of an"occurrence"or This insurance is primary and non- an offense which may result in a claim or contributory except when rendered "suit" under this insurance, and of any claim excess by endorsement G-140331-C31, or"suit"that does result; or when Paragraph b. below applies. (2) Except as provided in Paragraph B.3 of this D. Only for the purpose of the insurance provided by endorsement,agree to make available any this endorsement,SECTION V-DEFINITIONS is other insurance the additional insured has amended to add the following definition: for a loss we cover under this Coverage Part; "Written contract"means a written contract or written agreement that requires you to make a (3) Send us copies of all legal papers received, person or organization an additional insured on this and otherwise cooperate with us in the Coverage Part, provided the contract or agreement: investigation, defense, or settlement of the 1. Is currently in effect or becomes effective during claim or"suit";and the term of this policy; and (4) Tender the defense and indemnity of any 2.Was executed prior to: • claim or"suit"to any other insurer or self insurer whose policy or program applies to a a.The"bodily injury'or"property damage";or loss we cover under this Coverage Part. b The offense that caused the"personal and But if the"written contract" requires this advertising injury" insurance to be primary and non- for which the additional insured seeks coverage contributory, this provision (4)does not under this Coverage Part. apply to insurance on which the additional insured is a Named Insured. • G-140331-C31 Includes copyrighted material of Insurance Services Office, Inc.,with its permission Page 2 of 2 (Ed. 10/10) 4:a .created witta fi,*1Faetoy3 Pre traa63verriouwwww..pdffactoft 3 of 11 2/1/2013 2:55:25 PM PST (GMT-8) FROM: 100005-TO: 14088460429 Page: 5 of 12 4014291109 2/1/2013 FBD Vanguard Construction, Inc. G-18652-I • CNA (Ed. 07/09) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. i CONTRACTORS' GENERAL LIABILITY EXTENSION ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART Coverage afforded under this extension of coverage endorsement does not apply to any person or organization covered as an additional insured on any other endorsement now or hereafter attached to this Coverage Part Coverages are summarized below. For particulars and limitations affecting each coverage, please refer to the corresponding policy provisions in the body of this endorsement. 1. Miscellaneous Additional Insureds 13. Liberalization Clause 7 additional insured extensions. 14. Unintentional Failure To Disclose Hazards 2. Employees As Insureds—Health Care Services 15. Notice of Occurrence 3. Joint Ventures!Partnership/Limited Liability 16. Broad Knowledge of Occurrence Companies Coverage for your interest in such terminated or 17. Aggregate Limits Per Project ended organizations. 18. Bodily Injury—Extension of Coverage 4. Expanded Personal And Advertising Injury 19. Expected Or Intended Injury 5. Medical Payments Reasonable force—bodily injury or property Limits increased to$15,000. damage. Reporting increased to three years from the date of accident. 20. Wrap-Up Extension 6. Legal Liability And Borrowed Equipment 21. Contractual Liability—Railroads Extended perils. Expanded definition of"insured contract." Limit increased to$200,000 for Damage to 22. Blanket Waiver of Subrogation - Premises Rented To You Waiver of subrogation where required by written 7. Non-owned Watercraft contract or written agreement, Increased to 55 feet 23. In Rem Actions 8. Non-owned Aircraft Coverage 9. Contractual Liability For Personal And Advertising Injury 10. Supplementary Payments Cost of bail bonds increased to$2,500. Daily loss of earnings increased to$1,000. 11. Liquor Liability Coverage Extension 12. Newly Formed Or Acquired Organizations • Coverage extended to the end of the policy period. G-18652-I Includes copyrighted material of Insurance Services Office,Inc.,with its permission. Page 1 of 8 (Ed. 07/09) cROF.created with, 6. tFaetory3 Prc :tria13verrior►Uw vw.pdfactorwr1ta of n 2/1/2013 2:55:25 PM PST (GMT-8) FROM: 100005-TO: 14088460429 Page: 6 of 12 CNA G 07 (Ed.. 07/109)09) 1. MISCELLANEOUS ADDITIONAL INSUREDS b. Controlling Interest Section It Who Is An Insured is amended to Any persons or organizations with a include as an insured any person or organization controlling interest in you but only with (called additional insured) described in Paragraphs respect to their liability arising out of: 2.a. through 2.g. below whom you are required to (1) Their financial control of you; or add as an additional insured on this policy under a written contract or written agreement. However, the (2) Premises they own, maintain or written contract or written agreement must be: control while you lease or occupy these premises. 1. Currently in effect or becoming effective during the term of this policy;and This insurance does not apply to structural alterations, new construction 2. Executed prior to the "bodily injury," and demolition operations performed by "property damage" or "personal injury and or for such additional insured. advertising injury,"but • c. Managers or Lessors of Premises Only the following persons or organizations are additional insureds under this endorsement and A manager or lessor of premises but coverage provided to such additional insureds is only with respect to liability arising out of limited as provided herein: the ownership, maintenance or use of that specific part of the premises leased a. State or Governmental Agency or to you and subject to the following Subdivision or Political Subdivisions additional exclusions: • A state or governmental agency or This insurance does not apply to: subdivision or political subdivision subject to the following provisions: (1) Any"occurrence"which takes place after you cease to be a tenant in (1) This insurance applies only with that premises; or respect to the following hazards for which the state or governmental (2) Structural alterations, new agency or subdivision or political construction or demolition subdivision has issued a permit or operations performed by or on authorization in connection with behalf of such additional insured. premises you own, rent, or control d. Mortgagee,Assignee or Receiver and to which this insurance applies (a) The existence, maintenance, A mortgagee, assignee or receiver but ( ) only with respect to their liability as repair, construction, erection, or mortgagee, assignee, or receiver and removal of advertising signs, arising out of the ownership, awnings, canopies, cellar maintenance, or use of a premises by entrances, coal holes, you. driveways, manholes, marquees, hoistaway openings, This insurance does not apply to sidewalk vaults, street banners, structural alterations, new construction or decorations and similar or demolition operations performed by exposures;or or for such additional insured. (b) The construction, erection, or e. Owners/Other Interests — Land is removal of elevators;or Leased (2) This insurance applies only with An owner or other interest from whom respect to operations performed by land has been leased by you but only • you or on your behalf for which the with respect to liability arising out of the state or governmental agency or ownership, maintenance or use of that subdivision or political subdivision specific part of the land leased to you has issued a permit or and subject to the following additional authorization. exclusions: This insurance does not apply to"bodily This insurance does not apply to: injury," "property damage" or "personal (1) Any"occurrence"which takes place and advertising injury" arising out of after you cease to lease that land; operations performed for the federal or government, state or municipality. G-18652-I Includes copyrighted material of Insurance Services Office, Inc.,with its permission. Page 2 of 8 (Ed. 07/09) cRDF created withr (i.r.Wactory3Prehtriai3versionowwwpdffactorwoom5 of 11 2/1/2013 2:55:25 PM PST (GMT-8) FROM: 100005-TO: 14088460429 Page: 7 of 12 G-18652-I CI'IA (Ed. 07/09) (2) Structural alterations, new this insurance be either primary or construction or demolition primary and noncontributing.Where • i operations performed by or on required by written contract or behalf of such additional insured. written agreement, we will consider f. Co-owner of Insured Premises any other insurance maintained by the additional insured for injury or A co-owner of a premises co-owned by damage covered by this you and covered under this insurance endorsement to be excess and but only with respect to the co-owners noncontributing with this insurance. liability as co-owner of such premises. 2. EMPLOYEES AS INSUREDS — HEALTH CARE g. Lessor of Equipment SERVICES Any person or organization from whom Paragraph 2.a.