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American Civil Constructors - Insurance Certificate (2020)
DATE (MM/DD/YYYY) A� " CERTIFICATE OF LIABILITY INSURANCE 4/30/2020 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 CONTACT NAME: Aaron Augustine Arthur J. Gallagher Risk Management Services, Inc. I PHONE FAX 12444 Powerscourt Drive (A/C. No. Extl: 314-800-2288 (A/C, No): Saint Louis MO 63131 I ADDRESS: Aaron_Augustine@ajg.com INSURER(S) AFFORDING COVERAGE NAIC # INSURERA: Twin City Fire Insurance Company 29459 INSURED INFAAND-01 INSURER B : Hartford Fire Insurance Company 19682 American Civil Constructors West Coast LLC I 2990 Bay Vista Court INSURERC: Hartford Casualty Insurance Company 29424 Suite D I INSURERD: Trumbull Insurance Company 27120 Benicia CA 94510 I INSURER E : Indian Harbor Insurance Company 36940 INSURER F : COVERAGES CERTIFICATE NUMBER: 1516820310 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 SUBR POLICY EFF POLICY EXP LIMITS LTR INSD WVD POLICYNUMBER (MM/DDIYYYY) (MM/DDIYYYY) A X COMMERCIAL GENERAL LIABILITY Y Y 84ECXWQ0020 12/31/2019 12/31/2020 EACH OCCURRENCE $ 2 000 000 CLAIMS -MADE � OCCUR X GL SIR:$500K GEN'L AGGREGATE LIMIT APPLIES PER: ❑X PRO- ❑ POLICY JECT LOC OTHER: B AUTOMOBILE LIABILITY Y Y 84UELWQ0019 12/31/2019 12/31/2020 X ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS X HIRED X NON -OWNED AUTOS ONLY AUTOS ONLY C UMBRELLA LIAB H OCCUR Y Y 84XSJWQ0056 12/31/2019 12/31/2020 X EXCESS LIAB CLAIMS -MADE DED I I RETENTION $ D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANYPROPRI ETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? NI N/A (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E Contractors Professional & Pollution DAMAGE TO RENTED PREMISES (Ea occurrence) $ 300,000 MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 2,000,000 GENERAL AGGREGATE $4,000,000 PRODUCTS - COMP/OP AGG $ 4,000,000 COMBINED SINGLE LIMIT $ 2,000,000 (Ea accident) BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE $ (Per accident) Comp/Coll. Deductible $ $5,000/$5,000 EACH OCCURRENCE $ 10,000,000 AGGREGATE $ 10,000,000 Y 84WVWQ0018 12/31/2019 12/31/2020 IX I PER STATUTE OERH E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 CE07420967 12/31/2019 12/31/2020 Each Incident $10,000,000 Aggregate $10, 000,000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Project: Bridge Preventative Maintenance Program, City Project No. 18-PW-246, Federal Project No. BPMP-5034(026) The City of Gilroy, its officers and employees are named as an additional insured, per the attached endorsement. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Gilroy 7351 Rosanna Street AUTHORIZED REPRESENTATIVE Gilroy CA 95020 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: 84 ECx WQ0020 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - OPTION III This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Designated Project(s) Or Location(s) Or Organization(s): Of Covered Operations: The City of Gilroy, its officers, officials and employees are named as an Bridge Preventative Maintenance Program, City Project No. 18-PW-246, additional insured Federal Project No. BPMP-5034(026) 7351 Rosanna Street Gilroy, CA 95020 Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. With respect to those person(s) or organization(s) shown in the Schedule above when you have agreed in a written contract or written agreement to provide insurance such as is afforded under this policy to them, Subparagraph f., Any Other Party, under the Additional Insureds When Required By Written Contract, Written Agreement Or Permit Paragraph of Section II — Who Is An Insured is replaced with the following: f. Any Other Party Any other person or organization who is not an insured under Paragraphs a. through e., but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused by your acts or omissions or the acts or omissions of those acting on your behalf: (1) In the performance of your ongoing operations for such additional insured at the project(s) or location(s) designated in the Schedule; (2) In connection with your premises owned by or rented to you and shown in the Schedule; or (3) In connection with "your work" for the additional insured at the project(s) or location(s) designated in the Schedule and included within the "products - completed operations hazard", but only