HomeMy WebLinkAbout6815 Play-Creation IncPLAYCRE-01
DATE (MMIDDIYYYY)
AC7"N" CERTIFICATE OF LIABILITY INSURANCE 2/16/2025
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THISLYAMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIESCERTIFICATEDOESNOTAFFIRMATIVELYORNEGATIVESUINGINSURER(S) AUTHORIZED BELOW.
THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE IS, 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. IfSUBROGATIONISWAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on thiscertificatedoesnotconferrightstothecertificateholderinlieuofsuchnorsement(s). E
PRODUCER
PHONE FAX No):(253) 473-5363 Fournier — (
A/c, No, Ext): (253) 473-3010 5712
Orchard St. W. I RECEIVED Eoo AIL • clrequest fournierinsurance.com University
Place, WA 98467 NAIC a NSURER(S) AFFORDING COVERAGE INSURED
Play -
Creation Inc. —y u, Bremerton 2104
SW 152nd St Suite 1 Risk Management Burien,
WA 98166 i F:
The
Princeton Excess & Surplus Lines Insurance Company OVERAGES
CERTIFICATE NUMt3hK: D
BELOW VE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE THATTHEPOLICIESOFINSUNCEINDICATED.
CIFY
NOTWI
THISISTOTTHSANDNGANY REQUIREMENT, TERMLISTE ORCONDITION APOLICY
OF
ANY
CO TRACTT OR OTHER D CUMENT WITHRESPECT TO WHICH THIS RANCE AFFORDED
BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL CERTIFICATE MAYBEISSUEDORMAYPERTAIN, THE INSUTHE TERMS, EXCLUSIONS
AND CONDITIONS
OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY P IPOLICY EFF POLICYEXPSLIMITS3RADDLSUBR
POLICY
NUMBER DD ID 1,000,000 TYPE OF INSURANCEDDEACHOCCURRENCESkXCOMMERCIAL
GENERAL LIABILITY DAMAGE TO HEN TED 300,000CLAIMS -MADE X
OCCUR X X CSARCGL000605301 2117/2025 2117/2026 a 5,000 MED EXP An
one erson 1.000,000 L AGGREGATE LIMIT
APPLIES PER: POLICY a PRO
LOC JECT AUTOMOBILE LIABILITYX
X X
BAS60618122 ANY AUTO AUTOSONLYH
AUTOSULED AUTOS
ONLY
AOTO
pNED C UMBRELLA LIAB
1l OCCUR 82A3FF000353303 X EXCESS
LIAB
CLAIMS -MADE DED RETENTION $ A
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITYYINCSARCGL000605301ANY PROPRIETOR/PARTNER/
EXECUTIVE N I A FFIC Rory in
BEEXCLUDED? Ifyes, describe
under DESCRIPTION OF OPERATIONSbelowXSM00026800n lExcess Liab-$511Ax$5M 2/17/2025
1 2/17/2026 2/17/2025
1 2/17/2026 2/17/2025
1 2/1712026 2,000, 5,
000,000
1000,00 000,
00 000,
00 11000,
00 arks
Schedule, maybe
attached if more space is required) DESCRIPTION OF OPERATIONSILOCATIONSIVEHICLES (ACORD 101, Additional Rem The hCty, its
iedformsials, employees, 01agents and
volunteers: Additional
51Prim
09, A 8501n-Contributory, andWaiverofSubrogation provisions apply per atta CG2 kTHE LD ANY
OF THE
ABOVE
DESCRIBED POLICIES BE CANCELLED BEFORE City of Bremerton RDANCE WTH
DATE THEREOF, THE
POTCY PROVISO
TICE WILL
BE DELIVERED IN
S. 345 6th St, Suite
100
Bremerton, WA 98337 IZED REPRESENTATIVE
1988-2015 ACORD CORPORATION. All
rights reserved. ACORD 25 (2016/03) The
ACORD name and logo are registered marks of ACORD
POLICY NUMBER:CSAR-CGL-0006053 - 01
COMMERCIAL GENERAL LIABILITY
CG20101001
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED - OWNERS, LESSEES ORCONTRACTORS - SCHEDULED PERSON OR
ORGANIZATION
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
Name of Person or Organization:
Blanket where required by written contract signed by both parties and the insured contract is executed prior toanyloss
If no entry appears above, information required to complete this endorsement will be shown in the Declarations asapplicabletothisendorsement.)
