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HomeMy WebLinkAbout6249 - COI - Berg Equipment & Scaffolding_212/13/2022 12:27 Remote ID Remote ID D 1/20 Fax City of Bremerton TO : Fax: 1-360-473-5161 Attn: Attn: Travis Olson Berg Equipment & Scaffolding Co, Inc. FROM Phone: AssuredPartners of Washington, LLC Agency. AssuredPartners of Wash. Ins. Agency, LLC CA Lic OK61066 Phone: 1-206-343-2323 Subj--ct: Delivery by CertificatesNow If you have questions regarding the content of this document or need any changes, please contact the Producer/Agent listed on the certificate of insurance. If you have received this certificate via mail and would like to receive future certificates electronically, please contact us with your email address or fax number. cc: The data included in this notice and in the attached document is confidential to Ebix BPO and the party responsible for bringing you this information_ Certificate Delivery by CertificatesNow - www.ConfirmNat.com - 877.669.8600 12/13/2022 12:27 Remote ID Remote ID D 2/20 CERTIFICATE OF LIABILITY INSURANCE 12/130122YY) /2 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 WA#877030 1-206-343-2323 AssuredPartners of Washington, LLC AssuredPartners of Wash. Ins. Agency, LLC CA Lic OK61066 1325 Fourth Avenue, Suite 2100 CONTACTNAME: Roberta Tansey PHONE FAX AIC No Ext : 206 .748 .9573 AIC No): E-MAIL ADDRESS: roberta.tansey®AssuredPartners.com INSURER(S) AFFORDING COVERAGE NAIC # INSURERA:INDIAN HARBOR INS CO 36940 Seattle, WA 98101 INSURED INSURER : WESTERN NATL MUT INS CO 15377 Berg Equipment & Scaffolding Co, Inc. INSURER C EVANSTON INS CO 35378 INSURERD: 2130 East D Street INSURER E INSURERF: Tacoma, WA 98421-1497 COVERAGES CERTIFICATE NUMBER: 67296116 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 LTR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF MMIUDIYYYY POLICY EXP MM IDD YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY X X ESGO059382 07/01/22 07/01/23 EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE � OCCUR PREMISES TED PREMISES Ea occurrence $ 100,000 X MED EXP (Any one person) $ EXCLUDED WA Stop Gap 1M/1M/1M PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY PRO- PRODUCTS AGG $ 2,000,000 $ OTHER: B AUTOMOBILE LIABILITY X X CPP127665001 12/15/22 12/15/23 COMBINEDSINGLELIMIT Ea accident $ 1,000,000 BODILY INJURY (Per person) $ X ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ X HIRE❑ X NON -OWNED AUTOS ONLY AUTOS ONLY $ X COMP $2000 X COLL $2000 A UMBRELLA LIAB X OCCUR X X SXS0059381 07/01/22 07/01/23 EACH OCCURRENCE $ 5,000,000 X AGGREGATE $ 5,000,000 EXCESS LIAB CLAIMS -MADE ❑ED I X RETENTION 0 $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y 1 N ANYPROPRIETORIPARTNERIEXECUTIVE OFFICER/MEMBER EXCLUDED? ❑ (Mandatory in NH) NIA ESGO059382 - WA Stop Gap 07/01/22 07/01/23 STATUTE EERH E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 B Umbrella - Auto Only X X UME104695401 12/15/22 12/15/23 Occ/Agg 4,000,000 C Pollution MKLV5ENV103658 07/01/22 07/01/23 Aggregate Limit 1,000,000 DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Re: Wastewater Treatment Plant - Digester No. 2 The following are additional insured as required per contract: City of Bremerton, and any others as required by written contract. This insurance is primary and non-contributory with a waiver of subrogation when required by written contract. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Bremerton THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Attn- Travis Olson 345 6th Street, Suite 100 AUTHORIZED REPRESENTATIVE Bremerton, WA 98337 USA ACORD 25 (2016103) robertatansey 67296116 c0 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 12/13/2022 12:27 Remote ID Remote ID D 3/20 This endorsement, effective 12:O1am,7/z/22forms zpart of Pnli9'no. E88nn5v/xz THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART The following additional provisions apply to any person or entity added as an additional Insured by endorsement to this 1. Solely tothe extent required byawritten contract which the Named Insured enters into prior toan~occurrence^or offense for which the additional insured is provided coverage under this policy: a. This policy shall apply as primary insurance in relation to any other policy issued to that additional insured. b. Any insurance or self insurance maintained by the additional insured shall be excess of the insurance afforded to the. additional insured by this policy and shall not contribute /oit. includes copyrighted material of insurance Services Office, Inc., with Its permission. n� 2012 XL America, Inc. All Rights Reserved. May not becopied without permission. 12/13/2022 12:27 Remote ID Remote ID D 4/20 SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS, 4. Other Insurance, is modified to the extent it is Inconsistent with this endorsement. 