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Home My WebLink AboutAGMT - G2 Construction Inc (2018 Environmental Cleanup Program Project CIP SD1901Recorded in Official Records, Orange County RECORDING REQUESTED BY Hugh Nguyen, Clerk -Recorder AND WHEN RECORDED MAIL TO I III III I IIIIIIIIIII III IIIIIIIIII II II VIII I VIII III II NO FEE *$ R 0 0 1 1 0 0 7 4 6 4$* CITY OF SEAL BEACH 201900027294110:06 am 07/29/19 Attn: City Clerk 47 422 N12 1 211 - 8th Street 0.00 0.00 0.00 0.00 0.00 0.00 0.000.000.00 0.00 Seal Beach, CA 90740 Space of above this line for Recorder's use. No Recording Fee Pursuant to Government Code Section 6103, 27383 1 ,n NOTICE OF COMPLETION Notice pursuant to Civil Code Section 9204, must be filed within 15 days after completion. Notice is hereby given that: 1. The undersigned is owner or corporate officer of the owner of the interest or estate stated below in the property hereinafter described: 2. The full name of the owner is: City of Seal Beach. 3. The address of the owner is: 211 — 8th Street, Seal Beach, CA 90740. 4. The nature of the interest or estate of the owner is: In Fee. The City of Seal Beach. 5. A work of improvement on the property hereinafter is described as substantially completed on June 21, 2019. The work was 2018 Environmental Cleanup Program- CIP No. SD1901. 6. The name of the contractor(s), if any, for such improvement was: G2 Construction, Inc. The date of the Contract Award was May 13, 2019. 7. The property on which said work of improvement was completed in the City of Seal Beach, County of Orange, State of California, and is described as follows: Various locations in Old Town District. alona Seal Beach Boulevard. and alona Westminster Avenue. Date: / Direc of F5u5Iic Works, P. E, City of Seal Beach Signature of owner or corporate officer of owner named in paragraph 2 or agent. VERIFICATION I, the undersigned, say: the Director of Public Works declarant of the foregoing notice of completion; have read said notice of completion and know the contents thereof; the same is true of my own knowledge. RECEIVED I declare under penalty of perjury the foregoing is true and correct. Executed on �c�,�c. `� Z,::, 2019, at Seal Beach, California. AUG 15 2019 Gate of Signature) CITY CLERK CITY OF SEAL BEACH Die ublic y of Seal Beach PUBLIC WORKS AGREEMENT 2018 ENVIRONMENTAL CLEANUP PROGRAM Project CIP SD1901 between City of Seal Beach 211 - 8th Street Seal Beach, CA 90740 0 G2 Construction, Inc. 1352 E. Borchard Avenue Santa Ana, CA 92705 (714) 448-8080 THIS AGREEMENT is made as of May 13. 2019, by and between the City of Seal Beach, a California charter city (City"), and G2 Construction, Inc.. --a_ Califomia Corporation and General Contractor ("Contractor"). 1 of 12 RECITALS A. WHEREAS, the City Council has approved the plans and specifications for the 2018 Environmental Cleanup Program Project CIP SD1901 ("Project") with respect to design criteria; B. WHEREAS, Contractor has submitted a bid to City for the Project dated April 25, 2019 in the amount of $145.613.00 ("Accepted Proposal" hereinafter). The Accepted Proposal is attached hereto as Exhibit G and contains, among other things, provisions defining the Project scope; and C. WHEREAS, Contractor's California State Contractor's license number is 801253 (Class A, C-8, and C60). D. NOW, THEREFORE, in consideration of performance by the parties of the mutual promises, covenants, and conditions herein contained, the parties hereto agree as follows: AGREEMENT 1. Contractor's Services. 1.1 Scope and Level of Services. For and in consideration of the mutual promises set forth herein, and subject to the terms and conditions set forth in this Agreement, Contractor shall perform and complete in good and workmanlike manner all work ("Work") required by this Agreement and the documents listed in Subsection 1.2 for the Project. 1.2 Contract Documents. The "Contract Documents" that comprise the agreement between the City and the Contractor are the: Notice Inviting Bids, Instructions to Bidders, Accepted Proposal, Non -Collusion Declaration, Bid Schedule(s), List of Subcontractors, Contractor's Industrial Safety Record, Contractor's Qualification Statement, Bid Security Forms for Check or Bond, Specifications, General and Special Provisions and documents referenced therein, all addenda as prepared prior to the date of bid opening setting forth any modifications or interpretations of any of said documents, this Agreement, Exhibits attached to this Agreement, including but not limited to the Performance Bond (Exhibit A), Payment Bond (Exhibit B), Workers' Compensation Insurance Certificate (Exhibit C), Insurance Endorsements (Exhibit D), Acknowledgment of Penal and Civil Penalties Concerning Contractor Licensing Laws (Exhibit E), Labor Law Requirements (Exhibit F), Accepted Proposal (Exhibit G) and any and all supplemental agreements executed amending or extending the Work contemplated and that may be required to complete the Work in a substantial and acceptable manner. These Contract Documents are hereby incorporated into this Agreement. 1.3 The Work shall be performed in accordance with the Plans, Specifications and other Contract Documents. Contractor shall furnish at its own 2of12 expense all labor, materials, equipment and services necessary therefor, except such labor, materials, equipment and services as are specified in the Contract Documents to be furnished by City. 1.4 In the event of any material discrepancy between the express provisions of this Agreement and the provisions of the other Contract Documents, the provisions of this Agreement shall prevail. 2. Effective Date. This Agreement is effective as of May 13, 2019 (the "Effective Date"), and shall remain in full force and effect until Contractor has rendered the services required by this Agreement. 3. Payment. For performing and completing the Work in accordance with the Contract Documents, City shall pay Contractor, in full compensation therefor, the amount of $145.613.00, subject to any additions and deletions pursuant to the terms of the Contract Documents. Said sum shall constitute payment in full for all work performed hereunder, including, without limitation, all labor, materials, equipment, tools and services used or incorporated in the Work, supervision, administration, overhead, expenses and any and all other things required, furnished or incurred for completion of the Work as specified in the Contract Documents. City shall make payments to Contractor on account of the contract sum at the time, in the manner, and upon the conditions specified in the Contract Documents. The City Manager may authorize extra work to fund unforeseen conditions up to the amount approved at the time of award by the City Council. Payment for additional work in excess of this amount requires prior City Council authorization. 4. Contractor's Personnel. 4.1 All Work shall be performed by Contractor or under Contractor's direct supervision, and all personnel shall possess the qualifications, permits, and licenses required by state and local law and by the Notice Inviting Bids/instructions to Bidders to perform such Services, including, without limitation, a City of Seal Beach business license as required by the Seal Beach Municipal Code. 4.2 Contractor shall be responsible for payment of all employees' wages and benefits, and shall comply with all requirements pertaining to employer's liability, workers' compensation, unemployment insurance, and Social Security. Contractor shall fully comply with the workers' compensation law regarding Contractor and Contractor's employees. 4.3 Contractor shall indemnify and hold harmless City and its elected officials, officers, employees, servants, designated volunteers, and agents serving as independent contractors in the role of city officials, from any and all liabilities, damages, claims, costs and expenses of any nature to the extent arising from Contractor's alleged violations of personnel practices. 3of12 4.4 Contractor is, and shall at all times remain as to City, a wholly independent contractor. Contractor shall have no power to incur any debt, obligation, or liability on behalf of City or otherwise act as an agent of City. Neither City nor any of its agents shall have control over the conduct of Contractor or any of Contractor's employees, except as set forth in this Agreement. Contractor shall not, at any time, or in any manner, represent that it or any of its officers, agents, or employees are in any manner employees of City. Contractor shall pay all required taxes on amounts paid to Contractor under this Agreement, and indemnify and hold City harmless from any and all taxes, assessments, penalties, and interest asserted against City by reason of the work performed pursuant to this Agreement. 4.5 City shall have the right to offset against the amount of any fees due to Contractor under this Agreement any amount due to City from Contractor as a result of Contractor's failure to promptly pay to City any reimbursement or indemnification arising under this Section 4. 5. Indemnification. 5.1 Contractor's Duty. Contractor shall defend, indemnify, and hold the City, its elected officials, officers, employees, volunteers, agents, and those City agents serving as independent contractors in the role of City officials (collectively "Indemnitees") free and harmless from and against any and all claims (including, without limitation, claims for bodily injury, death or damage to property), demands, obligations, damages, actions, causes of action, suits, losses, bid protests, stop notices, judgments, fines, penalties, liabilities, costs and expenses (including, without limitation, attorney's fees, disbursements and court costs) of every kind and nature whatsoever (individually, a "Claim," collectively, "Claims"), in any manner arising out of or incident to the performance of the Agreement, including without limitation, the payment of all consequential damages and attorneys' fees and other related costs and expenses. Further, Contractor shall appoint competent defense counsel, at Contractor's own cost, expense and risk, to defend any and all such suits, actions or other legal proceedings of every kind arising out of or incident to the performance of the Agreement that may be brought or instituted against Indemnitees. Contractor shall pay and satisfy any judgment, award or decree that may be rendered against City or the other Indemnitees in any such suit, action, or other legal proceeding arising out of or incident to the performance of the Agreement. Contractor shall reimburse the City and the other Indemnitees, for any and all legal expenses and costs incurred by each of them in connection therewith or in enforcing the indemnity herein provided. Contractor's obligation to indemnify shall not be restricted to insurance proceeds, if any, received by Contractor or Indemnitees. This indemnity shall apply to all Claims and liability regardless of whether any insurance policies are applicable. 4of12 5.2 Bid Protests. In addition to its obligations pursuant to Section 5.1, Contractor shall reimburse the City for all attorneys' fees and costs incurred by City in connection with, arising out of or incident to any bid protest. 5.3 City's Sole Negligence. Nothing in Section 5.1 shall be construed to require Contractor to indemnify Indemnitees for that portion of any Claim to the extent arising from the sole negligence or willful misconduct of the Indemnitees. 5.4 Nonwaiver of Rights. Indemnitees do not, and shall not, waive any rights that they may possess against Contractor because of the acceptance by City, or the deposit with City, of any insurance policy or certificate required pursuant to this Agreement. 5.5 Waiver of Right of Subrogation. Contractor, on behalf of itself and all parties claiming under or through it, hereby waives all rights of subrogation against the Indemnitees, while acting within the scope of their duties, from all claims, losses, and liabilities arising out of or incident to activities or operations performed by or on behalf of the Indemnitor. 5.6 Survival. The provisions of this Section 5 shall survive the termination of the Agreement and are in addition to any other rights or remedies that Indemnitees may have under the law. Payment is not required as a condition precedent to an Indemnitee's right to recover under this indemnity provision, and an entry of judgment against a Contractor shall be conclusive In favor of the Indemnitee's right to recover under this indemnity provision. 6. Insurance. 6.1 Liability Insurance. Contractor shall procure and maintain in full force and effect for the duration of this Agreement insurance against claims for injuries to persons or damages to property which may arise from or in connection with the performance of the services hereunder by Contractor, and its agents, representatives, employees and subcontractors. The policy limits set forth below do not act as a limitation upon the amount of indemnification to be provided by Contractor. Contractor shall complete and execute the following documents attached as Exhibits hereto and incorporated herein by this reference: 6.1.1 Exhibit D-1: Additional Insured Endorsement - Commercial General Liability. Automobile Liability. 6.1.2 Exhibit D-2: Additional Insured Endorsement - 6.1.3 Exhibit D-3: Additional Insured Endorsement. 5of12 6.2 Minimum Scope of Insurance. Unless otherwise approved by City, coverage shall be at least as broad as: 6.2.1 Insurance Services Office Commercial General Liability coverage (occurrence form CG 0001). 6.2.2 Insurance Services Office form number CA 0001 (Ed. 1/87) covering Automobile Liability, code 1 (any auto). 6.2.3 Insurance Services Office form number CG 20 10 11 85 (Ed. 11/85) covering Additional Insured—Owners, Lessees or Contactors (Form B). 6.2.4 Workers' Compensation insurance as required by the State of California and Employer's Liability Insurance. 6.2.5 Professional Liability insurance. Unless the City waives in the requirement for professional liability insurance, Contractor shall provide to City the standard form issued by the carrier. 6.3 Minimum Limits of Insurance. Contractor shall maintain limits no less than: 6.3.1 General Liability: $2,000,000 per occurrence and in the aggregate for bodily injury, personal injury and property damage. Commercial General Liability Insurance or other form with a general aggregate limit shall apply separately to this Agreement or the general limit shall be twice the required occurrence limit. 6.3.2 Automobile Liability: $2,000,000 per occurrence for bodily injury and property damage. 6.3.3 Employer's Liability: $1,000,000 per occurrence and in the aggregate for bodily injury or disease and Workers' Compensation Insurance in the amount required by law. 6.4 Deductibles and Self-insured Retentions. Contractor shall inform City of any deductibles or self-insured retentions except with respect to any professional liability insurance. 6.5 Other Insurance Provisions. The general liability and automobile liability policies are to contain, or be endorsed to contain, the following provisions: 6.5.1 City, its officers, officials, employees, designated volunteers and agents serving as independent contractors in the role of City officials, are to be covered as additional insureds as respects: liability arising out of activities performed by or on behalf of Contractor; products and completed 6of12 operations of Contractor, premises owned, occupied or used by Contractor; or automobiles owned, leased, hired or borrowed by Contractor. The coverage shall contain no limitations on the scope of protection afforded to City, its officers, officials, employees, designated volunteers or agents serving as independent contractors in the role of City officials which are not also limitations applicable to the named insured. 6.5.2 For any claims related to this Agreement, Contractor's insurance coverage shall be primary insurance as respects City, its officers, officials, employees, designated volunteers and agents serving as independent contractors in the role of City officials. Any insurance or self- insurance maintained by City, their officers, officials, employees, designated volunteers or agents serving as independent contractors in the role of City officials shall be excess of Contractor's insurance and shall not contribute with it. 6.5.3 Contractor's insurance shall apply separately to each insured against whom claim is made or suit is brought, except with respect to the limits of the insurer's liability. 6.5.4 Each insurance policy required by this Section 6 shall be endorsed to state that coverage shall not be canceled or materially modified except after 30 days prior written notice by first class mail has been given to City. 6.5.5 Each insurance policy, except for any professional liability policy, required by this Section 6 shall expressly waive the insurer's right of subrogation against City and its elected officials, officers, employees, servants, attorneys, designated volunteers, and agents serving as independent contractors in the role of city or agency officials. 6.6 Acceptability of Insurers. Insurance is to be placed with insurers with a current A.M. Best's rating of no less than A:VIII unless waived in writing by City's Risk Manager. 6.7 Verification of Coverage. All insurance coverages shall be confirmed by execution of endorsements on forms approved by the City. The endorsements are to be signed by a person authorized by that insurer to bind coverage on its behalf. All endorsements are to be received and approved by City before services commence. As an alternative to City forms, Contractor's insurer may provide complete, certified copies of all required insurance policies, including endorsements effecting the coverage required by these specifications. 7. Liquidated Damages. Should the Contractor fail to complete the project, or any part thereof, within forty (401 working days following the date specified on the Notice to Proceed from the City, the Contractor shall reimburse the City for the additional expense and damage for each calendar day that the Contract remains uncompleted after the Contract completion date. It is agreed 7 of 12 that the amount of such additional expense and damage incurred by reason of failure to complete the Contract is the per diem rate of $500.00 per calendar day. Such amount is hereby agreed upon as liquidated damages for the loss to the City resulting from the failure of the Contractor to complete the project within the allotted time and to the value of the operation of the works dependent thereon. It is expressly understood and agreed that this amount is a reasonable amount and is established in lieu of damages that are incapable of calculation at the inception hereof; and this amount is not to be considered in the nature of a penalty. The City shall have the right to deduct such damages from any amount due, or that may become due to the Contractor, or the amount of such damages shall be due and collectible from the Contractor or the Contractor's Surety. Progress payments made after the scheduled completion date shall not constitute a waiver of liquidated damages. 8. Suspension. City may, in writing, order Contractor to suspend all or any part of the Contractor's Services for the convenience of City or for work stoppages beyond the control of City or Contractor. A suspension of the Services does not void this Agreement. 9. Notices. Any notices, bills, invoices, or reports authorized or required by this Agreement shall be in writing and shall be deemed received on (a) the day of delivery if delivered by hand or overnight courier service during Contractor's and City's regular business hours or by facsimile before or during Contractor's regular business hours; or (b) on the third business day following deposit in the United States mail, postage prepaid, to the addresses heretofore set forth in the Agreement, or to such other addresses as the parties may, from time to time, designate in writing pursuant to the provisions of this Section. All notices shall be addressed as follows: If to City: City Clerk City of Seal Beach 211 -8th Street Seal Beach, California 90740 Telephone: (562) 431-2527 Fax: (562) 493-9857 With a copy to: Public Works Director City of Seal Beach 211 -8th Street Seal Beach, California 90740 If to Contractor: G2 Construction, Inc. 1352 E. Borchard Avenue Santa Ana, CA 92705 Telephone: (714) 448-8080 Attn: John R. Alvarado 8of12 10. Non-Assignabiliil /: Subcontracting. Contractor shall not assign, transfer, or subcontract any interest in this Agreement or the performance of any of Contractor's obligations hereunder. Any attempt by Contractor to so assign, transfer, or subcontract any rights, duties, or obligations arising hereunder shall be null, void and of no effect. 11. Claim Disoute Resolution. 11.1 In the event of any dispute or controversy with the City over any matter whatsoever, the Contractor shall not cause any delay or cessation in or of Work, but shall proceed with the performance of the Work in dispute. Contractor shall retain any and all rights provided that pertain to the resolution of disputes and protests between the parties. The Disputed Work will be characterized as an "unresolved dispute" and payment, if any, shall be as later determined by mutual agreement or a court of law. Contractor shall keep accurate, detailed records of all Disputed Work, claims and other disputed matters. 11.2 All claims arising out of or related to the Contract Documents or this Project, and the consideration and payment of such claims, are subject to the Government Claims Act (Government Code Section 810 et seq.) with regard to filing claims. All such claims are also subject to Public Contract Code Section 9204 and Public Contract Code Section 20104 et seq. (Article 1.5), where applicable. This Contract hereby incorporates those provisions as though fully set forth herein. Thus, Contractor or any Subcontractor must file a claim in accordance with the Government Claims Act as a prerequisite to filing a construction claim in compliance with Section 9204 and Article 1.5 (if applicable), and must then adhere to Article 1.5 and Section 9204, as applicable, pursuant to the definition of "claim" as individually defined therein. 12. Compliance with Laws. Contractor shall comply with all applicable federal, state and local laws, ordinances, codes and regulations in force at the time Contractor performs the Services. 13. Non -Waiver of Terms. Rights and Remedies. Waiver by either party of any one or more of the conditions of performance under this Agreement shall not be a waiver of any other condition of performance under this Agreement. In no event shall the making by City of any payment to Contractor constitute or be construed as a waiver by City of any breach of covenant, or any default which may then exist on the part of Contractor, and the making of any such payment by City shall in no way impair or prejudice any right or remedy available to City with regard to such breach or default. 14. Attorneys' Fees. in the event that either party to this Agreement shall commence any legal action or proceeding to enforce or interpret the provisions of this Agreement, the prevailing party in such action or proceeding 9of12 shall be entitled to recover its costs of suit, including all attorneys' fees incurred in connection therewith. 15. Construction. The validity, interpretation, and performance of this Agreement shall be controlled by and construed under the laws of the State of California. In the event of any asserted ambiguity in, or dispute regarding the interpretation of any matter herein, the interpretation of this Agreement shall not be resolved by any rules of interpretation providing for interpretation against the party who causes the uncertainty to exist or against the party who drafted the Agreement or who drafted that portion of the Agreement. 16. Entire Agreement. This Agreement, including any other documents incorporated herein by specific reference, represents the entire and integrated agreement between Contractor and City. This Agreement supersedes all prior oral or written negotiations, representations, or agreements. This Agreement may not be amended, nor any provision or breach hereof waived, except in a writing signed by the parties which expressly refers to this Agreement. 17. Severability. The invalidity in whole or in part of any provisions of this Agreement shall not void or affect the validity of the other provisions of this Agreement. IN WITNESS WHEREOF, the parties, through their respective authorized representatives, have executed this Agreement as of the date first written above. (Intentionally Left Blank) 10 of 12 CITY OF SEAL BEACH CONTRACTOR: G2 Cons ruction, Inc., a California corporation By: By l� Jill R. alngrarm, C -117y7 na Name, John R. Alvarado EAL �,r e= President Attest: By: Gloria D. Approved as to Fo By: Craig A. Steele, City Attorney 11 of 12 (Intentionally Left Blank) 12 of 12 EXHIBIT A FAITHFUL PERFORMANCE BOND Bond No. 1001126413 Bond Premium $3,495.03 PERFORMANCE BOND KNOW ALL PERSONS BY THESE PRESENTS that: WHEREAS the City of Seal Beach, has awarded G2 Construction Inc. 1352 East Borchard Ave. Santa Ana, CA 92705 (Name and address of Contractor) ("Principal"), a contract (the "Contract") for the work described as follows: 2018 Environmental Cleanup Program RmlectCIP 501901 WHEREAS, Principal is required under the terms of the Contract to furnish a bond for the faithful performance of the Contract NOW, THEREFORE, we, the undersigned Principal, and American Contractors Indemnity Company 8ol S. Figueroa Street, Suite 700, Los Angeles CA 90017 (Name and address of Surety) ("Surety") a duly admitted surety insurer under the laws of the State of California, as Surety, are held and firmly bound unto the Public Agency in the penal sum of One Hundred Forty -Five Thousand, Six Hundred Thirteen and 00 Dollars ($ $145,613.00 I, this amount being not less than the total contract price, in lawful money of the United States of America, for the payment of which sum well and truly to be made, we bind ourselves, our heirs, executors, administrators, successors, and assigns, jointly and severally, firmly by these presents. THE CONDITION OF THIS OBLIGATION IS SUCH THAT, if the hereby bounded Principal, his, her or its heirs, executors, administrators, successors or assigns, shall in all things stand to and abide by, and well and truly keep and perform all the undertakings, terms, covenants, conditions and agreements in the Contract and any alteration thereof made as therein provided, on the Principal's part to be kept and performed, all within the time and in the manner therein specified, and in all respects according to their true intent and meaning, and shall indemnify and hold harmless the Public Agency, its officers, agents, and others as therein provided, then this obligation shall become null and void; otherwise, it shall be and remain in full force and effect. In case suit is brought upon this bond, Surety further agrees to pay all court costs and reasonable attomeys' fees In an amount fixed by the court. FURTHER, the Surety, for value received, hereby stipulates and agrees that no change, extension of time, alteration, addition or modification to the terns of the Contract, or of the work to be performed there under, or the specifications for the same, shall in any way affect its obligations under this bond, and it does hereby waive notice of any such change, extension of time, alteration, addition, or modification to the terms of the Contract or to the work or to the specifications there under. Surety hereby waives the provisions of California Civil Code §§ 2845 and 2849. The City is the principal beneficiary of this bond and has all rights of a party hereto. IN WITNESS WHEREOF, two (2) Identical counterparts of this instrument, each of which shall for all purposes be deemed an original hereof, have been duly executed by Principal and Surety, on the date set forth below, the name of each corporate party being hereto affixed and these presents duly signed by its undersigned representative(s) pursuant to authority of its goveming body. Dated: "Principal` G2 Construction Inc. 1352 East Borchard Ave, Santa Ana, CA/�705 By. lt Its ,e its /;Ifss1a kl — "Surety" American Contractors Indemnity Company 801 S. FigueroA Street, Suite 700 Los Angeles, By: Ak irat, Attorney -In -Fact Its Megan Runde, ttorney-In-Fact (Seal) (Seal) Note: This bond must be dated, all signatures must be notarized, and evidence of the authority of any person signing as attorney -In -fact must be attached. JGj CORA Z RPORp,SEO 90 z v / Vor CO, ROH 6' CAL1F� A notary public or other officer completing this certificate verifies only the CA L I F O R N I A ALL-PURPOSE identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. CERTIFICATE O F State of California ) ACKNOWLEDGMENT County of�. ) On Milli 2412-00 before me, lL l� lI✓�(. %%fCl�1 zgzhh(2 (here insert name and titlil the officer) personally appeared John i l Ahlar k6 who proved to me on the basis of satisfactory evidence to be the person( whose name`s,) is/ke subscribed to the within instrument and acknowledged to me that he/tae/tiale'y executed the same in his/her/their authorized capacityks), and that by his/hw/thek signaturek on the instrument the person, or the entity = upon behalf of which the person( acted, executed the instrument. E I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. K. R. AVILA COMM. #2211653 z = WITNESS my hand and official seal. i@my Notary Public - California o Orange County ,(� Comm. resAug. 27, 2021 = Signature /`' Al? (Seal) OPTIONAL INFORMATION Although the information in this section is not required by law, it could prevent fraudulent removal and reattachment of this acknowledgment to an unauthorized document and may prove useful to persons relying on the attached document. Description of Attached Document Additional Inforriniation The preceding Certificate of Acknowledgment is attached to a document Method of Signer Identification titled/for the purpose of (�1 o f f.�lj� BjlJ�f Proved to me on the basis of satisfactory evidence: Lo forms) of identification 0 credible witness(es) P �� Notarial event is detailed in notary journal on: containing / pages, and dated /I%y, .2�/�' Page # Entry # 47 The signer(s) capacity or authority is/are as: (votary contact: ❑ Individual(s) Other ❑/Attorney-in-Fact ❑ Additional Signer(s) ❑ Signer(s)Thumbprint(s) L� Corporate Officer(s) , dhw f Almol ❑ ❑ Guardian/Conservator ❑ Partner-Limited/General ❑ Trustee(s) ❑ Other: _ representing: Name(s) of Person(s) or Entlty(ies) Signer is Representing Cl Copyright 2007-2014 Notary Rotary, Inc. PO Box 41400, Des Moines, IA 50311-0507. All Rights Reserved. Item Number 101772. Please contact your Authorized Reseller to purchase copies of this form. EXHIBIT B PAYMENT BOND Bond No. 1001126413 Bond Premium $3,495.03 PAYMENT BOND (LABOR AND MATERIALS) KNOW ALL PERSONS BY THESE PRESENTS that: WHEREAS the City of Seal Beach, has awarded to G2 Construction Inc. 1352 East Borchard_Av_ e, Santa Ana, CA 92705 (Name and address of Contractor) ("Principal"), a contract (the "Contract") for the work described as follows: 2918 Environmental Cleanup Program Profect CIP S01901 WHEREAS, Principal is required under the terms of the Contract and the California Civil Code to secure the payment of claims of laborers, mechanics, materialmen, and other persons as provided by law. NOW, THEREFORE, we, the undersigned Principal, and American Contractors Indemnity Company _80_LS. Fiaueroa Street, Suite 700, Los Angeles. CA 90017 (Name and address of Surety) ("Surety") a duly admitted surety insurer under the laws of the State of California, as Surety, are held and firmly bound unto the Public Agency in the penal sum of One Hundred Forty -Five Thousand, Six Hundred Thirteen and 00/100 Dollars ($ $145.613.00 this amount being not less than the total contract price, In lawful money of the United States of America, for the payment of which sum well and truly to be made, we bind ourselves, our heirs, executors, administrators, successors, and assigns, jolntty and severally, firmly by these presents. THE CONDITION OF THIS OBLIGATION IS SUCH THAT, if the hereby bounded Principal, his, her or Its heirs, executors, administrators, successors or assigns, or subcontractors shall fail to pay any of the persons named in Section 3181 of the California Civil Code, or any amounts due under the Unemployment Insurance Code with respect to work or labor performed under the Contract, or for any amounts required to be deducted, withheld, and paid over to the Employment Development Department from the wages of employees of the Principal and subcontractors pursuant to Section 13020 of the Unemployment Insurance Code, with respect to work or labor performed under the Contract, the Surety will pay for the same in an amount not exceeding the penal sum specified in this bond; otherwise, this obligation shall become null and void. This bond shall insure to the benefit of any of the persons named in Section 3181 of the California Civil Code so as to give a right of action to such persons or their assigns in any suit brought upon the bond. In case suit is brought upon this bond, Surety further agrees to pay all court costs and reasonable attorneys' fees in an amount fixed by the court. FURTHER, the Surety, for value received, hereby stipulates and agrees that no change, extension of time, alteration, addition or modification to the terms of the Contract, or of the work to be performed thereunder, or the specifications for the same, shall in any way affect its obligations under this bond, and it does hereby waive notice of any such change, extension of time, alteration, addition, or modification to the terms of the Contract or to the work or to the specifications thereunder. Surety hereby waives the provisions of California Civil Code §§ 2845 and 2849. IN WITNESS WHEREOF, two (2) identical counterparts of this instrument, each of which shall for all purposes be deemed an original hereof, have been duly executed by Principal and Surety, an the date set forth below, the name of each corporate party being hereto affixed and these presents duly signed by Its undersigned representative(s) pursuant to authority of its governing body. Dated: "Principar, "Surety" G2 Construction Inc. America 1352 East Borchard Ave. i 801 S. By. By: Aksel Firat, A e In -Fact By: y- /IaS.Z A17- - Its Mega u de, Attorney -In -Fact (Seal) (Seal) Note: This bond must be dated, all signatures must be notarized, and evidence of the authority of any person signing as attorney-in-fact must be attached. �G�10 N Cp,� 0 a INCORP0��0 9a MARCH 6, 2006 z \CALIFORN\P A notary public or other officer completing this certificate verifies only the CALIFORNIA ALL-PURPOSE identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. CERTIFICATE O F - State of California ) ACKNOWLEDGMENT = County of On �� Zb before me,y 4a 1C /J (here insert name and tit of the officer) personally appeared JD/l�'j V 141yaniclo who proved to me on the basis of satisfactory evidence to be the personXwhose name is/e subscribed to the within instrument and acknowledged to me that he/s %�/thty_ executed the same in his/hIlst/their _ authorized capacity(ies), and that by his/h/thel signature(s�,on the instrument the person(, or the entity 3 upon behalf of which the personts) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. K. R. AVILA COMM. #2211653 z WITNESS my hand and official seal. z �► Notary Public • California o Orange County Comm. Ex ' es A4.27, 2021 = Signature *kZkA (Seal) OPTIONAL INFORMATION Although the information in this section is not required by law, it could prevent fraudulent removal and reattachment of this acknowledgment to an unauthorized document and may prove useful to persons relying on the attached document. Description of Attached Document The preceding Certificate of Acknowledgment is attached to a document Method of Signer Identification titled/for the purpose of 6� 0)1_S"1&&_-17Proved tome on the basis satisfactory evidence: Lo form(s) of identification 0 credible witness(es) Notarial event is detailed in notaryjournal on: containing pages, and dated21/ /2019 Page n Entry# The signer(s) capacity or authority is/are as: Notary contact: ❑ Individual(s) Other ❑ A rney in Fact �j ❑ Additional Signer(s) ❑ Signer(s)Thumbprint(s) Corporate Officer(s) �%h/'l /4�l�GIYDCiO Title(s) ❑ �i'p:51Gr/2197L" ❑ Guardian/Conservator ❑ Partner - Limited/General ❑ Trustee(s) ❑ Other: representing: Name(s) of Person(s) or Entity(ies) Signer is Representing 0 Copyright 2007-2014 Notary Rotary, Inc. PO Box 41400, Des Moines, IA 50311-0507, All Rights Reserved. Item Number 101772. Please contact your Authorized Reseller to purchase copies of this form. STATE OF Arizona ) On this 23rd day of May in the year 2019 r ) ss. before me, Magen Graves a COUNTY OF Marieopa ) Notary Public, State of Arizona , duly commissioned and sworn, personally appeared Aksel Firat personally known to me (or proved to me on the basis of satisfactory evidence) to be the person(s) whose name is/are subscribed to tate within instrument, and acknowledged to me that hetshe/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. WITNESS my hand and official seal. MAGEN GRAVES (Seal) NOTARY PUBLIC, ARIZONA Notary Public, State of Arizona a MARICOPA COUNTY M commission expires 08/09/2021 1212 * My Commission Expires Y P August 09, 2021 STATE OF Arizona ) On this 23rd day of May in the year 2019 ) ss. before me, Magen Graves a COUNTY OF Marieopa ) Notary Public, State of Arizona , duly commissioned and sworn, personally appeared Megan Runde *personally known to me (or proved to me on the basis of satisfactory evidence) to be the person(s) whose name is/are subscribed to the within instrument, and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. WITNESS my hand and official seal. MAGEN GRAVES (Seal) NOTARY PUBLIC, ARIZONA Notary Public, State of nzona MARICOPA COUNTY My commission expires 08/09/2021 �f1 MY Commission Expires August 09, 2021 STATE OF } On this day of in the year ) ss. before me, a COUNTY OF } Notary Public, State of , duly commissioned and sworn, personally appeared , personally }mown to me (or proved to me on the basis of satisfactory evidence) to be the person(s) whose name istare subscribed to the within instrument, and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. WITNESS my hand and official seal. (Seal) Notary Public, State of My commission expires STATE OF ) On this day of W in the year )ss' before me, a COUNTY OF } Notary Public, State of , duly commissioned and sworn, personally appeared , personally known to me (or proved to me on the basis of satisfactory evidence) to be the person(s) whose name is/are subscribed to the within instrument, and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. WITNESS my hand and official seal. (Seal) Notary Public, State of My commission expires TOKIO MARI N E HCC POWER OF ATTORNEY AMERICAN CONTRACTORS INDEMNITY COMPANY TEXAS BONDING COMPANY UNITED STATES SURETY COMPANY U.S. SPECIALTY INSURANCE COMPANY KNOW ALL MEN BY THESE PRESENTS: That American Contractors Indemnity Company, a California corporation, Texas Bonding Company, an assumed name of American Contractors Indemnity Company, United States Surety Company, a M aryland corporation and U.S. Specialty Insurance Company, a Texas corporation (collectively, the "Companies"), do by these presents make, constitute and appoint: Aaron West, Aksel Firat, Kelli Linsted or Megan Runde of Scottsdale, AZ its true and lawful Attomey(s)-in-fad, each in their separate capacity if more than one is named above, with full paver and authority- hereby uthorityhereby conferred in its name, place and stead, to execute, acknowledge and deliver any and all bonds-- recognizances; undertakings or other instruments or contracts of suretyship to include riders, amendments, and consents of surety, providing the bond penalty does not exceed *****Three Million***** Dol}ars ( ***$3,000,000.00*** ). This Power of Attorney shall expire without further action on April 231d, 2022. This Power of Attorney is granted under and by authority of the following resolutions adopted by the Boards of Directors of the Companies: Be it Resolved, that the President, any Vice -President, any Assistant Vice -President, any Secretary or any Assistant Secretary shall be and Whereby vested with full power and authority to appoint any one or more suitable persons as Attorney(s)-in-Fact to represent and act for and € n behalf of the Company subject to the following provisions: Attomey-in-Fact may be given full power and authority for and in the name of and on behalf of the Company, to execute, acknowledge and deliver, any and all bonds, recognizances, contracts, agreements or indemnity and other conditional or obligatory undertakings, including any and all consents for the release of retained percentages and/or final estimates on engineering and construction contracts, and any and all notices and documents canceling or terminating the Company's liability thereunder, and any such instruments so executed by any such Attomey-in-Fact shall be binding upon the Company as if signed by the President and sealed and effected by the Corporate Secretary. Be it Resolved, that the signature of any authorized officer and seal of the Company heretofore or hereafter affixed to any power of attorney or any certificate relating thereto by facsimile, and any power of attorney or certificate bearing facsimile signature or facsimile seal shall be valid and binding upon the Company with respect to any bond or undertaking to which it is attached. IN WITNESS WHEREOF, The Companies have caused this instrument to be signed and their corporate seals to be hereto affixed, this 1st day of June, 2018. AMERICAN CONTRACTORS INDEMNITY COMPANY TEXAS BONDING OMPANY UNITED STAXERSURETY.CAMPANY COMPANY State of California AMA :�IN i . ffIL M.1N0 i� W 2 W. f2-i r ' tp County of Los Angeles �� f •ssa;• �m %7 �jr� S r' J By: 4Z,�,, moM�# : ,; Daniel P. Aguilar, Vice President A Notary Public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document On this 131 day of June, 2018, before me, Sonia O. Carrejo, a notary public, personaffy appeared Daniel P. Aguilar, Vice President of American Contractors Indemnity Company, Texas Bonding Company, United States Surety Company and U.S. Specialty Insurance Company who proved to me on the basis of satisfactory evidence to be the person whose name is subscribed to the within instrument and acknowledged to me that he executed the same in his authorized capacity, and that by his signature on the instrument the person, or the entity upon behalf of which the person acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. S,kA,D,C„E.0�{! • 7�1.rr wmk cwam cawty wi�p�st Cmnnb+lon f U39979 Signature(seal) 16MYCOMMAKWHAPr23,1022 I, Kio Lo, Assistant Secretary American Contractors Indemnity Company, Texas Bonding Company, United States Surety Company and U -S_ Specialty Insurance Company, do hereby certify that the above and foregoing is a true and correct copy of a Power of Attorney, executed by said Companies, which is still in full force and effect; furthermore, the resolutions of the Boards of Directors, set out in the Power of Attorney are in full force and effect. In Witne$s Whereof, I have hereunto set my hand and affixed the seals of said Companies at Los Angeles, California this -Z:;'rcJday of /'YlDil.1— raw!?. NN C70 r'k. DIN nr'e ............ ye **Mawrr Corporate Seals ' �' aw - .4 Bond No. % � � �.0=�� J ;oa=off{ � � E 4"N 8 .► {�_v a Al i + ; Kio Lo, Assiftag# Secretary Agency No. 9833 . , •-......: M.-. yF',IfO.M� bawr�xna*M`� anu*aM" �r'Mnwmi�mre HCCSMANP0A0W018 visit tmhcc.com/surety for more information EXHIBIT C WORKER'S COMPENSATION INSURANCE CERTIFICATE WORKER'S COMPENSATION CERTIFICATE OF INSURANCE WHEREAS, the CITY OF SEAL BEACH has required certain insurance to be provided by NOW THEREFORE, the undersigned insurance company does hereby certify that it has issued the policy or policies described below to the following named insureds and that the same are in force at this time. 1. This certificate is issued to: CITY OF SEAL BEACH, City Hall, 211 EIGHTH STREET, SEAL BEACH, CA 90740-6379. 2. The insureds under such policy or policies ate: 3. Worker's Compensation Policy or Policies in a form approved by the Insurance Commissioner of California covering all operations of the named insureds, as follows: POLICY NUMBER EFFECTIVE DATE EXPIRATION DATE 4. Said policy or policies shall not be canceled, voided or reduced in coverage or limits of liability, unless and until thirty days' advance written notice thereof has been served upon the City Clerk of the CITY OF SEAL BEACH. By: Its Authorized Representative EXHIBIT D-1 ADDITIONAL INSURED ENDORSEMENT COMMERCIAL GENERAL LIABILITY (INSERT INSURANCE CERTIFICATE SNOWING COMMERCIAL GENERAL UABILIM ADDITIONAL INSURED ENDORSEMENT COMPREHENSIVE GENERAL LIABILITY Name and address of named insured ("Named Insured"): Name and address of Insurance Company ("Company"): OFFICIAL TITLE OF PROJECT: 2018 ENVIRONMENTAL CLEANUP PROGRAM PROJECT CIP SD1901 Notwithstanding any inconsistent statement in the policy to which this endorsement is attached (the "Policy") or in any endorsement now or hereafter attached thereto, it is agreed as follows: 1. The City of Seal Beach, its elected officials, officers, attorneys, agents, employees, and volunteers are additional insureds (the above named additional insureds are hereafter referred to as the "Additional Insureds") under the Policy in relation to those activities described generally above with regard to operations performed by or on behalf of the Named Insured. The Additional Insureds have no liability for the payment of any premiums or assessments under the Policy. 2. The insurance coverages afforded the Additional Insureds under the Policy shall be primary insurance, and no other insurance maintained by the Additional Insureds shall be called upon to contribute with the insurance coverages provided by the Policy. 3. Each insurance coverage under the Policy shall apply separately to each Additional Insured against whom claim is made or suit is brought except with respect to the limits of the Company's liability. 4. Nothing in this contract of insurance shall be construed to preclude coverage of a claim by one insured under the policy against another insured under the policy. All such claims shall covered as third -party claims, i.e., in the same manner as if separate policies had been issued to each insured. Nothing contained in this provision shall operate to increase or replicate the Company's limits of liability as provided under the policy. 5. The insurance afforded by the Policy for contractual liability insurance (subject to the terms, conditions and exclusions applicable to such insurance) includes liability assumed by the Named Insured under the indemnification and/or hold harmless provision(s) contained in or executed in conjunction with the written agreement(s) or permit(s) designated above, between the Named Insured and the Additional Insureds. 6. The policy to which this endorsement is attached shall not be subject to cancellation, change in coverage, reduction of limits (except as the result of the payment of claims), or non- renewal except after written notice to Public Agency, by certified mail, return receipt requested, not less than thirty (30) days prior to the effective date thereof. In the event of Company's failure to comply with this notice provision, the policy as initially drafted will continue in full force and effect until compliance with this notice requirement. 7. Company hereby waives all rights of subrogation and contribution against the Additional Insureds, while acting within the scope of their duties, from all claims, losses and liabilities arising out of or incident to the perils insured against in relation to those activities described generally above with regard to operations performed by or on behalf of the Named Insured regardless of any prior, concurrent, or subsequent active or passive negligence by the Additional Insureds. 8. It is hereby agreed that the laws of the State of Califomia shall apply to and govern the validity, construction, interpretation, and enforcement of this contract of insurance. 9. This endorsement and all notices given hereunder shall be sent to Public Agency at: City of Seal Beach Public Works Department 211 8th Street, 2nd Floor Seal Beach CA 90740 10. Except as stated above and not in conflict with this endorsement, nothing contained herein shall be held to waive, alter or extend any of the limits, agreements, or exclusions of the policy to which this endorsement is attached. TYPE OF COVERAGES TO WHICH THIS ENDORSEMENT ATTACHES POLICY PERIOD LIMITS OF FROM/TO LIABILITY 11. Scheduled items or locations are to be identified on an attached sheet. The following inclusions relate to the above coverages. Includes: Contractual Liability Owners/Landlords/Tenants Manufacturers/Contractors Products/Completed Operations Broad Form Property Damage Extended Bodily Injury Broad Form Comprehensive General Liability Endorsement Explosion Hazard Collapse Hazard Underground Property Damage Pollution Liability Liquor Liability 12. A deductible or self-insured retention (check one) of $ applies to all coverage(s) except: (if none, so state). The deductible is applicable per claim or per occurrence (check one). 13. This is an occurrence or claims made policy (check one). 14. This endorsement is effective on forms a part of Policy Number at 12:01 A.M. and 1, (print name), hereby declare under penalty of perjury under the laws of the State of California, that I have the authority to bind the Company to this endorsement and that by my execution hereof, I do so bind the Company. Executed Signature of Authorized Representative (Original signature only; no facsimile signature or initialed signature accepted) Phone No.: ( EXHIBIT D-2 ADDITIONAL INSURED ENDORSEMENT AUTOMOBILE LIABILITY [INSERT INSURANCE CERTIFICATE SHOWING AUTOMOBILE LIABILITY] ADDITIONAL INSURED ENDORSEMENT AUTOMOBILE LIABILITY Name and address of named insured ("Named Insured"): Name and address of insurance Company ("Company'): OFFICIAL TITLE OF PROJECT: 2018 ENVIRONMENTAL CLEANUP PROGRAM PROJECT CIP SD1901 Notwithstanding any inconsistent statement in the policy to which this endorsement is attached (the "Policy' j or in any endorsement now or hereafter attached thereto, it is agreed as follows: The City of Seal Beach, its elected officials, officers, attorneys, agents, employees, and volunteers are additional insureds (the above named additional insureds are hereafter referred to as the "Additional Insureds") under the Policy in relation to those activities described generally above with regard to operations performed by or on behalf of the Named insured. The Additional insureds have no liability for the payment of any premiums or assessments under the Policy. 1. The insurance coverages afforded the Additional Insureds under the Policy shall be primary insurance, and no other insurance maintained by the Additional Insureds shall be called upon to contribute with the insurance coverages provided by the Policy. 2. Each insurance coverage under the Policy shall apply separately to each Additional Insured against whom claim is made or suit is brought except with respect to the limits of the Company's liability. 3. Nothing in this contract of insurance shall be construed to preclude coverage of a claim by one insured under the policy against another insured under the policy. All such claims shall covered as third -party claims, i.e., in the same manner as if separate policies had been issued to each insured. Nothing contained in this provision shall operate to increase or replicate the Company's limits of liability as provided under the policy. 4. The insurance afforded by the Policy for contractual liability insurance (subject to the terms, conditions and exclusions applicable to such insurance) includes liability assumed by the Named Insured under the indemnification and/or hold harmless provision(s) contained or executed in conjunction with the written agreement(s) or permit(s) designated above, between the Named Insured and the Additional Insureds. 5. The policy to which this endorsement is attached shall not be subject to cancellation, change in coverage, reduction of limits (except as the result of the payment of claims), or non -renewal except after written notice to Public Agency, by certified mail, return receipt requested, not less than thirty (30) days prior to the effective date thereto. In the event of Company's failure to comply with this notice provision, the policy as initially drafted will continue in full force and effect until compliance with this notice requirement. 6. Company hereby waives all rights of subrogation and contribution against the Additional Insureds, while acting within the scope of their duties, from all claims, losses and liabilities arising out of or Incident to the perils insured against in relation to those activities described generally above with regard to operations performed by or on behalf of the Named Insured regardless of any prior, concurrent, or subsequent active or passive negligence by the Additional Insureds. It is hereby agreed that the laws of the State of California shall apply to and govern the validity, construction, interpretation, and enforcement of this contract of insurance. This endorsement and all notices given hereunder shall be sent to Public Agency at: City of Seal Beach Public Works Department 211 8th Street, 2i0 Floor Seal Beach CA 90740 7. Except as stated above and not in conflict with this endorsement, clothing contained herein shall be held to waive, alter or extend any of the limits, agreements, or exclusions of the policy to which this endorsement is attached. TYPE OF COVERAGES TO WHICH POLICY PERIOD THIS ENDORSEMENT ATTACHES FROM/ TO LIMITS OF LIABILITY Scheduled items or locations are to be identified on an attached sheet. The following inclusions relate to the above coverages. Includes: Any Automobiles All Owned Automobiles Non -owned Automobiles Hired Automobiles Scheduled Automobiles Garage Coverage Truckers Coverage Motor Carrier Act Bus Regulatory Reform Act Public Livery Coverage 11. A deductible or self-insured retention (check one) of $ applies to all coverage(s) except: (if none, so state). The deductible is applicable per claim or per occurrence (check one). 12. This is an occurrence or claims made policy (check one). 13. This endorsement is effective on at 12:01 A.M. and forms a part of Policy Number 1, (print name), hereby declare under penalty of perjury under the laws of the State of California, that I have the authority to bind the Company to this endorsement and that by my execution hereof, I do so bind the Company. Executed , 20 Signature of Authorized Representative (Original signature only; no facsimile signature or initialed signature accepted) Phone No.: ( EXHIBIT D-3 ADDITIONAL INSURED ENDORSEMENT [INSERT INSURANCE CERTIFICATE SHOWING PROFESSIONAL INSURANCE LIABILITY, IF REQUIRED] EXHIBIT E ACKNOWLEDGMENT OF PENAL AND CIVIL PENALTIES CONCERNING CONTRACTOR LICENSING LAWS STATEMENT ACKNOWLEDGING PENAL AND CIVIL PENALTIES CONCERNING THE CONTRACTORS' LICENSING LAWS [Business & Professions Code § 7028.15] [Public Contract Code § 20103.51 I, the undersigned, certify that I am aware of the following provisions of California law and that 1, or the entity on whose behalf this certification is given, hold a currently valid California contractor's license as set forth below (required at time of award): Business & Professions Code § 7028.15: (a) It is a misdemeanor for any person to submit a bid to a public agency in order to engage in the business or act in the capacity of a contractor within this state without having a license therefore, except in any of the following cases: (1) The person is particularly exempted from this chapter. (2) The bid is submitted on a state project governed by Section 10164 of the Public Contract Code or on any local agency project governed by Section 20104 [now § 20103.51 of the Public Contract Code. (b) If a person has been previously convicted of the offense described in this section, the court shall impose a fine of 20 percent of the price of the contract under which the unlicensed person performed contracting work, or four thousand five hundred dollars ($4,500), whichever is greater, or imprisonment in the county jail for not less than 10 days nor more than six months, or both. In the event the person performing the contracting work has agreed to furnish materials and labor on an hourly basis, "the price of the contract" for the purposes of this subdivision means the aggregate sum of the cost of materials and labor furnished and the cost of completing the work to be performed. (c) This section shall not apply to a joint venture license, as required by Section 7029.1. However, at the time of making a bid as a joint venture, each person submitting the bid shall be subject to this section with respect to his or her individual licensure. (d) This section shall not affect the right or ability of a licensed architect, land surveyor, or registered professional engineer to form joint ventures with licensed contractors to render services within the scope of their respective practices. (e) Unless one of the foregoing exceptions applies, a bid submitted to a public agency by a contractor who is not licensed in accordance with this chapter shall be considered non-responsive and shall be rejected by the public agency. Unless one of the foregoing exceptions applies, a local public agency shall, before awarding a contract or issuing a purchase order, verify that the contractor was properly licensed when the contractor submitted the bid. Notwithstanding any other provision of law, unless one of the foregoing exceptions applies, the registrar may issue a citation to any public officer or employee of a public entity who knowingly awards a contract or issues a purchase order to a contractor who is not licensed pursuant to this chapter. The amount of civil penalties, appeal, and finality of such citations shall be subject to Sections 7028.7 to 7028.13, inclusive. Any contract awarded to, or any purchase order issued to, a contractor who is not licensed pursuant to this chapter is void. (f) Any compliance or noncompliance with subdivision (e) of this section, as added by Chapter 863 of the Statutes of 1989, shall not invalidate any contract or bid awarded by a public agency during which time that subdivision was in effect (g) A public employee or officer shall not be subject to a citation pursuant to this section if the public employee, officer, or employing agency made an inquiry to the board for the purposes of verifying the license status of any person or contractor and the board failed to respond to the inquiry within three business days. For purposes of this section, a telephone response by the board shall be deemed sufficient. Public Contract Code § 20103.5: In all contracts subject to this part where federal funds are involved, no bid submitted shall be invalidated by the failure of the bidder to be licensed in accordance with the laws of this state. However, at the time the contract is awarded, the contractor shall be properly licensed in accordance with the laws of this state. The first payment for work or material under any contract shall not be made unless and until the Registrar of Contractors verifies to the agency that the records of the Contractors' State License Board indicate that the contractor was properly licensed at the time the contract was awarded. Any bidder or contractor not so licensed shall be subject to all legal penalties imposed by law, including, but not limited to, any appropriate disciplinary action by the Contractors' State License Board. The agency shall include a statement to that effect in the standard form of pre -qualification questionnaire and financial statement. Failure of the bidder to obtain proper and adequate licensing for an award of a contract shall constitute a failure to execute the contract and shall result in the forfeiture of the security of the bidder. License No.: 801253 Class: A, C-8, C60 Expiration Date: 08/31/2020 Date: 4/26/2019 EXHIBIT F LABOR LAW REQUIREMENTS AGREEMENT TO COMPLY WITH CALIFORNIA LABOR LAW REQUIREMENTS [Labor Code §§ 1720, 1773.8,1775, 1776, 1777.5, 1813, 1860, 1861, 37001 The undersigned Contractor certifies that it is aware of and hereby agrees to fully comply with the Following provisions of California law: 1. Contractor acknowledges that this contract is subject to the provisions of Division 2, Part 7, Chapter 1 (commencing with Section 1720) of the Califomia Labor Code relating to public works and the awarding public agency ("Agency") and agrees to be bound by all the provisions thereof as though set forth in full herein. 2. Contractor agrees to comply with the provisions of California Labor Code Section 1773.8 which requires the payment of travel and subsistence payments to each worker needed to execute the work to the extent required by law. 3. Contractor agrees to comply with the provisions of California Labor Code Sections 1774 and 1775 concerning the payment of prevailing rates of wages to workers and the penalties for failure to pay prevailing wages. The Contractor shall, as a penalty to the Agency, forfeit not more than fifty dollars ($50) for each calendar day, or portion thereof, for each worker paid less than the prevailing rates as determined by the Director of Industrial Relations for the work or craft in which the worker is employed for any public work done under the contract by Contractor or by any subcontractor. 4. Contractor agrees to comply with the provisions of California Labor Code Section 1776 which require Contractor and each subcontractor to (1) keep accurate payroll records, (2) certify and make such payroll records available for inspection as provided by Section 1776, and (3) inform the Agency of the location of the records. The Contractor is responsible for compliance with Section 1776 by itself and all of its subcontractors. 5. Contractor agrees to comply with the provisions of California Labor Code Section 1777.5 concerning the employment of apprentices on public works projects, and further agrees that Contractor is responsible for compliance with Section 1777.5 by itself and all of its subcontractors. 6. Contractor agrees to comply with the provisions of California Labor Code Section 1813 concerning penalties for workers who work excess hours. The Contractor shall, as a penalty to the Agency, forfeit twenty-five dollars ($25) for each worker employed in the execution of the contract by the Contractor or by any subcontractor for each calendar day during which such worker is required or permitted to work more than 8 hours in any one calendar day and 40 hours in any one calendar week in violation of the provisions of Division 2, Part 7, Chapter 1, Article 3 of the California Labor Code. 7. California Labor Code Sections 1860 and 3700 provide that every contractor will be required to secure the payment of compensation to its employees. In accordance with the provisions of California Labor Code Section 1861, Contractor hereby certifies as follows: "I am aware of the provisions of Section 3700 of the Labor Code which require every employer to be insured against liability for worker's compensation or to undertake self-insurance in accordance with the provisions of that code, and I will comply with such provisions before commencing the performance of the work of this contract." Date 4/26/2019 Signatu EXHIBIT ACCEPTED PROPOSAL AtllillR*00,3MOMUMIC, Policyholder Message Named Insured: G2 CONSTRUCTION INC Dear Policyholder: Our Corporate Headquarters' and Northeast Regional B Policy Number: CA000033399-01 f Office i Jess is: r� Admiral Insurance Company (A Berkley C' any) �o Mt. Laurel Corporate Park 1000 Howard Blvd., Suite 300, P.O. Box 5430 Mt. Laurel, NJ 08054 , Our telephone number: General: (856)429— 9200 If you need to report a claim please direct it: By regular or overnight mail to; Admiral Insurance Company (A Berkley Company) Mt. Laurel Corporate Park 1000 Howard Blvd., Suite 300 P.O. Box 5430 Mt. Laurel, NJ 08054 Attention: New Claim Clearly state it is a "NEW CLAIM". I1. By Email to; admclaims@admiralins.com Do not email claims to ANY claims individual. III. By FAX to; Fax #: (856) 429-3630 Attention: New Claim Clearly state it is a "NEW CLAIM'. (amu ;VK. Berkley Cum�ranp FM 30 11 02 15 V Page 1 of 1 13 ADMIRAL INSURANCE COMPANY A Stock Company COMMERCIAL LINES POLICY THIS POLICY IS NOT OBTAINED PRIMARILY FOR PERSONAL, FAMILY OR HOUSEHOLD PURPOSES. THIS POLICY CONSISTS OF: - DECLARATIONS - COMMON POLICY CONDITIONS - ONE OR MORE COVERAGE PARTS. A COVERAGE PART CONSISTS OF: - ONE OR MORE COVERAGE FORMS - APPLICABLE FORMS AND ENDORSEMENTS In Witness Whereof, we have caused this policy to be executed and attested, and, if required by state law, this policy shall not be valid unless countersigned by our authorized representative. Secretary 1000 Howard Blvd., Suite 300, P.O. Box 5430 Mt. Laurel, NJ 08054 Telephone (856) 429-9200 Facsimile (856) 429-8611 JA1001 (03/13) ® W K. Brr&ley Company Policy Number: CA000033399-01 Al 80 00 09 17 Effective Date: 02/01/2019 ADM/RAL Named Insured: G2 CONSTRUCTION INC IMPORTANT — POLICYHOLDER NOTICES Form Intentionally Left Blank Al 80 00 09 17 Page 1 of 1 13 Policy Number: CA000033399-01 Al 07 34 01 17 Effective Date: 02/01/2019 CALIFORNIA DISCLOSURE NOTICE 1. THE INSURANCE POLICY THAT YOU HAVE PURCHASED IS BEING ISSUED BY AN INSURER THAT IS NOT LICENSED BY THE STATE OF CALIFORNIA. THESE COMPANIES ARE CALLED "NONADMITTED" OR "SURPLUS LINE" INSURERS. 2. THE INSURER IS NOT SUBJECT TO THE FINANCIAL SOLVENCY REGULATION AND ENFORCEMENT THAT APPLY TO CALIFORNIA LICENSED INSURERS. 3. THE INSURER DOES NOT PARTICIPATE IN ANY OF THE INSURANCE GUARANTEE FUNDS CREATED BY CALIFORNIA LAW. THEREFORE, THESE FUNDS WILL NOT PAY YOUR CLAIMS OR PROTECT YOUR ASSETS IF THE INSURER BECOMES INSOLVENT AND IS UNABLE TO MAKE PAYMENTS AS PROMISED. 4. THE INSURER SHOULD BE LICENSED EITHER AS A FOREIGN INSURER IN ANOTHER STATE IN THE UNITED STATES OR AS A NON-UNITED STATES (ALIEN) INSURER. YOU SHOULD ASK QUESTIONS OF YOUR INSURANCE AGENT, BROKER, OR "SURPLUS LINE" BROKER OR CONTACT THE CALIFORNIA DEPARTMENT OF INSURANCE AT THE FOLLOWING TOLL- FREE TELEPHONE NUMBER: 1-800-927-4357 OR INTERNET WEB SITE WWW.INSURANCE.CA.GOV. ASK WHETHER OR NOT THE INSURER IS LICENSED AS A FOREIGN OR NON- UNITED STATES (ALIEN) INSURER AND FOR ADDITIONAL INFORMATION ABOUT THE INSURER. YOU MAY ALSO CONTACT THE NAILS INTERNET WEB SITE AT WWW.NAIC.ORG. 5. FOREIGN INSURERS SHOULD BE LICENSED BY A STATE IN THE UNITED STATES AND YOU MAY CONTACT THAT Al 07 34 01 17 Page 1 of 2 13 STATE'S DEPARTMENT OF INSURANCE TO OBTAIN MORE INFORMATION ABOUT THAT INSURER. 