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HomeMy WebLinkAbout1 - Original Submission_ Besco COISHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. INSURER(S) AFFORDING COVERAGE INSURER F : INSURER E : INSURER D : INSURER C : INSURER B : INSURER A : NAIC # NAME:CONTACT (A/C, No):FAX E-MAILADDRESS: PRODUCER (A/C, No, Ext): PHONE INSURED REVISION NUMBER:CERTIFICATE NUMBER:COVERAGES 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). 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. OTHER: (Per accident) (Ea accident) $ $ N / A SUBR WVD ADDL INSD 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. $ $ $ $PROPERTY DAMAGE BODILY INJURY (Per accident) BODILY INJURY (Per person) COMBINED SINGLE LIMIT AUTOS ONLY AUTOSAUTOS ONLY NON-OWNED SCHEDULEDOWNED ANY AUTO AUTOMOBILE LIABILITY Y / N WORKERS COMPENSATION AND EMPLOYERS' LIABILITY OFFICER/MEMBER EXCLUDED? (Mandatory in NH) DESCRIPTION OF OPERATIONS below If yes, describe under ANY PROPRIETOR/PARTNER/EXECUTIVE $ $ $ E.L. DISEASE - POLICY LIMIT E.L. DISEASE - EA EMPLOYEE E.L. EACH ACCIDENT EROTH-STATUTEPER LIMITS(MM/DD/YYYY)POLICY EXP(MM/DD/YYYY)POLICY EFFPOLICY NUMBERTYPE OF INSURANCELTRINSR DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) EXCESS LIAB UMBRELLA LIAB $EACH OCCURRENCE $AGGREGATE $ OCCUR CLAIMS-MADE DED RETENTION $ $PRODUCTS - COMP/OP AGG $GENERAL AGGREGATE $PERSONAL & ADV INJURY $MED EXP (Any one person) $EACH OCCURRENCE DAMAGE TO RENTED $PREMISES (Ea occurrence) COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO- JECT LOC CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) CANCELLATION AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. CERTIFICATE HOLDER The ACORD name and logo are registered marks of ACORD HIRED AUTOS ONLY X Attn: Travis Olson 2,000,000 WA Stop Gap 1M/1M/1M Kielie.Hilliard@AssuredPartners.com This insurance is primary and non-contributory with a waiver of subrogation when required by written contract. 4,000,000 X UMC0006413 City of Bremerton, and any others as required by written contract. The following are additional insured as required per contract: Re: Wastewater Treatment Plant - Digester No. 2 USA X XLS0114112 B 1-206-343-2323 Tacoma, WA 98421-1497 06/14/2021 BCS0038770 12/15/21 X 1,000,000 colinmeding 07/01/2107/01/20 1,000,000 Berg Equipment & Scaffolding Co, Inc. 1,000,000 X MUTUAL OF ENUMCLAW INS CO X SCOTTSDALE INS CO X A 2,000,000 07/01/20 2130 East D Street X X X 345 6th Street, Suite 100 206-262-6376 100,000 62476593 62476593 1325 Fourth Avenue, Suite 2100 Seattle, WA 98101 1,000,00007/01/20 WA#877030 4,000,000 CPP0024442 1,000,000 X X 07/01/21 COLL $500 X 12/15/21 COMP $500 X 12/15/20 Bremerton, WA 98337 EXCLUDED 0 Umbrella - AUTO ONLY X X BCS0038770 - WA Stop Gap City of Bremerton A 1,000,000 A 07/01/21 12/15/20X X 14761 Aggregate Limit 41297 4,000,000 Kielie Hilliard AssuredPartners of Wash. Ins. Agency, LLC CA Lic 0K61066 AssuredPartners of Washington, LLC DocuSign Envelope ID: 25DE888D-D0C9-4C7D-89C4-84437942674A SPECIAL BUSINESS AUTO ENHANCEMENT ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by this endorsement. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. COMMERCIAL AUTO EA 99 11 03 18 Page 1 of 6EA 99 11 03 18 Includes copyrighted material of Insurance Services Office, Inc., with its permission The following changes revise SECTION I –COVERED AUTOS Paragraph C.1.is deleted and replaced with the following: 1. Trailers a.“Trailers”with a load capacity of 2,000 pounds or less designed primarily for travel on public roads; or b.“Trailers”designed primarily for travel on public roads when: (1)Pulled by an owned private passenger auto specifically described in Item Three of the Declarations as a covered “auto”for Liability Coverage under this Coverage Form; and (2)Not used for business,farming or ranching purposes. Private passenger auto means a motor vehicle of the private passenger,station wagon,pickup or van type designed for use on public highways and subject to motor vehicle registration. The following is added: D.Temporary Substitute Autos – Physical Damage If Physical Damage Coverage is provided by this Coverage Form,the following types of vehicles are also covered “autos”for Physical Damage Coverage: Any “auto”you do not own while used with the permission of its owner as a temporary substitute for a covered “auto”you own that is out of service because of its: 1.Breakdown; 2.Repair; 3.Servicing; 4.