if: (a) The written contract or written agreement requires you to provide such coverage to such additional insured at the project(s) or location(s) designated in the Schedule; and (b) This Coverage Part provides coverage for "bodily injury" or "property damage" included within the "products -completed operations hazard". The insurance afforded to the additional insured shown in the Schedule applies: (1) Only if the "bodily injury" or "property damage" occurs, or the "personal and advertising injury" offense is committed: (a) During the policy period; and (b) Subsequent to the execution of such written contract or written agreement; and Form HS 24 82 07 13 © 2013, The Hartford (Includes copyrighted material of Insurance Services Office, Inc., with its permission.) Page 1 of 2 (c) Prior to the expiration of the period of time that the written contract or written agreement requires such insurance be provided to the additional insured. (2) Only to the extent permitted by law; and (3) Will not be broader than that which you are required by the written contract or written agreement to provide for such additional insured. With respect to the insurance afforded to the person(s) or organization(s) that are additional insureds under this endorsement, 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 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, designs or specifications; or (2) Supervisory, inspection, architectural or engineering activities. The limits of insurance that apply to the additional insured shown in the schedule are described in the Limits Of Insurance section. How this insurance applies when other insurance is available to the additional insured is described in the Other Insurance Condition in Section IV — Commercial General Liability Conditions, except as otherwise amended below. B. With respect to insurance provided to the person(s) or organization(s) that are additional insureds under this endorsement, the When You Add Others As An Additional Insured To This Insurance subparagraph, under the Other Insurance Condition of Section IV — Commercial General Liability Conditions is replaced with the following: When You Add Others As An Additional Insured To This Insurance (a) Primary Insurance When Required By Contract This insurance is primary if you have agreed in a written contract or written agreement that this insurance be primary. If other insurance is also primary, we will share with all that other insurance by the method described in Paragraph (c) below. This insurance does not apply to other insurance to which the additional insured in the Schedule has been added as an additional insured. (b) Primary And Non -Contributory To Other Insurance When Required By Contract This insurance is primary to and will not seek contribution from any other insurance available to an additional insured under your policy provided that: (i) The additional insured in the Schedule is a Named Insured under such other insurance; and (ii) You have agreed in a written contract or written agreement that this insurance would be primary and would not seek contribution from any other insurance available to the additional insured in the Schedule. (c) IMethod 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. All other terms and conditions in the policy remain unchanged. Page 2 of 2 Form HS 24 82 07 13 POLICY NUMBER: 84 ECx WQ0020 COMMERCIAL GENERAL LIABILITY CG 20 37 04 13 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: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Location And Description Of Completed Operations The City of Gilroy, its officers, officials and employees are Bridge Preventative Maintenance Program, City Project No. 18-PW-246, named as an additional insured Federal Project No. BPMP-5034(026) 7351 Rosanna Street Gilroy, CA 95020 Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, 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 of this endorsement 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. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is 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. CG 20 37 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 1 COMMERCIAL AUTOMOBILE HA 99 16 0312 THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ IT CAREFULLY. E11DORSEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM To the extent that the provisions of this endorsement provide broader beneflis to the "insured" than other provisions of the Coverage Form, the provisions of this endorsement apply. 