6. FOR NON-UNITED STATES (ALIEN) INSURERS, THE INSURER SHOULD BE LICENSED BY A COUNTRY OUTSIDE OF THE UNITED STATES AND SHOULD BE ON THE NAIC'S INTERNATIONAL INSURERS DEPARTMENT (IID) LISTING OF APPROVED NONADMITTED NON-UNITED STATES INSURERS. ASK YOUR AGENT, BROKER, OR "SURPLUS LINE" BROKER TO OBTAIN MORE INFORMATION ABOUT THAT INSURER. 7. CALIFORNIA MAINTAINS A LIST OF APPROVED SURPLUS LINE INSURERS. ASK YOUR AGENT OR BROKER IF THE INSURER IS ON THAT LIST, OR VIEW THAT LIST AT THE INTERNET WEB SITE OF THE CALIFORNIA DEPARTMENT OF INSURANCE: WWW.INSURANCE.CA.GOV. 8. IF YOU, AS THE APPLICANT, REQUIRED THAT THE INSURANCE POLICY YOU HAVE PURCHASED BE BOUND IMMEDIATELY, EITHER BECAUSE EXISTING COVERAGE WAS GOING TO LAPSE WITHIN TWO BUSINESS DAYS OR BECAUSE YOU WERE REQUIRED TO HAVE COVERAGE WITHIN TWO BUSINESS DAYS, AND YOU DID NOT RECEIVE THIS DISCLOSURE FORM AND A REQUEST FOR YOUR SIGNATURE UNTIL AFTER COVERAGE BECAME EFFECTIVE, YOU HAVE THE RIGHT TO CANCEL THIS POLICY WITHIN FIVE DAYS OF RECEIVING THIS DISCLOSURE. IF YOU CANCEL COVERAGE, THE PREMIUM WILL BE PRORATED AND ANY BROKER'S FEE CHARGED FOR THIS INSURANCE WILL BE RETURNED TO YOU. D-2 (Effective January 1, 2017) Al 07 34 01 17 Page 2 of 2 13 ADMIRAL INSURANCE COMPANY A STOCK COMPANY (herein called the Company) Policy No.: CA000033399-01 Named Insured and Mailing Address G2 CONSTRUCTION INC 1352 EAST BORCHARD AVE. SANTA ANA, CA 92705 COMMON POLICY DECLARATIONS Renewal/Rewrite of: NEW POLICY PERIOD: From 02/01/2019 to 02/01/2020 At 12:01 A.M. Standard Time at the address of the Named Insured as stated herein THE NAMED INSURED IS: Corporation BUSINESS DESCRIPTION: Manufacturing and Installing of Sidewalk Debris Gates AUDIT PERIOD: Annual IN RETURN FOR THE PAYMENT OF THE PREMIUM AND SUBJECT TO ALL THE TERMS OF THIS POLICY, WE AGREE WITH YOU TO PROVIDE THE INSURANCE AS STATED IN THIS POLICY. THIS POLICY CONSISTS OF THE FOLLOWING COVERAGES FOR WHICH A PREMIUM IS INDICATED. THIS PREMIUM MAY BE SUBJECT TO ADJUSTMENT. Commercial General Liability Coverage Products/Completed Operations Liability Coverage Form(s) and Endorsement(s) made a part of this policy at inception: REFER TO SCHEDULE OF FORMS, Al 00 18 03 98 $15,000.00 PREMIUM: $15,000.00 TERRORISM PREMIUM: TOTAL PREMIUM: $15,000.00 This policy is not binding unless countersigned by Admiral Insurance Company or its authorized representative. Countersigned On: 2/19/2019 At: Seattle, WA By. Authorized ReppKerifative THESE COMMON POLICY DECLARATIONS AND THE COMMERCIAL GENERAL LIABILITY COVERAGE PART DECLARATIONS (OR PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART DECLARATIONS), TOGETHER WITH THE COMMON POLICY CONDITIONS, COVERAGE PART(S), FORM(S) AND ENDORSEMENT(S), IF ANY, ISSUED TO FORM A PART THEREOF, COMPLETE THE ABOVE NUMBERED POLICY. a W R. Berkley Company DE20010700 a Page 1 of 1 ADMIRAL INSURANCE COMPANY A STOCK COMPANY (herein called the Company) POLICY NUMBER CA000033399-01 LIMITS OF INSURANCE COMMERCIAL GENERAL LIABILITY COVERAGE PART DECLARATIONS Each Occurrence Limit $ 1,000,000 General Aggregate Limit $ 2,000,000 (Other Than Products- Completed Operations) Products - Completed Operations Aggregate Limit $ 2,000,000 Personal and Advertising Injury Limit $ 1,000,000 Damage To Premises Rented To You Limit $ 300,000 Medical Expense Limit $ 5,000 PREMIUM Classification Code Premium Basis Rate OPERATIONS RATED AS: Manufacturing and Installing of Sidewalk Debris Gates 97653 $1,900,000 $7.90 Any One Premises Any One Person Per $1,000 Sales Advance Premium $15,000.00 Total Advance Premium $15,000.00 Minimum Term Premium $15,000.00 THESE DECLARATIONS ARE PART OF THE POLICY DECLARATIONS CONTAINING THE NAME OF THE INSURED AND THE POLICY PERIOD. u [t: K. T3erkday CompanyDE20021218 �}, Page 1 of 1 SCHEDULE OF FORMS Named Insured: G2 CONSTRUCTION INC Policy No.: CA000033399-01 FORM NUMBER TITLE JAI0010313 COVER JACKET - ADMIRAL INSURANCE COMPANY AI07340117 CALIFORNIA DISCLOSURE NOTICE DE20010700 COMMON POLICY DECLARATIONS DE20021218 COMMERCIAL GENERAL LIABILITY COVERAGE PART DECLARATIONS AI00180398 SCHEDULE OF FORMS CG00010413 COMMERCIAL GENERAL LIABILITY COVERAGE FORM CG20100413 ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION CG20100413 ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION CG20120413 ADDITIONAL INSURED - STATE OR POLITICAL SUBDIVISIONS - PERMITS CG20120413 ADDITIONAL INSURED - STATE OR POLITICAL SUBDIVISIONS - PERMITS CG20120413 ADDITIONAL INSURED - STATE OR POLITICAL SUBDIVISIONS - PERMITS CG20370413 ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS CG20370413 ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS CG21060514 EXCLUSION -ACCESS OR DISCLOSURE OF CONFIDENTIAL OR PERSONAL INFORMATION AND DATA -RELATED LIABILITY - WITH LIMITED BODILY INJURY EXCEPTION Al 00 18 03 98 Page 1 of 3 13 CG21411185 EXCLUSION - INTERCOMPANY PRODUCT SUITS CG21651204 TOTAL POLLUTION EXCLUSION WITH A BUILDING HEATING EQUIPMENT EXCEPTION CG21750115 EXCLUSION OF CERTIFIED ACTS OF TERRORISM AND EXCLUSION OF OTHER ACTS OF TERRORISM COMMITTED OUTSIDE THE UNITED STATES CG22340413 EXCLUSION - CONSTRUCTION MANAGEMENT ERRORS AND OMISSIONS CG22790413 EXCLUSION - CONTRACTORS - PROFESSIONAL LIABILITY CG24260413 AMENDMENT OF INSURED CONTRACT DEFINITION CG24500615 LIMITED COVERAGE FOR DESIGNATED UNMANNED AIRCRAFT IL00171198 COMMON POLICY CONDITIONS IL00210702 NUCLEAR ENERGY LIABILITY EXCLUSION ENDORSEMENT AD06620204 EMPLOYEE BENEFITS LIABILITY COVERAGE CLAIMS MADE COVERAGE AD07400207 CROSS LIABILITY EXCLUSION AD08420216 BODILY INJURY REDEFINED AD08700507 EIFS & SPRAY - ON SIDING EXCLUSION AD66010715 PUNITIVE DAMAGE EXCLUSION AD66090295 MINIMUM PREMIUM AND MINIMUM RETAINED PREMIUM AMENDATORY ENDORSEMENT AD66110511 DEDUCTIBLE LIABILITY INSURANCE AD68830413 LONG TERM EXPOSURE EXCLUSIONS JOINT FORM AD68930117 CONTRACTORS ENHANCED COVERAGE AD68881213 SPECIAL EXCLUSIONS JOINT FORM OCCURRENCE VERSION AI 00 18 03 98 Page 2 of 3 13 AD66800608 INDEPENDENT CONTRACTOR INSURANCE AGREEMENT AD67180813 RESIDENTIAL CONSTRUCTION ACTIVITIES EXCLUSION (ABSOLUTE EXCEPT APARTMENTS) AD67190705 CONDOMINIUM CONVERSION EXCLUSION AD67270406 INJURY TO TEMPORARY, VOLUNTEER OR CASUAL WORKER EXCLUSION AD67480511 INTELLECTUAL PROPERTY EXCLUSION (AMENDED DEFINITION OF PERSONAL AND ADVERTISING INJURY) AD67600415 PREMIUM BASIS DEFINITION -GROSS SALES AI07100818 SERVICE OF SUIT - CALIFORNIA Al 00 18 03 98 Page 3 of 3 13 COMMERCIAL GENERAL LIABILITY CG 00 0104 13 COMMERCIAL GENERAL LIABILITY COVERAGE FORM Various provisions in this policy restrict coverage. Read the entire policy carefully to determine rights, duties and what is and is not covered. Throughout this policy the words "you" and "your" refer to the Named Insured shown in the Declarations, and any other person or organization qualifying as a Named Insured under this policy. The words "we", "us" and 'bur" refer to the company providing this insurance. The word "insured" means any person or organization qualifying as such under Section II — Who Is An Insured. Other words and phrases that appear in quotation marks have special meaning. Refer to Section V —Definitions. SECTION I —COVERAGES COVERAGE A — BODILY INJURY AND PROPERTY DAMAGE LIABILITY 1. Insuring Agreement a. We will pay those sums that the insured becomes legally obligated to pay as damages because of "bodily injury" or "property damage" to which this insurance applies. We will have the right and duty to defend the insured against any "suit" seeking those damages. However, we will have no duty to defend the insured against any "suit" seeking damages for "bodily injury" or "property damage" to which this insurance does not apply. We may, at our discretion, investigate any 'occurrence" and settle any claim or "suit" that may result. But: (1) The amount we will pay for damages is limited as described in Section III — Limits Of Insurance; and (2) Our right and duty to defend ends when we have used up the applicable limit of insurance in the payment of judgments or settlements under Coverages A or B or medical expenses under Coverage C. No other obligation or liability to pay sums or perform acts or services is covered unless explicitly provided for under Supplementary Payments — Coverages A and B. b. This insurance applies to "bodily injury" and "property damage" only if: (1) The "bodily injury" or "property damage" is caused by an 'occurrence" that takes place in the "coverage territory"; (2) The "bodily injury" or "property damage" occurs during the policy period; and (3) Prior to the policy period, no insured listed under Paragraph 1. of Section II — Who Is An Insured and no "employee" authorized by you to give or receive notice of an 'occurrence" or claim, knew that the "bodily injury" or "property damage" had occurred, in whole or in part. If such a listed insured or authorized "employee" knew, prior to the policy period, that the "bodily injury" or "property damage" occurred, then any continuation, change or resumption of such "bodily injury" or "property damage" during or after the policy period will be deemed to have been known prior to the policy period. c. 'Bodily injury" or "property damage" which occurs during the policy period and was not, prior to the policy period, known to have occurred by any insured listed under Paragraph 1. of Section II — Who Is An Insured or any "employee" authorized by you to give or receive notice of an 'occurrence" or claim, includes any continuation, change or resumption of that "bodily injury" or "property damage" after the end of the policy period. d. 'Bodily injury" or "property damage" will be deemed to have been known to have occurred at the earliest time when any insured listed under Paragraph 1. of Section II — Who Is An Insured or any "employee" authorized by you to give or receive notice of an 'occurrence" or claim: (1) Reports all, or any part, of the "bodily injury" or "property damage" to us or any other insurer; (2) Receives a written or verbal demand or claim for damages because of the "bodily injury" or "property damage"; or (3) Becomes aware by any other means that "bodily injury" or "property damage" has occurred or has begun to occur. e. Damages because of "bodily injury" include damages claimed by any person or organization for care, loss of services or death resulting at any time from the "bodily injury". CG 00 0104 13 © Insurance Services Office, Inc., 2012 Page 1 of 16 2. Exclusions This insurance does not apply to: a. Expected Or Intended Injury "Bodily injury" or "property damage" expected or intended from the standpoint of the insured. This exclusion does not apply to "bodily injury" resulting from the use of reasonable force to protect persons or property. b. Contractual Liability "Bodily injury" or "property damage" for which the insured is obligated to pay damages by reason of the assumption of liability in a contract or agreement. This exclusion does not apply to liability for damages: (1) That the insured would have in the absence of the contract or agreement; or (2) Assumed in a contract or agreement that is an "insured contract", provided the "bodily injury" or "property damage" occurs subsequent to the execution of the contract or agreement. Solely for the purposes of liability assumed in an "insured contract", reasonable attorneys' fees and necessary litigation expenses incurred by or for a party other than an insured are deemed to be damages because of "bodily injury" or "property damage", provided: (a) Liability to such party for, or for the cost of, that party's defense has also been assumed in the same "insured contract"; and (b) Such attorneys' fees and litigation expenses are for defense of that party against a civil or alternative dispute resolution proceeding in which damages to which this insurance applies are alleged. c. Liquor Liability "Bodily injury" or "property damage" for which any insured may be held liable by reason of: (1) Causing or contributing to the intoxication of any person; (2) The furnishing of alcoholic beverages to a person under the legal drinking age or under the influence of alcohol; or (3) Any statute, ordinance or regulation relating to the sale, gift, distribution or use of alcoholic beverages. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in: (a) The supervision, hiring, employment, training or monitoring of others by that insured; or (b) Providing or failing to provide transportation with respect to any person that may be under the influence of alcohol; if the "occurrence" which caused the "bodily injury" or "property damage", involved that which is described in Paragraph (1), (2) or (3) above. However, this exclusion applies only if you are in the business of manufacturing, distributing, selling, serving or furnishing alcoholic beverages. For the purposes of this exclusion, permitting a person to bring alcoholic beverages on your premises, for consumption on your premises, whether or not a fee is charged or a license is required for such activity, is not by itself considered the business of selling, serving or furnishing alcoholic beverages. d. Workers' Compensation And Similar Laws Any obligation of the insured under a workers' compensation, disability benefits or unemployment compensation law or any similar law. e. Employer's Liability "Bodily injury" to: (1) An "employee" of the insured arising out of and in the course of: (a) Employment by the insured; or (b) Performing duties related to the conduct of the insured's business; or (2) The spouse, child, parent, brother or sister of that "employee" as a consequence of Paragraph (l) above. This exclusion applies whether the insured may be liable as an employer or in any other capacity and to any obligation to share damages with or repay someone else who must pay damages because of the injury. This exclusion does not apply to liability assumed by the insured under an "insured contract". CG 00 01 04 13 © Insurance Services Office, Inc., 2012 Page 2 of 16 f. Pollution (d) At or from any premises, site or location on (1) "Bodily injury" or "property damage" arising which any insured or any contractors or out of the actual, alleged or threatened subcontractors working directly or indirectly discharge, dispersal, seepage, migration, release on any insured's behalf are performing or escape of "pollutants": operations if the "pollutants" are brought on (a) At or from any premises, site or location or to the premises, site or location in connection with such operations by such which is or was at any time owned or insured, contractor or subcontractor. occupied by, or rented or loaned to, any However, this subparagraph does not apply insured. However, this subparagraph does to: not apply to: (i) "Bodily injury" or "property damage" (i) "Bodily injury" if sustained within a arising out of the escape of fuels, building and caused by smoke, fumes, lubricants or other operating fluids vapor or soot produced by or originating which are needed to perform the normal from equipment that is used to heat, cool electrical, hydraulic or mechanical or dehumidify the building, or functions necessary for the operation of equipment that is used to heat water for "mobile equipment" or its parts, if such personal use, by the building's occupants fuels, lubricants or other operating fluids or their guests; escape from a vehicle part designed to (ii) "Bodily injury" or "property damage" for hold, store or receive them. This which you may be held liable, if you are exception does not apply if the "bodily a contractor and the owner or lessee of injury" or "property damage" arises out such premises, site or location has been of the intentional discharge, dispersal or added to your policy as an additional release of the fuels, lubricants or other insured with respect to your ongoing operating fluids, or if such fuels, operations performed for that additional lubricants or other operating fluids are insured at that premises, site or location brought on or to the premises, site or and such premises, site or location is not location with the intent that they be and never was owned or occupied by, or discharged, dispersed or released as part rented or loaned to, any insured, other of the operations being performed by than that additional insured; or such insured, contractor or (iii) "Bodily injury" or "property damage" subcontractor; arising out of heat, smoke or fumes from (ii) "Bodily injury" or "property damage" a "hostile fire'; sustained within a building and caused (b) At or from any premises, site or location by the release of gases, fumes or vapors which is or was at any time used by or for from materials brought into that building any insured or others for the handling, in connection with operations being storage, disposal, processing or treatment of performed by you or on your behalf by a waste; contractor or subcontractor; or (c) Which are or were at any time transported, (iii) "Bodily injury" or "property damage" handled, stored, treated, disposed of or arising out of heat, smoke or fumes from processed as waste by or for: a "hostile fire". (i) Any insured; or (e) At or from any premises, site or location on which any insured or any contractors or (ii) Any person or organization for whom subcontractors working directly or indirectly you may be legally responsible; or on any insured's behalf are performing operations if the operations are to test for, monitor, clean up, remove, contain, treat, detoxify or neutralize, or in any way respond to, or assess the effects of, "pollutants". CG 00 0104 13 © Insurance Services Office, Inc., 2012 Page 3 of 16 (2) Any loss, cost or expense arising out of any: (a) Request, demand, order or statutory or regulatory requirement that any insured or others test for, monitor, clean up, remove, contain, treat, detoxify or neutralize, or in any way respond to, or assess the effects of, "pollutants"; or (b) Claim or suit by or on behalf of a governmental authority for damages because of testing for, monitoring, cleaning up, removing, containing, treating, detoxifying or neutralizing, or in any way responding to, or assessing the effects of, "pollutants". However, this paragraph does not apply to liability for damages because of "property damage" that the insured would have in the absence of such request, demand, order or statutory or regulatory requirement, or such claim or "suit" by or on behalf of a governmental authority. g. Aircraft, Auto Or Watercraft "Bodily injury" or "property damage" arising out of the ownership, maintenance, use or entrustment to others of any aircraft, "auto" or watercraft owned or operated by or rented or loaned to any insured. Use includes operation and "loading or unloading". 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" involved the ownership, maintenance, use or entrustment to others of any aircraft, "auto" or watercraft that is owned or operated by or rented or loaned to any insured. This exclusion does not apply to: (1) A watercraft while ashore on premises you own or rent; (2) A watercraft you do not own that is: (a) Less than 26 feet long; and (b) Not being used to carry persons or property for a charge; (3) Parking an "auto" on, or on the ways next to, premises you own or rent, provided the "auto" is not owned by or rented or loaned to you or the insured; (4) Liability assumed under any "insured contract" for the ownership, maintenance or use of aircraft or watercraft; or (5) "Bodily injury" or "property damage" arising out of: (a) The operation of machinery or equipment that is attached to, or part of, a land vehicle that would qualify under the definition of "mobile equipment" if it were not subject to a compulsory or financial responsibility law or other motor vehicle insurance law where it is licensed or principally garaged; or (b) The operation of any of the machinery or equipment listed in Paragraph f.(2) or f.(3) of the definition of "mobile equipment". h. Mobile Equipment "Bodily injury" or "property damage" arising out of: (1) The transportation of "mobile equipment" by an "auto" owned or operated by or rented or loaned to any insured; or (2) The use of "mobile equipment" in, or while in practice for, or while being prepared for, any prearranged racing, speed, demolition, or stunting activity. i. War "Bodily injury" or "property damage", however caused, arising, directly or indirectly, out of: (1) War, including undeclared or civil war; (2) Warlike action by a military force, including action in hindering or defending against an actual or expected attack, by any government, sovereign or other authority using military personnel or other agents; or (3) Insurrection, rebellion, revolution, usurped power, or action taken by governmental authority in hindering or defending against any of these. j. Damage To Property "Property damage" to: (1) Property you own, rent, or occupy, including any costs or expenses incurred by you, or any other person, organization or entity, for repair, replacement, enhancement, restoration or maintenance of such property for any reason, including prevention of injury to a person or damage to another's property; (2) Premises you sell, give away or abandon, if the "property damage" arises out of any part of those premises; (3) Property loaned to you; CG 00 0104 13 © Insurance Services Office, Inc., 2012 Page 4 of 16 (4) Personal property in the care, custody or control of the insured; (5) That particular part of real property on which you or any contractors or subcontractors working directly or indirectly on your behalf are performing operations, if the "property damage" arises out of those operations; or (6) That particular part of any property that must be restored, repaired or replaced because "your work" was incorrectly performed on it. Paragraphs (1), (3) and (4) of this exclusion do not apply to "property damage" (other than damage by fire) to premises, including the contents of such premises, rented to you for a period of seven or fewer consecutive days. A separate limit of insurance applies to Damage To Premises Rented To You as described in Section III — Limits Of Insurance. Paragraph (2) of this exclusion does not apply if the premises are "your work" and were never occupied, rented or held for rental by you. Paragraphs (3), (4), (5) and (6) of this exclusion do not apply to liability assumed under a sidetrack agreement. Paragraph (6) of this exclusion does not apply to "property damage" included in the "products - completed operations hazard". k. Damage To Your Product "Property damage" to "your product" arising out of it or any part of it. 1. Damage To Your Work "Property damage" to "your work" arising out of it or any part of it and included in the "products - completed operations hazard". This exclusion does not apply if the damaged work or the work out of which the damage arises was performed on your behalf by a subcontractor. m. Damage To Impaired Property Or Property Not Physically Injured "Property damage" to "impaired property" or property that has not been physically injured, arising out of: (1) A defect, deficiency, inadequacy or dangerous condition in "your product" or "your work"; or (2) A delay or failure by you or anyone acting on your behalf to perform a contract or agreement in accordance with its terms. This exclusion does not apply to the loss of use of other property arising out of sudden and accidental physical injury to "your product" or "your work" after it has been put to its intended use. n. Recall Of Products, Work Or Impaired Property Damages claimed for any loss, cost or expense incurred by you or others for the loss of use, withdrawal, recall, inspection, repair, replacement, adjustment, removal or disposal of: (1) "Your product"; (2) "Your work"; or (3) "Impaired property"; if such product, work, or property is withdrawn or recalled from the market or from use by any person or organization because of a known or suspected defect, deficiency, inadequacy or dangerous condition in it. o. Personal And Advertising Injury "Bodily injury" arising out of "personal and advertising injury". p. Electronic Data Damages arising out of the loss of, loss of use of, damage to, corruption of, inability to access, or inability to manipulate electronic data. However, this exclusion does not apply to liability for damages because of "bodily injury". As used in this exclusion, electronic data means information, facts or programs stored as or on, created or used on, or transmitted to or from computer software, including systems and applications software, hard or floppy disks, CD- ROMs, tapes, drives, cells, data processing devices or any other media which are used with electronically controlled equipment. q. Recording And Distribution Of Material Or Information In Violation Of Law "Bodily injury" or "property damage" arising directly or indirectly out of any action or omission that violates or is alleged to violate: (1) The Telephone Consumer Protection Act (TCPA), including any amendment of or addition to such law; (2) The CAN -SPAM Act of 2003, including any amendment of or addition to such law; (3) The Fair Credit Reporting Act (FCRA), and any amendment of or addition to such law, including the Fair and Accurate Credit Transactions Act (FACTA); or CG 00 0104 13 © Insurance Services Office, Inc., 2012 Page 5 of 16 (4) Any federal, state or local statute, ordinance or regulation, other than the TCPA, CAN -SPAM Act of 2003 or FCRA and their amendments and additions, that addresses, prohibits, or limits the printing, dissemination, disposal, collecting, recording, sending, transmitting, communicating or distribution of material or information. Exclusions c. through n. do not apply to damage by fire to premises while rented to you or temporarily occupied by you with permission of the owner. A separate limit of insurance applies to this coverage as described in Section III — Limits Of Insurance. COVERAGE B — PERSONAL AND ADVERTISING INJURY LIABILITY 1. Insuring Agreement a. We will pay those sums that the insured becomes legally obligated to pay as damages because of "personal and advertising injury" to which this insurance applies. We will have the right and duty to defend the insured against any "suit" seeking those damages. However, we will have no duty to defend the insured against any "suit" seeking damages for "personal and advertising injury" to which this insurance does not apply. We may, at our discretion, investigate any offense and settle any claim or "suit" that may result. But: (1) The amount we will pay for damages is limited as described in Section III — Limits Of Insurance; and (2) Our right and duty to defend end when we have used up the applicable limit of insurance in the payment of judgments or settlements under Coverages A or B or medical expenses under Coverage C. No other obligation or liability to pay sums or perform acts or services is covered unless explicitly provided for under Supplementary Payments — Coverages A and B. b. This insurance applies to "personal and advertising injury" caused by an offense arising out of your business but only if the offense was committed in the "coverage territory" during the policy period. 2. Exclusions This insurance does not apply to: a. Knowing Violation Of Rights Of Another "Personal and advertising injury" caused by or at the direction of the insured with the knowledge that the act would violate the rights of another and would inflict "personal and advertising injury". b. Material Published With Knowledge Of Falsity "Personal and advertising injury" arising out of oral or written publication, in any manner, of material, if done by or at the direction of the insured with knowledge of its falsity. c. Material Published Prior To Policy Period "Personal and advertising injury" arising out of oral or written publication, in any manner, of material whose first publication took place before the beginning of the policy period. d. Criminal Acts "Personal and advertising injury" arising out of a criminal act committed by or at the direction of the insured. e. Contractual Liability "Personal and advertising injury" for which the insured has assumed liability in a contract or agreement. This exclusion does not apply to liability for damages that the insured would have in the absence of the contract or agreement. f. Breach Of Contract "Personal and advertising injury" arising out of a breach of contract, except an implied contract to use another's advertising idea in your "advertisement". g. Quality Or Performance Of Goods — Failure To Conform To Statements "Personal and advertising injury" arising out of the failure of goods, products or services to conform with any statement of quality or performance made in your "advertisement". h. Wrong Description Of Prices "Personal and advertising injury" arising out of the wrong description of the price of goods, products or services stated in your "advertisement". CG 00 0104 13 0 Insurance Services Office, Inc., 2012 Page 6 of 16 i. Infringement Of Copyright, Patent, Trademark Or Trade Secret "Personal and advertising injury" arising out of the infringement of copyright, patent, trademark, trade secret or other intellectual property rights. Under this exclusion, such other intellectual property rights do not include the use of another's advertising idea in your "advertisement". However, this exclusion does not apply to infringement, in your "advertisement", of copyright, trade dress or slogan. j. Insureds In Media And Internet Type Businesses "Personal and advertising injury" committed by an insured whose business is: (1) Advertising, broadcasting, publishing or telecasting; (2) Designing or determining content of web sites for others; or (3) An Internet search, access, content or service provider. However, this exclusion does not apply to Paragraphs 14.a., b. and c. of "personal and advertising injury" under the Definitions section. For the purposes of this exclusion, the placing of frames, borders or links, or advertising, for you or others anywhere on the Internet, is not by itself, considered the business of advertising, broadcasting, publishing or telecasting. k. Electronic Chatrooms Or Bulletin Boards "Personal and advertising injury" arising out of an electronic chatroom or bulletin board the insured hosts, owns, or over which the insured exercises control. 1. Unauthorized Use Of Another's Name Or Product "Personal and advertising injury" arising out of the unauthorized use of another's name or product in your e-mail address, domain name or metatag, or any other similar tactics to mislead another's potential customers. m. Pollution "Personal and advertising injury" arising out of the actual, alleged or threatened discharge, dispersal, seepage, migration, release or escape of "pollutants" at any time. n. Pollution -related Any loss, cost or expense arising out of any: (1) Request, demand, order or statutory or regulatory requirement that any insured or others test for, monitor, clean up, remove, contain, treat, detoxify or neutralize, or in any way respond to, or assess the effects of, "pollutants"; or (2) Claim or suit by or on behalf of a governmental authority for damages because of testing for, monitoring, cleaning up, removing, containing, treating, detoxifying or neutralizing, or in any way responding to, or assessing the effects of, "pollutants". o. War "Personal and advertising injury", however caused, arising, directly or indirectly, out of: (1) War, including undeclared or civil war; (2) Warlike action by a military force, including action in hindering or defending against an actual or expected attack, by any government, sovereign or other authority using military personnel or other agents; or (3) Insurrection, rebellion, revolution, usurped power, or action taken by governmental authority in hindering or defending against any of these. p. Recording And Distribution Of Material Or Information In Violation Of Law "Personal and advertising injury" arising directly or indirectly out of any action or omission that violates or is alleged to violate: (1) The Telephone Consumer Protection Act (TCPA), including any amendment of or addition to such law; (2) The CAN -SPAM Act of 2003, including any amendment of or addition to such law; (3) The Fair Credit Reporting Act (FCRA), and any amendment of or addition to such law, including the Fair and Accurate Credit Transactions Act (FACTA); or (4) Any federal, state or local statute, ordinance or regulation, other than the TCPA, CAN -SPAM Act of 2003 or FCRA and their amendments and additions, that addresses, prohibits, or limits the printing, dissemination, disposal, collecting, recording, sending, transmitting, communicating or distribution of material or information. CG 00 0104 13 © Insurance Services Office, Inc., 2012 Page 7 of 16 COVERAGE C — MEDICAL PAYMENTS 1. Insuring Agreement a. We will pay medical expenses as described below for "bodily injury" caused by an accident: (1) On premises you own or rent; (2) On ways next to premises you own or rent; or (3) Because of your operations; provided that: (a) The accident takes place in the "coverage territory" and during the policy period; (b) The expenses are incurred and reported to us within one year of the date of the accident; and (c) The injured person submits to examination, at our expense, by physicians of our choice as often as we reasonably require. b. We will make these payments regardless of fault. These payments will not exceed the applicable limit of insurance. We will pay reasonable expenses for: (1) First aid administered at the time of an accident; (2) Necessary medical, surgical, X-ray and dental services, including prosthetic devices; and (3) Necessary ambulance, hospital, professional nursing and funeral services. 2. Exclusions We will not pay expenses for "bodily injury": a. Any Insured To any insured, except "volunteer workers". b. Hired Person To a person hired to do work for or on behalf of any insured or a tenant of any insured. c. Injury On Normally Occupied Premises To a person injured on that part of premises you own or rent that the person normally occupies. d. Workers' Compensation And Similar Laws To a person, whether or not an "employee" of any insured, if benefits for the "bodily injury" are payable or must be provided under a workers' compensation or disability benefits law or a similar law. e. Athletics Activities To a person injured while practicing, instructing or participating in any physical exercises or games, sports, or athletic contests. f. Products -Completed Operations Hazard Included within the "products -completed operations hazard". g. Coverage A Exclusions Excluded under Coverage A. SUPPLEMENTARY PAYMENTS — COVERAGES A AND B 1. We will pay, with respect to any claim we investigate or settle, or any "suit" against an insured we defend: a. All expenses we incur. b. Up to $250 for cost of bail bonds required because of accidents or traffic law violations arising out of the use of any vehicle to which the Bodily Injury Liability Coverage applies. We do not have to furnish these bonds. c. The cost of bonds to release attachments, but only for bond amounts within the applicable limit of insurance. We do not have to furnish these bonds. d. All reasonable expenses incurred by the insured at our request to assist us in the investigation or defense of the claim or "suit", including actual loss of earnings up to $250 a day because of time off from work. e. All court costs taxed against the insured in the "suit". However, these payments do not include attorneys' fees or attorneys' expenses taxed against the insured. f. Prejudgment interest awarded against the insured on that part of the judgment we pay. If we make an offer to pay the applicable limit of insurance, we will not pay any prejudgment interest based on that period of time after the offer. g. All interest on the full amount of any judgment that accrues after entry of the judgment and before we have paid, offered to pay, or deposited in court the part of the judgment that is within the applicable limit of insurance. These payments will not reduce the limits of insurance. 2. If we defend an insured against a "suit" and an indemnitee of the insured is also named as a party to the "suit", we will defend that indemnitee if all of the following conditions are met: a. The "suit" against the indemnitee seeks damages for which the insured has assumed the liability of the indemnitee in a contract or agreement that is an "insured contract"; b. This insurance applies to such liability assumed by the insured; c. The obligation to defend, or the cost of the defense of, that indemnitee, has also been assumed by the insured in the same "insured contract"; CG 00 0104 13 © Insurance Services Office, Inc., 2012 Page 8 of 16 d. The allegations in the "suit" and the information we know about the "occurrence" are such that no conflict appears to exist between the interests of the insured and the interests of the indemnitee; e. The indemnitee and the insured ask us to conduct and control the defense of that indemnitee against such "suit" and agree that we can assign the same counsel to defend the insured and the indemnitee; and f. The indemnitee: (1) Agrees in writing to: (a) Cooperate with us in the investigation, settlement or defense of the "suit"; (b) Immediately send us copies of any demands, notices, summonses or legal papers received in connection with the "suit"; (c) Notify any other insurer whose coverage is available to the indemnitee; and (d) Cooperate with us with respect to coordinating other applicable insurance available to the indemnitee; and (2) Provides us with written authorization to: (a) Obtain records and other information related to the "suit"; and (b) Conduct and control the defense of the indemnitee in such "suit". So long as the above conditions are met, attorneys' fees incurred by us in the defense of that indemnitee, necessary litigation expenses incurred by us and necessary litigation expenses incurred by the indemnitee at our request will be paid as Supplementary Payments. Notwithstanding the provisions of Paragraph 2.b.(2) of Section I — Coverage A — Bodily Injury And Property Damage Liability, such payments will not be deemed to be damages for "bodily injury" and "property damage" and will not reduce the limits of insurance. Our obligation to defend an insured's indemnitee and to pay for attorneys' fees and necessary litigation expenses as Supplementary Payments ends when we have used up the applicable limit of insurance in the payment of judgments or settlements or the conditions set forth above, or the terms of the agreement described in Paragraph f. above, are no longer met. SECTION II — WHO IS AN INSURED 1. If you are designated in the Declarations as: a. An individual, you and your spouse are insureds, but only with respect to the conduct of a business of which you are the sole owner. b. A partnership or joint venture, you are an insured. Your members, your partners, and their spouses are also insureds, but only with respect to the conduct of your business. c. A limited liability company, you are an insured. Your members are also insureds, but only with respect to the conduct of your business. Your managers are insureds, but only with respect to their duties as your managers. d. An organization other than a partnership, joint venture or limited liability company, you are an insured. Your "executive officers" and directors are insureds, but only with respect to their duties as your officers or directors. Your stockholders are also insureds, but only with respect to their liability as stockholders. e. A trust, you are an insured. Your trustees are also insureds, but only with respect to their duties as trustees. 2. Each of the following is also an insured: Your "volunteer workers" only while performing duties related to the conduct of your business, or your "employees", other than either your "executive officers" (if you are an organization other than a partnership, joint venture or limited liability company) or your managers (if you are a limited liability company), but only for acts within the scope of their employment by you or while performing duties related to the conduct of your business. However, none of these "employees" or "volunteer workers" are insureds for: (1) "Bodily injury" or "personal and advertising injury": (a) To you, to your partners or members (if you are a partnership or joint venture), to your members (if you are a limited liability company), to a co -"employee" while in the course of his or her employment or performing duties related to the conduct of your business, or to your other "volunteer workers" while performing duties related to the conduct of your business; (b) To the spouse, child, parent, brother or sister of that co -"employee" or "volunteer worker" as a consequence of Paragraph (1)(a) above; (c) For which there is any obligation to share damages with or repay someone else who must pay damages because of the injury described in Paragraph (1)(a) or (b) above; or CG 00 01 04 13 © Insurance Services Office, Inc., 2012 Page 9 of 16 (d) Arising out of his or her providing or failing to provide professional health care services. (2) 'Property damage" to property: (a) Owned, occupied or used by; (b) Rented to, in the care, custody or control of, or over which physical control is being exercised for any purpose by; you, any of your "employees", "volunteer workers", any partner or member (if you are a partnership or joint venture), or any member (if you are a limited liability company). b. Any person (other than your "employee" or "volunteer worker"), or any organization while acting as your real estate manager. c. Any person or organization having proper temporary custody of your property if you die, but only: (1) With respect to liability arising out of the maintenance or use of that property; and (2) Until your legal representative has been appointed. d. Your legal representative if you die, but only with respect to duties as such. That representative will have all your rights and duties under this Coverage Part. a. Insureds; b. Claims made or "suits" brought; or c. Persons or organizations making claims or bringing "suits". 2. The General Aggregate Limit is the most we will pay for the sum of: a. Medical expenses under Coverage C; b. Damages under Coverage A, except damages because of "bodily injury" or "property damage" included in the "products -completed operations hazard"; and c. Damages under Coverage B. 3. The Products -Completed Operations Aggregate Limit is the most we will pay under Coverage A for damages because of "bodily injury" and "property damage" included in the "products -completed operations hazard". 4. Subject to Paragraph 2. above, the Personal And Advertising Injury Limit is the most we will pay under Coverage B for the sum of all damages because of all "personal and advertising injury" sustained by any one person or organization. 5. Subject to Paragraph 2. or 3. above, whichever applies, the Each Occurrence Limit is the most we will pay for the sum of: 3. Any organization you newly acquire or form, other than a partnership, joint venture or limited liability company, and over which you maintain ownership or majority interest, will qualify as a Named Insured if there is no other similar insurance available to that organization. However: 6. a. Coverage under this provision is afforded only until the 90th day after you acquire or form the organization or the end of the policy period, whichever is earlier; b. Coverage A does not apply to "bodily injury" or "property damage" that occurred before you acquired or formed the organization; and c. Coverage B does not apply to "personal and advertising injury" arising out of an offense committed before you acquired or formed the organization. No person or organization is an insured with respect to the conduct of any current or past partnership, joint venture or limited liability company that is not shown as a Named Insured in the Declarations. SECTION III — LIMITS OF INSURANCE 1. The Limits of Insurance shown in the Declarations and the rules below fix the most we will pay regardless of the number of: a. Damages under Coverage A; and b. Medical expenses under Coverage C because of all "bodily injury" and "property damage" arising out of any one 'occurrence". Subject to Paragraph 5. above, the Damage To Premises Rented To You Limit is the most we will pay under Coverage A for damages because of "property damage" to any one premises, while rented to you, or in the case of damage by fire, while rented to you or temporarily occupied by you with permission of the owner. 7. Subject to Paragraph 5. above, the Medical Expense Limit is the most we will pay under Coverage C for all medical expenses because of "bodily injury" sustained by any one person. The Limits of Insurance of this Coverage Part apply separately to each consecutive annual period and to any remaining period of less than 12 months, starting with the beginning of the policy period shown in the Declarations, unless the policy period is extended after issuance for an additional period of less than 12 months. In that case, the additional period will be deemed part of the last preceding period for purposes of determining the Limits of Insurance. CG 00 0104 13 C Insurance Services Office, Inc., 2012 Page 10 of 16 SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS 1. Bankruptcy Bankruptcy or insolvency of the insured or of the insured's estate will not relieve us of our obligations under this Coverage Part. 2. Duties In The Event Of Occurrence, Offense, Claim Or Suit a. You must see to it that we are notified as soon as practicable of an "occurrence" or an offense which may result in a claim. To the extent possible, notice should include: (1) How, when and where the "occurrence" or offense took place; (2) The names and addresses of any injured persons and witnesses; and (3) The nature and location of any injury or damage arising out of the "occurrence" or offense. b. If a claim is made or "suit" is brought against any insured, you must: (1) Immediately record the specifics of the claim or "suit" and the date received; and (2) Notify us as soon as practicable. You must see to it that we receive written notice of the claim or "suit" as soon as practicable. c. You and any other involved insured must: (1) Immediately send us copies of any demands, notices, summonses or legal papers received in connection with the claim or "suit"; (2) Authorize us to obtain records and other information; (3) Cooperate with us in the investigation or settlement of the claim or defense against the "suit"; and (4) Assist us, upon our request, in the enforcement of any right against any person or organization which may be liable to the insured because of injury or damage to which this insurance may also apply. d. No insured will, except at that insured's own cost, voluntarily make a payment, assume any obligation, or incur any expense, other than for first aid, without our consent. 3. Legal Action Against Us No person or organization has a right under this Coverage Part: a. To join us as a party or otherwise bring us into a "suit" asking for damages from an insured; or b. To sue us on this Coverage Part unless all of its terms have been fully complied with. A person or organization may sue us to recover on an agreed settlement or on a final judgment against an insured; but we will not be liable for damages that are not payable under the terms of this Coverage Part or that are in excess of the applicable limit of insurance. An agreed settlement means a settlement and release of liability signed by us, the insured and the claimant or the claimant's legal representative. 4. Other Insurance If other valid and collectible insurance is available to the insured for a loss we cover under Coverages A or B of this Coverage Part, our obligations are limited as follows: a. Primary Insurance This insurance is primary except when Paragraph b. below applies. If this insurance is primary, our obligations are not affected unless any of the other insurance is also primary. Then, we will share with all that other insurance by the method described in Paragraph c. below. b. Excess Insurance (1) This insurance is excess over: (a) Any of the other insurance, whether primary, excess, contingent or on any other basis: (i) That is Fire, Extended Coverage, Builder's Risk, Installation Risk or similar coverage for "your work"; (ii) That is Fire insurance for premises rented to you or temporarily occupied by you with permission of the owner; (iii) That is insurance purchased by you to cover your liability as a tenant for "property damage" to premises rented to you or temporarily occupied by you with permission of the owner; or (iv) If the loss arises out of the maintenance or use of aircraft, "autos" or watercraft to the extent not subject to Exclusion g. of Section I — Coverage A — Bodily Injury And Property Damage Liability. (b) Any other primary insurance available to you covering liability for damages arising out of the premises or operations, or the products and completed operations, for which you have been added as an additional insured. CG 00 0104 13 C Insurance Services Office, Inc., 2012 Page 11 of 16 (2) When this insurance is excess, we will have no duty under Coverages A or B to defend the insured against any "suit" if any other insurer has a duty to defend the insured against that "suit". If no other insurer defends, we will undertake to do so, but we will be entitled to the insured's rights against all those other insurers. (3) When this insurance is excess over other insurance, we will pay only our share of the amount of the loss, if any, that exceeds the sum of: (a) The total amount that all such other insurance would pay for the loss in the absence of this insurance; and (b) The total of all deductible and self-insured amounts under all that other insurance. (4) We will share the remaining loss, if any, with any other insurance that is not described in this Excess Insurance provision and was not bought specifically to apply in excess of the Limits of Insurance shown in the Declarations of this Coverage Part. c. Method Of Sharing If all of the other insurance permits contribution by equal shares, we will follow this method also. Under this approach each insurer contributes equal amounts until it has paid its applicable limit of insurance or none of the loss remains, whichever comes first. If any of the other insurance does not permit contribution by equal shares, we will contribute by limits. Under this method, each insurer's share is based on the ratio of its applicable limit of insurance to the total applicable limits of insurance of all insurers. 5. Premium Audit a. We will compute all premiums for this Coverage Part in accordance with our rules and rates. b. Premium shown in this Coverage Part as advance premium is a deposit premium only. At the close of each audit period we will compute the earned premium for that period and send notice to the first Named Insured. The due date for audit and retrospective premiums is the date shown as the due date on the bill. If the sum of the advance and audit premiums paid for the policy period is greater than the earned premium, we will return the excess to the first Named Insured. 6. Representations By accepting this policy, you agree: a. The statements in the Declarations are accurate and complete; b. Those statements are based upon representations you made to us; and c. We have issued this policy in reliance upon your representations. 7. Separation Of Insureds Except with respect to the Limits of Insurance, and any rights or duties specifically assigned in this Coverage Part to the first Named Insured, this insurance applies: a. As if each Named Insured were the only Named Insured; and b. Separately to each insured against whom claim is made or "suit" is brought. 8. Transfer Of Rights Of Recovery Against Others To Us If the insured has rights to recover all or part of any payment we have made under this Coverage Part, those rights are transferred to us. The insured must do nothing after loss to impair them. At our request, the insured will bring "suit" or transfer those rights to us and help us enforce them. 9. When We Do Not Renew If we decide not to renew this Coverage Part, we will mail or deliver to the first Named Insured shown in the Declarations written notice of the nonrenewal not less than 30 days before the expiration date. If notice is mailed, proof of mailing will be sufficient proof of notice. SECTION V — DEFINITIONS 1. "Advertisement" means a notice that is broadcast or published to the general public or specific market segments about your goods, products or services for the purpose of attracting customers or supporters. For the purposes of this definition: a. Notices that are published include material placed on the Internet or on similar electronic means of communication; and b. Regarding web sites, only that part of a web site that is about your goods, products or services for the purposes of attracting customers or supporters is considered an advertisement. 2. "Auto" means: c. The first Named Insured must keep records of the a. A land motor vehicle, trailer or semitrailer designed information we need for premium computation, and for travel on public roads, including any attached send us copies at such times as we may request. machinery or equipment; or CG 00 0104 13 C Insurance Services Office, Inc., 2012 Page 12 of 16 b. Any other land vehicle that is subject to a compulsory or financial responsibility law or other motor vehicle insurance law where it is licensed or principally garaged. However, "auto" does not include "mobile equipment". 3. "Bodily injury" means bodily injury, sickness or disease sustained by a person, including death resulting from any of these at any time. 4. "Coverage territory" means: a. The United States of America (including its territories and possessions), Puerto Rico and Canada; b. International waters or airspace, but only if the injury or damage occurs in the course of travel or transportation between any places included in Paragraph a. above; or c. All other parts of the world if the injury or damage arises out of: (1) Goods or products made or sold by you in the territory described in Paragraph a. above; (2) The activities of a person whose home is in the territory described in Paragraph a. above, but is away for a short time on your business; or (3) "Personal and advertising injury" offenses that take place through the Internet or similar electronic means of communication; provided the insured's responsibility to pay damages is determined in a "suit" on the merits, in the territory described in Paragraph a. above or in a settlement we agree to. 5. "Employee" includes a "leased worker". "Employee" does not include a "temporary worker". 6. "Executive officer" means a person holding any of the officer positions created by your charter, constitution, bylaws or any other similar governing document. 7. "Hostile fire" means one which becomes uncontrollable or breaks out from where it was intended to be. 8. "Impaired property" means tangible property, other than "your product" or "your work", that cannot be used or is less useful because: a. It incorporates "your product" or "your work" that is known or thought to be defective, deficient, inadequate or dangerous; or b. You have failed to fulfill the terms of a contract or agreement; if such property can be restored to use by the repair, replacement, adjustment or removal of "your product" or "your work" or your fulfilling the terms of the contract or agreement. 9. "Insured contract" means: a. A contract for a lease of premises. However, that portion of the contract for a lease of premises that indemnifies any person or organization for damage by fire to premises while rented to you or temporarily occupied by you with permission of the owner is not an "insured contract"; b. A sidetrack agreement; c. Any easement or license agreement, except in connection with construction or demolition operations on or within 50 feet of a railroad; d. An obligation, as required by ordinance, to indemnify a municipality, except in connection with work for a municipality; e. An elevator maintenance agreement; L That part of any other contract or agreement pertaining to your business (including an indemnification of a municipality in connection with work performed for a municipality) under which you assume the tort liability of another party to pay for "bodily injury" or "property damage" to a third person or organization. Tort liability means a liability that would be imposed by law in the absence of any contract or agreement. Paragraph f. does not include that part of any contract or agreement: (1) That indemnifies a railroad for "bodily injury" or "property damage" arising out of construction or demolition operations, within 50 feet of any railroad property and affecting any railroad bridge or trestle, tracks, road -beds, tunnel, underpass or crossing; (2) That indemnifies an architect, engineer or surveyor for injury or damage arising out of: (a) Preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or (b) Giving directions or instructions, or failing to give them, if that is the primary cause of the injury or damage; or (3) Under which the insured, if an architect, engineer or surveyor, assumes liability for an injury or damage arising out of the insured's rendering or failure to render professional services, including those listed in (2) above and supervisory, inspection, architectural or engineering activities. CG 00 0104 13 © Insurance Services Office, Inc., 2012 Page 13 of 16 10. "Leased worker" means a person leased to you by a labor leasing firm under an agreement between you and the labor leasing firm, to perform duties related to the conduct of your business. "Leased worker" does not include a "temporary worker". 11. "Loading or unloading" means the handling of property: a. After it is moved from the place where it is accepted for movement into or onto an aircraft, watercraft or "auto"; b. While it is in or on an aircraft, watercraft or "auto"; or c. While it is being moved from an aircraft, watercraft or "auto" to the place where it is finally delivered; but "loading or unloading" does not include the movement of property by means of a mechanical device, other than a hand truck, that is not attached to the aircraft, watercraft or "auto". 12. "Mobile equipment" means any of the following types of land vehicles, including any attached machinery or equipment: a. Bulldozers, farm machinery, forklifts and other vehicles designed for use principally off public roads; b. Vehicles maintained for use solely on or next to premises you own or rent; c. Vehicles that travel on crawler treads; d. Vehicles, whether self-propelled or not, maintained primarily to provide mobility to permanently mounted: (1) Power cranes, shovels, loaders, diggers or drills; or (2) Road construction or resurfacing equipment such as graders, scrapers or rollers; e. Vehicles not described in Paragraph a., b., c. or d. above that are not self-propelled and are maintained primarily to provide mobility to permanently attached equipment of the following types: (1) Air compressors, pumps and generators, including spraying, welding, building cleaning, geophysical exploration, lighting and well servicing equipment; or (2) Cherry pickers and similar devices used to raise or lower workers; f. Vehicles not described in Paragraph a., b., c. or d. above maintained primarily for purposes other than the transportation of persons or cargo. However, self-propelled vehicles with the following types of permanently attached equipment are not "mobile equipment" but will be considered "autos": (1) Equipment designed primarily for: (a) Snow removal; (b) Road maintenance, but not construction or resurfacing; or (c) Street cleaning; (2) Cherry pickers and similar devices mounted on automobile or truck chassis and used to raise or lower workers; and (3) Air compressors, pumps and generators, including spraying, welding, building cleaning, geophysical exploration, lighting and well servicing equipment. However, "mobile equipment" does not include any land vehicles that are subject to a compulsory or financial responsibility law or other motor vehicle insurance law where it is licensed or principally garaged. Land vehicles subject to a compulsory or financial responsibility law or other motor vehicle insurance law are considered "autos". 13. "Occurrence" means an accident, including continuous or repeated exposure to substantially the same general harmful conditions. 14. "Personal and advertising injury" means injury, including consequential "bodily injury", arising out of one or more of the following offenses: a. False arrest, detention or imprisonment; b. Malicious prosecution; c. The wrongful eviction from, wrongful entry into, or invasion of the right of private occupancy of a room, dwelling or premises that a person occupies, committed by or on behalf of its owner, landlord or lessor; d. Oral or written publication, in any manner, of material that slanders or libels a person or organization or disparages a person's or organization's goods, products or services; e. Oral or written publication, in any manner, of material that violates a person's right of privacy; f. The use of another's advertising idea in your "advertisement"; or g. Infringing upon another's copyright, trade dress or slogan in your "advertisement". 15. "Pollutants" mean any solid, liquid, gaseous or thermal irritant or contaminant, including smoke, vapor, soot, fumes, acids, alkalis, chemicals and waste. Waste includes materials to be recycled, reconditioned or reclaimed. CG 00 0104 13 © Insurance Services Office, Inc., 2012 Page 14 of 16 16. "Products -completed operations hazard": a. Includes all "bodily injury" and "property damage" occurring away from premises you own or rent and arising out of "your product" or "your work" except: (1) Products that are still in your physical possession; or (2) Work that has not yet been completed or abandoned. However, "your work" will be deemed completed at the earliest of the following times: (a) When all of the work called for in your contract has been completed. (b) When all of the work to be done at the job site has been completed if your contract calls for work at more than one job site. As used in this definition, electronic data means information, facts or programs stored as or on, created or used on, or transmitted to or from computer software, including systems and applications software, hard or floppy disks, CD-ROMs, tapes, drives, cells, data processing devices or any other media which are used with electronically controlled equipment. 18. "Suit" means a civil proceeding in which damages because of "bodily injury", "property damage" or "personal and advertising injury" to which this insurance applies are alleged. "Suit" includes: (c) When that part of the work done at a job site has been put to its intended use by any 19 person or organization other than another contractor or subcontractor working on the same project. Work that may need service, maintenance, correction, repair or replacement, but which is otherwise complete, will be treated as completed. b. Does not include "bodily injury" or "property damage" arising out of: (l) The transportation of property, unless the injury or damage arises out of a condition in or on a vehicle not owned or operated by you, and that condition was created by the "loading or unloading" of that vehicle by any insured; (2) The existence of tools, uninstalled equipment or abandoned or unused materials; or (3) Products or operations for which the classification, listed in the Declarations or in a policy Schedule, states that products -completed operations are subject to the General Aggregate Limit. 17. "Property damage" means: a. Physical injury to tangible property, including all resulting loss of use of that property. All such loss of use shall be deemed to occur at the time of the physical injury that caused it; or b. Loss of use of tangible property that is not physically injured. All such loss of use shall be deemed to occur at the time of the 'occurrence" that caused it. For the purposes of this insurance, electronic data is not tangible property. a. An arbitration proceeding in which such damages are claimed and to which the insured must submit or does submit with our consent; or b. Any other alternative dispute resolution proceeding in which such damages are claimed and to which the insured submits with our consent. "Temporary worker" means a person who is furnished to you to substitute for a permanent "employee" on leave or to meet seasonal or short-term workload conditions. 20. "Volunteer worker" means a person who is not your "employee", and who donates his or her work and acts at the direction of and within the scope of duties determined by you, and is not paid a fee, salary or other compensation by you or anyone else for their work performed for you. 21. "Your product": a. Means: (1) Any goods or products, other than real property, manufactured, sold, handled, distributed or disposed of by: (a) You; (b) Others trading under your name; or (c) A person or organization whose business or assets you have acquired; and (2) Containers (other than vehicles), materials, parts or equipment furnished in connection with such goods or products. b. Includes: (1) Warranties or representations made at any time with respect to the fitness, quality, durability, performance or use of "your product"; and (2) The providing of or failure to provide warnings or instructions. c. Does not include vending machines or other property rented to or located for the use of others but not sold. CG 00 0104 13 © Insurance Services Office, Inc., 2012 Page 15 of 16 22. "Your work": a. Means: (1) Work or operations performed by you or on your behalf, and (2) Materials, parts or equipment furnished in connection with such work or operations. b. Includes: (1) Warranties or representations made at any time with respect to the fitness, quality, durability, performance or use of "your work"; and (2) The providing of or failure to provide warnings or instructions. CG 00 0104 13 0 Insurance Services Office, Inc., 2012 Page 16 of 16 Policy Number: CA000033399-01 CG 20 10 04 13 Effective Date: 02/01/2019 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) Location(s) Of Covered Operations Or Organization(s) Any person or organization that is an owner or manager of All locations at which the Named Insured is performing real property or personal property on which you are per- ongoing operations. forming ongoing operations, or a contractor on whose be- half you are performing ongoing operations, but only if cov- erage as an additional insured is required by a written contract or written agreement that is an "insured contract", and provided the "bodily injury" or "property damage" first occurs, or the "personal and advertising injury" offense is first committed, subsequent to the execution of the contract oragreement. 