HomeMy WebLinkAboutCOI - Allied Fire Protection - Expires 2022-10-01P52(,i9i2F)X)2
ACORO CERTIFICATE OF LIABILITY INSURANCE
09/29�o21
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 endorsements .
PRODUCER CA LIC OB29370 1-925-244-7700
Edgewood Partners Insurance Centers (EPIC)
[San Ramon -Branch ID 14394]
P. 0. Box 5003
CONTACT
NAME: Certificates Department
PHONE FAX
.925-244-7700 AIC No: 925-901-0671
E-MAIL
ADDRESS: EPICcerts8spicbrokers . com
E
INSURERS AFFORDING COVERAGE
NAIC #
INSURERA:TRAVELERS IND CO OF CT
25682
San Ramon, CA 94583
INSURED
INSURERS: TRAVELERS PROP CAS CO OF AMER
25674
Allied Fire Protection
INSURER CINDIAN HARBOR INS CO
36940
INSURERD:
555 High Street
INSURER E :
INSURERF:
Oakland, CA 94601
CnVFROGFS CERTIFICATE NIIMRFR- 63385070 RFVISIAN NIIMRFR-
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.
ILTR
TYPE OF INSURANCE
ADDL
SU R
POLICY NUMBER
IPNWDDDY EFF
MIDDY EXP
LIMITS
A
X
COMMERCIAL GENERAL LIABILITY
DT22CO7S268392TCT21
10/01/21
10/01/22
EACH OCCURRENCE
$ 1,000,000
CLAIMS -MADE 51 OCCUR
DAMAGE TO RENTED
PREMISES Ea ocwrrence
S 300,000
X
MED EXP (Any one person)
$ 5,000
BI/PD DED: $10, 000
PERSONAL 8 ADV INJURY
$ 1,000,000
AGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE
S 2,000,000
GENt
POLICY FX] JEC LOC
PRODUCTS - COMP/OP AGG
$ 2,000,000
$
OTHER:
A
AUTOMOBILE LIABILITY
8109P33626521260
10/01/21
10/01/22
COMBINED SINGLE LIMIT
Ea ccident
S
1,000,000
BODILY INJURY (Per person)
$
X ANY AUTO
OWNED SCHEDULED
AUTOS ONLY AUTOS
BODILY INJURY (Per accident)
$
PROPERTY DAMAGE
P I IX
S
NON -OWNED
X HIRED 1xx
AUTOS ONLY AUTOS ONLY
$
$1R CONP $1R COLL
B
X
UMBRELLALIA13
X
OCCUR
CUP73272909
10/01/21
10/01/22
EACH OCCURRENCE
$ 11,000,000
AGGREGATE
$ 11, 000, 000
EXCESS LIAB
CLAIMS -MADE
DED I X I RETENTIONS 101000
$
B
COMPENSATION
IIB1R230969
10/01/21
10/01/22
X STATUTE ERI PER H
AND EMPLOYERS' LIABILIABILITYWORKERS
E.L. EACH ACCIDENT
$ 1,000,000
ANYPROPRIETORIPARTNEWEXECUTIVE
OFFICERIMEMBER EXCLUDED?
NIA
E.L. DISEASE - EA EMPLOYEE
$ 1,000,000
(Mandatory in NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
E.L. DISEASE - POLICY LIMIT
$ 1,000,000
C
Prof & Poll Incl. Mold
PE0004779005
10/01/21
10/01/22
$50,000 RET
10,000,000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required)
Re: All Operations of the Named Insured
CERTIFICATE MOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
City of Gilroy THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
7351 Rosanna Street AUTHORIZED REPRESENTATIVE
Gilroy, CA 95020
USA
01988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD
AHammonds-src
63385070
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3000 Executive Parkway
Suite 325
San Ramon, CA 94583
Phone 925.244.7700
Fax 925.901.0244
To: Whom it may concern
From: EPIC Insurance Brokers & Consultants
Named Insured: Allied Fire Protection
Policy Number(s): DT22C07S268392TCT21; 8109P3362652126G;
CU P7S272909; U B1R230969; 6014222015;
106551628;PEC004779005
RE: Notice of Cancellation
Should the above described policy be cancelled before the expiration date thereof, we will mail
30 days written notice to the Certificate Holder; except, 10 days notice for non-payment of
premium.
Sincerely,
Senior Account Manager
925-244-7700
www.epicbrokers.com I CA License OB29370
Pc20(X)281H)2
POLICY NUMBER: DT22CO7S268392TCT21 COMMERCIAL GENERAL LIABILITY
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
rn
BLANKET ADDITIONAL INSURED
(Includes Products -Completed Operations If Required By Contract)
0
z
This endorsement modifies insurance provided under the following: W
COMMERCIAL GENERAL LIABILITY COVERAGE PART
PROVISIONS
The following is added to SECTION II — WHO IS AN
INSURED:
Any person or organization that you agree in a
written contract or agreement to include as an
additional insured on this Coverage Part is an
insured, but only:
a. With respect to liability for "bodily injury" or
"property damage" that occurs, or for "personal
injury" caused by an offense that is committed,
subsequent to the signing of that contract or
agreement and while that part of the contract or
agreement is in effect; and
b. If, and only to the extent that, such injury or
damage is caused by acts or omissions of you or
your subcontractor in the performance of "your
work" to which the written contract or agreement
applies. Such person or organization does not
qualify as an additional insured with respect to
the independent acts or omissions of such
person or organization.
