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HomeMy WebLinkAboutGuerra Construciton Group - Insurance CertificateOP ID: YV CERTIFICATE OF LIABILITY INSURANCE DA 08/28/12 V, 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 408 - 288 -6262 Badocker Ins. Svs. -San Jose 408 -298 -7635 LIc. # 0580438 1330 S. Bascom Ave. San Jose, CA 95126 Nicholas A. Weintraub NA FACT PHONE FAX AM No Eilt : (AM, No): E-MAIL ADDRESS: GENERALLIABILITY PRODUCER CUSTOMEl GUERR -8 INSURER(S) AFFORDING COVERAGE WCC INSURED Guerra Construction Group INsuRERA:lronshore Specialty Ins. Co. 25445 INSURER B: Golden Eagle Insurance Corp. 10836 Santa Clara Construction& INSURERC:Everest National Insurance Co. 10120 Engineering Inc 984 Memorex Drive Santa Clara, CA 95050 INSURERS :Assurance Company ofAmerica 19305 CLAIMS -MADE OCCUR INSURER E: INSURER F: MED E(P(Anyone person) $ .5,000 rr1VFRAGFS CERTtEICATE NI IMRER- 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. NOTVVITHSTAN DING 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 MAYHAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR rypE OF INSURANCE ADDL. INSR SUB WVD POLICY NUMBER POLICY EFF MMrDDM/YY POLICY EXP MMIVOM'YV LIMITS GENERALLIABILITY 2. EACH OCCURRENCE $ 1,000,000 A X COMMERCIAL GENERAL LIABILITY X AGS0000801 04101112 04/01/13 DAMAGE TO RENTED PREMISES Ea occurrence $ - 50,000 CLAIMS -MADE OCCUR MED E(P(Anyone person) $ .5,000 PERSONAL B ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'LAGGREGATE LIMITAPPLIES PER PRODUCTS- COMP /OP AGG $ 2,000,000 $ POLICY X PRO- JECT LOC AUTOMOBILE LIABILITY COMBINED S IN GLE L IM IT $ 1,000,000 B X ANY AUTO BA3058848 04/01/12 04/01/13 (Eaec d dent/ , BODILY INJURY (Perperson) $ ALL OWNEDAUTOS BODILY INJURY (Per accident) $ SCHEDULED AUTOS PROPERTY DAMAGE HIREDAUTOS (Pereccidenf) $ $ NON -OWNED AUTOS $ X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 4,000,000 AGGREGATE $ .4,000,000 A EXCESS LIAB CLAIMS -MADE AG 00002900 04101/12 04/01/13 DEDUCTIBLE $ X $ RETENTION $ 10,000 WORKERS COMPENSATION X WCSTATU- 0TH- AND EMPLOYERS' LIABILITY YIN TORY LIM ITS ER EL EACH ACCIDENT $ 1,000,000 C ANY PROPRIETORIPARTNERIEXECUTIVE 7600005159121 04/01/12 04/01/13 OFFICER/MEMBER EXCLUDED? (Mandatory In NH) NfA EL. DISEASE-EAEMPLOYEE $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 D Builders Risk BR71357661 08127/12 08/27/13 312,63 Ded 1,00 DESCRIPTION OF OPERATIONS / LOCATIONS /VEHCLES (Attach ACORD 101, Additional Remarks Schedule, If more space is required) The City of Gilroy, its officers, officials, employees and volunteers are named as additional Insured per GL form CG2010 & CG2037 attached. RE: Uvas Creek Trail Gilroy CA OFRTIFICATF HOLDER CANCELLATION CITYGIL SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Gilroy ACCORDANCE WITH THE POLICY PROVISIONS. 7351 Rosanna Street AUTHORIIZEDREPRESENTATIVE Gilroy, CAS5070 2. ©1988 -2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009109) The ACORD name and logo are registered marks of ACORD THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. POLICY CHANGES Policy Change Number POLICY NUMBER POLICY CHANGES COMPANY EFFECTIVE BR71357661 From 08127l2012To 08!27!2013 American Zurich Insurance Company NAMED INSURED AUTHORIZED REPRESENTATIVE Guerra Construction Group BARLOCKER INSURANCE SERVICES 984 Memorex Dr PO BOX 6300 Santa Clara, CA 95050 SAN JOSE, CA 951 50 -6 300 COVERAGE PARTS AFFECTED Builders Risk Coverage CHANGES Additional Insured: City of Gilroy 7351 Rosanna Street Gilroy, CA 95020 Authorized Representative Signature Copyright, Insurance Services Office, Inc., 1983 IL 12 01 11 85 Copyright, ISO Commercial Risk Services, Inc., 1983 Page 1 of 1 POLICY NUMBER: AGS0000801 COMMERCIAL GENERAL LIABILITY CG 20 10 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s): Locations Of Covered Operations As required by written contract. If required by your agreement with such Additional Insured, this insurance shall be primary insurance and non- contributory for that Additional Insured. I£ anyone, other than the Additional Insured, provides similar insurance for the Additional Insured, then this insurance will apply as outlined in SECTION IV- COMMERCIAL GENERAL LIABILITY CONDITIONS, paragraph 4, Other Insurance, subparagraph c., Method of Sharing. The inclusion of one or more Insured under the terms of this endorsement does not increase our limits of liability. 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", '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 for the additional insured(s) at the location(s) designated above. B. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to "bodily injury" or "property damage" occurring after: 1. All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or 2. That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. CG 2010 07 04 0 ISO Properties, Inc., 2004 Page 1 of 1 ❑ POLICY NUMBER: AGS0000801 COMMERCIAL GENERAL LIABILITY CG 20 37 07 04 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 «91:1=19111IL Name Of Additional Insured Person(s) Or Organization(s): Location And Description Of Completed Operations Blanket as required by written contract and Blanket as required by contract. effective during the policy period as stated on the Primary Insurance Applies: It is agreed that such policy declarations. insurance as is afforded by this policy for the benefit of the additional insured shown shall be primary insurance, and any other insurance maintained by the additional insured(s) shall be excess and non contributory as respects any claim, loss or liability allegedly arising out of the operations of the named insured, provided however that this insurance will not apply to any claim loss or liability which is determined to be solely the result of the additional insured's responsibility. This insurance also does not apply to any structure intended to be occupied as a private residence, not including apartments. Section II — Who Is An Insured is amended tc 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 ih the "products- completed operations hazard ". CG 20 37 07 04 © ISO Properties, Inc., 2004 Page 1 of 1 0 0 Disclosure Statement ZURICH It is our pleasure to present the enclosed policy to you for presentation to your customer. INSTRUCTION TO AGENT OR BROKER: WE REQUIRE THAT YOU TRANSMIT THE ATTACHED /ENCLOSED DISCLOSURE STATEMENT TO THE CUSTOMER WITH THE POLICY. Once again, thank you for your interest, and we look forward to meeting your needs and those of your customers. U -GU -873 -A CW (06/11) Page 1 of 1 California Disclosure Statement Fully Earned premium ZURICH This policy is subject to the Total Fully Earned Policy Premium shown in the Declarations. If this policy is cancelled you must pay at least the Total Fully Earned Policy Premium unless the policy is cancelled as of the inception date shown in the Declarations. U -GU -884 -A CA (01 -12) Page 1 of 1 Disclosure Statement ZURICH" NOTICE OF DISCLOSURE FOR AGENT & BROKER COMPENSATION If you want to learn more about the compensation Zurich pays agents and brokers visit: http://www.zurichnaproducercompensation.com or call the following toll -free number: (866) 903 -1192. This Notice is provided on behalf of Zurich American Insurance Company and its underwriting subsidiaries. U- GU- 874 -ACW (06/11) Page 1 of 1 BUILDERS RISK COVERAGE DECLARATIONS The Declarations, Supplemental Declarations, Common American Zurich Insurance Company Policy Conditions, Commercial Inland Marine Conditions, A Stock Company Coverage Form(s) And Endorsement(s), if any, issued to Administrative Office: 1400 American Lane and forming a part thereof, complete the Commercial Schaumburg, IL 60196 Insurance Policy numbered as follows: THIS IS A COINSURANCE CONTRACT X New Policy BR71357661 ❑ ❑ Renewal of Please read your policy. ❑ Rewrite of In return for the payment of the premium, and subject to all terms of this policy, we agree with you to provide the insurance as stated in this policy. 1. Named Insured and Mailing Address: 2. Producer Information: Guerra Construction Group A Name: BARLOCKER INSURANCE SERVICES 984 Memorex Dr PO BOX 6300 Santa CLara, CA 95050 SAN JOSE, CA 95150 -6300 B Telephone # 408 - 288 -6262 C Fax # 408 - 298 -7635 D Zurich Producer # 18167742 3. Policy Period — From: 08127/2012 To: 08/27/2013 E Field Office Name CENTRAL CALIFORNIA 12:01 a.m. at your mailing address above. F Field Office Code 78 4. Form of Business: ❑ Individual ❑ Partnership ❑x Corporation ❑ Joint Venture ❑ Other 5. Limits of Insurance (either One -Shot or Reporting Form as indicated below) x SUPPLEMENTAL DECLARATIONS ❑ (If this box is checked, Supplemental Declarations is attached to and forms a part of this policy) ❑ Reporting Form (continuous policy) ❑x One -Shot (non- reporting form /single structure policy) ❑ Annual Rate ❑ Monthly Rate (HBIS — 4) ❑ 1 -4 Family Dwelling fc❑ Commercial Structure Property Location A) Any one building or structure $ TBD Syrah Ct B) All covered property at all locations $ Gilroy, GA 95020 C) Rate Per Report D) Premium Per Report New Construction E) Total Taxes and Surcharges Per Report A) Anyone building or structure $ 312,632 (per attached endorsement — N/A in NY) B) All covered property at all locations $ 312,632 F) Total Fully Earned Policy Premium Per Report (same as A unless otherwise noted) Remodeling D) Renovations and improvements $ E) Existing buildings or structures $ F) Rate $ 0.23 G) Premium $ 910.00 H) Total Taxes and Surcharges $ 0.00 (per attached endorsement) 1) Total Fully Earned Policy Premium $ 910.00 minimum premium a licable 6. Deductible: ❑$500 ❑X $1,000 ❑$2,500 ❑$5,000 ❑Other 7. Forms Applicable To This Coverage Part: SEE SCHEDULE OF FORMS AND ENDORSEMENTS Countersigned: By: Authorized Representative FM-170001 (04-10) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. POLICY CHANGES Policy Change Number POLICY NUMBER POLICY CHANGES COMPANY EFFECTIVE BR71357661 From 08127/2012To 08/27/2013 - American Zurich Insurance Company NAMED INSURED AUTHORIZED REPRESENTATIVE Guerra Construction Group BARLOCKER INSURANCE SERVICES 984 Memorex or PO BOX 6300 Santa CLara, CA 95050 SAN JOSE, CA 95150 -6300 COVERAGE PARTS AFFECTED Builders Risk Coverage CHANGES Additional Insured: City of Gilroy 7351 Rosanna Street Gilroy, CA 95020 Authorized Representative Signature Copyright, Insurance Services Office, Inc., 1983 IL 12 01 11 85 Copyright, ISO Commercial Risk Services, Inc., 1983 Page 1 of 1 Policy Number: BR71357661 Policy Type: ❑ Reporting Forms (continuous policy) OR Z One -Shot (non - reporting form /single structure policy) ADDITIONAL COVERAGES (COVERAGE FORM) LIMIT OF INSURANCE a. Collapse $ Included b. Scaffolding, Construction Forms And Temporary Structures $ 20,000 Re- erection Of Scaffolding $ 10,000 c. Debris Removal $ 20,000 d. Back -Up Or Overflow Of Sewers, Drains Or Sumps $ 5,000 e. Fire Department Service Charge $ 10,000 f. Valuable Papers And Records $ 20,000 g. Pollutant Clean -Up And Removal $ 15,000 h. Ordinance Or Law — Direct Damage $ ❑ Loss To The Undamaged Portion Of The Building $ Included ❑ Demolition Cost $ 1,000,000 ❑ Increased Cost Of Construction $ 1,000,000 Combined Aggregate For Demolition Cost And Increased Cost Of Construction $ 1,000,000 i. Preservation Of Property Included j. Rewards $ 10,000 k. Property At A Temporary Storage Location $ 10,000 I. Property In Transit $ 25,000 OPTIONAL ADDITIONAL COVERAGES (ENDORSEMENTS) ❑ Business Income (HBIS -95) $ Anticipated Project Completion Date Monthly Limit Of Indemnity (fraction) Deductible Period days Civil Authority Included ❑ Business Income And Extra Expense (HBIS -82) $ Anticipated Project Completion Date Monthly Limit Of Indemnity (fraction) Deductible Period days Business Income Included Extra Expense Included Civil Authority Included ❑ Development Or Subdivision Fences, Walls And Signs (HBIS -58) $ ❑ Expediting Expense (HBIS -93) $ ❑ Extra Expense (HBIS -92) $ ❑ Marine Model Home Contents Coverage (❑ HBIS -52 —OR— ❑ HBIS -77) $ ❑ Soft Costs Coverage (HBIS -88) $ Anticipated Project Completion Date Deductible Period days Expense To Mitigate Loss Included Civil Authority (coverage extended for 3 additional consecutive weeks) Included OPTIONAL COVERAGE EXTENSION (ENDORSEMENT) ❑ Builders Risk Green Building Coverage Extension (HBIS -96) Aggregate Limit of Liability $ "LEED Building Rating" HBIS -91 (04 -09) Policy Number BR71357661 SCHEDULE OF FORMS AND Named Insured: Guerra Construction Group Effective Date: 08/27/2012 12:01 A.M., Standard Time Aeent Name: BARLOCKER INSURANCE SERVICES Agent No.: 18167742 U -GU- 884 -A, FM170001(04 /10), IL1201(I1/85), HBIS- 91(04/09), U -GU -619 -A CW(10 /02), U -GU- 630- C(12/07), U -GU- 767- A(01 /08), CM0001(09 /04), IL0017(11 /98), 40471(04/09), HBIS- 1(04/09), HBIS- 78(04/09), HBIS - 83(04/09), HBIS- 84(04/09), HBIS-85(04/09), IL0003(09/08), IL0102(05/05), IL0104(09/07), IL0270(08/1 1), U -GU- 319- F(01 /09) U -GU -619 -A CW (10/02) 9 ZURICH THIS DISCLOSURE IS ATTACHED TO AND MADE PART OF YOUR POLICY. DISCLOSURE OF IMPORTANT INFORMATION RELATING TO TERRORISM RISK INSURANCE ACT SCHEDULE* Premium attributable