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. 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 CG 20 10 04 13 © Insurance Services Office, Inc., 2012 Page I of 2 13 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. 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 Declarations. CG 20 10 04 13 C Insurance Services Office, Inc., 2012 Page 2 of 2 13 Policy Number: CA000033399-01 CG 20 10 04 13 Effective Date: 02/01/2019 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 Organization(s) Location(s) Of Covered Operations The City of Placentia, it's elected and appointed boards, officers, officials, agents, employees, and volunteers All locations at which the Named Insured is performing ongoing operations. 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. 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. 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; CG 20 10 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 2 13 whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. CG 20 10 04 13 © Insurance Services Office, Inc., 2012 Page 2 of 2 13 Policy Number: CA000033399-01 CG 20 12 04 13 Effective Date: 02/01/2019 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - STATE OR GOVERNMENTAL AGENCY OR SUBDIVISION OR POLITICAL SUBDIVISION - PERMITS OR AUTHORIZATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE State Or Governmental Agency Or Subdivision Or Political Subdivision: City of LA Canada Flintridge 1327 Foothill Blvd La Canada Flintridge, CA 91011 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 any state or governmental agency or subdivision or political subdivision shown in the Schedule, subject to the following provisions: 1. This insurance applies only with respect to operations performed by you or on your behalf for which the state or governmental agency or subdivision or political subdivision has issued a permit or authorization. However: a. The insurance afforded to such additional insured only applies to the extent permitted by law; and b. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. 2. This insurance does not apply to: a. "Bodily injury", "property damage" or "personal and advertising injury" arising out of operations performed for the federal government, state or municipality; or b. "Bodily injury" or "property damage" included within the "products -completed operations hazard". 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 12 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 1 13 Policy Number: CA000033399-01 CG 20 12 04 13 Effective Date: 02/01/2019 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - STATE OR GOVERNMENTAL AGENCY OR SUBDIVISION OR POLITICAL SUBDIVISION - PERMITS OR AUTHORIZATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE State Or Governmental Agency Or Subdivision Or Political Subdivision: The County of Los Angeles and public entity or special district for which The Los Angeles County Board of Supervisors is the Governing Body, and their agents, officer and employees, shall be additional insured(s) while acting within the scope of their duties against all claims arising out of or in connection with the work to be performed 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 any state or governmental agency or subdivision or political subdivision shown in the Schedule, subject to the following provisions: 1. This insurance applies only with respect to operations performed by you or on your behalf for which the state or governmental agency or subdivision or political subdivision has issued a permit or authorization. However: a. The insurance afforded to such additional insured only applies to the extent permitted by law; and b. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. 2. This insurance does not apply to: a. "Bodily injury", "property damage" or "personal and advertising injury" arising out of operations performed for the federal government, state or municipality; or b. "Bodily injury" or "property damage" included within the "products -completed operations hazard". 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 12 04 13 0 Insurance Services Office, Inc., 2012 Page 1 of 1 13 Policy Number: CA000033399-01 CG 20 12 04 13 Effective Date: 02/01/2019 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - STATE OR GOVERNMENTAL AGENCY OR SUBDIVISION OR POLITICAL SUBDIVISION - PERMITS OR AUTHORIZATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE State Or Governmental Agency Or Subdivision Or Political Subdivision: The City of Los Alamitos, its officers, employees, agents and volunteers 3191 Katella Avenue Los Alamitos, CA 90720 Re: Install catch basin curb -opening screens 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 any state or governmental agency or subdivision or political subdivision shown in the Schedule, subject to the following provisions: 1. This insurance applies only with respect to operations performed by you or on your behalf for which the state or governmental agency or subdivision or political subdivision has issued a permit or authorization. However: a. The insurance afforded to such additional insured only applies to the extent permitted by law; and b. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. 2. This insurance does not apply to: a. "Bodily injury", "property damage" or "personal and advertising injury" arising out of operations performed for the federal government, state or municipality; or b. "Bodily injury" or "property damage" included within the "products -completed operations hazard". 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 12 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 1 13 Policy Number: CA000033399-01 CG 20 37 04 13 Effective Date: 02/01/2019 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) Location And Description Of Or Organization(s) Completed Operations Any person or organization that is an owner or manager of All locations except locations where "your work" is or was real property or personal property for whom you work or related to a job or project involving single-family dwellings, have worked, or a contractor on whose behalf you work or multi -family dwellings (other than rental apartments in an have worked, but only if coverage as an additional insured apartment building: (a) originally constructed and at all times extending to "bodily injury" or "property damage" included used for such purpose, or (b) converted from a commercial in the "products -completed operations hazard" is required by building), condominiums, townhomes, townhouses, time - a written contract or written agreement that is an "insured share units, fractional -ownership units, cooperatives and/or contract" and provided that the "bodily injury" or "property any other structure or space used or intended to be used as a damage" first occurs subsequent to the execution of the residence. contract or agreement. 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 C Insurance Services Office, Inc., 2011 Page 1 of 1 13 Policy Number: CA000033399-01 CG 20 37 04 13 Effective Date: 02/01/2019 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) Location And Description Of Or Organization(s) Completed Operations The City of Placentia, it's elected and appointed boards, All locations except locations where "your work" is or was officers, officials, agents, employees, and volunteers related to a job or project involving single-family dwellings, multi -family dwellings (other than rental apartments in an apartment building: (a) originally constructed and at all times used for such purpose, or (b) converted from a commercial building), condominiums, townhomes, townhouses, time- share units, fractional -ownership units, cooperatives and/or any other structure or space used or intended to be used as a residence. 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., 2011 Page 1 of 1 13 Policy Number: CA000033399-01 CG 2106 05 14 Effective Date: 02/01/2019 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EXCLUSION - ACCESS OR DISCLOSURE OF CONFIDENTIAL OR PERSONAL INFORMATION AND DATA -RELATED LIABILITY - WITH LIMITED BODILY IN- JURY EXCEPTION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Exclusion 2.p. of Section I —Coverage A— Bodily Injury And Property Damage Liability is replaced by the follow- ing: 2. Exclusions This insurance does not apply to: p. Access Or Disclosure Of Confidential Or Personal Information And Data -related Liability Damages arising out of: (1) Any access to or disclosure of any person's or organization's confidential or personal information, including patents, trade secrets, processing methods, customer lists, financial information, credit card information, health information or any other type of nonpublic information; or (2) The loss of, loss of use of, damage to, corruption of, inability to access, or inability to manipulate electronic data. This exclusion applies even if damages are claimed for notification costs, credit monitoring expenses, forensic expenses, public relations expenses or any other loss, cost or expense incurred by you or others arising out of that which is described in Paragraph (1) or (2) above. However, unless Paragraph (1) above applies, this exclusion does not apply to damages because of "bodily in- jury". As used in this exclusion, electronic data means information, facts or programs stored as or on, created or used on, or transmitted to or from computer software, including systems and applications software, hard or floppy disks, CD-ROMs, tapes, drives, cells, data processing devices or any other media which are used with electroni- cally controlled equipment. B. The following is added to Paragraph 2. Exclusions of Section I —Coverage B— Personal And Advertising Injury Lia- bility: 2. Exclusions This insurance does not apply to: Access Or Disclosure Of Confidential Or Personal Information "Personal and advertising injury" arising out of any access to or disclosure of any person's or organization's confi- dential or personal information, including patents, trade secrets, processing methods, customer lists, financial infor- mation, credit card information, health information or any other type of nonpublic information. This exclusion applies even if damages are claimed for notification costs, credit monitoring expenses, forensic ex- penses, public relations expenses or any other loss, cost or expense incurred by you or others arising out of any ac- cess to or disclosure of any person's or organization's confidential or personal information. CG 2106 05 14 0 Insurance Services Office, Inc., 2013 Page 1 of 1 13 Policy Number: CA000033399-01 CG 2141 1185 Effective Date: 02/01/2019 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EXCLUSION - INTERCOMPANY PRODUCTS SUITS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART This insurance does not apply to any claim for damages by any Named Insured against another Named Insured because of "bodily injury" or "property damage" arising out of "your products" and included within the "products -completed operations hazard." CG 2141 1185 Copyright, Insurance Services Office, Inc., 1984 Page 1 of 1 D Policy Number: CA000033399-01 CG 2165 12 04 Effective Date: 02/01/2019 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. TOTAL POLLUTION EXCLUSION WITH A BUILDING HEATING, COOLING AND DEHUMIDIFYING EQUIPMENT EXCEPTION AND A HOSTILE FIRE EXCEPTION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART Exclusion f, under Paragraph 2. Exclusions of Section I — (i) At any premises, site or location which is Coverage A — Bodily Injury And Property Damage or was at any time used by or for any in - Liability is replaced by the following: sured or others for the handling, storage, This insurance does not apply to: disposal, processing or treatment of f. Pollution waste; or (l) "Bodily injury" or "property Ydama e" which (ii) At any premises, site or location on which any insured or any contractors or subcon- would not have occurred in whole or part but for tractors working directly or indirectly on the actual, alleged or threatened discharge, disper- any insured's behalf are performing oper- sal, seepage, migration, release or escape of "pol- ations to test for monitor, clean up, re- lutants" at any time. move, contain, treat, detoxify, neutralize This exclusion does not apply to: or in any way respond to, or assess the ef- (a) "Bodily injury" if sustained within a building fects of, "pollutants". which is or was at any time owned or occu- (2) Any loss, cost or expense arising out of any: pied by, or rented or loaned to, any insured (a) Request, demand, order or statutory or regula- and caused by smoke, fumes, vapor or soot tory requirement that any insured or others produced by or originating from equipment test for, monitor, clean up, remove, contain, that is used to heat, cool or dehumidify the treat, detoxify or neutralize, or in any way re- building, or equipment that is used to heat wa- spond to, or assess the effects of, "pollutants"; ter for personal use, by the building's occu- or pants or their guests; or (b) Claim or suit by or on behalf of a governmen- (b) Bodily injuryor property damage' arising tal authority for damages because of testing out of heat, smoke or fumes from a "hostile for, monitoring, cleaning up, removing, con - fire" unless that "hostile fire" occurred or taining, treating, detoxifying or neutralizing, originated: or in any way responding to, or assessing the effects of, "pollutants". CG 2165 12 04 © ISO Properties, Inc., 2003 Page 1 of i Policy Number: CA000033399-01 CG 2175 01 15 Effective Date: 02/01/2019 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EXCLUSION OF CERTIFIED ACTS OF TERRORISM AND EXCLUSION OF OTHER ACTS OF TERRORISM COMMITTED OUTSIDE THE UNITED STATES This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART RAILROAD PROTECTIVE LIABILITY COVERAGE PART UNDERGROUND STORAGE TANK POLICY A. The following exclusion is added: This insurance does not apply to: TERRORISM "Any injury or damage" arising, directly or indirectly, out of a "certified act of terrorism", or out of an "other act of ter- rorism" that is committed outside of the United States (including its territories and possessions and Puerto Rico), but within the "coverage territory". However, with respect to an "other act of terrorism", this exclusion applies only when one or more of the following are attributed to such act: 1. The total of insured damage to all types of property exceeds $25,000,000 (valued in US dollars). In determining whether the $25,000,000 threshold is exceeded, we will include all insured damage sustained by property of all per- sons and entities affected by the terrorism and business interruption losses sustained by owners or occupants of the damaged property. For the purpose of this provision, insured damage means damage that is covered by any insur- ance plus damage that would be covered by any insurance but for the application of any terrorism exclusions; or 2. Fifty or more persons sustain death or serious physical injury. For the purposes of this provision, serious physical in- jury means: a. Physical injury that involves a substantial risk of death; or b. Protracted and obvious physical disfigurement; or c. Protracted loss of or impairment of the function of a bodily member or organ; or 3. The terrorism involves the use, release or escape of nuclear materials, or directly or indirectly results in nuclear reac- tion or radiation or radioactive contamination; or 4. The terrorism is carried out by means of the dispersal or application of pathogenic or poisonous biological or chemi- cal materials; or 5. Pathogenic or poisonous biological or chemical materials are released, and it appears that one purpose of the terror- ism was to release such materials. With respect to this exclusion, Paragraphs 1. and 2. describe the thresholds used to measure the magnitude of an incident of an "other act of terrorism" and the circumstances in which the threshold will apply for the purpose of determining whether this exclusion will apply to that incident. CG 21 75 01 15 © Insurance Services Office, Inc., 2015 Page l of 2 13 B. The following definitions are added: 1. For the purposes of this endorsement, "any injury or damage" means any injury or damage covered under any Cov- erage Part to which this endorsement is applicable, and includes but is not limited to "bodily injury", "property dam- age", "personal and advertising injury", "injury" or "environmental damage" as may be defined in any applicable Coverage Part. 2. "Certified act of terrorism" means an act that is certified by the Secretary of the Treasury, in accordance with the provisions of the federal Terrorism Risk Insurance Act, to be an act of terrorism pursuant to such Act. The criteria contained in the Terrorism Risk Insurance Act for a "certified act of terrorism" include the following: a. The act resulted in insured losses in excess of $5 million in the aggregate, attributable to all types of insurance subject to the Terrorism Risk Insurance Act; b. The act resulted in damage: (1) Within the United States (including its territories and possessions and Puerto Rico); or (2) Outside of the United States in the case of. (a) An air carrier (as defined in Section 40102 of title 49, United States Code) or United States flag vessel (or a vessel based principally in the United States, on which United States income tax is paid and whose insurance coverage is subject to regulation in the United States), regardless of where the loss oc- curs; or (b) The premises of any United States mission; and c. The act is a violent act or an act that is dangerous to human life, property or infrastructure and is committed by an individual or individuals as part of an effort to coerce the civilian population of the United States or to influ- ence the policy or affect the conduct of the United States Government by coercion. 3. "Other act of terrorism" means a violent act or an act that is dangerous to human life, property or infrastructure that is committed by an individual or individuals and that appears to be part of an effort to coerce a civilian population or to influence the policy or affect the conduct of any government by coercion, and the act is not a "certified act of ter- rorism". Multiple incidents of an "other act of terrorism" which occur within a seventy-two hour period and appear to be car- ried out in concert or to have a related purpose or common leadership shall be considered to be one incident. C. The terms and limitations of any terrorism exclusion, or the inapplicability or omission of a terrorism exclusion, do not serve to create coverage for injury or damage that is otherwise excluded under this Coverage Part. CG 21 75 01 15 © Insurance Services Office, Inc., 2015 Page 2 of 2 13 Policy Number: CA000033399-01 CG 22 34 04 13 Effective Date: 02/01/2019 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EXCLUSION - CONSTRUCTION MANAGEMENT ERRORS AND OMISSIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART The following exclusion is added to Paragraph 2. Exclu- sions of Section I — Coverage A — Bodily Injury And Property Damage Liability and Paragraph 2. Exclusions of Section I — Coverage B — Personal And Advertising Injury Liability: This insurance does not apply to "bodily injury", "property damage" or "personal and advertising injury" arising out of: 1. The preparing, approving, or failure to prepare or ap- prove, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifica- tions by any architect, engineer or surveyor performing services on a project on which you serve as construction manager; or 2. Inspection, supervision, quality control, architectural or engineering activities done by or for you on a project on which you serve as construction manager. This exclusion applies even if the claims against any in- sured allege negligence or other wrongdoing in the supervi- sion, hiring, employment, training or monitoring of others by that insured, if the 'occurrence" which caused the "bodi- ly injury" or "property damage", or the offense which caused the "personal and advertising injury", involved that which is described in Paragraph 1. or 2. This exclusion does not apply to "bodily injury" or "proper- ty damage" due to construction or demolition work done by you, your "employees" or your subcontractors. CG 22 34 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 1 13 Policy Number: CA000033399-01 CG 22 79 04 13 Effective Date: 02/01/2019 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EXCLUSION - CONTRACTORS - PROFESSIONAL LIABILITY This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART The following exclusion is added to Paragraph 2. Exclu- sions of Section I — Coverage A — Bodily Injury And Property Damage Liability and Paragraph 2. Exclusions of Section I — Coverage B — Personal And Advertising Injury Liability: 2. Subject to Paragraph 3. below, professional services include: 1. This insurance does not apply to "bodily injury", "property damage" or "personal and advertising injury" arising out of the rendering of or failure to render any professional services by you or on your behalf, but only with respect to either or both of the following operations: 3• a. Providing engineering, architectural or surveying services to others in your capacity as an engineer, architect or surveyor; and b. Providing, or hiring independent professionals to provide, engineering, architectural or surveying ser- vices in connection with construction work you per- form. This exclusion applies even if the claims against any in- sured allege negligence or other wrongdoing in the su- pervision, 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", in- volved the rendering of or failure to render any profes- sional services by you or on your behalf with respect to the operations described above. a. Preparing, approving, or failing to prepare or ap- prove, maps, shop drawings, opinions, reports, sur- veys, field orders, change orders, or drawings and specifications; and b. Supervisory or inspection activities performed as part of any related architectural or engineering ac- tivities. Professional services do not include services within construction means, methods, techniques, sequences and procedures employed by you in connection with your operations in your capacity as a construction con- tractor. CG 22 79 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 1 13 Policy Number: CA000033399-01 CG 24 26 04 13 Effective Date: 02/01/2019 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. AMENDMENT OF INSURED CONTRACT DEFINITION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART The definition of "insured contract" in the Definitions section is replaced by the following: "Insured contract" means: a. A contract for a lease of premises. However, that portion of the contract for a lease of premises that indemnifies any person or organization for damage by fire to premises while rented to you or temporari- ly occupied by you with permission of the owner is not an "insured contract"; b. A sidetrack agreement; c. Any easement or license agreement, except in con- nection with construction or demolition operations on or within 50 feet of a railroad; d. An obligation, as required by ordinance, to indemni- fy a municipality, except in connection with work for a municipality; e. An elevator maintenance agreement; L That part of any other contract or agreement pertain- ing to your business (including an indemnification of a municipality in connection with work per- formed for a municipality) under which you assume the tort liability of another party to pay for "bodily injury" or "property damage" to a third person or organization, provided the "bodily injury" or "prop- erty damage" is caused, in whole or in part, by you or by those acting on your behalf. However, such part of a contract or agreement shall only be consid- ered an "insured contract" to the extent your as- sumption of the tort liability is permitted by law. Tort liability means a liability that would be im- posed by law in the absence of any contract or agreement. Paragraph f, does not include that part of any con- tract or agreement: (1) That indemnifies a railroad for "bodily injury" or "property damage" arising out of construction or demolition operations, within 50 feet of any railroad property and affecting any railroad bridge or trestle, tracks, road -beds, tunnel, un- derpass or crossing; (2) That indemnifies an architect, engineer or sur- veyor for injury or damage arising out of: (a) Preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, re- ports, surveys, field orders, change orders or drawings and specifications; or (b) Giving directions or instructions, or failing to give them, if that is the primary cause of the injury or damage; or (3) Under which the insured, if an architect, engi- neer or surveyor, assumes liability for an injury or damage arising out of the insured's rendering or failure to render professional services, includ- ing those listed in (2) above and supervisory, in- spection, architectural or engineering activities. CG 24 26 04 13 © Insurance Services Office, Inc., 2012 Page I of 1 13 Policy Number: CA000033399-01 COMMERCIAL GENERAL LIABILITY CG 24 50 06 15 LIMITED COVERAGE FOR DESIGNATED UNMANNED AIRCRAFT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Description Of Unmanned Aircraft 1. Any "unmanned aircraft" operated under a FAA Section 333 Exemption. 2. Any "unmanned aircraft" weighing less than 4.4 pounds and operated under FAA Part 107 Rules. 3. Any "unmanned aircraft" that: a. Weighs less than 4.4 pounds; and b. Is operated at least 5 nautical miles away from an airport or heliport having an operational control tower or published instrument flight procedure; and c. Is operated at least 5 nautical miles away from a military base or national park; and d. Is operated at an altitude below 400 feet; and e. Is manually flown within the unaided (other than corrective lenses) visual line of sight of the remote pilot in command or the person manipulating the flight controls of the "unmanned aircraft". 4. Any other "unmanned aircraft" endorsed to this policy. Description Of Operation(s) Or Project(s) Operations directly related to the Business Description shown in the Declarations. Limit Of Insurance Paragraph C. below does not apply. Unmanned Aircraft Liability Aggregate Limit: $ please refer to Section III — Limits of Insurance. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Exclusion 2.g. Aircraft, Auto Or Watercraft under Section I —Coverage A —Bodily Injury And Property Damage Liability is replaced by the following: 2. Exclusions This insurance does not apply to: g. Aircraft, Auto Or Watercraft (1) Unmanned Aircraft "Bodily injury" or "property damage" arising out of the ownership, maintenance, use or entrustment to oth- ers of any aircraft that is an "unmanned aircraft". Use includes operation and "loading or unloading". This Paragraph g.(1) 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" involved the ownership, maintenance, use or en- trustment to others of any aircraft that is an "unmanned aircraft". This Paragraph g.(1) does not apply to "unmanned aircraft" described in the Schedule, but only with re- spect to the operation(s) or project(s) described in the Schedule. CG 24 50 06 15 0 Insurance Services Office, Inc., 2014 Page 1 of 3 13 (2) Aircraft (Other Than Unmanned Aircraft), Auto Or Watercraft "Bodily injury" or "property damage" arising out of the ownership, maintenance, use or entrustment to oth- ers of any aircraft (other than "unmanned aircraft"), "auto" or watercraft owned or operated by or rented or loaned to any insured. Use includes operation and "loading or unloading". This Paragraph g.(2) 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" involved the ownership, maintenance, use or en- trustment to others of any aircraft (other than "unmanned aircraft"), "auto" or watercraft that is owned or operated by or rented or loaned to any insured. This Paragraph g.(2) does not apply to: (a) A watercraft while ashore on premises you own or rent; (b) A watercraft you do not own that is: (i) Less than 26 feet long; and (ii) Not being used to carry persons or property for a charge; (c) Parking an "auto" on, or on the ways next to, premises you own or rent, provided the "auto" is not owned by or rented or loaned to you or the insured; (d) Liability assumed under any "insured contract" for the ownership, maintenance or use of aircraft or watercraft; or (e) "Bodily injury" or "property damage" arising out of: (i) The operation of machinery or equipment that is attached to, or part of, a land vehicle that would qualify under the definition of "mobile equipment" if it were not subject to a compulsory or finan- cial responsibility law or other motor vehicle insurance law where it is licensed or principally gar- aged; or (ii) The operation of any of the machinery or equipment listed in Paragraph f.(2) or f.(3) of the defini- tion of "mobile equipment". B. The following exclusion is added to Paragraph 2. Exclusions of Coverage B — Personal And Advertising Injury Lia- bility: 2. Exclusions This insurance does not apply to: Unmanned Aircraft "Personal and advertising injury" arising out of the ownership, maintenance, use or entrustment to others of any air- craft that is an "unmanned aircraft". Use includes operation and "loading or unloading". This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervi- sion, hiring, employment, training or monitoring of others by that insured, if the offense which caused the "personal and advertising injury" involved the ownership, maintenance, use or entrustment to others of any aircraft that is an "unmanned aircraft". This exclusion does not apply to: a. The use of another's advertising idea in your "advertisement"; b. Infringing upon another's copyright, trade dress or slogan in your "advertisement"; or c. "Unmanned aircraft" described in the Schedule, but only with respect to the operation(s) or project(s) described in the Schedule. C. If an Unmanned Aircraft Liability Aggregate Limit is shown in the Schedule, the following provisions are added to Sec- tion III — Limits Of Insurance: 1. Subject to Paragraph 2. or 3. of Section III —Limits Of Insurance, whichever applies, the Unmanned Aircraft Lia- bility Aggregate Limit shown in the Schedule is the most we will pay for the sum of: a. Damages under Coverage A; b. Damages under Coverage B; and CG 24 50 06 15 © Insurance Services Office, Inc., 2014 Page 2 of 3 c. Medical expenses under Coverage Q because of all "bodily injury", "property damage" and "personal and advertising injury" arising out of the owner- ship, maintenance, use or entrustment to others of any aircraft that is an "unmanned aircraft". 2. Paragraph 4., the Personal And Advertising Injury Limit, Paragraph 5., the Each Occurrence Limit, Paragraph 6., the Damage To Premises Rented To You Limit, and Paragraph 7., the Medical Expense Limit, of Section III — Limits Of Insurance continue to apply to "bodily injury", "property damage" and "personal and advertising injury", as applicable, arising out of the ownership, maintenance, use or entrustment to others of any aircraft that is an "un- manned aircraft" but only if, and to the extent that, a limit of insurance is available under the Unmanned Aircraft Liability Aggregate Limit. D. The following definition is added to the Definitions section: "Unmanned aircraft" means an aircraft that is not: 1. Designed; 2. Manufactured; or 3. Modified after manufacture; to be controlled directly by a person from within or on the aircraft. CG 24 50 06 15 © Insurance Services Office, Inc., 2014 Page 3 of 3 COMMON POLICY CONDITIONS All Coverage Parts included in this policy are subject to the following conditions. A. Cancellation I. The first Named Insured shown in the Declara- tions may cancel this policy by mailing or deliv- ering to us advance written notice of cancella- tion. 2. We may cancel this policy by mailing or deliver- ing to the first Named Insured written notice of cancellation at least: a. 10 days before the effective date of cancel- lation if we cancel for nonpayment of premi- um; or b. 30 days before the effective date of cancel- lation if we cancel for any other reason. 3. We will mail or deliver our notice to the first Named Insured's last mailing address known to us. 4. Notice of cancellation will state the effective date of cancellation. The policy period will end on that date. 5. If this policy is cancelled, we will send the first Named Insured any premium refund due. If we cancel, the refund will be pro rata. If the first Named Insured cancels, the refund may be less than pro rata. The cancellation will be ef- fective even if we have not made or offered a refund. 6. If notice is mailed, proof of mailing will be suffi- cient proof of notice. B. Changes This policy contains all the agreements between you and us concerning the insurance afforded. The first Named Insured shown in the Declarations is authorized to make changes in the terms of this policy with our consent. This policy's terms can be amended or waived only by endorsement issued by us and made a part of this policy. C. Examination Of Your Books And Records We may examine and audit your books and rec- ords as they relate to this policy at any time during the policy period and up to three years afterward. D. Inspections And Surveys 1. We have the right to: a. Make inspections and surveys at any time; IL 00 17 11 98 b. Give you reports on the conditions we find; and c. Recommend changes. 2. We are not obligated to make any inspections, surveys, reports or recommendations and any such actions we do undertake relate only to in- surability and the premiums to be charged. We do not make safety inspections. We do not un- dertake to perform the duty of any person or organization to provide for the health or safety of workers or the public. And we do not warrant that conditions: a. Are safe or healthful; or b. Comply with laws, regulations, codes or standards. 3. Paragraphs 1. and 2. of this condition apply not only to us, but also to any rating, advisory, rate service or similar organization which makes in- surance inspections, surveys, reports or rec- ommendations. 4. Paragraph 2. of this condition does not apply to any inspections, surveys, reports or recom- mendations we may make relative to certifica- tion, under state or municipal statutes, ordi- nances or regulations, of boilers, pressure ves- sels or elevators. E. Premiums The first Named Insured shown in the Declara- tions: 1. Is responsible for the payment of all premiums; and 2. Will be the payee for any return premiums we pay. F. Transfer Of Your Rights And Duties Under This Policy Your rights and duties under this policy may not be transferred without our written consent except in the case of death of an individual named insured. If you die, your rights and duties will be transferred to your legal representative but only while acting within the scope of duties as your legal representa- tive. Until your legal representative is appointed, anyone having proper temporary custody of your property will have your rights and duties but only with respect to that property. IL 0017 11 98 Copyright, Insurance Services Office, Inc., 1998 Page 1 of 1 D Policy Number: CA000033399-01 IL 00 2107 02 Effective Date: 02/01/2019 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. NUCLEAR ENERGY LIABILITY ENDORSEMENT (BROAD FORM) This endorsement modifies insurance provided under the following: COMMERCIAL AUTOMOBILE COVERAGE PART COMMERCIAL GENERAL LIABILITY COVERAGE PART FARM COVERAGE PART LIQUOR LIABILITY COVERAGE PART OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART PROFESSIONAL LIABILITY COVERAGE PART RAILROAD PROTECTIVE LIABILITY COVERAGE PART UNDERGROUND STORAGE TANK POLICY 1. The insurance does not apply: A. Under any Liability Coverage, to "bodily injury" or "property damage": (1) With respect to which an "insured" under the policy is also an insured under a nuclear ener- gy liability policy issued by Nuclear Energy Liability Insurance Association, Mutual Atomic Energy Liability Underwriters, Nucle- ar Insurance Association of Canada or any of their successors, or would be an insured under any such policy but for its termination upon exhaustion of its limit of liability; or (2) Resulting from the "hazardous properties" of "nuclear material" and with respect to which (a) any person or organization is required to maintain financial protection pursuant to the Atomic Energy Act of 1954, or any law amendatory thereof, or (b) the "insured" is, or had this policy not been issued would be, enti- tled to indemnity from the United States of America, or any agency thereof, under any agreement entered into by the United States of America, or any agency thereof, with any per- son or organization. B. Under any Medical Payments coverage, to expens- es incurred with respect to "bodily injury" result- ing from the "hazardous properties" of "nuclear material" and arising out of the operation of a "nu- clear facility" by any person or organization. C. Under any Liability Coverage, to "bodily injury" or "property damage" resulting from "hazardous properties" of "nuclear material", if: (1) The "nuclear material" (a) is at any "nuclear facility" owned by, or operated by or on be- half of, an "insured" or (b) has been dis- charged or dispersed therefrom; (2) The "nuclear material" is contained in "spent fuel" or "waste" at any time possessed, han- dled, used, processed, stored, transported or disposed of, by or on behalf of an "insured"; or (3) The "bodily injury" or "property damage" arises out of the furnishing by an "insured" of services, materials, parts or equipment in con- nection with the planning, construction, maintenance, operation or use of any "nuclear facility", but if such facility is located within the United States of America, its territories or possessions or Canada, this exclusion (3) ap- plies only to "property damage" to such "nu- clear facility" and any property thereat. IL 00 2107 02 © ISO Properties, Inc., 2001 Page 1 of 2 13 2. As used in this endorsement: "Hazardous properties" includes radioactive, toxic or explosive properties. "Nuclear material" means "source material", "Special nuclear material" or "by-product material". "Source material", "special nuclear material", and "by- product material' have the meanings given them in the Atomic Energy Act of 1954 or in any law amendatory thereof. "Spent fuel" means any fuel element or fuel compo- nent, solid or liquid, which has been used or exposed to radiation in a "nuclear reactor". "Waste" means any waste material (a) containing "by- product material" other than the tailings or wastes pro- duced by the extraction or concentration of uranium or thorium from any ore processed primarily for its "source material" content, and (b) resulting from the operation by any person or organization of any "nucle- ar facility" included under the first two paragraphs of the definition of "nuclear facility". "Nuclear facility" means: (a) Any "nuclear reactor"; (b) Any equipment or device designed or used for (1) separating the isotopes of uranium or plu- tonium, (2) processing or utilizing "spent fuel", or (3) handling, processing or packag- ing "waste"; (c) Any equipment or device used for the pro- cessing, fabricating or alloying of "special nu- clear material" if at any time the total amount of such material in the custody of the "in- sured" at the premises where such equipment or device is located consists of or contains more than 25 grams of plutonium or uranium 233 or any combination thereof, or more than 250 grams of uranium 235; (d) Any structure, basin, excavation, premises or place prepared or used for the storage or dis- posal of "waste"; and includes the site on which any of the foregoing is located, all operations conducted on such site and all premises used for such operations. "Nuclear reactor" means any apparatus designed or used to sustain nuclear fission in a self-supporting chain reaction or to contain a critical mass of fissionable ma- terial. "Property damage" includes all forms of radioactive contamination of property. IL 00 2107 02 © ISO Properties, Inc., 2001 Page 2 of 2 13 Policy Number: CA000033399-01 AD 06 62 02 04 Effective Date: 02/01/2019 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EMPLOYEE BENEFITS LIABILITY COVERAGE CLAIMS MADE COVERAGE This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE 1. Limits of Liability $1,000,000 each claim $2,000,000 aggregate 2. Deductible $1,000 each claim 3. Numbers of Employees: All Premium: $ Included 4. Retroactive Date: 02/01/2019 I. COVERAGES 1. Insuring Agreement We will pay those sums which you become legally obligated to pay as damages sustained by any employee, former employee, prospective employee or the beneficiaries or legal representatives thereof caused by your negligent act, error or omission or any other person for whose acts you are legally liable in the "administration" of your "Employee Benefits Programs" in the "policy territory". No other obligation or liability to pay sums or perform acts or services is covered unless explicitly provided for under SUPPLEMENTARY PAYMENTS. We will have the right and duty to defend any suit seeking damages, except, (a) the amount we will pay for damages is limited as described in SECTION III -LIMITS OF INSURANCE; (b) we may, at our discretion, investigate any negligent act, error or omission and settle any claim or suit that may result, and (c) our right and duty to defend ends when the applicable limit of insurance has been used up in the payment of judgments, settlements or SUPPLEMENTARY PAYMENTS This insurance applies to damages only if a claim for damages is first made against you during the policy period. If during this policy period you become aware of any occurrences or circumstances which might result in a claim or claims under this insurance and notice thereof is given to us as soon as practicable in accordance with Section IV, Conditions 2 of the policy, it is agreed that any subsequent claim arising out of such occurrences or circumstances, whether made during or after the expiration of this endorsement period (but no later than sixty days after the expiration of this endorsement period), shall be treated as a claim made during this endorsement period. AD 06 62 02 04 Page 1 of 3 13 A claim by a person or organization seeking damages will be deemed to have been made when notice of such claim is received and recorded by you or by us, whichever comes first. All claims for damages to the same person will be deemed to have been made at the time the first of those claims is made against you. 2. Exclusions This insurance does not apply to: (a) Damages arising out of a negligent act, error or omission which: (1) occurred prior to the policy period or the Retroactive Date shown in the Schedule, whichever is earlier; and (2) you knew or should have known prior to the policy period might result in a claim; (b) damages due to any dishonest, fraudulent, criminal or malicious act; (c) damages due to libel, slander, discrimination, humiliation, emotional distress, harassment, or termination from employment; (d) injury to, or sickness, disease or death of any person, or to injury to or destruction of any tangible property, including the loss of use thereof, (e) any loss or claim arising out of failure of performance of any contract by an insurer; (f) your failure to comply with any law concerning workers' compensation, unemployment insurance, social security or disability benefits; (g) any claim based upon; (1) failure of stock or other investments to perform as represented by you; (2) advice given by you to an employee to participate or not to participate in stock subscription plans; (3) the investment or non -investment of funds. 11=11soElic7.WWONLIKRVII7 1. If you are designated in the Declarations as: (a) an individual, the person so designated but only with respect to the conduct of a business of which you are the sole proprietor, and your spouse with respect to the conduct of such a business; (b) a partnership or joint venture, the partnership or joint venture so designated and any partner or member thereof but only with respect to their liability as such; (c) other than an individual, partnership, or joint venture, the organization so designated and any executive officer, director, or stockholder thereof while acting within the scope of their duties as such; 2. Each of the following is also an insured: (a) any of your employees authorized to act in the administration of your "Employee Benefits Programs", while acting within the scope of their duties in connection therewith; provided that the insurance shall not apply to any person included as a fiduciary un der the Employee Retirement Income Security Act of 1974, including any amendments and regulations relating thereto, while acting in their capacity as such. This insurance does not apply to loss arising out of the conduct of any partnership or joint venture in which you are a partner or member which is not designated in the policy as a "Named Insured". II1. LIMITS OF LIABILITY The limit of liability stated in the Schedule of this endorsement as applicable to "each claim" is the limit of your liability for all damages included in each claim to which this insurance applies; provided that the term "each claim" includes all claims because of any loss or losses sustained by any one employee or former employee and the estate, heirs, legal representatives, beneficiaries or assigns of such employee or former employee, as the result of any act, error or omission or combination of related acts, errors or omissions. Subject to the foregoing provisions respecting the limit of liability for "each claim", the limit of liability stated in the Schedule as "aggregate" is the total limit of our liability for all damages because of all losses under this insurance including all SUPPLEMENTARY PAYMENTS. The inclusion of this endorsement shall not increase our Limits of Liability as stated in the policy. IV. ADDITIONAL CONDITIONS All of the conditions of the policy apply except, as respects the insurance provided by this endorsement: (a) Premium: The premium stated in this endorsement is an estimated premium only. Upon termination of each annual period of this policy, you, on request, will furnish us with a statement of personnel changes, and the earned premiums shall be computed on the average number of employees at the beginning and end of such period. If the earned premium thus computed exceeds the estimated advance premium, you will pay the excess to us; if less, we will return to you the unearned portion subject to the Minimum Premium for this insurance. (b) Your Duties in the event of Negligent Act, Error or Omission, Claim or Suit: AD 06 62 02 04 Page 2 of 3 13 If any claim is made against you or if you learn of any occurrences or circumstances which might result in a claim hereunder, written notice shall be given by you as soon as practicable in accordance with the requirements of Condition 2 of the policy. (c) The following Condition is added: The Deductible amount shown in the Schedule of this endorsement shall apply to all payments (damages or supplementary payments) under this coverage. The terms and conditions of the Liability Deductible Endorsement attached to this policy apply to the Deductible for this coverage. (d) The following Condition is added: If the Retroactive Date shown in the Schedule is earlier than the policy period, this insurance is excess over any other similar insurance purchased by you that is effective prior to the beginning of the policy period. When this insurance is excess, all of the terms and conditions of Section IV -Condition 4.b. apply. V. DEFINITIONS When used in reference to this insurance: "Employee Benefit Programs" means any of the following employee benefit plans and programs maintained for the benefit of your employees or former employees: (a) group life insurance, group accident and health insurance, profit sharing plans, pension plans, employee stock subscription plans, workers' compensation, unemployment insurance, salary continuation plans, social security, disability benefits insurance and travel, savings or vacation plans; and (b) any other employee benefit plan or program added to your "Employee Benefits Program" after the effective date of this endorsement provided that written notice is given to us within 30 days of the effective date thereof and provided further that such addition is endorsed on this policy. "Administration" means: (a) providing interpretations and giving counsel to your employees regarding your "Employee Benefits Programs"; (b) handling records in connection with your "Employee Benefits Programs"; (c) the enrollment, termination or cancellation of employees under your "Employee Benefits Programs", "Policy Territory" means the United States of America, its territories or possessions, or Canada. AD 06 62 02 04 Page 3 of 3 C3 Policy Number: CA000033399-01 AD 07 40 02 07 Effective Date: 02/01/2019 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CARE- FULLY. CROSS LIABILITY EXCLUSION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART RAILROAD PROTECTIVE LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART It is agreed this insurance does not apply to: (1) Any claim made or "suit" brought for dam- ages or liability of any kind by any Named Insured or any "employee", "volunteer worker", "temporary worker", "executive of- ficer", director, stockholder, partner or member of any Named Insured against any other Named Insured or any "employee", "volunteer worker", "temporary worker", "executive officer", director, stockholder, partner or member of any other Named In- sured because of "bodily injury", "property damage" or "personal and advertising inju- ry"; or (2) Any claim made or "suit" brought for dam- ages by the spouse, child, parent, brother or sister of any "employee", "volunteer work- er", "temporary worker", "executive of- ficer", director, stockholder, partner or member of any Named Insured as a conse- quence of (1) above. It is further agreed the Company shall not have the obligation to indemnify, defend, adjust, investigate or pay any cost or expense of any kind for any claim made or "suit' brought which is excluded under the terms of this endorsement. AD 07 40 02 07 Page 1 of 1 Policy Number: CA000033399-01 AD 08 42 02 16 Effective Date: 02/01/2019 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BODILY INJURY REDEFINED This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE FORM (OCCURRENCE VERSION) COMMERCIAL GENERAL LIABILITY COVERAGE FORM (CLAIMS -MADE) PRODUCTS AND COMPLETED OPERATIONS LIABILITY COVERAGE FORM (OCCURRENCE VERSION) PRODUCTS AND COMPLETED OPERATIONS LIABILITY COVERAGE FORM (CLAIMS -MADE VERSION) LIQUOR LIABILITY COVERAGE (OCCURRENCE VERSION) LIQUOR LIABILITY COVERAGE (CLAIMS -MADE) OWNER'S AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE FORM RAILROAD PROTECTIVE LIABILITY COVERAGE FORM EXCESS LIABILITY COVERAGE FORM UMBRELLA LIABILITY COVERAGE FORM The definition of "bodily injury" in DEFINITIONS is amended as follows: "Bodily injury" means physical injury, physical sickness or physical disease sustained by any one person, including death resulting from any of these at any time. "Bodily injury" does not include shock or emotional, mental or psychological distress, injury, trauma or anguish, or other similar condition, unless such condition results solely and directly from that one person's prior physical injury, physical sickness or physical disease otherwise covered under this insurance. AD 08 42 02 16 Includes copyrighted material of Insurance Services Office, Inc., Page 1 of 1 with its permission, 2016. Policy Number: CA000033399-01 AD 08 70 05 07 Effective Date: 02/01/2019 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EIFS & SPRAY -ON SIDING EXCLUSION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART This insurance does not apply to liability, injury or damages b. an adhesive and/or mechanical fasteners used of any kind, to include but not limited to "bodily injury", to attach the insulation board to the substrate; "property damage" and "personal and advertising injury", and including costs or expenses, actually or allegedly arising c. a reinforced base coat; and out of, related to, caused by, contributed to by, or in any way connected with: d. a finish coat providing surface texture and color. A. EIFS (Exterior Insulation & Finish System) 1. The design, manufacture, sale, use, construction, fabrication, preparation, installation, application, maintenance or repair including remodeling, ser- vice, correction, or replacement of, an "exterior in- sulation and finish system" (commonly referred to as synthetic stucco or EIFS) or any part or portion thereof, or any substantially similar system or any part or portion thereof, including the application or use of conditioners, primers, accessories, flash- ings, coatings, caulkings or sealants in connection with such a system. 2. Any design, manufacture, construction, fabrica- tion, preparation, installation, application, mainte- nance, use, sale, service, repair, remodeling, cor- rection, replacement or service of any exterior component, fixture or feature of any structure if an "exterior insulation and finish system" is used on any part of that structure. For the purposes of this endorsement an "exterior insu- lation and finish system" means an exterior cladding or finish system used on any part of any structure and consisting of: a. a rigid or semi-rigid insulation board made of expanded polystyrene or other materials; and B. Spray -On Siding 1. The design, manufacture, sale, use, construction, fabrication, preparation, installation, application, maintenance or repair including remodeling, ser- vice, correction, or replacement of, "spray -on sid- ing", or any part or portion thereof, or any substan- tially similar siding or any part or portion thereof, including the application or use of conditioners, primers, accessories, flashings, coatings, caulkings or sealants in connection with such siding. 2. Any design, manufacture, construction, fabrica- tion, preparation, installation, application, mainte- nance, use, sale, service, repair, remodeling, cor- rection, replacement or service of any exterior component, fixture or feature of any structure if a "spray -on siding" is used on any part of that struc- ture. For the purposes of this endorsement "spray -on siding" means any spray -applied or brush -applied liquid or semi-liquid coating containing polyvinyl chloride resin or ceramic, and applied to any exterior part of any structure. AD 08 70 05 07 Page 1 of 1 13 Policy Number: CA000033399-01 AD 66 0107 15 Effective Date: 02/01/2019 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PUNITIVE DAMAGES EXCLUSION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE FORM LIQUOR LIABILITY COVERAGE FORM OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE FORM PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE FORM RAILROAD PROTECTIVE LIABILITY COVERAGE FORM This insurance does not apply to punitive or exemplary damages, in whatever form assessed, awarded against any insured. AD 66 0107 15 Page 1 of 1 13 Policy Number: CA000033399-01 AD 66 09 02 95 Effective Date: 02/01/2019 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. MINIMUM PREMIUM AND MINIMUM RETAINED PREMIUM AMENDATORY ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE PART 1. Condition 5. Premium Audit as shown in SECTION IV- CONDITIONS is deleted and replaced by the following condition: 5. Premium Audit All premiums for this policy shall be computed in accordance with our rules, rates, rating plans, premiums and minimum premiums applicable to the Insurance afforded herein. Premium designated in this policy as Advance Premium is a Deposit Premium which shall be credited to the amount of the earned premium due at the end of the policy period. At the close of each period (or part thereof terminating with the end of policy period), designated in the DECLARATIONS as the audit period, the earned premium shall be computed for such period and, upon notice thereof to the first Named Insured, shall become due and payable. Should it become necessary to institute collection activities, including litigation, in order to collect the additional earned premium, then you shall be responsible for 100% of the expenses, fees and costs incurred by the Company in that regard plus any collectible interest. If the total computed earned premium for the policy period is less than the premium previously paid, then we shall receive and retain no less than the minimum premium(s) listed in the coverage part(s) attached hereto. You shall maintain records of such information as is necessary for premium computation, and shall send copies of such records to us at the end of the policy period and at such times during the policy period as we may direct. 2. It is further agreed that Section A. Cancellation, paragraph 5. of the COMMON POLICY CONDITIONS IS amended to read as follows: 5. If the policy is cancelled, we will send the first Named Insured any premium refund due. If we cancel, the refund will be the lesser of the pro rata of the actual earned premium or Minimum Premium. If the Named Insured cancels, the refund may be less than pro rata. However in no event shall we retain less than 25% of the Advance Premium shown in the DECLARATIONS. AD 66 09 02 95 Page 1 of 1 13 Policy Number: CA000033399-01 AD 66 1105 11 Effective Date: 02/01/2019 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DEDUCTIBLE LIABILITY INSURANCE (APPLICABLE TO INDEMNITY AND EXPENSES) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE FORM SCHEDULE Coverage Amount and Basis of Deductible PER CLAIM PER OCCURRENCE Bodily Injury Liability $ $ Property Damage Liability $ $ Bodily Injury Liability and/or Property Damage Liability Combine $ $ $5,000.00 Personal and Advertising Injury Liability $ $ 1 $5,000.00 (If no entry appears above, the information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) APPLICATION OF ENDORSEMENT (Enter below any limitations on the application of this endorsement. If no limitation is entered, the deductibles apply to damages for all "bodily injury", "property damage" and "personal and advertising injury", however caused. Damages includes any payments made under the Supplementary Payments provisions of this policy including, but not limited to, expenses we incur to investigate or settle a claim or to defend a "suit'.): No limitations 1. Our obligation under the Bodily Injury Liability, Property Damage Liability, and Personal and Advertising Injury Liability Coverages to pay damages on your behalf applies only to the amount of damages in excess of any deductible amounts stated in the Schedule above as applicable to such coverages. Damages includes any payments made under the Supplementary Payments provisions of this policy including, but not limited to, expenses we incur to investigate or settle a claim, or to defend a "suit'. 2. The deductible applies to the coverage option and to the basis of the deductible indicated by the placement of the deductible amount in the Schedule above. The deductible amount stated in the Schedule above applies as follows: a. PER CLAIM BASIS. If the deductible amount indicated in the Schedule above is on a PER CLAIM basis, that deductible applies as follows: AD 66 1105 11 Page 1 of 2 13 (1) Under Bodily Injury Liability Coverage, to all damages sustained by any one person because of "bodily injury"; (2) Under Personal and Advertising Injury Liability Coverage, to all damages sustained by any one person because of"personal and advertising injury"; (3) Under Property Damage Liability Coverage, to all damages sustained by any one person because of "property damage"; or (4) Under Bodily Injury Liability and/or Property Damage Liability Coverage Combined, to all damages sustained by any one person because of: (a) "Bodily injury'; (b) "Property damage"; or (c) "Bodily injury" and "property damage" combined as the result of any one "occurrence". If damages are claimed for care, loss of services or death resulting at any time from "bodily injury", a separate deductible amount will be applied to each person making a claim for such damages. With respect to "property damage" and "personal and advertising injury", person includes an organization. b. PER OCCURRENCE BASIS. If the deductible amount indicated in the Schedule above is on a PER OCCURRENCE basis, that deductible amount applies as follows: (1) Under Bodily Injury Liability Coverage, to all damages because of "bodily injury"; (2) Under Personal and Advertising Injury Liability Coverage, to all damages sustained by any one person because of "personal and advertising injury"; (3) Under Property Damage Liability Coverage, to all damages because of "property damage"; or (4) Under Bodily Injury Liability and/or Property Damage Liability Coverage Combined, to all damages because of. (a) "Bodily injury"; (b) "Property damage"; or (c) "Bodily injury" and "property damage" combined, as the result of any one "occurrence", regardless of the number of persons or organizations who sustain damages because of that "occurrence". 3. The terms of this insurance, including those with respect to: a. Our right and duty to defend the insured against any "suits" seeking those damages; and b. Your duties in the event of an "occurrence", claim, or "suit"; apply irrespective of the application of the deductible amount. 4. We may pay any part or all of the deductible amount to effect settlement of any claim or "suit" and, upon notification of the action taken, you shall promptly reimburse us for such part of the deductible amount as has been paid by us. 5. When used in this endorsement, damages include any payments made under the Supplementary Payments provisions of this policy including, but not limited to, expenses we incur to investigate or settle a claim or to defend a "suit". 