(1)(d) of Section II — Who Is An you lease equipment. Such person or Insured is deleted. organization are insureds only with 3. JOINT VENTURES / PARTNERSHIP I LIMITED respect to their liability arising out of the LIABILITY COMPANY COVERAGE maintenance, operation or use by you of equipment leased to you by such A. The following is added to Section II — Who Is person or organization. A person's or An Insured: organization's status as an insured 4. You are an insured when you had an under this endorsement ends when interest in a joint venture, partnership or their written contract or written limited liability company which terminated or agreement with you for such leased ended prior to or during this policy period equipment ends. but only to the extent of your interest in such With respect to the insurance afforded joint venture, partnership or limited liability these additional insureds, the following company.This coverage does not apply: additional exclusions apply: a. Prior to the termination date of any joint This insurance does not apply: venture, partnership or limited liability ■ (1) To any "occurrence" which takes company;or place after the equipment lease b. If there is other valid and collectible expires;or insurance purchased specifically to (2) To "bodily injury," "property insure the partnership, joint venture or ( ) y 1 ry," p p y limited liability company. damage," or "personal and advertising injury" arising out of the c. To a joint venture, partnership or limited sole negligence of such additional liability company which is or was insured. insured under a"consolidated (wrap-up) Any insurance provided to an additional insured insurance program." designated under Paragraphs a. through g. "Consolidated (wrap-up) insurance above does not apply to "bodily injury' or program" means a construction, erection or "property damage" included within the demolition project for which the prime "products-completed operations hazard." contractor/project manager or owner of the As respects the coverage provided under this construction project has secured general liability insurance covering some or all of the provision, Paragraph 4.b.(1) of Section IV — contractors or subcontractors involved in Commercial General Liability Conditions is the project, otherwise referred to as an • deleted and replaced with the following: Owner Controlled Insurance Program 4. Other Insurance (O.C.I.P.) or Contractor Controlled b. Excess Insurance Insurance Program(C.C.I.P.). B. The last paragraph of Section II — Who Is An (1) This insurance is excess over: Insured is deleted and replaced by the Any other insurance naming the following: additional insured as an insured Except as provided in Paragraph 4. above, no whether primary, excess, person or organization is an insured with contingent or on any other basis respect to the conduct of any current or past unless a written contract or written partnership, joint venture or limited liability agreement specifically requires that G-18652-I Includes copyrighted material of Insurance Services Office,Inc.,with its permission. Page 3 of 8 (Ed. 07/09) cPDE created with pdfFaotot-y3 Pros:trial3verrionu vw.pdffactocwm6 of IL 2/1/2013 2:55:25 PM PST (GMT-8) FROM: 100005-TO: 14088460429 Page: 8 of 12 _ G-18652-I CNA (Ed.07/09) company that is not shown as a Named Insured — I — Coverage C for all medical expenses in the Declarations. because of"bodily injury" sustained by any 4. EXPANDED PERSONAL AND ADVERTISING one person. The Medical Expense Limit is INJURY the greater of: A. The following is added to Section V — (1) $15,000; or Definitions, the definition of "Personal and (2) The amount shown in the advertising injury": Declarations for Medical Expense h. Discrimination or humiliation that results in Limit. injury to the feelings or reputation of a B. This provision 5. (Medical Payments) does not natural person, but only if such apply if Section I — Coverage C Medical discrimination or humiliation is: Payments is excluded either by the provisions (1) Not done intentionally by or at the of the Coverage Part or by endorsement. direction of: C. Paragraph 1.a.(3)(b)of Section I—Coverage C (a) The insured;or — Medical Payments, is replaced by the ( ) following: (b) Any "executive officer," director, (b) The expenses are incurred and reported to stockholder, partner, member or us within three years of the date of the manager(if you are a limited liability accident; and company)of the insured; and (2) Not directly or indirectly related to the 6. LEGAL LIABILITY AND BORROWED . employment, prospective employment, EQUIPMENT past employment or termination of A.. Under Section I— Coverage A—Bodily Injury employment of any person or persons and Property Damage 2. Exclusions, by any insured. Exclusion j. is replaced by the following. B. Exclusions of Section I — Coverage B — "Property damage"to: Personal and Advertising Injury Liability is (1) Property you own, rent, or occupy; amended to include the following: Discrimination Relating To Room, (2) Premises you sell, give away or Dwelling Premises abandon, if the "property damage" g or arises out of any part of those Caused by discrimination directly or premises; indirectly related to the sale, rental,lease or (3) Property loaned to you; sub-lease or prospective sale, rental, lease or sub-lease of any room, dwelling or (4) Personal property in the care, premises by or at the direction of any custody or control of the insured;. insured. (5) That particular part of real property Fines Or Penalties on which you or any contractors or Fines or penalties levied or imposed by a subcontractors working directly or governmental entity because of indirectly on your behalf are discrimination. performing operations, if the "property damage" arises out of D. This provision 4. (EXPANDED PERSONAL those operations;or AND ADVERTISING INJURY COVERAGE) (6) That particular part of any property does not apply if Section I — Coverage B — that must be restored, repaired or • Personal And Advertising Injury Liability is replaced because "your work" was excluded either by the provisions of the incorrectly performed on it. Coverage Part or by endorsement. 5. MEDICAL PAYMENTS Paragraph (2)of this exclusion does not apply if the premises are "your work" A. Paragraph 7. Medical Expense Limit, of and were never occupied, rented or Section III — Limits of Insurance is deleted held for rental by you. and replaced by the following: Paragraphs (1), (3) and (4) of this 7. Subject to Paragraph 5. above (the Each exclusion do not apply to: Occurrence Limit), the Medical Expense (i) "property damage" to tools Limit is the most we will pay under Section or equipment loaned to you G-18652-I Includes copyrighted material of Insurance Services Office,Inc.,with its permission. Page 4 of 8 (Ed. 07/09) . °PDF.created with, 6,44Faototg3 Prr :tria63version.wwwpdffactory 1, of 11 2/1/2013 2:55:25 PM PST (GMT-8) FROM: 100005-TO: 14088460429 Page: 9 of 12 • G-18652 07/09) CIWA (Ed. -1 if the tools or equipment b. The Damage To Premises Rented To are not being used to You Limit shown in the Declarations. perform operations at the D. Paragraph 4.b.(1)(a)(ii) of Section IV - time of loss; or Commercial General Liability Conditions is (ii) "property damage" (other deleted and replaced by the following: than damage by fire) to (ii) That is property insurance premises rented to you or for premises rented to you temporarily occupied by or temporarily occupied by you with the permission of you with the permission of the owner, or to the contents of premises the owner; or rented to you for a period of E. This provision 6. (LEGAL LIABILITY AND 7 or fewer consecutive BORROWED EQUIPMENT) does not apply if days. A separate limit of . Damage To Premises Rented To You Liability insurance applies to under Section I - Coverage A is excluded Damage To Premises either by the provisions of the Coverage Part or Rented To You as by endorsement. described in Section III - 7. NON-OWNED WATERCRAFT Limits Of Insurance. Paragraphs (3), (4), (5) and (6) of this Under Section I - Coverage A, Exclusion 2.g., exclusion do not apply to liability subparagraph (2) is deleted and replaced by the assumed under a sidetrack agreement. following. Paragraph (6)of this exclusion does not (2) A watercraft you do not own that is: apply to "property damage" included in (a) Less than 55 feet long; and the "products-completed operations hazard." (b) Not being used to carry persons or property for a charge. B. Under Section I - Coverage A-Bodily Injury and Property Damage the last paragraph of 2. 8. NON-OWNED AIRCRAFT Exclusions is deleted and replaced by the Exclusion 2.g.of Section I-Coverage A-Bodily following. Injury and Property Damage, does not apply to an Exclusions c. through n. do not apply to aircraft you do not own, provided that: damage by fire to premises while rented to you 1. The pilot in command holds a currently or temporarily occupied by you with permission effective certificate issued by the duly of the owner or to the contents of premises constituted authority of the United States of rented to you for a period of 7 or fewer America or Canada, designating that person consecutive days. as a commercial or airline transport pilot; A separate limit of insurance applies to this 2. It is rented with a trained, paid crew; and coverage as described in Section III - Limits Of Insurance. 