to risk of loss from certified acts of terrorism for lines of insurance subject to TRIA: NONE *Any information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Disclosure of Premium In accordance with the federal Terrorism Risk Insurance Act ("TRIA'), as amended, we are required to provide you with a notice disclosing the portion of your premium, if any, attributable to the risk of loss from terrorist acts certified under that Act for lines subject to TRIA. That portion of premium attributable is shown in the Schedule above. The premium shown in the Schedule above is subject to adjustment upon premium audit, if applicable. B. Disclosure of Federal Participation in Payment of Terrorism Losses The United States Government may pay a share of insured losses resulting from an act of terrorism. The federal share equals 85% of that portion of the amount of such insured losses that exceeds the insurer retention. The insurer retention equals 20% of the insurer's prior calendar year direct earned premium associated with lines of insurance subject to TRIA. TRIA is scheduled to expire on December 31, 2014. C. Disclosure of $100 Billion Cap on All Insurer and Federal Obligations If aggregate insured losses attributable to terrorist acts certified under TRIA exceed $100 billion in a Program Year (January 1 through December 31) and an insurer has met its deductible under the program, that insurer shall not be liable for the payment of any portion of the amount of such losses that exceeds $100 billion, and in such case insured losses up to that amount are subject to pro rata allocation in accordance with procedures established by the Secretary of Treasury. D. Availability As required by TRIA, we have made available to you for lines subject to TRIA coverage for losses resulting from acts of terrorism certified under TRIA with terms, amounts and limitations that do not differ materially from those for losses arising from events other than acts of terrorism. E. Definition of Act of Terrorism under TRIA TRIA defines "act of terrorism" as any act that is certified by the Secretary of the Treasury, in concurrence with the Secretary of State and the Attorney General of the United States: 1. to be an act of terrorism; 2. to be a violent act or an act that is dangerous to human life, property or infrastructure; 3. to have resulted in damage within the United States, or outside of the United States in the case of an air carrier (as defined in section 40102 of Title 49, United States Code) or a United States flag vessel (or a vessel based principally in the United States, on which United States income tax is paid and whose insurance coverage is subject to regulation in the United States), or the premises of a United States mission; and 4. to have been committed by an individual or individuals as part of an effort to coerce the civilian population of the United States or to influence the policy or affect the conduct of the United States Government by coercion. No act may be certified as an act of terrorism if the act is committed as part of the course of a war declared by Congress (except for workers' compensation) or if losses resulting from the act, in the aggregate for insurance subject to TRIA, do not exceed $5,000,000. Copyright © 2007 Zurich American Insurance Company - U -GU -630 -C (12/07) Includes copyrighted material of ISO Properties, Inc. with its permission Page 1 of i 0 ZURICH CAP ON LOSSES FROM CERTIFIED ACTS OF TERRORISM Insureds Name - Policy Number Effective Date Endorsement Number THIS ENDORSEMENT CHANGES YOUR POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies your insurance: COMMERCIAL GENERAL LIABILITY COVERAGE PART COMMERCIAL INLAND MARINE COVERAGE PART COMMERCIAL PROPERTY COVERAGE PART COMMERCIAL UMBRELLA LIABILITY COVERAGE PART A. Cap on Losses From Certified Terrorism Losses "Certified act of terrorism" means an act that is certified by the Secretary of the Treasury, in concurrence with the Secretary of State and the Attorney General of the United States, to be an act of terrorism pursuant to the federal Terrorism Risk Insurance Act ( "TRIA "). The Terrorism Risk Insurance Act provides that the Secretary of Treasury shall certify an act of terrorism: 1. to be an act of terrorism; 2. to be a violent act or an act that is dangerous to human life, property or infrastructure; 3. to have resulted in damage within the United States, or outside of the United States in the case of an air carrier (as defined in section 40102 of Title 49, United States Code) or a United States flag vessel (or a vessel based principally in the United States, on which United States income tax is paid and whose insurance coverage is subject to regulation in the United States), or the premises of a United States mission; and 4. to have been committed by an individual or individuals as part of an effort to coerce the civilian population of the United States or to influence the policy or affect the conduct of the United States Government by coercion. No act may be certified as an act of terrorism if the act is committed as part of the course of a war declared by Congress (except for workers' compensation) or if losses resulting from the act, in the aggregate for insurance subject to TRIA, do not exceed $5,000,000. If aggregate insured losses attributable to one or more "certified acts of terrorism" exceed $100 billion in a Program Year (January 1 through December 31) and we have met our insurer deductible under the Terrorism Risk Insurance Act, we shall not be liable for the payment of any portion of the amount of such losses that exceeds $100 billion, and in such case insured losses up to that amount are subject to pro rata allocation in accordance with procedures established by the Secretary of Treasury. B. Application of Other Exclusions The terms and limitations of a terrorism exclusion or any other exclusion, or the inapplicability or omission of a terrorism exclusion or any other exclusion, do not serve to create coverage which would otherwise be excluded, limited or restricted under this policy. Copyright © 2008 Zurich American Insurance Company U -GU -767 -A CW (01/08) Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 1 COMMERCIAL INLAND MARINE CM 00 0109 04 COMMERCIAL INLAND MARINE CONDITIONS The following conditions apply in addition to the Common Policy Conditions and applicable Additional Conditions in Commercial Inland Marine Coverage Forms: LOSS CONDITIONS A. Abandonment There can be no abandonment of any property to us. B. Appraisal If we and you disagree on the value of the prop- erty or the amount of loss, either may make writ- ten demand for an appraisal of the loss. In this event, each party will select a competent and im- partial appraiser. The two appraisers will select an umpire. If they cannot agree, either may re- quest that selection be made by a judge of a court having jurisdiction. The appraisers will state sepa- rately the value of the property and amount of loss. If they fail to agree, they will submit their differences to the umpire. A decision agreed to by any two will be binding. Each party will: 1. Pay its chosen appraiser; and 2. Bear the other expenses of the appraisal and umpire equally. If there is an appraisal, we will still retain our right to deny the claim. C. Duties In The Event Of Loss You must see that the following are done in the event of loss or damage to Covered Property: 1. Notify the police if a law may have been bro- ken. 2. Give us prompt notice of the loss or damage. Include a description of the property involved. 3. As soon as possible, give us a description of how, when and where the loss or damage oc- curred. 4. Take all reasonable steps to protect the Cov- ered Property from further damage, and keep a record of your expenses necessary to pro- tect the Covered Property, for consideration in the settlement of the claim. This will not in- crease the Limit of Insurance. However, we will not pay for any subsequent loss or dam- age resulting from a cause of loss that is not a Covered Cause of Loss. Also, if feasible, set the damaged property aside and in the best possible order for examination. 5. You will not, except at your own cost, volun- tarily make a payment, assume any obliga- tion, or incur any expense without our con- sent. 6. As often as may be reasonably required, permit us to inspect the property proving the loss or damage and examine your books and records. Also permit us to take samples of damaged and undamaged property for inspection, test- ing and analysis, and permit us to make cop- ies from your books and records. 7. We may examine any insured under oath, while not in the presence of any other insured and at such times as may be reasonably re- quired, about any matter relating to this insur- ance or the claim, including an insured's books and records. In the event of an exami- nation, an insured's answers must be signed. 8. Send us a signed, sworn proof of loss con- taining the information we request to settle the claim. You must do this within 60 days after our request. We will supply you with the necessary forms. 9. Immediately send us copies of any demands, notices, summonses or legal papers received in connection with the claim or suit. 10. Cooperate with us in the investigation or set- tlement of the claim. D. Insurance Under Two Or More Coverages If two or more of this policy's coverages apply to the same loss or damage, we will not pay more than the actual amount of the loss or damage. E. Loss Payment 1. We will give notice of our intentions within 30 days after we receive the sworn proof of loss. 2. We will not pay you more than your financial interest in the Covered Property. 3. We may adjust losses with the owners of lost or damaged property if other than you. If we pay the owners, such payments will satisfy your claim against us for the owners' prop- erty. We will not pay the owners more than their financial interest in the Covered Prop- erty. 4. We may elect to defend you against suits arising from claims of owners of property. We will do this at our expense. 5. We will pay for covered loss or damage within 30 days after we receive the sworn proof of loss if you have complied with all the terms of this Coverage Part and: a. We have reached agreement with you on the amount of the loss; or b. An appraisal award has been made. CM 00 01 09 04 Copyright, ISO Properties, Inc., 2003 Page 1 of 3 UNIFORM F. G. l :1111 J. 6. We will not be liable for any part of a loss that has been paid or made good by others. Otherinsurance 1. You may have other insurance subject to the same plan, terms, conditions and provisions as the insurance under this Coverage Part. If you do, we will pay our share of the covered loss or damage. Our share is the proportion that the applicable Limit of Insurance under this Coverage Part bears to the Limits of In- surance of all insurance covering on the same basis. 2. If there is other insurance covering the same loss or damage, other than that described in 1. above, we will pay only for the amount of covered loss or damage in excess of the amount due from that other insurance, whether you can collect on it or not. But we will not pay more than the applicable Limit of Insurance. Pair, Sets Or Parts 1. Pair Or Set In case of loss or damage to any part of a pair or set we may: a. Repair or replace any part to restore the pair or set to its value before the loss or damage; or b. Pay the difference between the value of the pair or set before and after the loss or damage. 2. Parts In case of loss or damage to any part of Cov- ered Property consisting of several parts when complete, we will only pay for the value of the lost or damaged part. Recovered Property If either you or we recover any property after loss settlement, that party must give the other prompt notice. At your option, the property will be re- turned to you. You must then return to us the amount we paid to you for the property. We will pay recovery expenses and the expenses to re- pair the recovered property, subject to the Limit of Insurance. Reinstatement Of Limit After Loss The Limit of Insurance will not be reduced by the payment of any claim, except for total loss or damage of a scheduled item, in which event we will refund the unearned premium on that item. Transfer Of Rights Of Recovery Against Oth- ers To Us If any person or organization to or for whom we make payment under this Coverage Part 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: 1. Prior to a loss to your Covered Property. 