NBS - Insurance CertificateNBSGOVE -01 SADPATRATHREE
CERTIFICATE OF LIABILITY INSURANCE
DAT D/YYYY)
9//19/219 /2017
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed.
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on
this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
PRODUCER
NFP Property &Casualty Services, Inc.
6165 Greenwich Dr Suite 200
CONTACT
PHONE FAX
(ac, No, Ext) (858) 869 -8300 A/c, No) (858) 869 -8301
San Diego, CA 92122
ADDRESS
INSURER (S) AFFORDING COVERAGE
NAIC #
X
INSURER Hanover Insurance Company
122292
INSURED
INSURER B Allmerica Fin'I Benefit Ins Co
141840
INSURER C Gemini Insurance
110833
NBS Government Finance Group
INSURER D
32605 Temecula Parkway, Suite 100 & 101
Temecula, CA 92592
INSURER E
INSURER F
PERSONAL & ADV INJURY
COVERAGES CERTIFICATE Nl1MRFR• oCt/1cin4l du 111A01=0
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
ANSD
ISUB
POLICY NUMBER
POLICY EFF
POLICY EXP
LIMITS
A
X
1 COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE OCCUR
X
X
OH3A431963
0912412017
09/24/2018
EACH OCCURRENCE
I S 2'000'600
DAMAGE SESAEa occurrence)
1 S 21666'600
$ 10,000
MED EXP (Any one erson
PERSONAL & ADV INJURY
S 2,000,000
AGGREGATE LIMIT APPLIES PER
POLICY ❑ JECOT- n LOC
I GENERAL AGGREGATE
$ 4,0001000
GEN'L
X
PRODUCTS - COMP /OP AGG
$ 4,0001000
S
OTHER
B
I AUTOMOBILE
X
LIABILITY
ANY AUTO
OWNED SCHEDULED
AUTOS ONLY AUTOS
X
X
AW3A427458
09/24/2017
09124/2018
I Ea aBINED SINGLE LIMIT
$ 1,000,000
BODILY INJURY Per person)
$
BODILY INJURY (Per accident
$
HIRED NON -OWNED
AUTOS ONLY AUTOS ONLY
PROPERTY DAMAGE
Per accident
$
I
I$
A
X
UMBRELLA LIAB
EXCESS LIAB
OCCUR
CLAIMS -MADE
OH3A431963
09/24/2017
09/24/2018
EACH OCCURRENCE
$ 1,000,000
AGGREGATE 1
$ 1,000,000
DED RETENTION $
S
A
AND EMPLO COMPENSATION ERS' LIABILIITY
Y/N
ANY PROPRIETOR/ EXCLUDED?
FFICEtory in ER EXCLUDED?
Mandatory m Nnd
If es describe under
DESCRIPTION OF OPERATIONS below
N / A
X
WH3A42745704
09/24/2017
09/24/2018
,STATUTE ERH
E L EACH ACCIDENT
11000,600
$
E L DISEASE - EA EMPLOYEEI
$ 1,000,066
E L DISEASE - POLICY LIMIT
$ 1,000,000
C
E Lia
IVCPLO65285
09/2412017
09/24/2018
Annual Aggregate
2,000,000
C
E&O /Professional Lia
VCPLO65285
09/24/2017
09/24/2018
Each Wrongful Act
2,000,000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required)
Proof of Insurance
Blanket forms apply when required by written contract:
GENERAL LIABILITY:
Additional Insured - Special Broadening Endt: 391 -1006 08 16
Additional Insured - Completed Operations: 391 -1602 08 16
Primary & Non - Contributory: 391 -1003 08 16
Waiver of Subrogation: 391 -1003 08 16
SEE ATTACHED ACORD 101
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
City of Gilroy THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
Attn: Mr. Raymond Chin ACCORDANCE WITH THE POLICY PROVISIONS.
7351 Rosanna Street
Gilroy, CA 95020 AUTHORIZED REPRESENTATIVE
2016 /03) n 19RR-2n15 ArnRn rnaanaeTIr%N All
The ACORD name and logo are registered marks of ACORD
AC ®R®`
AGENCY CUSTOMER ID: NBSGOVE -01
LOC #: 1
ADDITIONAL REMARKS SCHEDULE
SADPATRATHREE
Page 1 of 1
AGENCY
NFP Property & Casualty Services, Inc.
NAMED INSURED
NBS Government Finance Group
32605 Temecula Parkway, Suite 100 & 101
Temecula, CA 92592
POLICY NUMBER
EE PAGE 1
CARRIER
NAIC CODE
EE PAGE 1
SEE P 1
EFFECTIVE DATE SEE PAGE 1
The ACORD name and logo are registered marks of ACORD
1OH3A431963
THIS ENDORSEMENT CHANGES THE POLICY PLEASE READ IT CAREFULLY
BUSINESSOWNERS LIABILITY SPECIAL BROADENING ENDORSEMENT
This endorsement modifies Insurance provided under the following.