6. If you do not promptly reimburse us for any deductible amount owed, then any cost incurred by us in collection of the deductible amount will be added and applied in addition to the applicable deductible amount without any limitation. These costs include, but are not limited to, collection agency fees, attorney's fees and interest. AD 66 1105 11 Page 2 of 2 13 Policy Number: CA000033399-01 AD 68 83 04 13 Effective Date: 02/01/2019 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY LONG TERM EXPOSURE EXCLUSIONS - JOINT FORM This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE FORM OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE FORM PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE FORM RAILROAD PROTECTIVE LIABILITY COVERAGE FORM ASBESTOS EXCLUSION (ABSOLUTE) This insurance does not apply to liability, injury or damages of any kind, to include but not limited to "bodily injury", "prop- erty damage" or "personal and advertising injury" including costs or expenses, actually or allegedly arising out of, related to, caused by, contributed to by, or in any way connected with actual, alleged or threatened past, present or future claims arising in whole or in part, either directly or indirectly, out of the mining, manufacturing, distribution, sale, resale, rebranding, instal- lation, repair, removal, encapsulation, abatement, replacement or handling of, exposure to, testing for or failure to disclose the presence of asbestos, products containing asbestos, or products designed or used to protect from the inhalation, ingestion, contact with or other exposure to asbestos whether or not the asbestos is or was at any time airborne as a fume, dust, powder, fiber or particle, contained in a product, carried on clothing, inhaled, transmitted in any fashion or found in any form whatso- ever. It is further agreed that this insurance does not apply to any loss, cost or expense including but not limited to, payment for investigation or defense, fines, penalties, interest and other costs or expenses, arising out of or related to any: (1) Clean up or removal of asbestos or products and materials containing asbestos; (2) Such actions as may be necessary to monitor, assess and evaluate the release or threat of same, of asbestos or products and material containing asbestos; (3) Disposal of asbestos substances or the taking of such other action as may be necessary to temporarily or permanently prevent, minimize or mitigate damage to the public health or welfare or to the environment, which may otherwise result; (4) Compliance with any law or regulation regarding asbestos; (5) Existence, storage, handling or transportation of asbestos; (6) Any supervision, instructions, recommendations, warranties (express or implied), warnings or advice given or which should have been given. We shall have no duty to investigate, defend or indemnify any insured against any loss, claim, "suit," demand, fine or other proceeding alleging injury or damages of any kind, to include but not limited to "bodily injury," "property damage," or "per- sonal and advertising injury" to which this endorsement applies. LEAD EXCLUSION (ABSOLUTE) This insurance does not apply to liability, injury or damages of any kind, to include but not limited to "bodily injury", "property damage" or "personal and advertising injury" including costs or expenses, actually or allegedly arising out of, related to, caused by, contributed to by, or in any way connected with actual, alleged or threatened past, present or future claims arising in whole or in part, either directly or indirectly, out of the mining, manufacturing, distribution, sale, resale, AD 68 83 04 13 Includes copyrighted material of Insurance Services Office, Inc., with Page 1 of 3 13 its permission, 2012. rebranding, installation, repair, removal, encapsulation, abatement, replacement or handling of, exposure to, ingestion of or testing for or failure to disclose the presence of lead, products containing lead, or products designed or used to protect from the inhalation, ingestion, contact with or other exposure to lead, whether or not the lead is or was at any time airborne as a fume, dust, powder, fiber or particle, contained in a product, carried on clothing, inhaled, transmitted in any fashion or found in any form whatsoever. It is further agreed that this insurance does not apply to any loss, cost or expense, including but not limited to payment for investigation or defense, fines, penalties, interest and other costs or expenses, arising out of or related to any: (1) Clean up or removal of lead or products and materials containing lead; (2) Such actions as may be necessary to monitor, assess and evaluate the release or threat of same, of lead or products and material containing lead; (3) Disposal of lead substances or the taking of such other action as may be necessary to temporarily or permanently prevent, minimize or mitigate damage to the public health or welfare or to the environment, which may otherwise result; (4) Compliance with any law or regulation regarding lead; (5) Existence, storage, handling or transportation of lead; (6) Any supervision, instructions, recommendations, warranties (express or implied), warnings or advice given or which should have been given. We shall have no duty to investigate, defend or indemnify any insured against any loss, claim, "suit," demand, fine or other proceeding alleging injury or damages of any kind, to include but not limited to "bodily injury," "property damage," or "per- sonal and advertising injury" to which this endorsement applies. MICROORGANISMS, BIOLOGICAL ORGANISMS OR ORGANIC CONTAMINANTS EXCLUSION (GENERAL LIABILITY BROAD FORM) This insurance does not apply to: (1) Liability, injury or damages of any kind, to include but not limited to "bodily injury", "property damage" or " personal and advertising injury", including costs or expenses, actually or allegedly arising out of, related to, caused by, contributed to by, or in any way connected with actual, alleged or threatened past, present or future claims arising in whole or in part, either directly or indirectly, out of the exposure to, presence of, formation of, existence of or actual, alleged or threatened discharge, dispersal, seepage, migration, release or escape of any microorganisms, biological organisms or organic con- taminants, including but not limited to mold, mildew, fungus, spores, yeast or other toxins, allergens, infectious agents, wet or dry rot or rust, or materials of any kind containing them at any time, regardless of the cause of growth, prolifera- tion or secretion; or (2) Any loss, cost or expense arising out of any: (a) Request, demand, order or statutory or regulatory requirement that any insured or others test for, monitor, clean up, remove, contain, treat, detoxify or neutralize, or in any way respond to, or assess the effects of microorganisms, bio- logical organisms or organic contaminants, including but not limited to mold, mildew, fungus, spores, yeast, or other toxins, allergens, infectious agents, wet or dry rot or rust, or any materials containing them at any time, regardless of the cause of growth, proliferation or secretion. (b) Claim or "suit' by or on behalf of a governmental authority for damages because of testing for, monitoring, cleaning up, removing, containing, treating, detoxifying or neutralizing, or in any way responding to, or assessing the effects of microorganisms, biological organisms or organic contaminants, including but not limited to mold, mildew, fungus, spores, yeast, or other toxins, allergens, infectious agents, wet or dry rot or rust, or any materials containing them at any time, regardless of the cause of growth, proliferation or secretion. We shall have no duty to investigate, defend or indemnify any insured against any loss, claim, "suit' or other proceeding alleging injury or damages of any kind, to include but not limited to "bodily injury", "property damage" or "personal injury and advertising injury" to which this endorsement applies. AD 68 83 04 13 Includes copyrighted material of Insurance Services Office, Inc., with Page 2 of 3 0 its permission, 2012 SILICA EXCLUSION (ABSOLUTE) This insurance does not apply to liability, injury or damages of any kind, to include but not limited to "bodily injury", "prop- erty damage" or "personal and advertising injury" including costs or expenses, actually or allegedly arising out of, related to , caused by, contributed to by, or in any way connected with actual, alleged, or threatened past, present or future claims arising in whole or in part, either directly or indirectly, out of the mining, manufacturing, distribution, sale, resale, rebranding, instal- lation, repair, removal, encapsulation, abatement, replacement or handling of, exposure to, ingestion of, testing for or failure to disclose the presence of, failure to warn or advise of silica, products containing silica, or products designed or used to protect from the inhalation, ingestion, contact with or any other exposure to silica, whether or not the silica is or was at any time airborne as a fume, dust, powder, fiber or particle, contained in a product, carried on clothing, inhaled, transmitted in any fashion or found in any form whatsoever. It is further agreed that this insurance does not apply to any loss, cost or expense including, but not limited to, payment for investigation or defense, fines, penalties, interest and other costs or expenses, arising out of or related to any: (1) Clean up or removal of silica or products and materials containing silica; (2) Such actions as may be necessary to monitor, assess and evaluate the release or threat of same, of silica or products and material containing silica; (3) Disposal of silica substances or the taking of such other action as may be necessary to temporarily or permanently pre- vent, minimize or mitigate damage to the public health or welfare or to the environment, which may otherwise result; (4) Compliance with any law or regulation regarding silica; (5) Existence, storage, handling or transportation of silica; (6) Any supervision, instructions, recommendations, warranties (express or implied), warnings or advice given or which should have been given. We shall have no duty to investigate, defend or indemnify any insured against any loss, claim, "suit," demand, fine or other proceeding alleging injury or damages of any kind, to include but not limited to "bodily injury," "property damage," or "per- sonal and advertising injury" to which this endorsement applies. ELECTROMAGNETIC RADIATION EXCLUSION (ABSOLUTE) This insurance does not apply to: 1. "Bodily injury", "property damage" or "personal and advertising injury", including costs or expenses, arising out of, related to, caused by, contributed to by, or in any way connected with the actual or alleged exposure to, presence of, formation of or existence of "electromagnetic radiation"; 2. Any loss, claim, "suit", cost or expense arising out of any request, demand, order, statutory, regulatory or govern- mental requirement that any insured or others for whom any insured is legally liable, test for, comply with standards for, monitor, clean up, remove, contain, treat, detoxify, neutralize, abate, mitigate or in any way respond to or assess the effects of "electromagnetic radiation"; 3. Any loss, claim, "suit', cost or expense, including but not limited to fines or penalties, arising out of any failure to comply with any statutory, regulatory or governmental standards concerning acceptable levels of "electromagnetic radiation"; 4. Any supervision, instructions, recommendations, warnings or advice given or which should have been given in con- nection with Paragraphs 1., 2. or 3. above; or 5. Any obligation to share damages with or repay anyone else who must pay damages in connection with Paragraphs 1., 2., 3. or 4. above. "Electromagnetic radiation" means any form of electrical and magnetic energy, or electric and magnetic field(s) within the electromagnetic spectrum, whether naturally occurring or artificially created, regardless of source, and includes, but is not limited to, radio frequency radiation. We shall have no duty to investigate, defend or indemnify any insured against any loss, claim, "suit," demand, fine or other proceeding alleging injury or damages of any kind, to include but not limited to "bodily injury," "property damage," or "per- sonal and advertising injury" to which this endorsement applies. AD 68 83 04 13 Includes copyrighted material of Insurance Services Office, Inc., with Page 3 of 3 0 its permission, 2012 Policy Number: CA000033399-01 AD 68 93 01 17 Effective Date: 02/01/2019 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CONTRACTORS ENHANCED COVERAGE (Commercial General Liability Coverage Form) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE FORM I. AMENDED EXCLUSIONS NON -OWNED WATERCRAFT COVERAGE - Up to 55 feet SECTION I — COVERAGES — COVERAGE A — BODILY INJURY AND PROPERTY DAMAGE LIABILITY, Exclu- sion g. Aircraft, Auto or Watercraft, Paragraph (2) is deleted in its entirety and replaced by the following: (2) A watercraft you do not own that is: (a) Less than 55 feet long; and (b) Not being used to carry persons or property for a charge; MEDICAL PAYMENTS — PRODUCTS -COMPLETED OPERATIONS HAZARD SECTION I — COVERAGES — COVERAGE C — MEDICAL PAYMENTS Exclusion f. Products -Completed Operations Hazard is deleted in its entirety. CONSOLIDATED (WRAP-UP) INSURANCE PROGRAM EXCLUSION (LIMITED EXCEPTION FOR OPERATIONS AWAY FROM PROJECT LOCATION) The following exclusion is added to paragraph 2., Exclusions of COVERAGE A — BODILY INJURY AND PROPERTY DAMAGE LIABILITY (Section I — Coverages): This insurance does not apply to "bodily injury" or "property damage" arising out of either your ongoing operations or opera- tions included within the "products -completed operations hazard" at any location for which a consolidated (wrap-up) insur- ance program has been provided by the prime contractor/project manager or owner of the construction project in which you are involved. This exclusion applies whether or not the consolidated (wrap-up) insurance program: (1) Provides coverage identical to that provided by this Coverage Form; (2) Has limits adequate to cover all claims; or (3) Remains in effect. However, if the consolidated (wrap-up) insurance program does not provide coverage for your operations that are performed away from the location of the construction project, this exclusion will not apply. AD 68 93 01 17 Includes copyrighted material of Insurance Services Office, Inc., Page 1 of 8 13 with its permission, 2009, 2012 & 2013. II. AMENDED COVERAGES KNOWLEDGE OF OCCURRENCE The following paragraph is added to Section IV — Commercial General Liability Conditions Paragraph 2. Duties In The Event Of Occurrence, Offense, Claim or Suit: Notice of an "occurrence" which may result in a claim under this insurance shall be given as soon as practicable after knowledge of the "occurrence" has been reported to you, one of your "executive officers", or any "employee" authorized by you to give or receive notice of an "occurrence". UNINTENTIONAL ERRORS AND OMISSIONS The following paragraph is added to Section IV — Commercial General Liability Conditions Paragraph 6. Representations: However, the unintentional omission of, or unintentional error in, any information given or provided by you shall not preju- dice your rights under this insurance. However, this provision does not affect our right to collect additional premium or to exercise our right of cancellation or non -renewal. III. ADDED COVERAGES PERSONAL PROPERTY OF OTHERS IN YOUR CARE, CUSTODY OR CONTROL — LIMITED COVERAGE SCHEDULE Sub -Limits of Insurance: $10,000 Each Occurrence (Included in the Each Occurrence Limit shown in the Declarations) $10,000 Aggregate (Included in the General Aggregate Limit shown in the Declarations) The Sub -Limits of Insurance shown above are included within and not in addition to the Each Occurrence Limit and the General Aggregate Limit shown in the Declarations. Supplementary Payments will reduce the Each Occurrence and Aggregate Sub -Limits of Insurance shown above. It is agreed COMMERCIAL GENERAL LIABILITY COVERAGE FORM - SECTION I — COVERAGE A Exclusion j. (4) is deleted, but only with respect to personal property of others in the care, custody or control of the Named Insured, subject to the following exclusions, conditions and limitations. 1. Exclusions This insurance does not apply to: a. "Property damage" arising out of operations performed on behalf of the Named Insured by others; b. "Property damage" arising out of an "occurrence" at premises owned, rented, leased, operated, occupied or used by you; c. "Property damage" to property while in transit; d. "Property damage" arising out of any error, omission or deficiency in the design, specifications, workmanship or materials of the personal property in the Named Insured's care, custody or control; e. "Property damage" arising out of delay, loss of market, loss of use, loss of profits, or any similar indirect or conse- quential loss of any kind; f. "Property damage" included within the "products -completed operations hazard"; or g. Damages exceeding the actual cash value of the personal property in the care, custody or control of the Named In- sured at the time of the "occurrence." 2. Conditions Our right and duty to defend ends when we have used up the applicable sub -limit of insurance in the payment of judg- ments or settlements or Supplementary Payments under the insurance provided by this endorsement. AD 68 93 01 17 Includes copyrighted material of Insurance Services Office, Inc., Page 2 of 8 13 with its permission, 2009, 2012 & 2013. 3. Limits of Insurance a. The amount we will pay for damages is limited as described below with respect to damages covered under this en- dorsement: (1) The Aggregate Limit shown in the Schedule is the most we will pay for the sum of all damages because of "property damage"; (2) The Each Occurrence Limit shown above is the most we will pay for the sum of all damages because of "prop- erty damage" arising out of any one "occurrence"; (3) Supplementary Payments will reduce the Each Occurrence and Aggregate Limits of Insurance shown in the Schedule; and (4) All sums we pay for damages or Supplementary Payments under this endorsement will reduce the Each Occur- rence Limit and the General Aggregate Limit shown in the Declarations. 4. Other Insurance This insurance is excess over any other valid and collectible Property or Inland Marine insurance available to you, either as a Named Insured or an Additional Insured, whether primary, excess, contingent or any other basis. PRIMARY AND NONCONTRIBUTORY — OTHER INSURANCE CONDITION (Insurance Services Office Endorsement CG 20 0104 13) 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 con- tribution from any other insurance available to the additional insured. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (Insurance Services Office Endorsement CG 24 04 05 09) SCHEDULE Name Of Person Or Organization: Any person or organization, but only if the following conditions are met: (1) You have expressly agreed to the waiver in a written contract; and (2) The injury or damage first occurs subsequent to the execution of the written contract. 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 — Condi- tions: 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 per- son or organization shown in the Schedule above. AD 68 93 01 17 Includes copyrighted material of Insurance Services Office, Inc., Page 3 of 8 13 with its permission, 2009, 2012 & 2013. CONTRACTUAL LIABILITY — RAILROADS (Insurance Services Office Endorsement CG 24 17 10 01) SCHEDULE Scheduled Railroad: Any railroad, but only if the following conditions are met: a. You have expressly agreed to indemnify the railroad in a written contract entered into by you; and b. The injury or damage occurs subsequent to the execu- tion of the written contract. Designated Job Site: Any job site covered by this insurance where you are per- forming operations for or affecting a Scheduled Railroad. (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applica- ble to this endorsement.) With respect to operations performed for, or affecting, a Scheduled Railroad at a Designated Job Site, the definition of "in- sured contract" in the Definitions section is replaced by the following: 9. "Insured Contract" means: a. A contract for a lease of premises. However, that portion of the contract for a lease of premises that indemnifies any person or organization for damage by fire to premises while rented to you or temporarily occupied by you with per- mission of the owner is not an "insured contract"; b. A sidetrack agreement; c. Any easement or license agreement; d. An obligation, as required by ordinance, to indemnify a municipality, except in connection with work for a munici- pality; e. An elevator maintenance agreement; f. That part of any other contract or agreement pertaining to your business (including an indemnification of a munici- pality in connection with work performed for a municipality) under which you assume the tort liability of another party to pay for "bodily injury" or "property damage" to a third person or organization. Tort liability means a liabil- ity that would be imposed by law in the absence of any contract or agreement. Paragraph f. does not include that part of any contract or agreement: (1) That indemnifies an architect, engineer or surveyor for injury or damage arising out of: (a) Preparing, approving or failing to prepare or approve maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or (b) Giving directions or instructions, or failing to give them, if that is the primary cause of the injury or dam- age; (2) Under which the insured, if an architect, engineer or surveyor, assumes liability for an injury or damage arising out of the insured's rendering or failure to render professional services, including those listed in Paragraph (1) above and supervisory, inspection, architectural or engineering activities. DESIGNATED CONSTRUCTION PROJECT(S) GENERAL AGGREGATE LIMIT (WITH TOTAL AGGREGATE LIMIT FOR COVERAGES A, B AND C) SCHEDULE Designated Construction Projects: All construction projects covered by this insurance. (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applica- ble to this endorsement.) AD 68 93 01 17 Includes copyrighted material of Insurance Services Office, Inc., Page 4 of 8 13 with its permission, 2009, 2012 & 2013. A. For all sums which the insured becomes legally obligated to pay as damages caused by "occurrences" under COVER- AGE A (SECTION I), and for all medical expenses caused by accidents under COVERAGE C (SECTION I), 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 pro- ject, and that limit is equal to the amount of the General Aggregate Limit shown in the Declarations. However, the most we will pay under the Designated Construction Project General Aggregate Limit for all Desig- nated Construction Projects combined is $5,000,000 . 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 pay- ments shall not reduce the General Aggregate Limit shown in the Declarations nor shall they reduce any other Des- ignated 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, Fire Damage 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. B. For all sums which the insured becomes legally obligated to pay as damages caused by "occurrences" under COVER- AGE A (SECTION I), and for all medical expenses caused by accidents under COVERAGE C (SECTION I), which can- not 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 Desig- nated 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 Limits Of Insurance (SECTION III) not otherwise modified by this endorsement shall continue to ap- ply as stipulated. IV. ADDITIONAL INSUREDS ADDITIONAL INSURED — LESSOR OF LEASED EQUIPMENT — AUTOMATIC STATUS WHEN REQUIRED IN LEASE AGREEMENT WITH YOU (Insurance Services Office Endorsement CG 20 34 04 13) A. Section II — Who Is An Insured is amended to include as an additional insured any person(s) or organization(s) from whom you lease equipment when you and such person(s) or organization(s) have agreed in writing in a contract or agree- ment that such person(s) or organization(s) be added as an additional insured on your policy. Such person(s) or organiza- tion(s) is an insured only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by your maintenance, operation or use of equipment leased to you by such person(s) or organization(s). However, the insurance afforded to such additional insured: 1. Only applies to the extent permitted by law; and AD 68 93 01 17 Includes copyrighted material of Insurance Services Office, Inc., Page 5 of 8 ❑ with its permission, 2009, 2012 & 2013. 2. Will not be broader than that which you are required by the contract or agreement to provide for such additional in- sured. A person's or organization's status as an additional insured under this endorsement ends when their contract or agree- ment with you for such leased equipment ends. B. With respect to the insurance afforded to these additional insureds, this insurance does not apply to any "occurrence" which takes place after the equipment lease expires. 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 you have entered into with the additional insured; 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. ADDITIONAL INSURED — MANAGERS OR LESSORS OF PREMISES (Insurance Services Office Endorsement CG 20 1104 13) SCHEDULE Designation Of Premises (Part Leased To You): All premises leased to you and covered by this insurance. Name Of Person(s) Or Organization(s) (Additional Insured): Any person or organization that is a manager or lessor of real property, but only if coverage as an additional insured is re- quired by a written contract or written agreement that is an "insured contract", and provided the "bodily injury" or "prop- erty damage" first occurs, or the "personal and advertising injury" offense is first committed, subsequent to the execution of the contract or agreement. 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 arising out of the ownership, maintenance or use of that part of the premises leased to you and shown in the Schedule and subject to the following additional exclusions: This insurance does not apply to: 1. Any "occurrence" which takes place after you cease to be a tenant in that premises. 2. Structural alterations, new construction or demolition operations performed by or on behalf of the person(s) or or- ganization(s) shown in the Schedule. 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. AD 68 93 01 17 Includes copyrighted material of Insurance Services Office, Inc., Page 6 of 8 ❑ with its permission, 2009, 2012 & 2013. ADDITIONAL INSURED — MORTGAGEE, ASSIGNEE OR RECEIVER (Insurance Services Office Endorsement CG 20 18 04 13) SCHEDULE Name Of Person(s) Or Organization(s) I Desienation Of Premises Any person or organization that is a mortgagee, assignee or re- ceiver for a premises shown in this Schedule, but only if cov- erage as an additional insured is required by a written contract or written agreement that is an "insured contract", and pro- vided the "bodily injury" or "property damage" first occurs, or the "personal and advertising injury" offense is first commit- ted, subsequent to the execution of the contract or agreement. All premises covered by this insurance. 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 their liability as mortgagee, assignee, or receiver and arising out of the owner- ship, maintenance, or use of the premises by you and shown in the Schedule. 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. This insurance does not apply to structural alterations, new construction and demolition operations performed by or for that person or organization. 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 Declarations. ADDITIONAL INSURED — TRADE SHOW SPONSOR — AUTOMATIC STATUS WHEN REQUIRED IN WRITTEN AGREEMENT WITH YOU A. Section II — Who Is An Insured is amended to include as an additional insured any person or organization who is a sponsor of a trade show where you are operating a booth or displaying your product, but only: 1. For injury or damage occurring at the trade show; and 2. When you and such person or organization have agreed in writing in a contract or agreement executed prior to the beginning of the trade show that such person or organization be added as an additional insured on your policy. Such person or organization 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: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf, while attending the trade show sponsored by this additional insured. AD 68 93 01 17 Includes copyrighted material of Insurance Services Office, Inc., Page 7 of 8 0 with its permission, 2009, 2012 & 2013. A person's or organization's status as an additional insured under this endorsement ends when your attendance at the trade show ends. B. With respect to the insurance afforded to these additional insureds, the following additional exclusion applies: This insurance does not apply to "bodily injury" or "property damage" arising out of "your work" or "your product" and included in the "products -completed operations hazard". 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 Declarations. ADDITIONAL INSURED — STATE OR GOVERNMENTAL AGENCY OR SUBDIVISION OR POLITICAL SUBDIVISION — PERMITS OR AUTHORIZATIONS (INSURANCE SERVICES OFFICE ENDORSEMENT CG 20 12 04 13) SCHEDULE State Or Governmental Agency Or Subdivision Or Political Subdivision: Any state or governmental agency or subdivision or political subdivision that has issued a permit or authorization for opera- tions performed by you or on your behalf. 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 any state or governmental agency or subdivision or political subdivision shown in the Schedule, subject to the following provisions: 1. This insurance applies only with respect to operations performed by you or on your behalf for which the state or governmental agency or subdivision or political subdivision has issued a permit or authorization. However: a. The insurance afforded to such additional insured only applies to the extent permitted by law; and b. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. 2. This insurance does not apply to: a. "Bodily injury", "property damage" or "personal and advertising injury" arising out of operations performed for the federal government, state or municipality; or b. "Bodily injury" or "property damage" included within the "products -completed operations hazard". 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. AD 68 93 01 17 Includes copyrighted material of Insurance Services Office, Inc., Page 8 of 8 0 with its permission, 2009, 2012 & 2013. Policy Number: CA000033399-01 AD 68 88 12 13 Effective Date: 02/01/2019 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. SPECIAL EXCLUSIONS - JOINT FORM This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE FORM (OCCURRENCE VERSION) PRE-EXISTING DAMAGE EXCLUSION It is agreed under Section 1 Coverages, Coverage A Bodily Injury and Property Damage Liability, 1. Insuring Agree- ment, Paragraphs b (3), c and d are deleted in their entirety and the following exclusion is added to this policy: This insurance does not apply to: 1. Any damages arising out of or related to "bodily injury" or "property damage", whether such "bodily injury" or "property damage" is known or unknown, (a) which first occurred prior to the inception date of this policy (or the retroactive date of this policy, if any; whichever is earlier); or (b) which are, or are alleged to be, in the process of occurring as of the inception date of the policy (or the retroac- tive date of this policy, if any; whichever is earlier) even if the "bodily injury" or "property damage" continues during this policy period. 2. Any damages arising out of or related to "bodily injury" or "property damage", whether known or unknown, which are in the process of settlement, adjustment or "suit" as of the inception date of this policy (or the retroactive date of this policy, if any; whichever is earlier). We shall have no duty to defend any insured against any loss, claim, "suit', or other proceeding alleging damages arising out of or related to "bodily injury" or "property damage" to which this endorsement applies. EMPLOYMENT-RELATED PRACTICES EXCLUSION A. The following exclusion is added to Paragraph 2., Exclusions of Section I — Coverage A — Bodily Injury And Proper- ty Damage Liability: This insurance does not apply to: "Bodily injury" to: (1) A person arising out of any "wrongful employment act(s)"; or (2) The spouse, child, parent, brother, sister or registered domestic partner of that person as a consequence of "bodi- ly injury" to that person at whom any of the "wrongful employment act(s)" described in Paragraph (1) above is directed. This exclusion applies: (1) Whether any insured may be liable as an employer or in any other capacity; (2) To any obligation to share damages with or repay someone else who must pay damages because of the injury; and (3) Whether the "wrongful employment act(s)" occurs before employment, during employment or after employment of that person. AD 68 88 12 13 Page i of 2 13 B. The following exclusion is added to Paragraph 2., Exclusions of Section I — Coverage B — Personal And Advertising Injury Liability: This insurance does not apply to: "Personal and advertising injury" to: (1) A person arising out of any "wrongful employment act(s)"; or (2) The spouse, child, parent, brother, sister or registered domestic partner of that person as a consequence of "per- sonal and advertising injury" to that person at whom any of the "wrongful employment act(s)" described in Par- agraph (1) above is directed. This exclusion applies: (1) Whether any insured may be liable as an employer or in any other capacity; (2) To any obligation to share damages with or repay someone else who must pay damages because of the injury; and (3) Whether the "wrongful employment act(s)" occurs before employment, during employment or after employment of that person. C. Additional Definitions: (1) "Wrongful employment act(s)" means any of the following actual, alleged or related acts committed by or on behalf of any insured arising out of a potential, actual or post employment relationship with any person: (a) Discrimination or harassment because of race, color, religion, age, sex, disability, pregnancy, national origin, sexual orientation, marital status, or any other basis prohibited by law which results in termination of the em- ployment relationship, or demotion, or failure or refusal to hire or promote, or failure to accommodate an "em- ployee" or potential "employee", or denial of an employment privilege, or the taking of any adverse or differen- tial employment action; or (b) Sexual harassment including unwelcome sexual advances, requests for sexual favors or other conduct of a sexual nature that is made a condition of employment, is used as a basis for employment decisions, or creates an intimi- dating, hostile or offensive work environment that interferes with work performance; or (c) Termination, constructive discharge, wrongful failure to hire, wrongful demotion, retaliation, misrepresentation, infliction of emotional distress, defamation, invasion of privacy, humiliation, wrongful evaluation, or breach of an implied contract or agreement relating to employment, whether arising out of any personnel manual, policy statement or oral representation; or (d) Physical assault or battery, or any other similar behavior that creates an intimidating, hostile, offensive or dan- gerous work environment; or (e) Training or failing to train any "employee" in accordance with any applicable federal, state or local law, regula- tion, ordinance, rule, guidance document or policy directive governing any act described in Paragraph C. (1) (a) through Paragraph C. (1) (d) above; or (f) Failure to comply with any applicable federal, state or local law, regulation, ordinance, rule, guidance document or policy directive related to the prevention of any act described in Paragraph C. (1) (a) through Paragraph C. (1) (d) above; or (g) malicious prosecution. AD 68 88 12 13 Page 2 of 2 13 Policy Number: CA000033399-01 AD 66 80 06 08 Effective Date: 02/01/2019 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. INDEPENDENT CONTRACTOR INSURANCE AGREEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART Schedule Type of Insurance Commercial General Liability Limits of Insurance General Aggregate Limit (Other than Products -Completed Operations) $2,000,000 Products -Completed Operations Aggregate Limit $2,000,000 Personal and Advertising Injury Limit $1,000,000 Each Occurrence Limit $1,000,000 Rate $12.00 Per $1,000 Cost It is agreed that the following Condition is added to SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS: 10. a. It is agreed that any independent contractors or subcontractors hired by or for you shall maintain insurance of the type described in the Schedule and with limits of insurance equal to or greater than those shown in the Schedule. b. It is further agreed that you will obtain a valid certificate of insurance from independent contractors or subcontractors hired by or for you stating that you have been named as an Additional Insured on the independent contractor's or subcontractor's insurance policy. Your failure to obtain the certificates of insurance as described above will not invalidate the insurance provided by this policy or relieve us of our obligation to you under the terms of this policy except as stated below; however, we will compute and charge an additional earned premium by multiplying the rate shown in the Schedule against the "cost" for all work performed by independent contractors or subcontractors from whom you did not obtain a certificate of insurance. It is further agreed that SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS 4. Other Insurance and 5. Premium Audit are amended to include the following additional conditions: 4. Other Insurance. paragraph b. Excess Insurance This insurance is excess over any other insurance available to you as an Additional Insured from any independent contractor or subcontractor or on any other basis, whether such insurance is primary, excess, or contingent: (1) That is fire, extended coverage, builders risk, installation risk, or similar coverage for "your work"; AD 66 80 06 08 Page 1 of 2 13 (2) That is fire insurance for premises rented to you or temporarily occupied by you with permission of the owner; or (3) If the loss arises out of the maintenance or use of aircraft, "autos", or watercraft to the extent not subject to Exclusion g. of COVERAGE A (SECTION I); or (4) If the loss arises out of work performed for you or on your behalf, or a product manufactured for you or on your behalf, by an independent contractor or subcontractor. The remainder of Condition 4. remains unchanged. 5. Premium Audit d. The first Named Insured must keep copies of all certificates of insurance obtained from all inde- pendent contractors and subcontractors evidencing the type and amount of insurance described in this endorsement, and provide copies to us at such times as we may request. AD 66 80 06 08 Page 2 of 2 13 Policy Number: CA000033399-01 AD 67 18 08 13 Effective Date: 02/01/2019 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. RESIDENTIAL CONSTRUCTION ACTIVITIES EXCLUSION (ABSOLUTE EXCEPT APARTMENTS) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE FORM OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE FORM PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE FORM It is agreed this insurance does not apply to liability arising in whole or in part, either directly or indirectly, out of any past, present or future "residential construction activities" performed by or on behalf of any insured or others. For the purposes of this endorsement, "residential construction activities" means any work or operations related to any job or project involving the construction, repair, remodeling, renovation, maintenance, change or modification of single-family dwellings, multi -family dwellings (excepting only rental apartments in an apartment building: (a) originally constructed and at all times used for such purpose; or (b) converted from a commercial building such as a warehouse, factory, hotel or bank), condominiums, townhomes, townhouses, time-share units, fractional -ownership units, cooperatives and/or any other structure or space used or intended to be used as a residence, whether full-time, part-time, live -work combination, vacation, or tempo- rary residence, and regardless of the actual use or occupancy of any such structure or space, whether or not: 1. The job or project also includes structures, space, areas and/or units designed, constructed, sold, leased, occupied or used for any commercial or other non-residential purpose; or 2. The present or future ownership of any such structure or space by any person or organization is fee simple, joint tenancy, tenancy -in -common, tenancy -in -the -entirety, tenancy -in -partnership, community property, deeded time-share, non -deeded time-share, fractional interest, shareholder interest and/or any other form of common or fractional interest ownership or management. It is further agreed that for any claim made or "suit' brought which is excluded under the terms of this endorsement, we will have no obligation to defend, adjust or investigate or pay any cost for investigation, defense, adjustment or attorney fees arising out of or related to such claims. AD 67 18 08 13 Page 1 of 1 13 Policy Number: CA000033399-01 AD 67 19 07 05 Effective Date: 02/01/2019 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CONDOMINIUM CONVERSION EXCLUSION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART It is agreed this insurance does not apply to liability arising in whole or in part, either directly or indirectly, out of any past, present or future job or project performed by or on behalf of any insured or others involving the construction, repair, remodeling, renovation, maintenance, change or modification of any structure, if the structure is or has been converted, changed or modified at any time by or on behalf of any insured or others to condominiums, townhomes or townhouses. It is further agreed that for any claim or "suit" brought which is excluded under the teens of this endorsement, we will have no obligation to defend, adjust or investigate or pay any cost for investigation, defense, adjustment or attor- ney fees arising out of or related to such claim or "suit". All other terms and conditions remain unchanged. AD 67 19 07 05 Page 1 of 1 ❑ Policy Number: CA000033399-01 AD 67 27 04 06 Effective Date: 02/01/2019 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. INJURY TO TEMPORARY, VOLUNTEER OR CASUAL WORKER EXCLUSION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART OWNERS' AND CONTRACTORS' PROTECTIVE LIABILITY COVERAGE PART This insurance does not apply to "bodily injury" or "per- worker" does not include a person who is furnished to any sonal and advertising injury" to any: insured by a labor union to substitute for a permanent "em- s. "Temporary worker"; ployee" on leave or to meet seasonal or short-term work- load conditions. 2. "Volunteer worker"; 3. "Casual worker"; or 4. The spouse, child, parent, brother, sister or registered domestic partner of that worker as a consequence of 1., 2. or 3. above. For the purposes of this endorsement only, "temporary worker" means: A person who is furnished to any insured to substitute for a permanent "employee" on leave or to meet seasonal or short-term workload conditions; however, "temporary For the purposes of this endorsement only, "casual worker" means: 1. A person, other than a person furnished to you by a labor union, who acts at the direction of and within the scope of duties determined by any insured, and is em- ployed by any insured for a short time and for a limited and temporary purpose; or 2. A person for whom any insured, or a labor leasing firm acting on behalf of any insured, does not withhold fed- eral income taxes and pay federal unemployment tax. AD 67 27 04 06 © ISO Properties, Inc., 2000 Page 1 of 1 13 Policy Number: CA000033399-01 AD 67 48 05 11 Effective Date: 02/01/2019 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. INTELLECTUAL PROPERTY EXCLUSION (AMENDED DEFINITION OF PERSONAL AND ADVERTISING INJURY) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART I. SECTION I — COVERAGES — COVERAGE B PER- SONAL AND ADVERTISING INJURY LIABILITY Exclusion i. is deleted in its entirety and replaced by the following: i. "Personal and advertising injury" arising out of - (1) f(1) Any infringement, disparagement, dilution or diminution of or damage to: (a) Copyright, slogan or title; (b) Patent; (c) Trademark, service mark, service name, collective mark or certification mark, in- cluding without limitation any word, name, symbol, device or any combination thereof used to identify or distinguish the origin of a good, product or service; (d) Trade secret or practice; (e) Trade dress, including without limitation any shape, color, design or appearance used to distinguish the origin of a good, product or service; (f) Advertising ideas, concepts, campaigns, or style of doing business; or (g) Any other proprietary property rights or intellectual property rights recognized or implied by law. (2) Any false designation of the origin of a good, product or service. (3) Any deceptive, false, fraudulent, misleading, unfair, unlawful or untrue business act or practice. II. The definition of "personal and advertising injury" in the DEFINITIONS section of the COMMERCIAL GENERAL LIABILITY COVERAGE FORM is de- leted in its entirety and replaced by the following: "Personal and advertising injury" means injury, includ- ing consequential "bodily injury", arising out of one or more of the following offenses: a. False arrest, detention or imprisonment; b. Malicious prosecution; c. The wrongful eviction from, wrongful entry into, or invasion of the right of private occupancy of a room, dwelling or premises that a person occupies, committed by or on behalf of its owner, landlord or lessor; d. Oral or written publication of material that slan- ders or libels a person or organization or dispar- ages a person's or organization's goods, products or services; or e. Oral or written publication of material that vio- lates a person's right of privacy. AD 67 48 05 11 Page I of 1 13 Policy Number: CA000033399-01 AD 67 60 04 15 Effective Date: 02/01/2019 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PREMIUM BASIS DEFINITION - GROSS SALES This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE PART RAILROAD PROTECTIVE LIABILITY COVERAGE PART When used as a Premium Basis, the following definition applies. Gross Sales 1. Definition Gross Sales means the gross amount charged by the named insured, concessionaires of the named insured or by others trading under the insured's name for: a. All goods or products sold or distributed. b. Operations performed during the policy period. c. Rentals. d. Dues or fees. 2. Inclusions The following items shall not be deducted from gross sales: a. Foreign exchange discounts. b. Freight allowance to customers. c. Total sales of consigned goods and warehouse receipts. d. Trade or cash discounts. e. Bad debts. f. Repossession of items sold on installments (amount actually collected). 3. Exclusions The following items shall be deducted from gross sales: a. Sales or excise taxes which are collected and submitted to a governmental division. b. Credits for repossessed merchandise and products returned. Allowances for damaged and spoiled goods. c. Finance charges for items sold on installments. d. Freight charges on sales if freight is charged as a separate item on customer's invoice. e. Royalty income from patent rights or copyrights which are not product sales. f. Rental receipts for products liability coverage only. AD 67 60 04 15 Includes copyrighted material of Insurance Services Office, Inc., Page 1 of 1 13 with its permission, 2012. Policy Number: CA000033399-01 All 07 10 08 18 Effective Date: 02/01/2019 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY SERVICE OF SUIT - CALIFORNIA Pursuant to any statute of any state, territory or district of the United States which makes provision therefore, the Company hereby designates the Superintendent, Commissioner or Director of Insurance or other Officer specified for that purpose in the Statute, or his successor or successors in office, as its true and lawful attorney upon whom may be served any lawful process in any action, suit or proceeding instituted by or on behalf of you or any beneficiary hereunder arising out of this contract of insurance, and hereby designates the below named as the person to whom the said Officer is authorized to mail such process or a true copy thereof. The Company may be sued upon any cause of action arising in the State of California upon any policy issued by it, or any evidence of insurance issued or delivered by a surplus lines broker, pursuant to the procedures of Sections 1610 to 1620 of the Insurance Code. Nothing herein shall constitute a selection or designation of forum, or a waiver of any of our rights to select a forum or court, including any of the federal courts of the United States. This includes any right to commence an action in or remove or transfer an action to the United States District Court or any other court of competent jurisdiction, as permitted by law. It is further agreed that service of process in such suit may be made upon Vivian Imperial, in care of CT Corporation System, 818 West Seventh St., Suite 930, Los Angeles, CA 90017 and that in any suit instituted against the Company upon this policy, it will abide by the final decision of such Court or of any Appellate Court in the event of an appeal. A1 07 10 08 18 Page 1 of 1 13 Coverage Is Provided In: Policy Number: Liberty Ohio Security Insurance Company - a stock company BAS (20) 57 13 18 11 Mutuals INSURANCE Policy Period: From 02/01/2019 To 02/01/2020 Business Automobile 12:01 am Standard Time Policy Declarations at Insured Mailing Location ITEM ONE: Named Insured Agent G2 CONSTRUCTION, INC. (951) 676-2229 STRACHOTA INSURANCE AGENCY " ITEM TWO: SCHEDULE OF COVERAGES AND COVERED AUTOS This policy provides only those coverages where a charge is shown in the premium column below. Each of these coverages will apply only to those "autos" shown as covered "autos". "Autos" are shown as covered "autos" for a particular coverage by the entry of one or more of the symbols from the COVERED AUTO Section of the Business Auto Coverage Form next to the name of the coverage. *See Business Auto Coverage Form CA 00 01 for Covered Auto Symbol Descriptions COVERAGES LIMIT PREMIUM Liability Insurance $1,000,000 each accident $11,865.00 Covered Auto Symbol(s) 01* Medical Payments $5,000 per person $640.00 Covered Auto Symbol(s) 02* Uninsured Motorists $500.000 each accident $420.00 California California Uninsured Motorists Coverage - Bodily Injury Covered Auto Symbol(s) 07* Physical Damage Refer to Item Three Comprehensive $796.00 m Covered Auto Symbol(s) 07* Collision $1,299.00 Covered Auto Symbol(s) 07* To report a claim, call your Agent or 1-800-362-0000 DS 70 43 01 08 12/18/18 57131811 POLSVCS 280 NCAOPPNO INSURED COPY 003642 PAGE 15 OF 80 '0� Coverage Is Provided In: Policy Number: Liberty Ohio Security Insurance Company - a stock company BAS (20) 57131811 Mutual- Policy Period: INSURANCE From 02/01/2019 To 02/01/2020 12:01 am Standard Time at Insured Mailing Location Common Policy Declarations Named Insured Agent G2 CONSTRUCTION, INC. (95 1) 676-2229 1352 E BORCHARD AVE STRACHOTA INSURANCE AGENCY SANTA ANA, CA 92705 27710 JEFFERSON AVE STE 100 TEMECULA, CA 92590-2669 POLICY FORMS AND ENDORSEMENTS - CONTINUED This section lists the Forms and Endorsements for your policy. Refer to these documents as needed for detailed information concerning your coverage. FORM NUMBER TITLE STATE(S) Applicable IL 00 21 09 08 Nuclear Energy Liability Exclusion Endorsement (Broad Form) IL 02 70 09 12 California Changes - Cancellation and NonRenewal To report a claim, call your Agent or 1-800-362-0000 CA CA DS 70 21 11 16 12/18/18 57131811 POLSVCS 280 NCAOPPNO INSURED COPY 003642 PAGE 13 OF 80 Coverage Is Provided In: Policy Number: Liberty Ohio Security Insurance Company - a stock company BAS (20) 57 13 18 11 Mutual, Policy Period: INSURANCE From 02/01/2019 To 02/01/2020 12.01 am Standard Time at Insured Mailing Location Common Policy Declarations Named Insured Agent G2 CONSTRUCTION, INC. 1352 E BORCHARD AVE SANTA ANA, CA 92705 POLICY FORMS AND ENDORSEMENTS (95 1) 676-2229 STRACHOTA INSURANCE AGENCY 27710 JEFFERSON AVE STE 100 TEMECULA, CA 92590-2669 This section lists all the Forms and Endorsements for your policy. Refer to these documents as needed for detailed information concerning your coverage. FORM NUMBER TITLE STATE(S) Applicable AC 00 31 01 14 Changes In Your Policy CA AC 04 01 11 16 Primary and NonContributory - Other Insurance Condition CA AC 21 16 11 16 California Uninsured Motorists Coverage - Bodily Injury CA AC 84 60 06 14 State Application Of Terrorism Exclusion Endorsements CA AC 84 70 05 15 Punitive or Exemplary Damages Exclusion - CA CA CA 00 01 03 06 Business Auto Coverage Fonn CA CA O1 43 05 17 California Changes CA CA 03 05 02 97 California Changes - Waiver of Collision Deductible CA CA 04 2404 06 California Medical Payments CA CA 20 48 02 99 Designated Insured CA CA 23 45 11 16 Public or Livery Passenger Conveyance and On - Demand Delivery Services CA Exclusion CA 23 84 01 06 Exclusion of Terrorism CA CA 23 86 01 06 Exclusion of Terrorism Above Minimum Statutory Limits CA CA 23 88 01 06 Alaska Exclusion of Terrorism Above Minimum Statutory Limits CA CA 23 92 01 06 Washington Exclusion of Terrorism CA CA 85 47 12 93 Temporary Substitute Auto - Physical Damage Insurance CA CA 85 4909 08 Exclusion of Named Person CA CA 85 53 12 93 Recreational Trailers and Boat Trailers CA CA 88 10 01 13 Business Auto Coverage Enhancement Endorsement CA IL 00 17 11 98 Common Policy Conditions CA In witness whereof, we have caused this policy to be signed by our authorized officers. Mark Touhey Paul Condrin Secretary President To report a claim, call your Agent or 1-800-362-0000 DS 70 21 11 16 12/18/18 57131811 POLSVCS 280 NCAOPPNO INSURED COPY 003642 PAGE 12 OF 80 Coverage Is Provided In: Policy Number: Liberty Ohio Security Insurance Company - a stock company BAS (20) 57 13 18 11 10�Mutual. Policy Period: INSURANCE From 02/01/2019 To 02/01/2020 12:01 am Standard Time at Insured Mailing Location Common Policy Declarations Named Insured & Mailing Address Agent Mailing Address & Phone No. G2 CONSTRUCTION, INC. (95 1) 676-2229 1352 E BORCHARD AVE STRACHOTA INSURANCE AGENCY SANTA ANA, CA 92705 27710 JEFFERSON AVE STE 100 TEMECULA, CA 92590-2669 Named Insured Is: CORPORATION Named Insured Business Is: CEMENT CONTRACTOR 7n return for the payment of the premium, and subject to all the terms of this policy, we agree with you to provide the insurance as stated in this policy. SUMMARY OF COVERAGE PARTS AND CHARGES This policy consists of this Common Policy Declarations page, Common Policy Conditions, Coverage Parts (which consist of coverage forms and other applicable forms and endorsements, if any, issued to form a part of them) and any other forms and endorsements issued to be part of this policy. COVERAGE PART Business Auto CHARGES $15,318.00 Total Charges for all of the above coverage parts: $15,318.00 Coverage for Terrorism is Excluded Note: This is not a bill IMPORTANT MESSAGES COVERAGE UNDER YOUR COMMERCIAL AUTO POLICY IS RESTRICTED DUE TO THE ATTACHMENT OF A NAMED DRIVER EXCLUSION. Issue Date 12/18/18 Authorized Representative To report a claim, call your Agent or 1-800-362-0000 DS 70 21 11 16 12/18/18 57131811 POLSVCS 280 NCAOPPNO INSURED COPY 003642 PAGE 11 OF 80 SNA 04 01 01 16 CALIFORNIA AUTO BODY REPAIR CONSUMER BILL OF RIGHTS A Consumer is entitled to: 1. Select the auto body repair shop to repair auto body damage covered by the insurance company. An insurance company shall not require the repairs to be done at a specific auto body repair shop. 2. An itemized written estimate for auto body repairs and, upon completion of repairs, a detailed invoice. The estimate and the invoice must include an itemized list of parts and labor along with the total price for the work performed. The estimate and invoice must also identify all parts as new, used, aftermarket, reconditioned or rebuilt. 3. Be informed about coverage for towing and storage services 4. Be informed about the extent of coverage, if any, for a replacement rental vehicle while a damaged vehicle is being repaired. 5. Be informed of where to report suspected fraud or other complaints and concerns about auto body repairs. 6. Seek and obtain an independent repair estimate directly from a registered auto body repair shop for repair of a damaged vehicle, even when pursuing an insurance claim for repair of the vehicle. Complaints within the jurisdiction of the Bureau of Automotive Repair Complaints concerning the repair of a vehicle by an auto body repair shop should be directed to: Toll Free (866) 799-3811 Bureau of Automotive Repair 10949 N Mather Blvd Rancho Cordova, CA 95670 The Bureau of Automotive Repair can also accept complaints on its website at: www.autorepair.c a.gov Complaints within the jurisdiction of the California Insurance Commissioner Any concerns regarding how an auto insurance claim is being handled should be submitted to the California Department of Insurance at: (800) 927-4357 or (213) 897-8921 California Department of Insurance Consumer Services Division 300 S Spring St Los Angeles, CA 90013 The California Department of Insurance can also accept complaints on its website at: www.insurance.ca.gov SNA 04 01 01 16 © 2015 Liberty Mutual Insurance Page 1 of 1 NP 91 91 02 13 IMPORTANT POLICYHOLDER INFORMATION CONCERNING BILLING PRACTICES - CALIFORNIA Dear Valued Policyholder: This insert provides you with important information about our policy billing practices that may affect you. Please review it carefully and contact your agent if you have any questions. Premium Notice: We will mail you a policy Premium Notice separately. The Premium Notice will provide you with specifics regarding your agent, the account and policy billed, the billing company, payment plan, policy number, transaction dates, description of transactions, charges/credits, policy amount balance, mini- mum amount, and payment due date. This insert explains fees that may apply to and be shown on your Premium Notice. Available Premium Payment Plans: • Annual Payment Plan: When this plan applies, you have elected to pay the entire premium amount balance shown on your Premium Notice in full. No installment billing fee applies when the Annual Payment Plan applies. • Installment Payment Plan: When this plan applies, you have elected to pay your policy premium in installments (e.g.: quarterly or monthly installments - Installment Payment Plans vary by state). As noted below, an installment fee may apply when the Installment Payment Plan applies. The Premium Payment Plan that applies to your policy is shown on the top of your Premium Notice. Please contact your agent if you want to change your Payment Plan election. Installment Payment Plan Fee: If you elected to pay your premiums in installments using the Installment Premium Payment Plan, an installment billing fee applies to each installment bill. The installment billing charge will not apply, however, if you pay the entire balance due when you receive the bill for the first " installment. Because the amount of the installment charge varies from state to state, please consult your Premium Notice for the actual fee that applies. Dishonored Payment Fee: Your financial institution may refuse to honor the premium payment withdrawal request you submit to us due to insufficient funds in your account or for some other reason. If that is the case, and your premium payment withdrawal request is returned to us dishonored, a payment return fee will apply. Because the amount of the return fee varies from state to state, please consult your Premium Notice for the actual fee that applies. Late Payment Fee: If we do not receive the minimum amount due on or before the date or time the payment is due, as indicated on your Premium Notice, you will receive a policy cancellation notice effective at a future date that will also reflect a late payment fee charge. Issuance of the cancellation notice due to non-payment of a scheduled installment(s) may result in the billing and collection of all or part of any outstanding premiums due for the policy period. Late Payment Fees vary from state to state and are not applicable in some states. Special Note: Please note that some states do not permit the charging of certain fees. Therefore, if your state does not allow the charging of an Installment Payment Plan, Dishonored Payment or Late Payment Fee, the disallowed fee will not be charged and will not be included on your Premium Notice. EFT -Automatic Withdrawals Payment Option: When you select this option, you will not be sent Premium Notices and, in most cases, will not be charged installment fees. For more information on our EFT -Auto- matic Withdrawals payment option, refer to the attached policyholder plan notice and enrollment sheet. Schedule of Fees Type of Fee Fee Amount Installment Payment Plan Non Recurring Payment Option $10.00 EFT -Automatic Withdrawals Payment Option $0.00 Dishonored Payment $20.00 Late Payment $25.00 Once again, please contact your agent if you have any questions about the above billing practice informa- tion. Thank you for selecting us to service your insurance needs. NP 91 91 02 13 © 2013 Liberty Mutual Insurance Page 1 of 1 NP 91 89 02 13 IMPORTANT INFORMATION Consumer Affairs -California Because of the complicated nature of the insurance business, there may be times when you will have questions regarding your coverage or the premium charged, or a problem may occur with your policy. If this occurs we urge you to contact either your agent or broker to answer your question or resolve your problem. However, if you are unable to receive a satisfactory answer or resolution to your problem, please contact us directly: American Fire and Casualty Company Ohio Security Insurance Company The Ohio Casualty Insurance Company West American Insurance Company 1-800-688-8661 If you are still not satisfied, you may contact the following State Agency: California Department of Insurance 300 South Spring Street Los Angeles, CA 90013 Toll Free Number: 1 -800 -927 -HELP (Calif. only) NP 91 89 02 13 © 2013 Liberty Mutual Insurance Page 1 of 1 NP 88 01 09 08 IMPORTANT INFORMATION ABOUT DRIVING OUTSIDE OF THE UNITED STATES AND PROOF OF AUTO INSURANCE THIS NOTICE DOES NOT PROVIDE ANY COVERAGE, NOR CAN IT BE CONSTRUED TO REPLACE ANY PROVISIONS OF YOUR POLICY. YOU SHOULD READ YOUR POLICY AND REVIEW YOUR POLICY DECLARATIONS FOR COMPLETE INFORMATION ABOUT THE COVERAGE THAT APPLIES. IF THERE IS ANY CONFLICT BETWEEN THE POLICY AND THIS NOTICE, THE PROVISIONS OF THE POLICY PREVAIL. This notice provides you with information about territory provisions included in your policy. Your policy provides coverage for accidents or losses that occur within the policy period shown on the Declarations and within the policy territory. The policy territory is defined as the United States of America, its possessions (such as American Samoa, Guam and the U.S. Virgin Islands), Puerto Rico or Canada. While that is the case, in locations outside of the United States, authorities may not accept the Auto Identification Card we pro- vided to you with your policy as proof that you have insurance. For example, Canada requires non-resident operators to carry a special identification Card. For this reason, before you drive outside of the United States, be sure that you: • Familiarize yourself with the motor vehicle laws in the countries or territories you plan to drive in; and • Obtain a "Canada Non -Resident Inter -Province Motor Vehicle Liability Insurance Card" from your independent insurance agent when driving in Canada. In addition, because your policy's territory definition does not include Mexico, if you plan to drive in Mexico, contact your independent insurance agent to purchase Mexican Auto Insurance. Under Mexican laws, auto accidents are not just civil offenses. They are considered criminal offenses and, therefore, the consequences of driving uninsured can be severe. If you have any questions about this notice or the territory provisions of your policy, please contact your independent insurance agent. Your agent can answer your questions and, to the extent possible, ensure your coverage meets your insurance needs. NP 88 01 09 08 Page 1 of 1 NP 74 44 09 06 U.S. TREASURY DEPARTMENT'S OFFICE OF FOREIGN ASSETS CONTROL ("OFAC") ADVISORY NOTICE TO POLICYHOLDERS No coverage is provided by this Policyholder Notice nor can it be construed to replace any provisions of your policy. You should read your policy and review your Declarations page for complete information on the coverages you are provided. This Notice provides information concerning possible impact on your insurance coverage due to directives issued by OFAC. Please read this Notice carefully. Please refer any questions you may have to your insurance agent. The Office of Foreign Assets Control (OFAC) administers and enforces sanctions policy, based on Presiden- tial declarations of "national emergency". OFAC has identified and listed numerous: • Foreign agents; • Front organizations; • Terrorists; • Terrorist organizations; and • Narcotics traffickers; as "Specially Designated Nationals and Blocked Persons". This list can be located on the United States Treasury's web site - http//www.treas.gov/ofac. In accordance with OFAC regulations, if it is determined that you or any other insured, or any person or entity claiming the benefits of this insurance has violated U.S. sanctions law or is a Specially Designated National and Blocked Person, as identified by OFAC, this insurance will be considered a blocked or frozen contract and all provisions of this insurance are immediately subject to OFAC. When an insurance policy is considered to be such a blocked or frozen contract, no payments nor premium refunds may be made without authorization from OFAC. Other limitations on the premiums and payments also apply. © 2011 Liberty Mutual Insurance. All rights reserved. NP 74 44 09 06 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 1 CNI 90 11 07 18 REPORTING A COMMERCIAL CLAIM 24 HOURS A DAY Liberty Mutual Insurance claims professionals across the United States are ready to resolve your claim quickly and fairly, so you and your team can focus on your business. Our claims teams are specialized, experienced and dedicated to a high standard of service. We're Just a Call Away - One Phone Number to Report All Commercial Insurance Claims Reporting a new claim has never been easier. A Liberty Mutual customer service representative is available to you 24/7 at 800-362-0000 for reporting new property, auto, liability and workers' compensa- tion claims. With contact centers strategically located throughout the country for continuity and accessibility, we're there when we're needed! Additional Resource for Workers' Compensation Customers In many states, employers are required by law to use state -specific workers compensation claims forms and posting notices. This type of information can be found in the Policyholders Toolkit section of our website along with other helpful resources such as: • Direct links to state workers compensation websites where you can find state -specific claim forms • Assistance finding local medical providers • First Fill pharmacy forms - part of our managed care pharmacy program committed to helping injured workers recover and return to work Our Policyholder Toolkit can be accessed at www.libertymutualgroup.com/toolkit. For all claims inquiries please call us at 800-362-0000. © 2018 Liberty Mutual Insurance CNI 90 11 07 18 Page 1 of 1 CNA 90 16 11 16 2016 COMMERCIAL AUTO MISCELLANEOUS FORM REVISIONS ADVISORY NOTICE TO POLICYHOLDERS This Notice does not form part of your policy. No coverage is provided by this Notice nor can it be construed to replace any provision of your policy. You should read your policy and review your Declarations page for complete information on the coverages you are provided. If there is any conflict between the Policy and this Notice, THE PROVISIONS OF THE POLICY SHALL PREVAIL. Carefully read your policy, including the endorsements attached to your policy. This Notice provides information concerning the following forms and endorsements which apply to your renewal policy being issued by us. The forms and endorsements may reduce or broaden coverage. Reductions Of Coverage CA 23 44 - Public Or Livery Passenger Conveyance Exclusion When this endorsement is attached to your policy, insurance provided under any applicable Covered Auto Liability, Physical Damage, Auto Medical Payments, Uninsured and/or Underinsured Motorists and Personal Injury Protection (or similar no-fault) Coverage is excluded while any covered auto is being used as a public or livery conveyance for passengers. This includes, but is not limited to, any period of time a covered auto is being used by an insured who is logged into a "transportation network platform" as a driver, whether or not a passenger is occupying the covered auto. CA 23 45 - Public Or Livery Passenger Conveyance And On -demand Delivery Services Exclusion When this endorsement is attached to your policy, insurance provided under any applicable Covered Auto Liability, Physical Damage, Auto Medical Payments, Uninsured and/or Underinsured Motorists and Personal Injury Protection (or similar no-fault) Coverage is excluded while any covered auto is being used: • As a public or livery conveyance for passengers. This includes, but is not limited to, any period of time a covered auto is being used by an insured who is logged into a "transportation network platform" as a driver, whether or not a passenger is occupying the covered auto; or • By an insured who is logged into a "transportation network platform" or "delivery network platform" as a driver to provide delivery services, which includes courier services, whether or not the goods, items or products to be delivered are in the covered auto. CNA 90 16 11 16 © 2016 Liberty Mutual Insurance Page 1 of 1 CNA 90 10 