The insurance provided to such additional insured is
subject to the following provisions:
a. If the Limits of Insurance of this Coverage Part
shown in the Declarations exceed the minimum
limits required by the written contract or
agreement, the insurance provided to the
additional insured will be limited to such
minimum required limits. For the purposes of
determining whether this limitation applies, the
minimum limits required by the written contract or
agreement will be considered to include the
minimum limits of any Umbrella or Excess
liability coverage required for the additional
insured by that written contract or agreement.
This provision will not increase the limits of
insurance described in Section III — Limits Of
Insurance.
(1) Any "bodily injury", "property damage" or
"personal injury" arising out of the providing.
or failure to provide, any professional
architectural, engineering or surveying
services, including. -
(a) The preparing, approving, or failing to
prepare or approve, maps, shop
drawings, opinions, reports, surveys,
field orders or change orders, or the
preparing, approving, or failing to
prepare or approve, drawings and
specifications; and
(b) Supervisory, inspection, architectural or
engineering activities.
(2) Any "bodily injury" or "property damage"
caused by "your work" and included in the
"products -completed operations hazard"
unless the written contract or agreement
specifically requires you to provide such
coverage for that additional insured during
the policy period.
c. The additional insured must comply with the
following duties:
(1) Give us written notice as soon as practicable
of an "occurrence" or an offense which may
result in a claim. To the extent possible, such
notice should include:
(a) How, when and where the "occurrence"
or offense took place;
(b) The names and addresses of any injured
persons and witnesses; and
(c) The nature and location of any injury or
damage arising out of the "occurrence"
or offense.
b. The insurance provided to such additional (2) If a claim is made or "suit" is brought against
insured does not apply to: the additional insured:
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COMMERCIAL GENERAL LIABILITY
(a) Immediately record the specifics of the
claim or "suit" and the date received; and
(b) Notify us as soon as practicable and see
to it that we receive written notice of the
claim or "suit" as soon as practicable.
(3) Immediately send us copies of all legal
papers received in connection with the claim
or "suit", cooperate with us in the
investigation or settlement of the claim or
defense against the "suit", and otherwise
comply with all policy conditions.
(4) Tender the defense and indemnity of any
claim or "suit" to any provider of other
insurance which would cover such additional
insured for a loss we cover. However, this
condition does not affect whether the
insurance provided to such additional
insured is primary to other insurance
available to such additional insured which
covers that person or organization as a
named insured as described in Paragraph 4.,
Other Insurance, of Section IV — Commercial
General Liability Conditions.
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COMMERCIAL GENERAL LIABILITY
4. Other Insurance I
(ii) That is insurance for "premises
If valid and collectible other insurance is available to
damage";
the insured for a loss we cover under Coverages A
(iii) If the loss arises out of the
or B of this Coverage Part., our obligations are
maintenance or use of aircraft,
limited as described in Paragraphs a. and b. below.
"autos" or watercraft to the extent
As used anywhere in this Coverage Part, other
not subject to any exclusion in this
insurance means insurance or the funding of
Coverage Part that applies to
losses, that is provided by, through or on behalf of:
aircraft, "autos" or watercraft;
(i) Another insurance company;
(iv) That is insurance available to a
premises owner, manager or
(ii) Us or any of our affiliated insurance companies,
lessor that qualifies as an insured
except when the Non cumulation of Each
tinder Paragraph 4. of Section II —
Occurrence Limit provision of Paragraph 5. of
Who Is An Insured, except when
Section 111 — Limits Of Insurance or the Non
Paragraph d. below applies; or
cumulation of Personal and Advertising Injury
(v) That is insurance available to an
Limit provision of Paragraph 4. of Section III —
equipment lessor that qualifies as
Limits of Insurance applies because the
an insured under Paragraph 5. of
Amendment — Non Cumulation Of Each
Section 11 — Who Is An Insured,
Occurrence Limit Of Liability And Non
except when Paragraph d. below
Cumulation Of Personal And Advertising Injury
applies
Limit endorsement is included in this policy;
(b) Any of the other insurance, whether
(iii) Any risk retention group; or
primary, excess, contingent or on any
(iv) Any self-insurance method or program, in
other basis, that is available to the
which case the insured will be deemed to be
insured when the insured is an
the provider of other insurance.
additional insured, or is any other
Other insurance does not include umbrella
insured that does not qualify as a
insurance, or excess insurance; that was bought
named insured, under such other
specifically to apply in excess of the Limits of
insurance.
Insurance shown in the Declarations of this
(2) When this insurance is excess, we will
Coverage Part.
have no duty under Coverages A or B to
As used anywhere in this Coverage Part, other
defend the insured against any "suit" if any
insurer means a provider of other insurance. As
other insurer has a duty to defend the
"suit".
used in Paragraph c. below, insurer means a
insured against that I€ no other
insurer defends, we will undertake to do so,
provider of insurance.
but we will be entitled to the insured's rights
a. Primary Insurance
against all those other insurers.