3. It does not transport persons or cargo for a charge. C. Paragraph 6. Damage To Premises Rented To You Limit of Section III- Limits Of Insurance 9. CONTRACTUAL LIABILITY FOR PERSONAL is replaced by the following: AND ADVERTISING INJURY 6. Subject to Paragraph 5. above, (the Each Exclusion e. Contractual Liability of Section I - Occurrence Limit), the Damage To Coverage B is deleted. Premises Rented To You Limit is the most 10. SUPPLEMENTARY PAYMENTS we will pay under Section-I-Coverage A for damages because of"property damage" A. Under Section I-Supplementary Payments- to any one premises while rented to you or Coverages A and B, Paragraph 1.b.,the limit of temporarily occupied by you with •the $250 shown for the cost of bail bonds is permission of the owner, including contents replaced by$2,500: of such premises rented to you for a period B. In Paragraph 1.d., the limit of $250 shown for of 7 or fewer consecutive days. The daily loss of earnings is replaced by$1,000. Damage To Premises Rented To You Limit is the greater of: 11. LIQUOR LIABILITY a. $200,000;or Exclusion c.of Section I-Coverage A is deleted. G-18652-1 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. Page 5 of 8 (Ed. 07/09) cROI .created with, e.04Factkr-y3 Pf-o tfha63version.www.pdffae ocw le of IL 2/1/2013 2:55:25 PM PST (GMT-8) FROM: 100005-TO: 14088460429 Page: 10 of 12 • -I CNA (Ed.G-18652 07!09) 12. NEWLY FORMED OR ACQUIRED (4) A manager, if you are a limited ORGANIZATIONS liability company. Paragraph 3.a. of Section II —Who Is An Insured 17. AGGREGATE LIMITS PER PROJECT is deleted and replaced by the following: A. For all sums which the insured becomes legally Coverage under this provision is afforded only until obligated to pay as damages caused by the end of the policy period or the next anniversary "occurrences" under Section I — Coverage A, of this policy's effective date after you acquire or and for all medical expenses caused by form the organization,whichever is earlier. accidents under Section I—Coverage C,which 13. LIBERALIZATION CLAUSE can be attributed only to ongoing operations at a single construction project away from premises If we adopt a change in our forms or rules which owned by or rented to the insured: would broaden coverage for contractors under this 1. A separate Single Construction Project endorsement without an additional premium charge, General Aggregate Limit applies to each your policy will automatically provide the additional construction project away from, premises coverages as of the date the revision is effective in owned by or rented to the insured, and that your state. limit is equal to the amount of the General 14. UNINTENTIONAL FAILURE TO DISCLOSE Aggregate Limit shown in the Declarations. HAZARDS 2. The Single Construction Project General Based on our reliance on your representations as to Aggregate Limit is the most we will pay for existing hazards, if unintentionally you should fail to the sum of all damages under Coverage A, disclose all such hazards at the inception date of except damages because of "bodily injury' your policy, we will not deny coverage under this or "property damage" included in the Coverage Part because of such failure. "products-completed operations hazard," • 15. NOTICE OF OCCURRENCE and for medical expenses under Coverage C regardless of the number of: The following is added to Paragraph 2. of Section a. Insureds; IV — Commercial General Liability Conditions — Duties In The Event of Occurrence, Offense, b. Claims made or"suits"brought; or Claim or Suit: c. Persons or organizations making claims Your rights under this Coverage Part will not be or bringing"suits." prejudiced if you fail to give us notice of an 3. Any payments made under Coverage A for "occurrence," offense, claim or"suit"and that failure damages or under Coverage C for medical is solely due to your reasonable belief that the expenses shall reduce the Single "bodily injury" or "property damage" is not covered Construction Project General Aggregate under this Coverage Part. However, you shall give Limit for that construction project away from written notice of this"occurrence," offense, claim or premises owned by or rented to the insured. "suit" to us as soon as you are aware that this Such payments shall not reduce the insurance may apply to such "occurrence," offense General Aggregate Limit shown in the claim or"suit." Declarations nor shall they reduce any other 16. BROAD KNOWLEDGE OF OCCURRENCE Single Construction Project General Aggregate Limit for any other separate The following is added to Paragraph 2. of Section construction•project away from premises IV — Commercial General Liability Conditions — owned by or rented to the insured. Duties in The Event of Occurrence, Offense, , Claim or Stilt: 4. The limits shown in the Declarations for You must give us or our authorized representative Each Occurrence, Damage To Premises Rented To You and Medical Expense notice of an "occurrence," offense, claim, or "suit" continue to apply. However, instead of only when the "occurrence," offense, claim or "suit" po y is known to: being subject to the General Aggregate Limit shown in the Declarations, such limits (1) You, if you are an individual; will be subject to the applicable Single Construction Project General Aggregate (2) A partner, if you are a partnership; Limit. (3) An executive officer or the B. For all sums which the insured becomes legally employee designated by you to give obligated to pay as damages caused by such notice, if you are a "occurrences" under Section I — Coverage A, corporation;or G-18652-1 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. Page 6 of 8 (Ed. 07/09) cPOE created with i,r,1Factor-y3Pre tria63versior"w va pdffactorVt 9 of IL 2/1/2013 2:55:25 PM PST (GMT-8) FROM: 100005-TO: 14088460429 Page: 11 of 12 G-18652-I CNA (Ed, 07/09) and for all medical expenses caused by 20. OWNER CONTROLLED INSURANCE PROGRAM, accidents under Section I—Coverage C,which CONTRACTOR CONTROLLED INSURANCE cannot be attributed only to ongoing operations PROGRAM OR CONSOLIDATED (WRAP-UP) at a single construction project away from INSURANCE PROGRAMS premises owned by or rented to the insured: The endorsement EXCLUSION—CONSTRUCTION 1. Any payments made under Coverage A for WRAP-UP PROGRAM which is attached to this damages or under Coverage C for medical policy is amended as follows: expenses shall reduce the amount available A. If the endorsement EXCLUSION — under the General Aggregate Limit or the CONSTRUCTION WRAP-UP or another Products Completed Operations Aggregate exclusionary endorsement pertaining to Owner, Limit,whichever is applicable; and Controlled Insurance Programs (O.C.I.P.) or 2. Such payments shall not reduce any Single Contractor Controlled Insurance Programs Construction Project General Aggregate • (C.C.I.P.) is attached to this policy, then it is Limit. amended to add the following: C. When coverage for liability arising out of the With respect to a "consolidated (wrap-up) "products-completed operations hazard" is insurance program" project in which you are or provided, any payments for damages because were involved, this exclusion does not apply to: of"bodily injury" or"property damage" included in the "products-completed operations hazard" 1. Your liability for "bodily injury," "property will reduce the Products-Completed Operations damage,"or "personal or advertising injury" • Aggregate Limit, and not reduce the General that occurs during your ongoing operations Aggregate Limit nor the Single Construction at the project, or during such operations of Project General Aggregate Limit. anyone acting on your behalf, D. If a single construction project away from 2. Your liability for "bodily injury" or "property premises owned by or rented to the insured has damage" included within the "products- been abandoned and then restarted, or if the completed operations hazard that arises authorized contracting parties deviate from out of those portions of the project that are plans, blueprints, designs, specifications or not"residential structures." timetables, the project will still be deemed to be B. The following is added to Paragraph 4.b.