04 15 IMPORTANT NOTICE TO POLICYHOLDER CONCERNING YOUR AUTOMOBILE POLICY PUNITIVE OR EXEMPLARY DAMAGES This notice contains a brief summary of coverage changes made to your policy. Please read your policy and review your Declarations page for complete coverage information. No coverage is provided by this notice, nor can it be construed to replace any provisions of your policy. If there are discrepancies between your policy and this notice, the provisions of the policy shall prevail. Should you have questions after reviewing the changes outlined below, please contact your independent agent. SUMMARY OF POLICY CHANGES CA 87 57 08 13 Punitive Or Exemplary Damages Exclusion CA 87 57 10 14 Punitive Or Exemplary Damages Exclusion Alaska AC 84 70 05 15 Punitive Or Exemplary Damages Exclusion California o AC 84 71 05 15 Punitive Or Exemplary Damages Exclusion Louisiana AC 84 63 08 13 Punitive Or Exemplary Damages Exclusion Massachusetts CA 88 77 06 14 Punitive Or Exemplary Damages Exclusion New York AC 84 72 05 15 Punitive Or Exemplary Damages Exclusion Wisconsin If any of the above listed endorsements is added to your policy for the first time, the following reduction in coverage will apply: COVERAGE REDUCTION This endorsement modifies your Commercial Automobile Policy: Regardless of any other provision of this policy, this policy does not apply to (and no coverage is provided for) "punitive or exemplary damages" or any costs, attorney's fees, interest, "damages" or any other amounts attributable to "punitive or exemplary damages". However, if a suit is brought against an "insured" arising out of a claim which alleges both compensatory damages and "punitive or exemplary damages", we will defend the entire suit despite the fact that coverage only applies to (and we will only pay for) the covered compensatory damages. • "Punitive or exemplary damages" include damages which are intended to punish or deter wrongful conduct, to set an example, to fine, penalize or impose a statutory penalty, and damages which are awarded for any purpose other than as compensatory damages for "bodily injury" or "property damage". © 2015 Liberty Mutual Insurance CNA 90 10 04 15 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 1 You Need To Know - continued NOTICE(S) TO POLICYHOLDER(S) The Important Notice(s) to Policyholder(s) provide a general explanation of changes in coverage to your policy. The Important Notice(s) to Policyholder(s) is not a part of your insurance policy and it does not alter policy provisions or conditions. Only the provisions of your policy determine the scope of your insurance protection. It is important that you read your policy carefully to determine your rights, duties and what is and is not covered. FORM NUMBER TITLE CNA90 10 04 15 Important Notice to Policyholder Concerning Your Automobile Policy Punitive or Exemplary Damages CNA90 16 11 16 2016 Commercial Auto Miscellaneous Form Revisions Advisory Notice to Policyholders CNI90 ll 07 18 Reporting A Commercial Claim 24 Hours A Day NP 74 44 0906 U.S. Treasury Department"s Office of Foreign Assets Control (OFAC) Advisory Notice to Policyholders NP 88 01 09 08 Important Information About Driving Outside of the United States and Proof of Auto Insurance NP 91 89 02 13 Important Information Consumer Affairs Policyholder Notice NP 91 91 02 13 Important Policyholder Information Concerning Billing Practices - California SNA04 01 01 16 California Auto Body Repair Consumer Bill of Rights This policy will be direct billed. You may choose to combine any number of policies on one bill with your billing account. Please contact your agent for more information. • LibMutualerty . INSURANCE Policyholder Information Named Insured & Mailing Address Agent Mailing Address & Phone No. G2 CONSTRUCTION, INC. 1352 E BORCHARD AVE SANTA ANA, CA 92705 (951) 676-2229 STRACHOTA INSURANCE AGENCY 27710 JEFFERSON AVE STE 100 TEPIVIECULA, CA 92590-" 6 log Dear Policyholder: y We know you work hard to build your business. We w oo ethers STRACHOTA INSURANCE AGENCY (951712229 to help protect the things you care about. Thank yo or electi Enclosed are your insurance documents consisti �' %K ,A • Business Auto 4 To find your specific coverages, limits of liability, and premium, please refer to your Declarations page(s). If you have any questions or changes that may affect your insurance needs, please contact your Agent at (951) 676-2229 Detach the ID Card located at the back of the policy • Verify that all information is correct If you have any changes, please contact your Agent at (951) 676-2229 Reminders In case of a claim, call your Agent or 1-800-362-0000 You Need To Know AUTO I.D. CARDS ARE INCLUDED AT THE BACK OF THE POLICY and can be used as evidence of insurance and provide you with information on what to do in case of an accident. . CONTINUED ON NEXT PAGE To report a claim, call your Agent or 1-800-362-0000 DS 70 20 01 08 Coverage Is Provided In: Policy Number: Liberty Ohio Security Insurance Company - a stock company BAS (20) 57 13 18 11 10�Mutual. Policy Period: INSURANCE From 02/01/2019 To 02/01/2020 Business Automobile 12:01 am Standard Time Policy Declarations at Insured Mailing Location Named Insured Agent G2 CONSTRUCTION, INC. (951) 676-2229 STRACHOTA INSURANCE AGENCY ITEM TWO: SCHEDULE OF COVERAGES AND COVERED AUTOS - continued COVERAGES LIMIT PREMIUM Miscellaneous Coverages Business Auto Enhancement Endorsement $250.00 Waiver of Collision Deductible $48.00 Total Provisional Charges: $15,318.00 Note: This is not a bill SUMMARY OF COVERED VEHICLES UNIT YEAR MAKE/MODEL VIN TERR ST CLASS ZIP SYM/COST 001 2007 Anderson Lowbed Ut 4YNBN 182070048671 186 04 69289 92705 $5,000 002 2000 CHEVROLET 3500 IGBGC34ROYR228138 186 04 03289 92705 $19,995 003 2006 Ford F250SD 1FTSX20PX6EA09619 186 04 03289 92706 $25,425 004 2006 FORD F-150 1 FTRF I2W26NA74500 186 04 03289 92706 $20,220 005 2006 Ford F450SD IFDXF46P06EB28254 186 04 23289 92706 $28,145 To report a claim, call your Agent or 1-800-362-0000 DS 70 43 01 08 12/18/18 57131811 POLSVCS 280 NCAOPPNO INSURED COPY 003642 PAGE 16 OF 80 Coverage Is Provided In: Liberty Policy Number: Ohio Security Insurance Company - a stock company BAS (20) 57 Mutuals Policy Period: INSURANCE From 02/01/2019 To 02/01/2020 Business Automobile 12:01 am Standard Time Policy Declarations at Insured Mailing Location Named Insured Agent G2 CONSTRUCTION, INC. (951) 676-2229 STRACHOTA INSURANCE AGENCY ITEM THREE: COVERED VEHICLES AND PREMIUM DETAIL UNIT 001 2007 Anderson Lowbed Utility Tr VIN: 4YNBN18207CO48671 Rating CLASS SYM/COST TERRITORY RISK STATE RATING ZIP TOWN CODE Factors 69289 $5,000 186 CA 92705 0217 DESCRIPTION PREMIUM Liability Insurance Included Medical Payments Included Uninsured Motorist Included Physical Damage Comprehensive - Actual Cash Value Less $500 Deductible $12.00 Collision - Actual Cash Value Less $500 Deductible $30.00 Total Premium $42.00 UNIT 002 2000 CHEVROLET 3500 VIN: 1GBGC34ROYR228138 Rating CLASS SYM/COST TERRITORY RISK STATE RATING ZIP TOWN CODE Factors 03289 $19,995 186 CA 92705 0217 DESCRIPTION PREMIUM ° Liability Insurance $2,771.00 Medical Payments $160.00 Uninsured Motorist $105.00 Physical Damage Comprehensive - Actual Cash Value Less $500 Deductible $137.00 Collision - Actual Cash Value Less $500 Deductible $228.00 Waiver of Collision Deductible $12.00 Total Premium $3,413.00 To report a claim, call your Agent or 1-800-362-0000 DS 70 43 01 08 12/18/18 57131811 POLSVCS 280 NCAOPPNO INSURED COPY 003642 PAGE 17 0F 80 Coverage Is Provided In: Policy Number: Liberty Ohio Security Insurance Company - a stock company BAS (20) 57 13 18 11 Mutuals Policy Period: INSURANCE From 02/01/2019 To 02/01/2020 Business Automobile 12:01 am Standard Time Policy Declarations at Insured Mailing Location Named Insured Agent G2 CONSTRUCTION, INC. (951) 676-2229 STRACHOTA INSURANCE AGENCY ITEM THREE: COVERED VEHICLES AND PREMIUM DETAIL - continued UNIT 003 2006 Ford F25OSD VIN: 1 FTSX20PX6EA09619 Rating CLASS SYM/COST TERRITORY RISK STATE RATING ZIP TOWN CODE Factors 03289 $25,425 186 CA 92706 0217 DESCRIPTION PREMIUM Liability Insurance $2,771.00 Medical Payments $160.00 Uninsured Motorist $105.00 Physical Damage Comprehensive - Actual Cash Value Less $500 Deductible $266.00 Collision - ,Actual Cash Value Less $500 Deductible $424.00 Waiver of Collision Deductible $12.00 Total Premium $3,738.00 UNIT 004 2006 FORD F-150 VIN: 1 FTRF12W26NA74500 Rating CLASS SYM/COST TERRITORY RISK STATE RATING ZIP TOWN CODE Factors 03289 $20,220 186 CA 92706 0217 DESCRIPTION PREMIUM Liability Insurance $2,771.00 Medical Payments $160.00 Uninsured Motorist $105.00 Physical Damage Comprehensive - Actual Cash Value Less $500 Deductible $179.00 Collision - Actual Cash Value Less $500 Deductible $295.00 Waiver of Collision Deductible $12.00 Total Premium $3,522.00 To report a claim, call your Agent or 1-800-362-0000 DS 70 43 01 08 12/18/18 57131811 POLSVCS 280 NCAOPPNO INSURED COPY 003642 PAGE 18 OF 80 Coverage Is Provided In: Policy Number: Liberty Ohio Security Insurance Company - a stock company BAS (20) 57 13 18 11 Mutual. Policy Period: INSURANCE From 02/01/2019 To 02/01/2020 Business Automobile 12:01 am Standard Time Policy Declarations at Insured Mailing Location Named Insured Agent G2 CONSTRUCTION, INC. (951) 676-2229 STRACHOTA INSURANCE AGENCY ITEM THREE: COVERED VEHICLES AND PREMIUM DETAIL - continued N UNIT 005 2006 Ford F450SD VIN: 1 FDXF46PO6EB28254 Rating CLASS SYM/COST TERRITORY RISK STATE RATING ZIP TOWN CODE Factors 23289 $28,145 186 CA 92706 0217 DESCRIPTION PREMIUM Liability Insurance $2,861.00 Medical Payments $160.00 Uninsured Motorist $105.00 N Physical Damage Comprehensive - Actual Cash Value Less $500 Deductible $202.00 Collision - Actual Cash Value Less $500 Deductible $322.00 Waiver of Collision Deductible $12.00 Total Premium $3,662.00 ITEM FOUR: HIRED AUTO COVERAGE Estimated Annual Rate Per Each Cost of Hire $100 Annual Cost of Hire Liability $100.00 4.046 $162.00 Cost of Hire means the total amount you incur for the hire of "autos" you don't own (not including "autos" you borrow or rent from your partners or employees or their family or their family members). Cost of hire does not include charges for services performed by motor carriers of property or passengers. To report a claim, call your Agent or 1-800-362-0000 DS 70 43 01 08 12/18/18 57131811 POLSVCS 280 NCAOPPNO INSURED COPY 003642 PAGE 19 OF 80 Coverage Is Provided In: Policy Number: L1bCrty Ohio Security Insurance Company - a stock company BAS (20) 57 13 18 11 Mutual. Policy Period: INSURANCE From 02/01/2019 To 02/01/2020 Business Automobile 12:01 am Standard Time Policy Declarations at Insured Mailing Location Named Insured Agent G2 CONSTRUCTION, INC. (951) 676-2229 STRACHOTA INSURANCE AGENCY ITEM FIVE: NON -OWNERSHIP LIABILITY COVERAGE Other than Garage Service Operations and Other Than Social Service Agencies Ratino Rai, a Number of Employees To report a claim, call your Agent or 1-800-362-0000 DS 70 43 01 08 Niimhor Premium 26 $529.00 12/18/18 57131811 POLSVCS 280 NCAOPPNO INSURED COPY 003642 PAGE 20 OF 80 Policy Number Issued by THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CHANGES IN YOUR POLICY This endorsement applies to: CA 00 01 12 93 - Business Auto Coverage Form CA 00 01 07 97 - Business Auto Coverage Form CA 00 01 10 01 - Business Auto Coverage Form CA 00 01 03 06 - Business Auto Coverage Form CA 00 05 12 93 - Garage Coverage Form " CA 00 05 07 97 - Garage Coverage Form CA 00 05 10 01 - Garage Coverage Form CA 00 05 03 06 - Garage Coverage Form CA 00 12 12 93 - Truckers Coverage Form CA 00 12 07 97 - Truckers Coverage Form CA 00 12 10 01 - Truckers Coverage Form CA 00 12 03 06 - Truckers Coverage Form CA 00 20 12 93 - Motor Carrier Coverage Form CA 00 20 07 97 - Motor Carrier Coverage Form CA 00 20 10 01 - Motor Carrier Coverage Form CA 00 20 03 06 - Motor Carrier Coverage Form This endorsement modifies the endorsements attached to the above coverage forms. 1. Any reference to Covered Autos Liability Coverage is changed to Liability Coverage. 2. Any reference in Physical Damage Coverage to 'loss" to any one covered "auto" is changed to "loss" in any one "accident." 3. Any reference to Auto Dealers Coverage Form is changed to Garage Coverage Form. 4. Any reference to Motor Carriers Coverage Form also applies to Truckers Coverage Form. AC 00 31 01 14 © 2013 Liberty Mutual Insurance. All rights reserved. Page 1 of 1 COMMERCIAL AUTO AC 04 01 11 16 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NONCONTRIBUTORY -OTHER INSURANCE CONDITION With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. BUSINESS AUTO COVERAGE FORM GARAGE COVERAGE FORM MOTOR CARRIER COVERAGE FORM TRUCKERS COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. A. The following is added to the Other Insurance Condition in the Business Auto and Garage Coverage Forms and the Other Insurance - Primary And Excess Insurance Provisions in the Motor Carrier and Truckers Coverage Forms 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 writing in a contract or agreement that this insurance would be primary and would not seek contribution from any other insurance available to such "insured". © 2016 Liberty Mutual Insurance AC 04 01 11 16 Includes copyrighted material of Insurance Services Office Inc., with its permission. Page 1 of 1 COMMERCIAL AUTO AC 21 16 11 16 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CALIFORNIA UNINSURED MOTORISTS COVERAGE - BODILY INJURY For a covered "auto" licensed or principally garaged in, or "garage operations" conducted in, California, this endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM GARAGE COVERAGE FORM MOTOR CARRIER COVERAGE FORM TRUCKERS COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. SCHEDULE Limit Of Insurance: $ Each "Accident" Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Coverage 1. We will pay all sums the "insured" is legally entitled to recover as compensatory damages from the owner or driver of an "uninsured motor vehicle". The damages must result from "bodily injury" sustained by the "insured" caused by an "accident". The owner's or driver's liability for these damages must result from the ownership, maintenance or use of the "uninsured motor vehicle". 2. We will pay only after the limits of liability under any liability bonds or policies have been exhausted by payment of judgments or settlements. 3. Any judgment for damages arising out of a "suit" brought without our written consent is not binding on us. B. Who Is An Insured If the Named Insured is designated in the Declarations as: 1. An individual, then the following are "insureds": a. The Named Insured and any "family members". b. Anyone else "occupying" a covered "auto" or a temporary substitute for a covered "auto". The covered "auto" must be out of service because of its breakdown, repair, servicing, "loss" or destruction. c. Anyone for damages he or she is entitled to recover because of "bodily injury" sustained by another "insured". 2. A partnership, limited liability company, corporation or any other form of organization, then the following are "insureds": a. Anyone "occupying" a covered "auto" or a temporary substitute for a covered "auto". The covered "auto" must be out of service because of its breakdown, repair, servicing, "loss" or destruction. b. Anyone for damages he or she is entitled to recover because of "bodily injury" sustained by another "insured". C. Exclusions This insurance does not apply to any of the following: 1. Punitive or exemplary damages. © 2017 Liberty Mutual Insurance AC 21 16 11 16 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 4 2. Any claim settled without our consent. However, this exclusion does not apply to a settlement made with the insurer of a vehicle described in Paragraph b. of the definition of "uninsured motor vehicle". 3. The direct or indirect benefit of any insurer or self -insurer under any workers' compensation, disability benefits or similar law or to the direct benefit of the United States, a state or its political subdivisions. 4. "Bodily injury" sustained by: a. An individual Named Insured while "occupying" or when struck by any vehicle owned by that Named Insured that is not a covered "auto" for Uninsured Motorists Coverage under this Coverage Form; b. Any "family member" while "occupying" or when struck by any vehicle owned by that "family member" that is not a covered "auto" for Uninsured Motorists Coverage under this Coverage Form; or c. Any "family member" while "occupying" or when struck by any vehicle owned by the Named Insured that is insured for Uninsured Motorists Coverage on a primary basis under any other Coverage Form or policy. However, Exclusion 4. shall not apply to "bodily injury" sustained by an individual Named Insured or "family member" when struck by a vehicle owned by that "insured" and operated or caused to be operated by a person without that "insured's" consent in connection with criminal activity that has been documented in a police report and to which that "insured" is not a party to. 5. "Bodily injury" sustained by an individual Named Insured or any "family member" while "occupying" any vehicle leased by that Named Insured or any "family member" under a written contract for a period of six months or more that is not a covered "auto". 6. Anyone using a vehicle without a reasonable belief that the person is entitled to do so. 7. "Bodily injury" sustained by an "insured" while "occupying" any "auto" that is rented or leased to that "insured" for use as a public or livery conveyance. However, this exclusion does not apply if the "insured" is in the business of providing public or livery conveyance. As used in this exclusion, public or livery conveyance includes, but is not limited to, any period of time an "auto" is being used by an "insured" who is logged into a "transporta- tion network platform" as a driver, whether or not a passenger is "occupying" the "auto". 8. "Bodily injury" arising directly or indirectly out of: a. War, including undeclared or civil war; b. Warlike action by a military force, including action in hindering or defending against an actual or expected attack, by any government, sovereign or other authority using military personnel or other agents; or c. Insurrection, rebellion, revolution, usurped power, or action taken by governmental authority in hindering or defending against any of these. D. Limit Of Insurance 1. Regardless of the number of covered "autos", "insureds", premiums paid, claims made or vehicles involved in the "accident", the most we will pay for all damages resulting from any one "accident" is the Limit Of Insurance for Uninsured Motorists Coverage shown in the Schedule or Declarations. 2. For a vehicle described in Paragraph b. of the definition of "uninsured motor vehicle", our Limit of Insurance shall be reduced by all sums paid because of "bodily injury" by or for anyone who is legally responsible, including all sums paid or payable under this policy's Liability Coverage. 3. No one will be entitled to receive duplicate payments for the same elements of "loss" under this coverage and any Liability Coverage form or Medical Payments Coverage endorsement attached to this Coverage Part. We will not make a duplicate payment under this coverage for any element of "loss" for which payment has been made by or for anyone who is legally responsible. We will not pay for any element of "loss" if a person is entitled to receive payment for the same element of "loss" under any workers' compensation, disability benefits or similar law. © 2017 Liberty Mutual Insurance AC 21 16 11 16 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 2 of 4 E. Changes In Conditions The Conditions are changed for California Uninsured Motorists Coverage - Bodily Injury as follows: 1. Duties In The Event Of Accident, Claim, Suit Or Loss is changed by adding the following: a. Promptly notify the police if a hit-and-run driver is involved; and b. Send us copies of the legal papers if a "suit" is brought. In addition, a person seeking coverage under Paragraph b. of the definition of "uninsured motor vehicle" must: (1) Provide us with a copy of the complaint by personal service or certified mail if the "insured" brings an action against the owner or operator of such "uninsured motor vehicle"; (2) Within a reasonable time, make all pleadings and depositions available for copying by us or furnish us copies at our expense; and (3) Provide us with proof that the limits of insurance under any applicable liability bonds or policies have been exhausted by payment of judgments or settlements. 2. Legal Action Against Us is replaced by the following: No legal action may be brought against us under this Coverage Form until there has been full compliance with all the terms of this Coverage Form and with respect to Paragraphs a., c. and d. of the definition of "uninsured motor vehicle" unless within two years from the date of the "accident": a. Agreement as to the amount due under this insurance has been concluded; b. The "insured" has formally instituted arbitration proceedings against us. In the event that the "insured" decides to arbitrate, the "insured" must formally begin arbitration proceed- ings by notifying us in writing, sent by certified mail, return receipt requested; or c. "Suit' for "bodily injury" has been filed against the uninsured motorist in a court of competent jurisdiction. Written notice of the "suit' must be given to us within a reasonable time after the "insured" knew, or should have known, that the other motorist is uninsured. In no event will such notice be required before two years from the date of the accident. " Failure of the "insured" or his or her representative to give us such notice of the "suit' will relieve us of our obligations under this Coverage Form only if the failure to give notice prejudices our rights. 3. Transfer Of Rights Of Recovery Against Others To Us is replaced by the following: a. With respect to Paragraphs a., c. and d. of the definition of "uninsured motor vehicle", if we make any payment, we are entitled to recover what we paid from other parties. Any person to or for whom we make payment must transfer to us his or her rights of recovery against any other party. This person must do everything necessary to secure these rights and must do nothing that would jeopardize them. b. With respect to Paragraph b. of the definition of "uninsured motor vehicle", if we make any payment and the "insured" recovers from another party, the "insured" shall hold the proceeds in trust for us and pay us back the amount we have paid. 4. Other Insurance in the Business Auto and Garage Coverage Forms and Other Insurance - Primary And Excess Insurance Provisions in the Motor Carrier and Truckers Coverage Forms are replaced by the following: If there is other applicable insurance available under one or more policies or provisions of coverage: " a. The maximum recovery under all Coverage Forms or policies combined may equal but not exceed the highest applicable limit for any one vehicle under any Coverage Form or policy providing coverage on either a primary or excess basis. b. Any insurance we provide with respect to a vehicle the Named Insured does not own shall be excess over any other collectible uninsured motorists insurance providing coverage on a primary basis. c. If the coverage under this Coverage Form is provided: (1) On a primary basis, we will pay only our share of the "loss" that must be paid under insurance providing coverage on a primary basis. Our share is the proportion that our limit of liability bears to the total of all applicable limits of liability for coverage on a primary basis. © 2017 Liberty Mutual Insurance AC 21 16 11 16 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 3 of 4 (2) On an excess basis, we will pay only our share of the "loss" that must be paid under insurance providing coverage on an excess basis. Our share is the proportion that our limit of liability bears to the total of all applicable limits of liability for coverage on an excess basis. 5. The following condition is added: Arbitration a. If we and an "insured" disagree whether the "insured" is legally entitled to recover damages from the owner or driver of an "uninsured motor vehicle" or do not agree as to the amount of damages that are recoverable by that "insured", the disagreement will be settled by arbitration. Such arbitration may be initiated by a written demand for arbitration made by either party. The arbitration shall be conducted by a single neutral arbitrator. However, disputes concerning coverage under this endorsement may not be arbitrated. Each party will bear the expenses of the arbitrator equally. b. Unless both parties agree otherwise, arbitration will take place in the county in which the "insured" lives. Local rules of law as to arbitration procedures and evidence will apply. 'The decision of the arbitrator will be binding. F. Additional Definitions The following are added to the Definitions section: 1. "Family member" means the individual Named Insured's spouse, whether or not a resident of the individual Named Insured's household, and any other person related to such Named Insured by blood, adoption, marriage or registered domestic partnership under California law, who is a resident of such Named Insured's household, including a ward or foster child. 2. "Occupying" means in, upon, getting in, on, out or off. 3. "Transportation network platform" means an online- enabled application or digital network used to connect passengers with drivers using vehicles for the purpose of providing prearranged transportation services for compensation. 4. "Uninsured motor vehicle" means a land motor vehicle or "trailer": a. For which no liability bond or policy at the time of an "accident" provides at least the amounts required by the applicable law where a covered "auto" is principally garaged; b. That is an underinsured motor vehicle. An underinsured motor vehicle is a land motor vehicle or "trailer" for which the sum of all liability bonds or policies at the time of an "accident" provides at least the amounts required by the applicable law where a covered "auto" is principally garaged but that sum is less than the Limit of Insurance for this coverage; c. For which an insuring or bonding company denies coverage or refuses to admit coverage except conditionally or with reservation or becomes insolvent; d. That is a hit-and-run vehicle and neither the driver nor owner can be identified. The vehicle must make physical contact with an "insured", a covered "auto" or a vehicle an "insured" is "occupying"; or e. That is owned by an individual Named Insured or "family member" and operated or caused to be operated by a person without the owner's consent in connection with criminal activity that has been documented in a police report. However, "uninsured motor vehicle" does not include any vehicle: a. Owned or operated by a self -insurer under any applicable motor vehicle law except a self -insurer who is or becomes insolvent and cannot provide the amounts required by that motor vehicle law; b. Owned by the United States of America, Canada, a state or political subdivision of any of those governments or an agency of any of the foregoing; or c. Designed or modified for use primarily off public roads while not on public roads. © 2017 Liberty Mutual Insurance AC 21 16 11 16 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 4 of 4 Policy Number: Issued by: THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. State Application Of Terrorism Exclusion Endorsements This endorsement. modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM GARAGE COVERAGE FORM TRUCKERS COVERAGE FORM If part of your policy, the below described Exclusion of Terrorism endorsements shall apply as follows: " Exclusion of Terrorism - CA 23 84 01 06 This endorsement applies in all states except Alaska, Connecticut, Florida, Georgia, Hawaii, Kansas, Kentucky, Massachusetts, New Jersey, New York, Oklahoma, Oregon, Virginia and Washington. m Exclusion of Terrorism Above Minimum Statutory Limits - CA 23 86 01 06 This endorsement applies only in Connecticut, Hawaii, Kansas, Kentucky, Massachusetts, New Jersey, Oklahoma and Oregon. Alaska Exclusion of Terrorism Above Minimum Statutory Limits - CA 23 88 01 06 This endorsement applies only in Alaska. Washington Exclusion of Terrorism - CA 23 92 01 06 This endorsement applies only in the state of Washington. AC 84 60 06 14 © 2014 Liberty Mutual Group of Companies. All rights reserved. Page 1 of 1 Policy Number AC 84 70 05 15 Issued by THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PUNITIVE OR EXEMPLARY DAMAGES EXCLUSION CALIFORNIA This endorsement modifies insurance provided under the following.- BUSINESS ollowing: BUSINESS AUTO COVERAGE FORM AUTO DEALERS COVERAGE FORM GARAGE AUTO COVERAGE FORM TRUCKERS COVERAGE FORM MOTOR CARRIER COVERAGE FORM A. LIABILITY COVERAGE is changed by adding the following exclusion: Regardless of any other provision of this policy, this policy does not apply to (and no coverage is provided for) "punitive or exemplary damages" or any costs, attorney's fees, interest, "damages" or any other amounts attributable to "punitive or exemplary damages". However, if a suit is brought against an "insured" arising out of a claim which alleges both compensatory damages and "punitive or exemplary damages", we will defend the entire suit despite the fact that coverage only applies to (and we will only pay for) the covered compensatory damages. B. ADDITIONAL DEFINITION "Punitive or exemplary damages" include damages which are intended to punish or deter wrongful conduct, to set an example, to fine, penalize or impose a statutory penalty, and damages which are awarded for any purpose other than as compensatory damages for "bodily injury" or "property dam- age". AC 84 70 05 15 © 2015 Liberty Mutual Insurance Page 1 of 1 Includes copyrighted material of Insurance Services Office, Inc., with its permission. CA 00 01 03 06 BUSINESS AUTO COVERAGE FORM Various provisions in this policy restrict coverage. Read the entire policy carefully to determine rights, duties and what is and is not covered. Throughout this policy the words "you" and "your' refer to the Named Insured shown in the Declarations. The words "we", "us" and "our" refer to the Company providing this insurance. Other words and phrases that appear in quotation marks have special meaning. Refer to Section V - Definitions. SECTION I - COVERED AUTOS ITEM TWO of the Declarations shows the "autos" that are covered "autos" for each of your cov- erages. The following numerical symbols de- scribe the "autos" that may be covered "autos". The symbols entered next to a coverage on the Declarations designate the only "autos" that are covered "autos". A. Description Of Covered Auto Designation Symbols Symbol Description Of Covered Auto Designation Symbols 1 An "Auto" 2 Owned Only those "autos" you own (and for Liability Coverage any "trailers" "Autos" you don't own while attached to power units you own.) This includes OnIV those "autos" you acquire ownership of after the policy begins. 3 Owned Only the private passenger "autos" you own. This includes those private Private passenger "autos" you acquire ownership of after the policy begins. Passenger "Autos" Only 4 Owned Only those "autos" you own that are not of the private passenger type "Autos" Other (and for Liability Coverage any "trailers" you don't own while attached Than Private to power units you own). This includes those "autos" not of the Passenger private passenger type you acquire ownership of after the policy begins. "Autos" Only 5 Owned Only those "autos" you own that are required to have No -Fault benefits "Autos" in the state where they are licensed or principally garaged. This Subject includes those "autos" you acquire ownership of after the policy begins To No -Fault provided they are required to have No -Fault benefits in the state where they are licensed or Principally garaged. 6 Owned Only those "autos" you own that because of the law in the state where "Autos" they are licensed or principally garaged are required to have and Subject cannot reject Uninsured Motorists Coverage. This includes those To A "autos" you acquire ownership of after the policy begins provided Compulsory they are subject to the same state uninsured motorists requirement. Uninsured Motorists Law 7 Specifically Only those "autos" described in Item Three of Declarations for which Described a premium charge is shown (and for Liability Coverage any "trailers" "Autos" you don't own while attached to any power unit described in Item Three). 8 Hired "Autos" Only those "autos" you lease, hire, rent or borrow. This does not include Only any "auto" you lease, hire, rent, or borrow from any of your "employees", partners (if you are a partnership), members (if you are a limited liability com an or members of their households. CA 00 01 03 06 ©ISO Properties, Inc., 2005 Page 1 of 13 Symbol Description Of Covered Auto Desi nation Symbols 9 Non -Owned Only those "autos" you do not own, lease, hire, rent or borrow that "Autos" are used in connection with your business. This includes "autos" owned Only by your "employees", partners (if you are a partnership), members (if you are a limited liability company), or members of their households but only while used in vour business or Vour personal affairs. 19 Mobile Equip- Only those "autos" that are land vehicles and that would qualify under the ment Subject definition of "mobile equipment' under this policy if they were not To Compul- subject to a compulsory or financial responsibility law or other sory Or motor vehicle insurance law where they are licensed or principally garaged. Financial Responsibility Or Other Motor Vehicle Insurance Law Only B. Owned Autos You Acquire After The Policy Begins 1. If symbols 1, 2, 3, 4, 5, 6 or 19 are entered next to a coverage in ITEM TWO of the Declarations, then you have cov- erage for "autos" that you acquire of the type described for the remainder of the policy period. 2. But, if symbol 7 is entered next to a coverage in ITEM TWO of the Declara- tions, an "auto" you acquire will be a covered "auto" for that coverage only if: a. We already cover all "autos" that you own for that coverage or it re- places an "auto" you previously owned that had that coverage; and b. You tell us within 30 days after you acquire it that you want us to cover it for that coverage. C. Certain Trailers, Mobile Equipment And Tem- porary Substitute Autos If Liability Coverage is provided by this Cov- erage Form, the following types of vehicles are also covered "autos" for Liability Cov- erage: 1. "Trailers" with a load capacity of 2,000 pounds or less designed primarily for travel on public roads. 2. "Mobile equipment' while being carried or towed by a covered "auto." 3. 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: a. Breakdown; b. Repair; c. Servicing; d. "Loss"; or e. Destruction SECTION II - LIABILITY COVERAGE A. Coverage We will pay all sums an "insured" legally must pay as damages because of "bodily injury" or "property damage" to which this insurance applies, caused by an "accident' and resulting from the ownership, mainten- ance or use of a covered "auto." We will also pay all sums an "insured" le- gally must pay as a "covered pollution cost or expense" to which this insurance applies, caused by an "accident' and resulting from the ownership, maintenance or use of cov- ered "autos." However, we will only pay for the , "covered pollution cost or expense" if there is either "bodily injury" or "property damage" to which this insurance applies that is caused by the same "accident." We have the right and duty to defend any "insured" against a "suit' asking for such damages or a "covered pollution cost or ex- pense". However, we have no duty to defend any "insured" against a "suit' seeking dam- ages for "bodily injury" or "property dam- age" or a "covered pollution cost or expense" to which this insurance does not apply. We may investigate and settle any claim or "suit' as we consider appropriate. Our duty to defend or settle ends when the Liability Coverage Limit of Insurance has been exhausted by payment of judgments or settlements. 1. Who Is An Insured The following are "insureds": a. You for any covered "auto." b. Anyone else while using with your permission a covered "auto" you own, hire or borrow except: CA 00 01 03 06 ©ISO Properties, Inc., 2005 Page 2 of 13 (1) The owner or anyone else from whom you hire or borrow a cov- ered "auto". This exception does not apply if the covered "auto" is a "trailer" connected to a cov- ered "auto" you own. (2) Your "employee" if the covered "auto" is owned by that "em- ployee" or a member of his or her household. (3) Someone using a covered "auto" while he or she is work- ing in a business of selling, ser- vicing, repairing, parking or storing "autos" unless that busi- ness is yours. (4) Anyone other than your "em- ployees", partners (if you are a partnership), members (if you are a limited liability company), or a lessee or borrower or any of their "employees", while moving property to or from a covered "auto". (5) A partner (if you are a partner- ship), or a member (if you are a limited liability company), for a covered "auto" owned by him or her or a member of his or her household. c. Anyone liable for the conduct of an "insured" described above but only to the extent of that liability. 2. Coverage Extensions a. Supplementary Payments. We will pay for the "insured": (1) All expenses we incur. (2) Up to $2,000 for cost of bail bonds (including bonds for re- lated traffic law violations) re- quired because of an "accident' we cover. We do not have to furnish these bonds. (3) The cost of bonds to release at- tachments in any "suit' against the "insured" we defend, but only for bond amounts within our Limit of Insurance. (4) All reasonable expenses incurred by the "insured" at our request, including actual loss of earnings up to $250 a day because of time off from work. (5) All costs taxed against the "in- sured" in any "suit' against the "insured" we defend. (6) All interest on the full amount of any judgment that accrues after entry of the judgment in any "suit" against the "insured" we defend, but our duty to pay in- terest ends when we have paid, offered to pay or deposited in court the part of the judgment that is within our Limit of Insur- ance. These payments will not reduce the Limit of Insurance. b. Out of State Coverage Extensions. While a covered "auto" is away from the state where it is licensed we will: (1) Increase the Limit of Insurance for Liability Coverage to meet the limits specified by a compul- sory or financial responsibility law of the jurisdiction where the covered "auto" is being used. This extension does not apply to the limit or limits specified by any law governing motor carriers of passengers or property. (2) Provide the minimum amounts and types of other coverages, such as no-fault, required of out- of-state vehicles by the jurisdic- tion where the covered "auto" is being used. We will not pay anyone more than once for the same elements of loss because of these extensions. B. Exclusions This insurance does not apply to any of the following: 1. Expected Or Intended Injury "Bodily injury" or "property damage" ex- pected or intended from the standpoint of the "insured". 2. Contractual Liability assumed under any contract or agreement. But this exclusion does not apply to li- ability for damages: a. Assumed in a contract or agreement that is an "insured contract' pro- vided the "bodily injury" or "prop- erty damage" occurs subsequent to the execution of the contract or agreement; or CA 00 01 03 06 ©ISO Properties, Inc., 2005 Page 3 of 13 b. That the "insured" would have in the absence of the contract or agree- ment. 3. Workers' Compensation 4. Any obligation for which the "insured" or the "insured's" insurer may be held liable under any workers' compensation, disability benefits or unemployment com- pensation law or any similar law. Employee Indemnification And Employ- er's Liability "Bodily injury" to: a. An "employee" of the "insured" arising out of and in the course of: (1) Employement by the "insured"; or (2) Performing the duties related to the conduct of the "insured's" business; or b. The spouse, child, parent, brother or sister of that "employee" as a con- sequence of Paragraph a. above. This exclusion applies: (1) Whether the "insured" may be liable as an employer or in any other capacity; and (2) To any obligation to share dam- ages with or repay someone else who must pay damages because of the injury. But this exclusion does not apply to "bodily injury" to domestic "employees" not entitled to workers' compensation benefits or to liability assumed by the "insured" under an "insured contract". For the purposes of the Coverage Form, a domestic "employee" is a person en- gaged in household or domestic work performed principally in connection with a residence premises. Fellow Employee "Bodily injury" to any fellow "employee" of the "insured" arising out of and in the course of the fellow "employee's" em- ployment or while performing duties re- lated to the conduct of your business. 6. Care, Custody Or Control "Property damage" to or "covered pollution cost or expense" involving property owned or transported by the "insured" or in the "insured's" care, cus- tody or control. But this exclusion does not apply to liability assumed under a sidetrack agreement. 7. Handling Of Property "Bodily injury" or "property damage" re- sulting from the handling of property: a. Before it is moved from the place where it is accepted by the "insured" for movement into or onto the cov- ered "auto"; or b. After it is moved from the covered "auto" to the place where it is finally delivered by the "insured". 8. Movement Of Property By Mechanical Device "Bodily injury" or "property damage" re- sulting from the movement of property by a mechanical device (other than a hand truck) unless the device is attached to the covered "auto". 9. Operations "Bodily injury" or "property damage" arising out of the operation of: a. Any equipment listed in Paragraphs 6.b. and 6.c. of the definition of "mo- bile equipment"; or b. Machinery or equipment that is on, attached to, or part of, a land vehicle that would qualify under the defini- tion of "mobile equipment" if it were not subject to a compulsory or finan- cial responsibility law or other motor vehicle insurance law where it is li- censed or principally garaged. 10. Completed Operations "Bodily injury" or "property damage" arising out of your work after that work has been completed or abandoned. In this exclusion, your work means: a. Work or operations performed by you or on your behalf; and b. Materials, parts or equipment fur- nished in connection with such work or operations. CA 00 01 03 06 ©ISO Properties, Inc., 2005 Page 4 of 13 Your work includes warranties or repre- sentations made at any time with respect to the fitness, quality, durability or per- formance of any of the items included in Paragraphs a. or b. above. Your work will be deemed completed at the earliest of the following times: (1) When all of the work called for in your contract has been completed. (2) When all of the work to be done at the site has been completed if your contract calls for work at more than one site. (3) When that part of the work done at a job site has been put to its intended use by any person or organization other than another contractor or sub- contractor working on the same pro- ject. Work that may need service, main- tenance, correction, repair or replacement, but which is otherwise complete, will be treated as complet- ed. 11. Pollution "Bodily injury" or "property damage" arising out of the actual, alleged or threatened discharge, dispersal, seepage, migration, release or escape of "pollu- tants".- a. pollu- tants":a. That are, or that are contained in any property that is: (1) Being transported or towed by, handled, or handled for move- ment into, onto or from, the cov- ered "auto"; (2) Otherwise in the course of transit by or on behalf of the "insured"; or (3) Being stored, disposed of, treat ed or processed in or upon the covered "auto"; b. Before the "pollutants" or any prop- erty in which the "pollutants" are contained are moved from the place where they are accepted by the "in- sured" for movement into or onto the covered "auto"; or c. After the "pollutants" or any prop- erty in which the "pollutants" are contained are moved from the cov- ered "auto" to the place where they are finally delivered, disposed of or abandoned by the "insured". CA 00 01 03 06 ©ISO Properties, Paragraph a. above does not apply to fuels, lubricants, fluids, exhaust gas- es or other similar "pollutants" that are needed for or result from the normal electrical, hydraulic or me- chanical functioning of the covered "auto" or its parts, if: (1) The "pollutants" escape, seep, migrate, or are discharged, dis- persed or released directly from an "auto" part designed by its manufacturer to hold, store, re- ceive or dispose of such "pollu- tants"; and (2) The "bodily injury", "property damage" or "covered pollution cost or expense" does not arise out of the operation of any equipment listed in Paragraphs 6.b. and 6.c. of the definition of "mobile equipment". Paragraphs b. and c. above of this exclu- sion do not apply to "accidents" that occur away from premises owned by or rented to an "insured" with respect to "pollutants" not in or upon a covered "auto" if: (1) The "pollutants" or any property in which the "pollutants" are contained are upset, overturned or damaged as a result of the maintenance or use of a covered "auto"; and (2) The discharge, dispersal, seep- age, migration, release or escape of the "pollutants" is caused di- rectly by such upset, overturn or damage. 12. War "Bodily injury" or "property damage" arising directly or indirectly out of: a. War, including undeclared or civil war; b. Warlike action by a military force, including action in hindering or de- fending against an actual or expect- ed attack, by any government, sovereign or other authority using military personnel or other agents; or c. Insurrection, rebellion, revolution, usurped power, or action taken by governmental authority in hindering or defending against any of these. Inc., 2005 Page 5 of 13 13. Racing Covered "autos" while used in any pro- fessional or organized racing or demoli- tion contest or stunting activity, or while practicing for such contest or activity. This insurance also does not apply while that covered "auto" is being prepared for such a contest or activity. C. Limit Of Insurance Regardless of the number of covered "autos", "insureds", premiums paid, claims made or vehicles involved in the "accident", the most we will pay for the total of all damages and "covered pollution cost or ex- pense" combined, resulting from any one "accident" is the Limit of Insurance for Liabil- ity Coverage shown in the Declarations. All "bodily injury," "property damage" and "covered pollution cost or expense" resulting from continuous or repeated exposure to substantially the same conditions will be con- sidered as resulting from one "accident". No one will be entitled to receive duplicate payments for the same elements of "loss" under this Coverage Form and any Medical Payments Coverage Endorsement, Uninsured Motorists Coverage Endorsement or Underin- sured Motorists Coverage Endorsement at- tached to this Coverage Part. SECTION III - PHYSICAL DAMAGE COVERAGE A. Coverage 1. We will pay for "loss" to a covered "auto" or its equipment under: a. Comprehensive Coverage. From any cause except: (1) The covered "auto's" collision with another object; or (2) The covered "auto's" overturn. b. Specified Causes of Loss Coverage. Caused by: (1) Fire, lightning or explosion; (2) Theft; (3) Windstorm, hail or earthquake; (4) Flood; (5) Mischief or vandalism; or (6) The sinking, burning, collision or derailment of any conveyance transporting the covered "auto". c. Collision Coverage. Caused by: (1) The covered "auto's" collision with another object; or (2) The covered "auto's" overturn. CA 00 01 03 06 ©ISO Properties, 2. Towing. We will pay up to the limit shown in the Declarations for towing and labor costs incurred each time a covered "auto" of the private passenger type is disabled. However, the labor must be performed at the place of disablement. 3. Glass Breakage - Hitting a Bird or Ani- mal - Falling Objects or Missiles. If you carry Comprehensive Coverage for the damaged covered "auto", we will pay for the following under Comprehen- sive Coverage: a. Glass breakage; b. "Loss" caused by hitting a bird or animal; and c. "Loss" caused by falling objects or missiles. However, you have the option of having glass breakage caused by a covered "auto's" collision or overturn considered a "loss" under Collision Coverage. 4. Coverage Extensions a. Transporation Expenses We will pay up to $20 per day to a maximum of $600 for temporary transportation expense incurred by you because of the total theft of a covered "auto" of the private pas- senger type. We will pay only for those covered "autos" for which you carry either Comprehensive or Speci- fied Causes of Loss Coverage. We will pay for temporary transportation expenses incurred during the period beginning 48 hours after the theft and ending, regardless of the poli- cy's expiration, when the covered "auto" is returned to use or we pay for its "loss". b. Loss Of Use Expenses For Hired Auto Physical Damage, we will pay expenses for which an "in- sured" becomes legally responsible to pay for loss of use of a vehicle rented or hired without a driver, un- der a written rental contract or agreement. We will pay for loss of use expenses if caused by: (1) Other than collision only if the Declarations indicate that Com- prehensive Coverage is provided for any covered "auto"; Inc., 2005 Page 6 of 13 (2) Specified Causes Of Loss only if 3. We will not pay for "loss" caused by or the Declarations indicate that resulting from any of the following un - Specified Causes Of Loss Cov- less caused by other "loss" that is cov- erage is provided for any cov- ered by this insurance: ered "auto; or a. Wear and tear, freezing, (3) Collision only if the Declarations mechanical or electrical break - indicate that Collision Coverage down. is provided for any covered "auto". b. Blowouts, punctures or other However, the most we will pay for road damage to tires. any expenses for loss of use is $20 4. We will not pay for "loss" to any of the per day, to a maximum of $600. following: B. Exclusions a. Tapes, records, discs or other similar 1. We will not pay for "loss" caused by or audio, visual or data electronic de - resulting from any of the following. Such vices designed for use with audio, "loss" is excluded regardless of any oth- visual or data electronic equipment. er cause or event that contributes con- b. Any device designed or used to de - currently or in any sequence to the tect speed measuring equipment ,'loss". such as radar or laser detectors and a. Nuclear Hazard. any jamming apparatus intended to o elude or disrupt speed measurement (1) The explosion of any weapon equipment. employing atomic fission or fu- sion; or c. Any electronic equipment, without regard to whether this equipment is (2) Nuclear reaction or radiation, or permanently installed, that receives radioactive contamination, how- or transmits audio, visual or data N ever caused. signals and that is not designed sole - b. War or Military Action. ly for the reproduction of sound. (1) War, including undeclared or civ- d. Any accessories used with the elec- il war; tronic equipment described in (2) Warlike action by a military Paragraph c. above. force, including action in hinder- Exclusions 4.c. and 4.d. do not apply to: ing or defending against an ac- a. Equipment designed solely for the tual or expected attack, by any reproduction of sound and accesso- government, sovereign or other ries used with such equipment, pro - authority using military person- vided such equipment is nel or other agents; or permanently installed in the covered (3) Insurrection, rebellion, revolu- "auto" at the time of the "loss" or tion, usurped power or action such equipment is removable from a m taken by governmental authority housing unit which is permanently in hindering or defending against installed in the covered "auto" at the any of these. time of the "loss", and such equip - 2. We will not pay for "loss" to any cov- ment is designed to be solely op- ered "auto" while used in any profes- erated by use of the power from the "auto's" sional or organized racing or demolition electrical system, in or upon "auto"; contest or stunting activity, or while the covered or practicing for such contest or activity. We b. Any other electronic equipment that will also not pay for "loss" to any cov- is: ered "auto" while that covered "auto" is (1) Necessary for the normal opera - being prepared for such a contest or ac- tion of the covered "auto" or the tivity. monitoring of the covered "auto's" operating system; or CA 00 01 03 06 ©ISO Properties, Inc., 2005 Page 7 of 13 (2) An integral part of the same unit a. Pay its chosen appraiser; and housing any sound reproducing b. Bear the other expenses of the ap- equipment described in a. above praisal and umpire equally. and permanently installed in the opening of the dash or console If we submit to an appraisal, we will still of the covered "auto" normally retain our right to deny the claim, used by the manufacturer for in- 2. Duties In The Event Of Accident, Claim, stallation of a radio. Suit Or Loss 5. We will not pay for "loss" to a covered We have no duty to provide coverage "auto" due to "diminution in value". under this policy unless there has been C. Limit Of Insurance full compliance with the following duties: 1. The most we will pay for "loss" in any a. In the event of "accident", claim, one "accident" is the lesser of: "suit" or "loss", you must give us or our authorized representative prompt a. The actual cash value of the damag- notice of the "accident" or "loss". ed or stolen property as of the time Include: of the "loss"; or (1) How, when and where the "ac - b. The cost of repairing or replacing the cident" or "loss" occurred; damaged or stolen property with oth- er property of like kind and quality. (2) The "insured's" name and ad - dress; and 2. An adjustment for depreciation and phys- ical condition will be made in (3) To the extent possible, the determining actual cash value in the names and addresses of any in - event of a total "loss". jured persons and witnesses. 3. If a repair or replacement results in bet- b. Additionally, you and any other in - ter than like kind or quality, we will not volved "insured" must: pay for the amount of the betterment. (1) Assume no obligation, make no D. Deductible payment or incur no expense without our consent, except at For each covered "auto", our obligation to the "insured's" own cost. pay for, repair, return or replace damaged or stolen property will be reduced by the ap- (2) Immediately send us copies of plicable deductible shown in the Declara- any request, demand, order, no- tions. Any Comprehensive Coverage tice, summons or legal paper re - deductible shown in the Declarations does ceived concerning the claim or not apply to "loss" caused by fire or light- "suit". ning. (3) Cooperate with us in the inves- SECTION IV - BUSINESS AUTO CONDITIONS tigation or settlement of the claim or defense against the The following conditions apply in addition to the "suit". Common Policy Conditions: (4) Authorize us to obtain medical ° A. Loss Conditions records or other pertinent infor- 1. Appraisal For Physical Damage Loss mation. If you and we disagree on the amount of (5) Submit to examination, at our "loss", either may demand an appraisal expense, by physicians of our of the "loss". In this event, each party choice, as often as we reason - will select a competent appraiser. The ably require. two appraisers will select a competent c. If there is "loss" to a covered "auto" and impartial umpire. The appraisers will or its equipment you must also do state separately the actual cash value the following: and amount of "loss". If they fail to agree, they will submit their differences (1) Promptly notify the police if the to the umpire. A decision agreed to by covered "auto" or any of its any two will be binding. Each party will: equipment is stolen. CA 00 01 03 06 ©ISO Properties, Inc., 2005 Page 8 of 13 (2) Take all reasonable steps to pro- tect the covered "auto" from fur- ther damage. Also keep a record of your expenses for consider- ation in the settlement of the claim. (3) Permit us to inspect the covered "auto" and records proving the "loss" before its repair or dis- position. (4) Agree to examinations under oath at our request and give us a signed statement of your an- swers. 3. Legal Action Against Us No one may bring a legal action against us under this Coverage Form until: a. There has been full compliance with all the terms of this Coverage Form; and b. Under Liability Coverage, we agree in writing that the "insured" has an obligation to pay or until the amount of that obligation has finally been determined by judgment after trial. No one has the right under this poli- cy to bring us into an action to deter- mine the "insured's" liability. 4. Loss Payment - Physical Damage Coverages At our option we may: a. Pay for, repair or replace damaged or stolen property; b. Return the stolen property, at our ex- pense. We will pay for any damage that results to the "auto" from the theft; or C. Take all or any part of the damaged or stolen property at an agreed or appraised value. If we pay for the "loss", our payment will include the applicable sales tax for the damaged or stolen property. 5. Transfer Of Rights Of Recovery Against Others To Us If any person or organization to or for whom we make payment under this Cov- erage Form has rights to recover dam- ages from another, those rights are transferred to us. That person or organi- zation must do everything necessary to secure our rights and must do nothing after "accident" or "loss" to impair them. B. General Conditions 1. Bankruptcy Bankruptcy or insolvency of the "in- sured" or the "insured's" estate will not relieve us of any obligations under this Coverage Form. 2. Concealment, Misrepresentation Or Fraud This Coverage Form is void in any case of fraud by you at any time as it relates to this Coverage Form. It is also void if you or any other "insured", at any time, intentionally conceal or misrepresent a material fact concerning: a. This Coverage Form; b. The covered "auto"; c. Your interest in the covered "auto"; or d. A claim under this Coverage Form 3. Liberalization If we revise this Coverage Form to pro- vide more coverage without additional premium charge, your policy will auto- matically provide the additional coverage as of the day the revision is effective in your state. 4. No Benefit To Bailee - Physical Damage Coverages We will not recognize any assignment or grant any coverage for the benefit of any person or organization holding, storing or transporting property for a fee regard- less of any other provision of this Cov- erage Form. CA 00 01 03 06 ©ISO Properties, Inc., 2005 Page 9 of 13 5. Other Insurance b. If this policy is issued for more than a. For any covered "auto" you own, one year, the premium for this Cov- erage Form will be computed annu- this Coverage Form provides primary "auto" ally based on our rates or premiums insurance. For any covered in effect at the beginning of each you don't own, the insurance pro- year of the policy. vided by this Coverage Form is ex- cess over any other collectible 7. Policy Period, Coverage Territory insurance. However, while a covered Under this Coverage Form, we cover "ac - "auto" which is a "trailer" is con- cidents" and "losses" occurring: nected to another vehicle, the Liabil- ity Coverage this Coverage Form a. During the policy period shown in provides for the "trailer" is: the Declarations; and (1) Excess while it is connected to a b. Within the coverage territory. motor vehicle you do not own. The coverage territory is: (2) Primary while it is connected to a. The United States of America; a covered "auto" you own. b. The territories and possessions of b. For Hired Auto Physical Damage the United States of America; Coverage, any covered "auto" you c. Puerto Rico; lease, hire, rent or borrow is deemed to be a covered "auto" you own. d. Canada; and However, any "auto" that is leased, e. Anywhere in the world if: hired, rented or borrowed with a driver is not a covered "auto". (1) A covered "auto" of the private passenger type is leased, hired, c. Regardless of the provisions of Para- rented or borrowed without a graph a. above, this Coverage Form's driver for a period of 30 days or Liability Coverage is primary for any less; and liability assumed under an "insured contract". (2) The "insured's" responsibility to pay damages is determined in a d. When this Coverage Form and any "suit" on the merits, in the Unit - other Coverage Form or policy cov- ed States of America, the ter- ers on the same basis, either excess ritories and possessions of the or primary, we will pay only our United States of America, Puerto share. Our share is the proportion Rico, or Canada or in a settle - that the Limit of Insurance of our ment we agree to. Coverage Form bears to the total of the limits of all the Coverage Forms We also cover "loss" to, or "accidents" and policies covering on the same involving, a covered "auto" while being basis. transported between any of these places. 6. Premium Audit 8. Two Or More Coverage Forms Or Poli- cies Issued By Us a. The estimated premium for this Cov- If this Coverage Form and any other Cov- erage Form is based on the expo- erage erage Form or policy issued to you by us you told us you would have or any company affiliated with us apply when this policy began. We will compute the final premium due to the same "accident", the aggregate when we determine your actual ex- maximum Limit of Insurance under all posures. The estimated total premi- the Coverage Forms or policies shall not um will be credited against the final exceed the highest applicable Limit of premium due and the first Named Insurance under any one Coverage Form Insured will be billed for the balance, or policy. This condition does not apply if any. If the estimated total premium to any Coverage Form or policy issued exceeds the final premium due, the by us or an affiliated company specifi- first Named Insured will get a re- cally to apply as excess insurance over fund. this Coverage Form. CA 00 01 03 06 ©ISO Properties, Inc., 2005 Page 10 of 13 SECTION V - DEFINITIONS b. Before the "pollutants" or any prop - A. "Accident" includes continuous or repeated erty in which the "pollutants" are exposure to the same conditions resulting in contained are moved from the place "bodily injury" or "property damage". where they are accepted by the "in - B. "Auto" means; sured" for movement into or onto the covered "auto"; or 1. Aland motor vehicle, "trailer" or semi - trailer designed for travel on public c. After the "pollutants" or any prop - roads; or erty in which the "pollutants" are 2. Any other land vehicle that is subject to contained are moved from the cov- "auto" a compulsory or financial responsbility ered to the place where they law or other motor vehicle insurance law are finally delivered, disposed of or where it is licensed or principally ga- abandoned by the "insured." raged. Paragraph a. above does not apply to However, "auto" does not include "mobile fuels, lubricants, fluids, exhaust gas - equipment". es or other similar "pollutants" that are needed for or result from the C. "Bodily injury" means bodily injury, sickness normal electrical, hydraulic or me - or disease sustained by a person including chanical functioning of the covered death resulting from any of these. "auto" or its parts, if: D. "Covered pollution cost or expense" means (1) The "pollutants" escape, seep, o any cost or expense arising out of: migrate, or are discharged, dis- 1. Any request, demand, order or statutory persed or released directly from or regulatory requirement that any "in- an "auto" part designed by its sured" or others test for, monitor, clean manufacturer to hold, store, re - up, remove, contain, treat, detoxify or ceive or dispose of such "pollu- neutralize, or in any way respond to, or tants"; and assess the effects of "pollutants"; or (2) The "bodily injury," "property 2. Any claim or "suit" by or on behalf of a damage" or "covered pollution governmental authority for damages be- cost or expense" does not arise cause of testing for, monitoring, cleaning out of the operation of any up, removing, containing, treating, detox- equipment listed in Paragraphs ifying or neutralizing, or in any way re- 6.b. or 6.c. of the definition of sponding to or assessing the effects of "mobile equipment." "pollutants". Paragraphs b. and c. above do not "Covered pollution cost or expense" does not apply to "accidents" that occur away include any cost or expense arising out of from premises owned by or rented the actual, alleged or threatened discharge, to an "insured" with respect to "pol- dispersal, seepage, migration, release or es- lutants" not in or upon a covered cape of "pollutants": "auto" if: m a. That are, or that are contained in any (1) The "pollutants" or any property ° property that is: in which the "pollutants" are contained are upset, overturned (1) Being transported or towed by, or damaged as a result of the handled, or handled for move- maintenance or use of a covered ment into, onto or from the cov- "auto"; and ered "auto"; (2) Otherwise in the course of transit by or on behalf of the "insured"; (3) Being stored, disposed of, treat- ed or processed in or upon the covered "auto"; or (2) The discharge, dispersal, seep- age, migration, release or escape of the "pollutants" is caused di- rectly by such upset, overturn or damage. CA 00 01 03 06 ©ISO Properties, Inc., 2005 Page 11 of 13 E. "Diminution in value" means the actual or perceived loss in market value or resale val- ue which results from a direct and accidental "loss". F. "Employee" includes a 'leased worker". "Employee" does not include a "temporary worker". G. "Insured" means any person or organization qualifying as an insured in the Who Is An Insured provision of the applicable coverage. Except with respect to the Limit of Insurance, the coverage afforded applies separately to each insured who is seeking coverage or against whom a claim or "suit' is brought. H. "Insured contract' means: 1. A lease of premises; 2. A sidetrack agreement; 3. Any easement or license agreement, ex- cept in connection with construction or demolition operations on or within 50 feet of a railroad; 4. An obligation, as required by ordinance, to indemnify a municipality, except in connection with work for a municipality; 5. That part of any other contract or agree- ment pertaining to your business (includ- ing an indemnification of a municipality in connection with work performed for a municipality) under which you assume the tort liability of another to pay for "bodily injury" or "property damage" to a third person or organization. Tort liabil- ity means a liability that would be im- posed by law in the absence of any contract or agreement. 