2. After a loss to your Covered Property only if, at time of loss, that party is one of the follow- ing: a. Someone insured by this insurance; or b. A business firm: (1) Owned or controlled by you; or (2) That owns or controls you. This will not restrict your insurance. GENERAL CONDITIONS A. Concealment, Misrepresentation Or Fraud This Coverage Part is void in any case of fraud, intentional concealment or misrepresentation of a material fact, by you or any other insured, at any time, concerning: 1. This Coverage Part; 2. The Covered Property; 3. Your interest in the Covered Property; or 4. A claim under this Coverage Part. B. Control Of Property Any act or neglect of any person other than you beyond your direction or control will not affect this insurance. The breach of any condition of this Coverage Part at any one or more locations will not affect cover- age at any location where, at the time of loss or damage, the breach of condition does not exist. C. Legal Action Against Us No one may bring a legal action against us under this Coverage Part unless: 1. There has been full compliance with all the terms of this Coverage Part; and 2. The action is brought within 2 years after you first have knowledge of the direct loss or damage. D. No Benefit To Bailee No person or organization, other than you, having custody of Covered Property will benefit from this insurance. E. Policy Period, Coverage Territory We cover loss or damage commencing: 1. During the policy period shown in the Decla- rations; and 2. Within the coverage territory. F. Valuation The value of property will be the least of the fol- lowing amounts: 1. The actual cash value of that property; Page 2 of 3 Copyright, ISO Properties, Inc., 2003 CM 00 0109 04 2. The cost of reasonably restoring that property to its condition immediately before loss or damage; or 3. The cost of replacing that property with sub- stantially identical property. In the event of loss or damage, the value of prop- erty will be determined as of the time of loss or damage. CM 00 0109 04 Copyright, ISO Properties, Inc., 2003 Page 3 of 3 COMMON POLICY CONDITIONS All Coverage Parts included in this policy are subject to the following conditions. A. Cancellation 1. The first Named Insured shown intheDeclara- tions may cancel this policy by mailing or deliv- ering to us advance written notice of cancella- tion. 2. We may cancel this policy by mailing or deliv- ering to the first Named Insured written notice of cancellation at least: a. 10 days before the effective date of cancel- lation if we cancel for nonpayment of pre- mium; or b. 30 days before the effective date of cancel- lation if we cancel for any other reason. 3. We will mail or deliver our notice to the first Named Insured's last mailing address known to us. 4. Notice of cancellation will state the effective date of cancellation. The policy period will end on that date. D. Inspections And Surveys 1. We have the right to: a. Make inspections and surveys at anytime; b. Give you reports on the conditions we find; and c. Recommend changes. 2. We are not obligated to make any inspections, surveys, reports or recommendations and any such actions we do undertake relate only to insurability and the premiums to be charged. We do not make safety inspections. We do not undertake to perform the duty of any person or organization to provide forthe health or safety of workers orthe public. And we do notwarrant that conditions: a. Are safe or healthful; or b. Comply with laws, regulations, codes or standards. 5. If this policy is cancelled, we will send the first 3. Paragraphs 1. and 2. of this condition apply not Named Insured any premium refund due. If we only to us, but also to any rating, advisory, rate cancel, the refund will be pro rata. If the first service or similar organization which makes in- Named Insured cancels, the refund maybe less surance inspections, surveys, reports or rec- than pro rata. The cancellation will be effective ommendations. even if we have not made or offered a refund. 6. If notice is mailed, proof of mailing will be suffi- cient proof of notice. B. Changes This policy contains all the agreements between you and us concerning the insurance afforded. The first Named Insured shown in the Declarations is authorized to make changes in the terms of this policywith ourconsent. This policy's terms can be amended orwaived only by endorsement issued by us and made a part of this policy. C. Examination Of Your Books And Records We may examine and audit your books and records as they relate to this policy at any time dur- ing the policy period and upto three years afterward. 4. Paragraph 2. of this condition does not applyto anyinspections, surveys, reports orrecommen- dations we may make relative to certification, under state or municipal statutes, ordinances or regulations, of boilers, pressure vessels or elevators. E. Premiums The first Named Insured shown in the Declarations: 1. Is responsible forthe payment of all premiums; and 2. Will be the payee for any return premiums we pay. Page 1 of IL 00 17 1198 Copyright, Insurance Services Office, Inc„ 1998 F. Transfer Of Your Rights And Duties U nderThis Policy Your rights and duties under this policy may not be transferred without ourwritten 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 acting within the scope of duties as your legal represen- tative. Until your legal representative is appointed, anyone having proper temporary custody of your propertywill have yourrights and duties butonlywith respect to that property. oo Page 2 of 2 IL 0017 1198 Copyright, Insurance Services ice, Inc., 1998 Builders Risk Coverage Form ZURICH Various provisions in this policy restrict coverage. Read the entire policy carefully to determine rights, duties and what is and is not covered. Throughout this policy, the words "you" and "your' refer to the Named Insured shown in the Declarations. The words "we ", "us" and "our" refer to the Company providing this insurance. Words and phrases that appear in quotation marks have special meaning. Refer to Section F. DEFINITIONS. Coverage provided by Coverage Form is also subject to all Conditions in the Common Policy Conditions and Commercial Inland Marine Conditions forms. A. COVERAGE We will pay for direct physical loss or damage to Covered Property from any Covered Cause of Loss described in this Coverage Form. 1. Covered Property, as used in the Coverage Form, means: Property which has been installed, or is to be installed in any "commercial structure' or any one to four family dwelling, private garage or other structure that will be used to service the "commercial structure' or one to four family dwelling at the location which you have reported to us. This includes: a. Your property; b. Property of others for which you are legally responsible; c. Paving, curbing, fences and outdoor fixtures; d. Trees, shrubs, plants and lawns installed by you or on your behalf; e. Completed single family dwelling which is being used as a Model Home when reported to us as such on monthly reports with an amount shown; and f. Foundations of buildings and foundations of structures in the course of construction. 2. Property Not Covered Covered Property does not include: a. Existing buildings or structures to which an addition, alteration, improvement, or repair is being made, unless specifically endorsed; b. Plans, blueprints, designs or specifications, except as provided in paragraph A.4. Additional Coverage of this Coverage Form; c. Land and water; d. "Existing inventory", unless specifically endorsed; e. Contractors tools and equipment. 3. Covered Cause Of Loss Covered Cause of Loss means risk of direct physical loss or damage to Covered Property, except those causes of loss listed in Section B. EXCLUSIONS. 4. Additional Coverages a. Collapse Includes copyrighted material of Insurance Services Office, Inc., with its permission 40471 (04 -09) Page 1 of 12 We will pay for direct physical loss or damage to Covered Property, caused by collapse of all or part of a building or structure insured under this Coverage Form, if the collapse is caused by one or more of the following: (1) Fire; lightning; windstorm; hail; explosion; smoke; aircraft; vehicles, riots; civil commotion; vandalism; breakage of glass; falling objects; weight of snow, ice or sleet; or "water damage'; but only if the causes of loss are otherwise covered in this Coverage Form; (2) Hidden decay; (3) Hidden insect or vermin damage; (4) Weight of people or personal property; (5) Weight of rain that collects on a roof; (6) Use of defective materials or methods in construction, remodeling or renovation if the collapse occurs during the course of the construction, remodeling or renovation. This Additional Coverage does not increase the Limits of Insurance provided in the Coverage Form. b. Scaffolding, Construction Forms And Temporary Structures (1) We will pay for direct physical loss or damage which is caused by or results from a Covered Cause of Loss, to scaffolding, construction forms and temporary structures, including fully enclosed office and fully enclosed tool trailers, but only while they are at a construction site you have reported to us. The most we will pay under this Additional Coverage is the amount shown in the Supplemental Declarations for Scaffolding, Construction Forms And Temporary Structures. (2) We will also pay for the cost of re- erection of the scaffold if the loss or damage of the scaffolding is caused by or results from a Covered Cause of Loss. The most we will pay under this Additional Coverage is the amount shown in the Supplemental Declarations for Re- erection Of Scaffolding. No deductible applies to this Additional Coverage. c. Debris Removal We will pay your expenses to remove debris of Covered Property. This debris must result from a Covered Cause of Loss under this Coverage Form. The expenses will be paid only if they are reported to us in writing within 180 days of the date of direct physical loss or damage. If the sum of the loss or damage and debris removal expenses exceeds the limit of insurance applicable to the property, we will pay an additional amount of debris removal expenses you incur in excess of the limit of insurance applicable to the property up to, but not exceeding the amount shown in the Supplemental Declarations for Debris Removal. This Additional Coverage does not apply to costs to: (1) Extract "pollutants" from land or water; or (2) Remove, restore or replace polluted land or water. No deductible applies to this Additional Coverage. d. Back -Up Or Overflow Of Sewers, Drains Or Sumps We will pay for loss or damage to Covered Property caused by water that backs up or overflows from a sewer, drain or sump from within the reported location. The most we will pay under this Additional Coverage is the amount shown in the Supplemental Declarations for Back -Up Or Overflow Of Sewers, Drains Or Sumps. No deductible applies to this Additional Coverage. e. Fire Department Service Charge When the fire department is called to save or protect Covered Property from a Covered Cause of Loss, we will pay for your liability for the fire department service charges which are: (1) Assumed by contract or agreement prior to loss or damage; or 40471 (04 -09) Page 2 of 12 Includes copyrighted material of Insurance Services Office, Inc., with its permission. (2) Required by local ordinance. The most we will pay under this Additional Coverage is the amount shown in the Supplemental Declarations for Fire Department Service Charge. No deductible applies to this Additional Coverage. f. Valuable Papers And Records We will pay for direct physical loss or damage to "valuable papers and records' caused by or resulting from a Covered Cause of Loss. The value will be based on the blank materials for reproducing the records and labor to transcribe or copy the records when there is a duplicate. When there is no duplicate, we will pay the costs to research, replace, restore or reproduce the lost information on lost or damaged "valuable papers and records'. The most we will pay under this Additional Coverage is the amount shown in the Supplemental Declarations for Valuable Papers And Records. No deductible applies to this Additional Coverage. g. Pollutant Clean -Up And Removal We will pay your expense to extract "pollutants" from land or water at locations reported to us if the discharge, dispersal, seepage, migration, release or escape of the "pollutants' is caused by or results from a Covered Cause of Loss that occurs during the policy period. The expenses will be paid only if they are reported to us in writing within 180 days of the date on which the Covered Cause of Loss occurs. This Additional Coverage does not apply to costs to test for, monitor, or assess the existence, concentration or effects of "pollutants'. But we will pay for testing which is performed in the course of extracting the "pollutants" from land or water. The most we will pay under this Additional Coverage is the amount shown on the Supplemental Declarations for Pollutant Clean -Up And Removal for the sum of all expenses which are incurred as a result of all Covered Causes of Loss during each separate 12 month period from the effective date of the policy. No deductible applies to this Additional Coverage. h. Ordinance Or Law— Direct Damage (1) Coverage For Loss To Undamaged Portion Of The Building Or Structure (a) If a Covered Cause of Loss occurs to Covered Property at the construction site reported to us, we will pay for loss or damage to the undamaged portion of the property as a consequence of enforcement of any ordinance or law that: (i) Requires the demolition