BUSINESSOWNERS COVERAGE FORM
SUMMARY OF COVERAGES
Limits
i Page
I
1. Additional Insured by Contract, Agreement or Permit
Included
1
2. Additional Insured - Broad Form Vendors
Included
2
3. Alienated Premises
Included
�- Included
3
4. Broad Form Property Damage - Borrowed Equipment, Customers
Goods and Use of Elevators
3
5. Incidental Malpractice,(Employed Nurses, EMT's and Paramedics)
Included
3
6. Personal an_d Advertising Injury - Broad Form
Included
4
-7•
Included
$25,000
Occurrence
4
5
Product Recall Expense Each Occurrence Limit
Product Recall Expense Aggregate Limit
$50,000
Aggregate
5 --
Product Recall Deductible
$500
5
8. Unintentional Failure to Disclose Hazards
Included
6
9. Unintentional Failure to Notify
Included
6
This endorsement amends coverages provided under the Businessowners Coverage Form through new
coverages and broader coverage grants. This coverage is subject to the provisions applicable to the
Businessowners Coverage Form, except as provided below
The following changes are made to SECTION II -
LIABILITY:
1. Additional Insured by Contract, Agreement or
Permit
The following is added to SECTION II -
UABILITY, C. Who Is An Insured:
Additional Insured by Contract, Agreement or
Permit
a. Any person or organization with whom you
agreed in a written contract, written
agreement or permit to add such person or
organization as an additional insured on
your policy 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 your acts or omissions, or the acts
or omissions of those acting on your behalf,
but only with respect to
(1) "Your work" for the additional insured(s)
designated in the contract, agreement or
perm it;
(2) Premises you own, rent, lease or
occupy; or
(3) Your maintenance, operation or use of
equipment leased to you.
b. The insurance afforded to such additional
insured described above.
(1) Only applies to the extent permitted by
law; and
(2) Will not be broader than the insurance
which you are required by the contract,
agreement or permit to provide for such
additional insured.
(3) Applies on a primary basis if that is
required by the written contract, written
agreement or permit.
(4) Will not be broader than coverage
provided to any other insured
(5) Does not apply If the "bodily injury",
"property damage" or "personal and
advertising injury"is otherwise excluded
from coverage under this Coverage Part,
including any endorsements thereto.
391 -1006 08 16 Includes copyrighted materials of Insurance Services Offices, Inc., with its permission Page 1 of 6
c. This provision does not apply:
(1) Unless the written contract or written
agreement was executed or permit was
issued prior to the "bodily Injury ",
"property damage ", or "personal Injury
and advertising injury"
(2) To any person or organization Included
as an Insured by another endorsement
issued by us and made part of this
Coverage Part.
(3) To any lessor of equipment:
(a) After the equipment lease expires, or
(b) If the "bodily injury", "property
damage ", "personal and advertising
injury" arises out of sole negligence
of the lessor.
(4) To any.
(a) Owners or other interests from whom
land has been leased If the
"occurrence" takes place or the
offense is committed after the lease
for the land expires; or
(b) Managers or lessors of premises if:
(i) The "occurrence" takes place or
the offense is committed after
you cease to be a tenant in that
premises; or
(ii) The "bodily injury ", "property
damage ", "personal - injury" or
"advertising injury" arises out of
structural alterations, new
construction or demolition
operations performed by or on
behalf of the manager or lessor
(5) To "bodily Injury ", "property damage" or
"personal and advertising injury" arising
out of the rendering of or the failure to
render any professional services.
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 failure to render any
professional services by or for you
d. With respect to the insurance afforded to
these additional insureds, the following is
added to SECTION II - LIABILITY, D. Liability
and Medical Expense Limits of Insurance:
aI ?y® Rr
�` • Insurance GmuI-)
b H 3 A431963 1001554
The most we will pay on behalf of the
additional Insured for a covered claim is the
lesser of the amount of Insurance.
1. Required by the contract, agreement or
permit described In Paragraph a.; or
2. Available under the applicable Limits of
Insurance shown In the Declarations.