This insurance is primary except when
(3) When this insurance is excess over other
Paragraph b. below applies. If this insurance is
insurance, we will pay only our share of the
primary, our obligations are not affected unless
amount of the loss, if any, that exceeds the
any of the other insurance is also primary.
sum of:
Then, we will share with all that other insurance
(a) The total amount that all such other
by the method described in Paragraph c. below,
insurance would pay for the loss in the
except when Paragraph d. below applies,
absence of this insurance; and
b. Excess Insurance
(b) The total of all deductible and self -
insured amounts under all that other
(1) This insurance is excess over:
insurance.
(a) Any of the other insurance, whether (4) We will share the remaining loss, if any,
primary, excess, contingent or on any with any other insurance that is not
other basis: described in this Excess Insurance
provision and was not bought specifically to
(i) That is Fire, Extended Coverage, apply in excess of the Limits of Insurance
Builders Risk, Installation Risk or shown in the Declarations of this Coverage
similar coverage for "your work"; Part
CG Tt 00 0219 Cc, 20117 The Travelers Indemnity Company. All rights reserved.
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COMMERCIAL GENERAL LIABILITY
c. Method Of Sharing
If all of the other insurance permits contribution
by equal shares, we will follow this method also.
Under this approach each insurer contributes
equal amounts until it has paid its applicable
limit of insurance or none of the loss remains,
whichever comes first.
If any of the other insurance does not permit
contribution by equal shares, we will contribute
by limits. Under this method, each insurer's
share is based on the ratio of its applicable limit
of insurance to the total applicable limits of
insurance of all insurers.
d. Primary And Non -Contributory Insurance If
Required By Written Contract
If you specifically agree in a written contract or
agreement that the insurance afforded to an
insured under this Coverage Part must apply on
a primary basis, or a primary and non-
contributory basis, this insurance is primary to
other insurance that is available to such insured
which covers such insured as a named insured,
and we will not share with that other insurance,
provided that:
(1) The "bodily injury" or "property damage" for
which coverage is sought occurs; and
(2) The "personal and advertising injury" for
which coverage is sought is caused by an
offense that is committed;
subsequent to the signing of that contract or
agreement by you.
5. Premium Audit
a. We will compute all premiums for this Coverage
Part in accordance with our rules and rates.
b. Premium shown in this Coverage Part as
advance premium is a deposit premium only. At
the close of each audit period we will compute
the earned premium for that period and send
notice to the first Named Insured. The due date
for audit and retrospective premiums is the date
shown as the due date on the bill. If the sum of
the advance and audit premiums paid for the
policy period is greater than the earned
premium, we will return the excess to the first
Named Insured.
c. The first Named Insured must keep records of
the information we need for premium
computation, and send us copies at such times
as we may request.
6. Representations
By accepting this policy, you agree:
a. The statements in the Declarations are
accurate and complete;
b. Those statements are based upon
representations you made to us; and
c. We have issued this policy in reliance upon
your representations.
The unintentional omission of, or unintentional error
in, any information provided by you which we relied
upon in issuing this policy will not prejudice your
rights under this insurance. However, this provision
does not affect our right to collect additional
premium or to exercise our rights of cancellation or
nonrenewal in accordance with applicable insurance
laws or regulations.
7. Separation Of insureds
Except with respect to the Limits of Insurance, and
any rights or duties specifically assigned in this
Coverage Part to the first Named Insured, this
insurance applies:
a. As if each Named Insured were the only
Named Insured; and
b. Separately to each insured against whom claim
is made or "suit" is brought.
8. Transfer Of Rights Of Recovery Against Others
To Us
If the insured has rights to recover all or part of any
payment we have made under this Coverage Part,
those rights are transferred to us. The insured must
do nothing after loss to impair them. At our request,
the insured will bring "suit" or transfer those rights
to us and help us enforce them.
9. When We Do Not Renew
If we decide not to renew this Coverage Part, we will
mail or deliver to the first Named Insured shown in
the Declarations written notice of the nonrenewal
not less than 30 days before the expiration date.
If notice is mailed, proof of mailing will be sufficient
proof of notice.
SECTION V — DEFINITIONS
1. "Advertisement" means a notice that is broadcast or
published to the general public or specific market
segments about your goods, products or services
for the purpose of attracting customers or
supporters. For the purposes of this definition:
a. Notices that are published include material
placed on the Internet or on similar electronic
means of communication; and
b. Regarding websites, only that part of a website
that is about your goods, products or services
for the purposes of attracting customers or
supporters is considered an advertisement.
(D 2017 The Travelers indemnity Company. All rights reserved, CG T1 00 02 19
Includes copyrighted material of Insurance Services Office, Inc. with its permission.
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POLICY NUMBER: DT22CO7S268392TCT21
COMMERCIAL GENERAL LIABILITY
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
XTEND ENDORSEMENT FOR CONTRACTORS
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
GENERAL DESCRIPTION OF COVERAGE — This endorsement broadens coverage. However, coverage for any
injury, damage or medical expenses described in any of the provisions of this endorsement may be excluded or
limited by another endorsement to this Coverage Part, and these coverage broadening provisions do not apply to
the extent that coverage is excluded or limited by such an endorsement. The following listing is a general
coverage description only. Read all the provisions of this endorsement and the rest of your policy carefully to
determine rights, duties, and what is and is not covered.