1. BROAD FORM INSURED A. Subsidiaries and Newly Acquired or Formed Organizations The Named Insured shown in the Declarations is amended to include: (1) Any legal business entity other than a partnership or joint venture, formed as a subsidiary In which you have an ownership interest of more than 50% on the effective date of the Coverage Form. However, the Named Insured does not include any subsidiary that is an "Insured" under any other automobile policy or would be an "insured" under such a policy but for Its termination or the exhaustion of its Limit of Insurance. (2) Any organization that is acquired or formed by you and over which you maintain majority ownership. However, the Named Insured does not include any newly formed or acquired organization: (a) That is a partnership or joint venture, (b) That Is an "insured" under any other policy, (c) That has exhausted its Limit of Insurance under any other policy, or (d) 180 days or more after Its acquisition or formation by you, unless you have given us notice of the acquisition or formation. Coverage does not apply to "bodlly injury" or "property damage" that results from an "accident" that occurred before you formed or acquired the organization. B, Employees as Insureds Paragraph A.I. - WHO IS AN INSURED - of SECTION 11 - LIABILITY COVERAGE is amended to add: d. Any "employee" of yours while using a covered "auto" you don't own, hire or borrow in your business or your personal affairs. C. Lessors as Insureds Paragraph A. 1, -WHO IS AN INSURED - of Section it - Liability Coverage is amended to add: e, The lessor of a covered "auto" while the "auto" Is leased to you under a written agreement if: (1) The agreement requires you to provide direct primary insurance for the lessor and (2) The "auto" is leased without a driver. Such a leased "auto" will be considered a covered "auto" you own and not a covered "auto" you hire. D. Additional Insured If Required by Contract (1) Paragraph A.I. - WHO IS AN INSURED - of Section II - Liability Coverage Is amended to add: f. When you have agreed, in a written contract or written agreement, that a person or organization be added as an additional insured on your business auto policy, such person or organization is an "Insured", but only to the extent such person or organization is liable for "bodily njury' or "property damage" caused by the conduct of an "Insured" under paragraphs a. or b, of Who Is An Insured with' regard to the ownership, maintenance or use of a covered "auto." ©2011, The Hartford (Includes copyrighted matorial Form HA 9916 0312 of 130 Properties, Inc„ with its permission.) Page 1 of 5 The insurance afforded to any such E. Primary and Non -Contributory if additional Insured applies only if the Required by Contract "bodily Injury" or "property damage" Only with respect to Insurance provided to occurs: an additional insured In I.D. - Additional (1) During the policy period, and insured If Required by Contract, the (2) Subsequent to the execution of such following provisions apply: written contract, and (3) Primary Insurance When Required By (3) Prior to the expiration of the period Contract of time that the written contract This Insurance is primary if you have requires such Insurance be provided agreed In a written contract or written to the additional Insured. agreement that this insurance be (2) How Limits Apply primary. If other Insurance is also Iyou have agreed in a written contract primary, we will share with all that other f Y Insurance by the method described in or written agreement that another Other Insurance 54 person or organization be added as an additional insured on your policy, the (4) Primary And Non -Contributory To Other most we will pay on behalf of such Insurance When Required By Contract additional insured is the lesser of: If you have agreed in a written contract (a) The limits of insurance specified in or written agreement that this insurance the written contract or written is primary and non-contributory with the agreement; or additional insured's own insurance, this b The Limits of Insurance shown in insurance is primary and we will not O seek contribution from that other the Declarations, insurance. Such