(1) of the same construction project. Section IV-Commercial General Liability E. The provisions of Section III — Limits Of Conditions Insurance not otherwise modified by this This insurance is excess over: endorsement shall continue to apply as stipulated. (c) Any of the other insurance whether primary,excess, contingent or any other 18. EXPANDED BODILY INJURY basis that is insurance available to you Section V — Definitions, the definition of "bodily as a result of your being a participant in injury" is changed to read: a "consolidated (wrap-up) insurance program," but only as respects your "Bodily injury" means bodily injury, sickness or involvement in that"consolidated (wrap- disease sustained by a person, including death, up) insurance program." humiliation, shock, mental anguish or mental injury C. The following is added to Section V — by that person at any time which results as a consequence of the bodily injury, sickness or Definitions: disease. "Consolidated (wrap-up) insurance program" 19. EXPECTED OR INTENDED INJURY means a construction, erection or demolition project for which the prime contractor/project Exclusion a. of Section I — Coverage A — Bodily manager or owner of the construction project Injury and Property Damage Liability is replaced has secured general liability insurance covering by the following: some or all of the contractors or subcontractors a. "Bodily injury" or "property damage" involved in the project, otherwise referred to as expected or intended from the an Owner Controlled Insurance Program (O.C.I.P.) or Contractor Controlled Insurance standpoint of the insured. This exclusion does not apply to "bodily Program(C.C.I.P.). . injury" or "property damage" resulting "Residential structure" means any structure from the use of reasonable force to where 30% or more of the square foot area is protect persons or property. used or is intended to be used for human G-18652-I Includes copyrighted material of Insurance Services Office.Inc.,with its permission. Page 7 of 8 (Ed. 07/09) cPDF created wittar polFactoy3 Pra:trial3version"vorvampdffaetocV 10 of 11 2/1/2013 2:55:25 PM PST (GMT-8) FROM: 100005-TO: 14088460429 Page: 12 of 12 G-18652-I CNA (Ed. 07/09) residency including but not limited to single or (1) That indemnifies an architect, multifamily housing, apartments, condominiums, engineer or surveyor for injury or townhouses, co-operatives or planned unit damage arising out of: developments and also includes their common areas and/or appurtenant structures (including (a) Preparing, approving or failing pools, hot tubs, detached garages, guest to prepare or approve maps, houses or any similar structures). When there is shop drawings, opinions, no individual ownership of units, residential reports, surveys, field orders, structure does not include military housing, change orders or drawings and specifications; or college/university housing or dormitories, long term care facilities, hotels, or motels. (b) Giving directions or instructions, Residential structure also does not include or failing to give them, if that is hospitals or prisons. the primary cause of the injury 21. CONTRACTUAL LIABILITY—RAILROADS or damage; • With respect to operations performed within 50 feet (2) Under which the insured, if an of railroad property, the definition of "insured architect, engineer or surveyor, contract" in Section V— Definitions is replaced by assumes liability for an injury or the following: damage arising out of the insured's .rendering or failure to render "Insured Contract"means, professional services, including a. A contract for a lease of premises. those listed in (1) above and However, that portion of the contract For supervisory, inspection, a lease of premises that indemnifies architectural or engineering any person or organization for damage activities. es. by fire to premises while rented to you 22. BLANKET WAIVER OF SUBGROGATION or temporarily occupied by you with The Transfer Of Rights Of Recovery Against permission of the owner is not an Others To Us Condition(Section IV—Commercial "insured contract"; General Liability Conditions) is amended by the b. A sidetrack agreement; addition of the following: c. Any easement or license agreement; We waive any right of recovery we may have d. An obligation, as required by ordinance, against any person or organization because of to indemnify a municipality, except in payments we make for injury or damage arising out connection with work for a municipality; of: e. An elevator maintenance agreement; 1. Your ongoing operations; or f. That part of any other contract or 2. "Your work" included in the "products- agreement pertaining to your business completed operations hazard." (including an indemnification of a However, this waiver applies only when you have municipality in connection with work agreed in writing to waive such rights of recovery in performed for a municipality) under a contract or agreement, and only if the contract or which you assume the tort liability of agreement: another party to pay for"bodily injury"or 1. Is in effect or becomes effective during the "property damage" to a third•person or organization. Tort liability means a term of this policy;and liability that would be imposed by law in 2. Was executed prior to loss. the absence of any contract or 23. IN REM ACTIONS agreement. Paragraph f. does not include that part Any action in rem against any vessel owned, of any contractor agreement: operated by or for, or chartered by or for you will be treated in the same manner as though the action were in personam against you. G-18652-I Inc'udes copyrighted material of Insurance Services Office,Inc.,with its permission. Page 8 of 8 (Ed. 07/09) cPOF created with i'rtFaetor-y3Pr&#,ria63verrioFu .Odifa€tOfy1oom11 of 11 9/24/2012 9:10:44 AM PST (GMT-8) FROM: 100005-TO: 14088460429 Page: 2 of 12 qco® CERTIFICATE OF LIABILITY INSURANCE GATE(MM/DDIYYYY) ‘1..-.)---' 9/24/2012 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). PRODUCER Arthur J. Gallagher&Co. CONTACT NAME: 3697 Mt. Diablo Blvd., Suite 300 PHONE(NC.No.EMI' 925-299-1112 INC. Lafayette, CA 94549 FAx No) 925-299-0328 EMAIL ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC 0 www.ajg.com 0726293 INSURERA: National Fire Ins.Co.of Hartford , 20478 INSURED INSURER B: Valley Forge Insurance Comoany 20508 FBD Vanguard Construction, Inc. INSURER : Fireman's Fund Insurance Comoany 21873 dba: Vanguard Construction v 651 Enterprise Ct. INSURER 0: Zurich American Insurance Co. 16535 Livermore, CA 94550-5200 INSURER INSURERF _ COVERAGES CERTIFICATE NUMBER: 14165229 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE INSR SINVD POLICY NUMBER PMIOO!Y FF POLICY EXP LIMITS (MMlODIYYYY) (MMIDOIYYYY) A GENERAL LIABILITY 4014291109 3/25/2012 3/25/2013 EACH OCCURRENCE $ 2,000,000 DAMAGE TO RENTED 1 00,000 COMMERCIAL GENERAL LIABILITY PREMISES(Ea occurrence) $ CLAIMS-MADE n OCCUR MED EXP(Any one person) $ 5,000 XCU Included PERSONAL&ADV INJURY $ 2,000,000 Contractural Liab GENERAL AGGREGATE $ 4,000,000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OP AGG $ 4,000,000 —7 POLICY n F° n LOC Deductible $ $5,000 B AUTOMOBILE LIABILITY 4013610249 3/25/2012 3/25/2013 EOtaBctgeotSINoil LIMIT $ 1,000,000 J ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED 1 BODILY INJURY(Per accident) • „� _$ AUTOS AUTOS J HIRED AUTOS J NON-OWNED PROPERTY(DAMAGE AUTOS (Per accident) _$ form CA 0001 03 06 $ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 10,000,000 C _ H SSE00024201725 3/25/2012 3/25/2013 i EXCESS LIAR I I CLAIMS-MADE AGGREGATE $ 10,000,000 DED I i I RETENTION$0 $ $ D WORKERS COMPENSATION Y!N WC489238202 2/1/2012 2/1/2013 1 We sTATU- ID�7+- AND EMPLOYERS'LIABILITY J TORY LIMITS 1 ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? n N/A -- (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E L DISEASE•POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS!LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) City of Gilroy is included as additional insured for General Liability perform G-140331-C31 10/10 attached(Primary Wording Included).Waiver of Subrogation applies for General Liability per form G-18652-107/09 attached. The above Additional Insured, Primary Wording and Waiver of Subrogation Endorsements are only valid if requested by written contract. VG986 Protect-VERBS Safe Route to School-Project No 12-PW-199,Federal Project No RPSTPLE-5035(024) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Gilroy THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Putlic Works Department ACCORDANCE WITH THE POLICY PROVISIONS. 