This endorsement shall not increase the
applicable Limits of Insurance shown in the
Declarations
e. All other insuring agreements, exclusions,
and conditions of the policy apply
2. Additional Insured - Broad Form Vendors
The following is added to SECTION II -
LIABILITY, C. Who Is An Insured:
Additional Insured - Broad Form Vendors
a. Any person or organization that is a vendor
with whom you agreed in a written contract
additional Insured under this Coverage Part
is an Insured, but only with respect to liability
for "bodily injury" or "property damage"
arising out of "your products" which are
distributed or sold in the regular course of
the vendor's business
b. The insurance afforded to such vendor
described above:
(1) Only applies to the extent permitted by
law;
(2) Will not be broader than the insurance
which you are required by the contract or
agreement to provide for such vendor;
(3) WIII not be broader than coverage
provided to any other insured; and
(4) Does not apply if the "bodily injury ",
"property damage" or "personal and
advertising injury" is otherwise excluded
from coverage under this Coverage Part,
including any endorsements thereto
c. With respect to insurance afforded to such
vendors, the following additional exclusions
apply-
The Insurance afforded to the vendor does
not apply to:
(1) "Bodily Injury" or "property damage" for
which the vendor is obligated to pay
damages by reasons of the assumption of
liability in a contract or agreement. This
exclusion does not apply to liability for
damages that the Insured would have in
the absence of the contract or
agreement,
(2) Any express warranty unauthorized by
you;
E~;y 391 -1006 08 16 Includes copyrighted materlals of Insurance Services Offices, Inc., with Its permission. Page 2 of 6
70186
(3) Any physical or chemical change in the
product made intentionally by the
vendor;
(4) Repackaging, unless unpacked solely for
the purpose of inspection,
demonstration, testing, or the
substitution of parts under Instruction
from the manufacturer, and then
repackaged in the original container;
(5) Any failure to make such inspection,
adjustments, tests or servicing as the
vendor has agreed to make or normally
undertakes to make in the usual course
of business in connection with the sale
of the product;
(6) Demonstration, installation, servicing or
repair operations, except such
operations performed at the vendor's
premises in connection with the sale of
the product,
(7) Products which, after distribution or sale
by you, have been labeled or relabeled
or used as a container, part or
ingredient of any other thing or
substance by or for the vendor;
(8) "Bodily injury" or "property damage"
arising out of the sole negligence of the
vendor for its own acts or omissions or
those of its employees or anyone else
acting on its behalf. However, this
exclusion does not apply to-
(a) The exceptions contained within the
exclusion In subparagraphs (4) or (6)
above; or
The most we will pay on behalf of the vendor
for a covered claim is the lesser of the
amount of insurance.
1. Required by the contract or agreement
described in Paragraph a.; or
2. Available under the applicable Limits of
Insurance shown in the Declarations;
This endorsement shall not increase the
applicable Limits of Insurance shown in the
Declarations
3. Alienated Premises
SECTION II - LIABILITY, B. Exclusions, 1.
Applicable To Business Liability Coverage k.
Damage to Property, paragraph (2) is replaced by
the following:
(2) Premises you sell, give away or abandon, if
the "property damage" arises out of any part
of those premises and occurred from hazards
that were known by you, or should have
reasonably been known by you, at the time
the property was transferred or abandoned
4. Broad Form Property Damage - Borrowed
Equipment, Customers Goods, Use of Elevators
a. The following is added to SECTION II -
LIABILITY, B. Exclusions, 1. Applicable To
Business Liability Coverage, k. Damage to
Property:
Paragraph (4) does not apply to "property
damage" to borrowed equipment while at a
jobsite and not being used to perform
operations.
(b) Such inspections, adjustments, tests
or servicing as the vendor has
agreed to make or normally
undertakes to make in the usual b•
course of business, in connection
with the distribution or sale of the
products.
(9) "Bodily injury" or "property damage"
place before you have signed the
contract or agreement with the vendor.
(10)To any person or organization' included
as an insured by another endorsement
issued by us and made part of this
Coverage Part.
(11)Any insured person or organization,
from whom you have acquired such
products, or any ingredient, part or
container, entering into, accompanying
or containing such products.
Paragraph (3), (4) and (6) do not apply to
"property damage" to "customers goods"
while on your premises nor to the use of
elevators.
For the purposes of this endorsement, the
following definition is added to SECTION II -
LIABILITY, F. Liability and Medical Expenses
Definitions:
1. "Customers goods" means property of
your customer on your premises for the
purpose of being-
a. Worked on, or
b. Used in your manufacturing process.
c. The insurance afforded under this provision is
excess over any other valid and collectible
property insurance (including deductible)
available to the insured whether primary,
excess, contingent or on any other basis.
5. Incidental Malpractice - Employed Nurses, EMT's
and Paramedics
d. With respect to the insurance afforded to SECTION II - LIABILITY, C. Who Is An Insured,
these vendors, the following is added to paragraph 2.a.(1)(d) does not apply to a nurse,
SECTION II - LIABILITY, D. Liability and
Medical Expense Limits of Insurance.
391 -1006 08 16 Includes copyrighted materials of Insurance Services Offices, Inc., with Its permission Page 3 of 6
fari`�
010187
emergency medical technician or paramedic
employed by you If you are not engaged in the
business or occupation of providing medical,
paramedical, surgical, dental, x -ray or nursing
services
6. Personal Injury - Broad Form
a. SECTION II - LIABILITY, B. Exclusions, 2.