A. Section II — Who Is An Insured is amended toincludeasaninsuredthepersonororganization
shown in the Schedule, but only with respect to
liability arising out of your ongoing operations per- formed for that insured.
B. With respect to the insurance afforded to these
additional insureds, the following exclusion isadded:
2. Exclusions
This insurance does not apply to "bodily inju-
ry" or "property damage" occurring after:
CG20101001 ISO Properties, Inc., 2000
1) All work, including materials, parts orequipmentfurnishedinconnectionwith
such work, on the project (other than
service, maintenance or repairs) to be
performed by or on behalf of the addi-
tional insured(s) at the site of the cov-
ered 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 con-
tractor or subcontractor engaged in
performing operations for a principal as
a part of the same project.
Page 1 of 1
Print Date: 2/14/2025
POLICY NUMBER: CSAR-CGL-0006053 - 01 COMMERCIAL GENERAL LIABILITY
CG 20 37 10 01
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
oil
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
Name of Person or Organization: Any person or organization you have agreed in a written contract to add as an additional insured on your policy provided the
written contract is executed prior to the "bodily injury", "property damage" or "personal and advertising injury".
Location And Description of Completed Operations:
Premises covered under this policy when required by written contract executed prior to the "bodily injury", "property damage" or
personal and advertising injury".
Additional Premium:
If no entry appears above, information required to complete this endorsement will be shown in the ueciarations as
applicable to this endorsement.)
Section II — Who Is An Insured is amended to include as an insured the person or organization shown in the
Schedule, but only with respect to liability arising out of "your work" at the location designated and described in thescheduleofthisendorsementperformedforthatinsuredandincludedinthe "products -completed operations haz-
ard".
CG20371001
Print Date: 2/14/2025
ISO Properties, Inc., 2000 Page 1 of 1
THIS ENDORSEMENT CHANGES/MODIFIES THE POLICY. PLEASE READ IT CAREFULLY.
PRIMARY AND NON-CONTRIBUTING INSURANCE
This endorsement changes/modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE FORM
PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE FORM
To the extent that this insurance is afforded to any additional insured under this policy, SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS, 4. Other Insurance, is deleted in its entirety and replaced withthefollowingcondition:
4. Other Insurance
If all of the other insurance permits contribution by equal shares, we will follow this method unless the
insured is required by written contract signed by both parties, to provide insurance that is primary and non- contributory, and the "insured contract" is executed prior to any loss. Where required by a written contractsignedbybothparties, this insurance will be primary and non-contributing only when and to the extent asrequiredbythatcontract. However, under the contributory 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. Underthismethod, each insurer's share is based on the ratio of its applicable limit of insurance to the totalapplicablelimitsofinsuranceofallinsurers.
ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED.
This endorsement is attached to and forms a part of the Policy as listed in the Declarations Page or Declarations ExtensionSchedule, effective on the inception date of the Policy unless otherwise stated herein.
The following information is required only when this endorsement is issued subsequent to preparation of the Policy.)
Endorsement effective date: Policy No.: Endorsement No.:
Named Insured:
Authorized Representative
CIS CGL 4026 12 15
Print Date: 2/14/2025
POLICY NUMBER: CSAR-CGL-0006053 - 01 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:
As required by written contract signed by both parties and the insured contract is executed prior to any 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
Print Date: 2/14/2025
COMMERCIAL AUTO
AC 85 01 06 18
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
BUSINESS AUTO COVERAGE ENHANCEMENT ENDORSEMENT
This endorsement modifies insurance provided under the following:
BUSINESS AUTO COVERAGE FORM
With respect to coverage afforded by this endorsement, the provisions of the policy apply unless modifiedbytheendorsement.
If the policy to which this endorsement is attached also contains a Business Auto Coverage Enhancement
Endorsement with a specific state named in the title, this endorsement does not apply to vehicles garaged inthatspecifiedstate.