2. in no event shall this Endorsement be construed as increasing the limits of insurance set forth in the Declarations page or altering the rules which fix the most we will pay set forth in SECTION III — LIPWITS OF INSURANCE. 3. Notwithstanding any other provision of this policy or any endorsement attached thereto, no coverage shall be afforded under this policy for any loss, cost or expense arising out of the sole negligence of any additional insured or any person or organization acting on behalf of any additional insured. All other terms and conditions of this policy remain unchanged. Includes copyrighted material of insurance Services Office, Inc., with its permission. SLC 016 0912 ® 2012 XL America, Inca All Rights Reserved. May not be copied without permission. 12/13/2022 12:27 Remote ID Remote ID D 5/20 POLICY NUMBER: ESGO059382 COMMERCIAL GENERAL LIABILITY CG 20 10 0413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Or aniaation s : Location(s) Of Covered Operations As required by written contract executed prior to a loss 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", "property damage" or "personal and advertising injury" caused, in whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured(s) at the location(s) designated above. 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. CG 20 10 0413 B. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to "bodily injury" or "property damage" occurring after: 1. All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or 2. That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. O Insurance Services Office, Inc., 2012 Insured Copy Page 1 of 2 12/13/2022 12:27 Remote ID Remote ID D 6/20 C. 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 shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the ❑eclarations. CG 20 10 0413 O Insurance Services Office, Inc., 2012 Page 2 of 2 12/13/2022 12:27 Remote ID Remote ID D 7/20 COMMERCIAL GENERAL LIABILITY CG 20 38 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. 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. 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 CG 20 38 04 13 9 Insurance Services Office, Inc., 2012 Page 1 of 2 12/13/2022 12:27 Remote ID Remote ID D 8/20 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 Insurance shown in the Declarations; whichever is less. This endorsement shall not increase applicable Limits of Insurance shown in Declarations. of the the Page 2 of 2 9 Insurance Services Office, Inc., 2012 CG 20 38 04 13 12/13/2022 12:27 Remote ID Remote ID D 9/20 POLICY NUMBER: ESGUO59382 COMMERCIAL GENERAL LIABILITY CG 20 37 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Location And Description Of Completed Operations As required by written contract executed prior to a loss 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 shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. CG 20 37 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 1 12/13/2022 12:27 Remote ID Remote ID D 10/20 POLICY NUMBER: ESGOU59382 COMMERCIAL GENERAL LIABILITY CG 24 04 05 09 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Person Or Organization: Any persun or organization for whom thu insured has agrud lu waive rights of rccuvery, as required byvarillen conlracl executed prior to a 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 we may have against the person or organization shown in the Schedule above 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". This waiver applies only to the person or organization shown in the Schedule above. CG 24 04 05 09 ® Insurance Services Office, Inc., 2008 Page 1 of 1 0 12/13/2022 12:27 Remote ID Remote ID D 11/20 WNCA800619 BUSINESS AUTO ENHANCEMENT EDGE ENDORSEMENT The Business Auto Enhancement Edge Endorsement is an optional endorsement that provides coverage enhancements. The following is a summary of broadened coverages provided by this endorsement. No coverage is provided by this summary, refer to the following endorsement for changes in your policy. SUMMARY OF COVERAGES PAGE Accidental Airbag Deployment Coverage 5 Audio, Visual and Data Electronic Equipment — Limit Amended 5 Auto Loan/Lease Gap Coverage 5 Blanket Additional Insured 3 Blanket Waiver of Subrogation 5 Broadened Definition of Insured includes: • Newly Acquired Organizations for up to 180 Days 2 • Employees as Insureds 2 • Subsidiaries in Which You Own 50% or More 2 Deductible Waiver for Glass Repair 4 Employee Hired Auto 6 Fellow Employee Coverage 3 Hired Auto Physical Damage Coverage 3, 6 Knowledge of Accident, Claim, Suit or Loss 5 Loss Of Use Expenses - Amended 3 Personal Effects 3 Primary and Noncontributory If Required by a Written Contract or Written Agreement 6 Rental Reimbursement Coverage 4 Supplementary Payments - Amended: • Bail Bonds up to $5,000 3 Loss of Earnings up to $500/Day 3 Temporary Substitute Vehicle Physical Damage 2 Towing 3 Transportation Expense Limits — Amended 3 Unintentional Failure to Disclose Hazards 6 WN CA 80 0619 Page 1 of 6 Includes copyrighted material of Insurance Services Office, with its permission. 