amount shall be a part of and not Paragraphs (3) and (4) do not apply to other In addition to Limits of Insurance shown Insurance to which the additional insured in the Declarations and described in this has been added as an additional Insured. Section. When this Insurance Is excess, we will have no (3) Additional Insureds Other Insurance duty to defend the insured against any "suit" if if we cover a claim or "suit" under this any other insurer has a duty to defend the Coverage Part that may also be covered insured against that "suit". If no other insurer by other insurance available to an defends, we will undertake to do so, but we will additional insured, such additionaf be entitled to the insureds rights against all insured must submit such claim or "suit" those other insurers. to the other insurer for defense and When this insurance is excess over other Indemnity. insurance, we will pay only our share of the However, this provision does not apply amount of the loss, If any, that excoods the sum to the extent that you have agreed In a of: written contract or written agreement (1) The total amount that all such other that this insurance is primary and non- insurance would pay for the loss in the contributory with the additional insured's absence of this insurance; and own insurance. (2) The total of all deductible and soli-ihsuted (4) Duties in The Event Of Accident, Claim, amounts under all that other insurance. Suit or Loss We will share the remaining loss, if any, by the If you have agreed in a written contract method described in Other Insurance 5.d. or written agreement that another person or organization be added as an 2. AUTOS RENTED BY EMPLOYEES additional insured on your policy, the Any "auto" hired or rented by your "employee" additional insured shall be required to on your behalf and at your direction will be comply with the provisions in LOSS considered an "auto" you hire. CONDITIONS 2. - DUTIES IN THE The OTHER INSURANCE Condition is amended EVENT OF ACCIDENT', CLAIM , SUIT by adding the following: OR Loss . OF SECTION IV BUSINESS AUTO CONDITIONS, In the same manner as the Named Insured. © 2011, The Hartford (Includes copyrighted material Form HA 99 16 03 12 of ISO Properties, Inc., with Its permission.) Page 2 of 6 If an "employees" personal insurance also applies on an excess basis fo a covered "auto" hired or rented by your "employee" on your behalf and at your direction, this Insurance will be primary fo the "employee's" personal insurance. 3. AMENDED FELLOW EMPLOYEE EXCLUSION EXCLUSION 5. -FELLOW EMPLOYEE - of SECTION ll _LIABILITY COVERAGE does not apply if you have workers' compensation insurance in -force covering all of your "employees". Coverage Is excess over any other collectible insurance. 4. HIRED AUTO PHYSICAL DAMAGE COVERAGE ]f hired "autos" are covered "autos" for Liability Coverage and if Comprehensive, Specified Causes of Loss, or Collision coverages are provided under this Coverage Form for any "auto" you own, then the Physical Damage Coverages provided are extended to "autos" you hire or borrow, subject to the following limit. 'the most we will pay for "loss" to any hired "auto"is: (2) The actual cash value of the damaged or stolen property at the time of the "loss'; ar (3) The cost of repairing or replacing the damaged orstolen property, whichever is smallest, minus a deductible. The deducfible will 6e equal ko the largest deductible applicable to any owned "auto" far that coverage. No deductible applies to "lass" caused by fire or lightning. Hired Auto Phys(cal Damage coverage is excess over any other collectible insurance. Subject to the above Iimlt, deductible and excess provisions, we will provide coverage equal to the broadest coverage applicable to any covered "auto" you own. We will also cover lass of use of the hired "auto" if it results from an "accident", you are legally liable and the lessor incurs an actual flnanclal loss, subJect to a maximum of $1000 per "accident". This extension of coverage does not apply to any "auto" you hire or borrow from any of your "employees", partners (If you are a partnership), members (if you are a limited liability company), or members of their households. 5. PHYSICAL � DAMAGE - ADD]TIONAL TEMPORARY TRANSPORTATION EXPENSE COVERAGE Paragraph A.4.a, of SECTION III -PHYSICAL DAMAGE COVERAGE is amended to provide a Iimlt of $50 per day and a maximum limit of $1,000. 