“Loss”; or 5.Destruction. The coverage that applies is the same as the coverage provided for the vehicle being replaced. Physical Damage Coverage is extended to the temporary substitute auto for the lesser of the following number of days: 1.The number of days reasonably required to repair or replace the covered “auto”that is out of service; or 2.30 days. The following changes revise SECTION II –LIABILITY COVERAGE The following is added to Paragraph A.1.: d.Blanket Additional Insured Any person or organization that you are required to include as an additional insured on this Coverage Form in a written contract or agreement that is signed and executed by you before the “bodily injury”or “property damage”occurs and that is in effect during the policy period is an “insured”for Liability Coverage,but only for damages to which this insurance applies. A person’s or organization’s status as an additional insured under this endorsement ends when your contract or agreement with such person or organization ends. The Limits of Insurance applicable to the Additional Insured are those specified in the written contract or agreement but not more than the Limits of Insurance specified in the Declarations of this policy.The Limits of Insurance applicable to the Additional Insured are inclusive of and not in addition to the Limits of Insurance shown in the declarations for the Named Insured. This Coverage does not apply to lessors of leased “autos”. DocuSign Envelope ID: 25DE888D-D0C9-4C7D-89C4-84437942674A Page 2 of 6EA 99 11 03 18 Includes copyrighted material of Insurance Services Office, Inc., with its permission e.Broadened Named Insured Any business entity newly acquired or formed by you during the policy period provided you own 51%or more of the business entity and the business is not separately insured for Business Auto Coverage.Coverage is extended up to a maximum of 180 days following acquisition or formation of the business entity or until the end of the policy period,whichever comes first. f.Employee Hired Auto An “employee”of yours is an “insured”while operating an “auto”hired or rented under a contract or agreement in that “employee’s” name,with your permission,while performing duties related to the conduct of your business. Paragraphs A.2.a.(2)and A.2.a.(4)are deleted and replaced with the following: 2.Coverage Extensions a.Supplementary Payments (2)Up to $5,000 for cost of bail bonds (including bonds for related traffic law violations)required because of an “accident”we cover.We do not have to furnish these bonds. (4)All reasonable expenses incurred by the “insured”at our request,including actual loss of earnings up to $500 a day because of time off from work. Paragraph B.5. is deleted and replaced with the following: 5.Fellow Employee “Bodily Injury” to: a.Any fellow “employee”of the “insured” arising out of and in the course of the fellow “employee’s”employment or while performing duties related to the conduct of your business.This exclusion does not apply to an “insured”who occupies a position as an officer,manager or supervisor.; or b.The spouse,child,parent,brother or sister of that fellow "employee"as a consequence of Paragraph a. above. The following changes revise SECTION III – PHYSICAL DAMAGE COVERAGE This coverage applies only for a covered “auto”for which Physical Damage Coverage is provided for on this policy. Paragraph A.2.is deleted and replaced with the following: A.COVERAGE 2.Towing We will pay up to $200 for a covered “auto”for towing and labor costs incurred each time the covered “auto”is disabled.However,the labor must be performed at the place of disablement. This coverage is excess over a.any limit shown in the Declarations for towing and labor costs; and b.any other collectible insurance. This coverage applies only for an “auto” covered on this policy for c.Comprehensive or Specified Causes of Loss Coverage; and d.Collision Coverage. The following is added to Paragraph A.3 Glass Repair – Waiver of Deductible No deductible will apply to glass breakage if such glass is repaired in a manner acceptable to us rather than replaced. Paragraph A.4.a. is deleted and replaced with the following: 4.Coverage Extensions a. Limited Rental Reimbursement or Travel Expense We will pay up to $75 per day to a maximum of $2,250 for rental reimbursement expenses for the rental of an "auto"or other transportation expense incurred by you because of "loss"to a covered "auto"which is covered by Comprehensive,Specified Causes of Loss, or Collision coverage under this policy.No deductible applies to this coverage. (1)We will pay only for those expenses incurred as a result of a covered "loss" occurring during the policy period beginning 24 hours after the "loss"and