7351 Rosanna Street Gilroy CA 95020 AUTHORIZED REPRESENTATIVE Jamie Yaudes ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD CERT. NO.: 14165229 CLIENT CODE: 1997-02-03 15:55:28.603 Jamie Yaudes 9/24/2012 9:08'.49 AM Page 1 of 11 9/24/2012 9:10:44 AM PST (GMT-8) FROM: 100005-TO: 14088460429 Page: 3 of 12 4014291109 9/24/2012 • FBD Vanguard Construction, Inc. CNAG-140331-C31 Ed. 10/10) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS -WITH PRODUCTS-COMPLETED OPERATIONS COVERAGE This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE (OPTIONAL) Name of Additional Insured Persons Or Organizations t reoo edoby"written contract"per Paragraph A. below.) Putlic Works Department 7351 Rosanna Street Gilroy CA 95020 Locations of Covered Operations (As per the"written contract", provided the location is within the"coverage territory"of this Coverage Part.) A. Section II-Who Is An Insured is amended to 2. We will not provide the additional insured any include as an additional insured: broader coverage or any higher limit of 1.Any person or organization whom you are insurance than the least that is: required by'written contract"to add as an a. Required by the"written contract", additional insured on this Coverage Part;and b. Described in B.1.above;or 2.The particular person or organization, if any, scheduled above. c. Afforded to you under this policy. B. The insurance provided to the additional insured is 3. This insurance is excess of all other insurance limited as follows: available to the additional insured whether on a 1. The person or organization is an additional primary,excess, contingent or any other basis. insured only with respect to liability for"bodily But if required by the"written contract", this insurance will be primary and non-contributory injury","property damage", or`personal and relative to insurance on which the additional advertising injury"caused in whole or in part by: insured nsured is a Named Insured. a. Your acts or omissions; or 4. The insurance provided to the additional insured b. The acts or omissions of those acting on - does not apply to"bodily injury","property your behalf damage", or"personal and advertising injury in the performance of your ongoing operations arising out of: specified in the"written contract"; or a. The rendering of, or the failure to render, c. "Your work"that is specified in the"written any professional architectural, engineering, contract"but only for"bodily injury"or or surveying services, including: "property damage"included in the (1) The preparing, approving,or failing to • "products-completed operations hazard", prepare or approve maps, shop and only if: drawings,opinions,reports,surveys, (1)The"written contract"requires you to field orders,change orders or drawings provide the additional insured such and specifications; and coverage;and (2) Supervisory, inspection,architectural or (2)This Coverage Part provides such engineering activities;or coverage. b. Any premises or work for which the additional insured is specifically listed as an G-140331-C31 Includes copyrighted material of Insurance Services Office,Inc.,with its permission Page 1 of 2 (Ed. 10/10) cPD created with, 6,r 1Factor-y3 Pre trial3verriOr u Mp iffactor/€Gm 2 of LL 9/24/2012 9:10:44 AM PST (GMT-8) FROM: 100005-TO: 14088460429 Page: 4 of 12 CNAG-140331-C31 Ed. 10/10) additional insured on another endorsement We have no duty to defend or pay on behalf of attached to this Coverage Part. an additional insured under this endorsement C. SECTION IV—COMMERCIAL GENERAL until we receive from the additional insured LIABILITY CONDITIONS is amended as follows: written notice of a claim or"suit". 1. The Duties In The Event of Occurrence, 2. With respect only to the insurance provided by Offense, Claim or Suit condition is amended to this endorsement,the first sentence of add the following additional conditions Paragraph 4.a.of the Other Insurance Condition applicable to the additional insured: is deleted and replaced with the following; An additional insured under this endorsement 4. Other Insurance will as soon as practicable: a. Primary Insurance (1) Give us written notice of an"occurrence"or This insurance is primary and non- an offense which may result in a claim or contributory except when rendered "suit" under this insurance, and of any claim excess by endorsement G-140331-C31, or"suit"that does result; or when Paragraph b.below applies. (2) Except as provided in Paragraph B.3 of this D. Only for the purpose of the insurance provided by endorsement,agree to make available any this endorsement,SECTION V—DEFINITIONS is other insurance the additional insured has • amended to add the following definition: for a loss we cover under this Coverage Part; "Written contract"means a written contract or written agreement that requires you to make a (3) Send us copies of all legal papers received, person or organization an additional insured on this and otherwise cooperate with us in the Coverage Part, provided the contract or agreement: investigation, defense, or settlement of the 1. Is currently in effect or becomes effective during claim or"suit";and the term of this policy; and (4) Tender the defense and indemnity of any 2.Was executed prior to: claim or"suit"to any other insurer or self insurer whose policy or program applies to a a.The"bodily injury"or"property damage";or loss we cover under this Coverage Part. b The offense that caused the"personal and But if the"written contract"requires this advertising injury" insurance to be primary and non- for which the additional insured seeks coverage contributory,this provision (4)does not under this Coverage Part. apply to insurance on which the additional insured is a Named Insured. • G-140331-C31 Includes copyrighted material of Insurance Services Office,Inc.,with its permission Page 2 of 2 (Ed. 10110) cPDE created with, A 4Factary3 P 05 trial3versionuww pdffad#01VAGfl 3 of 11 9/24/2012 9:10:44 AM PST (GMT-8) FROM: 100005-TO: 14088460429 Page: 5 of 12 4014291109 9/24/2012 • FBD Vanguard Construction, Inc. G-18652-I CNA (Ed 07/09) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CONTRACTORS' GENERAL LIABILITY EXTENSION ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART Coverage afforded under this extension of coverage endorsement does not apply to any person or organization covered as an additional insured on any other endorsement now or hereafter attached to this Coverage Part SCHEDULE Coverages are summarized below. For particulars and limitations affecting each coverage, please refer to the corresponding policy provisions in the body of this endorsement. 1. Miscellaneous Additional Insureds 13. Liberalization Clause 7 additional insured extensions. 14. Unintentional Failure To Disclose Hazards 2. Employees As Insureds—Health Care Services 15. Notice of Occurrence 3. Joint VentureslPartnership/Limited Liability 16. Broad Knowledge of Occurrence Companies Coverage for your interest in such terminated or 17. Aggregate Limits Per Project ended organizations_ 18. Bodily Injury—Extension of Coverage 4. Expanded Personal And Advertising Injury 19. Expected Or Intended Injury 5. Medical Payments Reasonable force—bodily injury or property Limits increased to S15,000. damage. Reporting increased to three years from the date of accident. 20. Wrap-Up Extension 6. Legal Liability And Borrowed Equipment 21. Contractual Liability—Railroads Extended perils. Expanded definition of"insured contract." Limit increased to$200,000 for Damage to 22. Blanket Waiver of Subrogation Premises Rented To You Waiver of subrogation where required by written 7. Non-owned Watercraft contract or written agreement. Increased to 55 feet. 23. In Rem Actions 8. Non-owned Aircraft Coverage 9. Contractual Liability For Personal And Advertising Injury 10. Supplementary Payments Cost of bail bonds increased to$2,500. Daily loss of earnings increased to$1,000. 11. Liquor Liability Coverage Extension 12. Newly Formed Or Acquired Organizations Coverage extended to the end of the policy period. G-18652-I Includes copyrighted material of Insurance Services Office,Inc.,with its permission. Page 1 of 8 (Ed. 07/09) cREI .created with, ra.r.iFaetny3 fire :tria63versionuwnr .prEffaetary,ectraa 4 of 11 9/24/2012 9:10:44 AM PST (GMT-8) FROM: 100005-TO: 14088460429 Page: 6 of 12 • G-18652-I • CNA (Ed. 07/09) , 1. MISCELLANEOUS ADDITIONAL INSUREDS b. Controlling Interest Section II Who Is An Insured is amended to Any persons or organizations with a include as an insured any person or organization controlling interest in you but only with (called additional insured) described In Paragraphs respect to their liability arising out of: 2.a. through 2.g. below whom you are required to (1) Their financial control of you;or add as an additional insured on this policy under a written contract or written agreement. However, the (2) Premises they own, maintain or written contract or written agreement must be: control while you lease or occupy 1. Currently in effect or becoming effective these premises. during the term of this policy;and This insurance does not apply to injury," structural alterations, new construction 2. Executed prior to the "bodily 1 ry, and demolition operations performed by "property damage" or "personal injury and or for such additional insured. advertising injury,"but c. Managers or Lessors of Premises Only the following persons or organizations are additional insureds under this endorsement and A manager or lessor of premises but coverage provided to such additional insureds is only with respect to liability arising out of limited