6. That part of any contract or agreement entered into, as part of your business, pertaining to the rental of lease, by you or any of your "employees", of any "auto." However, such contract or agree- ment shall not be considered an "insured contract' to the extent that it obligates you or any of your "employees" to pay for "property damage" to any "auto" re- nted or leased by you or any of your "employees". An "insured contract' does not include that part of any contract or agreement: a. That indemnifies a railroad for "bod- ily injury" or "property damage" arising out of construction or demoli- tion operations, within 50 feet of any railroad property and affecting any railroad bridge or trestle, tracks, road beds, tunnel, underpass or crossing; or b. That pertains to the loan, lease or rental of an "auto" to you or any of your "employees", if the "auto" is loaned, leased or rented with a driv- er; or c. That holds a person or organization engaged in the business of transport- ing property by "auto" for hire harm- less for your use of a covered "auto" over a route or territory that person or organization is authorized to serve by public authority. I. "Leased worker" means a person leased to you by a labor leasing firm under an agree- ment between you and the labor leasing firm, to perform duties related to the conduct of your business. "Leased worker" does not in- clude a "temporary worker". J. "Loss" means direct and accidental loss or damage. K. "Mobile equipment' means any of the fol- lowing types of land vehicles, including any attached machinery or equipment: 1. Bulldozers, farm machinery, forklifts and other vehicles designed for use princi- pally off public roads; 2. Vehicles maintained for use solely on or next to premises you own or rent; 3. Vehicles that travel on crawler treads; 4. Vehicles, whether self-propelled or not, maintained primarily to provide mobility to permanently mounted: a. Power cranes, shovels, loaders, dig- gers or drills; or b. Road construction or resurfacing equipment such as graders, scrapers or rollers. CA 00 01 03 06 ©ISO Properties, Inc., 2005 Page 12 of 13 5. Vehicles not described in Paragraphs 1., L. "Pollutants" means any solid, liquid, gaseous 2., 3., or 4. above that are not self-pro- or thermal irritant or contaminant, including pelled and are maintained primarily to smoke, vapor, soot, fumes, acids, alkalis, provide mobility to permanently attached chemicals and waste. Waste includes materi- equipment of the following types: als to be recycled, reconditioned or re- a. Air compressors, pumps and gener- claimed. ators, including spraying, welding, M. "Property damage" means damage to or loss building cleaning, geophysical explo- of use of tangible property. ration, lighting and well servicing N. "Suit" means a civil proceeding in which: equipment; or 1. Damages because of "bodily injury" or b. Cherry pickers and similar devices "property damage"; or used to raise or lower workers. 2. A "covered pollution cost or expense", 6. Vehicles not described in Paragraphs 1., 2., 3. or 4. above maintained primarily to which this insurance applies, are alleged. for purposes other than the transporta- "Suit" includes: tion of persons or cargo. However, self- propetled vehicles with the following a. An arbitration proceeding in which types of permanently attached equipment such damages or "covered pollution are not "mobile equipment" but will be costs or expenses" are claimed and considered "autos": to which the "insured" must submit or does submit with our consent; or a. Equipment designed primarily for: b. Any other alternative dispute resolu- (1) Snow removal; tion proceeding in which such dam- (2) Road maintenance, but not con- ages or "covered pollution costs or struction or resurfacing; or expenses" are claimed and to which the insured submits with our con- (3) Street cleaning; sent. b. Cherry pickers and similar devices mounted on automobile or truck O. "Temporary worker" means a person who is chassis and used to raise or lower furnished to you to substitute for a perma- workers; and nent "employee" on leave or to meet sea- sonal or short-term workload conditions. c. Air compressors, pumps and gener£tors, including spraying, weld- ing, building cleaning, geophysical exploration, lighting or well servicing equipment. However, "mobile equipment" does not in- clude land vehicles that are subject to a com- pulsory or financial responsibility law or other motor vehicle insurance law where it is m licensed or principally garaged. Land vehicles subject to a compulsory or financial respon- sibility law or other motor vehicle insurance law are considered "autos". CA 00 01 03 06 ©ISO Properties, Inc., 2005 Page 13 of 13 COMMERCIAL AUTO CA 01 43 05 17 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CALIFORNIA CHANGES For a covered "auto" licensed or principally garaged in, or "auto dealer operations" conducted in, Califor- nia, this endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. A. The following are added to the Other Insur- b. The other provides coverage to a ance Condition in the Auto Dealers and Busi- person not engaged in that business; ness Auto Coverage Forms and the Other In- and surance - Primary And Excess Insurance c. At the time of an "accident", an "in - Provisions Condition in the Motor Carrier sured" under the Coverage Form de - Coverage Form and supersede any provisions scribed in Paragraph 2.a. is operating to the contrary: an "auto" owned by a person de - 1. When this Coverage Form and any other scribed in Paragraph 2.b., then the Coverage Form or policy providing liabil- Coverage Form issued to the busi- ity coverage apply to an "auto" and: ness described in Paragraph 2.a. is a. One provides coverage to a Named primary and the liability coverage is - Insured engaged in the business of sued to a person described in Para - selling, repairing, servicing, graph 2.b. is excess over any cover - delivering, testing or road-testing age available to the business. "autos"; and 3. When this Coverage Form and any other b. The other provides coverage to a Coverage Form or policy providing liabil- person not engaged in that business; ity coverage apply to a "commercial ve- and hicle" and: c. At the time of an "accident", a per- a. One provides coverage to a Named son described in Paragraph 1.b. is Insured, who in the course of busi- operating an "auto" owned by the ness, rents or leases "commercial business described in Paragraph 1.a., vehicles" without operators; and then that person's liability coverage b. The other provides coverage to a is primary and the Coverage Form is- person other than as described in sued to a business described in Para- Paragraph 3.a.; and graph 1.a. is excess over any cover- c. At the time of an "accident", a per - age available to that person. son who is not the Named Insured of 2. When this Coverage Form and any other the Policy described in Paragraph Coverage Form or policy providing liabil- 3.a., and who is not the agent or ity coverage apply to an "auto" and: "employee" of such Named Insured, a. One provides coverage to a Named is operating a "commercial vehicle" Insured engaged in the business of provided by the business covered by selling, repairing, servicing, the Coverage Form or policy de - delivering, testing or road-testing scribed in Paragraph 3.a., then the li- "autos"; and ability coverage provided by the Cov- erage Form or policy described in Paragraph 3.b. is primary, and the li- ability coverage provided by the Cov- erage Form or policy described in Paragraph 3.a. is excess over any coverage available to that person. CA 01 43 05 17 © Insurance Services Office, Inc., 2016 Page 1 of 2 4. Notwithstanding Paragraph A.3., when this Coverage Form and any other Cov- erage Form or policy providing liability coverage apply to a power unit and any connected "trailer" or "trailers" and: a. One provides coverage to a Named Insured engaged in the business of transporting property by "auto" for hire; and b. The other provides coverage to a Named Insured not engaged in that business; and c. At the time of an "accident", a power unit is being operated by a person in- sured under the Coverage Form or policy described in Paragraph 4.a., then that Coverage Form or policy is primary for both the power unit and any connected "trailer" or "trailers" and the Coverage Form or policy de- scribed in Paragraph 4.b. is excess over any other coverage available to such power unit and attached "trail- er" or "trailers". B. As used in this endorsement: "Commercial vehicle" means an "auto" sub- ject to registration or identification under California law which is: I. Used or maintained for the transportation of persons for hire, compensation or profit; 2. Designed, used or maintained primarily for the transportation of property; or 3. Leased for a period of six months or more. Page 2 of 2 © Insurance Services Office, Inc., 2016 CA 01 43 05 17 POLICY NUMBER: COMMERCIAL AUTO CA 03 05 02 97 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CALIFORNIA CHANGES - WAIVER OF COLLISION DEDUCTIBLE For a covered "auto" licensed or principally garaged in or "garage operations" conducted in California this endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM BUSINESS AUTO PHYSICAL DAMAGE COVERAGE FORM GARAGE COVERAGE FORM MOTOR CARRIER COVERAGE FORM TRUCKERS COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. Endorsement Effective: Countersigned By: (Authorized Representative) Named Insured: SCHEDULE Waiver Of Collision Deductible Designation Or Description Of Covered "Auto" Premium (If no entry appears above, information required to complete this endorsement will be shown in the Declara- tions as applicable to this endorsement.) A. When Physical Damage Coverage provides coverage for a "loss" to a covered "auto" caused by its collision or upset, and: 1. The "loss" involves an "uninsured motor vehicle"; and 2. You are legally entitled to recover the full amount of your 'loss" from the owner or operator of the "uninsured motor vehi- cle"; and 3. The Schedule indicates that the Waiver Of Collision deductible provision applies to the covered "auto"; then We will pay the full deductible. Subject to the above, if you are legally entitled to recover only a percentage of your "loss", we will pay that percentage of your deductible. However, if the amount of the 'loss" is less than your deductible, we will pay the percentage of the "loss" that you are legally entitled to recover. In no event will we pay more than the amount of the "loss". CA 03 05 02 97 Copyright, Insurance Services Office, Inc., 1996 Page 1 of 2 B. Conditions (2) A vehicle designed, used or 1. The following is added to the Conditions maintained primarily for the Section: transportation of property; or ARBITRATION (3) "Mobile equipment'. a. If we and an "insured" disagree b. "Uninsured motor vehicle" means a whether the "insured" is legally en- land motor vehicle or trailer which is titled to recover damages from the involved in a collision with a covered owner or operator of an "uninsured "auto" and for which: motor vehicle" or do not agree as to (1) No liability bond or policy at the the amount of damages that are re- time of an "accident' provides at coverable by that "insured", the dis- least the amount required for agreement will be settled by a single property damage liability by the neutral arbitrator. However, disputes California Financial Responsibil- concerning coverage under this en- ity Law; or dorsement may not be arbitrated. (2) The insuring or bonding com- The arbitration must be formally pany denies coverage or refuses instituted by the "insured" within to admit coverage except condi- one year from the date of the "ac- tionally or with reservation or cident". Each party will bear the ex- becomes insolvent. penses of the arbitrator equally. o The collision must involve direct b. Unless both parties agree otherwise, physical contact between a covered arbitration will take place in the "auto" and the "uninsured motor ve- county in which the "insured" lives. hicle" and: Local rules of law as to arbitration procedure and evidence will apply. (1) The owner or operator of that ve- The decision of the arbitrator will be hicle must be identified; or binding. (2) The "uninsured motor vehicle" 2. Paragraph 2.a. of the Duties In The Event must be identified by its license Of Accident, Claim, Suit Or Loss Loss number. Condition is replaced as follows: However, "uninsured motor vehicle" a. You must report the "accident' or does not include any vehicle: "loss" to us or our agent within ten (1) Owned or operated by a self -in - business days. You must tell us how, surer under any applicable mo - when and where the 'loss" hap- for vehicle law except a self-in- pened. You must assist in obtaining surer who is or becomes names and addresses of any injured insolvent and cannot provide the persons and witnesses. amounts required by that motor C. Additional Definitions vehicle law; (2) Owned by a governmental unit As used in this endorsement: or agency; or 1. For Physical Damage Coverage: o (3) Designed for use mainly off pub - a. "Auto" means a self-propelled motor lic roads while not on public vehicle. However, it does not in- roads. clude: (1) A vehicle transporting persons for hire, compensation or profit, other than a van pool vehicle; CA 03 05 02 97 Copyright, Insurance Services Office, Inc., 1996 Page 2 of 2 COMMERCIAL AUTO CA 04 24 04 06 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CALIFORNIA AUTO MEDICAL PAYMENTS COVERAGE This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM GARAGE COVERAGE FORM MOTOR CARRIER COVERAGE FORM TRUCKERS COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. A. Coverage 4. "Bodily injury" to your "employee" aris- We will pay reasonable expenses incurred for ing out of and in the course of employ - necessary medical and funeral services to or ment by you. However, we will cover for an "insured" who sustains "bodily injury' "bodily injury" to your domestic "em - caused by "accident". We will pay only those ployees" if not entitled to workers' com- expenses incurred, for services rendered pensation benefits. For the purposes of within three years from the date of the "ac- this endorsement, a domestic "employ- cident". ee" is a person engaged in household or domestic work performed principally in B. Who Is An Insured connection with a residence premises. 1. You while "occupying" or, while a pedes- 5. "Bodily injury" to an "insured" while trian, when struck by any "auto". working in a business of selling, servic- 2. If you are an individual, any "family ing, repairing or parking "autos" unless member" while "occupying" or, while a that business is yours. pedestrian, when struck by any "auto". 6. "Bodily injury" arising directly or indi- 3. Anyone else "occupying" a covered rectly out of: "auto" or a temporary substitute for a a. War, including undeclared or civil covered "auto". The covered auto' must be out of service because of its war; breakdown, repair, servicing, loss or de- b. Warlike action by a military force, in- struction. cluding action in hindering or de- fending against an actual or expect - C. Exclusions ed attack, by any government, This insurance does not apply to any of the sovereign or other authority using following: military personnel or other agents; 1. "Bodily injury" sustained by an "in- or sured" while "occupying" a vehicle locat- c. Insurrection, rebellion, revolution, ed for use as a premises. usurped power, or action taken by 2. "Bodily injury" sustained by you or any governmental authority in hindering "family member" while "occupying" or or defending against any of these. struck by any vehicle (other than a cov- 7. "Bodily injury" to anyone using a vehicle ered "auto") owned by you or furnished without a reasonable belief that the per - or available for your regular use. son is entitled to do so. 3. "Bodily injury" sustained by any "family member" while "occupying" or struck by any vehicle (other than a covered "auto") owned by or furnished or available for the regular use of any "family member". CA 04 24 04 06 © ISO Properties, Inc., 2005 Page 1 of 2 8. "Bodily injury" sustained by an "in- E. Changes In Conditions sured" while "occupying" any covered The Conditions are changed for Auto Medical "auto" while used in any professional Payments Coverage as follows: racing or demolition contest or stunting activity, or while practicing for such con- 1. The Transfer Of Rights Of Recovery test or activity. This insurance also does Against Others To Us Condition does not not apply to any "bodily injury" sus- apply. tained by an "insured" while the "auto" 2. The reference in Other Insurance in the is being prepared for such a contest or Business Auto and Garage Coverage activity. Forms and Other Insurance - Primary D. Limit Of Insurance And Excess Insurance Provisions in the Truckers and Motor Carrier Coverage Regardless of the number of covered "autos", Forms to "other collectible insurance" "insureds", premiums paid, claims made or applies only to other collectible auto vehicles involved in the "accident", the most medical payments insurance. we will pay for "bodily injury" for each "in- sured" injured in any one "accident" is the F. Additional Definitions Limit Of Insurance for Auto Medical Pay- As used in this endorsement: ments Coverage shown in the Declarations. 1. "Family member" means a person relat- No one will be entitled to receive duplicate ed to you by blood, adoption, marriage or payments for the same elements of "loss" registered domestic partnership under under this coverage and any Liability Cover- California law, who is a resident of your age Form, Uninsured Motorists Coverage En- household, including a ward or foster dorsement or Underinsured Motorists Cover- child. age Endorsement attached to this Coverage 2. "Occupying" means in, upon, getting in, Part. on, out or off. CA 04 24 04 06 © ISO Properties, Inc., 2005 Page 2 of 2 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CA 20 48 02 99 DESIGNATED INSURED ENDORSEMENT The endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM GARAGE COVERAGE FORM MOTOR CARRIER COVERAGE FORM TRUCKERS COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. This endorsement identifies person(s) or organization(s) who are "insureds" under the WHO IS AN IN- SURED provision of the Coverage Form. This endorsement does not alter coverage provided in the Cov- erage Form. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Endorsement Effective Policy Number Named Insured Countersi ned b SCHEDULE Name of Person(s) or Organization(s) City of La Canada Flintridge 1327 Foothill Blvd. La Canada Flintridge, CA 91011 (Authorized Representative) (If no entry appears above, information required to complete this endorsement will be shown in the Declara- tions as applicable to this endorsement.) Each person or organization shown in the Schedule is an "insured" for LIABILITY COVERAGE, but only to the extent that person or organization qualifies as an "insured" under the WHO IS AN INSURED provision contained in SECTION II of the Coverage Form. CA 20 48 02 99 Copyright, Insurance Services Office, Inc.. 1998 Page 1 Of 1 COMMERCIAL AUTO CA 23 45 11 16 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PUBLIC OR LIVERY PASSENGER CONVEYANCE AND ON -DEMAND DELIVERY SERVICES EXCLUSION This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. A. Changes In Covered Autos Liability Cov- erage The following exclusion is added: Public Or Livery Passenger Conveyance And On -demand Delivery Services This insurance does not apply to any cov- ered "auto" while being used: 1. As a public or livery conveyance for passengers. This includes, but is not limited to, any period of time a covered "auto" is being used by an "insured" who is logged into a "transportation network platform" as a driver, whether or not a passenger is "occupying" the covered "auto"; or 2. By an "insured" who is logged into a "transportation network platform" or "delivery network platform" as a driver to provide "delivery services", whether or not the goods, items or products to be delivered are in the covered "auto". B. Changes In Physical Damage Coverage The following exclusion is added: We will not pay for "loss" to any covered "autos" while being used: 1. As a public or livery conveyance for passengers. This includes, but is not limited to, any period of time a covered "auto" is being used by an "insured" who is logged into a "transportation network platform" as a driver, whether or not a passenger is "occupying" the covered "auto"; or 2. By an "insured" who is logged into a "transportation network platform" or "delivery network platform" as a driver to provide "delivery services", whether or not the goods, items or products to be delivered are in the covered "auto". C. Changes In Auto Medical Payments If Auto Medical Payments Coverage is at- tached, then the following exclusion is added: Public Or Livery Passenger Conveyance and On -demand Delivery Services This insurance does not apply to: "Bodily injury" sustained by an "insured" "occupying" a covered "auto" while it is being used: 1. As a public or livery conveyance for passengers. This includes, but is not limited to, any period of time a covered "auto" is being used by an "insured" who is logged into a "transportation network platform" as a driver, whether or not a passenger is "occupying" the covered "auto"; or 2. By an "insured" who is logged into a "transportation network platform" or "delivery network platform" as a driver to provide "delivery services", whether or not the goods, items or products to be delivered are in the covered "auto". D. Changes In Uninsured And/Or Underinsured Motorists Coverage 1. If Uninsured and/or Underinsured Mo- torists Coverage is attached, and: a. Contains, in whole or in part, a public or livery exclusion, then the following exclusion in Paragraph 2. does not apply. CA 23 45 11 16 © Insurance Services Office, Inc., 2016 Page 1 of 2 E b. Does not contain a public or livery exclusion, then the following exclu- sion in Paragraph 2. is added. 2. Public Or Livery Passenger Conveyance And On- demand Delivery Services This insurance does not apply to any covered "auto" while being used: a. As a public or livery conveyance for passengers. This includes, but is not limited to, any period of time a covered "auto" is being used by an "insured" who is logged into a "transportation network platform" as a driver, whether or not a pas- senger is 'occupying" the covered "auto"; or b. By an "insured" who is logged into a "transportation network platform" or "delivery network platform" as a driver to provide "delivery ser- vices", whether or not the goods, items or products to be delivered are in the covered "auto". Changes In Personal Injury Protection Cov- erage 1. If Personal Injury Protection, no-fault or other similar coverage is attached, and: a. Contains, in whole or in part, a public or livery exclusion, then the following exclusion in Paragraph 2. does not apply. b. Does not contain a public or livery exclusion, then the following exclu- sion in Paragraph 2. is added. 2. Public Or Livery Passenger Conveyance And On- demand Delivery Services This insurance does not apply to any covered "auto" while being used: a. As a public or livery conveyance for passengers. This includes, but is not limited to, any period of time a covered "auto" is being used by an "insured" who is logged into a "transportation network platform" as a driver, whether or not a pas- senger is 'occupying" the covered "auto"; or b. By an "insured" who is logged into a "transportation network platform" or "delivery network platform" as a driver to provide "delivery ser- vices", whether or not the goods, items or products to be delivered are in the covered "auto". F. Additional Definitions As used in this endorsement: 1. "Delivery network platform" means an online- enabled application or digital network, used to connect customers: a. With drivers; or b. With local vendors using drivers; for the purpose of providing prear- ranged "delivery services" for compen- sation. A "delivery network platform" does not include a "transportation net- work platform". 2. "Delivery services" includes courier ser- vices. 3. "Occupying" means in, upon, getting in, on, out or off. 4. "Transportation network platform" means an online- enabled application or digital network used to connect passen- gers with drivers using vehicles for the purpose of providing prearranged trans- portation services for compensation. Page 2 of 2 © Insurance Services Office, Inc., 2016 CA 23 46 11 16 COMMERCIAL AUTO CA 23 84 01 06 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EXCLUSION OF TERRORISM This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM BUSINESS AUTO PHYSICAL DAMAGE COVERAGE FORM GARAGE COVERAGE FORM MOTOR CARRIER COVERAGE FORM SINGLE INTEREST AUTOMOBILE PHYSICAL DAMAGE INSURANCE POLICY TRUCKERS COVERAGE FORM With respect to coverage provided by this en- dorsement, the provisions of the Coverage Form apply unless modified by the endorsement. A. The following definitions are added and apply under this endorsement wherever the term terrorism, or the phrase any injury, damage, loss or expense, are enclosed in quotation marks: 1. "Terrorism" means activities against per- sons, organizations or property of any na- ture: a. That involve the following or prep- aration for the following: (1) Use or threat of force or violence; or (2) Commission or threat of a dan- gerous act; or (3) Commission or threat of an act that interferes with or disrupts an electronic, communication, information, or mechanical sys- tem; and b. When one or both of the following applies: (1) The effect is to intimidate or co- erce a government or the civilian population or any segment thereof, or to disrupt any seg- ment of the economy; or (2) It appears that the intent is to in- timidate or coerce a govern- ment, or to further political, ideological, religious, social or economic objectives or to ex- press (or express opposition to) a philosophy or ideology. CA 23 84 01 06 2. "Any injury, damage, loss or expense" means any injury, damage, loss or ex- pense covered under any Coverage Form or Policy to which this endorsement is applicable, and includes but is not limited to "bodily injury", "property damage", "personal injury", "personal and adver- tising injury", 'loss", loss of use, rental reimbursement after "loss" or "covered pollution cost or expense", as may be de- fined under this Coverage Form, Policy or any applicable endorsement. B. Except with respect to Physical Damage Cov- erage, Trailer Interchange Coverage, Garagekeepers Coverage, Garagekeepers Coverage . Customers' Sound Receiving Equipment or the Single Interest Automobile Physical Damage Insurance Policy, the fol- lowing exclusion is added: EXCLUSION OF TERRORISM We will not pay for "any injury, damage, loss or expense" caused directly or indirectly by "terrorism", including action in hindering or defending against an actual or expected in- cident of "terrorism". "Any injury, damage, loss or expense" is excluded regardless of any other cause or event that contributes con- currently or in any sequence to such injury, damage, loss or expense. But this exclusion applies only when one or more of the follow- ing are attributed to an incident of "terror- ism": 1. The "terrorism" is carried out by means of the dispersal or application of radioac- tive material, or through the use of a nu- clear weapon or device that involves or produces a nuclear reaction, nuclear radi- ation or radioactive contamination; or ©ISO Properties, Inc., 2004 Page 1 of 3 2. Radioactive material is released, and it C. With respect to Physical Damage Coverage, appears that one purpose of the "terror- Trailer Interchange Coverage, Garagekeepers ism" was to release such material; or Coverage, Garagekeepers Coverage . Cus- 3. The "terrorism" is carried out by means tomers' Sound Receiving Equipment or the of the dispersal or application of patho- Single Interest Automobile Physical Damage genic or poisonous biological or chemi- Insurance Policy, the following exclusion is cal materials; or added: 4. Pathogenic or poisonous biological or EXCLUSION OF TERRORISM chemical materials are released, and it We will not pay for any "loss", loss of use or appears that one purpose of the "terror- rental reimbursement after "loss" caused di - ism" was to release such materials; or rectly or indirectly by "terrorism", including 5. The total of insured damage to all types action in hindering or defending against an of property exceeds $25,000,000. In de- actual or expected incident of "terrorism". termining whether the $25,000,000 But this exclusion applies only when one or threshold is exceeded, we will include all more of the following are attributed to an insured damage sustained by property of incident of "terrorism": all persons and entities affected by the 1. The "terrorism" is carried out by means "terrorism" and business interruption of the dispersal or application of radioac- losses sustained by owners or occupants tive material, or through the use of a nu - of the damaged property. For the purpose clear weapon or device that involves or of this provision, insured damage means produces a nuclear reaction, nuclear radi- damage that is covered by any insurance ation or radioactive contamination; or plus damage that would be covered by 2. Radioactive material is released, and it any insurance but for the application of appears that one purpose of the "terror - any terrorism exclusions; or ism" was to release such material; or 6. Fifty or more persons sustain death or se- 3. The "terrorism" is carried out by means rious physical injury. For the purposes of of the dispersal or application of patho- this provision, serious physical injury genic or poisonous biological or chemi- means: cal materials; or a. Physical injury that involves a sub- 4. Pathogenic or poisonous biological or stantial risk of death; or chemical materials are released, and it b. Protracted and obvious physical dis- appears that one purpose of the "terror- figurement; or ism" was to release such materials; or c. Protracted loss of or impairment of 5. The total of insured damage to all types the function of a bodily member or of property exceeds $25,000,000. In de - organ. termining whether the $25,000,000 Multiple incidents of "terrorism" threshold is exceeded, we will include all which occur within a 72 -hour period insured damage sustained by property of and appear to be carried out in con- all persons and entities affected by the cert or to have a related purpose or "terrorism" and business interruption common leadership will be deemed losses sustained by owners or occupants to be one incident, for the purpose of of the damaged property. For the purpose determining whether the thresholds of this provision, insured damage means in Paragraphs B.S. and B.6. are ex- damage that is covered by any insurance ceeded. plus damage that would be covered by With respect to this Exclusion, Para- any insurance but for the application of graphs B.S. and B.6. describe the any terrorism exclusions. thresholds used to measure the mag- Multiple incidents of "terrorism" which occur nitude of an incident of "terrorism" within a 72 -hour period and appear to be car - and the circumstances in which the ried out in concert or to have a related pur- threshold will apply, for the purpose pose or common leadership will be deemed of determining whether this Exclu- to be one incident, for the purpose of deter- sion will apply to that incident. When mining whether the threshold in Paragraph the Exclusion applies to an incident C.S. is exceeded. of "terrorism", there is no coverage under this Coverage Form, Policy or any applicable endorsement. CA 23 84 01 06 ©ISO Properties, Inc., 2004 Page 2 of 3 With respect to this Exclusion, Paragraph C.S. describes the threshold used to measure the magnitude of an incident of "terrorism" and the circumstances in which the threshold will apply, for the purpose of determining wheth- er this Exclusion will apply to that incident. When the Exclusion applies to an incident of "terrorism", there is no coverage under this Coverage Form, Policy or any applicable en- dorsement. D. In the event of any incident of "terrorism" that is not subject to the Exclusion in Para- graphs B. or C., coverage does not apply to "any injury, damage, loss or expense" that is otherwise excluded under this Coverage Form, Policy or any applicable endorsement. CA 23 84 01 06 ©ISO Properties, Inc., 2004 Page 3 of 3 COMMERCIAL AUTO CA 23 86 01 06 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EXCLUSION OF TERRORISM ABOVE MINIMUM STATUTORY LIMITS This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM BUSINESS AUTO PHYSICAL DAMAGE COVERAGE FORM GARAGE COVERAGE FORM MOTOR CARRIER COVERAGE FORM SINGLE INTEREST AUTOMOBILE PHYSICAL DAMAGE INSURANCE POLICY TRUCKERS COVERAGE FORM With respect to coverage provided by this en- dorsement, the provisions of the Coverage Form apply unless modified by the endorsement. A. The following definitions are added and apply under this endorsement wherever the term terrorism, or the phrase any injury, damage, loss or expense, are enclosed in quotation marks: 1. "Terrorism" means activities against per- sons, organizations or property of any na- ture: a. That involve the following or prep- aration for the following: (1) Use or threat of force or violence; or (2) Commission or threat of a dan- gerous act; or (3) Commission or threat of an act that interferes with or disrupts an electronic, communication, information, or mechanical sys- tem; and b. When one or both of the following applies: (1) The effect is to intimidate or co- erce a government or the civilian population or any segment thereof, or to disrupt any seg- ment of the economy; or (2) It appears that the intent is to in- timidate or coerce a govern- ment, or to further po- litical, ideological, religious, social or economic objectives or to ex- press (or express opposition to) a philosophy or ideology. 2. "Any injury, damage, loss or expense" means any injury, damage, loss or ex- pense covered under any Coverage Form or Policy to which this endorsement is applicable, and includes but is not limited to "bodily injury", "property damage", "personal injury", "personal and adver- tising injury", "loss", loss of use, rental reimbursement after "loss" or "covered pollution cost or expense", as may be de- fined under this Coverage Form, Policy or any applicable endorsement. B. Except with respect to Physical Damage Cov- erage, Trailer Interchange Coverage, Garagekeepers Coverage, Garagekeepers Coverage . Customers' Sound Receiving Equipment or the Single Interest Automobile Physical Damage Insurance Policy, the fol- lowing exclusion is added: EXCLUSION OF TERRORISM We will not pay for "any injury, damage, loss or expense" caused directly or indirectly by "terrorism", including action in hindering or defending against an actual or expected in- cident of "terrorism". "Any injury, damage, loss or expense" is excluded, regardless of any other cause or event that contributes con- currently or in any sequence to such injury, damage, loss or expense. But this exclusion applies only when one or more of the follow- ing are attributed to an incident of "terror- ism": 1. The "terrorism" is carried out by means of the dispersal or application of radioac- tive material, or through the use of a nu- clear weapon or device that involves or produces a nuclear reaction, nuclear radi- ation or radioactive contamination; or CA 23 86 01 06 © ISO Properties, Inc., 2004 Page 1 of 3 2. Radioactive material is released, and it However, with respect to Liability and Per - appears that one purpose of the "terror- sonal Injury Protection Coverage, if applica- ism" was to release such material; or ble, this Exclusion applies only to the extent 3. The "terrorism" is carried out by means that the limit of such coverage exceeds the of the dispersal or application of patho- state compulsory or financial responsibility genic or poisonous biological or chemi- law minimum limits for each coverage. cal materials; or With respect to Uninsured and/or 4. Pathogenic or poisonous biological or Underinsured Motorists Coverage, if applica- chemical materials are released, and it ble, this Exclusion applies only to the extent appears that one purpose of the "terror- that the limit of such coverage exceeds the ism" was to release such materials; or minimum statutory permitted limits for Unin- sured and/or Underinsured Motorists Cover - 5. The total of insured damage to all types age. Those limits are equal to the minimum of property exceeds $25,000,000. In de- limit permitted for Liability Coverage. termining whether the $25,000,000 threshold is exceeded, we will include all C. With respect to Physical Damage Coverage, insured damage sustained by property of Trailer Interchange Coverage, Garagekeepers all persons and entities affected by the Coverage, Garagekeepers Coverage . Cus- "terrorism" and business interruption tomers' Sound Receiving Equipment or the losses sustained by owners or occupants Single Interest Automobile Physical Damage 0 of the damaged property. For the purpose Insurance Policy, the following exclusion is of this provision, insured damage means added: damage that is covered by any insurance EXCLUSION OF TERRORISM plus damage that would be covered by We will not pay for any "loss", loss of use or any insurance but for the application of rental reimbursement after "loss" caused di - any terrorism exclusions; or rectly or indirectly by "terrorism", including 6. Fifty or more persons sustain death or se- action in hindering or defending against an rious physical injury. For the purposes of actual or expected incident of "terrorism". this provision, serious physical injury But this exclusion applies only when one or means: more of the following are attributed to an a. Physical injury that involves a sub- incident of "terrorism": stantial risk of death; or 1. The "terrorism" is carried out by means b. Protracted and obvious physical dis- of the dispersal or application of radioac- figurement; or tive material, or through the use of a nu- c. Protracted loss of or impairment of clear weapon or device that involves or the function of a bodily member or produces a nuclear reaction, nuclear radi- ation or radioactive contamination; or organ. Multiple incidents of "terrorism" which occur 2. Radioactive material is released, and it "terror within a 72 -hour period and appear to be car- appears that one purpose of the - ism" was to release such material; or m ried out in concert or to have a related pur- pose or common leadership will be deemed 3. The "terrorism" is carried out by means to be one incident, for the purpose of deter- of the dispersal or application of patho- mining whether the thresholds in Paragraphs genic or poisonous biological or chemi- B.5. and B.6. are exceeded. cal materials; or N With respect to this Exclusion, Paragraphs 4. Pathogenic or poisonous biological or B.S. and B.6. describe the thresholds used to chemical materials are released, and it measure the magnitude of an incident of "ter- appears that one purpose of the "terror- rorism" and the circumstances in which the ism" was to release such materials; or threshold will apply, for the purpose of deter- mining whether this Exclusion will apply to that incident. When the Exclusion applies to an incident of "terrorism", there is no cov- erage under this Coverage Form, Policy or any applicable endorsement. CA 23 86 01 06 © ISO Properties, Inc., 2004 Page 2 of 3 5. The total of insured damage to all types of property exceeds $25,000,000. In de- termining whether the $25,000,000 threshold is exceeded, we will include all insured damage sustained by property of all persons and entities affected by the "terrorism" and business interruption losses sustained by owners or occupants of the damaged property. For the purpose of this provision, insured damage means damage that is covered by any insurance plus damage that would be covered by any insurance but for the application of any terrorism exclusions. Multiple incidents of "terrorism" which occur within a 72 -hour period and appear to be car- ried out in concert or to have a related pur- pose or common leadership will be deemed to be one incident, for the purpose of deter- mining whether the threshold in Paragraph C.S. is exceeded. With respect to this Exclusion, Paragraph C.S. describes the threshold used to measure the magnitude of an incident of "terrorism" and the circumstances in which the threshold will apply, for the purpose of determining wheth- er this Exclusion will apply to that incident. When the Exclusion applies to an incident of "terrorism", there is no coverage under this Coverage Form, Policy or any applicable en- dorsement. D. In the event of any incident of "terrorism" that is not subject to the Exclusion in Para- graphs B. or C., coverage does not apply to "any injury, damage, loss or expense" that is otherwise excluded under this Coverage Form, Policy or any applicable en- dorsement. CA 23 86 01 06 © ISO Properties, Inc., 2004 Page 3 of 3 COMMERCIAL AUTO CA 23 88 01 06 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ALASKA EXCLUSION OF TERRORISM ABOVE MINIMUM STATUTORY LIMITS This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM BUSINESS AUTO PHYSICAL DAMAGE COVERAGE FORM GARAGE COVERAGE FORM MOTOR CARRIER COVERAGE FORM SINGLE INTEREST AUTOMOBILE PHYSICAL DAMAGE INSURANCE POLICY TRUCKERS COVERAGE FORM With respect to coverage provided by this en- dorsement, the provisions of the Coverage Form apply unless modified by the endorsement. A. The following definitions are added and apply under this endorsement wherever the term terrorism, or the phrase any injury, damage, loss or expense, are enclosed in quotation marks: 1. "Terrorism" means activities against per- sons, organizations or property of any na- ture: a. That involve the following or prep- aration for the following: (1) Use or threat of force or violence; or (2) Commission or threat of a dan- gerous act; or (3) Commission or threat of an act that interferes with or disrupts an electronic, communication, information, or mechanical sys- tem; and b. When one or both of the following applies: (1) The effect is to intimidate or co- erce a government or the civilian population or any segment thereof, or to disrupt any seg- ment of the economy; or (2) It appears that the intent is to in- timidate or coerce a govern- ment, or to further political, ideological, religious, social or economic objectives or to ex- press (or express opposition to) a philosophy or ideology. 2. "Any injury, damage, loss or expense" means any injury, damage, loss or ex- pense covered under any Coverage Form or Policy to which this endorsement is applicable, and includes but is not limited to "bodily injury", "property damage", "personal injury", "personal and adver- tising injury", "loss", loss of use, rental reimbursement after "loss" or "covered pollution cost or expense", as may be de- fined under this Coverage Form, Policy or any applicable endorsement. B. Except with respect to Physical Damage Cov- erage, Trailer Interchange Coverage, Garagekeepers Coverage, Garagekeepers Coverage - Customers' Sound Receiving Equipment or the Single Interest Automobile Physical Damage Insurance Policy, the fol- lowing exclusion is added: EXCLUSION OF TERRORISM We will not pay for "any injury, damage, loss or expense" caused by "terrorism", including action in hindering or defending against an actual or expected incident of "terrorism". But this exclusion applies only when one or more of the following are attributed to an incident of "terrorism": 1. The "terrorism" is carried out by means of the dispersal or application of radioac- tive material, or through the use of a nu- clear weapon or device that involves or produces a nuclear reaction, nuclear radi- ation or radioactive contamination; or CA 23 88 01 06 ©ISO Properties, Inc., 2004 Page 1 of 3 2. Radioactive material is released, and it However, with respect to Liability Coverage, appears that one purpose of the "terror- this Exclusion applies only to the extent that ism" was to release such material; or the limit of such coverage exceeds the state 3. The "terrorism" is carried out by means compulsory or financial responsibility law of the dispersal or application of patho- minimum limits. genic or poisonous biological or chemi- With respect to Uninsured and Underinsured cal materials; or Motorists Coverage, this Exclusion applies 4. Pathogenic or poisonous biological or only to the extent that the limit of such cov- chemical materials are released, and it erage exceeds the minimum statutory permit - appears that one purpose of the "terror- ted limits for Uninsured and Underinsured ism" was to release such materials; or Motorists Coverage. Those limits are equal to 5. The total of insured damage to all types the minimum limit permitted for Liability of property exceeds $25,000,000. In de- Coverage. termining whether the $25,000,000 C. With respect to Physical Damage Coverage, threshold is exceeded, we will include all Trailer Interchange Coverage, Garagekeepers insured damage sustained by property of Coverage, Garagekeepers Coverage - Cus- all persons and entities affected by the tomers' Sound Receiving Equipment or the "terrorism" and business interruption Single Interest Automobile Physical Damage losses sustained by owners or occupants Insurance Policy, the following exclusion is of the damaged property. For the purpose added: of this provision, insured damage means EXCLUSION OF TERRORISM damage that is covered by any insurance We will not pay for any "loss", loss of use or plus damage that would be covered by rental reimbursement after "loss" caused by any insurance but for the application of "terrorism", including action in hindering or any terrorism exclusions; or defending against an actual or expected in - 6. Fifty or more persons sustain death or se- cident of "terrorism". But this exclusion ap- rious physical injury. For the purposes of plies only when one or more of the following this provision, serious physical injury are attributed to an incident of "terrorism": means: 1. The "terrorism" is carried out by means a. Physical injury that involves a sub- of the dispersal or application of radioac- stantial risk of death; or tive material, or through the use of a nu- b. Protracted and obvious physical dis- clear weapon or device that involves or figurement; or produces a nuclear reaction, nuclear radi- c. Protracted loss of or impairment of ation or radioactive contamination; or the function of a bodily member or 2• Radioactive material is released, and it organ. appears that one purpose of the "terror - Multiple incidents of "terrorism" which occur ism" was to release such material; or within a 72 -hour period and appear to be car- 3. The "terrorism" is carried out by means ried out in concert or to have a related pur- of the dispersal or application of patho- pose or common leadership will be deemed genic or poisonous biological or chemi- m to be one incident, for the purpose of deter- cal materials; or mining whether the thresholds in Paragraphs 4. Pathogenic or poisonous biological or B.S. and B.6. are exceeded. chemical materials are released, and it With respect to this Exclusion, Paragraphs appears that one purpose of the "terror - B.5. and B.6. describe the thresholds used to ism" was to release such materials; or measure the magnitude of an incident of "ter- rorism" and the circumstances in which the threshold will apply, for the purpose of deter- mining whether this Exclusion will apply to that incident. When the Exclusion applies to an incident of "terrorism", there is no cov- erage under this Coverage Form, Policy or any applicable endorsement. CA 23 88 01 06 ©ISO Properties, Inc., 2004 Page 2 of 3 5. The total of insured damage to all types of property exceeds $25,000,000. In de- termining whether the $25,000,000 threshold is exceeded, we will include all insured damage sustained by property of all persons and entities affected by the "terrorism" and business interruption losses sustained by owners or occupants of the damaged property. For the purpose of this provision, insured damage means damage that is covered by any insurance plus damage that would be covered by any insurance but for the application of any terrorism exclusions. Multiple incidents of "terrorism" which occur within a 72 -hour period and appear to be carried out in concert or to have a related purpose or common leadership will be deemed to be one incident, for the purpose of determining whether the threshold in Paragraph C.S. is exceeded. With respect to this Exclusion, Paragraph C.S. describes the threshold used to mea- sure the magnitude of an incident of "ter- rorism" and the circumstances in which the threshold will apply, for the purpose of determining whether this Exclusion will apply to that incident. When the Ex- clusion applies to an incident of "terror- ism", there is no coverage under this Coverage Form, Policy or any applicable endorsement. D. In the event of any incident of "terrorism" that is not subject to the Exclusion in Para- graphs B. or C., coverage does not apply to "any injury, damage, loss or expense" that is otherwise excluded under this Coverage Form, Policy or any applicable endorsement. CA 23 88 01 06 ©ISO Properties, Inc., 2004 Page 3 of 3 COMMERCIAL AUTO CA 23 92 01 06 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WASHINGTON EXCLUSION OF TERRORISM This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM BUSINESS AUTO PHYSICAL DAMAGE COVERAGE FORM GARAGE COVERAGE FORM MOTOR CARRIER COVERAGE FORM SINGLE INTEREST AUTOMOBILE PHYSICAL DAMAGE INSURANCE POLICY TRUCKERS COVERAGE FORM With respect to coverage provided by this en- 2. "Any injury, damage, loss or expense" dorsement, the provisions of the Coverage Form means any injury, damage, loss or ex - apply unless modified by the endorsement. pense covered under any Coverage Form A. The following definitions are added and apply or Policy to which this endorsement is under this endorsement wherever the term applicable, and includes but is not limited terrorism, or the phrase any injury, damage, to "bodily injury", "property damage", loss or expense, are enclosed in quotation "personal injury", "personal and adver- marks: tising injury", "loss", loss of use, rental reimbursement after "loss" or "covered 1. "Terrorism" means activities against per- pollution cost or expense", as may be de- sons, organizations or property of any na- fined under this Coverage Form, Policy or ture: any applicable endorsement. a. That involve the following or prep- B. Except with respect to Physical Damage Cov- aration for the following: erage, Trailer Interchange Coverage, (1) Use or threat of force or Garagekeepers Coverage, Garagekeepers violence; or Coverage . Customers' Sound Receiving (2) Commission or threat of a dan- Equipment or the Single Interest Automobile gerous act; or Physical Damage Insurance Policy, the fol - (3) Commission or threat of an act lowing exclusion is added: that interferes with or disrupts EXCLUSION OF TERRORISM an electronic, communication, We will not pay for "any injury, damage, loss information, or mechanical sys- or expense" caused directly or indirectly by tem; and "terrorism", including action in hindering or b. When one or both of the following defending against an actual or expected in - applies: cident of "terrorism". But this exclusion ap- (1) The effect is to intimidate or co- plies only when one or more of the following erce a government or the civilian are attributed to an incident of "terrorism": population or any segment 1. The "terrorism" is carried out by means thereof, or to disrupt any seg- of the dispersal or application of radioac- ment of the economy; or tive material, or through the use of a nu - (2) It appears that the intent is to in- clear weapon or device that involves or timidate or coerce a govern- produces a nuclear reaction, nuclear radi- ment, or to further political, ation or radioactive contamination; or ideological, religious, social or 2. Radioactive material is released, and it economic objectives or to ex- appears that one purpose of the "terror - press (or express opposition to) ism" was to release such material; or a philosophy or ideology. CA 23 92 01 06 © ISO Properties, Inc., 2004 Page 1 of 3 3. The "terrorism" is carried out by means C. With respect to Physical Damage Coverage, of the dispersal or application of patho- Trailer Interchange Coverage, Garagekeepers genic or poisonous biological or chemi- Coverage, Garagekeepers Coverage . Cus- cal materials; or tomers' Sound Receiving Equipment or the 4. Pathogenic or poisonous biological or Single Interest Automobile Physical Damage chemical materials are released, and it Insurance Policy, the following exclusion is appears that one purpose of the "terror- added: ism" was to release such materials; or EXCLUSION OF TERRORISM 5. The total of insured damage to all types We will not pay for any "loss", loss of use or of property exceeds $25,000,000. In de- rental reimbursement after "loss" caused di- termining whether the $25,000,000 rectly or indi-rectly by "terrorism", including threshold is exceeded, we will include all action in hindering or defending against an insured damage sustained by property of actual or expected incident of "terrorism". all persons and entities affected by the But this exclusion applies only when one or "terrorism" and business interruption more of the following are attributed to an losses sustained by owners or occupants incident of "terrorism": of the damaged property. For the purpose 1. The "terrorism" is carried out by means of this provision, insured damage means of the dispersal or application of radioac- damage that is covered by any insurance tive material, or through the use of a nu - plus damage that would be covered by clear weapon or device that involves or any insurance but for the application of produces a nuclear reaction, nuclear radi- any terrorism exclusions; or ation or radioactive contamination; or 6. Fifty or more persons sustain death or se- 2. Radioactive material is released, and it rious physical injury. For the purposes of appears that one purpose of the "terror - this provision, serious physical injury ism" was to release such material; or means: 3. The "terrorism" is carried out by means a. Physical injury that involves a sub- of the dispersal or application of patho- stantial risk of death; or genic or poisonous biological or chemi- b. Protracted and obvious physical dis- cal materials; or figurement; or 4. Pathogenic or poisonous biological or c. Protracted loss of or impairment of chemical materials are released, and it the function of a bodily member or appears that one purpose of the "terror - organ. ism" was to release such materials; or Multiple incidents of "terrorism" which occur 5. The total of insured damage to all types within a 72 -hour period and appear to be car- of property exceeds $25,000,000. In de- ried out in concert or to have a related pur- termining whether the $25,000,000 pose or common leadership will be deemed threshold is exceeded, we will include all to be one incident, for the purpose of deter- insured damage sustained by property of mining whether the thresholds in Paragraphs all persons and entities affected by the m B.S. and B.6. are exceeded. "terrorism" and business interruption ° With respect to this Exclusion, Paragraphs losses sustained by owners or occupants B.S. and B.6. describe the thresholds used to of the damaged property. For the purpose measure the magnitude of an incident of "ter- of this provision, insured damage means rorism" and the circumstances in which the damage that is covered by any insurance threshold will apply, for the purpose of deter- plus damage that would be covered by mining whether this Exclusion will apply to any insurance but for the application of that incident. When the Exclusion applies to any terrorism exclusions. an incident of "terrorism", there is no cov- erage under this Coverage Form, Policy or any applicable endorsement. CA 23 92 01 06 © ISO Properties, Inc., 2004 Page 2 of 3 Multiple incidents of "terrorism" which occur within a 72 -hour period and appear to be car- ried out in concert or to have a related pur- pose or common leadership will be deemed to be one incident, for the purpose of deter- mining whether the threshold in Paragraph C.S. is exceeded. With respect to this Exclusion, Paragraph C.S. describes the threshold used to measure the magnitude of an incident of "terrorism" and the circumstances in which the threshold will apply, for the purpose of determining wheth- er this Exclusion will apply to that incident. When the Exclusion applies to an incident of "terrorism", there is no coverage under this Coverage Form, Policy or any applicable en- dorsement. D. In the event of any incident of "terrorism" that is not subject to the Exclusion in Para- graphs B. or C., coverage does not apply to "any injury, damage, loss or expense" that is otherwise excluded under this Coverage Form, Policy or any applicable endorsement. CA 23 92 01 06 © ISO Properties, Inc., 2004 Page 3 of 3 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. TEMPORARY SUBSTITUTE AUTO -PHYSICAL DAMAGE INSURANCE 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 the endorsement. 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: a. Breakdown; b. Repair; c. Servicing; d. "Loss"; or e. Destruction. CA 85 47 12 93 Page 1 of 1 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EXCLUSION OF NAMED PERSON This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM GARAGE COVERAGE FORM MOTOR CARRIER COVERAGE FORM TRUCKERS COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Endorsement effective Policy Number: 02/01/2019 BAS(20)57131811 Named Insured Countersigned by G2 CONSTRUCTION, INC. (Authorized Representative) In consideration of the issuance and/or continuance of this policy, it is hereby agreed that the insurance provided by this policy does not apply to any person or entity for any "accident" or "loss" of any kind arising out of the operation or use of a covered "auto" by the following person(s): NAMED PERSON(S) 1. GABRIEL TAMAYOPANLAGUA 2. (Type or Print Person's Name) In the event that this endorsement excludes liability coverage for the Named Insured or others in violation of any law, then this exclusion shall apply to the extent the limits indicated in the declarations exceed the minimum limits required by law at the time of "loss". In the event that this endorsement excludes unin- sured or underinsured motorists coverage in violation of any law, then this exclusion shall apply to the extent that the limits indicated in the declarations exceed the minimum limits required by law at the time of any "loss". This endorsement is valid until canceled by the insurer and shall apply to all renewals of this policy, substitute or replacement policies issued by the insurer or affiliate of the insurer. This endorsement can be canceled or deleted by written request of the Named Insured, with approval of the Company. ACCEPTED BY Signature of a Named Insured ACCEPTED BY Signature of a Named Insured (A signed copy of this endorsement is on file with the Company.) The Named Insured hereby accepts the restrictions of this endorsement on his/her behalf and on the behalf of all persons and entities insured under this Coverage Form. CA 85 49 09 08 Page 1 of 1 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. RECREATIONAL TRAILERS AND BOAT TRAILERS This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM TRUCKERS COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. CERTAIN TRAILERS, MOBILE EQUIPMENT AND TEMPORARY SUBSTITUTE AUTOS of SECTION I - COVERED AUTOS is amended by the addition of the following: 4. Recreational trailers and boat trailers designed for use with an auto of the private passenger type provided the trailers are not used for business purposes. CA 85 53 12 93 Page 1 of 1 COMMERCIAL AUTO CA 88 10 01 13 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 modified by the endorsement. COVERAGEINDEX SUBJECT ADDITIONAL INSURED BY CONTRACT, AGREEMENT OR PERMIT ACCIDENTAL AIRBAG DEPLOYMENT AMENDED DUTIES IN THE EVENT OF ACCIDENT, CLAIM, SUIT OR LOSS AMENDED FELLOW EMPLOYEE EXCLUSION AUDIO, VISUAL AND DATA ELECTRONIC EQUIPMENT COVERAGE BROAD FORM INSURED BODILY INJURY REDEFINED EMPLOYEES AS INSUREDS (including employee hired auto) EXTENDED CANCELLATION CONDITION EXTRA EXPENSE -BROADENED COVERAGE GLASS REPAIR - WAIVER OF DEDUCTIBLE HIRED AUTO PHYSICAL DAMAGE (including employee hired auto and loss of use) HIRED AUTO COVERAGE TERRITORY LOAN / LEASE GAP PARKED AUTO COLLISION COVERAGE (WAIVER OF DEDUCTIBLE) PERSONAL EFFECTS COVERAGE PHYSICAL DAMAGE - ADDITIONAL TRANSPORTATION EXPENSE COVERAGE RENTAL REIMBURSEMENT SUPPLEMENTARY PAYMENTS TOWING AND LABOR TWO OR MORE DEDUCTIBLES UNINTENTIONAL FAILURE TO DISCLOSE HAZARDS WAIVER OF TRANSFER OF RIGHTS OF RECOVERYAGAINST OTHERS TO US SECTION II - LIABILITY COVERAGE is amended as follows: 1. BROAD FORM INSURED PROVISION NUMBER 3 12 19 5 13 1 22 2 23 10 15 6 20 14 16 11 8 9 4 7 17 18 20 SECTION II - LIABILITY COVERAGE, paragraph A.1. - WHO IS AN INSURED is amended to include the following as an insured: d. Any legally incorporated entity of which you own more than 50 percent of the voting stock during the policy period. 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; or (3) Has exhausted its Limit of Insurance under any other automobile policy. Paragraph d. (2) of this provision does not apply to a policy written to apply specifically in excess of this policy. e. Any organization you newly acquire or form, other than a partnership or joint venture, of which you own more than 50 percent of the voting stock. This automatic coverage is afforded only for 180 days from the date of acquisition or formation. However, coverage under this provision does not apply: (1) If there is similar insurance or a self-insured retention plan available to that organization,- @) rganization;© 2013 Liberty Mutual Insurance CA 88 10 01 13 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 7 (2) If the Limits of Insurance of any other insurance policy have been exhausted; or (3) To "bodily injury" or "property damage" that occurred before you acquired or formed the organization. 2. EMPLOYEES AS INSUREDS SECTION II - LIABILITY COVERAGE, paragraph A.1. - WHO IS AN INSURED is amended to include the following as an insured: f. 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 endorse- ment is excess over any other insurance available to any "employee". g. An "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 re- lated 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". 3. ADDITIONAL INSURED BY CONTRACT, AGREEMENT OR PERMIT SECTION II - LIABILITY COVERAGE, paragraph A.I. - WHO IS AN INSURED is amended to include the following as an insured: h. 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, 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 agreement, or the permit has been issued to you; and (3) Only for the duration of that contract, agreement or permit 4. SUPPLEMENTARY PAYMENTS SECTION II - LIABILITY COVERAGE, Coverage Extensions, 2.a. Supplementary Payments, para- graphs (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 earn- ings up to $500 a day because of time off from work. 5. AMENDED FELLOW EMPLOYEE EXCLUSION In those jurisdictions where, by law, fellow employees are not entitled to the protection afforded to the employer by the workers compensation exclusivity rule, or similar protection, the following provision is added: SECTION II - LIABILITY, exclusion B.5. FELLOW EMPLOYEE does not apply if the "bodily injury" results from the use of a covered "auto" you own or hire. SECTION III - PHYSICAL DAMAGE COVERAGE is amended as follows: 6. HIRED AUTO PHYSICAL DAMAGE Paragraph A.4. Coverage Extensions of SECTION III - PHYSICAL DAMAGE COVERAGE, is amended by adding the following: 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" you own, then the Physical Damage coverages provided are extended to "autos": a. You hire, rent or borrow; or © 2013 Liberty Mutual Insurance CA 88 10 01 13 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 2 of 7 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. eductible: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 like kind and quality, 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 the hired "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". For the purposes of this provision, SECTION V - DEFINITIONS is amended by adding the following: "Total loss" means a "loss" in which the cost of repairs plus the salvage value exceeds the actual cash value. 7. 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 dis- abled: a. For private passenger type vehicles, we will pay up to $50 per disablement. b. For "light trucks", we will pay up to $50 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. 8. PHYSICAL DAMAGE -ADDITIONAL TRANSPORTATION EXPENSE COVERAGE Paragraph AA.a., Coverage Extension of SECTION III - PHYSICAL DAMAGE COVERAGE, is amend- ed to provide a limit of $50 per day and a maximum limit of $1,500 © 2013 Liberty Mutual Insurance CA 88 10 01 13 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 3 of 7 9. 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 expenses incurred after the first 24 hours following the "accident" or "loss" to the covered "auto." b. Rental Reimbursement will be based on the rental of a comparable 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". d. This coverage does not apply unless you have a business necessity that other "autos" avail- able 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. For the purposes of this endorsement provision, materials and equipment do not include "personal effects" as defined in provision 11. 