of parts of the same property not damaged by a Covered Cause of Loss; (ii) Regulates the construction or repair of property, or establishes zoning or land use requirements at the construction site; and (it!) Is in force at the time of loss or damage. (b) Coverage for loss or damage to the undamaged portion of the structure is included within the applicable limit of insurance for that location at the construction site. This only applies when the ordinance or law went into effect after the start of the construction of the structure or dwelling. (2) Demolition Cost Coverage (a) If a Covered Cause of Loss occurs to Covered Property at the construction site reported to us, we will pay the cost to demolish and clear the construction site of undamaged parts of the property, caused by enforcement of building, zoning or land use ordinance or law. (b) The most we will pay for Demolition Cost is the amount of loss or damage or the amount shown in the Supplemental Declarations for Demolition Cost Coverage, whichever is less. 40471 (04 -09) Page 3 of 12 Includes copyrighted material of Insurance Services Office, Inc., with its permission. (3) Increased Cost Of Construction Coverage (a) If a Covered Cause of Loss occurs to Covered Property at the construction site reported to us, we will pay for the increased cost necessary to repair or reconstruct the damaged portions of that Covered Property when the increased cost is a consequence of enforcement of building, zoning or land use ordinance or law. If the Covered Property is repaired or rebuilt, it must be intended for the same occupancy as the property prior to the loss or damage, unless otherwise required by zoning land use ordinance or law. (b) If the ordinance or law requires relocation to another site, we will pay the increased cost of construction at the new site as set forth below in paragraph (c) below. (c) The most we will pay for Increased Cost of Construction Coverage is the amount of loss or damage or the amount shown in the Supplemental Declarations for Increased Cost Of Construction Coverage, whichever is less. (4) The most we will pay in total for Demolition Cost Coverage and Increased Cost of Construction Coverage for loss or damage from any one occurrence is the limit shown in the Supplemental Declarations for Combined Aggregate For Demolition Cost And Increased Cost Of Construction. (5) We will not pay under: (a) Coverage For Loss To The Undamaged Portion Of The Building Or Structure; (b) Demolition Cost Coverage; or (c) Increased Cost Of Construction Coverage for costs associated with the enforcement of any ordinance or law which requires any insured or others to test for, monitor, clean up, remove, contain, treat, detoxify or neutralize, or in any way respond to or assess the effects of "pollutants ". (6) In the event that this policy is endorsed to provide coverage for existing buildings or structures, or the policy covers renovation, remodeling or other work being done on such buildings or structures, this Additional Coverage shall not apply to such buildings or structures. I. Preservation Of Property If it is necessary to move Covered Property from the location reported to us or described on the Declarations, to preserve it from loss or damage by a Covered Cause of Loss, we will pay for any direct physical loss or damage to that property: (1) While it is being moved or while temporarily stored at another location; and (2) Only if the loss or damage occurs within 30 days after the property is first moved. This Additional Coverage is part of, and not in addition to, the Limit of Insurance applicable to the Covered Property. j. Rewards At our option, we may reimburse you for rewards you pay, other than to you, your partners or officers, for information which leads to the conviction of any one or more persons responsible for loss or damage covered under this Coverage Form. We will be the sole judge as to the payment and amount of reimbursement. The most we will pay for this Additional Coverage is the amount shown in the Supplemental Declarations for Rewards. k. Property At A Temporary Storage Location (1) We will pay for direct physical loss or damage caused by a Covered Cause of Loss to Covered Property while temporarily in storage at a location other than a location which you have reported to us. (2) We will not pay under this Additional Coverage for property in storage if the property has not been specifically allocated to or otherwise identified with a covered building or structure. 40471 (04 -09) Page 4 of 12 Includes copyrighted material of Insurance Services Office, Inc., with its permission. (3) The most we will pay for this Additional Coverage is the amount shown in the Supplemental Declarations for Property At A Temporary Storage Location. I. Property In Transit We will pay for direct physical loss or damage caused by a Covered Cause of Loss to Covered Property while in transit. The most we will pay for this Additional Coverage is the amount shown in the Supplemental Declarations for Property In Transit. B. EXCLUSIONS 1. We will not pay for a loss or damage caused directly or indirectly by any of the following. Such loss or damage is excluded regardless of any other cause or event that contributes concurrently or in any sequence to the loss or damage. a. Governmental Action Seizure or destruction of property by order of any governmental authority. But we will pay for acts of destruction ordered by governmental authority and taken at the time of a fire to prevent its spread, if that fire would be covered under this Coverage Form. b. Nuclear Hazard Nuclear reaction or radiation, or radioactive contamination, however caused. But if nuclear reaction or radiation contamination results in fire, we will pay for the loss or damage caused by that fire. c. War And Military Action (1) War, including undeclared or civil war; (2) Warlike action by a military force, including action hindering or defending against an actual or expected attack by any government sovereign or other authority using military personnel or other agents; or (3) Insurrection, rebellion, revolution, usurped power or action taken by government authority in hindering or defending against any of these. d. Earth Movement (1) Any earth movement (other than sinkhole collapse), such as an earthquake, landslide, mine subsidence or earth sinking, rising or shifting. But if earth movement results in fire or explosion, we will pay for the loss or damage caused by that fire or explosion. (2) Volcanic Action Volcanic eruption, explosion or effusion. But if volcanic eruption, explosion or effusion results in fire, building glass breakage or volcanic action, we will pay for the loss or damage caused by that fire, building glass breakage or volcanic action. Volcanic action means direct loss or damage resulting from the eruption of a volcano when the loss or damage is caused by: (a) Airborne volcanic blast or airborne shock waves; (b) Ash, dust or particulate matter; or (c) Lava flow. All volcanic eruptions that occur within any 168 hour period will constitute a single occurrence. Volcanic action does not include the cost to remove ash, dust or particulate matter that does not cause direct physical loss or damage to the described property. This exclusion does not apply to Covered Property while in transit. e. Water Includes copyrighted material of Insurance Services Office, Inc., with its permission. 40471 (04 -09) Page 5 of 12 (1) Flood, surface water, waves, tides, tidal waves, overflow of any body of water or their spray, all whether driven by wind or not; (2) The interior of any building or structure caused by or resulting from rain, snow, sleet, ice, sand or dust, whether driven by wind or not, unless: (a) The building or structure first sustains damage by a Covered Cause of Loss to its roof or walls through which the rain, snow, sleet, ice, sand or dust enters; or (b) The loss or damage is caused by or results from thawing of snow, sleet or ice on the building or structure. (3) Mudslide or mudflow; (4) Water that backs up or overflows from a sewer, drain or sump, except as provided in the Back -Up Or Overflow Of Sewers, Drains Or Sumps Additional Coverage; (5) Water under the ground surface pressing on, or flowing or seeping through: (a) Foundations, walls, floors or paved surfaces; (b) Basements, whether paved or not; or (c) Doors, windows or other openings. But if water, as described in e.(1) through e.(5) above, results in fire, explosion or sprinkler leakage, we will pay for the loss or damage caused by that fire, explosion or sprinkler leakage. 2. We will not pay for a loss or damage caused by or resulting from any of the following: a. Delay, loss of use, or loss of market. This does not include "profit' if reported in compliance with the Reporting Provisions Additional Condition; b. Dishonest or criminal acts by you, any of your partners, employees or leased employees, directors, trustees, authorized representatives or anyone to whom you entrust the property for any purpose. This exclusion applies: (1) While acting alone or in collusion with others; or (2) Whether or not occurring during the hours of employment. This exclusion does not apply to acts of destruction by your employees or leased employees; but theft by employees or leased employees is not covered. This exclusion does not apply to Covered Property while it is entrusted to others who are carriers for hire. c. Unexplained or mysterious disappearance except for property in custody of a carrier for hire. d. Shortage of property found on taking inventory. e. Penalties for noncompliance with contract conditions. f. Collapse, except as provided in the Collapse Additional Coverage. g. (1) Wear and tear; (2) Any quality in the property itself that causes it to damage or destroy itself; or that causes gradual deterioration; (3) Insects, vermin, rodents; (4) Corrosion, rust, fungus, mold, mildew, rot; (5) Dampness, changes in or extremes of temperatures, freezing; However, we will cover freezing loss or damage to property in the building reported to us, if you have shut off the water supply and drained the plumbing systems and appliances or made a reasonable effort to maintain heat in the building. (6) Settling, cracking, shrinking, or expansion of any Covered Property. 40471 (04 -09) Page 6 of 12 Includes copyrighted material of Insurance Services Office, Inc., with its permission. h. Rain, snow, sleet, sand or dust if Covered Property is in the open. This does not apply to Covered Property in the custody of a carrier for hire. I. Artificially generated electrical current; mechanical breakdown; rupturing or bursting caused by centrifugal force. j. Testing, start-up, commissioning, examination or trial of Covered Property such as boilers, ovens, stoves, turbines, pumps, process equipment or equipment of a similar nature to prove their ability or function. This includes any form of testing making use of feedstock, including operational tests, performance tests, or other tests performed in conjunction with such testing. This exclusion does not apply to "electrical testing ", "mechanical testing", "pneumatic testing" or "hydrostatic testing" used in the start-up and testing of building systems that are intended to service a building. 3. We will not pay for loss or damage caused by or resulting from any of the following. But if loss or damage by a Covered Cause of Loss results, we will pay for the resulting loss or damage caused by that Covered Cause of Loss. a. Weather conditions which contribute in any way to a cause or event excluded in paragraph 1. above to produce the loss or damage. b. Acts or decisions, including the failure to act or decide, of any person, group, or organization representing a governmental, regulatory or controlling body. c. Faulty, inadequate or defective: (1) Planning, zoning, development, surveying, siting; (2) Design, specifications, workmanship, repair, construction, renovation, remodeling, grading, compaction; (3) Materials used in repair, construction, renovation or remodeling; or (4) Maintenance of all or part of any Covered Property wherever located. d. The discharge, dispersal, seepage, migration, release or escape of "pollutants', except as provided under Pollutant Clean -Up And Removal Additional Coverage, C. LIMITS OF INSURANCE The most we will pay for loss or damage to any one building or structure is the lesser of the Limit of Insurance shown in the Declarations for that one building or structure or the "total estimated completed value' that was reported to us for that one building or structure. The most we will pay for loss or damage in any one occurrence is the limit shown in the Declarations for all Covered Property at all locations. D. DEDUCTIBLE We will not pay for loss or damage until the amount of covered loss or damage exceeds the Deductible shown in the Declarations. We will then pay the amount of the covered loss or damage which exceeds the Deductible, up to the applicable Limit of Insurance. E. ADDITIONAL CONDITIONS The following conditions apply in addition to the Common Policy Conditions and the Commercial Inland Marine Conditions: 1. Coverage Territory The coverage territory is United States of America (including its territories and possessions) and Canada. 