Additional Exclusions Applicable only to
"Personal and Advertising Injury", paragraph
e. is deleted.
b. SECTION II - LIABILITY, F. Liability and
Medical Expenses Definitions, 14. "Personal
and advertising Injury ", paragraph b. is
replaced by the following
b. Malicious prosecution or abuse of
process
c. The following is added to SECTION 11 -
LIABILITY, F. Liability and Medical Expenses
Definitions, Definition 14. "Personal and
advertising injury ":
"Discrimination" (unless insurance thereof is
prohibited by law) that results in injury to the
feelings or reputation of a natural person,
but only If such "discrimination" Is
(1) Not done intentionally by or at the
direction of:
(a) The Insured,
(b) Any officer of the corporation,
director, stockholder, partner or
member of the insured; and
(2) Not directly or indirectly related to an
"employee ", not to the employment,
prospective employment or termination
of any person or persons by an insured
d. For purposes of this endorsement, the
following definition is added to SECTION II -
LIABILITY, F. Liability and Medical Expenses
Definitions:
1. "Discrimination" means the unlawful
treatment of Individuals based upon race,
color, ethnic origin, gender, religion, age,
or sexual preference. "Discrimination"
does not Include the unlawful treatment
of individuals based upon developmental,
physical, cognitive, mental, sensory or
emotional impairment or any
combination of these.
e. This coverage does not apply if liability
coverage for "personal and advertising
injury" is excluded either by the provisions of
the Coverage Form or any endorsement
thereto.
HAnover
Insurance Group.
0113A431963 1001554
o. Recall of Products, Work or Impaired
Property Is replaced by the following -
o. Recall of Products, Work or Impaired
Property
Damages claimed for any loss, cost or
expense incurred by you or others for
the loss of use, withdrawal, recall,
Inspection, repair, replacement,
adjustment, removal or disposal of.
(1) "Your product ";
(2) "Your work "; or
(3) "Impaired property ";
If such product, work or property Is
withdrawn or recalled from the market or
from use by any person or organization
because of a known or suspected defect,
deficiency, Inadequacy or dangerous
condition in it, but this exclusion does
not apply to "product recall expenses"
that you incur for the "covered recall" of
"your product".
However, the exception to the exclusion
does not apply to "product recall
expenses" resulting from:
(4) Failure of any products to accomplish
their intended purpose;
(5) Breach of warranties of fitness,
quality, durability or performance,
(6) Loss of customer approval, or any
cost incurred to regain customer
approval;
(7) Redistribution or replacement of
"your product" which has been
recalled by like products or
substitutes;
(8) Caprice or whim of the insured;
(9) A condition likely to cause loss of
which any insured knew or had
reason to know at the Inception of
this insurance;
(10)Asbestos, Including loss, damage or
clean up resulting from asbestos or
asbestos containing materials; or
(11) Recall of "your products" that have
no known or suspected defect solely
because a known or suspected
defect in another of "your products"
has been found.
b. The following Is added to SECTION II -
LIABILITY, C. Who Is An Insured, paragraph
3.b.:
7. Product Recall Expense "Product recall expense" arising out of any
a. SECTION II - LIABILITY, B. Exclusions, 1. withdrawal or recall that occurred before you
Applicable To Business Liability Coverage, acquired or formed the organization.
391 -1006 08 16 Includes copyrighted matenals of Insurance Services Offices, Inc, with its permission Page 4 of 6
c. The following is added to SECTION II -
LIABILITY, D. Liability and Medical Expenses
Limits of Insurance:
Product Recall Expense Limits of Insurance
a. The Limits of Insurance shown in the
SUMMARY OF COVERAGES of this
endorsement and the rules stated below
fix the most that we will pay under this
Product Recall Expense Coverage
regardless of the number of:
(1) Insureds;
(2) "Covered Recalls" initiated, or
(3) Number of "your products"
withdrawn.
b. The Product Recall Expense Aggregate d.
Limit is the most that we will reimburse
you for the sum of all "product recall
expenses" incurred for all "covered
recalls" initiated during the policy period.
c. The Product Recall Each Occurrence
Limit is the most we will pay in
connection with any one defect or
deficiency.
d. All "product recall expenses" in
connection with substantially the same
general harmful condition will be
deemed to arise out of the same defect
or deficiency and considered one
"occurrence ".
e. Any amount reimbursed for "product
recall expenses" in connection with any
one "occurrence" will reduce the amount
of the Product Recall Expense Aggregate
Limit available for reimbursement of
"product recall expenses" in connection e.
with any other defect or deficiency.
f. If the Product Recall Expense Aggregate
Limit has been reduced by
reimbursement of "product recall
expenses" to an amount that is less than
the Product Recall Expense Each
Occurrence Limit, the remaining
Aggregate Limit is the most that will be
available for reimbursement of "product
recall expenses" in connection with any
other defect or deficiency.
g. Product Recall Deductible
We will only pay for the amount of
"product recall expenses" which are in
excess of the $500 Product Recall
Deductible. The Product Recall
Deductible applies separately to each
"covered recall ". The limits of insurance
will not be reduced by the amount of this
deductible.