COVERAGEINDEX
SUBJECT PROVISION NUMBER
ACCIDENTAL AIRBAG DEPLOYMENT 13ADDITIONALINSUREDBYCONTRACT, AGREEMENT OR PERMIT 4AMENDEDDUTIESINTHEEVENTOFACCIDENT, CLAIM, SUIT OR LOSS 21
AMENDED FELLOW EMPLOYEE EXCLUSION 6AUDIO, VISUAL AND DATA ELECTRONIC EQUIPMENT COVERAGE 15
BODILY INJURY REDEFINED 25
EMPLOYEES AS INSUREDS (Including Employee Hired Auto) 3
EXTRA EXPENSE -BROADENED COVERAGE 11
GLASS REPAIR- WAIVER OF DEDUCTIBLE 17HIREDAUTOCOVERAGETERRITORY23
HIRED AUTO PHYSICAL DAMAGE (Including Employee Hired Auto) 7LOAN / LEASE GAP (Coverage Not Available In New York) 16NEWLYFORMEDORACQUIREDSUBSIDIARIES2
PARKED AUTO COLLISION COVERAGE (WAIVER OF DEDUCTIBLE) 18
PERSONAL EFFECTS COVERAGE 12PHYSICALDAMAGE -ADDITIONAL TRANSPORTATION EXPENSE COVERAGE g
PHYSICAL DAMAGE DEDUCTIBLE -VEHICLE TRACKING SYSTEM 14
PRIMARY AND NON-CONTRIBUTORY -WRITTEN CONTRACT OR WRITTEN AGREEMENT 24
RENTAL REIMBURSEMENT 10
SUPPLEMENTARY PAYMENTS 5TOWINGANDLABOR8
TRAILERS - INCREASED LOAD CAPACITY 1
TWO OR MORE DEDUCTIBLES 19
UNINTENTIONAL FAILURE TO DISCLOSE HAZARDS 20
WAIVER OF TRANSFER OF RIGHTS OF RECOVERYAGAINST OTHERS TO US 22
SECTION I - COVERED AUTOS is amended as follows:
1. TRAILERS - INCREASED LOAD CAPACITY
The following replaces Paragraph C.I. Certain Trailers, Mobile Equipment And Temporary SubstituteAutosofSECTIONI - COVERED AUTOS:
Trailers" with a load capacity of 3,000 pounds or less designed primarily for travel on public roads.
2017 Liberty Mutual Insurance
AC 85 01 06 18 Includes copyrighted material of Insurance Services Office Inc., with its Permission. Page 1 of 7
SECTION II - LIABILITY COVERAGE is amended as follows:
2. NEWLY FORMED OR ACQUIRED SUBSIDIARIES
SECTION II - LIABILITY COVERAGE, Paragraph
following as an "insured":
A.I. - Who Is An Insured is amended to include the
d. Any legally incorporated subsidiary of which you own more than 50 percent interest during the
policy period. Coverage is afforded only for 90 days from the date of acquisition or formation.
However, "insured" does not include any organization that:
1) Is a partnership or joint venture; or
2) Is an "insured" under any other automobile policy except a policy written specifically to apply
in excess of this policy; or
3) Has exhausted its Limit of Insurance or had its policy terminated under any other automobile
policy.
Coverage under this provision d. does not apply to "bodily injury" or "property damage" that
occurred before you acquired or formed the organization.
3. EMPLOYEES AS INSUREDS
SECTION II - LIABILITY COVERAGE, Paragraph A.I. Who Is An Insured is amended to include the
following as an "insured":
e. Any "employee" of yours while using a covered "auto" you do not own, hire or borrow but only for
acts within the scope of their employment by you. Insurance provided by this endorsement is
excess over any other insurance available to any "employee".
f. Any "employee" of yours while operating an "auto" hired or borrowed under a written contract or
agreement in that "employee's" name, with your permission, while performing duties related to
the conduct of your business and within the scope of their employment. Insurance provided by this
endorsement is excess over any other insurance available to the "employee".
4. ADDITIONAL INSURED BY CONTRACT, AGREEMENT OR PERMIT
SECTION 11 - LIABILITY COVERAGE, Paragraph A.1. Who Is An Insured is amended to include the
following as an "insured":
g. Any person or organization with respect to the operation, maintenance or use of a covered "auto",
provided that you and such person or organization have agreed in a written contract, written
agreement, or permit issued to you by governmental or public authority, to add such person, or
organization, or governmental or public authority to this policy as an "insured".