5. LOAN/LEASE GAP COVERAGE Under SECTION Ill - PHYSICAL DAMAGE COVERAGE, Ih the event of a total "loss" to a covered "auto", we will pay your additional legal obligation For any difference between the actual cash value of the "auto" at the lime of the "lass" and the "outstanding balance" of the loantlease. "Outstanding balance" means the amount you owe on the loantlease at the time of "loss" less any amounfs representing taxes; overdue payments; penalties, interest or charges resulting from overdue payments; additional mileage charges; excess wear and tear charges; [ease termination fees; security deposits not returned by the lessor; costs ..(or extended warranties, credit Itfe Insurance, health, accident or disability Insurance purchased with the loan or lease; and carry-over balances from previous loans or leases. 7. AIRBAG COVERAGE Under Paragraph B. EXCLUSIONS - of SECTION Ill - PHYSICAL DAMAGE COVERAGE, the following is added: The exclusion relating to mechanical breakdown does not apply fo the accidental discharge of an airbag. 8. ELECTRONIC E4UIPMENT - BROADENED COVERAGE a. The exceptions to Paragraphs B.4 - EXCLUSIONS - of SECTION III - PHYS[CAL DAMAGE COVERAGE are replaced by the following: Exclusions 4.c. and 4.d. do not apply to equipment designed Yo be operated solely by use of the power from the "auto's" electrical system that, at the time of "loss", Is; (1) Permanently installed In or upon the covered "auto"; (2) Removable from a housing unit which is permanently installed in or upon the covered "auto"; (3) An integral part of the same unit housing any electronic equipment described in Paragraphs (1) and (2) above; or © 2011, The Hartford (Includes copyrighted material Form HA 9918 0312 of ISO Properties, Inc., with its permission.) Page 3 of 5 (4) Necessary for the normal operation of the covered "auto" or the monitoring of the covered "autc's"operating system. b.Section III —Version CA 00 Di 03 10 of the Business Auto Coverage Form, Physical Damage Coverage, Limit of Insurance, Paragraph C.2 and Version CA 00 01 10 01 of the Business Auto Coverage Form, Physical Damage Coverage, Limit of Insurance, Paragraph C are each amended to add the following: $1,500 is the most we will pay for "loss" in any one "accident" fo all electronic equipment (other Phan equipment designed solely for the reproduct(on of sound, and accessories used wifh such equipment} that reproduces, receives oY transmits audio, visual or data signals which, at the time of "loss", is: (1}Permanently installed In or upon the covered "auto" in a housing, opening or other location that is not normally used by the "auto" manufacturer for the installation of such equipment; (2) Removable from a permanently Installed housing unit as described in Paragraph 2.a, above or is an integral part of that equipment; or (3) An integral part of such equipment. c. For each covered "auto", should loss be limited to electron[c equipment only, our obligation to pay for, repair, return or replace damaged or stolen electronic equipment will be reduced by the applicable deductible shown in the Declarations, or $250, whichever deductible is less. 9. EXTRA EXPENSE - BROADENED COVERAGE Under Paragraph A. -COVERAGE - of SECTION (II -PHYSICAL DAMAGE COVERAGE, we will pay for the expense of returning a stolen covered "auto" to you. 10. GLASS REPAIR - WAIVER OF DEDUCTIBLE Under Paragraph D. -DEDUCTIBLE - of SECTION III - PHYSICAL DAMAGE COVERAGE, the following is added: [f another Hartford Financial Services Group, Inc. company policy or coverage form that is not an automobile policy or coverage farm applies to the same "accident", the following applies: (1) If the deductible under this Business Auto Coverage Form is the smaller (or smallest) deductible, it will be waived; (2) If the deductible under this Business Auto Coverage Form is not the smaller (or smallest) deductible, it will be reduced by the amount of the smaller {or smallest) deductible. 12. AMENDED DUTIES IN THE EVENT OF ACCIDENT, CLAIM, SUIT OR LOSS The requirement In LOSS CONDITIONS 2.a. - DUTIES I N THE EVENT O F ACCIDENT,CLAIM, SUIT OR LOSS - of SECTION IV -BUSINESS AUTO CONDITIONS that you must notify us of an "accident" applies only when the "accident" is known to: (1) You, if you are an individual; (L) A partner, ff you are a partnership; (3) A member, if you are a limited liability company; or (4) An executive officer or Insurance manager, if you era a corporation. 