ending,regardless of the policy's expiration,with the lesser of the following number of days: (a)The number of days reasonably required to repair or replace the covered "auto”.If "loss"is caused by theft,this number of days is added to the number of days it takes to locate the covered "auto" and return it to you; or (b)30 days. (2)Our payment under this Coverage Extension (4.a.)is limited to the lesser of the necessary and actual expenses incurred or the maximum amount shown, $2,250. DocuSign Envelope ID: 25DE888D-D0C9-4C7D-89C4-84437942674A Page 3 of 6EA 99 11 03 18 Includes copyrighted material of Insurance Services Office, Inc., with its permission (3)Coverage under this Coverage Extension (4.a.)does not apply while there are spare or reserve "autos" available to you for your operations. (4)If a covered “auto”is described or designated as a covered “auto”on endorsement EA 99 01,the coverage provided by this extension is excess over coverage provided by endorsement EA 99 01. The following is added to paragraph A.4. c.Tapes, Records and Discs We will pay for "loss"to tapes,records, compact discs,or other similar devices used with audio,visual or data electronic devices. (1)We will pay only if the tapes,records, compact discs, or other similar devices: (a)Are your property or that of a family member; or (b)Are the property of an “employee” using a covered "auto"in your business affairs at the time of the "loss”; and (c)Are in a covered "auto"which sustains other covered "loss"under Comprehensive or Collision coverage at the time of the "loss"to tapes,records,compact discs,or other similar devices. (2)The most we will pay for "loss”under this Coverage Extension (4.c.) is $200. (3)Physical Damage Coverage provisions apply to this coverage,except that any deductible applicable to Comprehensive or Collision coverage does not apply to this Coverage Extension (4.c.). d.Audio,Visual and Data Electronic Equipment (1)Coverage (a)We will pay with respect to a covered “auto”described in the Schedule for “loss”to any electronic equipment that receives or transmits audio,visual or data signals and that is not designed solely for the reproduction of sound. This coverage applies only if the equipment is permanently installed in the covered “auto”at the time of the “loss”or the equipment is removable from a housing unit which is permanently installed in the covered “auto”at the time of the “loss”,and such equipment is designed to be solely operated by use of the power from the “auto’s” electrical system,in or upon the covered “auto”. (b)We will pay with respect to a covered “auto”described in the Schedule for “loss”to any accessories used with the electronic equipment described in Paragraph (1)(a)above.However, this does not include tapes,records or discs. (2) Exclusions The exclusions that apply to Physical Damage Coverage,except for the exclusion relating to Audio,Visual and Data Electronic Equipment,also apply to coverage provided by this extension. In addition,the following exclusions apply: We will not pay,under this extension, for either any electronic equipment or accessories used with such electronic equipment that is: (a)Necessary for the normal operation of the covered “auto”or the monitoring of the covered “auto’s” operating system; or (b)An integral part of the same unit housing any sound reproducing equipment designed solely for the reproduction of sound if the sound reproducing equipment is permanently installed in the covered “auto”in the opening of the dash or console normally used by the manufacturer for the installation of a radio. (3)Limit of Insurance With respect to coverage under this extension the Limit of Insurance provision of Physical Damage Coverage is replaced by the following: (a)The most we will pay for all “loss”to audio,visual or data electronic equipment and any accessories used with this equipment as a result of any one “accident”is the lesser of: (i)The actual cash value of the damaged or stolen property as of the time of the “loss”; DocuSign Envelope ID: 25DE888D-D0C9-4C7D-89C4-84437942674A Page 4 of 6EA 99 11 03 18 Includes copyrighted material of Insurance Services Office, Inc., with its permission (ii)The cost of repairing or replacing the damaged or stolen property with other property of like kind and quality; or (iii)$500. (b)An adjustment for depreciation and physical condition will be made in determining actual cash value at the time of the “loss”. (c)If a repair or replacement results in better than like kind or quality,we will not pay for the amount of betterment. (4)Deductible