We may, or will if required by law, pay all
or any part of any deductible amount, if
applicable. Upon notice of our payment
of a deductible amount, you shall
promptly reimburse us for the part of the
deductible amount we paid.
The Product Recall Expense Limits of
Insurance apply separately to each
consecutive annual period and to any
remaining period of less than 12 months,
starting with the beginning of the policy
period shown in the Declarations, unless the
policy period is extended after issuance for
an additional period of less than 12 months.
In that case, the additional period will be
deemed part of the last preceding period for
the purposes of determining the Limits of
Insurance.
The following is added to SECTION II -
LIABILITY, E. Liability and Medical Expense
General Conditions, 2. Duties in the Event of
Occurrence, Offense, Claim or Suit.
You must see to it that the following are
done in the event of an actual or anticipated
"covered recall" that may result in "product
recall expense ":
(1) Give us prompt notice of any discovery
or notification that "your product" must
be withdrawn or recalled Include a
description of "your product" and the
reason for the withdrawal or recall;
(2) Cease any further release, shipment,
consignment or any other method of
distribution of like or similar products
until it has been determined that all
such products are free from defects that
could be a cause of loss under this
insurance.
For the purposs of this endorsement, the
following definitions are added to SECTION
II - LIABILITY, F. Liability and Medical
Expenses Definitions:
1. "Covered recall" means a recall made
necessary because you or a government
body has determined that a known or
suspected defect, deficiency,
inadequacy, or dangerous condition in
"your product" has resulted or will result
in "bodily injury" or "property damage ".
2. "Product recall expense(s)" means.
a. Necessary and reasonable expenses
for.
(1) Communications, including radio
or television announcements or
printed advertisements including
stationary, envelopes and
postage,
391 -1006 08 16 Includes copyrighted materials of Insurance Services Offices, Inc , with its permission. Page 5 of 6
(2) Shipping the recalled products
from any purchaser, distributor or
user to the place or places
designated by you,
(3) Remuneration paid to your
regular "employees" for
necessary overtime;
(4) Hiring additional persons, other
than your regular "employees ",
(5) Expenses incurred by "employees" 8.
Including transportation and
accommodations,
(6) Expenses to rent additional
warehouse or storage space,
(7) Disposal of 'your product ", but
only to the extent that specific
methods of destruction other than
those employed for trash
discarding or disposal are 9,
required to avoid "bodily injury"
or "property damage" as a result
of such disposal,
you incur exclusively for the purpose
of recalling 'your product'; and
b. Your lost profit resulting from such
"covered recall ".
f. This Product Recall Expense Coverage does
not apply-
r ��Ha`nover
Incunncc Croup.
01-13A431963 1001554
(1) If the "products - completed operations
hazard" is excluded from coverage under
this Coverage Part including any
endorsement thereto, or
(2) To "product recall expense" arising out of
any of "your products" that are otherwise
excluded from coverage under this
Coverage Part including endorsements
thereto_
Unintentional Failure to Disclose Hazards
The following is added to SECTION II -
LIABILITY, E. Liability and Medical Expenses
General Conditions:
Representations
We will not disclaim coverage under this
Coverage Part if you fall to disclose all hazards
existing as of the Inception date of the policy
provided such failure is not intentional.
Unintentional Failure to Notify
The following is added to SECTION II -
LIABILITY, E. Liability and Medical Expenses
General Conditions, 2. Duties in the Event of
Occurrence, Offense, Claim or Suit:
Your rights afforded under this Coverage Part
shall not be prejudiced if you fail to give us
notice of an "occurrence ", offense, claim or "suit',
solely due to your reasonable and documented
belief that the "bodily injury", "property damage"
or "personal and advertising injury" is not
covered under this Policy.
ALL OTHER TERMS, CONDITIONS, AND EXCLUSIONS REMAIN UNCHANGED
� I V 391 -1006 08 16 Includes copyrighted materials of Insurance Services Offices, Inc , with Its permission Page 6 of 6
na1aa
#01113A431963
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS -
COMPLETED OPERATIONS
This endorsement modifies Insurance provided under the following-
BUSINESSOWNERS COVERAGE FORM
cr -ui`ni u F
Of Person Or Organization
ANY PERSON OR ORGANIZATION WHEN REQUIR
Location And Description Of Completed Operations
AS REQUIRED BY CONTRACT
(If no entry appears above, information required to complete this endorsement will be shown in the
Declarations as applicable to this endorsement.)