12/13/2022 12:27 Remote ID Remote ID D 12/20 WNCA8DD619 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BUSINESS AUTO ENHANCEMENT EDGE ENDORSEMENT This endorsement modifies the insurance provided under the following: BUSINESS AUTO COVERAGE FORM With respect to the coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by this endorsement. The SECTIONS of the Business Auto Coverage Form identified in this endorsement will be amended as shown below. SECTION I — COVERED AUTOS COVERAGE e. Any organization which is newly acquired or AMENDMENTS formed by you and over which you maintain A. Temporary Substitute Vehicle Physical Damage majority ownership. However, coverage under SECTION I — COVERED AUTOS, C. Certain this provision: Trailers, Mobile Equipment And Temporary (1) is afforded only for the first 180 days after you Substitute Autos is amended by adding the acquire or form the organization or until the following: end of the policy period, whichever comes If a covered "auto" you own is out of service because first; of its: (2) does not apply to "bodily injury" or "property a. Breakdown; damage" that results from an "accident" that occurred before you formed or acquired the b. Repair; organization; c. Servicing; (3) does not apply to any newly acquired or d. "Loss", or formed organization that is a joint venture or e. Destruction; partnership; and the Physical Damage Coverages provided by the (4) does not apply to an "insured" under any Business Auto Coverage Form for that disabled other automobile liability policy or would be covered "auto" are extended to any "auto" you do not an "insured" under such a policy but for ter - own while used with the permission of its owner as a mination of such policy or the exhaustion of temporary substitute for the covered "auto" that is out such policy's limits of insurance. of service. f. Any "employee" of yours is an "insured" while SECTION II — COVERED AUTOS LIABILITY using a covered "auto" you don't own, hire or COVERAGE AMENDMENTS borrow in your business or your personal affairs. A. Who Is An Insured g. Any "employee" of yours is an "insured" while operating a covered "auto" hired or rented under SECTION II — COVERED AUTOS LIABILITY a contract or agreement in the "employee's" COVERAGE, A. Coverage, 1. Who Is An Insured is name, with your permission, while performing amended to add: duties related to the conduct of your business. d. Any legally incorporated subsidiary of yours in which you own more than 50% of the voting stock on the effective date of this coverage form. However, "insured" does not include any subsidiary of yours that is an "insured" under any other automobile liability policy or would be an "insured" under such policy but for termination of such policy or the exhaustion on such policy's limits of insurance. WN CA 80 0619 Includes copyrighted material of Insurance Services Office, with its permission Page 2 of 6 12/13/2022 12:27 Remote ID Remote ID D 13/20 B. Blanket Additional Insured SECTION II — COVERED AUTOS LIABILITY COVERAGE, A. Coverage, 1. Who Is An Insured, paragraph c. is amended to add the following: 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 additional insured is an "insured" for Liability Coverage, but only for damages to which this insurance applies and only to the extent that persons or organization qualifies as an "insured" under the Who Is An Insured provision contained in Section II. C. Liability Coverage Extensions — Supplementary Payments SECTION II — COVERED AUTOS LIABILITY COVERAGE, A. Coverage, 2. Coverage Extensions, a. Supplementary Payments is amended by replacing subparagraphs (2) and (4) with the following: (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. D. Fellow Employee Coverage SECTION II — COVERED AUTOS LIABILITY COVERAGE, B. Exclusions, 5. Fellow Employee, the following is added: Co -Employee Lawsuit Defense Cost Reimbursement If a suit seeking damages for "bodily injury" to 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, or a suit seeking damages brought by the spouse, child, parent, brother or sister of that fellow "employee", is brought against you, we will reimburse reasonable costs that you incur in the defense of such matters. Any reimbursement made pursuant to this sub -section will be in addition to the limits of liability set forth