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HomeMy WebLinkAboutGilroy Golf Course - Insurance Certificate (2020)NOTICE OF CANCELLATION Liberty STATE OF CALIFORNIA M trIalf. INSURANCE CANCELLATION WILL TAKE EFFECT AT 12:01 A.M. ON 08/24/2019 Date of Notice: 08/09/2019 Policy No.: BKW56427935 Issued at: DOVER, NH Agent No: 4293062 Agent: TELEPHONE (559) 432-0222 Account of: DIBUDUO & DEFENDIS INSURANCE GILROY GOLF COURSE INC BROKERS, LLC 2695 HECKER PASS HWY PO BOX 5479 GILROY, CA 95020 FRESNO, CA 93755-5479 Notice Issued To: CITY OF GILROY 7351 ROSANNA ST GILROY, CA 95020 Company Name: LIBERTY MUTUAL INSURANCE PO BOX 188025 FAIRFIELD, OH 45018-8025 For Payment/Billing Inquiries: 1-866-290-2920 mybusinessonline. libertymutual.corn NOTICE TO: ADDITIONAL INTEREST Line of Business: COMMERCIAL LINES PACKAGE You are hereby notified that your interest under this policy has been cancelled as of the time and date stated above. Authorized Representative Info Copy DNOC_INFO 00979 BKW56427935 08090038 002005 GCXCPCN Page 1 r. Libel" Mrttt.�alf. INSURANCE NOTICE OF REINSTATEMENT Policy number BKW56427935 is reinstated without any lapse in coverage for the period of 01/01/2019 - 01 /01 /2020. The reinstatement is dependent upon payment being honored by the financial institution. If payment is not honored by the financial institution, the policy will terminate on the date and time shown on the cancellation notice issued for non-payment of premium. Agent No: 4293062 Agent: TELEPHONE (559) 432-0222 DIBUDUO & DEFENDIS INSURANCE BROKERS, LLC PO BOX 5479 FRESNO, CA 93755-5479 Notice Mailed To: CITY OF GILROY 7351 ROSANNA ST GILROY, CA 95020 Date of Notice: 05/23/2019 Policy Number: BKW56427935 Account of: GILROY GOLF COURSE INC 2695 HECKER PASS HWY GILROY, CA 95020 Coverage Provided By: WEST AMERICAN INSURANCE COMPANY Policy Period: 01/01/2019 - 01/01/2020 Account Number: 201648450 For Billing Inquiries: 1-866-290-2920 mybusinessonline.libertymutual.com Info Cony REINS 02163 BKW56427935 05230059 004711 ZCXCPEN Page 1 NOTICE OF CANCELLATION STATE OF CALIFORNIA CANCELLATION WILL TAKE EFFECT AT 12:01 A.M. ON 05/25/2019 Policy No.: BKW56427935 Issued at: DOVER, NH Agent No: 4293062 . Lilyerlry Mutu�xl. INSURANCE Date of Notice: 05/10/2019 Agent: TELEPHONE (559) 432-0222 Account of: DIBUDUO & DEFENDIS INSURANCE GILROY GOLF COURSE INC BROKERS, LLC 2695 HECKER PASS HWY PO BOX 5479 GILROY, CA 95020 FRESNO, CA 93755-5479 Notice Issued To: CITY OF GILROY 7351 ROSANNA ST GILROY, CA 95020 Company Name: LIBERTY MUTUAL INSURANCE PO BOX 188025 FAIRFIELD, OH 45018-8025 For Payment/Billing Inquiries: 1-866-290-2920 mybusinessonline.libertymutual.com NOTICE TO: ADDITIONAL INTEREST Line of Business: COMMERCIAL LINES PACKAGE You are hereby notified that your interest under this policy has been cancelled as of the time and date stated above. Authorized Representative Info Copy DNOC_INFO 00852 BKW56427935 05100126 001748 GCXCPCN Page 1 GILRGOL-01 MHENRY A` ®a CERTIFICATE OF LIABILITY INSURANCE DATE 04/10/2019Y) 04/10/2019 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER License # OE02096 CONTACT NAME: DiBuduo & DeFendis Insurance Brokers, LLC PHONE FAX P.O. Box 5479 (A/C, No, Ext): (559) 432-0222 (A/C, No):(559) 431-7941 1 Fresno, CA 93755-5479 ADDAR'ESS: INSURER(M AFFORDING COVERAGE NAIC # INSURER A: West American Insurance Company 44393 INSURED INSURER B: American Fire and Casualty Company 24066 Gilroy Golf Course, Inc. INSURER C:Oak River Insurance Company 34630 2695 Hecker Pass Hwy INSURER D : Gilroy, CA 95020 INSURERE: INSURER F : COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLIC ES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH 'OLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY RAID CLAIMS. 'VTR TYPE OF INSURANCE INSD SVWD POLICY NUMBER (MMIUD�IYYYYI (MM/DDY YYYI LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,0001 CLAIMS -MADE X OCCUR X BKW56427935 01/01/2019 01/01/2020 DAMAGE TO RENTED PREMISES (Ea occurrence) $ 500,0001 MED EXP (Anv one person) $ 15,000 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY ❑ PE� ® GENERAL AGGREGATE $ 2,000,006 2,000,000 LOC PRODUCTS - COMP/OP AGG $ OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) $ ANY AUTO OWNED SCHEDULED BODILY INJURY (Per person) $ AUTOS ONLY AUTOS - BODILY INJURY (Per accident) $ E AUTOS AOTOS ONNLY ONLY (PeCaccldentDAMAGE $ B UMBRELLA LIAB X OCCUR $ EACH OCCURRENCE $ 1,000,000 _ X EXCESS LIAB CLAIMS -MADE ESA56427935 01/01/2019 01/01/2020 I AGGREGATE 1,000,000 DED RETENTION $ $ C WORKERS COMPENSATION $ PER OTH- I I AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE GIWC014992 N / A STATUTE ER 04/10/2019 04/10/2020 E.L. EACH ACCIDENT $ I 1,000+000I OFFICER/MEMBgER EXCLUDED? (Mandatory iNH) E.L. DISEASE - EA EMPLOYEE $ +n 1,000 0001 yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000� DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if mores ace is required) The certificate holder Is named as additional insured when required by written contract in regards to the general liability form attached CG 88 10 0413 - Commercial General Liability Extension. CERTIFICATE Hni nF=P IIIIIiIII�iIII�IIIII�I�Iilli�lillltl�lilllill��lilill�lilll�l'�" ***************AUTO**MIXED AADC 936 Tray 2 : Piece 431 431 2 MB 0.428 City of Gilroy It's Officers, Officials and Employees 7351 Rosanna St Gilroy CA 95020-6141 CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE /k4L.-' ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD COMMERCIAL GENERAL LIABILITY CO 88 10 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. COMMERCIAL GENERAL LIABILITY EXTENSION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART m SUBJECT PAGE NON -OWNED AIRCRAFT 2 NON -OWNED WATERCRAFT 2 PROPERTY DAMAGE LIABILITY -ELEVATORS 2 EXTENDED DAMAGE TO PROPERTY RENTED TO YOU (Tenant's Property Damage) 2 MEDICAL PAYMENTS EXTENSION 3 EXTENSION OF SUPPLEMENTARY PAYMENTS - COVERAGES A AND B 3 ADDITIONAL INSUREDS -BY CONTRACT, AGREEMENT OR PERMIT 3 PRIMARY AND NON-CONTRIBUTORY- ADDITIONAL INSURED EXTENSION S ADDITIONAL, INSUREDS -EXTENDED PROTECTION OF YOUR "LIMITS OF INSURANCE" 6 WHO IS AN INSURED - INCIDENTAL MEDICAL ERRORSIMALPRACTICE AND WHO IS AN INSURED - FELLOW EMPLOYEE EXTENSION - MANAGEMENT EMPLOYEES 6 NEWLY FORMED ORADDITIONALLY ACQUIRED ENTITIES 7 FAILURE TO DISCLOSE HAZARDS AND PRIOR OCCURRENCES 7 KNOWLEDGE OF OCCURRENCE, OFFENSE, CLAIM OR SUIT 7 LIBERALIZATION CLAUSE 7 BODILY INJURY REDEFINED 7 EXTENDED PROPERTY DAMAGE 8 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US - 8 WHEN REQUIRED IN A CONTRACT OR AGREEMENT WITH YOU '�' 2013Liberty Mutual Insurance CG 88 10 04 13 Includes copyrighted material of Insuranco Services Office, Inc., with Its permission, Page 1 of 8 With respect to coverage afforded by this endorsement, the provisions of the policy apply un|wao modified by the endorsement, A. NON -OWNED AIRCRAFT , Undo/ Paragraph 2. Exclusions of Section | ^ Coverage A~ Bodily Injury And Property Damage Liability, exclusion U. A|n:roft, Auto Or Watercraft does not apply to an aircraft provided: 1, k|anot owned by any insured; 2. It in hinad, chartered or loaned with atnainad paid crew; ' 8. The pilot in command holds anunanUy effective cart0cete, issued by the duly constituted authority of the United States of America or Canada, deo|Qnot\ng her *rhim 000mmenia| or airline pilot; and 4. It is not being used to carry persons or property for aoha»Qo. Howmvar, the insurance afforded by this pum|a|on does not apply If there is avm1|ub|a to the Insured other valid and un||outib|e Insurance, whether primary, excess (other than insurance written to apply opao|f|oa||y � in excess of this po|ioy), contingent or on any other hmaio' that would also apply to the |oon covered under this provision. B. NON -OWNED WATERCRAFT 8 Under Paragraph 2Exclusions ofSection |- Coverage A'Bodily Injury And Property Damage L|ob{Uh/. � Subparagraph (2) of axu|uo1un g. Aircraft, Auto Or Watercraft is replaced by the fn||mw|ng� This exclusion does not apply to: (2) Avvnderoruft you do not own that is: (o) Less than 52 feet long; and � (b) Not being used to carry paomnm or property for acharge. C. PROPERTY DAMAGE LIABILITY -ELEVATOR8 1. Under Paragraph 2. Exclusions of Section | ~ Coverage A^ Bodily Injury And Property Damage Liabil- ity, Subparagraphs (%), (4) and 00o[ exclusion J. Cmnnoge To Property do not apply if such "property damage" results from the use of elevators. For the purpose of this p,mviaion, elevators do not Include vehicle lifts. Vehicle lifts are lifts or hoists used In automobile service or repair operations. 2. The following Is added to Section K/ -Cnmmuro|u| General Liability Cond|tiona, Condition 4^ Other Insurance, Paragraph b.Excess Insurance: The insurance afforded by this provision of this endorsement is axoenn over any property insurance, whether primary, excaxa, contingent or on any other basis. D. EXTENDED DAMAGE TOPROPERTY RENTED TOYOU (Twnnnt'mProperty Damage) m If Damage To pmm|uea Rented To You is not otherwise excluded from this Coverage Port: � 1. Under Paragraph 2. Exclusions of Section I - Coverage A - Bodily Injury and Property Damage Liability: a. The fourth from the |eat paragraph of exclusion ]. Damage To Property Is replaced by the follow- ing: Paragraphs (1), (3)and (4)o{this exclusion do not apply to "property damage" (other than damage by hro. lightning, exposiom, smoke, or leakage from an automatic fie protection system) to: (0 Premises rented to you for apehod of 7or fewer consecutive days; or (||) Contents that you rent or lease as part of a premises nsnte| or |eona agreement for apodod of more than 7dmya. Paragraphs (1), (3) and (4) of this exclusion do not apply to "property damage" to contents of pnam|aem rented to you for apedod of 7orfewer consecutive days. A aepaxe(a limit of insurance applies to this coverage on described in Section ||II ~ Limits of Insurance. � 2013L|hvrty Mutual Insurance CG88 10O413 |nv|udonuopy,ighted material v[Insurance Sam|ceoOffice, |nc,w|th its permission. Page 2nf8 b The last paragraph of subsection 2. Exclusions Is replaced by the following: Exclusions c,through n. do not apply to damage by fire, lightning, exploaon, smoke or leakage from automatic fire protection oynbamo to prom|nmo while rented to you or temporarily occupied by you with permission of the owner. Aaeporate limit of Insurance applies to Damage To Pmm|ooa Rented To You as described in 8mcdun U| ^ Limits Of Insurance, 2. Paragraph G. under Section U| ~ Limits Of Insurance is replaced by the following: 6. Subject to Paragraph b. above. the Damage To Poom|aam Rented To You Limit Is the most we will pay under Coverage Afon damages b000uws of "property damage" to: a Any one premise: (1) VYh||o rented to you; or (2) VYhi|o rented to you or temporarily occupied by you with permission of the owner for damage by fire, |ightning, exp|oaion, smoke or leakage from autmnmUo protection sys- tems; or b. Contents that you rent or lease as part of apnamineu nanUo| or kaama agreement, l As regards coverage provided by this provision D. EXTENDED DAMAGE TO PROPERTY RENTED TO YOU (Tenant's Property Damage) - Paragraph 9.a. of Definitlons is replaced with the following: &.a. Acontract for o lease of premises. However, that portion of the contract for o|oaoe of premises that |ndemn|f|ea any person or organization for damage by fire, lightning, oxp|oo|on, smoke, or leakage from automatic fire protection systems to pnom|oeo vvhi|a rented to you or bmmpnnah|y occupied by you with the permission of the mwner, or for damage to contents of such premises that are included In your premises mo(o| or lease aQeement, is not an "Insured contract". E. MEDICAL PAYMENTS EXTENSION If Coverage CMedum| Payments Is not otherwise excluded, the Medical Payments provided by this policy are amended as follows: Under Paragraph 1. Insuring Agreement of Section | ~ Coverage C~Medical Payments, subparagraph (b)ofParagraph a.