For the purpose of coverage provided by this
endorsement, the following changes are made to
SECTION 11 - LIABILITY:
A. The following Is added to SECTION II -
LIABILITY, C. Who Is An Insured:
Any person or organization shown in the
Schedule above is also an additional insured,
but only with respect to liability for "bodily
injury" or "property damage" caused, in whole
or in part, by "your work" at the location
designated and described in the Schedule
above, performed for that additional insured and
included In the "products- completed operations
hazard ".
However-
1. The insurance afforded to such additional
insured only applies to the extent permitted
by law; and
2. If coverage provided to the additional
insured is required by a contract or
agreement, the insurance afforded to such
additional insured will not be broader than
that which you are required by the contract
or agreement to provide for such additional
Insured.
B. The following Is added to SECTION II -
LIABILITY, D. Liability And Medical Expenses
Limits Of Insurance:
If coverage provided to the additional insured is
required by a contract or agreement, the most
we will pay on behalf of the additional insured is
the amount of insurance:
1. Required by the contract or agreement; 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, CONDITIONS AND EXCLUSIONS REMAIN UNCHANGED
391 -1602 08 16 Includes copyrighted material of Insurance Services Office, Inc, with its permission Page 1 of 1
The
Hanover
Insurance Croup.
0113A431963 1001554
1. SECTION I - PROPERTY, if two or more of
However, if you agree in a written
this coverage part's coverages apply to
contract, written agreement, or
the same loss or damage, we will not pay
written permit that the insurance
more than the actual amount of the loss or
provided to any person or
damage.
organization Included as an
2. SECTION II - LIABILITY, it is our stated
Additional Insured under this
Intent that the various Coverage Parts,
Coverage Part is primary and
forms, endorsements or policies issued to
non - contributory, we will not seek
the named insured by us, or any company
contribution from any other
affiliated with us, do not provide any
insurance available to that Additional
duplication or overlap of coverage for the
Insured which covers the Additional
same claim, "suit ", "occurrence ", offense,
Insured as a Named Insured except.
accident, "wrongful act' or loss. We will
(1) For the sole negligence of the
not pay more than the actual amount of
Additional Insured; or
the loss or damage
(2) When the Additional Insured is
If this Coverage Part and any other
an Additional Insured under
Coverage Part, form, endorsement or
another liability policy.
policy issued to the named insured by us,
b. Excess Insurance
or any company affiliated with us, apply to
the same claim, "suit", occurrence,
This insurance is excess over
offense, accident, "wrongful act" or loss,
(1) Any of the other insurance,
the maximum Limit of Insurance under all
whether primary, excess,
such Coverage Parts, forms,
contingent or on any other basis:
endorsements or policies combined shall
not exceed the highest applicable Limit of
(a) That is Fire, Extended
Insurance under any one Coverage Part,
Coverage, Builder's Risk,
form, endorsement or policy
Installation Risk or similar
This condition does not apply to any
coverage for "your work ";
Excess or Umbrella Policy issued by us
(b) That is Property Insurance for
specifically to apply as excess insurance
premises rented to you or
over this policy.
temporarily occupied by you
G. Liberalization
with permission of the owner,
If we adopt any revision that would broaden
(c) That is insurance purchased
by you to cover your liability
the coverage under this policy without
as a tenant for "property
additional premium within 45 days prior to or
damage" to premises rented
during the policy period, the broadened
to you or temporarily
coverage will immediately apply to this policy.
occupied by you with
H. Other Insurance
permission of the owner; or
1. SECTION I - PROPERTY
(d) If the loss arises out of the
If there is other insurance covering the
maintenance or use of
same loss or damage, we will pay only for
aircraft, "autos" or watercraft
the amount of covered loss or damage in
to the extent not subject to
excess of the amount due from that other
SECTION II - LIABILITY,
insurance, whether you can collect on it or
Exclusion g. Aircraft, Auto or
not. But, we will not pay more than the
Watercraft; and
applicable Limit of Insurance of SECTION 1
(2) Any other primary insurance
- PROPERTY.
available to you covering liability
2. SECTION II - LIABILITY
for damages arising out of the
premises or operations, or the
If other valid and collectible insurance is
products and completed
available to the insured for a loss we
operations, for which you have
cover under SECTION 11 - LIABILITY, our
been added as an additional
obligations are limited as follows.
insured by attachment of an
a. Primary Insurance
endorsement.