in the Declarations. SECTION III — PHYSICAL DAMAGE COVERAGE AMENDMENTS A. Towing SECTION III — PHYSICAL DAMAGE COVERAGE, A. Coverage, 2. Towing, is amended by adding the following: 2. Towing We will pay up to $250 for towing and labor costs incurred each time a covered "auto" is disabled. However, the labor must be performed at the place of disablement. This $250 limit is reduced by any applicable towing limit shown in the declarations. Regardless of the number of disablements, the maximum amount we will pay under this endorsement for all towing and labor costs combined during any one year is $2,500. B. Transportation Expense — Limits Amended SECTION III — PHYSICAL DAMAGE COVERAGE, A. Coverage, 4. Coverage Extensions, a. Trans- portation Expenses is amended by replacing $20 per day/$600 maximum limit with $50 per day/$1,000 maximum. C. Hired Auto Physical Damage — Loss Of Use Expenses — Limits Amended SECTION III — PHYSICAL DAMAGE COVERAGE, A. Coverage, 4. Coverage Extensions, b. Loss of Use Expenses is amended by replacing the $20 per day/$600 maximum limit with $50 per day/$750 maximum limit. D. Personal Effects Coverage SECTION III — PHYSICAL DAMAGE COVERAGE, A. Coverage, 4. Coverage Extensions is amended by adding the following: c. Personal Effects We will pay up to $500 for "loss" to personal effects, which are: (1) Owned by an "insured"; and (2) In or on your covered "auto." This coverage applies only in the event of the total theft of your covered "auto." No deductible applies to this coverage WN CA 80 0619 Includes copyrighted material of Insurance Services Office, with its permission Page 3 of 6 12/13/2022 12:27 Remote ID Remote ID D 14/20 E. Glass Repair— Deductible Waiver SECTION III — PHYSICAL DAMAGE COVERAGE, A. Coverage, 3. Glass Breakage — Hitting A Bird Or Animal — Falling Objects Or Missiles, is amended by adding the following: No deductible will apply to glass breakage if such glass is repaired, in a manner acceptable to us, rather than replaced. F. Hired Auto Physical Damage SECTION III — PHYSICAL DAMAGE COVERAGE, A. Coverage is amended by adding the following: 5. Hired Auto Physical Damage If hired "autos" are covered "autos" for Liability Coverage and if Comprehensive, Specified Causes of Loss, or Collision coverages are pro- vided 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 cost to repair or 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. Any Comprehensive deducti- ble does not apply to "loss" caused by fire or lightening; 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 added to, the $50,000 limit indicated above. G. Rental Reimbursement SECTION III — PHYSICAL DAMAGE COVERAGE A. Coverage, is amended by adding the following: 6. Rental Reimbursement This coverage applies only to a covered "auto" of the private passenger or light truck type as follows: a. We will pay for rental reimbursement expenses incurred by you for the rental of a private passenger or light truck type "auto" because of "loss" to a covered private pas- senger or light truck type "auto". Payment applies in addition to the otherwise applicable amount of each coverage you have on a covered private passenger or light truck type "auto." No deductibles apply to this coverage. b. We will pay only for those expenses incurred during the policy period beginning 24 hours after the "loss" and ending, regardless of the policy's expiration, with the lesser of the fol- lowing number of days: (1) The number of days reasonably required to repair or replace the covered private passenger or light truck type "auto". If "loss" is caused by theft, this number of days is added to the number of days it takes to locate the covered private passenger or light truck type "auto" and return it to you; or (2) 30 days. c. Our payment is limited to the lesser of the following amounts: (1) Necessary and actual expenses incurred, or (2) $50 per day, up to a maximum of $1,000. WN CA 80 0619 Includes copyrighted material of Insurance Services office, with its permission Page 4 of 6 12/13/2022 12:27 Remote ID Remote ID D 15/20 d. This coverage does not apply while there are spare or reserve private passenger or light truck type "autos" available to you for your operations. e. If "loss" results from the total theft of a covered "auto" of the private passenger or light truck type, we will pay under this cover- age only that amount of your rental reim- bursement expenses which is not already provided for under SECTION III — PHYSICAL DAMAGE COVERAGE, A. Coverage, 4. Coverage Extensions. For the purposes of this Rental Reimbursement coverage, light truck is defined as a truck with a gross vehicle weight of 10,000 lbs. or less as defined by the manufacturer as the maximum loaded weight the auto is designed