A. Who Is An Insured — Unnamed Subsidiaries
B. Blanket Additional Insured — Governmental
Entities — Permits Or Authorizations Relating To
Operations
PROVISIONS
A. WHO IS AN INSURED — UNNAMED
SUBSIDIARIES
The following is added to SECTION II — WHO IS
AN INSURED:
Any of your subsidiaries, other than a partnership,
joint venture or limited liability company, that is
not shown as a Named Insured in the
Declarations is a Named Insured if:
a. You are the sole owner of, or maintain an
ownership interest of more than 50% in, such
subsidiary on the first day of the policy period;
and
b. Such subsidiary is not an insured tinder
similar other insurance.
No such subsidiary is an insured for "bodily injury'
or "property damage" that occurred, or "personal
and advertising injury" caused by an offense
committed:
a. Before you maintained an ownership interest
of more than 50% in such subsidiary; or
b. After the date, if any, during the policy period
that you no longer maintain an ownership
interest of more than 50% in such subsidiary.
For purposes of Paragraph 1. of Section II — Who
Is An Insured, each such subsidiary will be
deemed to be designated in the Declarations as:
C. Incidental Medical Malpractice
D. Blanket Waiver Of Subrogation
E. Contractual Liability — Railroads
F. Damage To Premises Rented To You
a. An organization other than a partnership, joint
venture or limited liability company: or
b. A trust;
as indicated in its name or the documents that
govern its structure.
B. BLANKET ADDITIONAL INSURED —
GOVERNMENTAL ENTITIES — PERMITS OR
AUTHORIZATIONS RELATING TO OPERATIONS
The following is added to SECTION II — WHO IS
AN INSURED:
Any governmental entity that has issued a permit
or authorization with respect to operations
performed by you or on your behalf and that you
are required by any ordinance, law, building code
or written contract or agreement to include as an
additional insured on this Coverage Part is an
insured, but only with respect to liability for "bodily
injury", "property damage" or "personal and
advertising injury" arising out of such operations.
The insurance provided to such governmental
entity does not apply to:
a. Any "bodily injury", "property damage" or
"personal and advertising injury" arising out of
operations performed for the governmental
entity; or
b. Any "bodily injury" or "property damage"
included in the "products -completed
operations hazard".
CG D3 16 0219 � 2017 The Travelers Indemnity Company. All rights reserved Page 1 of 3
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COMMERCIAL GENERAL LIABILITY
C. INCIDENTAL MEDICAL MALPRACTICE
1. The following replaces Paragraph b. of the
definition of "occurrence" in the
DEFINITIONS Section:
b. An act or ornission committed in providing
or failing to provide "incidental medical
services", first aid or "Good Samaritan
services" to a person, unless you are in
the business or occupation of providing
professional health care services.
2. The following replaces the last paragraph of
Paragraph 2.a.(1) of SECTION 11 — WHO IS
AN INSURED:
Unless you are in the business or occupation
of providing professional health care services,
Paragraphs (1)(a), (b), (c) and (d) above do
not apply to "bodily injury" arising out of
providing or failing to provide:
(a) "Incidental medical services" by any of
your "employees" who is a nurse, nurse
assistant, emergency medical technician
or paramedic; or
(b) First aid or "Good Samaritan services" by
any of your "employees" or "volunteer
workers", other than an employed or
volunteer doctor. Any such "employees"
or "volunteer workers" providing or failing
to provide first aid or "Good Samaritan
services" during their work hours for you
will be deemed to be acting within the
scope of their employment by you or
performing duties related to the conduct
of your business.
3. The following replaces the last sentence of
Paragraph 5. of SECTION III — LIMITS OF
INSURANCE:
For the purposes of determining the
applicable Each Occurrence Limit, all related
acts or ornissions committed in providing or
failing to provide "incidental medical
services", first aid or "Good Samaritan
services" to any one person will be deemed to
be one "occurrence".
4. The following exclusion is added to
Paragraph 2., Exclusions; of SECTION I —
COVERAGES — COVERAGE A — BODILY
INJURY AND PROPERTY DAMAGE
LIABILITY:
Sale Of Pharmaceuticals
"Bodily injury" or "property damage" arising
out of the violation of a penal statute or
ordinance relating to the sale of
pharmaceuticals committed by, or with the
knowledge or consent of, the insured.
5. The following is added to the DEFINITIONS
Section:
"Incidental medical services" means:
a. Medical, surgical, dental, laboratory. x-ray
or nursing service or treatment, advice or
instruction, or the related furnishing of
food or beverages; or
b. The furnishing or dispensing of drugs or
medical, dental, or surgical supplies or
appliances.
6. The following is added to Paragraph 4.b.,
Excess Insurance, of SECTION IV —
COMMERCIAL GENERAL LIABILITY
CONDITIONS:
This insurance is excess over any valid and
collectible other insurance, whether primary,
excess, contingent or on any other basis, that
is available to any of your "employees" for
"bodily injury" that arises out of providing or
failing to provide "incidental medical services"
to any person to the extent not subject to
Paragraph 2.a.(1) of Section II — Who Is An
Insured.
I D. BLANKET WAIVER OF SUBROGATION I
The following is added to Paragraph 8., Transfer
Of Rights Of Recovery Against Others To Us,
of SECTION IV — COMMERCIAL GENERAL
LIABILITY CONDITIONS:
If the insured has agreed in a contract or
agreement to waive that insured's right of
recovery against any person or organization, we
waive our right of recovery against such person or
organization.. but only for payments we make
because of:
a. "Bodily injury" or "property damage" that
occurs: or
b. "Personal and advertising injury" caused by
an offense that is committed;
subsequent to the execution of the contract or
agreement.