as provided herein: the ownership, maintenance or use of a. State or Governmental Agency or that specific part of the premises leased 9 Y to you and subject to the following Subdivision or Political Subdivisions additional exclusions: A state or governmental agency or This insurance does not apply to: subdivision or political subdivision subject to the following provisions: (1) Any"occurrence"which takes place after you cease to be a tenant in (1) This insurance applies only with that premises: or respect to the following hazards for which the state or governmental (2) Structural alterations, new agency or subdivision or political construction or demolition subdivision has issued a permit or operations performed by or on authorization in connection with behalf of such additional insured, premises you own, rent, or control d. Mortgagee,Assignee or Receiver and to which this insurance applies. (a) The existence, maintenance, A mortgagee, assignee or receiver but ( ) only with respect to their liability as repair, construction, erection, or mortgagee, assignee, or receiver and removal of advertising signs, arising out of the ownership, awnings, canopies, cellar maintenance, or use of a premises by entrances, coal holes, you. driveways, manholes, marquees, hoistaway openings, This insurance does not apply to sidewalk vaults, street banners, structural alterations, new construction or decorations and similar or demolition operations performed by exposures;or or for such additional insured. (b) The construction, erection, or e. Owners/Other Interests — Land is removal of elevators;or Leased (2) This insurance applies only with An owner or other interest from whom respect to operations performed by land has been leased by you but only • you or on your behalf for which the with respect to Inability arising out of the state or governmental agency or ownership, maintenance or use of that subdivision or political subdivision specific part of the land leased to you has issued a permit or and subject to the following additional authorization. exclusions: This insurance does not apply to"bodily This insurance does not apply to: injury," "property damage" or "personal (1) Any"occurrence"which takes place and advertising injury" arising out of after you cease to lease that land; operations performed for the federal or government, state or municipality. G-18652-I Includes copyrighted material of Insurance Services Office,Inc.,with its permission. Page 2 of 8 (Ed. 07/09) cROF.created wit> r a AfFaetorg3Pco trial3versionvAv w.cadff oopco 5 of 11 9/24/2012 9:10:44 AM PST (GMT-8) FROM: 100005-TO: 14088460429 Page: 7 of 12 • G-18652-I CNA (Ed. 07109) (2) Structural alterations, new this insurance be either primary or construction or demolition primary and noncontributing.Where • operations performed by or on required by written contract or behalf of such additional insured. written agreement, we will consider f. Co-owner of Insured Premises any other insurance maintained by the additional insured for injury or A co-owner of a premises co-owned by damage covered by this you and covered under this insurance endorsement to be excess and but only with respect to the co-owners noncontributing with this insurance. liability as co-owner of such premises. 2. EMPLOYEES AS INSUREDS — HEALTH CARE g. Lessor of Equipment SERVICES Any person or organization from whom Paragraph 2.a.(1)(d) of Section II — Who Is An you lease equipment. Such person or Insured is deleted. organization are insureds only with 3. JOINT VENTURES / PARTNERSHIP / LIMITED respect to their liability arising out of the LIABILITY COMPANY COVERAGE maintenance, operation or use by you of equipment leased to you by such A. The following is added to Section II — Who Is person or organization. A person's or An Insured: organization's status as an insured 4. You are an insured when you had an under this endorsement ends when interest in a joint venture, partnership or their written contract or written limited liability company which terminated or agreement with you for such leased ended prior to or during this policy period equipment ends. but only to the extent of your interest in such With respect to the insurance afforded joint venture, partnership or limited liability these additional insureds, the following company.This coverage does not apply: additional exclusions apply: a. Prior to the termination date of any joint This insurance does not apply: venture, partnership or limited liability (1) To any "occurrence" which takes company;or place after the equipment lease b. If there is other valid and collectible expires;or insurance purchased specifically to (2) To "bodily injury," "property insure the partnership, joint venture or ( ) y ry. p p y limited liability company. damage," or "personal and advertising injury" arising out of the c. To a joint venture, partnership or limited sole negligence of such additional liability company which is or was insured. insured under a"consolidated (wrap-up) Any insurance provided to an additional insured insurance program." designated under Paragraphs a. through g. "Consolidated (wrap-up) insurance above does not apply to "bodily injury" or . program" means a construction, erection or "property damage" included within the demolition project for which the prime "products-completed operations hazard." contractor/project manager or owner of the As respects the coverage provided under this construction project has secured general liability insurance covering some or all of the provision, Paragraph 4.b.(1) of Section IV — contractors or subcontractors involved in Commercial General Liability Conditions is the project, otherwise referred to as an deleted and replaced with the following: Owner Controlled Insurance Program 4. Other Insurance (O.C.I.P.) or Contractor Controlled b. Excess Insurance Insurance Program(C.C.I.P.). B. The last paragraph of Section II — Who Is An (1) This insurance is excess over: Insured is deleted and replaced by the Any other insurance naming the following: additional insured as an insured Except as provided in Paragraph 4, above, no whether primary, excess, person or organization is an insured with contingent or on any other basis respect to the conduct of any current or past unless a written contract or written partnership, joint venture or limited liability agreement specifically requires that G-18652-1 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. Page 3 of 8 (Ed. 07/09) cRD.created with a A Wactory3 Pr&trialoversion"v .pdfae rvicom 6 of I1 9/24/2012 9:10:44 AM PST (GMT-8) FROM: 100005-TO: 14088460429 Page: 8 of 12 G-18652-I CNA (Ed.07/09) company that is not shown as a Named Insured — I — Coverage C for all medical expenses in the Declarations. because of"bodily injury" sustained by any 4. EXPANDED PERSONAL AND ADVERTISING one person. The Medical Expense Limit is INJURY the greater of: A. The following is added to Section V — (1) $15,000; or Definitions, the definition of "Personal and (2) The amount shown in the advertising injury": Declarations for Medical Expense h. Discrimination or humiliation that results in Limit. injury to the feelings or reputation of a B. This provision 5. (Medical Payments) does not natural person, but only if such apply if Section I — Coverage C Medical discrimination or humiliation is: Payments is excluded either by the provisions (1) Not done intentionally by or at the of the Coverage Part or by endorsement direction of: C. Paragraph 1.a.(3)(b)of Section I—Coverage C (a) The insured;or — Medical Payments, is replaced by the following: (b) Any "executive officer," director, (b) The expenses are incurred and reported to stockholder, partner, member or us within three years of the date of the manager(if you are a limited liability accident;and company)of the insured; and (2) Not directly or indirectly related to the 6. LEGAL LIABILITY AND BORROWED employment, prospective employment, EQUIPMENT past employment or termination of A. Under Section I— Coverage A—Bodily Injury employment of any person or persons and Property Damage 2. Exclusions, by any insured. Exclusion j.is replaced by the following. B. Exclusions of Section I — Coverage B — "Property damage"to: Personal and Advertising Injury Liability is amended to include the following: (1) Property you own, rent,or occupy; Discrimination Relating To Room, (2) Premises you sell, give away or Dwelling or Premises abandon, if the "property damage" arises out of any part of those Caused by discrimination directly or premises; indirectly related to the sale, rental, lease or (3) Property loaned to you; sub-lease or prospective sale, rental, lease or sub-lease of any room, dwelling or (4) Personal property in the care, premises by or at the direction of any custody or control of the insured;. insured. (5) That particular part of real property Fines Or Penalties on which you or any contractors or Fines or