to carry. H. Accidental Airbag Deployment Coverage SECTION III — PHYSICAL DAMAGE COVERAGE, A. Coverage is amended by adding the following: 7. Accidental Airbag Deployment Coverage We will pay to reset or replace factory installed airbag(s) in any covered "auto" for accidental discharge, other than discharge due to a collision loss. This coverage is applicable only if comprehensive coverage applies to the covered "auto". This coverage is excess over any other collectible insurance or reimbursement by manufacturer's warranty. I. Auto Loan/Lease Gap Coverage SECTION III PHYSICAL DAMAGE COVERAGE, Item A., Coverage, is amended by adding the following: 8. Auto Loan/Lease Gap Coverage This coverage applies only to a covered "auto" described or designated in the Schedule or in the Declarations as including physical damage 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 any unpaid amount due on the lease or loan for a covered "auto" less: a. The amount paid under the Physical Damage Coverage Section on 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. J. Audio, Visual and Data Electronic Equipment — Limit Amended SECTION III - PHYSICAL DAMAGE COVERAGE, C. Limits of Insurance, 1.b. is amended by replacing the $1,000 limit with a $2,500 limit. SECTION IV — BUSINESS AUTO CONDITIONS AMENDMENTS A. Duties In The Event Of Accident, Claim, Suit Or Loss Amended SECTION IV — BUSINESS AUTO CONDITIONS, A. Loss Conditions, 2. Duties In The Event Of Accident, Claim, Suit Or Loss, a. is amended by adding the following: This condition applies only when the "accident" or "loss" is known to: (1) You, if you are an individual; (2) A partner, if you are a partnership; (3) An executive officer or insurance manager, if you are a corporation; or (4) A member or manager, if you are a limited liability company. But this section does not amend the provisions relating to notification of police, protection or exami- nation of the property which was subject to the "loss". B. Blanket Waiver of Subrogation Section IV — BUSINESS AUTO CONDITIONS, A. Loss Conditions, 5. Transfer of Rights of Recovery Against Others to Us, is amended by adding the following exception: However, we waive any right of recovery we may have against any person or organization to the extent required of you by a written contract signed and executed prior to any "accident' or "loss", provided that the "accident" or "loss" arises out of operations contemplated by such contract. The waiver applies only to the person or organization designated in such contract. WN CA 80 0619 Includes copyrighted material of Insurance Services office, with its permission Page 5 of 6 12/13/2022 12:27 Remote ID Remote ID D 16/20 C. Unintentional Failure to Disclose Hazards E. Primary and Noncontributory If Required By SECTION IV — BUSINESS AUTO CONDITIONS, B. Written Contract or Written Agreement General Conditions, 2. Concealment, Misrepre- SECTION IV — BUSINESS AUTO CONDITIONS, B. sentation Or Fraud, is amended by adding the General Conditions, 5. Other Insurance c., the following paragraph: following is added and supersedes any provision to If you unintentionally fail to disclose any hazards the contrary: existing at the inception date of the policy, or during This Coverage Form's Covered Autos Liability the policy period in connection with any additional Coverage is primary to and will not seek contribution hazards, we will not deny coverage under this Cov- from any other insurance available to an "insured" erage Part because of such failure. under your policy provided that: D. Employee Hired Auto (1) Such "insured" is a Named Insured under such SECTION IV — BUSINESS AUTO CONDITIONS, B. other insurance; and General Conditions, 5. Other Insurance, paragraph (2) You have agreed in writing in a contract or b. is deleted and replace by the following: agreement that this insurance would be primary b. For Hired Auto Physical damage Coverage, the and would not seek contribution from any other "insured". following are deemed to be a covered "auto" you insurance available to such own: (1) Any covered "auto" you lease, hire, rent or borrow. (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". WN CA 80 0619 Includes copyrighted material of Insurance Services Office, with its permission Page 6 of 6 12/13/2022 12:27 Remote ID Remote ID D 17/20 Endorsement No.: i Effective Date: Tolyl'ZU22 Issue Date: July l.3O23 Attached to and forming part of Policy No.: SXS00_539381 Amendment to Condition J. Other Insurance Endorsement — Primary and Non -Contributory Where Required by Contract This endorsement changes the policy. Please read dcarefully. This endorsement modifies insurance provided under the following: Excess Liability Policy SECTION V — CONDITIONS, J. Other