10. EXTRA EXPENSE - BROADENED COVERAGE Under SECTION III - PHYSICAL DAMAGE COVERAGE, A. COVERAGE, we will pay for the expense of returning a stolen covered "auto" to you. The maximum amount we will pay is $1,000. 11. 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 securities. 12. ACCIDENTAL AIRBAG DEPLOYMENT SECTION III - PHYSICAL DAMAGE COVERAGE, B. EXCLUSIONS is amended by adding the follow- ing: 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 cov- erage or warranty. 13. AUDIO, VISUAL AND DATA ELECTRONIC EQUIPMENT COVERAGE SECTION III - PHYSICAL DAMAGE COVERAGE, B. EXCLUSIONS, exception paragraph a. to exclu- sions 4.c. and 4.d. is deleted and replaced with the following: © 2013 Liberty Mutual Insurance CA 88 10 01 13 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 4 of 7 Exclusion 4.c. and 4.d. do not apply to: a. Electronic equipment that receives or transmits audio, visual or data signals, whether or not designed solely for the reproduction of sound, if the equipment 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" and physical damage coverages are provided for the covered "auto"; or 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. 14. LOAN / LEASE GAP COVERAGE 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 one "accident" 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 ab- normal wear and tear, c. Costs for extended warranties, Credit Life Insurance, Health, Accident or Disability Insurance 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", L 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. C. SECTION V - DEFINTIONS 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. © 2013 Liberty Mutual Insurance CA 88 10 01 13 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 5 of 7 15. 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. 16. 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. 17. 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: 18. 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 inception 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. 19. 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 following: 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. © 2013 Liberty Mutual Insurance CA 88 10 01 13 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 6 of 7 To the extent possible, notice to us should include: (1) How, when and where the "accident" or "loss" took place; (2) The "insureds" name and address; and (3) The names and addresses of any injured persons and witnesses. 20. 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 waived those rights before an "accident" or "loss", our rights are waived also. 21. 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. SECTION V - DEFINITIONS is amended as follows: 22. BODILY INJURY REDEFINED Under SECTION V- DEFINTIONS, 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. COMMMON POLICY CONDITIONS 23. EXTENDED CANCELLATION CONDITION COMMON POLICY CONDITIONS, paragraph A. - CANCELLATION condition applies except as fol- lows: If we cancel for any reason other than nonpayment of premium, we will mail to the first Named Insured written notice of cancellation at least 60 days before the effective date of cancellation. This provision does not apply in those states which require more than 60 days prior notice of cancella- tion. © 2013 Liberty Mutual Insurance CA 88 10 01 13 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 7 of 7 IL 00 17 11 98 COMMON POLICY CONDITIONS All Coverage Parts included in this policy are subject to the following conditions. A. CANCELLATION D. INSPECTIONS AND SURVEYS 1. The first Named Insured shown in the 1. We have the right to: Declarations may cancel this policy by a. Make inspections and surveys at any mailing or delivering to us advance writ- time; WOMEN ten notice of cancellation. b. Give you reports on the conditions 2. We may cancel this policy by mailing or we find; and delivering to the first Named Insured c. Recommend changes. written notice of cancellation at least: 2. We are not obligated to make any inspec- a. 10 days before the effective date of " tions, surveys, reports or recommenda- ancellation if we cancel for nonpay- cnt tions and any such actions we do under- of premium; or take relate only to insurability and the b. 30 days before the effective date of premiums to be charged. We do not cancellation if we cancel for any oth- make safety inspections. We do not un - o er reason. dertake to perform the duty of any person 3. We will mail or deliver our notice to the or organization to provide for the health first Named Insured's last mailing ad- or safety of workers or the public. And we dress known to us. do not warrant that conditions: 4. Notice of cancellation will state the effec- a. Are safe or healthful; or tive date of cancellation. The policy pe- b. Comply with laws, regulations, riod will end on that date. codes or standards. 5. If this policy is cancelled, we will send 3. Paragraphs 1. and 2. of this condition ap- the first Named Insured any premium re- ply not only to us, but also to any rating, fund due. If we cancel, the refund will be advisory, rate service or similar organiza- pro rata. If the first Named Insured can- tion which makes insurance inspections, cels, the refund may be less than pro surveys, reports or recommendations. rata. The cancellation will be effective 4. Paragraph 2. of this condition does not even if we have not made or offered a apply to any inspections, surveys, reports refund. or recommendations we may make rela- 6. If notice is mailed, proof of mailing will tive to certification, under state or mu - be sufficient proof of notice. nicipal statutes, ordinances or regula- tions, of boilers, pressure vessels or B. CHANGES elevators. This policy contains all the agreements be- tween you and us concerning the insurance E. PREMIUMS afforded. The first Named Insured shown in The first Named Insured shown in the Dec - the Declarations is authorized to make larations: changes in the terms of this policy with our 1. Is responsible for the payment of all pre - consent. This policy's terms can be amended or waived only by endorsement issued by us miums; and and made a part of this policy. 2. Will be the payee for any return premi- ums we pay. C. EXAMINATION OF YOUR BOOKS AND RECORDS F. TRANSFER OF YOUR RIGHTS AND DUTIES We may examine and audit your books and UNDER THIS POLICY records as they relate to this policy at any Your rights and duties under this policy may time during the policy period and up to three not be transferred without our written con - years afterward. sent except in the case of death of an individ- ual named insured. IL 00 17 11 98 Copyright, Insurance Services Office, Inc., 1998 Page 1 of 2 If you die, your rights and duties under this policy will be transferred to your legal repre- sentative but only while acting within the scope of duties as your legal representative. Until your legal representative is appointed, anyone having proper temporary custody of your property will have your rights and duties but only with respect to that property. IL 00 17 11 98 Copyright, Insurance Services Office, Inc., 1998 Page 2 of 2 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. NUCLEAR ENERGY LIABILITY EXCLUSION ENDORSEMENT (Broad Form) This endorsement modifies insurance provided under the following: COMMERCIAL AUTOMOBILE COVERAGE PART COMMERCIAL GENERAL LIABILITY COVERAGE PART FARM COVERAGE PART LIQUOR LIABILITY COVERAGE PART MEDICAL PROFESSIONAL LIABILITY COVERAGE PART OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART RAILROAD PROTECTIVE LIABILITY COVERAGE PART UNDERGROUND STORAGE TANK POLICY 1. The insurance does not apply: A. Under any Liability Coverage, to "bodily injury" or "property damage": (1) With respect to which an "insured" under the policy is also an insured under a nuclear energy liability poli- cy issued by Nuclear Energy Liabil- ity Insurance Association, Mutual Atomic Energy Liability Underwrit- ers, Nuclear Insurance Association of Canada or any of their succes- sors, or would be an insured under any such policy but for its termina- tion upon exhaustion of its limit of liability; or (2) Resulting from the "hazardous properties" of "nuclear material' and with respect to which (a) any person or organization is required to maintain financial protection pur- suant to the Atomic Energy Act of 1954, or any law amendatory there- of, or (b) the "insured" is, or had this policy not been issued would be, entitled to indemnity from the United States of America, or any agency thereof, under any agree- ment entered into by the United States of America, or any agency thereof, with any person or organi- zation. IL 00 21 09 08 IL 00 21 09 08 B. Under any Medical Payments coverage, to expenses incurred with respect to "bodily injury" resulting from the "haz- ardous properties" of "nuclear materi- al' and arising out of the operation of a "nuclear facility" by any person or or- ganization. C. Under any Liability Coverage, to "bodily injury" or "property damage" resulting from "hazardous properties" of "nuclear material', if: (1) The "nuclear material' (a) is at any "nuclear facility" owned by, or op- erated by or on behalf of, an "in- sured" or (b) has been discharged or dispersed therefrom; (2) The "nuclear material' is contained in "spent fuel' or "waste" at any time possessed, handled, used, pro- cessed, stored, transported or disposed of, by or on behalf of an "insured"; or © ISO Properties, Inc., 2007 Page 1 of 2 (3) The "bodily injury" or "property damage" arises out of the furnish- ing by an "insured" of services, materials, parts or equipment in connection with the planning, con- struction, maintenance, operation or use of any "nuclear facility", but if such facility is located within the United States of America, its ter- ritories or possessions or Canada, this exclusion (3) applies only to "property damage" to such "nucle- ar facility" and any property thereat. 2. As used in this endorsement: "Hazardous properties" includes radioactive, toxic or explosive properties. "Nuclear material" means "source materi- al', "special nuclear material' or "by-prod- uct material". "Source material", "special nuclear mate- rial', and "by-product material' have the meanings given them in the Atomic Energy Act of 1954 or in any law amendatory there- of. "Spent fuel" means any fuel element or fuel component, solid or liquid, which has been used or exposed to radiation in a "nuclear reactor". "Waste" means any waste material (a) con- taining "by-product material' other than the tailings or wastes produced by the extrac- tion or concentration of uranium or thorium from any ore processed primarily for its "source material" content, and (b) resulting from the operation by any person or or- ganization of any "nuclear facility" included under the first two paragraphs of the defini- tion of "nuclear facility". "Nuclear facility" means: (a) Any "nuclear reactor"; (b) Any equipment or device designed or used for (1) separating the iso- topes of uranium or plutonium, (2) processing or utilizing "spent fuel', or (3) handling, processing or pack- aging "waste"; (c) Any equipment or device used for the processing, fabricating or alloying of "special nuclear mate- rial' if at any time the total amount of such material in the custody of the "insured" at the premises where such equipment or device is located consists of or contains more than 25 grams of plutonium or uranium 233 or any combination thereof, or more than 250 grams of uranium 235; (d) Any structure, basin, excavation, premises or place prepared or used for the storage or disposal of "waste",- and waste"; and includes the site on which any of the foregoing is located, all operations conduct- ed on such site and all premises used for such operations. "Nuclear reactor" means any apparatus de- signed or used to sustain nuclear fission in a self-supporting chain reaction or to con- tain a critical mass of fissionable material. "Property damage" includes all forms of ra- dioactive contamination of property. IL 00 21 09 08 © ISO Properties, Inc., 2007 Page 2 of 2 IL 02 70 09 12 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CALIFORNIA CHANGES -CANCELLATION AND NONRENEWAL This endorsement modifies insurance provided under the following: CAPITAL ASSETS PROGRAM (OUTPUT POLICY) COVERAGE PART COMMERCIAL AUTOMOBILE COVERAGE PART COMMERCIAL GENERAL LIABILITY COVERAGE PART COMMERCIAL INLAND MARINE COVERAGE PART COMMERCIAL PROPERTY COVERAGE PART CRIME AND FIDELITY COVERAGE PART EMPLOYMENT-RELATED PRACTICES LIABILITY COVERAGE PART EQUIPMENT BREAKDOWN COVERAGE PART FARM COVERAGE PART LIQUOR LIABILITY COVERAGE PART MEDICAL PROFESSIONAL LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART A. Paragraphs 2. and 3. of the Cancellation 3. All Policies In Effect For More Than 60 Common Policy Condition are replaced by Days the following: a. If this policy has been in effect for 2. All Policies In Effect For 60 Days Or more than 60 days, or is a renewal " Less of a policy we issued, we may can - If this policy has been in effect for 60 cel this policy only upon the occur - days or less, and is not a renewal of a rence, after the effective date of the policy we have previously issued, we policy, of one or more of the fol - may cancel this policy by mailing or lowing: delivering to the first Named Insured, at (1) Nonpayment of premium, in - the mailing address shown in the poli- cluding payment due on a prior cy, and to the producer of record, ad- policy we issued and due dur- vance written notice of cancellation, ing the current policy term cov- stating the reason for cancellation, at ering the same risks. least: (2) Discovery of fraud or material a. 10 days before the effective date of misrepresentation by: cancellation if we cancel for: (a) Any insured or his or her W (1) Nonpayment of premium; or representative in obtaining (2) Discovery of fraud by: this insurance; or (a) Any insured or his or her (b) You or your representative representative in obtaining in pursuing a claim under this insurance; or this policy. (b) You or your representative (3) A judgment by a court or an in pursuing a claim under administrative tribunal that you this policy. have violated a California or b. 30 days before the effective date of Federal law, having as one of cancellation if we cancel for any its necessary elements an act other reason. which materially increases any of the risks insured against. IL 02 70 09 12 © Insurance Services Office, Inc., 2012 Page 1 of 4 (4) Discovery of willful or grossly B. The following provision is added to the negligent acts or omissions, or Cancellation Common Policy Condition: of any violations of state laws 7. Residential Property or regulations establishing safe- This provision applies to coverage on ty standards, by you or your real property which is used predomi- representative, which materially nantly for residential purposes and con - increase any of the risks in- sisting of not more than four dwelling sured against. units, and to coverage on tenants' (5) Failure by you or your repre- household personal property in a resi- sentative to implement reason- dential unit, if such coverage is written able loss control requirements, under one of the following: agreed to by you as a condition Commercial Property Coverage Part of policy issuance, or which Farm Coverage Part - Farm Property - were conditions precedent to Farm Dwellings, Appurtenant Structures our use of a particular rate or And Household Personal Property Cov- rating plan, if that failure ma- Form terially increases any of the erage risks insured against. a. If such coverage has been in effect (6) A determination by the Com- for 60 days or less, and is not a missioner of Insurance that the: renewal of coverage we previously issued, we may cancel this cover - (a) Loss of, or changes in, our age for any reason, except as pro- vided in b. and c. below. part of the risk would b. We may not cancel this policy sole- threaten eaten our financial integ- ly because the first Named Insured rity solvency; or has: (b) Continuation of the policy (1) Accepted an offer of earthquake coverage would: coverage; or (i) Place us in violation of (2) Cancelled or did not renew a California law or the policy issued by the California la la h laws of the state where Earthquake Authority (CEA) that are domiciled; included an earthquake policy (ii) Threaten our solvency. premium surcharge. (7) A change by you or your repre- However, we shall cancel this poli- sentative in the activities or cy if the first Named Insured has property of the commercial or accepted a new or renewal policy industrial enterprise, which re- issued by the CEA that includes an sults in a materially added, in- earthquake policy premium sur - creased or changed risk, unless charge but fails to pay the earth - the added, increased or quake policy premium surcharge changed risk is included in the authorized by the CEA. policy. c. We may not cancel such coverage o b. We will mail or deliver advance solely because corrosive soil condi- written notice of cancellation, stat- tions exist on the premises. This ing the reason for cancellation, to restriction (c.) applies only if cov- the first Named Insured, at the erage is subject to one of the fol - mailing address shown in the poli- lowing, which exclude loss or dam- cy, and to the producer of record, at age caused by or resulting from least: corrosive soil conditions: (1) 10 days before the effective (1) Commercial Property Coverage date of cancellation if we can- Part - Causes Of Loss - Special cel for nonpayment of premium Form; or or discovery of fraud; or (2) Farm Coverage Part -Causes Of (2) 30 days before the effective Loss Form - Farm Property, date of cancellation if we can- Paragraph D. Covered Causes cel for any other reason listed' ' Of Loss -Special. in Paragraph 3.a. IL 02 70 09 12 © Insurance Services Office, Inc., 2012 Page 2 of 4 C. The following is added and supersedes any (2) The Commissioner of Insurance provisions to the contrary: finds that the exposure to po- Nonrenewal tential losses will threaten our 1. Subject to the provisions of Paragraphs solvency or place us in a haz- C.2. and C.3. below, if we elect not to ardous condition. A hazardous renew this policy, we will mail or de- condition includes, but is not liver written notice, stating the reason limited to, a condition in which for nonrenewal, to the first Named In- we make claims payments for sured shown in the Declarations, and to losses resulting from an earth - the producer of record, at least 60 days, quake that occurred within the but not more than 120 days, before the preceding two years and that expiration or anniversary date. required a reduction in We will mail or deliver our notice to the policyholder surplus of at least first Named Insured, and to the pro- 25% for payment of those ducer of record, at the mailing address claims; or shown in the policy. (3) We have: 2. Residential Property (a) Lost or experienced a sub - This provision applies to coverage on stantial reduction in the real property used predominantly for availability or scope of re - residential purposes and consisting of insurance coverage; or not more than four dwelling units, and (b) Experienced a substantial to coverage on tenants' household increase in the premium property contained in a residential unit, charged for reinsurance if such coverage is written under one of coverage of our residential the following: property insurance policies; Commercial Property Coverage Part and Farm Coverage Part - Farm Property - the Commissioner has ap- Farm Dwellings, Appurtenant Structures proved a plan for the And Household Personal Property Cov- nonrenewals that is fair and erage Form equitable, and that is respon- sive to the changes in our re - a. We may elect not to renew such insurance position. coverage for any reason, except as C. We will not refuse to renew such provided in b., c. and d. below. coverage solely because the firstNamed b. We will not refuse to renew such Insured has cancelled or did coverage solely because the first not renew a policy, issued by the Named Insured has accepted an of- California Earthquake Authority, fer of earthquake coverage. that included an earthquake policy However, the following applies only premium surcharge. to insurers who are associate par- d. We will not refuse to renew such ticipating insurers as established by coverage solely because corrosive m Cal. Ins. Code Section 10089.16. We soil conditions exist on the prem - may elect not to renew such cov- ises. This restriction (d.) applies erage after the first Named Insured only if coverage is subject to one of has accepted an offer of earthquake the following, which exclude loss or coverage, if one or more of the fol- damage caused by or resulting lowing reasons applies: from corrosive soil conditions: (1) The nonrenewal is based on (1) Commercial Property Coverage sound underwriting principles Part - Causes Of Loss - Special that relate to the coverages Form; or provided by this policy and that are consistent with the ap- (2) Farm Coverage Part - Causes Of proved rating plan and related Loss Form - Farm Property, documents filed with the De- Paragraph D. Covered Causes partment of Insurance as re- quired by existing law; IL 02 70 09 12 © Insurance Services Office, Inc., 2012 Page 3 of 4 3. We are not required to send notice of nonrenewal in the following situations.- a. ituations:a. If the transfer or renewal of a poli- cy, without any changes in terms, conditions or rates, is between us and a member of our insurance group. b. If the policy has been extended for 90 days or less, provided that no- tice has been given in accordance with Paragraph C.1. c. If you have obtained replacement coverage, or if the first Named In- sured has agreed, in writing, within 60 days of the termination of the policy, to obtain that coverage. d. If the policy is for a period of no more than 60 days and you are no- tified at the time of issuance that it will not be renewed. e. If the first Named Insured requests a change in the terms or conditions or risks covered by the policy with- in 60 days of the end of the policy period. f. If we have made a written offer to the first Named Insured, in accor- dance with the timeframes shown in Paragraph C.1., to renew the policy under changed terms or con- ditions or at an increased premium rate, when the increase exceeds 25%. IL 02 70 09 12 © Insurance Services Office, Inc., 2012 Page 4 of 4 WSWUNCE ADMIRAL *QzXCWVMPLLC.Policyholder Message Named Insured: G2 CONSTRUCTION INC Dear Policyholder: Poky Aber: 0 Our Corporate Headquarters' and Northeast Regional Branch Admiral Insurance Company (A Berkley Company) Mt. Laurel Corporate Park 1000 Howard Blvd., Suite 300, P.O. Box 5430 Mt. Laurel, NJ 08054 Our telephone number: General: (856) 429 —9200 If you need to report a claim please direct it: By regular or overnight mail to; Admiral Insurance Company (A Berkley Company) Mt. Laurel Corporate Park 1000 Howard Blvd., Suite 300 P.O. Box 5430 Mt. Laurel, NJ 08054 Attention: New Claim Clearly state it is a "NEW CLAIM". II. By Email to; admclaims@admiralins.com Do not email claims to ANY claims individual. III. By FAX to; Fax #: (856) 429-3630 Attention: New Claim Clearly state it is a "NEW CLAIM". 000001983-01 i��rss it"° � .x if: K. Berkley Company FM 30 11 02 l5 4J Page 1 of 1 13 ADMIRAL INSURANCE COMPANY A Stock Company EXCESS LIABILITY POLICY THIS POLICY IS NOT OBTAINED PRIMARILY FOR PERSONAL, FAMILY OR HOUSEHOLD PURPOSES. THIS POLICY CONSISTS OF: DECLARATIONS EXCESS POLICY FORM SCHEDULE OF "UNDERLYING INSURANCE" APPLICABLE FORMS AND ENDORSEMENTS In Witness Whereof, we have caused this policy to be executed and attested, and, if required by state law, this policy shall not be valid unless countersigned by our authorized representative. Secretary V-.; a i - r"), 11 �- 0 1. W�,, A A W- -:051 1000 Howard Blvd., Suite 300, P.O. Box 5430 Mt. Laurel, NJ 08054 Telephone (856) 429-9200 Facsimile (856) 429-8611 JX4622 (03/13) bct: R. Berkley competny Policy Number: GX000001983-01 Al 80 00 09 17 Effective Date: 02/01/2019 ADMIRALUAW Named Insured: G2 CONSTRUCTION INC IMPORTANT — POLICYHOLDER NOTICES Form Intentionally Left Blank Al 80 00 09 17 Page 1 of 1 13 ADMIRAL INSURANCE COMPANY A STOCK COMPANY Policy No.: GX000001983-01 Named Insured and Mailing Address G2 CONSTRUCTION INC 1352 EAST BORCHARD AVE. SANTA ANA, CA 92705 COMMERCIAL EXCESS LIABILITY POLICY DECLARATIONS Renewal/Rewrite of: NEW POLICY PERIOD: From 02/01/2019 to 02/01/2020 At 12:01 A.M. Standard Time at the address of the Named Insured as stated herein In return for the payment of the premium and subject to all the terms of this policy, we agree with you to provide the insurance as stated in this policy. THE NAMED INSURED IS: ❑ Individual; ❑ Partnership; 0 Corporation; ❑ Joint Venture; ❑ LLC; ❑ Other AUDIT PERIOD: ❑ Annual ❑ Semi -Annual ❑ Quarterly ❑ Monthly ECJ N/A LIMITS OF INSURANCE: Each Loss Event Limit: $2,000,000 Policy Aggregate Limit: $2,000,000 PREMIUM: Advance Premium: Terrorism Premium: Total Premium: $6,244.00 $0.00 $6,244.00 MINIMUM RETAINED PREMIUM: Company to retain no less than 25% of the Total Premium if the Insured cancels FORMS AND ENDORSEMENTS MADE A PART OF THIS POLICY AT INCEPTION: See Schedule of Forms At 00 18 03 98 This policy is not binding unless countersigned by Admiral Insurance Company or its Authorized Representative. Countersigned On: 02/19/2019 At: Seattle, WA By. Authorized Reor<ferfative DE 2027 0603 6V. X. Berkley Company ADMIRAL INSURANCE COMPANY COMMERCIAL EXCESS LIABILITY Policy No.: GX000001983-01 SCHEDULE OF CONTROLLING UNDERLYING INSURANCE Commercial General Liability Company ADMIRAL INSURANCE COMPANY Minimum Applicable Limits of Insurance General Aggregate $ 2,000,000 (Other Than Products -Completed Operations Aggregate) Products -Completed Operations Aggregate $ 2,000,000 Each Occurrence $ 1,000,000 Personal And Advertising Injury $ 1,000,000 Commercial Auto Liability Company LIBERTY MUTUAL INSURANCE COMPANY Minimum Applicable Limits of Insurance Any One Accident $ 1,000,000 Employers' Liability Company CYPRESS INS CO Minimum Applicable Limits of Insurance Bodily injury by accident $ 1,000,000 Each Accident Bodily injury by disease $ 1,000,000 Each Employee Bodily injury by disease $ 1,000,000 Policy Limit This insurance does not apply to "injury or damage" caused by a "loss event" covered under Employer's Liability "controlling underlying insurance" in any jurisdiction where such insurance is or is required to be unlimited Employee Benefits Liability Company ADMIRAL INSURANCE COMPANY Minimum Applicable Limits of Insurance $ 1,000,000 Each Employee $ 2,000,000 Aggregate Limit DE 20 28 06 03 SCHEDULE OF FORMS Named Insured: G2 CONSTRUCTION INC FORM NUMBER TITLE JX46220313 COVER JACKET ADMIRAL EXCESS Policy No.: GX000001983-01 DE20270603 EXCESS LIABILITY POLICY DECLARATIONS DE20280603 EXCESS SCHEDULE OF "UNDERLYING INSURANCE" AI00180398 SCHEDULE OF FORMS EX46410416 COMMERCIAL EXCESS LIABILITY COVERAGE FORM EX50460115 CONDITIONAL EXCLUSION OF TERRORISM RELATED TO DISPOSITION OF FEDERAL TERRORISM RISK INSURANCE ACT Al 00 18 03 98 Page I of 1 13 COMMERCIAL EXCESS LIABILITY COVERAGE FORM Various provisions in this policy restrict coverage. Read the entire policy carefully to determine rights, duties and what is and is not covered. Throughout this policy the words "you" and "your" refer to the "Named Insured" shown in the Declarations. The words "we", "us" and "our" refer to the Company provid- ing this insurance. The first "Named Insured" is the person or organization first named in the Declarations and is responsible for the payment of all premiums. The first "Named Insured" will act on behalf of all other "Named Insureds" for giving and receiving notices of cancellation and for receiving any re- turn premium that may become payable. Other words and phrases that appear in quotation marks have special meaning. Refer to Section IV - Definitions and relevant references in the text of this policy. Other words and phrases that are not defined under this policy but defined in the "controlling underlying insur- ance" will have the meaning described in the policy of "controlling underlying insurance". SECTION I - EXCESS LIABILITY COVERAGE 1. Insuring Agreement a. We will pay on behalf of the "insured" the "ulti- mate net loss" in excess of the "controlling un- derlying insurance limit' because of "injury or damage" caused by a "loss event' to which this insurance applies, provided the applicable limits of "controlling underlying insurance", as shown in the Schedule Of Controlling Underlying Insur- ance, have been exhausted by payment of judg- ments, settlements and, if applicable, costs or ex- penses. b. The amount we will pay for the "ultimate net loss" is limited as described in Section II - Lim- its of Insurance. c. This insurance applies to "injury or damage" that is subject to a limit of applicable "controlling un- derlying insurance" that is specified in the Schedule Of Controlling Underlying Insurance. If any other limit, such as a sublimit, is specified in the "controlling underlying insurance", this in- surance does not apply to "injury or damage" arising out of that exposure unless that limit is specified in the Schedule Of Controlling Under- lying Insurance. d. If the "controlling underlying insurance" re- quires, for a particular claim, that the "injury or damage" occur during its policy period in order for that coverage to apply, then this insurance will only apply to that "injury or damage" if it occurs during the policy period of this policy. If the "controlling underlying insurance" requires that the "loss event" causing the particular "in- jury or damage" take place during its policy pe- riod in order for that coverage to apply, then this insurance will apply to the claim only if the "loss event' causing that "injury or damage" takes place during the policy period of this policy. e. The insurance provided under this policy will follow the same provisions, exclusions and limi- tations that are contained in the applicable "con- trolling underlying insurance", unless otherwise directed by this insurance. To the extent such provisions differ or conflict, the provisions of this policy will apply. However, the coverage provided under this policy will not be broader than that provided by the applicable "controlling underlying insurance". f. In the event that the Schedule Of Controlling Underlying Insurance identifies more than one policy of "controlling underlying insurance", the provisions, exclusions and limitations of the "controlling underlying insurance" applicable to the particular "loss event' for which a claim is made or "suit' is brought will apply to the extent not contradicted by the provisions of this policy. 2. Insuring Agreement — Defense a. We will have no duty to investigate or defend any claim or "suit'. We will have the right and be given the opportunity to associate with any "insured" or "controlling underlying insurer" in the investigation, settlement or defense of any claim or "suit' that may involve this insurance. b. At our discretion, we may investigate and settle any claim or "suit'. c. If we exercise our rights as described in Para- graphs 2.a. and 2.b. above, we will pay, with re- spect to any claim we investigate or settle, or any "suit' against an "insured" we defend, the fol- lowing costs or expenses: EX 46 4104 16 Includes copyrighted material of Insurance Services Office, Inc., Page 1 of 6 13 with its permission, 2012 (1) All expenses we incur, including but not This insurance does not apply to: limited to attorney fees; a. Auto (2) The cost of bonds to release attachments, but Any loss, cost or expense payable under or re - only for bond amounts within the applicable sulting from any of the following auto cover - limit of insurance. We do not have to furnish ages: these bonds; (1) First -party physical damage coverage; (3) All reasonable expenses incurred by the "in- sured" at our request to assist us in the in- (2) No-fault coverage; vestigation or defense of the claim or "suit", (3) Personal injury protection or auto medical including actual loss of earnings up to $250 payments coverage; or a day because of time off from work; (4) Uninsured or underinsured motorists cover - (4) All costs taxed against the "insured" in the age. "suit"; b. Employers Liability (5) Prejudgment interest awarded against the "Injury or damage" caused by a "loss event" "insured" on that part of the judgment we covered under Employer's Liability "controlling pay. If we make an offer to pay the applica- underlying insurance" in any jurisdiction where ble limit of insurance, we will not pay any such insurance is or is required to be unlimited. prejudgment interest based on that period of time after the offer; and c. Medical Payments (6) All interest on the full amount of any judg- Medical payments coverage or expenses that are ment that accrues after entry of the judgment provided without regard to fault, whether or not and before we have paid, offered to pay, or provided by the applicable "controlling underly - deposited in court the part of the judgment ing insurance". that is within the applicable limit of insur- d. Pollution ance. (1) "Injury or damage" which would not have These payments will not reduce the Each Loss occurred, in whole or in part, but for the ac - Event Limit or Policy Aggregate Limit shown in tual, alleged or threatened discharge, disper- the Declarations unless the policy of "controlling sal, seepage, migration, release or escape of underlying insurance" specifies that its "control- pollutants at any time. ling underlying insurance limit" is reduced by (2) Any loss, cost or expense arising out of any: costs or expenses. d. If we exercise our rights as described in Para- (a) Request, demand, order or statutory or regulatory requirement that any "in - graphs 2.a. and 2.b. above, we are under no obli- sured" or others test for, monitor, clean gation to continue any investigation, settlement up, remove, contain, treat, detoxify or or associated defense when the "controlling un- neutralize, or in any way respond to, or derlying insurance limit" has been exhausted, or assess the effects of, pollutants; or if on such exhaustion we continue any investiga- tion, settlement or associated defense, when we (b) Claim or "suit" by or on behalf of a have used up the applicable Each Loss Event governmental authority for damages be - Limit or Policy Aggregate Limit shown in the cause of testing for, monitoring, clean - Declarations in the payment of judgments, settle- ing up, removing, containing, treating, ments and, if applicable, costs or expenses. detoxifying or neutralizing, or in any e. When our limits of insurance have been ex- way responding to, or assessing the ef- fects of, pollutants. hausted, any defense provided by us under Para- graphs 2.a. and/or 2.d. will cease. This exclusion only applies when this policy is 3. Exclusions excess to a policy issued by an insurer other than US. The following exclusions, and any other exclusions This exclusion does not apply to the extent that added by endorsement, apply to this policy. In addi- the applicable "controlling underlying insurance" tion, the exclusions applicable to any "controlling un- for the pollution liability risks described in Para- derlying insurance" apply to this insurance unless su- graphs (1) and (2) above exist or would have perseded by the following exclusions, or superseded by any other exclusions added by endorsement to this policy. EX 46 4104 16 Includes copyrighted material of Insurance services Office, Inc., Page 2 of 6 0 with its permission, 2012 existed but for the exhaustion of the limit of such "controlling underlying insurance" for "injury or damage". e. Workers' Compensation And Similar Laws Any obligation of any insured under a workers' compensation, disability benefits or unemploy- ment compensation law or any similar law. SECTION II — LIMITS OF INSURANCE 1. The Limits of Insurance shown in the Declarations, and the rules below fix the most we will pay regard- less of the number of: a. "Insureds"; b. Claims made or "suits" brought, or number of vehicles involved; c. Persons or organizations making claims or bring- ing "suits"; or d. Limits available under any "controlling underly- ing insurance". 2. The Limits of Insurance of this policy will apply as follows: a. This insurance only applies in excess of the "controlling underlying insurance limit". b. The Policy Aggregate Limit is the most we will pay for the sum of all "ultimate net loss" for all "injury or damage" covered under this insurance. However, this Policy Aggregate Limit only ap- plies to "injury or damage" that is subject to an aggregate limit of insurance under the "control- ling underlying insurance" applicable to the par- ticular "loss event" for which a claim is made or "suit" is brought. c. Subject to Paragraph 2.b. above, the Each Loss Event Limit is the most we will pay for the sum of all "ultimate net loss" under this insurance be- cause of all "injury or damage" arising out of any one "loss event". d. If the Limits of Insurance of the "controlling un- derlying insurance" are reduced by costs or ex- penses by the terms of that policy, any payments for costs or expenses we make will reduce our applicable Limits of Insurance in the same man- ner. 3. If any "controlling underlying insurance" has a policy period that is different from the policy period of this policy then, for the purposes of this insurance, the "controlling underlying insurance limit" will only be reduced or exhausted by payments made for "injury or damage" covered under this insurance. The Policy Aggregate Limit described in Paragraph 2. above applies to the policy period shown in the Declara- tions. Any extension of the policy period will be deemed part of the policy period that is being extended and there- fore subject to the Policy Aggregate Limit. SECTION III —CONDITIONS The following conditions apply. In addition, the condi- tions applicable to any "controlling underlying insurance" are also applicable to the coverage provided under this in- surance unless superseded by the following conditions. 1. Appeals If the "controlling underlying insurer" or "insured" elects not to appeal a judgment in excess of the appli- cable "controlling underlying insurance limit", we may do so at our own expense. We will be liable for taxable costs, pre- and post judgment interest and disbursements. In no event will this provision in- crease our liability beyond the applicable Limits of Insurance described in Section II - Limits of Insur- ance. 2. Bankruptcy a. Bankruptcy Of Insured Bankruptcy or insolvency of the "insured" or of the "insured's" estate will not relieve us of our obligations under this policy. b. Bankruptcy Of Underlying Insurer Bankruptcy of the "controlling underlying in- surer" will not relieve us of our obligations under this policy. However, this insurance will not replace the "control- ling underlying insurance" in the event of bankruptcy or insolvency of the "controlling underlying insurer". This insurance will apply as if the "controlling under- lying insurance" were in full effect. 3. Cancellation a. The first "Named Insured" shown in the Declara- tions may cancel this policy by mailing or deliv- ering to us advance written notice of cancella- tion. b. We may cancel this policy by mailing or deliver- ing to the first "Named insured" written notice of cancellation at least: (1) 10 days before the effective date of cancella- tion if we cancel for nonpayment of pre- mium; or (2) 30 days before the effective date of cancella- tion if we cancel for any other reason. EX 46 4104 16 Includes copyrighted material of Insurance services Office, Inc., Page 3 of 6 13 with its permission, 2012 c. We will mail or deliver our notice to the first "Named Insured's" last mailing address known to us. d. Notice of cancellation will state the effective date of cancellation. The policy period will end on that date. e. If this policy is cancelled, we will send the first "Named Insured" any premium refund due. If we cancel, the refund will be pro rata. If the first "Named Insured" cancels, the refund may be less than pro rata. The cancellation will be effective even if we have not made or offered a refund. L If notice is mailed, proof of mailing will be suffi- cient proof of notice. 4. Changes This policy contains all the agreements between you and us concerning the insurance afforded. The first "Named Insured" shown in the Declarations is au- thorized to make changes in the terms of this policy with our consent. This policy's terms can be amended or waived only by endorsement issued by us and made a part of this policy. 5. Duties In The Event Of A Loss Event, Claim Or Suit a. You must see to it that we are notified in writing as soon as practicable of any "loss event", re- gardless of the amount, which may reasonably be expected to result in a claim under this policy. To the extent possible, notice should include: (1) How, when and where the "loss event" took place; (2) The names and addresses of any injured per- sons and witnesses; and (3) The nature and location of any "injury or damage" arising out of the "loss event". b. If a claim is made or "suit" is brought against any "insured", you must: (1) Immediately record the specifics of the claim or "suit" and the date received; and (2) Notify us in writing as soon as practicable. You must see to it that we receive written notice of the claim or "suit" as soon as practicable. c. You and any other involved "insured" must: (1) Immediately send us copies of any demands, notices, summonses or legal papers received in connection with the claim or "suit"; (2) Authorize us to obtain records and other in- formation; (3) Cooperate with us in the investigation or set- tlement of the claim or defense against the "suit"; and (4) Assist us, upon our request, in the enforce- ment of any right against any person or or- ganization which may be liable to the "in- sured" because of "injury or damage" to which this insurance may also apply. d. No "insured" will, except at that "insured's" own cost, voluntarily make a payment, assume any obligation, or incur any expense, other than for first aid, without our consent. 6. Examination Of Your Books And Records We may examine and audit your books and records as they relate to this policy at any time during the policy period and up to three years afterward. 7. Inspections And Surveys a. We have the right to: (1) Make inspections and surveys at any time; (2) Give you reports on the conditions we find; and (3) Recommend changes. b. We are not obligated to make any inspections, surveys, reports or recommendations and any such actions we do undertake relate only to in- surability and the premiums to be charged. We do not make safety inspections. We do not un- dertake to perform the duty of any person or or- ganization to provide for the health or safety of workers or the public. We do not warrant that conditions: (1) Are safe or healthful; or (2) Comply with laws, regulations, codes or standards. Paragraphs a. and b. of this condition apply not only to us, but also to any rating, advisory, rate service or similar organization which makes insurance inspec- tions, surveys, reports or recommendations on our be- half. 8. Legal Action Against Us No person or organization has a right under this policy: a. To join us as a party or otherwise bring us into a "suit" asking for damages from an "insured"; or b. To sue us on this policy unless all of its terms have been fully complied with. EX 46 4104 16 Includes copyrighted material of Insurance services Office, Inc., Page 4 of 6 ❑ with its permission, 2012 A person or organization may sue us to recover on an agreed settlement or on a final judgment against an "insured", but we will not be liable for damages that are not payable under the terms of this policy or that are in excess of the applicable limit of insurance. An agreed settlement means a settlement and release of liability signed by us, the "insured" and the claimant or the claimant's legal representative. 9. Other Insurance a. This insurance is excess over, and shall not con- tribute with any other insurance, whether pri- mary, excess, contingent or on any other basis. This condition will not apply to insurance specif- ically written as excess over this policy. b. When this insurance is excess over other insur- ance, we will pay only our share of the "ultimate net loss" that exceeds the sum of: (1) The total amount that all such other insur- ance would pay for the loss in the absence of this insurance; and (2) The total of all deductible and self-insured amounts under all that other insurance. 10. Premium Audit a. We will compute all premiums for this policy in accordance with our rules and rates. b. If this policy is auditable, the premium shown in this policy as advance premium is a deposit pre- mium only. At the close of each audit period we will compute the earned premium for that period and send notice to the first "Named Insured". The due date for audit premiums is the date shown as the due date on the bill. c. The first "Named Insured" must keep records of the information we need for premium computa- tion and send us copies at such times as we may request. 11. Representations Or Fraud By accepting this policy, you agree, represent and warrant that: a. The statements in the Declarations are accurate and complete; b. The statements and information contained in the application for insurance and any supplementary information are true and correct and that no facts have been suppressed or misstated; e. This policy is void in any case of fraud and/or misrepresentation by you as it relates to this pol- icy or any claim under this policy. 12. Separation Of Insureds Except with respect to the Limits of Insurance and any rights or duties specifically assigned in this pol- icy to the first "Named Insured", this insurance ap- plies: a. As if each "Named Insured" were the only "Named Insured"; and b. Separately to each "insured" against whom claim is made or "suit" is brought. However, nothing in this condition renders this pol- icy applicable to any "insured" where the policy is otherwise void due to fraud or misrepresentations made by that "insured" or any other "insured". 13. Transfer Of Rights Of Recovery Against Others To Us If the "insured" has rights to recover all or part of any payment we have made under this policy those rights are transferred to us. The "insured" must do nothing after loss to impair them. At our request, the "in- sured" will bring "suit" or transfer those rights to us and help us enforce them. 14. Transfer Of Rights And Duties Under This Policy The rights and duties of any "insured" under this pol- icy may not be transferred without our written con- sent, except in the case of death of an individual named "insured". If any "insured" dies, that "insured's" rights and duties will be transferred to that "insured's" legal representative, but only while acting within the scope of duties as that "insured's" legal representative. Until that "insured's" legal representative is appointed, anyone having proper temporary custody of that "insured's" property will have that "insured's" rights and duties but only with respect to that property. 15. No Duty To Notify If We Do Not Renew If we decide not to renew this policy, we are under no obligation to mail or deliver notice of the nonrenewal to any "insured" or others. 16. Loss Payable Liability under this policy does not apply to a given claim unless and until: c. This policy is being issued in full reliance upon a. The "insured" or "insured's" "controlling under - the statements and representations made in the lying insurer" has become obligated to pay the application and any supplementary information; "controlling underlying insurance limit"; and d. The application and any supplementary infor- mation are incorporated and made part of this policy by reference; and EX 46 4104 16 Includes copyrighted material of Insurance services Office, Inc., Page 5 of 6 with its permission, 2012 C b. The obligation of the "insured" to pay the "ulti- mate net loss" in excess of the "controlling un- derlying insurance limit" has been determined by a final settlement or judgment or written agree- ment among the "insured", claimant, "controlling underlying insurer" (or a representative of one or more of these) and us. 17. Maintenance Of Underlying Insurance You must maintain the "controlling underlying insur- ance" affording in total the coverage and limits as stated in the Schedule Of Controlling Underlying In- surance in full force and effect during the policy pe- riod shown in the Declarations of this policy, except for reduction of aggregate limits, where applicable, solely as a result of the payment of claims, settlement or judgments for "loss events" which: a. Take place during the policy period of this policy; and b. Are for "injury or damage", costs or expenses covered by this policy. You must notify us in writing within thirty days if any company cancels, non -renews, replaces or other- wise terminates or changes any terms or conditions of any of the "controlling underlying insurance". You must notify us immediately of the exhaustion of any aggregate limits of the "controlling underlying insur- ance". Your failure to comply with the foregoing will not in- validate this policy, but in the event of such failure we will be liable only to the extent that we would have been liable had you complied herewith. SECTION IV — DEFINITIONS The definitions applicable to any "controlling underlying insurance" also apply to this insurance. In addition, the following definitions apply. 1. "Controlling underlying insurance" means any policy of insurance or self-insurance listed in the Schedule Of Controlling Underlying Insurance that applies to the particular "loss event" for which a claim is made or "suit" is brought. 2. "Controlling underlying insurance limit" means the sum of amounts applicable to any claim or "suit" from: a. "Controlling underlying insurance", whether such "controlling underlying insurance" is col- lectible or not; b. Any other insurance, whether primary, excess, contingent or on any other basis, except such in- surance as is specifically purchased to apply in excess of this policy's Limits of Insurance; and c. Any applicable self-insured retention or deducti- ble 3. "Controlling underlying insurer" means any insurer who provides any policy or coverages of "controlling underlying insurance". 4. "Injury or damage" means any injury or damage cov- ered by the applicable "controlling underlying insur- ance" arising from a "loss event". 5. "Insured" means any person or organization qualify- ing as such under the "controlling underlying insur- ance". 6. "Loss event" means an occurrence, offense, accident, act, or other event, to which the applicable "control- ling underlying insurance" applies. 7. "Named Insured" means the entity(ies) or individ- ual(s) named in the Declarations. 8. "Suit" means a civil proceeding in which damages because of a "loss event" to which this insurance ap- plies are alleged. "Suit" includes: a. An arbitration proceeding in which such dam- ages are claimed and to which the "insured" must submit or does submit with our consent; or b. Any other alternative dispute resolution proceed- ing in which such damages are claimed and to which the "insured" submits with our consent or the "controlling underlying insurer's" consent. 9. "Ultimate net loss" means the total sum, after reduc- tion for recoveries, or salvages collectible, that the "insured" becomes legally obligated to pay as dam- ages by reason of: a. Settlements, judgments, binding arbitration; or b. Other binding alternate dispute resolution pro- ceeding entered into with our consent. "Ultimate net loss" includes costs and expenses if the "controlling underlying insurance" specifies that lim- its are reduced by costs or expenses. EX 46 4104 16 Includes copyrighted material of Insurance services Office, Inc., Page 6 of 6 0 with its permission, 2012 Policy Number: GX000001983-01 EX 50 46 01 15 Effective Date: 02/01/2019 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CONDITIONAL EXCLUSION OF TERRORISM (RELATING TO DISPOSITION OF FEDERAL TERRORISM RISK INSURANCE ACT) This endorsement modifies insurance provided under the following: EXCESS LIABILITY POLICY Any endorsement addressing acts of terrorism (however defined) in any "controlling underlying insurance" does not apply to this excess insurance. The following provisions addressing acts of terrorism apply with respect to this excess insurance. A. Applicability Of The Provisions Of This Endorsement 1. The provisions of this endorsement become applicable commencing on the date when any one or more of the following first occurs. But if your policy (meaning the policy period in which this endorsement applies) be- gins after such date, then the provisions of this endorsement become applicable on the date your policy be- gins. a. The federal Terrorism Risk Insurance Program ("Program"), established by the Terrorism Risk Insur- ance Act, has terminated with respect to the type of insurance provided under this Coverage Part; or b. A renewal, extension or replacement of the Program has become effective without a requirement to make terrorism coverage available to you and with revisions that: (1) Increase our statutory percentage deductible under the Program for terrorism losses. (That deducti- ble determines the amount of all certified terrorism losses we must pay in a calendar year, before the federal government shares in subsequent payment of certified terrorism losses.); or (2) Decrease the federal government's statutory percentage share in potential terrorism losses above such deductible; or (3) Redefine terrorism or make insurance coverage for terrorism subject to provisions or requirements that differ from those that apply to other types of events or occurrences under this policy. 2. If the provisions of this endorsement become applicable, such provisions: a. Supersede any terrorism endorsement already endorsed to this policy that addresses "certified acts of terrorism" and/or "other acts of terrorism", but only with respect to an incident(s) of terrorism (however defined) which results in injury or damage that occurs on or after the date when the provisions of this endorsement become applicable (for claims -made policies, such an endorsement is superseded only with respect to an incident of terrorism (however defined) that results in a claim for injury or damage first being made on or after the date when the provisions of this endorsement become applicable); and b. Remain applicable unless we notify you of changes in these provisions, in response to federal law. 3. If the provisions of this endorsement do NOT become applicable, any terrorism endorsement already en- dorsed to this policy, that addresses "certified acts of terrorism" and/or "other acts of terrorism", will con- tinue in effect unless we notify you of changes to that endorsement in response to federal law. B. The following definition is added and applies under this endorsement wherever the term terrorism is enclosed in quotation marks: "Terrorism" means activities against persons, organizations or property of any nature: 1. That involve the following or preparation for the following: a. Use or threat of force or violence; or EX 50 46 01 15 © Insurance Services Office, Inc., 2013 Page l of 2 13 b. Commission or threat of a dangerous act; or c. Commission or threat of an act that interferes with or disrupts an electronic, communication, information or mechanical system; and 2. When one or both of the following applies: a. The effect is to intimidate or coerce a government or the civilian population or any segment thereof, or to dis- rupt any segment of the economy; or b. It appears that the intent is to intimidate or coerce a government, or to further political, ideological, religious, social or economic objectives or to express (or express opposition to) a philosophy or ideology. C. The following exclusion is added: Exclusion Of Terrorism We will not pay for "injury or damage" caused directly or indirectly by "terrorism", including action in hindering or defending against an actual or expected incident of "terrorism". "Injury or damage" is excluded regardless of any other cause or event that contributes concurrently or in any sequence to such injury or damage. But this exclusion applies only when one or more of the following are attributed to an incident of "terrorism": 1. The "terrorism" is carried out by means of the dispersal or application of radioactive material, or through the use of a nuclear weapon or device that involves or produces a nuclear reaction, nuclear radiation or radioactive contamina- tion; or 2. Radioactive material is released, and it appears that one purpose of the "terrorism" was to release such material; or 3. The "terrorism" is carried out by means of the dispersal or application of pathogenic or poisonous biological or chemical materials; or 4. Pathogenic or poisonous biological or chemical materials are released, and it appears that one purpose of the "terror- ism" was to release such materials; or 5. The total of insured damage to all types of property exceeds $25,000,000. In determining whether the $25,000,000 threshold is exceeded, we will include all insured damage sustained by property of all persons and entities affected by the "terrorism" and business interruption losses sustained by owners or occupants of the damaged property. For the purpose of this provision, insured damage means damage that is covered by any insurance plus damage that would be covered by any insurance but for the application of any terrorism exclusions; or 6. Fifty or more persons sustain death or serious physical injury. For the purposes of this provision, serious physical injury means: a. Physical injury that involves a substantial risk of death; or b. Protracted and obvious physical disfigurement; or c. Protracted loss of or impairment of the function of a bodily member or organ. Multiple incidents of "terrorism" which occur within a 72 -hour period and appear to be carried out in concert or to have a related purpose or common leadership will be deemed to be one incident, for the purpose of determining whether the thresholds in Paragraph C.S. or C.6. are exceeded. With respect to this exclusion, Paragraphs C.S. and C.6. describe the threshold used to measure the magnitude of an inci- dent of "terrorism" and the circumstances in which the threshold will apply, for the purpose of determining whether this exclusion will apply to that incident. When the exclusion applies to an incident of "terrorism", there is no coverage un- der this Coverage Part. In the event of any incident of "terrorism" that is not subject to this exclusion, coverage does not apply to "injury or dam- age" that is otherwise excluded under this Coverage Part. EX 50 46 01 15 © Insurance Services Office, Inc., 2013 Page 2 of 2 BERKSHIRE HATHAWAY HOMESTATE COMPANIES Berkshire Hathaway Homestate Insurance Company Brookwood Insurance Company Continental Divide Insurance Company Cypress Insurance Company Oak River Insurance Company Redwood Fire and Casualty Insurance Company P.O. Box 881236, San Francisco, l e", In Witness Whereof, we have caused this policy to be executed and attested, and, if required by state law, this policy shall not be valid unless countersigned by our authorized representative President President Berkshire Hathaway Homestate Insurance Company Cypress Insurance Company Brookwood Insurance Company Oak River Insurance Company Continental Divide Insurance Company Redwood Fire and Casualty Insurance Company W� Secretary ILM 0314 07 11 Privacy Policy Berkshire Hathaway Homestate Companies Cypress Insurance Company PO Box 881236 San Francisco, CA 94188 Phone: (888) 495-8949 Fax (866) 288-4613 Definitions A "consumer" is a person who seeks or obtains products or services from us for personal, family or household needs. Only a natural person may be a consumer. "Personal information" is information about a consumer that is not publicly available. Information We Collect We collect personal information from: • People who apply for insurance from us; • People who visit our website; • People we insure; • People involved in claims under our policies; • The consumer's transactions with us, our affiliates, our agents or others; • Consumer reporting agencies or insurance support organizations; and • Other third parties including state motor vehicle departments. Information we collect from an insurance -support organization may be kept by them. They may disclose it to others. Information We Disclose We do not disclose personal information, except as required or allowed by law. Sometimes we are allowed to disclose personal information without consent. Examples of such disclosures include: • To a person who performs administrative, business, professional, or insurance functions for us; • To confirm eligibility for insurance benefits or payments; • To detect or prevent crime or fraud; • To insurers or agents that need it to perform an insurance function; • To insurers or agents so we can perform an insurance function; • To medical providers to confirm insurance coverage; • To insurance regulators; • To law enforcement; • In response to subpoenas, search warrants or other court orders; • For actuarial or research studies; • In connection with a sale of our business; • To an affiliate who is auditing us; • To a peer review group looking at the services or conduct of a medical provider; • To a public agency that may have paid health benefits for a consumer; • To a certificate holder or policy owner who wants to know the status of an insurance transaction; • To a person with a legal interest in a policy issued by us; • To rate advisory organizations; • To guaranty funds; • To rating agencies; • To our lawyers, accountants and auditors; • To a group policy owner to report claims experience; • To a group policy owner to conduct an audit; or • As otherwise required or allowed by law. Information Security • We authorize our workers, agents, outside vendors and others to access personal information only when they have a business reason to do so. We have physical, electronic, and procedural safeguards to protect personal information from unauthorized access. Right to Review & Correct Personal Information • A consumer who lives in AZ, CA, CT, GA, IL, MA, ME, MT, NC, NJ, OH, OR, VA may review personal information we have gathered about the consumer. The consumer may send a letter to: Chief Privacy Officer, P.O. Box 881236, San Francisco, CA 94188. • The letter should include name, address, phone number, policy number and describe the records that the consumer wants to review. Upon receipt of this request, we will review our records and inform the consumer if we have the information sought and if it is reasonably locatable and retrievable. If it is, the consumer may review the information in person or request that we mail them a copy. We will disclose to the consumer who else received the information in the past two years or who would normally have received it in the past two years. We may charge the consumer a fee. • The consumer may ask us to fix mistakes in our records. If we agree, we will correct our files. Upon request, we will send revised information to a person who received information from us in the past 2 years. If we disagree, the consumer may file a short statement of dispute. The statement will be included with information we share in the future. Upon request, we will send the statement to a person who received information from us in the past 2 years. Medical Record Rights • A consumer who lives in MT may ask for a record of medical record information we have disclosed. The consumer may send a letter to: Chief Privacy Officer, P.O. Box 881236, San Francisco, CA 94188. Changes to Policy • We may change this policy at any time. We will provide advance notice of changes if required by law. FINIBerkshire Hathaway HOMESTATE COMPANIES Policyholder Registration Instructions 3HH C, W 0F1KFFv CC)M P NS'AT.JN t1. I: i`)N f+F: cE.^J'II'v 3 S-k`:J;,.