penalties levied or imposed by a subcontractors working directly or governmental entity because of indirectly on your behalf are discrimination. performing operations, if the "property damage" arises out of D. This provision 4. (EXPANDED PERSONAL those operations;or AND ADVERTISING INJURY COVERAGE) (6) That particular part of any property does not apply if Section I — Coverage B — that must be restored, repaired or • Personal And Advertising Injury Liability is replaced because "your work" was excluded either by the provisions of the Coverage Part or by endorsement. incorrectly performed on it. 5. MEDICAL PAYMENTS Paragraph (2)of this exclusion does not apply if the premises are "your work" A. Paragraph 7. Medical Expense Limit, of and were never occupied, rented or Section III — Limits of Insurance is deleted held for rental by you. and replaced by the following: Paragraphs (1), (3) and (4) of this 7. Subject to Paragraph 5. above (the Each exclusion do not apply to: Occurrence Limit), the Medical Expense Limit is the most we will pay under Section (i) "property damage to tools or equipment loaned to you G-18652-I Includes copyrighted material of insurance Services Office,Inc.,with its permission. Page 4 of 8 (Ed. 07/09) cROF.created with r 4Faotooy3 Pra:trial3verrionuwwwpdf€aoo o of 9/24/2012 9:10:44 AM PST (GMT-8) FROM: 100005-TO: 14080460429 Page: 9 of 12 • • G-18652-I • CNA (Ed 07109) if the tools or equipment b. The Damage To Premises Rented To are not being used to You Limit shown in the Declarations. perform operations at the D. Paragraph 4.b.(1)(a)(ii) of Section IV - time of loss; or Commercial General Liability Conditions is (ii) "property damage" (other deleted and replaced by the following: than damage by fire) to (ii) That is property insurance premises rented to you or for premises rented to you temporarily occupied by or temporarily occupied by you with the permission of you with the permission of the owner, or to the the owner;or contents of premises rented to you for a period of E. This provision 6. (LEGAL LIABILITY AND 7 or fewer consecutive BORROWED EQUIPMENT) does not apply if days. A separate limit of . Damage To Premises Rented To You Liability insurance applies to under Section I - Coverage A is excluded Damage To Premises either by the provisions of the Coverage Part or Rented To You as by endorsement. described in Section III - 7. NON-OWNED WATERCRAFT Limits Of Insurance. Paragraphs (3), (4), (5) and (6) of this Under Section I - Coverage A, Exclusion 2.g., exclusion do not apply to liability subparagraph (2) is deleted and replaced by the assumed under a sidetrack agreement. following. Paragraph (6)of this exclusion does not (2) A watercraft you do not own that is: apply to "property damage" included in (a) Less than 55 feet long; and the "products-completed operations hazard." (b) Not being used to carry persons or property for a charge. B. Under Section I -Coverage A-Bodily Injury and Property Damage the last paragraph of 2. 8. NON-OWNED AIRCRAFT Exclusions is deleted and replaced by the Exclusion 2.g.of Section I-Coverage A-Bodily following. Injury and Property Damage, does not apply to an Exclusions c. through n. do not apply to aircraft you do not own, provided that: damage by fire to premises while rented to you 1. The pilot in command holds a currently or temporarily occupied by you with permission effective certificate issued by the duly of the owner or to the contents of premises constituted authority of the United States of rented to you for a period of 7 or fewer America or Canada, designating that person consecutive days. as a commercial or airline transport pilot; A separate limit of insurance applies to this 2. It is rented with a trained,paid crew; and coverage as described in Section III - Limits Of Insurance. 3. It does not transport persons or cargo for a charge. C. Paragraph 6. Damage To Premises Rented To You Limit of Section III- Limits Of Insurance 9. CONTRACTUAL LIABILITY FOR PERSONAL is replaced by the following: AND ADVERTISING INJURY 6. Subject to Paragraph 5. above, (the Each Exclusion e. Contractual Liability of Section I - Occurrence Limit), the Damage To Coverage B is deleted. Premises Rented To You Limit is the most 10. SUPPLEMENTARY PAYMENTS we will pay under Section-I-Coverage A for damages because of"property damage" A. Under Section I-Supplementary Payments- to any one premises while rented to you or Coverages A and B, Paragraph 1.b.,the limit of temporarily occupied by you with the $250 shown for the cost of bail bonds is permission of the owner, including contents replaced by$2,500: of such premises rented to you fora period B. in Paragraph 1.d., the limit of $250 shown for of 7 or fewer consecutive days. The daily loss of earnings is replaced by$1,000. Damage To Premises Rented To You Limit is the greater of: 11. LIQUOR LIABILITY a. $200,000;or Exclusion c.of Section I-Coverage A is deleted. G-18652-I Includes copyrighted material of Insurance Services Office,Inc.,with its permission. Page 5 of 8 (Ed. 07/09) cPf1.created with a,AtFactory Pre trial3verrtor v odffaotory€ oraa 8 of 11 9/24/2012 9:10:44 AM PST (GMT-B) FROM: 100005-TO: 14088460429 Page: 10 of 12 • G-18652-I • CNA (Ed. 07/09) 12. NEWLY FORMED OR ACQUIRED (4) A manager, if you are a limited ORGANIZATIONS liability company. Paragraph 3.a. of Section II —Who Is An Insured 17. AGGREGATE LIMITS PER PROJECT is deleted and replaced by the following: A. For all sums which the insured becomes legally Coverage under this provision is afforded only until obligated to pay as damages caused by the end of the policy period or the next anniversary "occurrences' under Section I — Coverage A, of this policy's effective date after you acquire or and for all medical expenses caused by form the organization,whichever is earlier. accidents under Section I—Coverage C,which 13. LIBERALIZATION CLAUSE can be attributed only to ongoing operations at a single construction project away from premises If we adopt a change in our forms or rules which owned by or rented to the insured: would broaden coverage for contractors under this 1. A separate Single Construction Project endorsement without an additional premium charge, General Aggregate Limit applies to each your policy will automatically provide the additional construction project away from, premises coverages as of the date the revision is effective in owned by or rented to the insured, and that your state. limit is equal to the amount of the General 14. UNINTENTIONAL FAILURE TO DISCLOSE Aggregate Limit shown in the Declarations. HAZARDS 2. The Single Construction Project General Based on our reliance on your representations as to Aggregate Limit is the most we will pay for existing hazards, if unintentionally you should fail to the sum of all damages under Coverage A, disclose all such hazards at the inception date of except damages because of "bodily injury" your policy, we will not deny coverage under this or "property damage" included in the Coverage Part because of such failure. "products-completed operations hazard," 15. NOTICE OF OCCURRENCE and for medical expenses under Coverage C regardless of the number of: The following is added to Paragraph 2. of Section a. Insureds; IV — Commercial General Liability Conditions — Duties In The Event of Occurrence, Offense, b. Claims made or"suits"brought; or Claim or Suit: c. Persons or organizations making claims Your rights under this Coverage Part will not be or bringing"suits." prejudiced if you fail to give us notice of an 3. Any payments made under Coverage A for "occurrence,"offense, claim or"suit"and that failure damages or under Coverage C for medical is solely due to your reasonable belief that the expenses shall reduce the Single "bodily injury" or "property damage" is not covered Construction Project General Aggregate under this Coverage Part. However, you shall give Limit for that construction project away from written notice of this"occurrence," offense, claim or premises owned by or rented to the insured. "suit" to us as soon as you are aware that this Such payments shall not reduce the insurance may apply to such "occurrence," offense General Aggregate Limit shown in the claim or"suit" Declarations nor shall they reduce any other 16. BROAD KNOWLEDGE OF OCCURRENCE Single Construction Project General The following is added to Paragraph 2. of Section Aggregate Limit for any other separate oonst IV — Commercial General Liability Conditions — Duties in The Event of Occurrence, Offense, owned duc by y ion or rented project away from premises to the insured. • • Claim or Suit: 4. The limits shown in the Declarations for Each Occurrence, Damage To Premises You must give us or our authorized representative Rented To You and Medical Expense notice of an "occurrence," offense, claim, or "suit" continue to apply. However, instead of only when the "occurrence," offense, claim or "suit" being