Insurance, is deleted in its entirety and replaced by the following: 1 OtherUnmunamce If valid and collectible "Other Insurance" applies to damages that are also covered by this policy, this policyk, will ap�excess ofthe "Other Insurance" and viU not conbibutowith such "Other Insurance" unless the "Insured" is required by contract to provide insurance on a primary and non-contributory basis. This provision will not apply if the "Other Insurance" is written to be excess of this policy. All other terms, conditions, definitions and exclusions of this policy remain unchanged. MANUSXSU168O2i3 92013X.L.America, Inc. All Rights Reserved. Page of 12/13/2022 12:27 Remote ID Remote ID D 18/20 Endorsement No.: 2 Effective Date: fuly 1, 2022 Attached to and forming part of Policy No.: SXS0059381 This endorsement changes the policy. Please read it carefully. This endorsement modifies insurance provided under the following: Excess Liability Policy I. This policy is amended as follows: If prior to the time of an "Occurrence", you and the insurer(s) of the "Underlying Insurance" waived the right of recovery against a specific person or organization in a written "Insured Contract", we hereby also agree to waive our right of recovery in the same manner. This waiver shall apply only with respect to a "Loss" occurring due to operations undertaken as per the specific contract in which you waived the right of recovery. 1111. Solely with respect to this endorsement, SECTION VI ® DEFINITIONS is amended to add the following: "Insured Contract" will have the same definition as such term or equivalent term in the "Controlling Underlying Policy". All other terms, conditions, definitions and exclusions of this policy remain unchanged. CXU 416 0715 9 2015 X.L. America, Inc. All Rights Reserved. Page 1 of I May not be copied without permission. 12/13/2022 12:27 Remote ID Remote ID D 19/20 IIIENVIRONMENTAL MARKED EVANSTON INSURANCE COMPANY This endorsement modifies insurance provided under the following, where indicated by an "X" in the checkbox below: ■ �Mm Person Or Organization - Any additional insured with whore you agree in a written contract signed by both parties and executed prior to the commencement of operations to provide Primary and Non -Contributory status under this insurance. With respect to the coverage provided by this endorsement, the following is added to the Other Insurance condition of the Coverage Form(s) indicated above: ..... .... ..... This insurance is primary to, and will not seek contribution from, any other insurance available to the Person Or Organization shown in the Schedule of this endorsement. However, this does not a.pply to any "Glaim", "suit" or "pollution condition" resulting from the sole negligence of the Person Or Organization shown in the, Schedule of this endorsement. All other terms and conditions remain unchanged. MEEI 2274 05 16 Includes copyrighted material of Insurance Services Office, Inc., Page 1 of 1 with its permission. 12/13/2022 12:27 Remote ID Remote ID D 20/20 IIIENVIRONMENTAL MUKEr EVANSTON . INSURANCE COMPANY OF TRAfISFER OF RIGATS OF RECOTERT AGAh,%ST OTAERS TO 4."!, WRITTEN CONTRACT LIMITATION This endorsement modifies insurance provided under the following, where indicated by an "X" in the chackbox(es) below: COMMERCIAL GENERAL LIABILITY COVERAGE FORM CONTRACTOR'S POLLUTION LIABILITY COVERAGE FORM PROD UCTS/COMPLETED OPERATIONS LIABILITY COVERAGE FORM Name Of Person Or Organization - Any person(s) or DrganizatiDn(s) with whom the insured agrees, in a written contract, signed by both parties and executed prior to the commencement of operations to provide a waiver of transfer of rights of recovery. Please refer to each Coverage Form to determine which terms are defined. Words shown in quotations on this endorsement may or may not be defined in all Coverage Forms. The following is added to the Transfer Of Rights Of Recovery Against Others To Us condition of the Coverage Form(s) indicated above: We waive any right of recovery we may have against the person or organization shown in the Schedule of this endorsement because of payments we make for' injury or damage arising taut oaf your ongoing operations or "yourwork" done under a written contract with that person or organization and included in the "prod ucts-com pleted operations hazard". This waiver applies only to the person or organization shown in the Schedule of this endorsement. This waiver will not apply to "occurrences" resulting fromi then sole negligence ofthe person or organization shown in the Schedule of this endorsement. All other terms and conditions remain unchanged. MEET 2211 05 16 Includes copyrighted material of Insurance Services Office, Inc., Page I of I with its permission.