2. Where Coverage Applies This coverage applies to Covered Property while within the coverage territory while: a. At any construction site you have reported; b. Temporarily at other premises, if the property has been designated to be installed at a location you have reported to us; or 40471 (04 -09) Page 7 of 12 Includes copyrighted material of Insurance Services Office, Inc., with its permission. c. In transit except imports or exports while ocean marine coverage applies. 3. When Coverage Begins And Ends We will cover risk of loss or damage from the time when you are legally responsible for the Covered Property on or after the effective date of this policy if all other conditions are met. Coverage will end at the earliest of the following: a. Once your interest in the Covered Property ceases; b. Ninety days after initial occupancy of the Covered Property unless: (1) That building is being used as a model home; (2) That building is being remodeled and is a single family dwelling; or (3) That building is being used as a "model home leaseback ". c. When the Covered Property is leased to or rented to others: (1) For a single family dwelling, when the building is leased or rented to others; (2) For a two, three or four family dwelling, when 50% or more of the units in the structure are leased to or rented to others; or (3) For a "commercial structure ", when 75% or more of the square footage space is leased to or rented to others. This does not apply to pre - leases established prior to construction. d. When you abandon the reported location with no intention to complete it; e. At the end of 12 months from the month when you first reported the location to us unless you report the location again and pay an additional premium. If the location is reported again and the additional premium is paid, coverage will end at the end of 12 months from the month when you re- reported the location to us as described in the Reporting Provisions Additional Condition. You have the option to report the same location a third time at the end of the second 12 month period, provided the required additional premium is paid. Coverage for this third 12 month term will end at the end of 12 months from the month you re- reported the location for a third term; Coverage for existing buildings or structures that are being or have been remodeled: At the end of 12 months from the month when you first reported the location to us unless you report the location again and pay an additional premium. If the location is reported again and the additional premium is paid, coverage will end at the end of 12 months from the month when you re- reported the location to us as described in the reporting provision below. There is no option to report a third year. f. When permanent property insurance applies; or g. Once the Covered Property is accepted by the owner or buyer. 4. Reporting Provisions a. Each month you must report to us the "total estimated completed values' of all Covered Property for each location started during,the previous month. This report'must be made on the form we provide. For the purpose of these reports, a location is started when you first put any building materials (including the foundation) on the construction site. If your policy is endorsed to provide coverage for existing structures that you are renovating or adding onto and for which you seek coverage, a location is started on the earlier of the following: (1) When you first put any building materials, which includes any new, altered or expanded foundation, on the site; or (2) When you acquire title to the existing structure. b. You must pay premiums based on the "total estimated completed value' of the Covered Property using the rate we furnish. You must send your premium payment with the report for the reported locations to be 40471 (04 -09) Page 8 of 12 Includes copyrighted material of Insurance Services Office, Inc., with its permission. covered. We must receive your report and the accompanying premium payments at the address designated in our form by the last business day of the month in which the report is due, or the report is late. c. If a report is received late, coverage begins on the day the report is received, and there is no coverage for any loss or damage that occurred before that report was received. Our acceptance of a report of values and premium payment does not waive or change any part of this policy nor stop us from asserting any right we have under the terms of this policy. d. The premium charged is fully earned and no refund is due you when coverage ends. e. A dwelling being used as a Model Home must be reported and should be identified as a Model Home. L You will keep accurate construction records regarding property we cover under this policy. This includes the "total estimated completed value" of the Covered Property and a record of all contracts of sale dealing with the Covered Property. g. If at the end of 12 months from the time you first reported a start to us, you still have that location in your inventory, you may report that location to us a second time. If at the end of the second 12 months from the time you first reported a start to us and you still have that location in your inventory, you may report that location to us a third time. Coverage for existing buildings or structures that are being or have been remodeled: If at the end of 12 months from the time you first reported a start to us, you still have that location in your inventory, you may report that location to us a second time. There is no option to report a third time (year). h. Cancellation Of this policy will not affect the insurance in force on any location which you have reported to us or on any location which started before the effective date of the cancellation notice if that location is reported on the report due and premium payment is made. However, you cannot report any location currently in your inventory a second time after the effective date of cancellation. However, coverage may be canceled on any location if notice is given in writing in accordance with the cancellation provision in the Common Policy Conditions, or state amendatory endorsements. 5. Mortgage Holders Clause a. The term mortgage holder includes trustees. b. We will pay for covered loss or damage to Covered Property to each mortgage holder shown on a Certificate of Insurance issued by the current Agent of Record. c. The mortgage holder has the right to receive payment for loss or damage even if the mortgage holder has started foreclosure or similar action on the Covered Property. d. If we deny your claim because of your acts or because you have failed to comply with the terms of this Coverage Part, the mortgage holder will still have the right to receive payment for loss or damage to Covered Property if the mortgage holder: (1) Pays any premium due under this Coverage Part at our request if you have failed to do so; (2) Submits a signed, sworn proof of loss within 60 days after receiving notice from us of your failure to do so; (3) Has notified us of any change in ownership, occupancy or substantial change in risk known to the mortgage holder. All of the terms of this Coverage Part will then apply directly to the mortgage holder. e. If we pay the mortgage holder for any loss or damage and deny payment to you because of your acts or because you have failed to comply with the terms of this Coverage Part: (1) The mortgage holder's rights under the mortgage will be transferred to us to the extent of the amount we pay; and (2) The mortgage holder's rights to recover the full amount of the mortgage holder's claim will not be impaired. 40471 (04 -09) Page 9 of 12. Includes copyrighted material of Insurance Services Office, Inc., with its permission. 6. 7 At our option, we may pay to the mortgage holder the whole principal on the mortgage plus any accrued interest. In this event, your mortgage and note will be transferred to us and you will pay your remaining mortgage debt to us. f. If we cancel this policy, we will give written notice to the mortgage holder at least: (1) 10 days before the effective date of cancellation if we cancel for non- payment of premium; or (2) 30 days before the effective date of cancellation if we cancel for any other reason. g. We will not notify the mortgage holder if: (1) You cancel this policy, or (2) Coverage ends for any reason other than if we cancel the policy. Waiver Of Coinsurance If there is loss or damage to Covered Property and the cost to repair or replace such property is less than or equal to $25,000, we will adjust the loss or damage without regard to the Coinsurance Additional Condition. Coinsurance If the reported value is less than the "total estimated completed value', you will bear a portion of any loss or damage. The amount we will pay is determined by the following steps: a. Divide the reported value by the "total estimated completed value' of the Covered Property; b. Multiply the total amount of the covered loss or damage before the application of any deductible by the percentage determined in paragraph a.; c. Subtract the deductible from the figure determined in paragraph b. Example No. 1 (This example assumes there is no penalty for underinsurance.) Deductible $1,000 Reported Value $100,000 "Total Completed Estimated Value" $100,000 Amount of loss or damage $60,000 a. Reported value divided by "total estimated completed value" $100,000/$100,000 = 1.00 b. Amount of loss or damage multiplied by percentage in paragraph a. $60,000 x 1.00 = $60,000 c. Deductible amount subtracted from result of paragraph b. $60,000 - $1,000 = $59,000 Example No. 2 (This example assumes there is a penalty for underinsurance) Deductible $1,000 Reported Value $100,000 "Total estimated completed value" $120,000 Amount of loss or damage $60,000 a. Reported value divided by "total estimated completed value' $100,000/$120,000 =.833 40471 (04 -09) Page 10 of 12 Includes copyrighted material of Insurance Services Office, Inc., with its permission. b. Amount of loss or damage multiplied by percentage in paragraph a. $60,000 x.833 = $49,980 c. Deductible amount Subtracted from result of paragraph b. $49,980 - $1,000 = $48,980 8. Liberalization Clause If we adopt any revision which would broaden the coverage under this Coverage Form without additional premium within 60 days prior to or during the policy period, the broadened coverage will immediately apply to this policy. 9. Interest Of Subcontractors, Sub - Subcontractors, Suppliers We cover the interest which your subcontractors, your sub - subcontractors and your suppliers have in the Covered Property, but only while such property is situated at a construction site you have reported to us. This condition does not impair any right of subrogation we would otherwise have. 10. Unintentional Failure To Disclose Hazards Your failure to disclose all hazards existing as of the inception date of the policy shall not affect the coverage afforded by this policy, provided such failure to disclose all hazards is not intentional and the hazard is reported to us as soon as practicable after you learn about it. F. DEFINITIONS 1. "Commercial structure" means any structure other than a one to four family dwelling. 2. "Electrical testing" means the testing of systems that are operated by electricity, excluding service equipment and service conductors, electrical systems greater than 600 volts nominal and electrical systems that are greater than single phase. 3. "Existing inventory" means buildings or structures in the course of construction that are more than 30% complete prior to the inception date of this policy. 4. "Hydrostatic testing" means testing through the use of water or other fluids, which are processed through the machinery or system being tested. 5. "Mechanical testing' means testing of moving parts of equipment and components, which are part of the buildings or structures insured, by operation of such equipment or components. 6. "Model home leaseback" means a dwelling purchased from the Insured and is then leased back to the Insured, by the purchaser, to be used by the Insured as a model home until the purchaser occupies the dwelling as a residence. 7. "Overhead" means those business expenses, other than materials and labor, incurred either directly or indirectly due to the construction of a dwelling or structure. 8. "Pollutants' mean any solid, liquid, gaseous or thermal irritant or contaminant, including smoke, vapor, soot fumes, acids, alkalis, chemicals and waste. Waste includes materials to be recycled, reconditioned or reclaimed. 9. "Pneumatic testing' means testing through the use of compressed air or other gas to fill test cavities which is processed through the machinery or system being tested. 10. 'Profit' means the difference between the selling price of the land and completed structure and your cost of the land and the completed structure. If you do not have a signed contract for the sale of the completed structure and land, the allowance for "profit" will not exceed 20 %. 