|oreplaced bythe following: (b) The expenses are incurred and reported within three years of the date of the accident; and F. E>Q[EWBKJN OFSUPPLEMBVTARYPAYMENTS-CDVERAGESAANDB t Under Supplementary Payments ~Onvarwgao Aond B. Paragraph i.b. is replaced by the following: b. Up to $3,000 'for cost of bail bonds required because of accidents or traffic law violations arising out of the use of any vehicle to which the Bodily Injury Liability Coverage applies, We do not have to furnish these bonds, � 1 Paragraph I.d. Is replaced bythe following: � d. All reasonable expenses incurred bythe insured atour request hoassist uainthe investigation o, defense of the claim or "suit", including ecLuo| |oaa of earnings up to $580 mday because of time off from work. G. ADDITIONAL |NSURED$ ^18YCDNTRAOT, AGREEMENT OR PERMIT 1. Paragraph 2. under Section U -VVhn Is An Insured is amended to include as an insured any person or organization whom you have agreed to add as an additional insured in avvriUen contract, written agreement or permit. Such person o, organization Is an additional Insured but only with mopad to ||ab|||h/ for "bodily Injury", "property damage" or "personal and advertising Injury" caused in whole or In port by: a. Your acts oromissions, or the acts or omissions of those acting on your behalf, In the performance of your on going operations for the additional insured that are the subject of the written contract or written agreement provided that the "bodily injury" or "property damage" ncoum, or the "Per- sonal and advertising injury" is committed, subsequent to the signing Of Such written contract or written agreement; or ' Q uV1nLiberty Mutual Insurance b. Premises or facilities rented by you or used by you; or c, The maintenance, operation or use by you of equipment rented or leased to you by such person or organization; or d. Operations performed by you or on your behalf for which the state or political subdivision has issued a permit subject to the following additional provisions: (1) This insurance does not apply to "bodily injury", "property damage", or "personal and ad- vertising injury" arising out of the operations performed for the state or political subdivision; (2) This insurance does not apply to "bodily Injury" or "property damage" included within the "completed operations hazard". (3) Insurance applies to premises you own, rent, or control but only with respect to the following hazards: ' (a) The existence, maintenance, repair, construction, erection, or removal of advertising _._=. signs, awnings, canopies, cellar entrances, coal holes, driveways, manholes, marquees, " hoist away openings, sidewalk vaults, street banners, or decorations and similar expo- sures; or (b) The construction, erection, or removal of elevators; or (c) The ownership, maintenance, or use of any elevators covered by this insurance. However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insur- ance afforded to such additional insured will not be broader than that which you are required by A the contract or agreement to provide for such additional Insured. With respect to Paragraph 1.a. above, a person's or organization's status as an additional insured under this endorsement ends when: (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. With respect to Paragraph 1,b, above, a person's or organization's status as an additional insured under this endorsement ends when their written contract or written agreement with you for such premises or facilities ends, s With respects to Paragraph 1.c. above, this insurance does not apply to any "occurrence" which takes place after the equipment rental or lease agreement has expired or you have returned such equipment to the lessor. The insurance provided by this endorsement applies only if the written contract or written agreement is signed prior to the "bodily injury" or "property damage". We have no duty to defend an additional Insured under this endorsement until we receive written notice of a "suit" by the additional insured as required in Paragraph b. of Condition 2. Duties In the Event Of Occurrence, Offense, Claim Or Suit under Section IV - Commercial general Liability Condi- tions, O 2013 Liberty Mutual Insurance Cg 88 10 04 13 Includes copyrighted material of Insurance Services Office, Inc., with Its permission. Page 4 of 8 N � m 2. With respect to the |naummca provided by this ondomemand. the following are added to Paragraph 2. Exclusions under Section I - Coverage A - Bodily Injury And Property Damage Liability: This Insurance does not apply to: u "Bodily kdwry" or "property damage" arising fromthe mdo negligence of the additional Insured. b. "Bodily injury" or "property damage" that occurs prior to you commencing operations at the location whom such "bodily injury" or "property damage" occurs. c� "Bodily Injury", "property damage" or "personal and advertising injury" arising out of the rendm` |ng of, or the failure to render, any professional architectural, engineering or surveying aom|onm. including: (i) The pnepodng, oppmvng, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or (2) Supervisory, |nopmoUon, architectural or engineering oohvitiwm. This exclusion enpUea evon'ifthe claims against any insured allege nogUQanoo or other wrongdoing In the aupem|sion, hiring, employment, hn|n|nQ or monitoring of others by that Insured, if the "occur- rence" which caused the "bodily injury" or "property damege", or the offense which 000aod the "personal and advertising injury". Involved the rendering of, or the ra||una to render, any professional arch}toctuno|, engineering or surveying oemioao. d. "Bodily kVuryf or "property damage" occurring after: (i) All work, including materialn, peda or equipment furnished In connection with such work, on the project (other than oenive, 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 vvh|oh the injury or damage arises has been put to Its intended use by any person or organization other than another contractor or subcontractor -^^- engaged, |nperfonning nperoi|mno for opdno|pa| amapart ofthe,aame project. ' o. Any person or organization specifically designated as an additional Insured for ongoing operations by a separate ADDITIONAL INSURED ~8VVNER$. LESSEES OR CONTRACTORS endorsement is- sued by us and made a part of this policy. 3. With respect to the insurance afforded to these additional |nnurada, the following is added to Section U| ^ Limits Of Insurance: If coverage provided to the mddK|nnu| Insured is required by ouontmct or egreomunt, the most we will pay on behalf of the additional insured is the amount of Insurance: m. Required by the contract or agreement; or b. Available under the applicable Limits of Insurance shown in the Dac|anaUpno| whichever is less, This endorsement shall not Increase the applicable Limits of Insurance shown in the Declaratio ns. H. PRIMARY AND NON-CONTRIBUTORY ADDITIONAL INSURED EXTENSION This provision applies to any person or organization who qualifies as an additional insured under any form or endorsement under this policy, Condition 4. Other Insurance of SECTION [V -COMK8EBCh4L GENERAL LIABILITY OOND[rK]NB is amend' ed as follows: a. The following is added toParagraph a,Primary Insurance: If an additional inoun+d's policy has on D&or |naunonoa provision making its policy excoan, and you have mgnond in awdUan contract or written agreement to provide the additional insured coverage on a primary and noncontributory bosin, this policy shall be primary and we will not seek contribution from the additional |nounad'a pv||oy for dommQoo we cover, m 2013L/berty MutUa| Insurance CG 88 10 04 13 Includes copyrighted mete,|a| vfInsurance Services Office, |no..xith Its permission. Page 5 of b The following Is added toParagraph bExcess Insurance: When *written contract or written agreement, other than apnenimea lemae, facilities rental contract or agreaman(, an equipment rental or lease contract or agreement, or permit |oeuad by a state or political subdivision between you and an additional insured does not require this Insurance to be primary o, primary and non-Gonhibu(ory. this Insurance Is exoeao over any other insurance for which the odd|- Upnm| insured is designated aaaNamed Insured. ' Regardless of the written agreement between you and an additional insured, this insurance is excess over any other Insurance whether phmary, exxeoa, contingent or on any other basis for which the additional Insured has been added as an additional insured on other policies, i ADDITIONAL INSUREDS ~EXrENDED PROTECTION OPYOUR "LIMITS OF INSURANCE" This provision mppi|om to any person or organization who qualifies as an additional Insured under any form or endorsement under this policy. � i. The following is added to Condition 2. Duties In The Event Of Occurrence, Offense, Claim or Suit: An additional insured under this endunoenoon( will as soon as practicable: a. Give written notice of an "occurrence" or an offense that may result In acla|m or "suit" under � this insurance tous; b Tender the defense and indemnity of any claim or "suit" to all insurers whom also have Insurance available to the additional Insured; and *. Agree to make available any other insurance which the additional Insured has for e|oeo we cover under this Coverage Part. d. We have no duty to defend or |ndemn|fy an additional insured under this endorsement until we receive written notice of a "suit" by the additional insured. 2. The limits ufinsurance applicable tothe additional insured are those specified Inewritten contract or written agreement or the UmKo of |noummne as stated in the Declarations of this policy and defined in Section |Q ~ Limits of Insurance of this policy, whichever are |ooe. These ||mhe are inclusive of and not in addition to the Um|ba of insurance available under this policy. J. WHO |8ANINSURED -INCIDENTAL MEDICAL ERRORS/ MALPRACTICE WHO |84NINSURED ' FELLOW EMPLOYEE EXTENS|ON-MANAGEu@ENT EMPLOYEES Paragraph 2.u.(1) of Section U 'VVho IeAnInsured Is replaced with the following: (1) "Bodily injury" or "personal and advertising injury": (m) Toyou, toyour partners nrmembers (if you are mpartnership orjoint ventun).toyour members (if you are m limited liability company), to aoo-"emp|oyam" while in the course of his or her employ- ment or performing duties m!edod to the conduct of your business, or to your other "volunteer � workers" while performing duties related tothe conduct of your business; (b) To the spouse, ch||d, parent, brother or sister of that co -"employee" or "volunteer wmrkar" as e consequence of Paragraph (1)(a)above; m (c) For which there Is any obligation to share damages with or repay someone else who must pay damages because of the Injury described in Paragraphs (1)(a)o,(b) above; or (d) Arising out of his or her providing or failing to provide professional health care services, Hovvovoc If you are not in the business of providing professional health oans aom|cen or providing profes- sional health care pomnuno| to others, or if coverage for providing pmhaon|one| health uonw ser- vices is not otherwise excluded by separate endnrsement, this provision (Paragraph (d))does not apply, Paragraphs (a) and (b) above dunot apply to "bodily injury" or "personal and advertising injury" caused by an "employee" who Is acting In oouparv|oory capacity for you, Supervisory capacity as used herein means the "employee's" job maponaiW|it|aa assigned by you. includes the d|noo supervision of other "employ- ees" of yours. Hnwover, none of these "employees" are insureds for "bodily injury" or "personal and Q un1V1-|uenyMutual Insurance CG88 10 04 13 Includes copyrighted material ofInsurance Services Office, |nc..