subject to the General Aggregate is known to: Limit shown in the Declarations, such limits (1) You, if you are an individual; will be subject to the applicable Single Construction Project General Aggregate (2) A partner, if you are a partnership; Limit. (3) An executive officer or the B. For all sums which the insured becomes legally employee designated by you to give obligated to pay as damages caused by such notice, if you are a "occurrences" under Section I — Coverage A, corporation;or G-18652-I Includes copyrighted material of Insurance Services Office,Inc.,with its permission. Page 6 of 8 (Ed. 07/09) APO created with a,4#Faotory3 Pi- tria63versior i w &pdifaorwicGm 9 o f 11 9/24/2012 9:10:44 AM PST (GMT-8) FROM: 100005-TO: 14088460429 Page: 11 of 12 • G-18652-I CNA (Ed. 07/09) and for all medical expenses caused by 20. OWNER CONTROLLED INSURANCE PROGRAM, accidents under Section I—Coverage C,which CONTRACTOR CONTROLLED INSURANCE cannot be attributed only to ongoing operations PROGRAM OR CONSOLIDATED (WRAP-UP) at a single construction project away from INSURANCE PROGRAMS premises owned by or rented to the insured: The endorsement EXCLUSION—CONSTRUCTION 1. Any payments made under Coverage A for WRAP-UP PROGRAM which is attached to this damages or under Coverage C for medical policy is amended as follows: expenses shall reduce the amount available A. If the endorsement EXCLUSION under the General Aggregate Limit or the CONSTRUCTION WRAP-UP or another Products Completed Operations Aggregate exclusionary endorsement pertaining to Owner Limit,whichever is applicable; and Controlled Insurance Programs (O.C.I.P.) or 2. Such payments shall not reduce any Single Contractor Controlled Insurance Programs Construction Project General Aggregate (C.C.I.P.) is attached to this policy, then it is Limit. amended to add the following: C. When coverage for liability arising out of the With respect to a "consolidated (wrap-up) 'products-completed operations hazard' is insurance program" project in which you are or provided, any payments for damages because were involved, this exclusion does not apply to: of"bodily injury or"property damage" included in the "products-completed operations hazard" 1. Your liability for "bodily injury," "property will reduce the Products-Completed Operations damage," or "personal or advertising injury" • Aggregate Limit, and not reduce the General that occurs during your ongoing operations Aggregate Limit nor the Single Construction at the project, or during such operations of Project General Aggregate Limit. anyone acting on your behalf, D. If a single construction project away from 2. Your liability for "bodily injury" or "property premises owned by or rented to the insured has damage" included within the "products been abandoned and then restarted, or if the completed operations hazard that arises authorized contracting parties deviate from out of those portions of the project that are plans, blueprints, designs, specifications or not"residential structures." • timetables, the project will still be deemed to be B. The following is added to Paragraph 4.b.(1) of the same construction project. Section IV-Commercial General Liability E. The provisions of Section III — Limits Of Conditions Insurance not otherwise modified by this This insurance is excess over: endorsement shall continue to apply as stipulated. (c) Any of the other insurance whether primary,excess, contingent or any other 18. EXPANDED BODILY INJURY basis that is insurance available to you Section V — Definitions, the definition of "bodily as a result of your being a participant in injury" is changed to read: a "consolidated (wrap-up) insurance program," but only as respects your "Bodily injury" means bodily injury, sickness or involvement in that"consolidated (wrap- disease sustained by a person, including death, up) insurance program." humiliation, shock, mental anguish or mental injury C. The following is added to Section V — by that person at any time which results as a Definitions: consequence of the bodily injury, sickness or disease. "Consolidated (wrap-up) insurance program" 19. EXPECTED OR INTENDED INJURY means a construction, erection or demolition project for which the prime contractor/project Exclusion a. of Section I — Coverage A — Bodily manager or owner of the construction project Injury and Property Damage Liability is replaced has secured general liability insurance covering by the following: some or all of the contractors or subcontractors a. "Bodily injury or "property damage" involved in the project, otherwise referred to as expected i ry or "property from damage" an Owner Controlled Insurance Program standpoint of the intended This (O.C.I.P.) or Contractor Controlled Insurance exclusion does not apply to "bodily Program(C.C.I.P.). . injury" or "property damage" resulting "Residential structure" means any structure from the use of reasonable force to where 30% or more of the square foot area is protect persons or property. used or is intended to be used for human G-18652-I Includes copyrighted material of Insurance Services Office,Inc..with its permission. Page 7 of 8 (Ed. 07/09) cRDE created with 6,r#Fact y3 Pro trialnverrio "v . edff ory€om 10 of 11 9/24/2012 9:10:44 AM PST (GMT-8) FROM: 100005-TO: 14088460429 Page: 12 of 12 • • G-18652-I CNA (Ed. 07/09) residency including but not limited to single or (1) That indemnifies an architect, multifamily housing,apartments, condominiums, engineer or surveyor for injury or townhouses, co-operatives or planned unit damage arising out of: developments and also includes their common areas and/or appurtenant structures (including (a) Preparing, approving or failing pools, hot tubs, detached garages, guest to prepare or approve maps, houses or any similar structures).When there is shop drawings, opinions, no individual ownership of units, residential reports, surveys, field orders, structure does not include military housing, change orders or drawings and college/university housing or dormitories, long specifications; or term care facilities, hotels, or motels. (b) Giving directions or instructions, Residential structure also does not include or failing to give them, if that is hospitals or prisons. the primary cause of the injury 21. CONTRACTUAL LIABILITY—RAILROADS or damage; With respect to operations performed within 50 feet (2) Under which the insured, if an of railroad property, the definition of "insured architect, engineer or surveyor, contract" in Section V— Definitions is replaced by assumes liability for an injury or the following; damage arising out of the insured's .rendering or failure to render "Insured Contract"means: professional services, including a. A contract for a lease of premises. those listed in (1) above and However, that portion of the contract for supervisory, inspection, architectural a lease of premises that indemnifies or engineering activities. any any person or organization for damage es. by fire to premises while rented to you 22. BLANKET WAIVER OF SUBGROGATION or temporarily occupied by you with The Transfer Of Rights Of Recovery Against permission of the owner is not an Others To Us Condition(Section IV—Commercial "insured contract"; General Liability Conditions) is amended by the b. A sidetrack agreement; addition of the following: c. Any easement or license agreement; We waive any right of recovery we may have d. An obligation, as required by ordinance, against any person or organization because of to indemnify a municipality, except in payments we make for injury or damage arising out connection with work for a municipality; of: e. An elevator maintenance agreement; . 1. Your ongoing operations; or f. That part of any other contract or 2. "Your work" included in the "products- agreement pertaining to your business completed operations hazard." (including an indemnification of a However, this waiver applies only when you have municipality in connection with work agreed in writing to waive such rights of recovery in performed for a municipality) under a contract or agreement, and only if the contract or which you assume the tort liability of agreement: another party to pay for"bodily injury"or 1. Is in effect or becomes effective during the "property damage" to a third.person or term of this oli organization. Tort liability means a p cy;and liability that would be imposed by law in 2. Was executed prior to loss. • the absence of any contract or 23. IN REM ACTIONS agreement. Paragraph f. does not include that part Any action in rem against any vessel owned, of any contract or agreement: operated by or for, or chartered by or for you will be treated in the same manner as though the action were in personam against you. G-18652-I Includes copyrighted material of Insurance Services Office,Inc.,with its permission. Page 8 of 8 (Ed.07/09) cROp.created with pdtFactorg3 Pro tri at 3versiorvuvomAkdd f€ ec €Gm 11 of 11