11. 'Total estimated completed value' means all costs associated with the building and designing of the Covered Property including labor, "overhead" and materials and if included, "profit'. 12. "Valuable papers and records' means inscribed, printed or written documents, manuscripts or records, including abstracts, books, deeds, drawings, films, maps or mortgages. However, "valuable papers and records" does not mean: a. Money or securities; 40471 (04 -09) Page 11 of 12 Includes copyrighted material of Insurance Services Office, Inc., with its permission. b. Converted data, c. Programs or instructions used in your data processing operation, including the materials on which the data is recorded. 13. "Water damage' means accidental discharge or leakage of water or steam as the direct result of the breaking apart or cracking of any part of a system or appliance (other than a sump system including its related equipment and parts) containing water or steam. 40471 (04 -09) Page 12 of 12 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Non - Reporting Endorsement ZURICH THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the: BUILDERS RISK COVERAGE FORM Section E. ADDITIONAL CONDITIONS is amended as follows: 1. Paragraph e. of Additional Condition 3. When Coverage Begins And Ends is replaced by the following: e. Upon expiration of the policy. 2. Additional Condition 4. Reporting Provisions is replaced by the following: 4. Reporting Provisions a. The premium charged is fully earned and no refund is due to you when coverage ends. b. You will keep accurate construction records regarding property we cover under this policy. This includes the "total estimated completed value" of the property and a record of all contracts of sale dealing with the property. 3. Additional Condition 7. Coinsurance is replaced by the following: 7. Coinsurance If the limit of insurance is less than the "total estimated completed value' of the property insured, you will bear a portion of any loss. The amount we will pay is determined by the following steps: a. Divide the limit of insurance by the "total estimated completed value' of the Covered Property, b. Multiply the total amount of the covered loss, before the application of any deductible, by the percentage determined in paragraph a.; c. Subtract the deductible from the figure determined in paragraph b. Example No 1. (This example assumes there is no penalty for underinsurance.) Deductible $1,000 Reported value $100,000 'Total Completed Estimated Value' $100,000. Amount of loss or damage $60,000 a. Limit of Insurance/Total Estimated Completed Value $100,000/$100,000 = 1.00 b. Amount of loss x percentage in A $60,000 x 1.00 = $60,000 c. Deductible amount subtracted from results in B HBIS -1 (04 -09) Page 1 of 2 Includes copyrighted material of Insurance Services Office, Inc., with its permission. $60,000 - $1,000 = $59,000 Total amount of loss payable = $59,000 Example No. 2 (This example assumes there is a penalty for underinsurance.) Deductible $1,000 Limit of Insurance $100,000 "Total Completed Estimated Value" $120,000 Amount of loss $60,000 a. Limit of Insurance/Total Estimated Completed Value $100,000/$120,000 = .833 b. Amount of loss x percentage in A $60,000 x.833 = $49,980 c. Deductible amount subtracted from results in B $49,980 - $1,000 = $48,980 Total amount of loss payable = $48,980 All other terms, conditions, provisions and exclusions of the policy remain the same. HBIS -1 (04 -09) Page 2 of 2 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Contract Change Order Coverage ZURICH THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the: BUILDERS RISK COVERAGE FORM The following is added to Section A. COVERAGE, Paragraph 4. Additional Coverages: Contract Change Order Coverage In the event of a total loss or damage, we will pay up to an additional 10 % of the Limits of Insurance, not to exceed $ 31_263 per total loss or damage, to cover increases in the cost of labor or materials or changes in construction specifications provided such increases are evidenced by change orders signed prior to the total loss or damage, or made necessary by an escalation clause within a construction contract signed prior to the total loss or damage. We will not pay under this Additional Coverage: (1) Until the property is actually repaired or replaced, at the same or another premises; and (2) Unless the repairs or replacement are made as soon as reasonably possible after the total loss or damage but no longer than 365 days from the date of the total loss or damage. This Additional Coverage does not ever apply to the increased costs incurred to comply with an ordinance or law. All other terms, conditions, provisions and exclusions of this policy remain the same. HBIS -78 (04 -09) Page 1 of 1 Changes In Cancellation Condition Q ZURICH THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the: BUILDERS RISK COVERAGE FORM Paragraph 5. in the Cancellation Common Policy Condition is replaced by the following: 5. The premium for this coverage is fully earned and no refund is due when the policy is cancelled. All other terms, conditions, provisions and exclusions of the policy remain the same. HBIS -83 (04 -09) Page 1 of 1 Includes copyrighted material of Insurance Services Office, Inc. with its permission. Changes In Valuation Condition ZURICH THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the: BUILDERS RISK COVERAGE FORM The Valuation General Condition in Commercial Inland Marine Conditions is replaced by the following: Valuation In the event of loss or damage, the value of the property will be determined as of the time of the loss or damage. 1. The value of the property will not be more than the amount necessary to replace the structure or repair the structure, whichever is less, to the same point of completion that had been achieved immediately before the loss or damage. 2. If the loss or damage involves building materials which have not been installed, the value of the property will not be more than the amount necessary to replace the materials with like kind and quality. All other terms, conditions, provisions and exclusions of the policy remain the same. HBIS -84 (04 -09) Page 1 of 1 Deletion Of Coinsurance Condition ZURICH THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the: BUILDERS RISK COVERAGE FORM Additional Condition 7. Coinsurance is deleted in its entirety. All other terms, conditions, provisions and exclusions of this policy remain the same. HBIS -85 (04 -09) Page 1 of 1 IL 00 03 09 08 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CALCULATION OF PREMIUM This endorsement modifies insurance provided under the following: CAPITAL ASSETS PROGRAM (OUTPUT POLICY) COVERAGE PART COMMERCIAL AUTOMOBILE COVERAGE PART COMMERCIAL GENERAL LIABILITY COVERAGE PART COMMERCIAL INLAND MARINE COVERAGE PART COMMERCIAL PROPERTY COVERAGE PART CRIME AND FIDELITY COVERAGE PART EMPLOYMENT - RELATED PRACTICES LIABILITY COVERAGE PART EQUIPMENT BREAKDOWN COVERAGE PART FARM COVERAGE PART LIQUOR LIABILITY COVERAGE PART MEDICAL PROFESSIONAL LIABILITY COVERAGE PART OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAGE PART PRODUCTS /COMPLETED OPERATIONS LIABILITY COVERAGE PART RAILROAD PROTECTIVE LIABILITY COVERAGE PART The following is added: The premium shown in the Declarations was com- puted based on rates in effect at the time the policy was issued. On each renewal, continuation, or anni- versary of the effective date of this policy, we will compute the premium in accordance with our rates and rules then in effect. IL 0003 09 08 © ISO Properties, Inc., 2007 Page 1 of 1 Wolters Kluwer Financial Services I Uniform FormSTM IL 01 02 05 05 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CALIFORNIA CHANGES - ACTUAL CASH VALUE This endorsement modifies insurance provided under the following: CAPITAL ASSETS PROGRAM (OUTPUT POLICY) COVERAGE PART COMMERCIAL INLAND MARINE COVERAGE PART COMMERCIAL PROPERTY COVERAGE PART FARM COVERAGE PART STANDARD PROPERTY POLICY With respect to an "open policy ", the following are added to any provision which uses the term actual cash value: A. In the event of a total loss to a building or struc- ture, actual cash value is calculated as the lesser of the following: 1. The Limit of Insurance applicable to that building or structure; or 2. The fair market value of the building or struc- ture. B. In the event of a partial loss to a building or structure, actual cash value is calculated as the lesser of the following: 1. The amount it would cost to repair, rebuild or replace the property less a fair and reason- able deduction for physical depreciation of the components of the building or structure that are normally subject to repair or replacement during its useful life. Physical depreciation is based upon the condition of the property at the time of the loss; or 2. The Limit of Insurance applicable to the prop- erty. C. In the event of a partial or total loss to Covered Property other than a building or structure, actual cash value is calculated as the lesser of the fol- lowing: 1. The amount it would cost to repair or replace the property less a fair and reasonable de- duction for physical depreciation, based on the condition of the property at the time of loss; or 2. The Limit of Insurance applicable to the prop- erty. D. An "open policy' is a policy under which the value of Covered Property is not fixed at policy incep- tion, but is determined at the time of loss in ac- cordance with policy provisions on valuation. The term "open policy" does not apply to Covered Property that is subject to an Agreed Value clause or similar clause that establishes an agreed value prior to loss, unless such clause has expired. IL 01 02 05 05 Copyright, ISO Properties, Inc., 2005 Page 1 of 1 UNIFORM IL 0104 09 07 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CALIFORNIA CHANGES This endorsement modifies insurance provided under the following: COMMERCIAL INLAND MARINE COVERAGE PART COMMERCIAL PROPERTY COVERAGE PART EQUIPMENT BREAKDOWN COVERAGE PART FARM COVERAGE PART— FARM PROPERTY— OTHER FARM PROVISIONS FORM — ADDITIONAL COVERAGES, CONDITIONS, DEFINITIONS FARM COVERAGE PART — LIVESTOCK COVERAGE FORM FARM COVERAGE PART— MOBILE AGRICULTURAL MACHINERY AND EQUIPMENT COVERAGE FORM STANDARD PROPERTY POLICY A. When this endorsement is attached to the Stan - dard Property Policy CP 00 99 the term Coverage Part in this endorsement is replaced by the term Policy. B. The Concealment, Misrepresentation Or Fraud Condition is replaced by the following with respect to loss ( "loss ") or damage caused by fire: We do not provide coverage to the insured ( "in- sured") who, whether before or after a loss ( "loss "), has committed fraud or intentionally con- cealed or misrepresented any material fact or cir- cumstance concerning: 1. This Coverage Part; 2. The Covered Property; 3. That insured's ( "insured's ") interest in the Covered Property; or 4. A claim under this Coverage Part or Cover- age Form. C. The Concealment, Misrepresentation Or Fraud Condition is replaced by the following with respect to loss ( "loss ") or damage caused by a Covered Cause of Loss other than fire: This Coverage Part is void if any insured ( "in- sured"), whether before or after a loss ( "loss "), has committed fraud or intentionally concealed or misrepresented any material fact or circumstance concerning: 1. This Coverage Part; 2. The Covered Property; 3. An insured's ( "insured's ") interest in the Cov- ered Property; or 4. A claim under this Coverage Part or Cover- age Form. D. Except as provided in E., the Appraisal Condition is replaced by the following: If we and you disagree on the value of the prop- erty or the amount of loss ( "loss "), either may make written request for an appraisal of the loss ( "loss "). If the request is accepted, each party will select a competent and impartial appraiser. Each party shall notify the other of the appraiser se- lected within 20 days of the request. The two ap- praisers will select an umpire. If they cannot agree within 15 days, either may request that se- lection be made by a judge of a court having ju- risdiction. The appraisers will state separately the value of the property and amount of loss ( "loss "). If they fail to agree, they will submit their differ- ences to the umpire. A decision agreed to by any two will be binding. Each party will: 1. Pay its chosen appraiser; and 2. Bear the other expenses of the appraisal and umpire equally. If there is an appraisal, we will still retain our right to deny the claim. E. The Appraisal Condition in: 1. Business Income (And Extra Expense) Cov- erage Form CP 00 30; and 2. Business Income (Without Extra Expense) Coverage Form CP 00 32; is replaced by the following: If we and you disagree on the amount of Net In- come and operating expense or the amount of loss, either may make written request for an ap- praisal of the loss. If the request is accepted, each party will select