This insurance Is primary except when
When this insurance is excess, we
b. below applies. If this
will have no duty under SECTION 11 -
i nsura
insurance ce is primary, our obligations
LIABILITY to defend the insured
are not affected unless any of the
against any "suit" if any other
other insurance is also primary Then,
insurer has a duty to defend the
we will share with all that other
insured against that "suit ". If no other
insurance by the method described in
insurer defends, we will undertake to
paragraph c. below.
do so, but we will be entitled to the
391 -1003 08 16 includes co Page 79 of 81
,�� copyrighted material of Insurance Services Office, Inc., with its permission 9
)10161
insured's rights against all those other
Insurers
c. When this insurance is excess over other
insurance, we will pay only our share of
the amount of the loss, if any, that
exceeds the sum of
(1) The total amount that all such other
insurance would pay for the loss In
the absence of this insurance, and
(2) The total of all deductible and
self- insured amounts under all that
other insurance_
d. We will share the remaining loss, if any,
with any other insurance that is not
described in this provision and was not
bought specifically to apply In excess of
the Limits of Insurance shown in the
Declarations for this Coverage
e. Method of Sharing
If all of the other insurance permits
contribution by equal shares, we will
follow this method also. Under this
approach each insurer contributes equal
amounts until it has paid its applicable
Limit of Insurance or none of the loss
remains, whichever comes first.
If any of the other insurance does not
permit contribution by equal shares, we
will contribute by limits. Under this
method, each insurer's share Is based on
the ratio 'of Its applicable Limit of
Insurance to the total applicable limits of
insurance of all insurers.
If. When this insurance is excess, we will
have no duty under Business Liability
Coverage to defend any claim or "suit'
that any other insurer has a duty to
defend. If no other insurer defends, we
will undertake to do so; but we will be
entitled to the insured's rights against all
those other insurers.
I. Premiums
1. The first Named Insured shown in the
Declarations:
a. Is responsible for the payment of all
premiums; and
b. Will be the payee for any return
premiums we pay.
2. The premium shown in the Declarations was
computed based on rates in effect at the time
the policy was issued On each renewal,
continuation or anniversary of the effective
date of this policy, we will compute the
premium in accordance with our rates and
rules then In effect
3. With our consent, you may continue this
policy in force by paying a continuation
premium for each successive one -year
period The premium must be.
a. Paid to us prior to the anniversary
date, and
b. Determined in accordance with
paragraph 2. above.
Our forms then In effect will apply. If you
do not pay the continuation premium, this
policy will expire on the first anniversary
date that we have not received the
premium
4. Undeclared exposures or change In your
business operation, acquisition or use of
locations may occur during the policy
period that is not shown in the
Declarations If so, we may require an
additional premium. That premium will be
determined In accordance with our rates
and rules then In effect
J. Premium Audit
1. This policy is subject to audit if a premium
designated as an advance premium is
shown in the Declarations. We will
compute the final premium due when we
determine your actual exposures.
2. Premium shown In this policy as advance
premium is a deposit premium only At the
close of each audit period, we will
compute the earned premium for that
period and send notice to the first Named
Insured. The due date for audit premiums
is the date shown as the due date on the
bill. If the sum of the advance and audit
premiums paid for the policy period is
greater than the earned premium, we will
return the excess to the first Named
Insured.
3. The first Named Insured must keep
records of the information we need for
premium computation and send us copies
at such times as we may request.
K. Transfer of Rights of Recovery Against Others
to Us
1. Applicable to SECTION I - PROPERTY
Coverage
If any person or organization to or for
whom we make payment under this policy
has rights to recover damages from
another, those rights are transferred to us
to the extent of our payment. That person
or organization must do everything
necessary to secure our rights and must
do nothing after loss to Impair them But
you may waive your rights against another
party In writing:
391 -1003 08 16 Includes copyrighted material of Insurance Services Office, Inc., with its permission Page 80 of 81
a. Prior to a loss to your Covered
Property
b. After a loss to your Covered Property
only if, at time of loss, that party is
one of the following:
(1) Someone insured by this
insurance;
(2) A business firm:
(a) Owned or controlled by you,
or
(b) That owns or controls you; or
(3) Your tenant
You may also accept the usual bills of
lading or shipping receipts limiting the
liability of carriers.
This will not restrict your Insurance
Applicable to SECTION II - LIABILITY
Coverage
If the Insured has rights to recover all or
part of any payment we have made
under this Coverage Part, those rights
are transferred to us. The insured must
do nothing after loss to impair such
rights. At our request, the Insured will
bring "suit" or transfer those rights to us
and help us enforce them.
Hanover
Jncurance Group.
01-13A4311963 1001554
We waive any right of recovery we may
have against any person or
organization with whom you have a
written contract, permit or agreement
to waive any rights of recovery against
such person or organization 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 condition does not apply to
Medical Expenses Coverage.