However, such person or organization is an "insured":
1) Only with respect to the operation, maintenance or use of a covered "auto";
2) Only for "bodily injury" or "property damage" caused by an "accident" which takes place after
you executed the written contract or written agreement, or the permit has been issued to you;
and
3) Only for the duration of that contract, agreement or permit.
The "insured" is required to submit a claim to any other insurer to which coverage could apply for
defense and indemnity. Unless the "insured" has agreed in writing to primary noncontributory
wording per enhancement number 24, this policy is excess over any other collectible insurance.
5. SUPPLEMENTARY PAYMENTS
SECTION II - LIABILITY COVERAGE, Coverage Extensions, 2.a. Supplementary Payments, Paragraphs
2) and (4) are replaced by the following:
2) Up to $3,000 for cost of bail bonds (including bonds for related traffic 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.
2017 Liberty Mutual Insurance
AC 85 01 06 18 Includes copyrighted material of Insurance Services Office Inc., with its Permission. Page 2 of 7
6. AMENDED FELLOW EMPLOYEE EXCLUSION
In those jurisdictions where, by law, fellow "employees" are not entitled to the protection afforded totheemployerbytheworkerscompensationexclusivityrule, or similar protection, the following provi- sion is added:
SECTION II - LIABILITY, Exclusion B.5. Fellow Employee does not apply if the "bodily injury" resultsfromtheuseofacovered "auto" you own or hire if you have workers compensation insurance in forceforallofyour "employees" at the time of "loss".
This coverage is excess over any other collectible insurance.
SECTION III - PHYSICAL DAMAGE COVERAGE is amended as follows:
7. HIRED AUTO PHYSICAL DAMAGE
Paragraph A.4. Coverage Extensions of SECTION III - PHYSICAL DAMAGE COVERAGE, is amended byaddingthefollowing:
If hired "autos" are covered "autos" for Liability Coverage, and if Comprehensive, Specified Causes of
Loss or Collision coverage are provided under the Business Auto Coverage Form for any "auto" youown, then the Physical Damage coverages provided are extended to "autos":
a. You hire, rent or borrow; or
b. Your "employee" hires or rents under a written contract or agreement in that "employee's" name,
but only if the damage occurs while the vehicle is being used in the conduct of your business,
subject to the following limit and deductible:
a. The most we will pay for "loss" in any one "accident" or "loss" is the smallest of:
1) $50,000; or
2) The actual cash value of the damaged or stolen property as of the time of the "loss'; or
3) The cost of repairing or replacing the damaged or stolen property with other property of likekindandquality, minus a deductible.
b. The deductible will be equal to the largest deductible applicable to any owned "auto" for that
coverage.
c. Subject to the limit, deductible and excess provisions described in this provision, we will provide
coverage equal to the broadest coverage applicable to any covered "auto" you own.
d. Subject to a maximum of $1,000 per "accident", we will also cover the actual loss of use of thehired "auto" if it results from an "accident", you are legally liable and the lessor incurs an actual
financial loss.
e. This coverage extension does not apply to:
1) Any "auto" that is hired, rented or borrowed with a driver; or
2) Any "auto" that is hired, rented or borrowed from your "employee" or any member of your
employee's" household.
Coverage provided under this extension is excess over any other collectible insurance available at the
time of "loss".
8. TOWING AND LABOR
SECTION III - PHYSICAL DAMAGE COVERAGE, Paragraph A.2. Towing, is amended by the addition of
the following:
We will pay towing and labor costs incurred, up to the limits shown below, each time a covered "auto"
classified and rated as a private passenger type, "light truck" or "medium truck" is disabled:
a. For private passenger type vehicles, we will pay up to $75 per disablement.
b. For "light trucks", we will pay up to $75 per disablement. "Light trucks" are trucks that have a gross
vehicle weight (GVW) of 10,000 pounds or less.
c. For "medium trucks" , we will pay up to $150 per disablement. "Medium trucks" are trucks that
have a gross vehicle weight (GVW) of 10,001 - 20,000 pounds.