E. CONTRACTUAL LIABILITY — RAILROADS
1. The following replaces Paragraph c. of the
definition of "insured contract" in the
DEFINITIONS Section:
c. Any easement or license agreement:
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2. Paragraph f.(1) of the definition of "insured
contract" in the DEFINITIONS Section is
deleted.
F. DAMAGE TO PREMISES RENTED TO YOU
The following replaces the definition of "premises
damage" in the DEFINITIONS Section:
"Premises damage" means "property damage" to:
COMMERCIAL GENERAL LIABILITY
U.
a. Any premises while rented to you or N
temporarily occupied by you with permission o
of the owner; or =°
b. The contents of any premises while such
premises is rented to you, if you rent such M
premises for a period of seven or fewer
consecutive days. >
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CG D316 0219 0 2017 The Travelers Indemnity Company. All rights reserved. Page 3 of 3
Includes copyrighted material of Insurance Services Office, Inc., with its permission.
P3260028002
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COMMERCIAL GENERAL LIABILITY
POLICY NUMBER: DT22CO7S268392TCT21
0
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY
0
DESIGNATED PROJECT(S)
GENERAL AGGREGATE LIMIT
Z
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
Designated Project
Designated Project(s): General Aggregate(s):
EACH "PROJECTd FOR WHICH YOU HAVE AGREED IN A GEMMRAL AG(WBGATE
WRITTEN CONTRACT THAT IS IN EFFECT DURING LIMIT SHOWN ON THE
THIS POLICY PERIOD, TO PROVIDE A SEPARATE DECIA RATIONS.
GENERAL AGGREGATE LIMIT, PROVIDED THAT THE
CONTRACT IS SIGNED BY YOU BEFORE THE "BODILY
INJURY" OR "PROPERTY DAMAGE" OCCURS.
A. For all sums which the insured becomes legally
obligated to pay as damages caused by "occur-
rences" under COVERAGE A. (SECTION 1), and
for all medical expenses caused by accidents un-
der COVERAGE C (SECTION 1), which can be
attributed only to operations at a single desig-
nated "project" shown in the Schedule above:
1. A separate Designated Project General Ag-
gregate Limit applies to each designated "pro-
ject", and that limit is equal to the amount of
the General Aggregate Limit shown in the
Declarations, unless separate Designated
Project General Aggregate(s) are sched-
uled above,
2. The Designated Project General Aggregate
Limit is the most we will pay for the sum of all
damages under COVERAGE A.. except
damages because of "bodily injury" or "prop-
erty damage" included in the "products -
completed operations hazard", and for medi-
cal expenses under COVERAGE C, regard-
less of the number of:
a. Insureds:
b. Claims made or "suits" brought; or
c. Persons or organizations making claims
or bringing "suits".
3. Any payments made under COVERAGE A.
for damages or under COVERAGE C. for
medical expenses shall reduce the Desig-
nated Project General Aggregate Limit for
that designated "project". Such payments
shall not reduce the General Aggregate Limit
shown in the Declarations nor shall they re-
duce any other Designated Project General
Aggregate Limit for any other designated
"project" shown in the Schedule above.
4. The limits shown in the Declarations for Each
Occurrence, Damage To Premises Rented
To You and Medical Expense continue to
apply. However, instead of being subject to
the General Aggregate Limit shown in the
Declarations, such limits will be subject to the
applicable Designated Project General Ag-
gregate Limit.
B. For all sums which the insured becomes legally
obligated to pay as damages caused by "occur-
rences" under COVERAGE A. (SECTION 1), and
for all medical expenses caused by accidents un-
der COVERAGE C. (SECTION 1), which cannot
be attributed only to operations at a single desig-
nated "project" shown in the Schedule above:
CG D2 11 0104 Copyright, The Travelers Indemnity Company, 2004 Page 1 of 2
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COMMERCIAL GENERAL LIABILITY
I. Any payments made under COVERAGE A.
for damages or under COVERAGE C. for
medical expenses shall reduce the amount
available under the General Aggregate Limit
or the Products -Completed Operations Ag-
gregate Limit, whichever is applicable; and
2. Such payments shall not reduce any Desig-
nated Project General Aggregate Limit.
C. Part 2. of SECTION III M LIMITS OF INSURANCE
is deleted and replaced by the following:
2. The General Aggregate Limit is the most we
will pay for the sum of:
a. Damages under Coverage B; and
b. Damages from 'occurrences" under
COVERAGE A (SECTION 1) and for all
medical expenses caused by accidents
under COVERAGE C (SECTION 1) which
cannot be attributed only to operations at
a single designated "project" shown in the
SCHEDULE above.
D. When coverage for liability arising out of the
"products -completed operations hazard" is pro-
vided, any payments for damages because of
"bodily injury" or "property damage" included in
the "products -completed operations hazard" will
reduce the Products -Completed Operations Ag-
gregate Limit, and not reduce the General Aggre-
gate Limit nor the Designated Project General
Aggregate Limit.