*itk Its permission. Page 6ufO P advertising injury" arising Out of their willful conduct, which is defined as the purposeful or willful Intent to cause "bodily injury" or "personal and advertising Injury", or caused in whole or in part by their Intoxica- tion by liquor or controlled substances, The coverage provided by provision J. is excess over any other valid and collectable insurance available to your "employee". K. NEWLY FORMED OR ADDITIONALLY ACQUIRED ENTITIES Paragraph 3, of Section 11 - Who Is An Insured is replaced by the following: 3. Any organization you newly acquire or form and over which you maintain ownership or majority Interest, will qualify as a Named Insured if there is no other similar insurance available to that organization, however: a. Coverage under this provision is afforded only until the expiration of the policy period in which the entity was acquired or formed by you; b. Coverage A does not apply to "bodily injury" or "property damage" that occurred before you acquired or formed the organization; and c. Coverage B does not apply to "personal and advertising injury" arising out of an offense committed before you acquired or formed the organization. d. Records and descriptions of operations must be maintained by the first Named Insured. No person or organization is an insured with respect to the conduct of any current or past partnership, joint venture or limited liability company that Is not shown as a Named Insured In the Declarations or qualifies as an insured under this provision. L. FAILURE TO DISCLOSE HAZARDS AND PRIOR OCCURRENCES Under Section IV - Commercial General Liability Conditions, the following is added to Condition 6. Repre- sentations; Your failure to disclose all hazards or prior 'occurrences" existing as of the inception date of the policy shall- not, prejudice -the coverage afforded by this policy provided such failure to disclose all hazards or prior "occurrences" is not intentional. M. KNOWLEDGE OF OCCURRENCE, OFFENSE, CLAIM OR SUIT Under Section IV - Commercial General Liability .Conditions, the following is added to Condition 2. Duties In The Event of Occurrence, Offense, Claim Or Suit: Knowledge of an "occurrence", offense, claim or "suit" by an agent, servant or "employee" of any insured shall not in itself constitute knowledge of the insured unless an insured listed under Paragraph I. of Section 11 - Who Is An Insured or a person who has been designated by them to receive reports of "occurrences", offenses, claims or "suits" shall have received such notice from the agent, servant or `employee". N. LIBERALIZATION CLAUSE If we revise this Commercial General Liability Extension Endorsement to provide more coverage without additional premium charge, your policy will automatically provide the coverage as of the day the revision Is effective in your state. O. BODILY INJURY REDEFINED Linder Section V - Definitions, Definition 3. is replaced by the following: 3. "Bodily Injury" means physical injury, sickness or disease sustained by a person. This includes mental anguish, mental Injury, shock, fright or death that results from such physical injury, sick- —� ness or disease. p 2013Liberty Mutual Insurance CG 88 10 04 13 Includes copyrighted material of Insurance Services Office, hzc„ with its permission, Page 7 of 8 P. EXTENDED PROPERTY DAMAGE Exclusion a. of COVERAGE A. BODILY INJURY AND PROPERTY DAMAGE LIABILITY Is replaced by the following: a. Expected OrIntended Injury "Bodily injury" or "property damage" expected or Intended from the standpoint of the insured. This exclusion does not apply to "bodily Injury" or "property damage" resulting from the use of reasonable force to protect persons or property. Q. WAIVER OF TRANSFER OF RIGHTS OFRECOVERY AGAINST OTHERS TO U8 -VVHEN REQUIRED IN /\ CONTRACT DRAGREEMENT WITH YOU Under Section |V - Commercial General Liability Conditions, the fn||mw|nQ in added to Condition 8. Trans- fer Of Rights Of Recovery Against Others To Us: We waive any right of recovery we may have against upemon or organization because ofpaymento we � make for injury or damage odu|ng out of your ongoing operations or "your work" done under a N unntrmcL wmt person oronganiodion mnd inc]udod �nihe"prnduuim-oomp|ahed oponadonm hazard" provided: 1. You and that person or organization have agreed in writing In aoontrao\ or agreement that you 19 waive such rights against that person or organization; and � h 2. The injury or damage occurs subsequent to the execution of the written contract or written agree- ment, � � y 00 2D13Liberty Mutual hmummno _. Lihc�rty Mutual., INSURANCE NOTICE OF REINSTATEMENT Policy number BKW56427935 is reinstated without any lapse in coverage for the period of 01/01/2019 - 01 /01 /2020. The reinstatement is dependent upon payment being honored by the financial institution. If payment is not honored by the financial institution, the policy will terminate on the date and time shown on the cancellation notice issued for non-payment of premium. Agent No: 4293062 Agent: TELEPHONE (559) 432-0222 DIBUDUO & DEFENDIS INSURANCE BROKERS, LLC PO BOX 54.79 FRESNO, CA 93755-5479 Notice Mailed To: CITY OF GILROY 73-91 ROSANNA ST GILROY, CA 95020 Date of Notice: 03/27/2019 Policy Number: BKW56427935 Account of: GILROY GOLF COURSE INC 2695 HECKER PASS HWY GILROY, CA 95020 Coverage Provided By: WEST AMERICAN INSURANCE COMPANY Policy Period: 01/01/2019 - 01/01/2020 Account Number: 201648450 For Billing Inquiries: 1-866-290-2920 mybusinessonline.libertymutual.com Info Copy REINS 02194 BI<W56427935 03270259 004759 ZCXCPEN Page 1 NOTICE OF CANCELLATION Lil�crty STATE OF CALIFORNIA 1VIL It«a,, l° _t INSURANCE CANCELLATION WILL TAKE EFFECT AT 12:01 A.M. ON 03/27/2019 Date of Notice: 03/12/2019 Policy No.: BKW56427935 Issued at: DOVER, NH Agent No: 4293062 Agent: TELEPHONE (559) 432-0222 Account of: DIBUDUO & DEFENDIS INSURANCE GILROY GOLF COURSE INC BROKERS, LLC 2695 HECKER PASS HWY PO BOX 5479 GILROY, CA 95020 FRESNO, CA 93755-5479 Notice Issued To: CITY OF GILROY 7351 ROSANNA ST GILROY, CA 95020 Company Name: LIBERTY MUTUAL INSURANCE PO BOX 188025 FAIRFIELD, OH 45018-8025 For Payment/Billing Inquiries: 1-866-290-2920 mybusinessonline. libertymutual.com NOTICE TO: ADDITIONAL INTEREST Line of Business: COMMERCIAL LINES PACKAGE You are hereby notified that your interest under this policy has been cancelled as of the time and date stated above. Authorized Representative Info Copy DNOC_INFO 01098 BI<W56427935 03120116 002262 GCXCPCN Page 1 Libert�� IVII� tualr, INSURANCE NOTICE OF REINSTATEMENT Policy number BKW56427935 is reinstated without any lapse in coverage for the period of 01/01/2019 - 01 /01 /2020. The reinstatement is dependent upon payment being honored by the financial institution. If payment is not honored by the financial institution, the policy will terminate on the date and time shown on the cancellation notice issued for non-payment of premium. Agent No: 4293062 Agent: TELEPHONE (559) 432-0222 DIBUDUO & DEFENDIS INSURANCE BROKERS, LLC PO BOX 5479 FRESNO, CA 93755-5479 Notice Mailed To: CITY OF GILROY 7351 ROSANNA ST GILROY, CA 95020 Date of Notice: 05/23/2019 Policy Number: BKW56427935 Account of: GILROY GOLF COURSE INC 2695 HECKER PASS HWY GILROY, CA 95020 Coverage Provided By: WEST AMERICAN INSURANCE COMPANY Policy Period: 01/01/2019 - 01/01/2020 Account Number: 201648450 For Billing Inquiries: 1-866-290-2920 mybusinessonline.libertymutual.com Info Copy REINS 02163 BKW56427935 05230059 004711 ZCXCPEN Page 1 NOTICE OF CANCELLATION STATE OF CALIFORNIA CANCELLATION WILL TAKE EFFECT AT 12:01 A.M. ON 05/25/2019 Policy No.: BKW56427935 Issued at: DOVER, NH Agent No: 4293062 _ Liberty Mutual., INSURANCE Date of Notice: 05/10/2019 Agent: TELEPHONE (559) 432-0222 Account of: DIBUDUO & DEFENDIS INSURANCE GILROY GOLF COURSE INC BROKERS, LLC 2695 HECKER PASS HWY PO BOX 5479 GILROY, CA 95020 FRESNO, CA 93755-5479 Notice Issued To: CITY OF GILROY 7351 ROSANNA ST GILROY, CA 95020 Company Name: LIBERTY MUTUAL INSURANCE PO BOX 188025 FAIRFIELD, OH 45018-8025 For Payment/Billing Inquiries: 1-866-290-2920 mybusinessonline. libertymutual.com NOTICE TO: ADDITIONAL INTEREST Line of Business: COMMERCIAL LINES PACKAGE You are hereby notified that your interest under this policy has been cancelled as of the time and date stated above. Authorized Representative Info Copy DNOC_INFO 00852 BKW56427935 05100126 001748 GCXCPCN Page 1 GILRGOL-01 MHENRY CERTIFICATE OF LIABILITY INSURANCE DATE 04110/2019Y) 04/10/2019 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER License # OE02096 I CONTACT NAME: DiBuduo & DeFendis Insurance Brokers, LLC PHONE FAX, -7941P.O. Box 5479 (,o, Ext): (559) 432-0222 ANo):(559) 431 Fresno, CA 93755-5479 E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: West American Insurance Company 44393 INSURED INSURER B : American Fire and Casualty Company 24066 Gilroy Golf Course, Inc. INSURER C:Oak River Insurance Company 34630 2695 Hecker Pass Hwy INSURER D : J Gilroy, CA 95020 INSURER E INSURER F : COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LTR INSD WVD (MM/DD/YYYY) (MM/DD/YYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY 1 0O0 0O CLAIMS -MADE ®OCCUR X BKW56427935 EACH OCCURRENCE $ 01/01/2019 01/01/2020 DAMAGE TO RENTED PREMISES (Ea occurrence) $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENT AGGREGATE LIMIT APPLIES PER: POLICY JE FX GENERAL AGGREGATE $ PRODUCTS - COMP/OP AGG I $ OTHER: $ AUTOMOBILE LIABILITY - COMBINED SINGLE LIMIT (Ea accident) $ ANY AUTO BODILY INJURY (Per $ - OWNED SCHEDULED AUTOS ONLY AUTOS person) BODILY INJURY (Per accident) $ NON -OWNED ONLY AUTOS PROPERTY accidentDAMAGE ONLY $ B UMBRELLA LIAB X OCCUR X ESA56427935 EACH OCCURRENCE $ 01/01/2019 01/01/2020 EXCESS LIAB CLAIMS -MADE AGGREGATE $ DED I I RETENTION $ $ C WORKERS COMPENSATION PER OTH- AND EMPLOYERS' LIABILITY �, / N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE GIWC014992 OFFICER/MEMBER EXCLUDED? N / A 04/10/2019 04/10/2020 E.L. EACH ACCIDENT $ (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 0 500,000 15,000 1,000,000 2,000,000 2,000,000 1,000,000 1,000,000 1,000,000 1,000,000 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) The certificate holder is named as additional insured when required by written contract in regards to the general liability form attached CG 88 10 0413 - Commercial General Liability Extension. CERTIFICATE Nni nER Illll�lll�llllelllllllll�lllllllllll�lllll�lllll�llll�lllll�l'�" ***************AUTO**MIXED AADC 936 Tray 2 : Piece 431 431 2 MB 0.428 City of Gilroy It's Officers, Officials and Employees 7351 