However, the labor must be performed at the place of disablement.
2017 Liberty Mutual Insurance
AC 85 01 06 18 Includes copyrighted material of Insurance Services Office Inc., with its Permission. Page 3 of 7
9. PHYSICAL DAMAGE -ADDITIONAL TRANSPORTATION EXPENSE COVERAGE
Paragraph AA.a. Coverage Extensions, Transportation Expenses of SECTION III - PHYSICAL DAMAGE
COVERAGE, is amended to provide a limit of $50 per day and a maximum limit of $1,500.
10. RENTAL REIMBURSEMENT
SECTION III - PHYSICAL DAMAGE COVERAGE, A. Coverage, is amended by adding the following:
a. We will pay up to $75 per day for rental reimbursement expenses incurred by you for the rental of
an "auto" because of "accident' or 'loss", to an "auto" for which we also pay a 'loss" under
Comprehensive, Specified Causes of Loss or Collision Coverages. We will pay only for those ex-
penses incurred after the first 24 hours following the "accident' or 'loss" to the covered "auto."
b. Rental Reimbursement requires the rental of a comparable or lessor vehicle, which in many cases
may be substantially less than $75 per day, and will only be allowed for the period of time it should
take to repair or replace the vehicle with reasonable speed and similar quality, up to a maximum of
30 days.
c. We will also pay up to $500 for reasonable and necessary expenses incurred by you to remove and
replace your tools and equipment from the covered "auto". This limit is excess over any other
collectible insurance.
d. This coverage does not apply unless you have a business necessity that other "autos" available for
your use and operation cannot fill.
e. If 'loss" results from the total theft of a covered "auto" of the private passenger type, we will pay
under this coverage only that amount of your rental reimbursement expenses which is not already
provided under Paragraph 4. Coverage Extension.
f. No deductible applies to this coverage.
g. The insurance provided under this extension is excess over any other collectible insurance.
If this policy also provides Rental Reimbursement Coverage you purchased, the coverage provided by
this Enhancement Endorsement is in addition to the coverage you purchased.
For the purposes of this endorsement provision, materials and equipment do not include "personal
effects" as defined in provision 12.13.
11. EXTRA EXPENSE - BROADENED COVERAGE
Under SECTION III - PHYSICAL DAMAGE COVERAGE, A. Coverage, we will pay for the expense of
returning astolen covered "auto" to you. The maximum amount we will pay is $1,000.
12. PERSONAL EFFECTS COVERAGE
A. SECTION III - PHYSICAL DAMAGE COVERAGE, A. Coverage, is amended by adding the following:
If you have purchased Comprehensive Coverage on this policy for an "auto" you own and that
auto" is stolen, we will pay, without application of a deductible, up to $600 for "personal effects"
stolen with the "auto."
The insurance provided under this provision is excess over any other collectible insurance.
B. SECTION V - DEFINITIONS is amended by adding the following:
For the purposes of this provision, "personal effects" mean tangible property that is worn or carried
by an "insured." "Personal effects" does not include tools, equipment, jewelry, money or securi-
ties.
13. ACCIDENTAL AIRBAG DEPLOYMENT
SECTION III - PHYSICAL DAMAGE COVERAGE, B. Exclusions is amended by adding the following:
If you have purchased Comprehensive or Collision Coverage under this policy, the exclusion for 'loss"
relating to mechanical breakdown does not apply to the accidental discharge of an airbag.
Any insurance we provide shall be excess over any other collectible insurance or reimbursement by
manufacturer's warranty. However, we agree to pay any deductible applicable to the other coverage or
warranty.
2017 Liberty Mutual Insurance
AC 85 01 06 18 Includes copyrighted material of Insurance Services Office Inc., with its Permission. Page 4 of 7
14. PHYSICAL DAMAGE DEDUCTIBLE - VEHICLE TRACKING SYSTEM
SECTION III - PHYSICAL DAMAGE COVERAGE, D. Deductible, is amended by adding the following:
Any Comprehensive Deductible shown in the Declarations will be reduced by 50% for any "loss"
caused by theft if the vehicle is equipped with a vehicle tracking device such as a radio tracking device
or a global position device and that device was the method of recovery of the vehicle.