E. For the purposes of this endorsement the Defini.
tions Section is amended by the addition of the
following definition:
"Project" means an area away from premises
owned by or rented to you at which you are per-
forming operations pursuant to a contract or
agreement. For the purposes of determining the
applicable aggregate limit of insurance, each
"project" that includes premises involving the
same or connecting lots, or premises whose con-
nection is interrupted only by a street, roadway,
waterway or right-of-way of a railroad shall be
considered a single "project".
F. The provisions of SECTION Ill i LIMITS OF
INSURANCE not otherwise modified by this en-
dorsement shall continue to apply as stipulated.
Page 2 of 2 Copyright, The Travelers Indemnity Company, 2004 CG D2 110104
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POLICY NUMBER: DT22CO7S268392TCT21 COMMERCIAL GENERAL LIABILITY
ISSUE DATE: 10/1/2021
M
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
n
EXCLUSION6ALL HAZARDS IN CONNECTION WITH A
DESIGNATED EXPOSURE
This endorsement modifies insurance provided under the following: z
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
DESCRIPTION
"Your work" on or for any project that, in whole or in part, is or
will become:
1. Any single-family housing;
2. Any multi -family housing other than any residential apartment; or
3. Any residential condominium
This description does not include "your work" that is fire sprinkler
installation or service work, other than such work in or for any
building, or part of any building, that is new construction
This description does not include "your work" for the Paul Ranch
project-6801 College Ranch Road, Santa Ynez, CA 93460
This insurance does not apply to "bodily injury," "property damage," personal injury" or "advertising injury"
arising out of:
1. Any exposure shown in the above schedule; or
2. Any supervision, instructions, recommendations or advice given or which should have been given in
connection therewith.
CG T4 81 11 88
Page 1 of 1
POLICY NUMBER: 8109P3362652126G
COMMERCIAL AUTO
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
BUSINESS AUTO EXTENSION ENDORSEMENT
This endorsement modifies insurance provided under the following:
BUSINESS AUTO COVERAGE FORM
GENERAL DESCRIPTION OF COVERAGE — This endorsement broadens coverage. However, coverage for any
injury, damage or medical expenses described in any of the provisions of this endorsement may be excluded or
limited by another endorsement to the Coverage Part, and these coverage broadening provisions do not apply to
the extent that coverage is excluded or limited by such an endorsement. The following listing is a general cover-
age description only. Limitations and exclusions may apply to these coverages. Read all the provisions of this en-
dorsement and the rest of your policy carefully to determine rights, duties, and what is and is not covered.
A. BROAD FORM NAMED INSURED
B. BLANKET ADDITIONAL INSURED
C. EMPLOYEE HIRED AUTO
D. EMPLOYEES AS INSURED
E. SUPPLEMENTARY PAYMENTS — INCREASED
LIMITS
F. HIRED AUTO — LIMITED WORLDWIDE COV-
ERAGE — INDEMNITY BASIS
G. WAIVER OF DEDUCTIBLE — GLASS
PROVISIONS
A. BROAD FORM NAMED INSURED
The following is added to Paragraph A.1., Who Is
An Insured, of SECTION II — COVERED AUTOS
LIABILITY COVERAGE:
Any organization you newly acquire or form dur-
ing the policy period over which you maintain
50% or more ownership interest and that is not
separately insured for Business Auto Coverage.
Coverage under this provision is afforded only un-
til the 180th day after you acquire or form the or-
ganization or the end of the policy period, which-
ever is earlier.
B. BLANKET ADDITIONAL INSURED
The following is added to Paragraph c. in A.1.,
Who Is An Insured, of SECTION II — COVERED
AUTOS LIABILITY COVERAGE:
Any person or organization who is required under
a written contract or agreement between you and
that person or organization, that is signed and
executed by you before the "bodily injury" or
"property damage" occurs and that is in effect
during the policy period, to be named as an addi-
tional insured is an "insured" for Covered Autos
Liability Coverage, but only for damages to which
H. HIRED AUTO PHYSICAL DAMAGE — LOSS OF
USE — INCREASED LIMIT
I. PHYSICAL DAMAGE — TRANSPORTATION
EXPENSES — INCREASED LIMIT
J. PERSONAL PROPERTY
K. AIRBAGS
L. NOTICE AND KNOWLEDGE OF ACCIDENT OR
LOSS
M. BLANKET WAIVER OF SUBROGATION
N. UNINTENTIONAL ERRORS OR OMISSIONS
this insurance applies and only to the extent that
person or organization qualifies as an "insured"
under the Who Is An Insured provision contained
in Section II.
C. EMPLOYEE HIRED AUTO
1. The following is added to Paragraph A.1.,
Who Is An Insured, of SECTION II — COV-
ERED AUTOS LIABILITY COVERAGE:
An "employee" of yours is an "insured" while
operating an "auto" hired or rented under a
contract or agreement in an "employee's"
name, with your permission, while performing
duties related to the conduct of your busi-
ness.
2. The following replaces Paragraph b. in B.S.,
Other Insurance, of SECTION IV — BUSI-
NESS AUTO CONDITIONS:
b. For Hired Auto Physical Damage Cover-
age, the following are deemed to be cov-
ered "autos" you own:
(1) Any covered "auto" you lease, hire,
rent or borrow; and
(2) Any covered "auto" hired or rented by
Your "employee" under a contract in
an "employee's" name, with your
CA T3 53 02 15 C�� 2015 The Travelers Indemnity Company. All rights reserved. Page 1 of 4
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COMMERCIAL AUTO
permission, while performing duties
related to the conduct of your busi-
ness.