a competent and impartial appraiser. Each party shall notify the other of the appraiser selected within 20 days of the request. The two appraisers will select an umpire. If they cannot agree within 15 days, either may request that selection be made by a judge of a court having jurisdiction. The appraisers will state separately the amount of Net Income and operating expense or amount of loss. If they fail to agree, they will submit their differences to the umpire. A decision agreed to by any two will be binding. Each party will: IL 01 04 09 07 Copyright, ISO Properties, Inc., 2006 Page 1 of 2 Wolters Kluwer Financial services I Uniform Formsw a. Pay its chosen appraiser; and If there is an appraisal, we will still retain our right b. Bear the other expenses of the appraisal and to deny the claim. umpire equally. Page 2 of 2 Copyright, ISO Properties, Inc., 2006 IL 01 04 09 07 IL 02 70 08 11 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CALIFORNIA CHANGES - CANCELLATION AND NONRENEWAL This endorsement modifies insurance provided under the following: CAPITAL ASSETS PROGRAM (OUTPUT POLICY) COVERAGE PART COMMERCIAL AUTOMOBILE COVERAGE PART COMMERCIAL GENERAL LIABILITY COVERAGE PART COMMERCIAL INLAND MARINE COVERAGE PART COMMERCIAL PROPERTY COVERAGE PART CRIME AND FIDELITY COVERAGE PART EMPLOYMENT - RELATED PRACTICES LIABILITY COVERAGE PART EQUIPMENT BREAKDOWN COVERAGE PART FARM COVERAGE PART LIQUOR LIABILITY COVERAGE PART MEDICAL PROFESSIONAL LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAGE PART PRODUCTS /COMPLETED OPERATIONS LIABILITY COVERAGE PART A. Paragraphs 2., 3. and 5. of the Cancellation Common Policy Condition are replaced by the following: 2. All Policies In Effect For 60 Days Or Less If this policy has been in effect for 60 days or less, and is not a renewal of a policy we have previously issued, we may cancel this policy by mailing or delivering to the first Named Insured, at the mailing address shown in the policy, and to the producer of record, advance written notice of cancellation, stating the reason for cancellation, at least: a. 10 days before the effective date of cancellation if we cancel for: (1) Nonpayment of premium; or (2) Discovery of fraud by: (a) Any insured or his or her representative in obtaining this insurance; or (b) You or your representative in pursuing a claim under this policy. b. 30 days before the effective date of cancellation if we cancel for any other reason. 3. All Policies In Effect For More Than 60 Days a. If this policy has been in effect for more than 60 days, or is a renewal of a policy we issued, we may cancel this policy only upon the occurrence, after the effective date of the policy, of one or more of the following: (1) Nonpayment of premium, including payment due on a prior policy we issued and due during the current policy term covering the same risks. (2) Discovery of fraud or material misrepresentation by: (a) Any insured or his or her representative in obtaining this insurance: or (b) You or your representative in pursuing a claim under this policy. (3) A judgment by a court or an administrative tribunal that you have violated a California or Federal law, having as one of its necessary elements an act which materially increases any of the risks insured against. IL 02 70 08 11 © Insurance Services Office, Inc., 2010 Page 1 of 4 Wolters Kluwer Financial Services I Uniform Fo"STM (4) Discovery of willful or grossly negligent acts or omissions, or of any violations of state laws or regulations establishing safety standards, by you or your representative, which materially increase any of the risks insured against. (5) Failure by you or your representative to implement reasonable loss control requirements, agreed to by you as a condition of policy issuance, or which were conditions precedent to our use of a particular rate or rating plan, if that failure materially increases any of the risks insured against. (6) A determination by the Commissioner of Insurance that the: (a) Loss of, or changes in, our reinsurance covering all or part of the risk would threaten our financial integrity or solvency; or (b) Continuation of the policy coverage would: (i) Place us in violation of California law or the laws of the state where we are domiciled; or (ii) Threaten our solvency. (7) A change by you or your representative in the activities or property of the commercial or industrial enterprise, which results in a materially added, increased or changed risk, unless the added, increased or changed risk is included in the policy. b. We will mail or deliver advance written notice of. cancellation, stating the reason for cancellation, to the first Named Insured, at the mailing address shown in the policy, and to the producer of record, at least: (1) 10 days before the effective date of cancellation if we cancel for nonpayment of premium or discovery of fraud; or (2) 30 days before the effective date of cancellation if we cancel for any other reason listed in Paragraph 3.a. 5. If this policy is cancelled, we will send the first Named Insured any premium refund due. The refund, if any, will be computed on a pro rata basis. However, the refund may be less than pro rata if we made a loan to you for the purpose of payment of premiums for this policy. The cancellation will be effective even if we have not made or offered a refund. B. The following provision is added to the Cancellation Common Policy Condition: 7. Residential Property This provision applies to coverage on real property which is used predominantly for residential purposes and consisting of not more than four dwelling units, and to coverage on tenants' household personal property in a residential unit, if such coverage is written under one of the following: Commercial Property Coverage Part Farm Coverage Part — Farm Property — Farm Dwellings, Appurtenant Structures And Household Personal Property Coverage Form a. If such coverage has been in effect for 60 days or less, and is not a renewal of coverage we previously issued, we may cancel this coverage for any reason, except as provided in b. and c. below. b. We may not cancel this policy solely because the first Named Insured has: (1) Accepted an offer of earthquake coverage; or (2) Cancelled or did not renew a policy issued by the California Earthquake Authority (CEA) that included an earthquake policy premium surcharge. However, we shall cancel this policy if the first Named Insured has accepted a new or renewal policy issued by the CEA that includes an earthquake policy premium surcharge but fails to pay the earthquake policy premium surcharge authorized by the CEA. c. We may not cancel such coverage solely because corrosive soil conditions exist on the premises. This restriction (c.) applies only if coverage is subject to one of the following, which exclude loss or damage caused by or resulting from corrosive soil conditions: (1) Commercial Property Coverage Part — Causes Of Loss — Special Form; or (2) Farm Coverage Part — Causes Of Loss Form — Farm Property, Paragraph D. Covered Causes Of Loss — Special. Page 2 of 4 © Insurance Services Office, Inc., 2010 IL 02 70 08 11 C. The following is added and supersedes any (2) The Commissioner of Insurance finds provisions to the contrary: that the exposure to potential losses will Nonrenewal threaten our solvency or place us in a hazardous condition. A hazardous 1. Subject to the provisions of Paragraphs C.2. condition includes, but is not limited to, a and C.3. below, if we elect not to renew this condition in which we make claims policy, we will mail or deliver written notice, payments for losses resulting from an stating the reason for nonrenewal, to the first earthquake that occurred within the Named Insured shown in the Declarations, and preceding two years and that required a to the producer of record, at least 60 days, but reduction in policyholder surplus of at not more than 120 days, before the expiration least 25% for payment of those claims; or anniversary date. or We will mail or deliver our notice to the first (3) We have: Named Insured, and to the producer of record, (a) Lost or experienced a substantial at the mailing address shown in the policy. reduction in the availability or scope 2. Residential Property of reinsurance coverage; or This provision applies to coverage on real (b) Experienced a substantial increase property used predominantly for residential in the premium charged for purposes and consisting of not more than four reinsurance coverage of our dwelling units, and to coverage on tenants' residential property insurance household property contained in a residential policies; and unit, if such coverage is written under one of the Commissioner has approved a plan the following: for the nonrenewals that is fair and Commercial Property Coverage Part equitable, and that is responsive to the Farm Coverage Part — Farm Property — Farm changes in our reinsurance position. Dwellings, Appurtenant Structures And c. We will not refuse to renew such coverage Household Personal Property Coverage Form solely because the first Named Insured has a. We may elect not to renew such coverage cancelled or did not renew a policy, issued for any reason, except as provided in b., c. by the California Earthquake Authority, that and d. below. included an earthquake policy premium b. We will not refuse to renew such coverage surcharge. solely because the first Named Insured has d. We will not refuse to renew such coverage accepted an offer of earthquake coverage. solely because corrosive soil conditions However, the following applies only to exist on the premises. This restriction (d.) insurers who are associate participating applies only if coverage is subject to one of insurers as established by Cal. Ins. Code the following, which exclude loss or Section 10089.16. We may elect not to damage caused by or resulting from renew such coverage after the first Named corrosive soil conditions: Insured has accepted an offer of (1) Commercial Property Coverage Part — earthquake coverage, if one or more of the Causes Of Loss — Special Form; or following reasons applies: (2) Farm Coverage Part — Causes Of Loss (1) The nonrenewal is based on sound Form — Farm Property, Paragraph D. underwriting principles that relate to the Covered Causes Of Loss — Special. coverages provided by this policy and that are consistent with the approved 3. We are not required to send notice of rating plan and related documents filed nonrenewal in the following situations: with the Department of Insurance as a. If the transfer or renewal of a policy, without required by existing law; any changes in terms, conditions or rates, is between us and a member of our insurance group. IL 02 70 08 11 © Insurance Services Office, Inc., 2010 Page 3 of 4 b. If the policy has been extended for 90 days or less, provided that notice has been given in accordance with Paragraph C.1. c. If you have obtained replacement coverage, or if the first Named Insured has agreed, in writing, within 60 days of the termination of the policy, to obtain that coverage. d. If the policy is for a period of no more than 60 days and you are notified at the time of issuance that it will not be renewed. e. If the first Named Insured requests a change in the terms or conditions or risks covered by the policy within 60 days of the end of the policy period. f. If we have made a written offer to the first Named Insured, in accordance with the timeframes shown in Paragraph C.1., to renew the policy under changed terms or conditions or at an increased premium rate, when the increase exceeds 25 %. Page 4 of 4 © Insurance Services Office, Inc., 2010 IL 02 70 08 11 .... _._... __......._ Important Notice — In Witness Clause ZURICH In return for the payment of premium, and subject to the terms of this policy, coverage is provided as stated in this policy. IN WITNESS WHEREOF, this Company has executed and attested these presents and, where required by law, has caused this policy to be countersigned by its duly Authorized Representative(s). -1�utt� ?i. President Corporate Secretary QUESTIONS ABOUT YOUR INSURANCE? Your agent or broker is best equipped to provide information about insurance. Should you require additional information or assistance in resolving a complaint, call or write to the folk (please have your policy or claim number ready): Zurich in North America Customer Inquiry Center 1400 American Lane Schaumburg, Illinois 60196 -1056 1 -800- 382.2150 (Business Hours: 8am - 4pm [CT]) Email: info.source @zurichna.com U -GU -319 -F (01 /09) Page 1 of 1 CERTIFICATE OF INSURANCE Return Completed Certificate to City of Gilroy (Agency) This certifies to the Agency that the following described policies have been Issued to the Insured named below and are in force at this time. Insured r q, " -=- J3'2by`^`:_ r•'Y. a 4 Address a� - �. ,r � � Description of operations /locations /products insured (show contract name and /or number, if any): POLICIES AND INSURERS Bodily LIMITS Property POLICY EXPIRATION Injury Damage NUMBER DATE Workers` Compensation Employers Liability $ '� kTTS (Name of Insurer) ' t--' "f:. = e s-t i F ,,, (Best's Rating) .s• 4 � !j " - - , Check policy type: "Claims Made" 6Occurre ce "..