15. AUDIO, VISUAL AND DATA ELECTRONIC EQUIPMENT COVERAGE
SECTION III - PHYSICAL DAMAGE COVERAGE, B. Exclusions, Paragraph a. of the exception to exclu-
sions 4.c. and 4.d. is deleted and replaced with the following:
Exclusions 4.c. and 4.d. do not apply to:
a. Electronic equipment that receives or transmits audio, visual or data signals, whether or not de-
signed solely for the reproduction of sound, if the equipment is:
1) Permanently installed in the covered "auto" at the time of the "loss" or removable from a
housing unit that is permanently installed in the covered "auto"; and
2) Designed to be solely operated by use from the power from the "auto's" electrical system; and
3) Physical damage coverages are provided for the covered "auto".
If the "loss" occurs solely to audio, visual or data electronic equipment or accessories used with
this equipment, then our obligation to pay for, repair, return or replace damaged or stolen property
will be reduced by a $100 deductible.
16. LOAN / LEASE GAP COVERAGE (Not Applicable In New York)
A. Paragraph C. Limit Of Insurance of SECTION III - PHYSICAL DAMAGE COVERAGE is amended by
adding the following:
The most we will pay for a "total loss" to a covered "auto" owned by or leased to you in any oneaccident" is the greater of the:
1. Balance due under the terms of the loan or lease to which the damaged covered "auto" is
subject at the time of the "loss" less the amount of:
a. Overdue payments and financial penalties associated with those payments as of the date
of the "loss";
b. Financial penalties imposed under a lease due to high mileage, excessive use or abnormal
wear and tear;
c. Costs for extended warranties, Credit Life Insurance, Health, Accident or Disability Insur-
ance purchased with the loan or lease;
d. Transfer or rollover balances from previous loans or leases;
e. Final payment due under a "Balloon Loan';
f. The dollar amount of any unrepaired damage which occurred prior to the "total loss" of a
covered "auto'
g. Security deposits not refunded by a lessor;
h. All refunds payable or paid to you as a result of the early termination of a lease agreement
or as a result of the early termination of any warranty or extended service agreement on a
covered "auto';
I. Any amount representing taxes;
j. Loan or lease termination fees; or
2. The actual cash value of the damage or stolen property as of the time of the "loss".
An adjustment for depreciation and physical condition will be made in determining the actual
cash value at the time of the "loss". This adjustment is not applicable in Texas.
B. Additional Conditions
This coverage applies only to the original loan for which the covered "auto" that incurred the
loss" serves as collateral, or lease written on the covered "auto" that incurred the "loss".
2017 Liberty Mutual Insurance
AC 85 01 06 18 Includes copyrighted material of Insurance Services Office Inc., with its Permission. Page 5 of 7
C. SECTION V - DEFINITIONS is changed by adding the following:
As used in this endorsement provision, the following definitions apply:
Total loss" means a 'loss" in which the cost of repairs plus the salvage value exceeds the actual
cash value.
A "balloon loan" is one with periodic payments that are insufficient to repay the balance over the
term of the loan, thereby requiring a large final payment.
17. GLASS REPAIR- WAIVER OF DEDUCTIBLE
Paragraph D. Deductible of SECTION III - PHYSICAL DAMAGE COVERAGE is amended by the addition
of the following:
No deductible applies to glass damage if the glass is repaired rather than replaced.
18. PARKED AUTO COLLISION COVERAGE (WAIVER OF DEDUCTIBLE)
Paragraph D. Deductible of SECTION III - PHYSICAL DAMAGE COVERAGE is amended by the addition
of the following:
The deductible does not apply to 'loss" caused by collision to such covered "auto" of the private
passenger type or light weight truck with a gross vehicle weight of 10,000 lbs. or less as defined by the
manufacturer as maximum loaded weight the "auto" is designed to carry while it is:
a. In the charge of an "insured";
b. Legally parked; and
c. Unoccupied.
The 'loss" must be reported to the police authorities within 24 hours of known damage.
The total amount of the damage to the covered "auto" must exceed the deductible shown in the
Declarations.
This provision does not apply to any 'loss" if the covered "auto" is in the charge of any person or
organization engaged in the automobile business.