13. UNINTENTIONAL FAILURE TO DISCLOSE HAZARDS If you unintentionally fail to disclose any hazards existing at the inception date of your policy, we will not deny coverage under this Coverage Forrn because of such fa(lure. 14. HIRED AUTO -COVERAGE TERRITORY Paragraph e. of GENERAL CONDITIONS 7. - POLICY PERIOD, COVERAGE TERRITORY - of SECTION lV - BUSINESS AUTO CONDITIONS is replaced by the following: e. For short-term hired "autos", the coverage territory wifh respect to Liability Coverage is anywhere in the world provided That if the "insured's" responsibility to pay damages for "bodily Injury" or "property damage" is determined in a "suit," the "suit" Is brought in the United States of America, the territories and possessions of the United States of America, Puerto Rico or Canada or in a settlement we agree to. No deductible applies to glass damage if the 15. WAIVER OF SUBROGATION glass Is repaired rather than replaced. TRANSFER OF RIGHTS OF RECOVERY 11. TWO OR MORE DEDUCTIBLES AGAINST OTHERS TO US - of SECTION IV Under Paragraph D.-bEDUCTIBLE-ofSECTION BUSINESS AUTO CONDITIONS is amended by ill - PHYSICAL DAMAGE COVERAGE, the adding the following: following is added: ©2011, The Hartford (Includes copyrighted material Form HA 9916 03 12 of ISO Properties, Inc„ wifh its permission.) Page 4 of 5 We waive any right of recovery we may have against any person or organization with whom you have a written contract that requires such waivor because of payments we make for damages under this Coverage Form. 16. RESULTANT MENTAL ANGUISH COVERAGE The definition of "bodily injury" in SECTION V- DEFINITIONS Is replaced by the following: "Bodily injury" means bodily injury, sicl<hess or diseaso sustained by any person, including mental anguish or death resulting from any of these. 1Z EXTENDED CANCELLATION CONDITION Paragraph 2. of the COMMON POLICY CONDITIONS - CANCELLATION - applies except as follows: If we cancel for any reason other than nonpayment of premium, we will mail or deliver to the first Nomad Insured written notice of cancellation at least 60 days before the effective date of cancellation. 98. HY6RIq ELECTRIC, OR NATURAL GAS VEHICLE PAYMENT COVERAGE In the event of a total loss to a "non -hybrid" auto for which Comprehensive, Speclfled Causes of Loss, or Collision coverages are provided under this Coverage Form, then such Physical Damage Coverages are amended as follows; a.lf the auto is replaced with a "hybrid" aufo or an auto powered solely by electricity or natural gas, we will pay an additional 10%, fo a maximum of $2,500, of the "non-hybdd" auto's actual cash value or replacement cast, whichever Is less, b.The auto must be replaced and a copy of a bill of sale or new lease agreement received by us within 60 calendar days of the date of "loss," c.Regardless of the number of autos deemed a total loss, the most we will pay under this Hybrid, Electric, or Natural Gas Vehicle Payment Coverage provision for any one "loss" is $10,000. for the purposes of the coverage provision, a.A "non -hybrid" aufo is defined as an aufo that uses only an internal combustion engine to move the auto but does not include autos powered solely by electrictty or natural gas. b.A "hybrid" auto is defined as an aufo with an Internal combustion engine and one or more electric motors; and that uses the intemal combustion engine and one or more electric motors to move the aufo, or the intemal combustion engine to charge one or more electric motors, which move the auto. 19. VEHICLE WRAP COVERAGE In the event of a total loss to an "auto" for which Comprehensive, Speclfled Causes of Loss, or Collision coverages are provided under th(s Coverage Form, then such Physical Damage Coverages are amended to add the following: In addition to the actual cash value of the "aufo", we will pay up to $1,000 for vinyl vehicle wraps which are displayed on the covered "auto" at the time of total loss. Regardless of the number of autos deemed a tote! loss, the most we will pay under this Vehicle Wrap Coverage provision for any one "loss" is $5,OOD. For purposes of this coverage provision, signs or other graphics painted or magnetically affixed to the vehicle are not considered vehicle wraps. ©2011, The Hartford (Includes copyrighted material Form HA 99 16 tl312 of ISO Propert(es, Inc., with ils permission.) Page 5 of 5 THtS ENDORSEMENT CHANGES THE POI.iGY. PLEASE READ IT CAREFULLY. This pollcy is subject to the following additional conditions: A. If this pollcy is cancelled by the Company, other than for nonpayment of premium, notico of such cancellation will be provided of least thirty (30) days in advance of the cancellafion effecCNe date to the certificafe holders) with mailing addresses on file with the agent of record or the Company. 