L. Transfer of Your Rights and Duties Under
This Policy
Your rights and duties under this policy
may not be transferred without our written
consent except in the case of death of an
individual Named Insured. If you die, your
rights and duties will be transferred to your
legal representative but only while that
legal representative is acting within the
scope of their duties as your legal
representative. Until your legal
representative is appointed, anyone with
proper temporary custody of your property
will have your rights and duties but only
with respect to that property.
t 391 -1003 08 16 Includes copyrighted material of Insurance Services Office, Inc., with Its permission. Page 81 of 81
D10162
Hanover
Insurance Group-_
AW3A427458 1001554
THIS ENDORSEMENT CHANGES THE POLICY PLEASE READ IT CAREFULLY
BLANKET ADDITIONAL INSURED - PRIMARY AND NON - CONTRIBUTORY
This endorsement modifies Insurance provided under the following:
BUSINESS AUTO COVERAGE PART
A. The following is added to SECTION If -
LIABILITY COVERAGE, Paragraph A.1. Who Is
An Insured:
Additional Insured if Required by Contract
If you agree in a written contract, written
agreement or written permit that a person or
organization be added as an additional
"Insured" under this Coverage Part, such
person or organization is an "insured "; but only
to the extent that such person or organization
qualifies as an "Insured" under paragraph A.1.c.
of this Section.
If you agree in a written contract, written
agreement or written permit that a person or
organization be added as an additional
"Insured" under this Coverage Part, the most
we will pay on behalf of such additional
"Insured" is the lesser of.
(1) The Limits of Insurance for liability coverage
specified in the written contract, written
agreement or written permit, or
(2) The Limits of Insurance for Liability
Coverage shown in the Declarations
applicable to this Coverage Part
Such amount shall be part of and not in addition
to the Limits of Insurance shown in the
Declarations applicable to this Coverage Part.
Regardless of the number of covered "autos ",
"insureds ", premiums paid, claims made or
vehicles involved In the "accident ", the most we
will pay for the total of all damages and
"covered pollution cost or expense" combined
resulting from any one "accident' is the Limit of
Insurance for Liability Coverage shown in the
Declarations.
B. The following is added to SECTION IV -
BUSINESS AUTO CONDITIONS, Paragraph B.
General Conditions, subparagraph 5. Other
Insurance:
Primary and Non - Contributory
If you agree in a written contract, written
agreement or written permit that the Insurance
provided to a person or organization who
qualifies as an additional "insured" under
SECTION If - LIABILITY COVERAGE, Paragraph
A.1. Who Is An Insured, subparagraph
Additional Insured if Required by Contract is
primary and non - contributory, the following
applies:
The liability coverage provided by this Coverage
Part is primary to any other insurance available
to the additional "Insured" as a Named Insured.
We will not seek contribution from any other
Insurance available to the additional "Insured"
except-
(1) For the sole negligence of the additional
"insured "; or
(2) For negligence arising out of the ownership,
maintenance or use of any "auto" not owned
by the additional "insured" or by you, unless
that "auto" is a "trailer" connected to an
"auto" owned by the additional "insured" or
by you; or
(3) When the additional "Insured" is also an
additional "insured" under another liability
policy.
C. This endorsement will apply only if the
"accident' occurs:
1. During the policy period;
2. Subsequent to the execution of the written
contract or written agreement or the
issuance of the written permit; and
3. Prior to the expiration of the period of time
that the written contract, written agreement
or written permit requires such insurance to
be provided to the additional "insured ".
D. Coverage provided to an additional "insured"
will not be broader than coverage provided to
any other "insured" under this Coverage Part.
ALL OTHER TERMS, CONDITIONS, AND EXCLUSIONS REMAIN UNCHANGED.
r? 461 -0478 12 12 Includes copyrighted material of ISO Insurance Services Office, Inc., with its permission Page 1 of 1
10271
Ha"nover
Insurance Group.
AW3A427458 1001554
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.
BUSINESS AUTO COVERAGE FORM
BUSINESS AUTO PHYSICAL DAMAGE COVERAGE FORM
GARAGE COVERAGE FORM
MOTOR CARRIER COVERAGE FORM
TRUCKERS 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: NBS GOVERNKM FINANCE GROUP
Endorsement Effective Date: 9/24/17
I
cr_NFnal u �
Name(s) Of Person(s) Or Organization (s):
ANY PERSON OR ORGANIZATION WHEN REQUIRED BY A WRIT
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.
461 -0500 11 13 Includes copyrighted material of Insurance Services Office, Inc., with its permission Page 1 of 1
)10254
The
anoVer
Insuiance Group.
WH3A427457 1001554
WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT - CALIFORNIA
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 2 % of the California workers' compensation premium otherwise
due on such remuneration
Schedule
Person or Organization Job Description
ONLY WHERE REQUIRED BY CONTRACT
This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated
(The information below is required only when this endorsement is issued subsequent to preparation of the policy )
Endorsement Effective 9/24/17 Policy No WH3- A427457 -04 Endorsement No.
Insured NSS GOVEREN[ENT FINANCE GROUP Premium $
Insurance CompanyTHE. HANOVE.R INSURANCE COMPAN7
Countersigned By '• i' r I { v `�� b G
r
WC 04 03 06 (Ed. 04 -84)