19. TWO OR MORE DEDUCTIBLES
Under SECTION III - PHYSICAL DAMAGE COVERAGE, if two or more company policies or coverage
forms apply to the same "accident', the following applies to Paragraph D. Deductible:
a. If the applicable Business Auto deductible is the smaller (or smallest) deductible, it will be waived;
or
b. If the applicable Business Auto deductible is not the smaller (or smallest) deductible , it will be
reduced by the amount of the smaller (or smallest) deductible; or
c. If the 'loss" involves two or more Business Auto coverage forms or policies, the smaller (or
smallest) deductible will be waived.
For the purpose of this endorsement, company means any company that is part of the Liberty Mutual
Group.
SECTION IV - BUSINESS AUTO CONDITIONS is amended as follows:
20. UNINTENTIONAL FAILURE TO DISCLOSE HAZARDS
SECTION IV- BUSINESS AUTO CONDITIONS, Paragraph B.2. is amended by adding the following:
If you unintentionally fail to disclose any hazards, exposures or material facts existing as of the incep-
tion date or renewal date of the Business Auto Coverage Form, the coverage afforded by this policy will
not be prejudiced.
However, you must report the undisclosed hazard of exposure as soon as practicable after its discovery,
and we have the right to collect additional premium for any such hazard or exposure.
2017 Liberty Mutual Insurance
AC 85 01 06 18 Includes copyrighted material of Insurance Services Office Inc., with its Permission. Page 6 of 7
21. AMENDED DUTIES IN THE EVENT OF ACCIDENT, CLAIM, SUIT, OR LOSS
SECTION IV - BUSINESS AUTO CONDITIONS, Paragraph A.2.a. is replaced in its entirety by the follow-
ing:
a. In the event of "accident", claim, "suit" or "loss", you must promptly notify us when it is known to:
1) You, if you are an individual;
2) A partner, if you are a partnership;
3) Member, if you are a limited liability company;
4) An executive officer or the "employee" designated by the Named Insured to give such notice, if
you are a corporation.
To the extent possible, notice to us should include:
a) How, when and where the "accident" or "loss" took place;
b) The "insureds" name and address; and
c) The names and addresses of any injured persons and witnesses.
22. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US
SECTION IV - BUSINESS AUTO CONDITIONS, Paragraph A.5. Transfer Of Rights Of Recovery Against
Others To Us, is amended by the addition of the following:
If the person or organization has in a written agreement waived those rights before an "accident" or
loss", our rights are waived also.
23. HIRED AUTO COVERAGE TERRITORY
SECTION IV - BUSINESS AUTO CONDITIONS, Paragraph B.7. Policy Period, Coverage Territory, is
amended by the addition of the following:
f. For "autos" hired 30 days or less, the coverage territory is anywhere in the world, provided that the
insured's" responsibility to pay for damages is determined in a "suit", on the merits, in the United
States, the territories and possessions of the United States of America, Puerto Rico or Canada or in
a settlement we agree to.
This extension of coverage does not apply to an "auto" hired, leased, rented or borrowed with a
driver.
24. PRIMARY AND NON-CONTRIBUTING IF REQUIRED BY WRITTEN CONTRACT OR WRITTEN AGREE-
MENT
The following is added to SECTION IV - BUSINESS AUTO CONDITIONS, General Conditions, B.5. Other
Insurance and supersedes any provision to the contrary:
This Coverage Form's Covered Autos Liability Coverage is primary to and will not seek contribution
from any other insurance available to an "insured" under your policy provided that:
1. Such "insured" is a Named Insured under such other insurance; and
2. You have agreed in a written contract or written agreement that this insurance would be primary
and would not seek contribution from any other insurance available to such "insured".
SECTION V - DEFINITIONS is amended as follows:
25. BODILY INJURY REDEFINED
Under SECTION V - DEFINITIONS, Definition C. is replaced by the following:
Bodily injury" means physical injury, sickness or disease sustained by a person, including mental
anguish, mental injury, shock, fright or death resulting from any of these at any time.
2017 Liberty Mutual Insurance
AC 85 01 06 18 Includes copyrighted material of Insurance Services Office Inc., with its Permission. Page 7 of 7