Rosanna St Gilroy CA 95020-6141 ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE COMMERCIAL GENERAL LIABILITY CG 88 10 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. COMMERCIAL GENERAL LIABILITY EXTENSION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART INDEX SUBJECT NON -OWNED AIRCRAFT NON -OWNED WATERCRAFT PROPERTY DAMAGE LIABILITY -ELEVATORS EXTENDER DAMAGE TO PROPERTY RENTED TO YOU (Tenant's Property Damage) MEDICAL PAYMENTS EXTENSION EXTENSION OF SUPPLEMENTARY PAYMENTS -+COVERAGES A AND B ADDITIONAL INSUREDS -BY CONTRACT, AGREEMENT OR PERMIT PRIMARY AND NON-CONTRIBUTORY- ADDITIONAL INSURED EXTENSION ADDITIONAL INSUREDS -EXTENDED PROTECTION OF YOUR "LIMITS OF INSURANCE'" WHO IS AN INSURED - INCIDENTAL MEDICAL ERRORS/MALPRACTICE AND WHO IS AN INSURED - FELLOW EMPLOYEE EXTENSION - MANAGEMENT EMPLOYEES NEWLY FORMED OR ADDITIONALLY ACQUIRED ENTITIES FAILURE TO DISCLOSE HAZARDS AND PRIOR OCCURRENCES KNOWLEDGE OF OCCURRENCE, OFFENSE, CLAIM OR SUIT LIBERALIZATION CLAUSE BODILY INJURY REDEFINED EXTENDED PROPERTY DAMAGE WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US - IIf WHEN REQUIRED IN A CONTRACT OR AGREEMENT WITH YOU PAGE 2 2 2 2 3 3 3 5 6 6 7 7 7 7 7 Q 2013 Liberty Mutual Insurance CG 88 16 04 13 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 8 With respect to coverage afforded by this endorsement, the provisions of the policy apply un|aao modified by the endorsement, A. NON -OWNED AIRCRAFT , Under Paragraph 2- Exclusions of Section | ^ Coverage A~ Bodily Injury And Property Damage L|abiUty, exclusion g. A|,ormft. Auto Or Watercraft does not apply to an aircraft provided: 1. It is not owned by any insured; 8. |tiohired, chartered or loaned with atroined paid crew; ' 3. The pilot in command holds acurrenUy effective certificate, issued by the duly constituted authority of the United States of America or Canada, designating her orhim ocommanuio| or airline pilot; and 4. It is not being used to carry persons or property for eoharge. However, the insurance afforded by this provision does not apply if there is available to the insured other valid and collectible insuranoo, whether primary, excess (other than insurance written to apply specifically � in axoeea of this po|ioy), contingent or on any other baoio, that would also apply to the bee covered under this provision. B. NON -OWNED WATERCRAFT Under Paragraph 2.Exclusions ofSection |~ Coverage /\^ Bodily Injury And Property DonnmUo L|mb|(|ty. � Subparagraph (2) of exclusion g. Aircraft, Auto Or Watercraft is replaced by the following'. This exclusion does not apply to: (2) Awatercraft you do not own that is: (o) Less than 52feet long; and � (b) Not being used to carry persons or property for ooherQe. C. PROPERTY DAMAGE LIABILITY ~ELEVATORS 1. Under Paragraph 2. Exclusions of Section | ^ Coverage A ~ Bodily Injury And Property Damage Liabil- ity, Subparagraphs (3). (4)and (G) of exclusion ]. Damage To Property do not apply if such "property damage" maau|ta from the use of elevators. For the purpose of this provlo(mm, elevators do not include vehicle ||ftm. Vehicle lifts are lifts or hoists used in automobile service or repair operations. 2. The following is added to Section |V -Cmmmmmo|a| General Liability Cond1tlons, Condition 4. Other Insurance, Paragraph b.Excess Insurance: The insurance afforded by this provision ofth|o endorsement is exooaa over any property |nmuronca, whether phmmry, excess, contingent or on any other basis. D. EXTENDED DAMAGE TO PROPERTY RENTED TCJYOU (Tenant's Property Damage) � � If Damage To Premises Rented To You is not otherwise excluded from this Coverage Port: 1. Under Paragraph 2. Emz|psymne of Section | ^ Coverage A^ Bodily Injury and Property Dumu0o Liability: m. The fourth from the last paragraph of exclusion ]. Damage To Property is replaced by the follow- ing: Paragraphs (1)' (3)oud (4) of this exclusion do not apply to "property damage" (other than damage by fire, lightning, axp|ooion, smoke, or leakage from an automatic fine protection system) to: (i) Premises rented to you for apehmd of 7or fewer consecutive days; or (U) Contents that you rent or lease as pad of a ppam|eee rental or |emeo agreement for aper|od of more than 7deya. Paragraphs (1), (3) and (4) of this exclusion do not apply to "property damage" to contents of premises rented to you for a period of 7orfewer consecutive days. A separate limit of insurance applies to this coverage as described in Section {|Y ~ Limits of Insurance. � 2013 Liberty Mutual Insurance CGOQ1OO413 Includes copyrighted material ofInsurance Services Office, |no�.w|m its permission. Page 2of8 b. The last paragraph of subsection 2. Exclusions Isreplaced bythe following: Exclusions c. through n. do not apply to damage by fire, lightning, explosion, smoke or leakage 'from automatic fine protection oymb*mn to premises while embed to you or temporarily occupied by you with permission of the owner. Aaeporate limit of insurance applies to Damage To Premises Rented To You as described in Section N - Limits Of Insurance. 2. Paragraph M. under Section |U^Limits Of Insurance is nyp|ooed bythe following: 6. Subject to Paragraph 5. above. the Damage To Premises Rented To You Limit is the most we will pay under Coverage Afbr damages because of "property damage" to: a. Any one premise: (1) VVh||e rented to you; or (2) VVhi|m rented to you or temporarily occupied by you with permission of the owner for damage by fire. |iQhtning, explosion, smoke or leakage from automatic protection sys- tems; or b. Contents that you nsmt or lease as part of apremiaes rental or lease agreement, 3. As regards coverage provided by this provision D. EXTENDED DAMAGE TO PROPERTY RENTED TO YOU (Tenant's Property DmnnmWe) ~PanaQnsph S.mofDefinitions is replaced with the following: Q.m^ Acontreot for a lease of premises. However, that portion of the contract for e|eese of premises that indemnifies any person or organization for damage by fire. |ightming, exp|os|on, smoke, or leakage from automatic fire protection systems to premises while rented to you or temporarily occupied by you with the permission of the owner, or for damage to contents of such pnam|meo that are included in your pnam|oea rental or lease ograement, is not an "insured contract". E. MEDICAL PAYMENTS EXTENSION If Coverage C Medical Payments Is not otherwise excluded. the Medical Payments provided by this policy are amended as follows: ` Under Paragraph 1. Insuring Agreement of Section | ~ Coverage C ~ Medical Payments, Subparagraph (b) of Paragraph a. is replaced by the following: (b) The expenses are incurred and reported within three years of the date of the accident; and F. EXTENSION OFSUPPLEMENTARY PAYMENTS -COVERAGES AAND B 1. Under Supplementary Payments -Conerages Amnd B, Paragraph tb. is replaced by the following: b. Up to $3,000 for cost of bail bonds required because of accidents or heffiu law violations arising out of the use of any vehicle to which the Bodily Injury Liability Coverage applies. We do not have to furnish these bonds. �� Paragraph ' 'replaced � � d |abythe fo|�w|mQc N " d. All reasonable expenses incurred by the insured at our request to ooaiot ma in the investigation or defense of the claim or "suit", including actual loss of earnings up to $500 adey because of time off from work. G. ADDITIONAL INSUREDS -BY CONTRACT, AGREEMENT OR PERMIT 1. Paragraph 2. under Section U -Who Is An Insured is amended to include as an insured any person or organization whom you have agreed to add as on additional insured in mwrittem contract, written agreement or permit. Such person or organization is an additional insured but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused in whole or in part by: m. Your acts cxomissions, or the acts oromissions of those acting on your behalf, in the performance of your on going operations for the additional insured that are the subject of the written contract or written agreement provided that the "bodily injury" or "property damage" ncnure, or the "per- sonal and advertising injury" is oommitted, subsequent to the signing of such written contract or written agreement; or @ 2o1ouuertyMutual Insurance b. Premises or facilities rented by you or used by you; or ` o. The maintenance, operation or use by you of equipment rented or leased to you by such person or organization; or d. Operations performed by you or on your behalf for which the state or political subdivision has issued opennit subject to the following additional provisions: (1) This insurance does not apply to "bodily injury". "property damage", or "personal and ad- vertising injury" arising out nfthe operations performed for the state or political subdivision; (2) This insurance does not apply to "bodily injury" or "property damage" included within the "completed operations hazard". (3) |noonanoo mppUes to premises you owm, rent, or control but only with respect to the following hazards: (a) The existence, maintenance, repair, conatruction, eraotion, or removal of advertising � e|Qno, ovvn|nga, canup|oo, o*||ar entrances, coal ho|me, drivewmyu, monho|am, marquees, m hoist away opeuinge, sidewalk vaults, street bannmny, or decorations and similar expo' ` aunea; or (b) The construction, enac|on, or removal of elevators; or � (o) The ownership, ma|ntanmnco, oruse ofany elevators, covered by this insurance. However, 1. The insurance afforded to such additional insured only applies tothe extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or egreememt, the insur- ance afforded to such additional insured will not be broader than that vvh|oh you are required by � the contract or agreement to provide for such additional insured. With respect to Paragraph 1.a. abnve, a peraon's or organizat|on's status as an additional insured under this endorsement ends when: (1) All wmrk, including materials, parts or equipment furnished in connection with such work' on the project (other than aem|ue, 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 e principal aaa pert of the same project. With respect to Paragraph v.b. above, a persom'a or orgonization'm status as an additional insured under this endorsement ends when their written contract or written agreement with you for such premises or facilities ends, N � With respects to Paragraph 1.o. above, this insurance does not apply to any "occurrence", vvh|nh takes place after the equipment rental or lease agreement has expired or you have returned such equipment to the lessor. m The insurance provided by this endorsement applies only if the written contract or written agreement is signed prior to the "bodily injury" or "property damage". We have no duty to defend an additional insured under this endorsement until we receive written notice of a "suit" by the additional insured as required in Paragraph b. of Condition 2. Duties In the Event Of Occurrence, Offense, Claim Or Suit under Section |V~Commercial General Liability Condi- tions. 