° COMPREHENSIVE Each °°-�Each A9 GENERAL Occurrence Occurrence 0'x%00 V0 y LIABILITY ,or $_ lEar %o0, COMMERCIALGEjvERAL Aggregate Aggregate LIABILITY $ C00, $ or Combined Single Limit (Name of Insurer) $ g �" ;IC L- Aggregate $ (Best's Rating)/ _ X1 BUSINESS AUTO POLICY Each Person Each Accident Liability Coverage Symbol S $ $ $r Each Accident $ or, Combined Single Limit UMBRELLA LIABILITY "Claims Made" _ CC L�, IY L " $ e0cr, c; en 0 ; ( Name of Insure) Sr elf- Insured Retention E 0 (Best's Rating) ( ^ Uvas Creek Trail Extension 13 -Pw -198 SECTION 00630 -32 The following coverage or conditions are in effect: Yes No The Agency, its officials, and employees are named on all liability policies described above as insureds as respects: (a) activities performed for the Agency by or on behalf of the Named Insured, (b) products and completed operations of the Named Insured, and (c) premises owned, teased or used by the Named Insured. Products and Completed Operations Y The undersigned will mail to the Agency 30 days written notice of cancellation or reduction of coverage or limits Cross Liability Clause (or equivalent wording) Personal Injury, Perlis A, B and C ` Broad Form Property Damage X, C, U& Hazards included Contractual Liability Coverage applying to this Contract Liquor liability Coverage afforded the Agency, its officials, employees and volunteers as Insureds applies as primary and not excess or contributing to any insurance issued in the name of the Agency Waiver of subrogation from Workers' Compensation Insurer X This certificate is issued as a matter of information. This certificate is not an insurance policy and does not amend, extend or alter the coverage afforded by the policies listed herein. Notwithstanding any requirement, term or condition of any contract or other document with respect to which this certificate of insurance 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. Agency or Brokerage Insurance Company s Addrlerss�9{ /.w Home Office <...- Name of Person to be Contacted k6th6rized Signature Date Telephone No, Note: Authorized signatures may be the agent's if the agent has placed insurance through an agency agreement with the Insurer. If insurance is brokered, authorized signature must be that of official of insurer. Uvas Creek Trail Extension 13-PW -198 SECTIDN 00630 -33 GUERRA TRANSMITTAL LETTER ATTN: FROM David Stubchaex Jose Corona COMPANY: DATE: City of Glhov 8/28/12 CITY /STATE: SENT VIA G, r.y, CA USPS/ Email PROJECT DESCRIPTION: 12 -087 Uws Creek Trail Extension Project URGENT ® FOR REVIEW ❑ PLEASE COMMENT F] PLEASE REPLY ❑ PLEASE RECYCLE COPIES DESCRIPTION 2 Contract Agreement 1 Workers Compensation Insurance Certificate 1 Notice of Nondiscrimination in Employment 1 Faithful Performance Bond 1 Payment Bond 1 Certificate of Insurance 1 Certificate of Insurance Statement - 1 Builder's Risk Insurance Disclosure Statement 1 City of Gilroy Business License Dear David, Please see attached Documents for above referenced project. Let me know if you have any questions. Thank you, Jose Corona Construction Administrator Date: 984 MEMOREX DRIVE, SANTA CLARA, CA. 95050— V: 405.279.2027-F: 408.279.2044 wWw.GUERRACO.COM LIC# 915544 CITY OF GrasROY BUSINESS LICENSE APPLICAnON FORM 73611Rasauna Street F Ta fi7// 79�� Gilroy, CA 95010 -6141 usi JD "I (408) 846 -0420 Fax (408) 846.0421 icenTD Pleaso camplelc both Bides of this form and the supplemental form. Omissions ormisrepreaearation5 will immediately taus reVO®tion of this license. Sales or use Paz may apply to your business activities.' You may seek advice regarding the application of tax to your particular business by contacting the nearest Santa Board of Equalization Office. Procodurm Each division in the sequence liated must Sign the back of this application farm. A business license must be issued btforc starting your business activity. if your business requires any other permits or licenses, you may not open your business until the requited permits have been obmioed. Cammcmial businesses please complete the "SUPPLEMENTAL FORM ". ADA NOTE: Do you have a qualified disability for which you request an accommodation? (Circle ono) YE NO If ycx, what accommodation do you desire? iv / A Regulutury Inspection/Review Fees: Ntw/MOved- HomeOttupetlon S 70,00 (2602) New/Moved -Other $100.00 - $370.00 __ (2603 5100,2607 5135,2609$135) New/Moved-Regulated 5190,00 -wo.00 (2603 S1o0, 2607 5135, 2608 $190, 26119 5135) Out-or-town business 5 30,00(2604) Pretreatment/CUPARevie 5 40.00 (2611) Change S 15.00 (2601) ([deluding changes in ownership) Business license Fees- Sea Fee Schedule Outer Licensts/Permits (FireJHazmnt/PD) TOTAL FEES: THIS BOX TO BE COMPLETED BY FINANCE., _Business is IDCatcd within tie airy Limits usiataD is looted ou;sidethe city limits ®Nan-txarnptbusinala Mise. huniacm `New busier qa _`Cbange of nannetsbip Change m )DCadOn Exempt bos(nces (Noo- Profit, must Basch copy of cettiFcotion) Home Occupation CONTRACTORS LOCATED OUTSIDE OF GILROY CITY LIMITS COMPLET'R TMS BOX[ STATE LICENSE = !2t I< (Lt_1 y CLASS 4 j g EXPPATEr_Sj_/, 3 LlJj, Puipd RE, SO. OeLNoV,Dec -J7 a) Pan,Peb,MnrJaoe) Apr,May,Jrme -Sept (Oat,Nov,Dec- ,;far) Ytru15'SlSO Semi - Assam S90,,,,_, Semi - Annual $9D` Seas- Annual S90— Semi -Annual 590_ RUSiNESSES COMPLfgTE, T141S Stitj N: BUSINESS TYPE (cheek one) : ( J SALESICOM. 1P4SC/MEAMERSH1PSlALL 07HER- Annual gross receipts, S _hrfCONTR4CMR ( )PROF ( )MASSAGE ( )APTS(Ounits) TRAN31ZN7T N0N- PR0FIr1=MPT ( )SERVICE ( ) VENDL4C MACHINES) (y ( ) DELTVERy 1Pz9P) (m) TAXI GIrS($) OWNERSIlIP TYPE (circicocc) SOLE PROPRLETORSKP P4R7?WHLa ORPOk4VON TRUST B LISINFS5 DESCRIPTION: G >_ —"a a- f L Cr) A/ -f (LA r -r t7 2 START DATE: Try /_L BUSINESS N:).lIAE: 6 t. e ol-A- rOA- ,i T fLr r_7I o u G P BUSINESS ADDRESS: (Bane[) E R -L— F t EM O (1-E> p /L-. (suite #) (city) <hA!'[4 t/!•(L,4- (state) (phone) Ctf0 1_ _l i`LAII ING ADDRESS (Street qi8 Lf t� F/h n /1 Fr Off (city) ur} N t 4 (St)CA. . (zip) R S r: S O OWNER(s) NAME (fltst) ,74 l nn C (m;_) 5 pest)__. � u F r f? A (fast) (mi.)^ (last) OWTIERADDRESSt (sliest) 5 � i (.AiLe4miF; C7 (City) E2.J✓ L? (stato_cA (zip) i N 5 (phone) C4 5 1(, - C 5 s S FEDERAL TAX ID # 0 f-, — 2� -- ( 3 L SOCIAL SECURITY it S G 10 STATE TAX M 4 :2.',613 [ b TE .BOARD OF EQUAInATION YJ /U A apPLICANT "g -�~ -/ Co Al . a- Title %)nt(N1S7d2A.7a(z_ Date v ntf "! FY-- cLt:n F:tYCi:, s. _r.6n CEiisE i.u00 3G.t6 OtiT iQOS1 y+.ag.,•'S6LGti ---------------- 6'1'•s�uG T.tiPErie��: LHAtic" 41Gfi OG CR�OI? CARD* ke: We,; UZJO� C4 ii 1' GF Gr, RGY•UTiU i r 7351 nOSAIVI`IA 571 s;ILr'.OY, CA 57 06J2"12012 gnOpu @]G�i40Sr2 Merd�anilD: pl,:� ?16 Terminal ID: 3 4166111991 CREDIT CARD VISA. SALE CARD 4 O:G; IAiVCICE 00 Batch IF, _'m5 Approval Coda: Manua! Entry Medwd: Cn!ine Mode: sG p Tax Amount! A.vs Code: YNA Card Code: M SALE AMOUNT i agree to Pay z!rva total. anwuni acccrdin4 to Cara isWer if agree ent Credit voud -er{ erdtant agreemUil MERCHANT COPY G� GUERR -8 OF ID: YV CERTIFICATE OF LIABILITY INSURANCE 004103 /2013 Y) 04!03/2013 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 Phone:408- 288 -6262 Leavitt Pacific Ins. Brokers License #OD79674 Fax: 408- 298 -7635 1330 S. Bascom Ave. San Jose, CA 95128 CONTACT NAME: (Alc °NN E.f (ac No): E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAICIf Nicholas A. Weintraub _ wsURERA dronshore Specialty Ins. Co. 25445 1 04/01/2013 04/01/2014 DAMAGE TO RENTED $ INSURED Guerra Construction Group Santa Clara Construction & Engineering, Inc. 984 Memorex Drive INSURERB:Golden Eagle Insurance Corp. 110836 INSURER C:EVerest National Insurance Co. 110120 INSURERD:National Union Fire Ins Co of 11.9445 INSURER E: Santa Clara, CA 95050 INSURER F MEO EXP (Any ane person) $ COVERAGES CFRTIFICGTF IJI IMRFR- RF\rrCV1N1 MI 11011RFR. 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 I ADDLISUBR, LTR' TYPE OFINSURANCE I POLICY NUMBER POLICY EFF I POLICY EXP MM /DD/YYYY MMIDD/YYYY. LIMITS . GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 A 1 X COMMERCIAL GENERAL LIABILITY X �1 AGS0000802 1 04/01/2013 04/01/2014 DAMAGE TO RENTED $ 50,00 �I .PREMISES Ea occurrence CLAIMS MADE j� OCCUR MEO EXP (Any ane person) $ 5,00 PERSONAL & ADV INJURY $ 11 GENERAL AGGREGATE I$ 1,000,00 2,000,00 '_ 11 GEML AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP /OP AGG $ 2,000,00 Poucv X PRO- ICI Loc Emp Ben. s 1,000,00 AUTOMOBILE LIABILITY 1 ! I COMBINED SINGLE LIMIT 1,000,00 B 1 X ANY AUTO I �BA3058848 04/01/20131 I (Ea accident) $ 04/01/201411 BODILY INJURY (Per person) $ ALL OWNED r —I SCHEDULED AUTOS _I AUTOS li BODILY INJURY $ I ( I I NON - OWNED HIRED AUTOS LEI AUTOS _ PROPERTY DAMAGE $ Peraccid III $ 111 X 11 UMBRELLA LIARI D !EXCESS uae X �I 1 OCCUR CLAIMS -MADE 1BE011566945 I'I 0410112013104/0112014 EACH OCCURRENCE AGGREI GArE $ $ 4,000,00 4,000,00 DED X I RETENTION $ 100001 WORKERS COMPENSATION 1 WC X IOER_ AND EMPLOYERS' LIABILITY YIN - IT RYTLIMIZII C ANY PROPRIETOR /PARTNER /EXECUTIVE 7600005159131 04/01/2013 04101/20141 E . EACH ACCIDENT $ 1,000,00 OFFICERIMEMBER EXCLUDED? N (Mandatory in NH) NIA E.L. DISEASE - EA EMPLOYEE$ 1,000,00 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT 11 $ 1,000,00 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) The City of Gilroy , its officers, officials, employees and volunteers are named as additional insured per GL form CG2010 & CG2037 attached. RE: Lives Creek Trail Gilroy CA CITYGIL City Of Gilroy 7351 Rosanna Street Gilroy CA 95070 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. ' AUTHORIZED REPRESENTATIVE I/ / " °'-- -01988 -2010 ACORD CORPORATION. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD 4 POLICY NUMBER: AGS0000802 COMMERCIAL GENERAL LIABILITY CG 20 i U 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ? IT CAREFULLY_ .. - .__ _ _ M - This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE !'dame OfAddiflonal insured Parson(s) Or Or anizations): Locations Of Covered Operations As required by written contract. If required by your agreement with such Additional Insured, this insurance shall he primary insurance and non - contributory for . that Additional Insured. If anyone, other than the Additional Insured, provides similar insurance for the Additional Insured, then, this insurance will ap7J1'y_.aa outlined in G� 3'lON iJ ^ +r7 kGIAL -�S d?ReZ .✓hO rI,@__I, COYSlli'SFQ315, paragraph ?, Other Insurance, subparagraph e., method of Sharing_ - The inclusion of one or more Insured(s)I - under the terms of this endorsement does not increase our limits of liability. Information required to complete this Schedule, if not shown above, will be shown in me Declarations. A. Section f6 - 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 io liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by: I- Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured(s) at the locations) designated above. CG 20 16 07 04 S. VJth respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to "bodily injury' or "property damage" occurring after: 1. All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or 2, That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. © ISO Properties, Inc., 2004 - Page I of 1 0 POLICYNUMBER: AGS0000802 COMMERCIAL GENERAL LIABILITY GG 20 37 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE RE A-1) IT CAREFULLY_ ADDITIONAL INSURED A OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS This endorsement modifies insurance provided underthe following: _ COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Flame Of Additional Insured Persons) Or Organization (s): I Location And Description Of Completed operations Blanket as required by written contract and Blanket as required by contract. effective during the policy period as stated on the primary Insurance: It is agreed that such insurance policy declarations. as is afforded 6y this policy for the benefit of the additional insured shown shall be primary i insurance, and any other insurance maintained by the additional insureds }shall be excess and non contributory as respects any claim, loss or liability allegedly arising out of the operations of the named . insured, provided however that this insurance wil1 not apply to any claim, loss or liability determined to arise or resultfrom the additional insured's sale negligence or willful misconduct. The insurance afforded by this policy for the benefit pf the additional insured does not apply to 'Property damage'tc any building, structure or - appurtenant, structure intended to be occupied as a'private residence'. The term "private residence" includes single family homes or residences, multi - family homes or residences, condominiums, townhomes. Section it — Who is An insured is amended to include as an additional insured the person(s) or organization(s) shorn 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 .hat additional insured and included in the "products- completed operations hazard ". CG 20 37 07 04 rrD ISO Properties, Inc., 2004 Page 1 of 1 r7