No deductible applies to this coverage. The insurance provided by this extension is excess over any other collectible insurance. e.Custom Signs and Decorations Physical Damage coverage on a covered “auto”may be extended to “loss”to custom signs and decorations including custom murals,paintings or other decals or graphics. Our limit of liability for loss to custom signs and decorations shall be the least of: (1)Actual cash value of the stolen or damaged property; (2)Amount necessary to repair or replace the property; or (3)$500. f.Personal Effects Coverage (1)Physical Damage Coverage on a covered “auto”may be extended to “loss”to your “personal effects”or,if you are an individual,the “personal effects”of a family member,that are in the covered “auto”at the time of the “loss”. (2)“Personal effects”as used in this extension means tangible property that is worn or carried by the “insured”. “Personal effects”does not include tools,jewelry,money,securities,radar or laser detectors, or tapes,records, discs or similar audio,visual or data electronic equipment. (3)The most we will pay for any one “loss” under this coverage extension is $500. No deductible applies to this extension. The insurance provided by this extension is excess over any other collectible insurance. g.Camper Bodies In the event of a “loss”to a detached “camper,”physical damage coverage will apply as if it were part of the covered "auto" on which it is rated. h.Contents of a Travel Trailer,Camper or Motor Home When a Travel Trailer,“Camper”or Motor Home is a scheduled auto for physical damage coverage,we will pay up to $1,000 for “loss”to personal property belonging to you or a family member that is within the Travel Trailer,“Camper”or Motor Home. We will pay up to $250 for “loss”to personal property belonging to you or a family member that is outside the Travel Trailer, “Camper” or Motor Home. (1)We will not pay for “loss” to: (a)Articles carried or held for sale, storage or repairs,or for later delivery;goods kept to show or sell; or theatrical wardrobes. (b)Business,store of office furniture or equipment. (c)Records or accounts,money, bullion,deeds,contracts,evidences of debt,securities,tokens or tickets, stamps in current use or manuscripts. (d)Animals,private passenger “autos,” motorcycles,aircrafts,boats or any other motorized vehicles or their equipment,furnishings or appurtenances. (e)Equipment or accessories while your Travel Trailer,“Camper”or Motor Home is leased or rented to any organization or any person other than you or a family member. (2)The maximum we will pay for “loss”is the lesser of: (a)The actual cash value of the personal property at the time of “loss”; (b)The cost of repairing the damage; or (c)The cost of replacing the damaged personal property with other personal property of like kind, condition, quality and value. DocuSign Envelope ID: 25DE888D-D0C9-4C7D-89C4-84437942674A Page 5 of 6EA 99 11 03 18 Includes copyrighted material of Insurance Services Office, Inc., with its permission i.Vacation Expense Allowance We will pay you $50 per day to a maximum of $500 for extra expenses when a Travel Trailer,“Camper”or Motor Home is a scheduled auto for physical damage coverage,and the Travel Trailer,“Camper” or Motor Home: (1)Is damaged or destroyed and is uninhabitable; and (2)While being used for vacation purposes within the policy period. Extra expenses must by supported by receipts or other valid evidence. The following is added to Paragraph A.: 5.Extra Expense – Broadened Coverage We will pay for the direct expense of returning a stolen covered “auto”to you.We will pay only for those covered “autos”for which you carry Comprehensive or Specified Causes of Loss Coverage.This coverage will only apply to vehicles recovered inside the 48 contiguous United States.This coverage does not apply to an “auto” we deem a total “loss”. 6.Auto Loan/Lease Gap Coverage In the event of a covered total “loss”to a covered “auto”described or designated in the Schedule or in the Declarations,we will pay up to $2,000 for any unpaid amount due on the lease or loan for a covered “auto” less: a.The Amount paid under the Physical Damage Coverage section A.1.of the policy; and b.Any: (1)Overdue lease/loan payments at the time of the “loss”; (2)Financial penalties imposed under a lease for excessive use,abnormal wear and tear or high mileage; (3)Security deposits not returned by the Lessor; (4)Costs for extended warranties,Credit Life Insurance,Health,Accident or Disability Insurance purchased with the loan or lease; and (5)Carry-over balances from previous loans or leases. 