0 mnoLiberty Mutual Insurance m 2. With respect to the insurance provided by this endorsement, the following are added to Paragraph 2. Exclusions under Section I - Coverage A - Bodily Injury And Property Damage Liability: This insurance does not apply to: m- "Bodily hVury" or "property damage" arising from the sole negligence of the additional insured. b. "Bodily injury" or "property damage" that occurs prior to you commencing operations at the location where such "bodily injury" or "property damage" occurs. c. "Bodily injury", "property damage" or "personal and advertising injury" arising out of the render- ing of, or the tmi|una to render, any professional architectural, engineering or surveying services, including: (1) The pneparng, appmving, or faN|ng to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or (2) Supervisory, inspectio, architectural or engineering activities. This exouo|cm applies even'ifthe claims against any insured allege negligence or other wrongdoing in the supervision, h|dng, omploymmmt, training or monitoring of others by that insured, if the "occur- rence" which caused the "bodily injuryr or "property dameQe", or the offense which caused the "personal and advertising injury"` Involved the rendering of, or the faUona to render, any professional arch/toctunal, eng|neehng or surveying services. d. "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 byor on behalf of the additional insured(s) at the location of the covered operations has been completed; or (D) That portion of "your work" out of vvh|nh 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, per-form)ngopann(|onm for apr|noipe| aeapart ofthe same project. m. Any person ororganization specifically designated eaen odditiono| insured for ongoing operations by a separate ADDITIONAL INSURED -OWNERS. LESSEES OR CONTRACTORS endorsement is- sued by us and made a part of this policy. 8. With respect to the insurance afforded to these additional |naunads, the following is added to Section U| ~ Limits OfInsurance: If coverage provided to the additional insured is required by e contract or agreement, the most we v�611 pay on behalf of the additional insured is the amount of insurance: m. Required by the contract or agreement; or b. Available under the applicable Limits of Insurance shown in the Dao|enaUona| ' whichever is |sme. This endorsement shall not increase the applicable Limits of Insurance shown inthe OeolarsUo no. H. PRIMARY AND NON-CONTRIBUTORY ADDITIONAL INSURED EXTENSION This provision applies to any person or organization who qualifies oaanadditional insured under any form or endorsement under this policy. Condition 4. Other Insurance o/SECTION Df-COMMERCIAL GENERAL LIABILITY CONDITIONS |mamend' ed as follows: ^a The following is added to Paragraph /a Primary Insurance: If an additional inoured'e policy has an Other Insurance provision making its pdb9 axcmeo and you have agreed in awdtten contract or written agreement to provide the additional insured coverage on primary and noncontributory bosim, this policy shall be primary and we will not seek contribution from the additional |noured'm policy for damages we cover, @ 2013uuanxMuma| Insurance C@88 10 0413 Includes copyrighted material ufInsurance Services Office, |nc.,mth its permission. Page 5ofQ b. The following is added to Paragraph b.Excess Insurance: When awritten contract or written agreement other than apremiaoo leaoe, facilities rental contract or agreemenL, an equipment rental or lease contract or agreenen(, or permit issued by astote or pd0ma| subdivision between you and an additional insured does not require this insurance to be primary or primary and non-contributory, this insurance is excess, over any other insurance for which the addi- tional insured is designated asaNamed Insured. ' ' Regardless of the written agreement between you and an additional |noured, this insurance is excess over any other insurance whether pdmary, excesa, contingent or on any other basis for which the additional insured has been added as an additional insured on other policies, |. ADDITIONAL INSUREDS ~ EXTENDED PROTECTION OFYOUR "LIMITS OF INSURANCE" This provision applies tuany person or organization who qualifies aoonadditional insured under any form or endorsement under this policy. � 1. The following is added to Condition 3.Duties |nThe Event OfOccurrence, Offense, Claim orSuit: An additional insured under this endorsement will as soon as practicable: a. Give written mot|oo of an "occurrence" or an offense that may result in a claim or "suit' under � this insurance to us; � b. Tender the defense and indemnity of any deinn or "suit" to all insurers whom also have insurance available to the additional insured; and o. Agree to nmka available any other insurance which the additional insured has for o|oea we cover under this Coverage Part. dL We have no duty to defend or indemnify an additional insured under this endorsement until � we receive written notice ofm"mu|t" by the additional insured. 2. The limits of insurance applicable to the additional insured are those specified in evvhtten contract or written agreement or the limits of insurance as stated in the Declarations of this policy and defined in Section |U ~ Limits of Insurance of this po(ioy, vvh[ohexar are less. These ||nn|ta are inclusive of and not in addition to the |im|bo of insurance available under this policy. J. WHO IS AN INSURED -INCIDENTAL MEDICAL ERRORS /MALPRACTICE WHO IS AN INSURED ' FELLOW EMPLOYEE EXTENSION -MAN4GEKVENT EMPLOYEES Paragraph 2.a.(1) of Section || -Who Is An Insured is nap|moed with the following: (1) "Bodily injury" or "personal and advertising injury": (u) To you, to your partners or members (if you are epartnership or joint vonture), to your members (if you are a ||nn|tod liability oompamy), to aoo'emp|oyea" vvhi|a in the course of his or her employ- ment or performing duties related to the conduct of your business, or to your other "volunteer � workers" while performing duties related \othe conduct of your business; (b) To the apoumm, child, parent, brother or sister of that co -"employee" or "volunteer worker" as o consequence of Paragraph (1)(a)mbove� m (m) For which theme is any obligation to share damages with or repay someone e|eo who must pay damages because of the injury described in Paragraphs (1)(a)or(b) above; or (d) Arising out of his or her providing or failing to provide professional health care services. However, if you are not in the business of providing pm#ama/onu| health cona som|oee or providing profes- sional health care personnel to othwrs, or if coverage for providing pno#eao|ono| health care ser- vices is not otherwise excluded by separate endoroemont, this provision (Paragraph (d))doem not apply. Paragraphs (a) and (b) above du not apply to "bodily injury" or "personal and advertising injury" caused by an "employee" who is acting in ooupom1aory capacity for you. Supervisory capacity as used herein means the "employee's" job responsibilities assigned by you, includes the directsupervision of other "employ- ees" of yours. However, none of these "employees" are insureds for "bodily injury" or "personal and «" 2013uuerty Mutual insurance CG0Q 10 041m Includes copyrighted material nrInsurance Services off/pm.|nc.'wim its permission. Page Gwf8 advertising injury" arising out of their willful conduct, which is defined asthe purposeful or willful intent to cause "bodily injury" or "personal and advertising injury", or caused in whoa or in part by their intoxica- tion by liquor or controlled subatanuee. The coverage provided by provision J.iaexcess over any other valid and collectable insurance available to your "employee". K. NEWLY FORMED ORADDITIONALLY ACQUIRED ENTITIES Paragraph 3. of Section l| ~VVhu Is An Insured is replaced by the following: 3. Any organization you newly acquire or form and over vvh|uh you maintain ownership or majority interest, will qualify as o Named Insured if there is no other similar insurance available to that organization. However: a. Coverage under this provision is afforded only until the expiration of the policy period in which the entity was acquired or formed by you; b. Coverage Adoea not apply to "bodily injury" or "property damage" that occurred before you eoqu|nad or formed the organization; and o. Coverage Bdoea not apply to "personal and advertising injury" arising out of an offense committed before you ooqu|nad or formed the organization. d. Records and deauhpUoma of operations must be maintained by the first Named Insured. No person or organization is an insured with respect to the conduct ofany current or past partnership' joint venture or limited [lability company that is not shown as Named Insured in the Declarations or qualifies as an insured under this provision. L. FAILURE TO DISCLOSE HAZARDS AND PRIOR OCCURRENCES Under Section |V~Commercial General Liability Cnndidona, the following is added to Condition G. Repre- sentations: Your failure to disclose all hazards or prior "000unanomo" existing amofthe inception date ofthe policy oMa|| not prejudice the coverage afforded by this policy provided such failure to disclose all hazards or prior "occurrences" is not intentional. M. KNOWLEDGE OF OCCURRENCE, OFFENSE, CLAIM OR SUIT Under Section [V ~ Commercial General Liability Conditions, the following is added to Condition 2. Duties In The Event of Occurrence, Offense, C|a|rn Or Suit: Knowledge of an "occurrence", nMenoe, o|e|m or "suit" by an agant, servant or "employee" of any insured shall not in itself constitute knowledge of the insured unless an insured listed under Paragraph 1. of Section l| ~ Who Is An Insured or e person who has been designated by them to receive reports of "ouounenoos", ofenmya, claims or "suits" oho|| have received such notice from the agent, servant or "employee". N. LIBERALIZATION CLAUSE If we revise this Commercial General Liability Extension Endorsement to provide more coverage without additional premium charge, your policy will automatically provide the coverage as of the day the revision is effective in your state. C>. BODILY INJURY REDEFINED Under Section V - Definitions, Definition 3. is replaced by the following: 3. "Bodily Injury" means physical injury, sickness or disease sustained by apormzn. This Includes mental anguish, mental |njury, shock, fright or death that results from such physical injury, sick- ness or disease, � 2n10Liberty Mutual Insurance CG881U041O Includes copyrighted material of Insurance Services Office, Inc., with its permission, Page 7mf8 P. EXTENDED PROPERTY DAMAGE Exclusion o- ofCOVERAGE A^ BODILY INJURY AND PROPERTY DAMAGE LIABILITY is replaced by the following: a. Expected Or Intended Injury "Bodily injury" or "property damage" expected or intended from the standpoint of the insured. This exclusion done not apply to "bodily injury" or "property damage" resulting from the use of reasonable force to protect persons or property. Q. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US -VVHEN REQUIRED IN A CONTRACT ORAGREEMENT WITH YOU Under Section |V - Commercial General Liability Cond}t/ons, the following in ad to Oondition ,one~ ferOfR|QhteUf Recovery Against Others ToUs: We waive any right of recovery we may have against opensnn or organization because of payments we � make for injury or damage arising out of your ongoing operations or "your work" done under a m contract with that person or organization and included in the "products -completed operations hazard" pmv|ded: 1. You and that person or organization have agreed in m/hdng in auontnyct or agreement that you waive such rights against that person or organization; and � � 2. The injury or damage 000una subsequent to the execution of the written contract or written agree- ment. 05 2o13uuartyMutua Insurance CG 88 10 0413 Includes copyrighted material ofInsurance Services Office, |nc..with Its permission. Page WofQ Liberty Mutual. INSURANCE NOTICE OF REINSTATEMENT Policy number BKW56427935 is reinstated without any lapse in coverage for the period of 01/01/2019 - 01 /01 /2020. The reinstatement is dependent upon payment being honored by the financial institution. If payment is not honored by the financial institution, the policy will terminate on the date and time shown on the cancellation notice issued for non-payment of premium. Agent No: 4293062 Agent: TELEPHONE (559) 432-0222 DIBUDUO & DEFENDIS INSURANCE BROKERS, LLC PO BOX 5479 FRESNO, CA 93755-5479 Notice Mailed To: CITY OF GILROY 7351 ROSANNA ST GILROY, CA 95020 Date of Notice: 03/27/2019 Policy Number: BKW56427935 Account of: GILROY GOLF COURSE INC 2695 HECKER PASS HWY GILROY, CA 95020 Coverage Provided By: WEST AMERICAN INSURANCE COMPANY Policy Period: 01/01/2019 - 01/01/2020 Account Number: 201648450 For Billing Inquiries: 1-866-290-2920 mybusinessonline.libertymutual.com Info Copy REINS 02194 BKW56427935 03270259 004759 ZCXCPEN Page 1 NOTICE OF CANCELLATION 1, - Liberty STATE OF CALIFORNIA Mutual INSURANCE CANCELLATION WILL TAKE EFFECT AT 12:01 A.M. ON 03/27/2019 Date of Notice: 03/12/2019 Policy No.: BKW56427935 Issued at: DOVER, NH Agent No: 4293062 Agent: TELEPHONE (559) 432-0222 DIBUDUO & DEFENDIS INSURANCE BROKERS, LLC PO BOX 5479 FRESNO, CA 93755-5479 Notice Issued To: CITY OF GILROY 7351 ROSANNA ST GILROY, CA 95020 Line of Business: COMMERCIAL LINES PACKAGE Account of: GILROY GOLF COURSE INC 2695 HECKER PASS HWY GILROY, CA 95020 Company Name: LIBERTY MUTUAL INSURANCE PO BOX 188025 FAIRFIELD, OH 45018-8025 For PaymenVBilling Inquiries: 1-866-290-2920 mybusinessonline. libertymutual.corn You are hereby notified that your interest under this policy has been cancelled as of the time and date stated above. Authorized Representative Info Copy DNOC_INFO 01098 BKW56427935 03120116 002262 GCXCPCN Page 1 Liberty Mutual. _......__. __.._.. INSURANCE NOTICE OF REINSTATEMENT Policy number BKW56427935 is reinstated without any lapse in coverage for the period of 01/01/2019 - 01 /01 /2020. The reinstatement is dependent upon payment being honored by the financial institution. If payment is not honored by the financial institution, the policy will terminate on the date and time shown on the cancellation notice issued for non-payment of premium. Agent No: 4293062 Agent: TELEPHONE (559) 432-0222 DIBUDUO & DEFENDIS INSURANCE BROKERS, LLC PO BOX 5479 FRESNO, CA 93755-5479 Notice Mailed To: CITY OF GILROY 7351 ROSANNA ST GILROY, CA 95020 Date of Notice: 01/24/2019 Policy Number: BKW56427935 Account of: GILROY GOLF COURSE INC 2695 HECKER PASS HWY GILROY, CA 95020 Coverage Provided By: WEST AMERICAN INSURANCE COMPANY Policy Period: 01/01/2019 - 01/01/2020 Account Number: 201648450 For Billing Inquiries: 1-866-290-2920 mybusinessonline.libertymutual.com I Info Copy REINS 02582 BKW56427935 01240114 005697 ZCXCPEN Page 1 NOTICE OF CANCELLATION STATE OF CALIFORNIA oLibe2'ty Mutu, INSURANCE CANCELLATION WILL TAKE EFFECT AT 12:01 A.M. ON 01/24/2019 Date of Notice: 01/09/2019 Policy No.: BKW56427935 Issued at: DOVER, NH Agent No: 4293062 Agent: TELEPHONE (559) 432-0222 DIBUDUO & DEFENDIS INSURANCE B PO BOX 5479 FRESNO, CA 93755-5479 Notice Issued To: CITY OF GILROY 7351 ROSANNA ST GILROY, CA 95020 NOTICE TO: ADDITIONAL INTEREST Line of Business: COMMERCIAL LINES PACKAGE Account of: GILROY GOLF COURSE INC 2695 HECKER PASS HWY GILROY, CA 95020 Company Name: LIBERTY MUTUAL INSURANCE PO BOX 188025 FAIRFIELD, OH 45018-8025 For Payment/Billing Inquiries: 1-866-290-2920 mybusinessonline.libertymutual.com You are hereby notified that your interest under this policy has been cancelled as of the time and date stated above. Authorized Representative Info Copy DNOC_INFO 01261 BKW56427935 01090449 002596 GCXCPCN Page 1 GILRGOL-01 MPRUITT A�RDY CERTIFICATE OF LIABILITY INSURANCE DATE 01/02/2019 ) 01 /02/2019 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER License # OE02096 CONTACT Mandy Pruitt DiBuduo & DeFendis Insurance Brokers, LLC PHONE , -7941P.O. Box 5479 , Ext): (559) 432-0222 wcNo):(559) 431 Fresno, CA 93755-5479 E-MAIL ADDRESS: INSURED Gilroy Golf Course, Inc. 2695 Hecker Pass Hwy Gilroy, CA 95020 COVERAGES INSURER(S) AFFORDING COVERAGE I NAIC # INSURER A: West American Insurance Company 44393 INSURER B: American Fire and Casualty Company I24066 INSURER C : Markel FlrstComp INSURER D : INSURER E : INSURER F : CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE 'ADDL SUBR POLICY NUMBER POLICY EFF I POLICY EXP LIMITS LTR INSD WVD (MM/DD/YYYYI (MM/DD/YYYYI A X I COMMERCIAL GENERAL LIABILITY I EACH OCCURRENCE $ 1,000,0001 CLAIMS -MADE OCCUR DAMAGX BKW56427935 01/01/2019 01/01/2020 PREMISESaoccurenco RENTED I $ 500,000 MED EXP (Anv one person) $ 15,0001 PERSONAL & ADV INJURY $ 1,000,0001 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,0001 POLICY PRO- -XLOC I PRODUCTS - COMP/OP AGG $ 2,000,OOO OTHER: S I AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY B UMBRELLA LIAB X OCCUR ESS X EXCLIAB CLAIMS -MADE DED I I RETENTION $ ESA56427935 C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y / N MWC012672701 OFFICER/MEMBER EXCLUDED? Y� N / A (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) I $ BODILY INJURY (Per accident) I $ PROPERTY DAMAGE (Per accident) $ $ j I$ EACH OCCURRENCE 01/01/2019 1 01/0112020 AGGREGATE $ 04/10/2018 104/10/2019 1$ X IPER STATUTE EERH i E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEEI $ E.L. DISEASE - POLICY LIMIT I $ 1 1,000,0001 1,000,0001 1,000,0001 1,000,0001 1,000,0001 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required) The certificate holder is named as additional insured when required by written contract in regards to the general liability form attached CG 88 10 04 13 - Commercial General Liability Extension. CERTIFICATE HOLDER CANCELLATION 'III'Itlll'IIIIIIrllll"''rr'Ilt'rrr)rIl'Irlllll�rllllll"'�rll�l SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN orCORDANCE WITH THE POLICY PROVISIONS. AUTO`*MIXED AADC 936 545 2 MB 0.424 Tray 2 Piece 545 City of Gilroy It's Officers, Officials and Employees AUTHORIZED REPRESENTATIVE 7351 Rosanna /� \ " Gilroy CA 95020-0-6141 �/'� ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD COMMERCIAL GENERAL LIABILITY CG 88 10 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. COMMERCIAL GENERAL LIABILITY EXTENSION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART INDEX SUBJECT PAGE NON -OWNED AIRCRAFT 2 NON -OWNED WATERCRAFT 2 PROPERTY DAMAGE LIABILITY - ELEVATORS 2 EXTENDED DAMAGE TO PROPERTY RENTED TO YOU (Tenant's Property Damage) 2 MEDICAL PAYMENTS EXTENSION 3 EXTENSION OF SUPPLEMENTARY PAYMENTS - COVERAGES A AND B 3 ADDITIONAL INSUREDS - BY CONTRACT, AGREEMENT OR PERMIT 3 PRIMARY AND NON-CONTRIBUTORY- ADDITIONAL INSURED EXTENSION g ADDITIONAL INSUREDS - EXTENDED PROTECTION OF YOUR "LIMITS OF INSURANCE" 6 WHO IS AN INSURED - INCIDENTAL MEDICAL ERRORSIMALPRACTICE AND WHO IS AN INSURED - FELLOW EMPLOYEE EXTENSION - MANAGEMENT EMPLOYEES 6 NEWLY FORMED OR ADDITIONALLY ACQUIRED ENTITIES 7 FAILURE TO DISCLOSE HAZARDS AND PRIOR OCCURRENCES 7 KNOWLEDGE OF OCCURRENCE, OFFENSE, CLAIM OR SUIT 7 LIBERALIZATION CLAUSE 7 BODILY INJURY REDEFINED 7 EXTENDED PROPERTY DAMAGE 8 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US - 8 WHEN REQUIRED IN A CONTRACT OR AGREEMENT WITH YOU © 2013 Liberty Mutual Insurance CG 88 10 04 13 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 8 With respect to coverage afforded by this endorsement, the provisions of the policy apply unless modified by the endorsement. A. NON -OWNED AIRCRAFT Under Paragraph 2. Exclusions of Section I - Coverage A - Bodily Injury And Property Damage Liability, exclusion g. Aircraft, Auto Or Watercraft does not apply to an aircraft provided: 1. It is not owned by any insured; 2. It is hired, chartered or loaned with a trained paid crew; 3. The pilot in command holds a currently effective certificate, issued by the duly constituted authority of the United States of America or Canada, designating her or him a commercial or airline pilot; and 4. It is not being used to carry persons or property for a charge. However, the insurance afforded by this provision does not apply if there is available to the insured other valid and collectible insurance, whether primary, excess (other than insurance written to apply specifically in excess of this policy), contingent or on any other basis, that would also apply to the loss covered under this provision. B. NON -OWNED WATERCRAFT Under Paragraph 2. Exclusions of Section I -Coverage A - Bodily Injury And Property Damage Liability, Subparagraph (2) of exclusion g. Aircraft, Auto Or Watercraft is replaced by the following; This exclusion does not apply to: (2) A watercraft you do not own that is: (a) Less than 52 feet long; and (b) Not being used to carry persons or property for a charge. C, PROPERTY DAMAGE LIABILITY -ELEVATORS 1. Under Paragraph 2. Exclusions of Section I - Coverage A - Bodily Injury And Property Damage Liabil- ity, Subparagraphs (3), (4) and (6) of exclusion J. Damage To Property do not apply if such "property damage" results from the use of elevators. For the purpose of this provision, elevators do not include vehicle lifts. Vehicle lifts are lifts or hoists used in automobile service or repair operations. 2. The following Is added to Section IV - Commercial General Liability Conditions, Condition 4. Other Insurance, Paragraph b. Excess Insurance: The insurance afforded by this provision of this endorsement is excess over any property insurance, whether primary, excess, contingent or on any other basis. D. EXTENDED DAMAGE TO PROPERTY RENTED TO YOU (Tenant's Property Damage) If Damage To Premises Rented To You is not otherwise excluded from this Coverage Part: 1. Under Paragraph 2. Exclusions of Section I - Coverage A - Bodily Injury and Property Damage Liability: a. The fourth from the last paragraph of exclusion j. Damage To Property is replaced by the follow- ing: Paragraphs (1), (3) and (4) of this exclusion do not apply to "property damage" (other than damage by fire, lightning, explosion, smoke, or leakage from an automatic fire protection system) to: (i) Premises rented to you for a period of 7 or fewer consecutive days; or (11) Contents that you rent or lease as part of a premises rental or lease agreement for a period of more than 7 days. Paragraphs (1), (3) and (4) of this exclusion do not apply to "property damage" to contents of premises rented to you for a period of 7 or fewer consecutive days. A separate limit of insurance applies to this coverage as described in Section III - Limits of Insurance. © 2013 Liberty Mutual Insurance CG 83 10 04 13 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 2 of 8 b. The last paragraph of subsection 2. Exclusions is replaced by the following: Exclusions c, through n. do not apply to damage by fire, lightning, explosion, smoke or leakage from automatic fire protection systems to premises while rented to you or temporarily occupied by you with permission of the owner. A separate limit of insurance applies to Damage To Premises Rented To You as described in Section III - Limits Of Insurance. 