However, any "auto" that is leased, hired,
rented or borrowed with a driver is not a
covered "auto".
D. EMPLOYEES AS INSURED
The following is added to Paragraph A.1., Who Is
An Insured, of SECTION II — COVERED AUTOS
LIABILITY COVERAGE:
Any "employee" of yours is an "insured" while us-
ing a covered "auto" you don't own, hire or borrow
in your business or your personal affairs.
E. SUPPLEMENTARY PAYMENTS — INCREASED
LIMITS
1. The following replaces Paragraph A.2.a.(2),
of SECTION II — COVERED AUTOS LIABIL-
ITY COVERAGE:
(2) Up to $3,000 for cost of bail bonds (in-
cluding bonds for related traffic law viola-
tions) required because of an "accident"
we cover. We do not have to furnish
these bonds.
2. The following replaces Paragraph A.2.a.(4),
of SECTION II — COVERED AUTOS LIABIL-
ITY COVERAGE:
(a) With respect to any claim made or "suit"
brought outside the United States of
America, the territories and possessions
of the United States of America, Puerto
Rico and Canada:
(i) You must arrange to defend the "in-
sured" against, and investigate or set-
tle any such claim or "suit" and keep
us advised of all proceedings and ac-
tions.
(ii) Neither you nor any other involved
"insured" will make any settlement
without our consent.
(iii) We may, at our discretion, participate
in defending the "insured" against, or
in the settlement of, any claim or
"suit".
(iv) We will reimburse the "insured" for
sums that the "insured" legally must
pay as damages because of "bodily
injury" or "property damage" to which
this insurance applies, that the "in-
sured" pays with our consent; but
only up to the limit described in Para-
graph C., Limits Of Insurance, of
SECTION II — COVERED AUTOS
LIABILITY COVERAGE.
(4) All reasonable expenses incurred by the
(v) We will reimburse the "insured" for
"insured" at our request, including actual
the reasonable expenses incurred
loss of earnings up to $500 a day be-
with our consent for your investiga-
cause of time off from work,
tion of such claims and your defense
of the "insured" against any such
F. HIRED AUTO —LIMITED WORLDWIDE COV-
"suit", but only up to and included
ERAGE —INDEMNITY BASIS
within the limit described in Para -
The following replaces Subparagraph (5) in Para-
graph C., Limits Of Insurance, of
graph B.7., Policy Period, Coverage Territory.
SECTION II — COVERED AUTOS
of SECTION IV — BUSINESS AUTO CONDI-
LIABILITY COVERAGE, and not in
TIONS:
addition to such limit. Our duty to
(5) Anywhere in the world, except any country or
make such payments ends when we
jurisdiction while any trade sanction, em-
have used up the applicable limit of
bargo, or similar regulation imposed by the
insurance in payments for damages,
United States of America applies to and pro-
settlements or defense expenses.
hibits the transaction of business with or
(b) This insurance is excess over any valid
within such country or jurisdiction, for Cov-
and collectible other insurance available
ered Autos Liability Coverage for any covered
to the "insured" whether primary, excess,
"auto" that you lease, hire, rent or borrow
contingent or on any other basis.
without a driver for a period of 30 days or less
(c) This insurance is not a substitute for re -
and that is not an "auto" you lease, hire, rent
quired or compulsory insurance in any
or borrow from any of your "employees",
country outside the United States, its ter -
partners (if you are a partnership), members
ritories and possessions, Puerto Rico and
(if you are a limited liability company) or
Canada.
members of their households.
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COMMERCIAL AUTO
U.
You agree to maintain all required or
compulsory insurance in any such coun-
try up to the minimum limits required by
local law. Your failure to comply with
compulsory insurance requirements will
not invalidate the coverage afforded by
this policy, but we will only be liable to the
same extent we would have been liable
had you complied with the compulsory in-
surance requirements.
(d) It is understood that we are not an admit-
ted or authorized insurer outside the
United States of America, its territories
and possessions, Puerto Rico and Can-
ada. We assume no responsibility for the
furnishing of certificates of insurance, or
for compliance in any way with the laws
of other countries relating to insurance.
G. WAIVER OF DEDUCTIBLE — GLASS
The following is added to Paragraph D., Deducti-
ble, of SECTION III -- PHYSICAL DAMAGE
COVERAGE:
No deductible for a covered "auto" will apply to
glass damage if the glass is repaired rather than
replaced.
H. HIRED AUTO PHYSICAL DAMAGE — LOSS OF
USE — INCREASED LIMIT
The following replaces the last sentence of Para-
graph A.4.b., Loss Of Use Expenses, of SEC-
TION III — PHYSICAL DAMAGE COVERAGE:
However, the most we will pay for any expenses
for loss of use is $65 per day, to a maximum of
$750 for any one "accident".
1. PHYSICAL DAMAGE — TRANSPORTATION
EXPENSES — INCREASED LIMIT
The following replaces the first sentence in Para-
graph A.4.a., Transportation Expenses, of
SECTION III — PHYSICAL DAMAGE COVER-
AGE:
We will pay up to $50 per day to a maximum of
$1,500 for temporary transportation expense in-
curred by you because of the total theft of a cov-
ered "auto" of the private passenger type.