7.Hired Auto Physical Damage Coverage If hired “autos”are covered “autos”for Liability Coverage and if Comprehensive,Specified Causes of Loss or Collision Coverages are provided under this coverage form for any “auto”you own,then the Physical Damage Coverages provided are extended to “autos” you hire of like kind and use,subject to the following: a.The most we will pay for any one “loss”is $50,000 or the actual cash value or the cost to repair and replace,whichever is less, minus a deductible; b.The deductible will be equal to the largest deductible applicable to any owned “auto” for that coverage; c.Hired Auto Physical Damage coverage is excess over any other collectible insurance; and d.Subject to the above limit,deductible and excess provisions,we will provide coverage equal to the broadest coverage applicable to any covered “auto” you own. If a limit for Hired Auto Physical Damage is indicated in the Declarations,then that limit replaces,and is not in addition to,the $50,000 limit indicated above. The following is added to Paragraph B.3.a.: Airbag Coverage – Accidental Deployment However,this exclusion does not apply to the unintended inflation of an airbag if the inflation is caused by mechanical or electrical breakdown. The following is added to Paragraph C.2. New Vehicle Replacement Cost If,however,a “loss”occurs to your covered “auto” within 180 days of your purchase of the “auto”and, we deem the covered “auto”to be a total “loss”and it has not been previously titled under the motor vehicle law of any state, we will pay at your option: a.the cost to replace the covered “auto”with a new “auto” of like make, model and year; or b.an amount equal to the original purchase price you paid to acquire the vehicle,including taxes, but excluding any extended warranties and licensing fees. This coverage applies only to a covered “auto”of the private passenger,light truck or medium truck type (20,000 lbs. or less gross vehicle weight). DocuSign Envelope ID: 25DE888D-D0C9-4C7D-89C4-84437942674A Page 6 of 6EA 99 11 03 18 Includes copyrighted material of Insurance Services Office, Inc., with its permission The following changes revise SECTION IV – BUSINESS AUTO CONDITIONS The following is added to Paragraph A.2.a.: Amended Duties in the Event of an Accident, Claim, Lawsuit or Loss However,this duty is only required when the “accident” is known to: (1)You, if you are an individual; (2)A partner, if you are a partnership; (3)A member,if you are a limited liability company; or (4)An executive officer or insurance manager,if you are a corporation. The following is added to Paragraph A.: 6.Blanket Waiver of Subrogation We waive any right of recovery we may have against any person or organization to the extent required of you by a written contract executed prior to any “accident”because of payments we make for damages under this coverage form. The following is added to Paragraph B.2.: Unintentional Failure to Disclose Hazards Any unintentional failure to disclose all exposures or hazards existing as of the effective date of the Business Auto Coverage Form or at any time during the policy period will not invalidate or adversely affect the coverage for such exposure or hazard. However,you must report the undisclosed exposure or hazard to us as soon as reasonably possible after its discovery. Paragraph B.5.b.is deleted and replaced with the following: a.For Hired Auto Physical Damage Coverage,the following are deemed to be covered “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 that individual “employee’s” name,with your permission,while performing duties related to the conduct of your business. However,any “auto”that is leased,hired,rented or borrowed with a driver is not a covered “auto”. The following is added to Paragraph B.5. d.To the extent required by an “insured contract”, this insurance is primary on behalf of the additional insured,and any other insurance maintained by the additional insured is excess and not contributory with this insurance.If the “insured contract”does not require this provision, then Paragraph a. above will apply. The following changes revise SECTION V – DEFINITIONS The following is added: Q."Camper"means a portable dwelling unit without axles or wheels that has been manufactured for attachment on the bed of a pickup truck to be used for casual travel or camping. DocuSign Envelope ID: 25DE888D-D0C9-4C7D-89C4-84437942674A Insured Copy POLICY NUMBER: COMMERCIAL GENERAL LIABILITY CG 25 03 05 09 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CG 25 03 05 09 