2. Paragraph 6, under Section IiI - Limits Of Insurance is replaced by the following: 6. Subject to Paragraph 5. above, the Damage To Premises Rented To You Limit is the most we will pay under Coverage A for damages because of "property damage" to: a. Any one premise: (1) While rented to you; or (2) While rented to you or temporarily occupied by you with permission of the owner for damage by fire, lightning, explosion, smoke or leakage from automatic protection sys- tems; or b. Contents that you rent or lease as part of a premises rental or lease agreement. 3. As regards coverage provided by this provision D. EXTENDED DAMAGE TO PROPERTY RENTED TO YOU (Tenant's Property Damage) - Paragraph 9.a. of Definitions is replaced with the following: 9.a. A contract for a lease of premises. However, that portion of the contract for a lease of premises that indemnifies any person or organization for damage by fire, lightning, explosion, smoke, or leakage from automatic fire protection systems to premises while rented to you or temporarily occupied by you with the permission of the owner, or for damage to contents of such premises that are included in your premises rental or lease agreement, is not an "insured contract". E. MEDICAL PAYMENTS EXTENSION If Coverage C Medical Payments Is not otherwise excluded, the Medical Payments provided by this policy are amended as follows: Under Paragraph 1. Insuring Agreement of Section I - Coverage C - Medical Payments, Subparagraph (b) of Paragraph a. is replaced by the following: (b) The expenses are incurred and reported within three years of the date of the accident; and F. EXTENSION OF SUPPLEMENTARY PAYMENTS -COVERAGES A AND B 1. Under Supplementary Payments - Coverages A and B, Paragraph 1.b. is replaced by the following: b. Up to $3,000 for cost of bail bonds required because of accidents or traffic law violations arising out of the use of any vehicle to which the Bodily Injury Liability Coverage applies. We do not have to furnish these bonds. 2. Paragraph 1.d. is replaced by the following: N d. All reasonable expenses incurred by the insured at our request to assist us in the investigation or defense of the claim or "suit", including actual loss of earnings up to $500 a day because of time off from work. G. ADDITIONAL INSUREDS -BY CONTRACT, AGREEMENT OR PERMIT 1. Paragraph 2. under Section II - Who Is An Insured is amended to include as an insured any person or organization whom you have agreed to add as an additional insured in a written contract, written agreement or permit. Such person or organization is an additional insured but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused in whole or in part by: a. Your acts or omissions, or the acts or omissions of those acting on your behalf, in the performance of your on going operations for the additional insured that are the subject of the written contract or written agreement provided that the "bodily injury" or "property damage" occurs, or the "per- sonal and advertising injury" is committed, subsequent to the signing of such written contract or written agreement; or © 20131-iberty Mutual Insurance CG 88 10 04 13 Includes copyrighted material of Insurance Services Office, Inc.,with its permission. Page 3 of 8 b. Premises or facilities rented by you or used by you; or c. The maintenance, operation or use by you of equipment rented or leased to you by such person or organization; or d. Operations performed by you or on your behalf for which the state or political subdivision has issued a permit subject to the following additional provisions: (1) This insurance does not apply to "bodily injury", "property damage", or "personal and ad- vertising injury" arising out of the operations performed for the state or political subdivision; (2) This insurance does not apply to "bodily injury" or "property damage" included within the "completed operations hazard". (3) Insurance applies to premises you own, rent, or control but only with respect to the following hazards: M (a) The existence, maintenance, repair, construction, erection, or removal of advertising signs, awnings, canopies, cellar entrances, coal holes, driveways, manholes, marquees, " hoist away openings, sidewalk vaults, street banners, or decorations and similar expo- sures; or (b) The construction, erection, or removal of elevators; or (c) The ownership, maintenance, or use of any elevators covered by this insurance. However; 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insur- ance afforded to such additional insured will not be broader than that which you are required by y the contract or agreement to provide for such additional insured. With respect to Paragraph 1.a. above, a person's or organization's status as an additional insured under this endorsement ends when: (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. With respect to Paragraph 1.1b. above, a person's or organization's status as an additional insured under this endorsement ends when their written contract or written agreement with you for such premises or facilities ends, With respects to Paragraph 1.c. above, this insurance does not apply to any "occurrence" which takes place after the equipment rental or lease agreement has expired or you have returned such equipment to the lessor. ri The insurance provided by this endorsement applies only if the written contract or written agreement is signed prior to the "bodily injury" or "property damage". We have no duty to defend an additional Insured under this endorsement until we receive written notice of a "suit" by the additional insured as required in Paragraph b. of Condition 2. Duties In the Event Of Occurrence, Offense, Claim Or Suit under Section IV - Commercial General Liability Condi- tions. O 2013Liberty Mutual Insurance CG 88 10 04 13 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 4 of 8 M 2. With respect to the Insurance provided by this endorsement, the following are added to Paragraph 2. Exclusions under Section I - Coverage A - Bodily Injury And Property Damage Liability: This Insurance does not apply to: a. "Bodily Injury" or "property damage" arising from the sole negligence of the additional insured. b. "Bodily injury" or "property damage" that occurs prior to you commencing operations at the location where such "bodily injury" or "property damage" occurs. c. "Bodily injury", "property damage" or "personal and advertising injury" arising out of the render- ing of, or the failure to render, any professional architectural, engineering or surveying services, including: (1) The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or (2) Supervisory, inspection, architectural or engineering activities. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by that insured, if the "occur- rence" which caused the "bodily injury" or "property damage", or the offense which caused the "personal and advertising injury", involved the rendering of, or the failure to render, any professional architectural, engineering or surveying services. d. "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. e. Any person or organization specifically designated as an additional insured for ongoing operations by a separate ADDITIONAL INSURED -OWNERS, LESSEES OR CONTRACTORS endorsement is- sued by us and made a part of this policy. 3. With respect to the insurance afforded to these additional insureds, the following is added to Section III - Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: a. Required by the contract or agreement; or b. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declaratio ns. H. PRIMARY AND NON-CONTRIBUTORY ADDITIONAL INSURED EXTENSION This provision applies to any person or organization who qualifies as an additional insured under any form or endorsement under this policy. Condition 4. Other Insurance of SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS is amend ed as follows: a. The following is added to Paragraph a. Primary Insurance: If an additional insured's policy has an Other Insurance provision making its policy excess, and you have agreed in a written contract or written agreement to provide the additional insured coverage on a primary and noncontributory basis, this policy shall be primary and we will not seek contribution from the additional Insured's policy for damages we cover. © 2013 Liberty Mutual Insurance CG 88 10 04 13 Includes copyrighted material of Insurance Services Office, Inc.,with its permission. Page 5 of 8 b. The following is added to Paragraph b. Excess Insurance: When a written contract or written agreement, other than a premises lease, facilities rental contract or agreement, an equipment rental or lease contract or agreement, or permit Issued by a state or political subdivision between you and an additional insured does not require this insurance to be primary or primary and non-contributory, this Insurance Is excess over any other Insurance for which the addi- tional insured is designated as a Named Insured. Regardless of the written agreement between you and an additional insured, this insurance is excess over any other insurance whether primary, excess, contingent or on any other basis for which the additional Insured has been added as an additional insured on other policies. I. ADDITIONAL INSUREDS -EXTENDED PROTECTION OF YOUR "LIMITS OF INSURANCE" This provision applies to any person or organization who qualifies as an additional insured under any form or endorsement under this policy. 1. The following is added to Condition 2. Duties In The Event Of Occurrence, Offense, Claim or Suit: An additional insured under this endorsement will as soon as practicable: a. Give written notice of an "occurrence" or an offense that may result in a claim or "suit" under this insurance to us; b. Tender the defense and indemnity of any claim or "suit" to all insurers whom also have insurance available to the additional Insured; and c. Agree to make available any other insurance which the additional Insured has for a loss we cover under this Coverage Part. d. We have no duty to defend or indemnify an additional insured under this endorsement until we receive written notice of a "suit" by the additional insured. 2. The limits of insurance applicable to the additional insured are those specified In a written contract or written agreement or the limits of insurance as stated in the Declarations of this policy and defined in Section IIi - Limits of Insurance of this policy, whichever are less. These limits are inclusive of and not in addition to the limits of insurance available under this policy. J. WHO IS AN INSURED -INCIDENTAL MEDICAL ERRORS/ MALPRACTICE WHO IS AN INSURED -FELLOW EMPLOYEE EXTENSION -MANAGEMENT EMPLOYEES Paragraph 2.a.