J. PERSONAL PROPERTY
(2) In or on your covered "auto".
This coverage applies only in the event of a total
theft of your covered "auto".
No deductibles apply to this Personal Property
coverage.
K. AIRBAGS
The following is added to Paragraph B.3., Exclu-
sions, of SECTION III --- PHYSICAL DAMAGE
COVERAGE:
Exclusion 3.a. does not apply to "loss" to one or
more airbags in a covered "auto" you own that in-
flate due to a cause other than a cause of "loss"
set forth in Paragraphs A.1.b. and A.1.c., but
only:
a. If that "auto" is a covered "auto" for Compre-
hensive Coverage under this policy;
b. The airbags are not covered under any war-
ranty; and
c. The airbags were not intentionally inflated.
We will pay up to a maximum of $1,000 for any
one "loss".
L. NOTICE AND KNOWLEDGE OF ACCIDENT OR
LOSS
The following is added to Paragraph A.2.a., of
SECTION IV — BUSINESS AUTO CONDITIONS:
Your, duty to give us or our authorized representa-
tive prompt notice of the "accident" or "loss" ap-
plies only when the "accident" or "loss" is known
to:
(a) You (if you are an individual);
(b) A partner (if you are a partnership);
(c) A member (if you are a limited liability com-
pany);
(d) An executive officer, director or insurance
manager (if you are a corporation or other or-
ganization); or
(e) Any "employee" authorized by you to give no-
tice of the "accident" or "loss".
[M::B:LANKET WAIVER OF SUBROGATION
The following replaces Paragraph A.S., Transfer
Of Rights Of Recovery Against Others To Us,
of SECTION IV — BUSINESS AUTO CONDI-
TIONS:
The following is added to Paragraph A.4., Cover- 5. Transfer Of Rights Of Recovery Against
age Extensions, of SECTION III — PHYSICAL Others To Us
DAMAGE COVERAGE: We waive any right of recovery we may have
Personal Property against any person or organization to the ex -
tent required of you by a written contract
We will pay up to $400 for "loss" to wearing ap- signed and executed prior to any "accident"
parel and other personal property which is: or "loss", provided that the "accident" or "loss"
(1) Owned by an "insured"; and arises out of operations contemplated by
CA T3 53 0216 C>) 2015 The Travelers Indemnity Company. All rights reserved. Page 3 of 4
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COMMERCIAL AUTO
such contract. The waiver applies only to the The unintentional omission of, or unintentional
person or organization designated in such error in, any information given by you shall not
contract. prejudice your rights under this insurance. How-
N. UNINTENTIONAL ERRORS OR OMISSIONS ever this provision does not affect our right to col -
The following is added to Paragraph B.2., Con- lect additional premium or exercise our right of
cealment, Misrepresentation, Or Fraud, of cancellation or non -renewal.
SECTION IV -- BUSINESS AUTO CONDITIONS:
Page 4 of 4 2015 The Travelers Indemnity Company. All rights reserved. CA T3 53 0215
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r326002HINQ
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C
POLICY NUMBER: 8109P3362652126G
COMMERCIAL AUTO
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
BLANKET ADDITIONAL INSURED - PRIMARY AND
NON-CONTRIBUTORY WITH OTHER INSURANCE -
CONTRACTORS
This endorsement modifies insurance provided under the following:
BUSINESS AUTO COVERAGE FORM
PROVISIONS
1. The following is added to Paragraph c. in A.1.,
Who Is An Insured, of SECTION II — COVERED
AUTOS LIABILITY COVERAGE:
This includes any person or organization who you
are required under a written contract or
agreement, that is signed by you before the
"bodily injury" or "property damage" occurs and
that is in effect during the policy period, to name
as an additional insured for Covered Autos
Liability Coverage, but only for damages to which
this insurance applies and only to the extent of
that person's or organization's liability for the
conduct of another "insured".
2. The following is added to Paragraph B.5., Other
Insurance of SECTION IV — BUSINESS AUTO
CONDITIONS:
Regardless of the provisions of paragraph a. and
paragraph d. of this part 5. Other Insurance, this
insurance is primary to and non-contributory with
applicable other insurance under which art
additional insured person or organization is a
named insured when a written contract or
agreement with you, that is signed by you before
the "bodily injury" or "property damage" occurs
and that is in effect during the policy period,
requires this insurance to be primary and non-
contributory.
CA T4 99 02 16 u 2016 The Travelers Indemnity Company. All rights reserved. Page 1 of 1
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iRAVELERSJAW&
WORKERS COMPENSATION
AND
EMPLOYERS LIABILITY POLICY
ENDORSEMENT WC 99 03 76 ( A)rl
WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS
ENDORSEMENT. CALIFORNIA
(BLANKET WAIVER)
We have the right to recover our payments from anyone liable for an injury covered by this policy. We will
not enforce our right against the person or organization named in the Schedule.
The additional premium for this endorsement shall
be mium.
Schedule
Person or Organization
BLANKET WHERE REQUIRED
BY WRITTEN CONTRACT
% of the California workers' compensation pre -
Job Description
BLANKET WHERE REQUIRED
BY WRITTEN CONTRACT
This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise
stated.
(The Information below is required only when this endorsement is Issued subsequent to preparation
of the policy.)
Endorsement Effective: 10/1/21 Policy No.: U131 R230969
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