6. If this policy Is cancelled by the Company for nonpayment of premium, or by fhe insurod, notice of such cancellation will be provided within (10) days of the cancellation effective date to the certificate hoider(s) with mailing addresses on file with fhe agent of record or the Company. If notice Is mailed, proof of mailing to the last known mailing address of the certificate holders) on ftle with the agent of record or the Company will be sufFcient proof of notice. Any notification rights provided by this endorsement apply only to active certificate holders) who were issued a cerflflcate of insurance applicable to this policy's term. Failure to provide such notice to the cert'rficate holders) will not amend or extend the date the cancellation becomes effective, nor w1ll it negate cancellation of the policy. Failure to send notice shall impose no liability of any k(nd upon the Company or its agents or representatives. Form 1H 03 13 0611 .. Page 9 of 1 C� 2011, The Hartford THIS ENpQRSHMIIENT CHANGES THE POLICY. PLEASE REACT IY CAREFULLY. WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSE(!11ENT PolicyNamher: 84WVWQ0018 EndorsemenfNumber: as Effective Dafe; y 2 /3•� � 1 9 Effectivo hour is the same as stated on the Informaflon Page of the policy. Named insured and Adaress: American Civil Constructors West Coast LLC 2990 Bay Vista Court Suite D Benicia, CA 94510 We have the right to recover our payments from anyone Ilabte for an injury covered by this policy. We wl➢ not enforce our rfghi against the person or organization named In the Schedule. Th[s agreementshall not operate diroctly or indirectly to benefit anyone not named in the Srhadule. SCHEDULE ANY PERSON OR ORGANYZATYON, RROM WHOM XOS7 ARE REQUIRED HX CONTRACT QR AGRS&MENT `A'O OBTAIN THIS WAIVER PROM OS. ENDORSEMENT LS NOT Y�PPLSCABLE YN ICY NA", NJ OR ANY h10 CONSTRUCTION RISK. Countersigned by man-no%C�""��' Authorized t2epresentafive Form WC OD 43 t3 Printed in U.S.A_ Process Dafe; Policy Exptrafion Date: THIS ENpORSEMENT CHANGES THE P(]LECY. PLEASE REAP IT CAhEFULLY. MOT1Cl= OF CANCELLATION TO CERTIFICATE HOLDERS) polrcyFlumber'84WVWQ001g Endorsement Number: s� Effective tlata:;1 2 /�� / 1 9 Effective hour is the same as stated on the information Page of the policy. Namodlnsurad and dress: - American CiVi1 Constructors West Coast LLC 2990 Bay Vista Caurt Suite D Benicia, CA 94510 This policy is suhjeat fo the following additional conditions: A. If this policy (s cancelled by the Company, other than For iron -payment of premium, notice of such cancellation will be provided at (east thirty (30) days In advance- of the cancellation effective date fo the certificate holdar(s) with mailing addresses on file with the agent of record or the Company. B. If this policy Is cancelled by tits company for nan-payment of premium, or 6y the Insured, notice of such cancellation will be provided within ten (t0) days of the cancellation efectNe date to the certificate holder{s) with mailing addresses on file with the agent of record orthe Campany. porn WC 99 03 94 Printed in U.S.A. Process Aafec 0 nonce (s mailed, proof of mailing to the last known mailing address of the certificate holders) on file with the agent of record or the Campany will be sufflc(ent proof of notice, Any notification dyhts provided by this endorsement apply only to aclEve certificate holders) who were Issued a certificate of insurance applicable to this policy's tens. Failure to provide such notice to the cerificate haider(s) will not amend or extend the date fho cancellation becomes effective, nor will It negate cahcellation of the policy. Failure to send notice sha(I Impose no liability of any kind upon the Company or Its agents or representatiues, ©tot 1, The Hartford Policy Expirattolt pate;