(1) of Section II -Who Is An Insured is replaced with the following: (1) "Bodily injury" or "personal and advertising injury": (a) To you, to your partners or members (if you are a partnership or joint venture), to your members (if you are a limited liability company), to a co -"employee" while in the course of his or her employ- ment or performing dutles related to the conduct of your business, or to your other "volunteer workers" while performing duties related to the conduct of your business; (b) To the spouse, child, parent, brother or sister of that co -"employee" or "volunteer worker" as a consequence of Paragraph (1) (a) above; 8 (c) For which there Is any obligation to share damages with or repay someone else who must pay damages because of the injury described in Paragraphs (1) (a) or (b) above; or (d) Arising out of his or her providing or failing to provide professional health care services. However, if you are not in the business of providing professional health care services or providing profes- sional health care personnel to others, or if coverage for providing professional health care ser- vices is not otherwise excluded by separate endorsement, this provision (Paragraph (d)) does not apply. Paragraphs (a) and (b) above do not apply to "bodily injury" or "personal and advertising injury" caused by an "employee" who is acting in a supervisory capacity for you. Supervisory capacity as used herein means the "employee's" job responsibilities assigned by you, includes the direct supervision of other "employ- ees" of yours. However, none of these "employees" are insureds for "bodily injury" or "personal and © 2013 Liberty Mutual Insurance CG 88 10 04 13 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 6 of 8 advertising injury" arising out of their willful conduct, which is defined as the purposeful or willful intent to cause "bodily injury" or "personal and advertising injury", or caused in whole or in part by their intoxica- tion by liquor or controlled substances, The coverage provided by provision J. is excess over any other valid and collectable insurance available to your "employee". K. NEWLY FORMED OR ADDITIONALLY ACQUIRED ENTITIES Paragraph 3, of Section 11 - Who Is An Insured is replaced by the following: 3. Any organization you newly acquire or form and over which you maintain ownership or majority interest, will qualify as a Named Insured if there is no other similar insurance available to that organization. However: a. Coverage under this provision is afforded only until the expiration of the policy period in which the entity was acquired or formed by you; b. Coverage A does not apply to "bodily injury" or "property damage" that occurred before you acquired or formed the organization; and c. Coverage B does not apply to "personal and advertising injury" arising out of an offense committed before you acquired or formed the organization. d. Records and descriptions of operations must be maintained by the first Named Insured. No person or organization is an insured with respect to the conduct of any current or past partnership, joint venture or limited liability company that is not shown as a Named Insured in the Declarations or qualifies as an insured under this provision. L. FAILURE TO DISCLOSE HAZARDS AND PRIOR OCCURRENCES Under Section IV - Commercial General Liability Conditions, the following is added to Condition 6. Repre- sentations: Your failure to disclose all hazards or prior "occurrences" existing as of the inception date of the policy shall not prejudice the coverage afforded by this policy provided such failure to disclose all hazards or prior "occurrences" is not intentional. M. KNOWLEDGE OF OCCURRENCE, OFFENSE, CLAIM OR SUIT Under Section IV - Commercial General Liability Conditions, the following is added to Condition 2. Duties In The Event of Occurrence, Offense, Claim Or Suit: Knowledge of an "occurrence", offense, claim or "suit" by an agent, servant or "employee" of any insured shall not in itself constitute knowledge of the insured unless an insured listed under Paragraph 1. of Section II - Who Is An Insured or a person who has been designated by them to receive reports of "occurrences", offenses, claims or "suits" shall have received such notice from the agent, servant or "employee". N. LIBERALIZATION CLAUSE If we revise this Commercial General Liability Extension Endorsement to provide more coverage without additional premium charge, your policy will automatically provide the coverage as of the day the revision is effective in your state. O. BODILY INJURY REDEFINED Under Section V - Definitions, Definition 3. is replaced by the following: 3. "Bodily Injury" means physical injury, sickness or disease sustained by a person, This includes mental anguish, mental injury, shock, fright or death that results from such physical injury, sick- ness or disease. © 2013Liberty Mutual Insurance CG 88 10 04 13 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 7 of 8 P. EXTENDED PROPERTY DAMAGE Exclusion a. of COVERAGE A. BODILY INJURY AND PROPERTY DAMAGE LIABILITY is replaced by the following: a. Expected Or Intended Injury "Bodily injury" or "property damage" expected or intended from the standpoint of the insured. This exclusion does not apply to "bodily injury" or "property damage" resulting from the use of reasonable force to protect persons or property. Q. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US - WHEN REQUIRED IN A CONTRACT OR AGREEMENT WITH YOU Under Section IV - Commercial General Liability Conditions, the following is added to Condition 8. Trans- fer Of Rights Of Recovery Against Others To Us: We waive any right of recovery we may have against a person or organization because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the "products -completed operations hazard" provided: 1. You and that person or organization have agreed in writing in a contract or agreement that you waive such rights against that person or organization; and 2. The injury or damage occurs subsequent to the execution of the written contract or written agree- ment, © 2D13Liberty Mutual Insurance CG 88 10 04 13 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 8 of 8 MPRUITT '4 EVIDENCE OF PROPERTY INSURANCE DATE 112/2019 ' THIS EVIDENCE OF PROPERTY INSURANCE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE ADDITIONAL INTEREST NAMED BELOW. THIS EVIDENCE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS EVIDENCE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE ADDITIONAL INTEREST. AGENCY (PHONE //559 432-0222 (COMPANY (A/C, No, Ext): l ) DiBuduo & DeFendis Insurance Brokers, LLC blest American Insurance Company P.O. Box 5479 Fresno, CA 93755-5479 FAX C. Nor(559) 431-7941 A DRIESS CODE: I SUB CODE: AGENC Y ID #: GILRGOL-01 License # OE02096 INSURED Gilroy Golf Course, Inc. 2695 Hecker Pass Hwy Gilroy, CA 95020 PROPERTY INFORMATION LOCATION/DESCRIPTION 2695 Hecker Pass Hwy, Gilroy, CA 95020 LOAN NUMBER POLICY NUMBER IBKW56427935 EFFECTIVE DATE EXPIRATION DATE 1/1/2019 1/1/2020 CONTINUED UNTIL TERM NATED IF CHECKED THIS REPLACES PRIOR EVIDENCE DATED: 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 EVIDENCE OF PROPERTY 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. COVERAGE INFORMATION PERILS INSURED I BASIC BROAD I X I SPECIAL COVERAGE/PERILS/FORMS AMOUNT OF INSURANCE DEDUCTIBLE Equipment, Special Form, Actual Cash Value $209,900 1,000 Business Personal Property, Special Form, Replacement Cost $68,654 1,000 REMARKS (Including Special Conditions) CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL B DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. ADDITIONAL INTEREST NAME AND ADDRESS HADDITIONAL INSURED �� LENDER'S LOSS PAYABLE X LOSS PAYEE MORTGAGEE LOAN # ***************AUTO**MIXED AADC 936 546 1 MB 0.424 Tray 2 Piece 546 City of Gilroy 7351 Rosanna St AUTHORIZED REPRESENTATIVE Gilroy CA 95020-6196 Cit of Gilroy ACORD 27 (20 b:�osanna St ©1993-2015 ACORD CORPORATION. All rights reserved. Gilroy, CA 95020 The ACORD name and logo are registered marks of ACORD POLICY NUMBER: COMMERCIAL PROPERTY CP 12 18 06 95 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. LOSS PAYABLE PROVISIONS This endorsement modifies insurance provided under the following: BUILDING AND PERSONAL PROPERTY COVERAGE FORM BUILDERS' RISK COVERAGE FORM CONDOMINIUM ASSOCIATION COVERAGE FORM CONDOMINIUM COMMERCIAL UNIT -OWNERS COVERAGE FORM STANDARD PROPERTYPOLICY SCHEDULE Provisions Applicable Loss Lender's Contract Payable Loss Payable Of Sale X Prem. Bldg. No. No. 2695 HECKER PASS HWY GILROY, CA 95020 Description Of Property Loss Payee{Name & Address} City of Gilroy 7351 Rosanna St. Gilroy, CA 95020 A. When this endorsement is attached to the STANDARD PROPERTY POLICY CP 00 99 the term Coverage Part in this endorsement is re- placed by the term Policy. The following is added to the LOSS PAYMENT Loss Condition, as indicated in the Declarations or by an "X" in the Schedule: B. LOSS PAYABLE For Covered Property in which both you and a Loss Payee shown in the Schedule or in the Declarations have an insurable interest, we will: 1. Adjust losses with you; and 2. Pay any claim for loss or damage jointly to you and the Loss Payee, as interests may appear. CP 12 18 06 95 Copyright, ISO Commercial Risk Services, Inc., 1994 Page 1 of 2 C. LENDER'S LOSS PAYABLE d. If we pay the Loss Payee for any loss 1. The Loss Payee shown in the Schedule or or damage and deny payment to you In the Declarations is a creditor, including because of your acts or because you a mortgageholder or trustee, whose In- have failed to comply with the terms terest in Covered Property is established of this Coverage Part: by such written instruments as: (1) The Loss Payee's rights will be a. Warehouse receipts; transferred to us to the extent of the amount we pay; and b. A contract for deed; (2) The Loss Payee's rights to recov- c. Bills of lading; er the full amount of the Loss d. Financing statements; or Payee's claim will not be !m- e. Mortgages, deeds of trust, or secu- paired. rity agreements. At our option, we may pay to the 2. For Covered Property in which both you Loss Payee the whole principal l and a Loss Payee have an insurable Inter- on the debt plus any accrued in- est: terest. In this event, you will pay a. We will pay for covered loss or dam- your remaining debt to us. age to each Loss Payee in their order 3. If we cancel this policy, we will give writ - of precedence, as interests may ap- ten notice to the Loss Payee at least: >' pear, a. 10 days before the effective date of � e b. The Loss Payee has the right to re- cancellation if we cancel for your ceive loss payment even if the Loss nonpayment of premium; or Payee has started foreclosure or b. 30 days before the effective date of similar action on the Covered Prop- cancellation if we cancel for any oth= erty er reason. c. If we deny your claim because of 4. If we elect not to renew this policy, we your acts or because you have failed will give written notice to the Loss Payee to comply with the terms of the Cov- at least 10 days before the expiration date erage Part, the Loss Payee will still of this policy. have the right to receive loss pay- D. CONTRACT OF SALE ment if the Loss Payee: (1) Pays any premium due under 1. The Loss Payee shown in the Schedule or this Coverage Part at our request in the Declarations is a person or organi- if you have failed to do so; zction you have entered a contract with for the sale of Covered Property. (2) Submits a signed, sworn proof 2. For Covered Property in which both you of loss within 60 days after re- and the Loss Payee have an insurable in- ceiving notice from us of your terest we will: failure to do so; and a. Adjust lasses with you; and (3) Has notified us of any change in ownership, occupancy or sub- b. Pay any claim for loss or damage ° stantlal change in risk known to jointly to you and the Loss Payee, as the Loss Payee. interests may appear: All of the terms of this Coverage Part 3. The following is added to the OTHER IN - will then apply directly to the Loss SURANCE Condition: Payee. For Covered Property that is the subject of a contract of sale, the word "you" in- cludes the Loss Payee. Page 2 of 2 Copyright, ISO Commercial Risk Services, Inc., 1994 CP 12 18 06 95