Insurance Services Office, Inc., 2008 Page 1 of 2 DESIGNATED CONSTRUCTION PROJECT(S) GENERAL AGGREGATE LIMIT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Designated Construction Project(s): Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. For all sums which the insured becomes legally obligated to pay as damages caused by "occurrences" under Section I ---- Coverage A, and for all medical expenses caused by accidents under Section I ---- Coverage C, which can be attributed only to ongoing operations at a single designated construction project shown in the Schedule above: 1. A separate Designated Construction Project General Aggregate Limit applies to each designated construction project, and that limit is equal to the amount of the General Aggregate Limit shown in the Declarations. 2. The Designated Construction 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 "property damage" included in the "products- completed operations hazard", and for medical expenses under Coverage C regardless 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 Designated Construction Project General Aggregate Limit for that designated construction project. Such payments shall not reduce the General Aggregate Limit shown in the Declarations nor shall they reduce any other Designated Construction Project General Aggregate Limit for any other designated construction 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 Construction Project General Aggregate Limit. #$4 ALL PROJECTS DocuSign Envelope ID: 25DE888D-D0C9-4C7D-89C4-84437942674A Insured Copy B. For all sums which the insured becomes legally obligated to pay as damages caused by "occurrences" under Section I ---- Coverage A, and for all medical expenses caused by accidents under Section I ---- Coverage C, which cannot be attributed only to ongoing operations at a single designated construction project shown in the Schedule above: 1. 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 Aggregate Limit, whichever is applicable; and 2. Such payments shall not reduce any Designated Construction Project General Aggregate Limit. C. When coverage for liability arising out of the "products-completed operations hazard" is provided, any payments for damages because of "bodily injury" or "property damage" included in the "products-completed operations hazard" will reduce the Products-completed Operations Aggregate Limit, and not reduce the General Aggregate Limit nor the Designated Construction Project General Aggregate Limit. D. If the applicable designated construction project has been abandoned, delayed, or abandoned and then restarted, or if the authorized contracting parties deviate from plans, blueprints, designs, specifications or timetables, the project will still be deemed to be the same construction project. E. The provisions of Section III ---- Limits Of Insurance not otherwise modified by this endorsement shall continue to apply as stipulated. DocuSign Envelope ID: 25DE888D-D0C9-4C7D-89C4-84437942674A POLICY NUMBER: BCS0038770 COMMERCIAL GENERAL LIABILITY CG 20 37 12 19 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CG 20 37 12 19 © Insurance Services Office, Inc., 2018 Page 1 of 1 ADDITIONAL INSURED – OWNERS, LESSEES OR CONTRACTORS – COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Location And Description Of Completed Operations ANY PERSON OR ORGANIZATION WHEN REQUIRED BY WRITTEN CONTRACT OR AGREEMENT, EXECUTED PRIOR TO THE OCCURRENCE TO WHICH THIS INSURANCE APPLIES, THAT SUCH PERSON OR ORGANIZATION BE ADDED AS AN ADDITIONAL INSURED ON YOUR POLICY. ALL LOCATIONS Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II – Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury" or "property damage" caused, in whole or in part, by "your work" at the location designated and described in the Schedule of this endorsement performed for that additional insured and included in the "products- completed operations hazard". However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds, the following is added to Section III – Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable limits of insurance; whichever is less. This endorsement shall not increase the applicable limits of insurance. DocuSign Envelope ID: 25DE888D-D0C9-4C7D-89C4-84437942674A COMMERCIAL GENERAL LIABILITY CG 20 38 12 19 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CG 20 38 12 19 © Insurance Services Office, Inc., 2018 Page 1 of 2 ADDITIONAL INSURED – OWNERS, LESSEES OR CONTRACTORS – AUTOMATIC STATUS FOR OTHER PARTIES WHEN REQUIRED IN WRITTEN CONSTRUCTION AGREEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Section II – Who Is An Insured is amended to include as an additional insured: 1. Any person or organization for whom you are performing operations when you and such person or organization have agreed in writing in a contract or agreement that such person or organization be added as an additional insured on your policy; and 2. Any other person or organization you are required to add as an additional insured under the contract or agreement described in Paragraph 1. above. Such person(s) or organization(s) is an additional insured 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 b. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured described in Paragraph 1. or 2. above. However, the insurance afforded to such additional insured described above: a. Only applies to the extent permitted by law; and b. Will not be broader than that which you are required by the contract or agreement to provide for such additional insured. A person's or organization's status as an additional insured under this endorsement ends when your operations for the person or organization described in Paragraph 1. above are completed. B.With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to: 1. "Bodily injury", "property damage" or "personal and advertising injury" arising out of the rendering of, or the failure to render, any professional architectural, engineering or surveying services, including: a. The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or b. 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 "occurrence" 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. 2. "Bodily injury" or "property damage" occurring after: a. 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 DocuSign Envelope ID: 25DE888D-D0C9-4C7D-89C4-84437942674A Page 2 of 2 © Insurance Services Office, Inc., 2018 CG 20 38 12 19 b. 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. C. With respect to the insurance afforded to these additional insureds, the following is added to Section III – Limits Of Insurance: The most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement described in Paragraph A.1.; or 2. Available under the applicable limits of insurance; whichever is less. This endorsement shall not increase the applicable limits of insurance. DocuSign Envelope ID: 25DE888D-D0C9-4C7D-89C4-84437942674A COMMERCIAL GENERAL LIABILITY CG 20 01 12 19 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CG 20 01 12 19 © Insurance Services Office, Inc., 2018 Page 1 of 1 PRIMARY AND NONCONTRIBUTORY – OTHER INSURANCE CONDITION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to the Other Insurance Condition and supersedes any provision to the contrary: Primary And Noncontributory Insurance This insurance is primary to and will not seek contribution from any other insurance available to an additional insured under your policy provided that: (1) The additional insured is a Named Insured under such other insurance; and (2) You have agreed in writing in a contract or agreement that this insurance would be primary and would not seek contribution from any other insurance available to the additional insured. DocuSign Envelope ID: 25DE888D-D0C9-4C7D-89C4-84437942674A POLICY NUMBER: BCS0038770 COMMERCIAL GENERAL LIABILITY CG 24 04 12 19 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CG 24 04 12 19 © Insurance Services Office, Inc., 2018 Page 1 of 1 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (WAIVER OF SUBROGATION) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART ELECTRONIC DATA LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAGE PART DESIGNATED SITES POLLUTION LIABILITY LIMITED COVERAGE PART DESIGNATED SITES PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART RAILROAD PROTECTIVE LIABILITY COVERAGE PART UNDERGROUND STORAGE TANK POLICY DESIGNATED TANKS SCHEDULE Name Of Person(s) Or Organization(s): ANY PERSON OR ORGANIZATION FOR WHOM THE INSURED HAS AGREED TO WAIVE RIGHTS OF RECOVERY, PROVIDED SUCH AGREEMENT IS MADE IN WRITING AND PRIOR TO THE LOSS. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV – Conditions: We waive any right of recovery against the person(s) or organization(s) shown in the Schedule above because of payments we make under this Coverage Part. Such waiver by us applies only to the extent that the insured has waived its right of recovery against such person(s) or organization(s) prior to loss. This endorsement applies only to the person(s) or organization(s) shown in the Schedule above. DocuSign Envelope ID: 25DE888D-D0C9-4C7D-89C4-84437942674A