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HomeMy WebLinkAboutCOI - RLI Insurance Company - Expires 2021-10-14BUSINESSOWNERS BP 12 01 08 10 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BUSINESSOWNERS POLICY CHANGES THIS ENDORSEMENT FORMS A PART OF THE POLICY NUMBERED BELOW. POLICY NUMBER POLICY CHANGES EFFECTIVE COMPANY AUTHORIZED REPRESENTATIVE BOP1047197 10/14/2020 RLI Insurance Company NAMED INSURED Jenny Ray -Camara CHANGES • Additional Insured Endorsement form, BP 04 02 , has been added. for City of Gilroy 10/14/2020_ Lindbergh Insurance Agency/88502 Lindbergh Insurance Agency/99999 BP12010810 © Insurance Services Office, Inc., 2009 Page 1 of 2 r� POLICY AMOUNT AND PREMIUM ADJUSTMENT Limits of Insurance Premiums Coverage Description Previous Limit of Insurance New Limit of Insurance Previous Premium New Premium ❑ Add'I Premium ❑ Return Premium OPTIONAL COVERAGES The following optional coverages are added under this policy when designated by an "X" in the box(es) shown below. ❑ Add'I. Premium ❑ Return Premium Limits of Insurance ❑ Outdoor Signs ❑ Burglary and Robbery (Named Peril Endorsement only) or ❑ Money and Securities Inside the Premises Outside the Premises ❑ Employee Dishonesty Each Occurrence ❑ Equipment Breakdown TOTAL PREMIUM ADJUSTMENTS PREMIUM DUE AT POLICY CHANGE EFFECTIVE DATE ADDITIONAL RETURN REMOVAL If Covered Property is removed to a new location that is described on this Policy Change, you may extend this PERMIT insurance to include that Covered Property at each location during the removal. Coverage at each location will apply in the proportion that the value at each location bears to the value of all Covered Property being removed. This permit applies up to 10 days after the effective date of this Policy Change: after that, this insurance does not apply at the previous location. Authorized Representative Signature BP 12 01 08 10 © Insurance Services Office, Inc., 2009 Page 2 of 2 Policy Number: BOP1047197 RLI Insurance Company THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - MANAGERS OR LESSORS OF PREMISES This endorsement modifies insurance provided under the following: BUSINESSOWNERS COVERAGE FORM Section II — Liability is amended as follows: A. The following is added to Paragraph C. Who Is An Insured: 3. The person(s) or organization(s) shown in- the Schedule is also an additional insured, but only with respect to liability arising out of the owner- ship, maintenance or use of that part of the prem- ises leased to you and shown in the Schedule. However: a. The insurance afforded to such additional insured only applies to the extent permitted by law; and b. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds the following additional exclusions apply: Designation Of Premises (Part Leased To You): C. SCHEDULE Name Of Person(s) Or Organization(s) (Additional Insured): City of Gilroy 7351 Rosanna Street Gilroy, CA 95020 This insurance does not apply to: 1. Any "occurrence" that takes place after you cease to be a tenant in the premises described in the Schedule. 2. Structural alterations, new construction or demo- lition operations performed by or for the person(s) or organization(s) designated in the Schedule. With respect to the insurance afforded to these addi- tional insureds, the following is added to Paragraph D. Liability And Medical Expenses Limits Of Insurance: If coverage provided to the additional insured is re- quired by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable Limits Of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits Of Insurance shown in the Declarations. BP 04 02 07 13 © Insurance Services Office, Inc., 2012 Page 1 of 2 r; ADDITIONAL INSURED — MANAGERS OR LESSORS OF PREMISES — Cont'd. Additional Premium: $20 Information required to complete this Schedule, if not shown above, will be shown in the Declarations. BP 04 02 07 13 © Insurance Services Office, Inc., 2012 Page 2 of 2