& ^IFF R:TY To access your account and billing information, and other online BHHC resources, go to our website at BHHC.com, and click on the white login box in the upper right-hand corner of the screen, and enter your username (full email address) and password. New, first-time users without a login and password should choose the "New User" link at the bottom of the box and follow the subsequent registration instructions. If you have a monthly reporting billing cycle (MPR), you must enter your payroll information on the Policyholder Portal. If applicable, a link on the Portal homepage will appear. If you have any additional questions, please contact the BHHC Customer Care Center at (888) 495-8949. Berkshire Hathaway Hornestate Insurance Compary I Brookwood insurance Company Continental Divide insurance Company Cypress Insurance Company I Oak River Insurance Company I Redwood Fir: and Casualty Insurance Company NCCI# 13013 Cypress Insurance Company WORKERS COMPENSATION AND EMPLOYERS LIABILITY POLICY This information page with "Policy Provisions" completes the below numbered Insured's Name and Mailing Address - ITEM 1 Policy No. GTWC013587 G2 Construction Inc. 1352 East Borchard Avenue Renewal Or Rewrite Of No. GTWC910184 Santa Ana, CA 92705 Agent: CAH06163 STRACHOTA INSURANCE AGENCY 27710 Jefferson Ave Ste 100 Temecula, CA 92589 Other Workplaces, not shown above: SEE LOCATION SCHEDULE ATTACHED Issue Date: 02/01/2019 Servicing Office: San Francisco Federal Employer 1. D. No. 01-0862732 Bureau I.D. No. 3521539 Effective - ITEM2: From: 02/01/2019 To: 02/01/2020 at 12:01 A.M. Standard Time at the insured's mailing address Form of Business: F] Individual ❑ Partnership ❑X Corporation ❑ Joint venture ❑ Other Coverage - ITEM3: A. Workers compensation Insurance: Part One of the policy applies to the Workers compensation Law of the states listed here. CA B. Employers Liability Insurance: Part Two of the polic7applies to work in each state listed in item 3A. The limits of our liability under Part Two are. Bodily Injury by Accident $1,000,000 Each Accident Bodily Injury by Disease $1,000,000 Policy Limit Bodily Injury by Disease $1,000,000 Each Employee C. Other States Insurance: Part Three of the policy applies to the states, if any, listed here: All States Except: ND, OH, WA, WY D. This policy includes these endorsements and schedules: See Schedule Attached Premium - ITEM4: The premium for this policy will be determined by our Manuals of Rules, Classifications, Rates and Rating Plans. All information required below is subject to verification and change by audit. Classification Premium Adjustment Period: Monthly WC 99 03 12 (Ed. 7-12) Code Premium Basis Total Rates Per No. Estimated Annual $100 of Remuneration Remuneration See Schedule Attached Total Estimated Annual Premium: Estimated Annual Premium $ 56,541 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY EXTENSION OF INFORMATION PAGE Policy Information Page Schedule Item 4 Insured Name: G2 Construction Inc. Effective Date: 02/01/2019 Expiration Date: 02/01/2020 Classification State California Policy Number: GTWC013587 Premium Basis Total Rate Per Estimated Code Estimated Annual $100 Annual No. Remuneration Remuneration Premium Effective: 02/01/2019-02/01/2020 Metal Goods Mfg - N.O.C. 3400 262,193 12.02 31,516 Millwright Work - N.O.C. 3724 322,423 7.25 23,376 Concrete/Cement Work -low wage < $25 5201 IF ANY 13.56 0 Concrete- sidewalks — $25/hr 5205 IF ANY 9.32 0 Clerical Office Employees N.O.C. 8810 81,327 .50 407 Blanket Waiver of Subrogation 0930 1.020 1,106 Experience Modification 9898 1.010 564 Risk Adjustment 561 Tot Est Standard Premium 02/01/2019-02/01/2020 57,530 Premium Discount 0063 1.893 -1,089 Minimum Premium $3,000 Tot Est Standard Premium for California 56,441 WC 99 03 13 (Ed. 9-14) WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY EXTENSION OF INFORMATION PAGE Policy Information Page Schedule Item 4 Insured Name: G2 Construction Inc. Effective Date: 02/01/2019 Expiration Date: 02/01/2020 Policy Totals Policy Number: GTWC013587 Total Estimated Premium for California 56,441 Expense Constant 100 Total Estimated Annual Premium 56,541 CA CA Workers Compensation Administration Revolving Fund 02/01/2019-02/01/2020 1.4479% 819 CA CA Workers Compensation Fraud Account Assessment 02/01/2019-02/01/2020 0.2878% 163 CA CIGA Surcharge 02/01/2019-02/01/2020 0.0000% 0 CA CA Subsequent Injuries Benefits Trust Fund Assessment 02/01/2019-02/01/2020 0.2737% 155 CA CA Uninsured Employers Benefits Trust Fund Assessment 02/01/2019-02/01/2020 0.0831% 47 CA CA Occupational Safety and Health Fund Assessment 02/01/2019-02/01/2020 0.3765% 213 CA CA Labor Enforcement and Compliance Fund 02/01/2019-02/01/2020 0.3431% 194 Total Estimated Cost for GTWC013587 58,132 WC 99 03 13 (Ed. 9-14) WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY Premium Payment Table PremPayTable Insured Name: G2 Construction Inc. Effective Date: 02/01/2019 Expiration Date: 02/01/2020 Policy No. GTWC013587 Policy Term Due Date Premium 02/01/2019 - 02/01/2020 Initial Deposit 02/15/2019 $10,072.15 $10,072.15 Insured Payment Plan - Monthly Payroll Reporting Berkshire Hathaway Homestate Companies Cypress Insurance Company Dear Policyholder: Cypress Insurance Company makes available to all policyholders Loss Control consultation services per Section 339.4, Article 6 of the Labor Code. Policyholders may request these services at no additional charge. We may conduct loss control visits for other purposes such as obtaining underwriting information. Loss Control Services may include: 0 Provision of training materials and training of employees and supervisors. • Noise surveys. • Assistance in developing safety meeting topics. Information on OSHA regulations. Major accident investigation. 0 Hazard identification surveys; safety inspections. Assistance in development of safety incentive plans and return to work programs. Assistance in evaluating and complying with Title 8 Section 3203 which requires all California employers to establish and implement an effective Injury and Illness Prevention Program. When appropriate, a Loss Control representative will schedule periodic visits to your facilities. If you are interested in scheduling a Loss Control visit, or would like more information, please contact your broker or Cypress Insurance Company Workers Compensation insurance policyholders may register comment about the insurer's Loss Control consultation services in writing to: State of California Department of Industrial Relations Division of Occupational Safety & Health P.O. Box 420603 San Francisco, CA 94142 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY ENDORSEMENT AGREEMENT LIMITING AND RESTRICTING THIS INSURANCE Employee Insured by General Employer Excluded WC 04 03 17 B (Ed. 10-16) The insurance under this policy is limited as follows: It is AGREED that, anything in this policy to the contrary notwithstanding, this policy DOES NOT INSURE: NO LIABILITY FOR EMPLOYEE Any liability you may have as the special employer of an employee who is not on your INSURED BY GENERAL payroll at the time of injury, based upon your representation that: (1) you have entered EMPLOYER into a valid and enforceable agreement pursuant to Labor Code Section 3602(d) with the employee's general employer under which the general employer agrees to secure the payment of compensation for such employee and (2) the general employer has obtained workers' compensation coverage for the employee. This policy will be deemed unlimited to the extent that any of the following requirements are not met: (1) the employer actually obtains coverage for the excluded liability and (2) such coverage remains in effect for the term of this policy. Nothing in this endorsement shall be held to vary, alter, waive or extend any of the terms, conditions, agreements, or limitations of this policy other than as above stated. Nothing elsewhere in this policy shall be held to vary, alter, waive or limit the terms, conditions, agreements or limitations in this endorsement. It is further agreed that "remuneration" when used as a premium basis for such insurance as is afforded by this policy shall not include the remuneration of any person excluded from coverage in accordance with the foregoing. FAILURE TO SECURE THE PAYMENT OF FULL COMPENSATION BENEFITS FOR ALL EMPLOYEES AS REQUIRED BY LABOR CODE SECTION 3700 IS A VIOLATION OF LAW AND MAY SUBJECT THE EMPLOYER TO THE IMPOSITION OF A WORK STOP ORDER, LARGE FINES AND OTHER SUBSTANTIAL PENALTIES (Labor Code Section 3710.1, et seq.). By signature below, you affirm that, with respect to any employee who is also the employee of a general employer, (1) you have entered into a valid and enforceable agreement pursuant to Labor Code Section 3602(d) with the employee's general employer under which the general employer agrees to secure the payment of compensation for such employee and (2) the general employer has obtained workers' compensation coverage for the employee. Countersigned By This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective: 02/01/2019 Policy No.: GTWC013587 Insured Insurance Company Cvoress Insurance Comoanv Countersigned by Endorsement No.: Premium $ WC 04 03 17 B Copyright 1983 National Council on Compensation Insurance. (Ed. 10-16) Berkshire Hathaway HOMESTATE COMPANIES .- -. - . -. San Francisco: P.O. Box 881236, San Francisco, CA 94188 1 (888) 495-8949 bhhc.co Dear Policyholder: Thank you for placing your Workers Compensation coverage with Berkshire Hathaway Homestate Companies (BHHC). We look forward to working with you to fulfill the Workers Compensation needs of your business. For your convenience, and out of consideration for the environment, we now offer electronic versions of our state -by -state Claims Kits at bhhc.com/workers-compensation/claim-center. You can access a state -specific Claims Kit by clicking on the Claims Center and selecting Workers Compensation. Please make sure that you print and post required notices in a place where your employees can easily access the information during company work hours. If you would like to receive a paper copy of our Claims Kit or any other required claim forms, please email us at customercare@bhhc.com. As a valued policyholder, you'll also have access to a variety of online services including: • 24/7 claims reporting via website, email, phone and fax • Streaming safety videos, and other Loss Control training, compliance, and educational resources • Loss Runs and Claim Summaries • Accounting information including monthly payroll reporting • And much, much more! Please visit our website at www.bhhc.com to register for online access to our many services. Berkshire Hathaway Homestate Companies Workers Compensation Division Representing Financial Strength & Integrity Berkshire Hathaway WORKERS COMPENSATION DIVISION HOMESTATE COMPANIES REPRESENTING FINANCIAL STRENGTH & INTEGRITY N ]Berkshire Hathaway HOMESTATE COMPANIES Workers Fe Compensation Servl,es Claim Centel, CA MPN P, ->,1c1cr Sellrc1) Injured %,Vorl,er-, Safety Rurces Claim Kits by State : KC A PAYMfm f AGENTFINDER ZfPCode To download the full PDF, Blease right -click on the link and select "Save link as". NP At -nnecticut ict Of a I i Claim Kits bar State : KC A PAYMfm f AGENTFINDER ZfPCode WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 00 00 00 C WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY In return for the payment of the premium and subject to all terms of this policy, we agree with you as follows: GENERAL SECTION A. The Policy This policy includes at its effective date the Infor- mation Page and all endorsements and schedules listed there. It is a contract of insurance between you (the employer named in Item 1 of the Infor- mation Page) and us (the insurer named on the In- formation Page). The only agreements relating to this insurance are stated in this policy. The terms of this policy may not be changed or waived except by endorsement issued by us to be part of this policy. B. Who is Insured You are insured if you are an employer named in Item 1 of the Information Page. If that employer is a partnership, and if you are one of its partners, you are insured, but only in your capacity as an em- ployer of the partnership's employees. C. Workers Compensation Law Workers Compensation Law means the workers or workmen's compensation law and occupational disease law of each state or territory named in Item 3.A. of the Information Page. It includes any amendments to that law which are in effect during the policy period. It does not include any federal workers or workmen's compensation law, any fed- eral occupational disease law or the provisions of any law that provide nonoccupational disability benefits. D. State State means any state of the United States of America, and the District of Columbia. E. Locations This policy covers all of your workplaces listed in Items 1 or 4 of the Information Page; and it covers all other workplaces in Item 3.A. states unless you have other insurance or are self-insured for such workplaces. (Ed. 1-15) PART ONE WORKERS COMPENSATION INSURANCE A. How This Insurance Applies This workers compensation insurance applies to bodily injury by accident or bodily injury by disease. Bodily injury includes resulting death. 1. Bodily injury by accident must occur during the policy period. 2. Bodily injury by disease must be caused or ag- gravated by the conditions of your employment. The employee's last day of last exposure to the conditions causing or aggravating such bodily in- jury by disease must occur during the policy period. B. We Will Pay We will pay promptly when due the benefits required of you by the workers compensation law. C. We Will Defend We have the right and duty to defend at our expense any claim, proceeding or suit against you for benefits payable by this insurance. We have the right to in- vestigate and settle these claims, proceedings or suits. We have no duty to defend a claim, proceeding or suit that is not covered by this insurance. D. We Will Also Pay We will also pay these costs, in addition to other amounts payable under this insurance, as part of any claim, proceeding or suit we defend: 1. reasonable expenses incurred at our request, but not loss of earnings; 2. premiums for bonds to release attachments and for appeal bonds in bond amounts up to the amount payable under this insurance; litigation costs taxed against you; interest on a judgment as required by law until we offer the amount due under this insurance; and 5. expenses we incur. E. Other Insurance We will not pay more than our share of benefits and costs covered by this insurance and other Page 1 of 6 © Copyright 2013 National Council on Compensation Insurance, Inc. All Rights Reserved. WC 00 00 00 C (Ed. 1-15) WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY insurance or self-insurance. Subject to any limits of liability that may apply, all shares will be equal until the loss is paid. If any insurance or self-insurance is exhausted, the shares of all remaining insurance will be equal until the loss is paid. F. Payments You Must Make You are responsible for any payments in excess of the benefits regularly provided by the workers compensation law including those required because: 1. of your serious and willful misconduct; 2. you knowingly employ an employee in violation of law; 3. you fail to comply with a health or safety law or regulation; or 4. you discharge, coerce or otherwise discriminate against any employee in violation of the workers compensation law. If we make any payments in excess of the benefits regularly provided by the workers compensation law on your behalf, you will reimburse us promptly. G. Recovery From Others We have your rights, and the rights of persons enti- tled to the benefits of this insurance, to recover our payments from anyone liable for the injury. You will do everything necessary to protect those rights for us and to help us enforce them. H. Statutory Provisions These statements apply where they are required by law. 1. As between an injured worker and us; we have notice of the injury when you have notice. 2. Your default or the bankruptcy or insolvency of you or your estate will not relieve us of our du- ties under this insurance after an injury occurs. 3. We are directly and primarily liable to any per- son entitled to the benefits payable by this in- surance. Those persons may enforce our duties; so may an agency authorized by law. Enforce- ment may be against us or against you and us. 4. Jurisdiction over you is jurisdiction over us for purposes of the workers compensation law. We are bound by decisions against you under that law, subject to the provisions of this policy that are not in conflict with that law. 5. This insurance conforms to the parts of the workers compensation law that apply to: a. benefits payable by this insurance; b. special taxes, payments into security or oth- er special funds, and assessments payable by us under that law. 6. Terms of this insurance that conflict with the workers compensation law are changed by this statement to conform to that law. Nothing in these paragraphs relieves you of your du- ties under this policy. PART TWO EMPLOYERS LIABILITY INSURANCE A. How This Insurance Applies This employers liability insurance applies to bodily injury by accident or bodily injury by disease. Bodily injury includes resulting death. 1. The bodily injury must arise out of and in the course of the injured employee's employment by you. 2. The employment must be necessary or inci- dental to your work in a state or territory listed in Item 3.A. of the Information Page. 3. Bodily injury by accident must occur during the policy period. 4. Bodily injury by disease must be caused or ag- gravated by the conditions of your employment. The employee's last day of last exposure to the conditions causing or aggravating such bodily in- jury by disease must occur during the policy period. 5. If you are sued, the original suit and any related legal actions for damages for bodily injury by ac- cident or by disease must be brought in the United States of America, its territories or pos- sessions, or Canada. B. We Will Pay Page 2 of 6 We will pay all sums that you legally must pay as damages because of bodily injury to your employ- ees, provided the bodily injury is covered by this Employers Liability Insurance. The damages we will pay, where recovery is permit- ted by law, include damages: 1. For which you are liable to a third party by rea- son of a claim or suit against you by that third party to recover the damages claimed against © Copyright 2013 National Council on Compensation Insurance, Inc. All Rights Reserved. WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY such third party as a result of injury to your employee; 2. For care and loss of services; and 3. For consequential bodily injury to a spouse, child, parent, brother or sister of the injured em- ployee; provided that these damages are the di- rect consequence of bodily injury that arises out of and in the course of the injured employee's employment by you; and 4. Because of bodily injury to your employee that arises out of and in the course of employment, claimed against you in a capacity other than as employer. C. Exclusions This insurance does not cover: 1. Liability assumed under a contract. This exclu- sion does not apply to a warranty that your work will be done in a workmanlike manner; 2. Punitive or exemplary damages because of bodi- ly injury to an employee employed in violation of law; 3. Bodily injury to an employee while employed in violation of law with your actual knowledge or the actual knowledge of any of your executive officers; 4. Any obligation imposed by a workers compensa- tion, occupational disease, unemployment com- pensation, or disability benefits law, or any simi- lar law; 5. Bodily injury intentionally caused or aggravated by you; 6. Bodily injury occurring outside the United States of America, its territories or possessions, and Canada. This exclusion does not apply to bodily injury to a citizen or resident of the United States of America or Canada who is temporarily outside these countries; 7. Damages arising out of coercion, criticism, de- motion, evaluation, reassignment, discipline, defamation, harassment, humiliation, discrimina- tion against or termination of any employee, or any personnel practices, policies, acts or omissions; 8. Bodily injury to any person in work subject to the Longshore and Harbor Workers' Compensation Act (33 U.S.C. Sections 901 et seq.), the Nonappropriated Fund Instrumentalities Act (5 U.S.C. Sections 8171 et seq.), the Outer Conti- nental Shelf Lands Act (43 U.S.C. Sections 1331 et seq.), the Defense Base Act (42 U.S.C. Sec- tions 1651-1654), the Federal Mine Safety and Health Act (30 U.S.C. Sections 801 et seq. and 901-944), any other federal workers or work- men's compensation law or other federal occu- pational disease law, or any amendments to the- se laws; WC 00 00 00 C (Ed. 1-15) 9. Bodily injury to any person in work subject to the Federal Employers' Liability Act (45 U.S.C. Sec- tions 51 et seq.), any other federal laws obligat- ing an employer to pay damages to an employee due to bodily injury arising out of or in the course of employment, or any amendments to those laws; 10.Bodily injury to a master or member of the crew of any vessel, and does not cover punitive dam- ages related to your duty or obligation to provide transportation, wages, maintenance, and cure under any applicable maritime law; 11.Fines or penalties imposed for violation of federal or state law; and 12.Damages payable under the Migrant and Sea- sonal Agricultural Worker Protection Act (29 U.S.C. Sections 1801 et seq.) and under any other federal law awarding damages for violation of those laws or regulations issued thereunder, and any amendments to those laws. D. We Will Defend We have the right and duty to defend, at our ex- pense, any claim, proceeding or suit against you for damages payable by this insurance. We have the right to investigate and settle these claims, proceed- ings and suits. We have no duty to defend a claim, proceeding or suit that is not covered by this insurance. We have no duty to defend or continue defending after we have paid our applicable limit of liability under this insurance. E. We Will Also Pay We will also pay these costs, in addition to other amounts payable under this insurance, as part of any claim, proceeding, or suit we defend: 1. Reasonable expenses incurred at our request, but not loss of earnings; 2. Premiums for bonds to release attachments and for appeal bonds in bond amounts up to the limit of our liability under this insurance; 3. Litigation costs taxed against you; 4. Interest on a judgment as required by law until we offer the amount due under this insurance; and 5. Expenses we incur. Page 3 of 6 © Copyright 2013 National Council on Compensation Insurance, Inc. All Rights Reserved. WC000000C (Ed. 1-15) F. Other Insurance WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY We will not pay more than our share of damages and costs covered by this insurance and other in- surance or self-insurance. Subject to any limits of li- ability that apply, all shares will be equal until the loss is paid. If any insurance or self-insurance is ex- hausted, the shares of all remaining insurance and self-insurance will be equal until the loss is paid. G. Limits of Liability Our liability to pay for damages is limited. Our limits of liability are shown in Item 3.6. of the Information Page. They apply as explained below. 1. Bodily Injury by Accident. The limit shown for "bodily injury by accident—each accident" is the most we will pay for all damages covered by this insurance because of bodily injury to one or more employees in any one accident. A disease is not bodily injury by accident unless it results directly from bodily injury by accident. 2. Bodily Injury by Disease. The limit shown for "bodily injury by disease—policy limit" is the most we will pay for all damages covered by this insurance and arising out of bodily injury by dis- ease, regardless of the number of employees who sustain bodily injury by disease. The limit shown for "bodily injury by disease—each em- ployee" is the most we will pay for all damages because of bodily injury by disease to any one employee. Bodily injury by disease does not include dis- ease that results directly from a bodily injury by accident. 3. We will not pay any claims for damages after we have paid the applicable limit of our liability un- der this insurance. H. Recovery From Others We have your rights to recover our payment from anyone liable for an injury covered by this insurance. You will do everything necessary to protect those rights for us and to help us enforce them. I. Actions Against Us There will be no right of action against us under this insurance unless: 1. You have complied with all the terms of this poli- cy; and 2. The amount you owe has been determined with our consent or by actual trial and final judgment. This insurance does not give anyone the right to add us as a defendant in an action against you to deter- mine your liability. The bankruptcy or insolvency of you or your estate will not relieve us of our obliga- tions under this Part. PART THREE OTHER STATES INSURANCE A. How This Insurance Applies 1. This other states insurance applies only if one or more states are shown in Item 3.C. of the Infor- mation Page. 2. If you begin work in any one of those states after the effective date of this policy and are not in- sured or are not self-insured for such work, all provisions of the policy will apply as though that state were listed in Item 3.A. of the Information Page. 3. We will reimburse you for the benefits required by the workers compensation law of that state if we are not permitted to pay the benefits directly to persons entitled to them. 4. If you have work on the effective date of this pol- icy in any state not listed in Item 3.A. of the In- formation Page, coverage will not be afforded for that state unless we are notified within thirty days. B. Notice Page 4 of 6 Tell us at once if you begin work in any state listed in Item 3.C. of the Information Page. PART FOUR YOUR DUTIES IF INJURY OCCURS Tell us at once if injury occurs that may be covered by this policy. Your other duties are listed here. 1. Provide for immediate medical and other ser- vices required by the workers compensation law. 2. Give us or our agent the names and addresses of the injured persons and of witnesses, and other information we may need. 3. Promptly give us all notices, demands and legal © Copyright 2013 National Council on Compensation Insurance, Inc. All Rights Reserved. WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY papers related to the injury, claim, proceeding or suit. 4. Cooperate with us and assist us, as we may re- quest, in the investigation, settlement or defense of any claim, proceeding or suit. 5. Do nothing after an injury occurs that would in- terfere with our right to recover from others. 6. Do not voluntarily make payments, assume obli- gations or incur expenses, except at your own cost. PART FIVE—PREMIUM A. Our Manuals All premium for this policy will be determined by our manuals of rules, rates, rating plans and classifica- tions. We may change our manuals and apply the changes to this policy if authorized by law or a gov- ernmental agency regulating this insurance. B. Classifications Item 4 of the Information Page shows the rate and premium basis for certain business or work classifi- cations. These classifications were assigned based on an estimate of the exposures you would have during the policy period. If your actual exposures are not properly described by those classifications, we will assign proper classifications, rates and premium basis by endorsement to this policy. C. Remuneration Premium for each work classification is determined by multiplying a rate times a premium basis. Remu- neration is the most common premium basis. This premium basis includes payroll and all other remu- neration paid or payable during the policy period for the services of: 1. all your officers and employees engaged in work covered by this policy; and 2. all other persons engaged in work that could make us liable under Part One (Workers Com- pensation Insurance) of this policy. If you do not have payroll records for these persons, the con- tract price for their services and materials may be used as the premium basis. This paragraph 2 will not apply if you give us proof that the em- ployers of these persons lawfully secured their workers compensation obligations. D. Premium Payments WC 00 00 00 C (Ed. 1-15) You will pay all premium when due. You will pay the premium even if part or all of a workers compensa- tion law is not valid. E. Final Premium The premium shown on the Information Page, schedules, and endorsements is an estimate. The final premium will be determined after this policy ends by using the actual, not the estimated, premi- um basis and the proper classifications and rates that lawfully apply to the business and work covered by this policy. If the final premium is more than the premium you paid to us, you must pay us the bal- ance. If it is less, we will refund the balance to you. The final premium will not be less than the highest minimum premium for the classifications covered by this policy. If this policy is canceled, final premium will be de- termined in the following way unless our manuals provide otherwise: 1. If we cancel, final premium will be calculated pro rata based on the time this policy was in force. Final premium will not be less than the pro rata share of the minimum premium. 2. If you cancel, final premium will be more than pro rata; it will be based on the time this policy was in force, and increased by our short -rate cancelation table and procedure. Final premium will not be less than the minimum premium. F. Records You will keep records of information needed to com- pute premium. You will provide us with copies of those records when we ask for them. G. Audit You will let us examine and audit all your records that relate to this policy. These records include ledg- ers, journals, registers, vouchers, contracts, tax re- ports, payroll and disbursement records, and pro- grams for storing and retrieving data. We may con- duct the audits during regular business hours during the policy period and within three years after the pol- icy period ends. Information developed by audit will be used to determine final premium. Insurance rate service organizations have the same rights we have under this provision. Page 6 of 6 © Copyright 2013 National Council on Compensation Insurance, Inc. All Rights Reserved. WC 00 00 00 C (Ed. 1-15) WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY PART SIX—CONDITIONS A. Inspection We have the right, but are not obliged to inspect your workplaces at any time. Our inspections are not safety inspections. They relate only to the insurabil- ity of the workplaces and the premiums to be charged. We may give you reports on the conditions we find. We may also recommend changes. While they may help reduce losses, we do not undertake to perform the duty of any person to provide for the health or safety of your employees or the public. We do not warrant that your workplaces are safe or healthful or that they comply with laws, regulations, codes or standards. Insurance rate service organiza- tions have the same rights we have under this provision. B. Long Term Policy If the policy period is longer than one year and six- teen days, all provisions of this policy will apply as though a new policy were issued on each annual anniversary that this policy is in force. C. Transfer of Your Rights and Duties Your rights or duties under this policy may not be transferred without our written consent. If you die and we receive notice within thirty days af- ter your death, we will cover your legal representa- tive as insured. D. Cancelation 1. You may cancel this policy. You must mail or de- liver advance written notice to us stating when the cancelation is to take effect. 2. We may cancel this policy. We must mail or de- liver to you not less than ten days advance writ- ten notice stating when the cancelation is to take effect. Mailing that notice to you at your mailing address shown in Item 1 of the Information Page will be sufficient to prove notice. 3. The policy period will end on the day and hour stated in the cancelation notice. 4. Any of these provisions that conflict with a law that controls the cancelation of the insurance in this policy is changed by this statement to com- ply with the law. E. Sole Representative The insured first named in Item 1 of the Information Page will act on behalf of all insureds to change this policy, receive return premium, and give or receive notice of cancelation. Page 6 of 6 © Copyright 2013 National Council on Compensation Insurance, Inc. All Rights Reserved. WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY CATASTROPHE (OTHER THAN CERTIFIED ACTS OF TERRORISM) PREMIUM ENDORSEMENT This endorsement is notification that your insurance carrier is charging premium to cover the losses that may occur in the event of a Catastrophe (other than Certified Acts of Terrorism) as that term is defined below. Your policy provides coverage for workers compensation losses caused by a Catastrophe (other than Certified Acts of Terrorism). This premium charge does not provide funding for Certified Acts of Terrorism contemplated under the Terrorism Risk Insurance Program Reauthorization Act Disclosure Endorsement (WC 00 04 22 B), attached to this policy. For purposes of this endorsement, the following definitions apply: • Catastrophe (other than Certified Acts of Terrorism): Any single event, resulting from an Earthquake, Noncertified Act of Terrorism, or Catastrophic Industrial Accident, which results in aggregate workers compensation losses in excess of $50 million. • Earthquake: The shaking and vibration at the surface of the earth resulting from underground movement along a fault plane or from volcanic activity. Noncertified Act of Terrorism: An event that is not certified as an Act of Terrorism by the Secretary of Treasury pursuant to the Terrorism Risk Insurance Act of 2002 (as amended) but that meets all of the following criteria: a. It is an act that is violent or dangerous to human life, property, or infrastructure; b. The act results in damage within the United States, or outside of the United States in the case of the premises of United States missions or air carriers or vessels as those terms are defined in the Terrorism Risk Insurance Act of 2002 (as amended); and c. It is an act that has been committed by an individual or individuals as part of an effort to coerce the civilian population of the United States or to influence the policy or affect the conduct of the United States Government by coercion. • Catastrophic Industrial Accident: A chemical release, large explosion, or small blast that is localized in nature and affects workers in a small perimeter the size of a building. The premium charge for the coverage your policy provides for workers compensation losses caused by a Catastrophe (other than Certified Acts of Terrorism) is shown in Item 4 of the Information Page or in the Schedule below. State Schedule Rate Premium This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective: 02/01/2019 Insured: Insurance Company: Cypress Insurance Company WC 00 04 21 D (Ed. 1-15) WC 00 04 21 D (Ed. 1-15) Policy No.: GTWC013587 Endorsement No.: Premium $ Countersigned by © Copyright 2015 National Council on Compensation Insurance, Inc. All Rights Reserved. WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 00 04 22 B (Ed. 1-15) TERRORISM RISK INSURANCE PROGRAM REAUTHORIZATION ACT DISCLOSURE ENDORSEMENT This endorsement addresses the requirements of the Terrorism Risk Insurance Act of 2002 as amended and extended by the Terrorism Risk Insurance Program Reauthorization Act of 2015. It serves to notify you of certain limitations under the Act, and that your insurance carrier is charging premium for losses that may occur in the event of an Act of Terrorism. Your policy provides coverage for workers compensation losses caused by Acts of Terrorism, including workers compensation benefit obligations dictated by state law. Coverage for such losses is still subject to all terms, definitions, exclusions, and conditions in your policy, and any applicable federal and/or state laws, rules, or regulations. Definitions The definitions provided in this endorsement are based on and have the same meaning as the definitions in the Act .If words or phrases not defined in this endorsement are defined in the Act, the definitions in the Act will apply. "Act" means the Terrorism Risk Insurance Act of 2002, which took effect on November 26, 2002, and any amendments thereto, including any amendments resulting from the Terrorism Risk Insurance Program Reauthorization Act of 2015. "Act of Terrorism" means any act that is certified by the Secretary of the Treasury, in consultation with the Secretary of Homeland Security, and the Attorney General of the United States as meeting all of the following requirements: a. The act is an act of terrorism. b. The act is violent or dangerous to human life, property or infrastructure. c. The act resulted in damage within the United States, or outside of the United States in the case of the premises of United States missions or certain air carriers or vessels. d. The act has been committed by an individual or individuals as part of an effort to coerce the civilian population of the United States or to influence the policy or affect the conduct of the United States Government by coercion. "Insured Loss" means any loss resulting from an act of terrorism (and, except for Pennsylvania, including an act of war, in the case of workers compensation) that is covered by primary or excess property and casualty insurance issued by an insurer if the loss occurs in the United States or at the premises of United States missions or to certain air carriers or vessels. "Insurer Deductible" means, for the period beginning on January 1, 2015, and ending on December 31, 2020, an amount equal to 20% of our direct earned premiums, during the immediately preceding calendar year. Limitation of Liability The Act limits our liability to you under this policy. If aggregate Insured Losses exceed $100,000,000,000 in a calendar year and if we have met our Insurer Deductible, we are not liable for the payment of any portion of the amount of Insured Losses that exceeds $100,000,000,000; and for aggregate Insured Losses up to $100,000,000,000, we will pay only a pro rata share of such Insured Losses as determined by the Secretary of the Treasury. Policyholder Disclosure Notice 1. Insured Losses would be partially reimbursed by the United States Government. If the aggregate industry Insured Losses exceed: a. $100,000,000, with respect to such Insured Losses occurring in calendar year 2015, the United States Government would pay 85% of our Insured Losses that exceed our Insurer Deductible. b. $120,000,000, with respect to such Insured Losses occurring in calendar year 2016, the United States Government would pay 84% of our Insured Losses that exceed our Insurer Deductible. c. $140,000,000, with respect to such Insured Losses occurring in calendar year 2017, the United States Government would pay 83% of our Insured Losses that exceed our Insurer Deductible. d. $160,000,000, with respect to such Insured Losses occurring in calendar year 2018, the United States Government would pay 82% of our Insured Losses that exceed our Insurer Deductible. WC 00 04 22 B (Ed. 1-15) © Copyright 2015 National Council on Compensation Insurance, Inc. All Rights Reserved WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 00 04 22 B (Ed. 1-15) e. $180,000,000, with respect to such Insured Losses occurring in calendar year 2019, the United States Government would pay 81 % of our Insured Losses that exceed our Insurer Deductible. f. $200,000,000, with respect to such Insured Losses occurring in calendar year 2020, the United States Government would pay 80% of our Insured Losses that exceed our Insurer Deductible. 2. Notwithstanding item 1 above, the United States Government will not make any payment under the Act for any portion of Insured Losses that exceed $100,000,000,000. 3. The premium charge for the coverage your policy provides for Insured Losses is included in the amount shown in Item 4 of the Information Page or in the Schedule below. State Schedule Rate Premium This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective: 02/01/2019 Policy No.: GTWC013587 Endorsement No.: Insured: Premium $ Insurance Company: Cypress Insurance Company WC 00 04 22 B Countersigned by (Ed. 1-15) © Copyright 2015 National Council on Compensation Insurance, Inc. All Rights Reserved WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 04 03 60B (Ed 1-15) EMPLOYERS' LIABILITY COVERAGE AMENDATORY ENDORSEMENT - CALIFORNIA The insurance afforded by Part Two (Employers' Liability Insurance) by reason of designation of California in item 3 of the information page is subject to the following provisions: A. "How This Insurance Applies," is amended to read as follows: A. How This Insurance Applies This employers' liability insurance applies to bodily injury by accident or bodily injury by disease. Bodily injury means a physical injury, including resulting death. 1. The bodily injury must arise out of and in the course of the injured employee's employment by you. 2. The employment must be necessary or incidental to your work in California. 3. Bodily injury by accident must occur during the policy period. 4. Bodily injury by disease must be caused or aggravated by the conditions of your employment. The employee's last day of last exposure to the conditions causing or aggravating such bodily injury by disease must occur during the policy period. 5. If you are sued, the original suit and any related legal actions for damages for bodily injury by accident or by disease must be brought in the United States of America, its territories or possessions, or Canada. C. The "Exclusions"section is modified as follows (all other exclusions in the "Exclusions" section remain as is): 1. Exclusion 1 is amended to read as follows: 1. liability assumed under a contract. 2. Exclusion 2 is deleted. 3. Exclusion 7 is amended to read as follows: 7. damages arising out of coercion, criticism,demotion, evaluation, reassignment, discipline, defamation, harassment, humiliation, discrimination against or termination of any employee, termination of employment, or any personnel practices, policies, acts or omissions. 4. The following exclusions are added: 1. bodily injury to any member of the flying crew of any aircraft. 2. bodily injury to an employee when you are deprived of statutory or common law defenses or are subject to penalty because of your failure to secure your obligations under the workers' compensation law(s) applicable to you or otherwise fail to comply with that law. 3. liability arising from California Labor Code Section 2810.3 which relates to labor contracting. This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective: 02/01/2019 Policy No.: GTWC013587 Endorsement No.: Insured: Premium $ Insurance Company: Cypress Insurance Company Countersigned by WC 04 03 60B (Ed 1-15) WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 99 03 02 (Ed. 1-07) LONGSHORE AND HARBOR WORKERS COMPENSATION ACT EXCLUSION ENDORSEMENT This endorsement applies only to work subject to the Longshore and Harbor Workers Compensation Act (33 USC Section 901-950). The policy definition of workers compensation law does not include the Longshore and Harbor Workers Compensation Act or any amendment to that Act. The insurance provided by Part Two (Employers Liability Insurance) of the policy does not cover bodily injury to any person in work subject to the Longshore and Harbor Workers Compensation Act or any amendment to that law. This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective: 02/01/2019 Insured: Insurance Company: Cypress Insurance Company WC 99 03 02 (Ed. 1-07) Policy No.: GTWC013587 Endorsement No.: Premium $ Countersigned by WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 99 0410B (Ed. 9-14) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT -CALIFORNIA BLANKET BASIS We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) The additional premium for this endorsement shall be 2% of the total manual premium otherwise due on such remuneration. The minimum premium for this endorsement is $350. This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. SCHEDULE BLANKET WAIVER Person/Organization Blanket Waiver — Any person or organization for whom the Named Insured has agreed by written contract to furnish this waiver. Job Description Waiver Premium All CA Operations 1106.00 This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective 02/01/2019 Insured Insurance Company Cypress Insurance Company WC 99 04 10B (Ed. 9-14) Policy No. GTWC013587 Countersigned by Endorsement No. Premium $ WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 04 04 21 (Ed. 1-08) OPTIONAL PREMIUM INCREASE ENDORSEMENT- CALIFORNIA You must provide us, or our authorized representative, access to records necessary to perform a payroll verification audit. If you fail to provide access within 90 days after expiration of the policy, you are liable to pay a total premium equal to 3 times our current estimate of the annual premium for your policy. In addition, if you fail to provide access after our third request within a 90 day or longer period, you are also liable for our costs in attempting to perform the audit unless you provide a compelling business reason for your failure. We will contact you to schedule appointments during normal business hours. We will notify you of your failure to provide access by mailing a certified, return -receipt document stating the increased premium and the total amount of our costs incurred in our attempt(s) to perform an audit. In addition to any other obligations under this contract, 30 days after you receive the notification, you will be obligated to pay the total premium and costs referenced above. If, thereafter, you provide access to your records within three years after the policy expires, or within another mutually agreed upon time, and we succeed in performing the audit to our satisfaction, we will revise your total premium and the costs due to reflect the results of the audit. This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective: 02/01/2019 Policy No.: GTWC013587 Endorsement No.: Insured: Insurance Company: Cypress Insurance Company Countersigned by WC 04 04 21 (Ed. 1-08) Premium $ WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 99 03 01A (Ed. 1-07) ENDORSEMENT AGREEMENT LIMITING AND RESTRICTING THIS INSURANCE 1. SOLE PROPRIETOR, INCLUDING A HUSBAND AND WIFE EITHER AS INDIVIDUALS OR AS A PARTNERSHIP. If the employer named in Item 1 of the Information Page is a sole proprietor, a husband and wife, or a partnership in which the general partners are husband and wife, the insurance under this policy is limited as follows: It is agreed that, anything in this policy to the contrary notwithstanding, this Policy DOES NOT EXTEND TO OR COVER bodily injury sustained by any of the following relatives of the employer and spouse or of either if at the time of injury such relative (1) resides in the household of the employer and spouse, or of either, or (2) is a child under the age of twelve years unless such relative is specifically covered by name in Item 4 of the Information Page or an endorsement is attached to this policy. RELATIVES Spouse, child by birth or adoption, stepchild, grandchild, son-in-law, daughter-in-law, parent, NOT INSURED: stepparent, parent -in-law, grandparent, brother, sister, stepbrother, stepsister, half-brother, half-sister, brother-in-law, sister-in-law, uncle, aunt, nephew, niece. Private Residence Employees Not Insured It is further agreed that this Policy DOES NOT EXTEND TO OR COVER bodily injury sustained by an employee who is covered for workers' compensation benefits of a policy also affording comprehensive personal liability insurance which has been issued to this insured. It is further agreed that "remuneration" when used as premium basis for insurance as is afforded by the policy by reason of the designation of California in Item 3 of the Information Page shall not include the remuneration of any person excluded from coverage in accordance with the foregoing. Sole Proprietor Not Insured If the employer named in Item 1 of the Information Page is an individual employer, whether as an individual or sole proprietor by any means, the employer is not insured as an employee by this policy, anything in this policy to the contrary notwithstanding. 2. PARTNERSHIP If the employer named in Item 1 of the Information Page is a partnership, this policy applies to the general partners, as employees, unless they are specifically excluded by an endorsement issued to form a part of this policy. The premium basis for this policy includes the entire remuneration of each covered general partner, subject to the minimum and maximum remuneration as established by the California Workers' Compensation Insurance Rating Bureau. 3. OFFICERS AND DIRECTORS OF A PRIVATE CORPORATION If the employer named in Item 1 of the Information Page is a private corporation, whose officers and directors are the sole shareholders, this policy applies to all such officers and directors, as employees, unless they are specifically excluded by an endorsement issued to form a part of this policy. WC 99 03 01A Page 1 of 2 (Ed. 1-07) WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 99 03 01A (Ed. 1-07) The premium basis for this policy includes the entire remuneration of each covered officer or director, subject to the minimum and maximum remuneration as established by the California Workers' Compensation Insurance Rating Bureau. EXCLUDED EMPLOYMENTS This policy shall not operate as an election by the insured to insure under Part One employees who are excluded by the Workers' Compensation Law of the State of California unless such employees are engaged in operations specifically described in the Information Pages. This policy does not apply under Part Two with respect to any employee employment not described in the declarations unless the policy applies under Part One with respect to such employee. FAILURE TO SECURE THE PAYMENT OF FULL COMPENSATION BENEFITS FOR ALL EMPLOYEES AS REQUIRED BY LABOR CODE SECTION 3700 IS A VIOLATION OF LAW AND MAY SUBJECT THE EMPLOYER TO THE IMPOSITION OF A WORK STOP ORDER, LARGE FINES AND OTHER SUBSTANTIAL PENALTIES (Labor Code Section 3710.1, et seq.). This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective: 02/01/2019 Policy No.: GTWC013587 Endorsement No.: Insured: Premium $ Insurance Company: Cypress Insurance Company Countersigned by WC 99 03 01A Page 2 of 2 (Ed. 1-07) PN 04 99 02 B (Ed. 1-07) POLICYHOLDER NOTICE California Workers' Compensation Insurance Rating Laws Pursuant to Section 11752.8 of the California Insurance Code, we are providing you with an explanation of the California workers' compensation rating laws. 1. We establish our own rates for workers' compensation. Our rates, rating plans, and related information are filed with the insurance commissioner and are open for public inspection. 2. The insurance commissioner can disapprove our rates, rating plans, or classifications only if he or she has determined after public hearing that our rates might jeopardize our ability to pay claims or might create a monopolyin the market. A monopoly is defined by law as a market where one insurer writes 20% or more of that part of the California workers' compensation insurance that is not written by the State Compensation Insurance Fund. If the insurance commissioner disapproves our rates, rating plans, or classifications, he or she may order an increase inthe rates applicable to outstanding policies. 3. Rating organizations may develop pure premium rates that are subject to the insurance commissioner's approval. Apure premium rate reflects the anticipated cost and expenses of claims per $100 of payroll for a given classification. Pure premium rates are advisory only, as we are not required to use the pure premium rates developed by any rating organization in establishing our own rates. 4. We must adhere to a single, uniform experience rating plan. If you are eligible for experience rating under the plan,we will be required to adjust your premium to reflect your claim history. A better claim history generally results in a lower experience rating modification; more claims, or more expensive claims, generally result in a higher experience rating modification. The uniform experience rating plan, which is developed by the insurance rating organization designated by the insurance commissioner, is subject to approval by the insurance commissioner. 5. A standard classification system, developed by the insurance rating organization designated by the insurance commissioner, is subject to approval by the insurance commissioner. The standard classification system is a method of recognizing and separating policyholders into industry or occupational groups according to their similarities and/or differences. We can adopt and apply the standard classification system or develop and apply our own classification system, provided we can report the payroll, expenses, and other costs of claims in a way that is consistent with the uniform statistical plan or the standard classification system. 6. Our rates and classifications may not violate the Unruh Civil Rights Act or be unfairly discriminatory. 7. We will provide an appeal process for you to appeal the way we rate your insurance policy. The process requires us to respond to your written appeal within 30 days. If you are not satisfied with the result of your appeal, you may appeal our decision to the insurance commissioner. CALIFORNIA WORKERS' COMPENSATION INSURANCE NOTICE OF NONRENEWAL Section 11664 of the California Insurance Code requires us, in most instances, to provide you with a notice of nonrenewal. Except as specified in paragraphs 1 through 6 below, if we elect to nonrenew your policy , we are required to deliver or mail to you a written notice stating the reason or reasons for the nonrenewal of the policy. The notice is required to be sent to you no earlier than 120 days before the end of the policy period and no later than 30 days before the end of the policy period. If we fail to provide you the required notice, we are required to continue the coverage under the policy with no change in the premium rate until 60 days after we provide you with the required notice. PN 04 99 02 B (Ed. 1-07) Page 1 of 2 PN 04 99 02 B (Ed. 1-07) We are not required to provide you with a notice of nonrenewal in any of the following situations: 1. Your policy was transferred or renewed without a change in its terms or conditions or the rate on which the premium is based to another insurer or other insurers who are members of the same insurance group as us. 2. The policy was extended for 90 days or less and the required notice was given prior to the extension. 3. You obtained replacement coverage or agreed, in writing, within 60 days of the termination of the policy, to obtain that coverage. 4. The policy is for a period of no more than 60 days and you were notified at the time of issuance that it may not berenewed. 5. You requested a change in the terms or conditions or risks covered by the policy within 60 days prior to the end ofthe policy period. 6. We made a written offer to you to renew the policy at a premium rate increase of less than 25 percent. (A) If the premium rate in your governing classification is to be increased 25 percent or greater and we intend to renew the policy, we shall provide a written notice of a renewal offer not less than 30 days prior to the policy renewal date. The governing classification shall be determined by the rules and regulations established in accordance with California Insurance Code Section 11750.3(c). (B) For purposes of this Notice, "premium rate" means the cost of insurance per unit of exposure prior to the application of individual risk variations based on loss or expense considerations such as scheduled rating and experience rating. This notice does not change the policy to which it is attached. PN 04 99 02 B (Ed. 1-07) Page 2 of 2 PN 04 99 04 (Ed. 1-07) POLICYHOLDER NOTICE CALIFORNIA INSURANCE GUARANTEE ASSOCIATION (CIGA) SURCHARGE Companies writing property and casualty insurance business in California are required to participate in the California Insurance Guarantee Association. If a company becomes insolvent, the California Insurance Guarantee Association settles the unpaid claims and assesses each insurance company for its fair share. California law requires all companies to surcharge policies to recover these assessments. If your policy is surcharged, "CA Surcharge" or "CA Surcharge (CIGA Surcharge)" with an amount will be displayed on your premium notice. This notice does not change the policy to which it is attached. PN 04 99 04 (Ed. 1-07) WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 04 00 02 (Ed 7-98) Named Insured ArcFab360 WC 04 00 02 (Ed. 7-98) EXTENSION OF INFORMATION PAGE Schedule of Named Insured ITEM 1 POLICY NO. GTWC013587 FEIN 01-0862732 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 04 00 03 (Ed 1-07) EXTENSION OF INFORMATION PAGE Schedule of Locations ITEM 1 POLICY NO. GTWC013587 WC 04 00 03 (Ed. 1-07) WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY INT0114 PolReglnst WC990312 WC 990313 PremPayTable WCLossControlNo WC040317B I N T0478 WC000000C WC000421 D WC000422B WC040360B WC990302 WC990410B WC040421 WC990301 A P N 049902 B P N 049904 WC040002 WC040003 WC040004 WC040301 B WC040303C WC040310 WC040336 WC990407A WC990412 WC990607D WC990608 PN049901F WC 04 00 04 (Ed. 1-07) EXTENSION OF INFORMATION PAGE Schedule of Forms ITEM 3D POLICY NO. GTWC013587 Form Numbers Applicable States Privacy Policy All Policyholder Registration Instructions All Information Page (Dec Page) All Policy Info Page (Class Schedule) All Prem Pay Table All Loss Control Availability All L&R-Employee Insrd by Gen Employer Excl All Electronic Claims Kit Notification All WC and Emp Liability Ins. Policy All Catastrophe Premium Endorsement All Terr Risk Ins Frog Reauthorization Act All CA Empl. Liab. Coverage Amendatory Endst All Longshore & Harbor WC Act All CA Waiver Of Right To Recover - Blanket All CA Optional Premium Endorsement All EndstLimiting and Restricting All CA Policyholder Notice - WC Rating Laws All CA Ins. Guarantee Assoc.(ciga) Surcharge All CA Ext Of Info Page-Sch Of Named Insured All CA Ext Of Info Page-Sch Of Locations All CA Ext Of Info Page -Schedule Of Forms All Policy Amendatory Endorsement -California All CA Officers & Directors Covrg/Exclusion All CA Duty To Defend All CA End't Agreement Limit/Restrict Insur All Premium Discount Endorsement All California Contractors Schedule Endorsem All California Cancellation Endorsement - Sh All Premium Endorsement All CA Your Right To Rating And Divdend Info All WC 04 00 04 (Ed 1-07) WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 04 03 01 B (Ed 01-12) POLICY AMENDATORY ENDORSEMENT –CALIFORNIA It is agreed that, anything in the policy to the contrary notwithstanding, such insurance as is afforded by this policy by reason of the designation of California in Item 3 of the Information Page is subject to the following provisions: 1. Minors Illegally Employed—Not Insured. This policy does not cover liability for additional compensation imposed on you under Section 4557, Division IV, Labor Code of the State of California, by reason of injury to an employee under sixteen years of age and illegally employed at the time of injury. 2. Punitive or Exemplary Damages—Uninsurable. This policy does not cover punitive or exemplary damages where insurance of liability therefor is prohibited by law or contrary to public policy. 3. Increase in Indemnity Payment—Reimbursement. You are obligated to reimburse us for the amount of increase in indemnity payments made pursuant to Subdivision (d) of Section 4650 of the California Labor Code, if the late indemnity payment which gives rise to the increase in the amount of payment is due less than seven (7) days after we receive the completed claim form from you. You are obligated to reimburse us for any increase in indemnity payments not covered under this policy and will reimburse us for any increase in indemnity payment not covered under the policy when the aggregate total amount of the reimbursement payments paid in a policy year exceeds one hundred dollars ($100). If we notify you in writing, within 30 days of the payment, that you are obligated to reimburse us, we will bill you for the amount of increase in indemnity payment and collect it no later than the final audit. You will have 60 days, following notice of the obligation to reimburse, to appeal the decision of the insurer to the Department of Insurance. 4. Application of Policy. Part One, "Workers Compensation Insurance", A, "How This Insurance Applies", is amended to read as follows: This workers compensation insurance applies to bodily injury by accident or disease, including death resulting therefrom. Bodily injury by accident must occur during the policy period. Bodily injury by disease must be caused oraggravated by the conditions of your employment. Your employee's exposure to those conditions causing or aggravating such bodily injury by disease must occurduring the policy period. 5. Rate Changes. The premium and rates with respect to the insurance provided by this policy by reason of the designation of California in Item 3 of the Information Page are subject to change if ordered by the Insurance Commissioner of the State of California pursuant to Section 11737 of the California Insurance Code. 6. Long Tenn Policy. If this policy is written for a period longer than one year, all the provisions of this policy shall apply separately to each consecutive twelve-month period or, if the first or last consecutive period is less than twelve months, to such period of less than twelve months, in the same manner as if a separate policy had been written for each consecutive period. 7. Statutory Provision. Your employee has a first lien upon any amount which becomes owing to you by us on account of this policy, and in the case of your legal incapacity or inability to receive the money and pay it to the claimant, we will pay it d irectly to the claimant. 8. Part Five, "Premium", E, "Final Premium", is amended to read as follows: The premium shown on the Information Page, schedules, and endorsements is an estimate. The final premium will be determined after this policy ends by using the actual, not the estimated, premium basis and the proper classifications and rates that lawfully apply to the business and work covered by this policy. If the final premium is more than the premium you paid to us, you must pay us the balance. If it is less, we will refund the balance to you. The final premium will not be less than the highest minimum premium for the classifications covered by this policy. If this policy is canceled, final premium will be determined in the following way unless our manuals provide otherwise: If we cancel, final premium will be calculated pro rata based on the time this policy was in force. Final premium will not be less than the pro rata share of the minimum premium. If you cancel, final premium may be more than pro rata; it will be based on the time this policy was in force, and may be increased by our short -rate cancelation table and procedure. Final premium will not be less than the pro rata share of the minimum premium. It is further agreed that this policy, including all endorsements forming a part thereof, constitutes the entire contract of insurance. No condition, provision, agreement, or understanding not set forth in this policy or such endorsements shall affect such contract or any rights, duties, or privileges arising therefrom. WC 04 03 01 B Page 1 of 2 (Ed. 1-12) WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 04 03 01 B (Ed 01-12) This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective 02/01/2019 Policy No. GTWC013587 Endorsement No. Insured Premium $ Insurance Company Countersigned by Berkshire Hathaway Homestate Insurance Company WC 04 03 01 B Page 2 of 2 (Ed. 1-12) WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 04 03 03 C (Ed. 07-18) ENDORSEMENT AGREEMENT LIMITING AND RESTRICTING THIS INSURANCE OFFICERS AND DIRECTORS COVERAGE I EXCLUSION -CALIFORNIA If the employer named in Item 1 of the Information Page is a quasi -public or private corporation, this policy applies to all officers and members of boards of directors while rendering actual service for the corporation for pay, as employees, except those excluded below who individually own at least 10 percent of the corporation's issued and outstanding stock, or 2. individually own at least 1 percent of the corporation's issued and outstanding stock if that officer's or member's parent, grandparent, sibling, spouse, or child owns at least 10 percent of the corporation's issued and outstanding stock and that officer or member is covered by a health insurance policy or a health care service plan, or 3. are officers or members of the board of directors of a cooperative corporation organized pursuant to the Cooperative Corporation Law (Corporations Code, Sections 12200 - 12704) who state that he or she is covered by both a health care service plan or health insurance policy, and a disability insurance policy that is comparable in scope and coverage, as determined by the Insurance Commissioner, to a workers' compensation policy. If the employer named in Item 1 of the Information Page is a private corporation, or a private cooperative corporation organized pursuant to the Cooperative Corporation Law, this policy applies to an officer or director who is the sole shareholder of the corporation, as an employee, except if excluded below. The insurance under this policy is limited as follows: It is AGREED that, anything in this policy to the contrary notwithstanding, this policy DOES NOT INSURE: Officers, Directors and Trustees Excluded Title John Alvarado President Lydia Alvarado Vice President Nothing in this endorsement shall be held to vary, alter, waive or extend any of the terms, conditions, agreements, or limitations of this policy other than as above stated. Nothing elsewhere in this policy shall be held to vary, alter, waive or limit the terms, conditions, agreements or limitations in this endorsement. It is further agreed that "remuneration" when used as a premium basis for such insurance as is afforded by this policy shall not include the remuneration of any person excluded from coverage in accordance with the foregoing. FAILURE TO SECURE THE PAYMENT OF FULL COMPENSATION BENEFITS FOR ALL EMPLOYEES AS REQUIRED BY LABOR CODE SECTION 3700 IS A VIOLATION OF LAW AND MAY SUBJECT THE EMPLOYER TO THE IMPOSITION OF A WORK STOP ORDER, LARGE FINES, AND OTHER SUBSTANTIAL PENALTIES (Labor Code Section 3710.1, et seq.). This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective: 02/01/2019 Policy No.: GTWC013587 Endorsement No.: Insured: Insurance Company: Cypress Insurance Company Countersigned by WC040303C (Ed 07-18) Premium $ Page 1 of 1 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY DUTY TO DEFEND - CALIFORNIA WC 04 03 10 (Ed. 1-07) The insurance afforded by Part One, Section C, "We Will Defend," is hereby deleted and replaced with the following: WE WILL DEFEND We have the right and duty to defend at our expense any claim or proceeding against you before the California Workers' Compensation Appeals Board or its equivalent in any other state (and any appeal of a decision therefrom) for the benefits payable by this workers' compensation insurance. We have the right to investigate and settle these claims or proceedings. We have no duty to defend a claim, proceeding, or suit that is not covered by this insurance. Nothing contained in this Section shall amend, modify, restrict or otherwise alter any obligations or conditions under Part Two— Employer's Liability Insurance of the policy. This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective: 02/01/2019 Insured: Insurance Company: Cypress Insurance Company WC 04 03 10 (Ed. 1-07) Policy No.: GTWC013587 Endorsement No.: Premium $ Countersigned by WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY ENDORSEMENT AGREEMENT LIMITING AND RESTRICTING THIS INSURANCE The insurance under this policy is limited as follows: WC 04 03 36 (Ed. 1-07) It is AGREED that, anything in this policy to the contrary notwithstanding, this policy DOES NOT INSURE: LIABILITY Any liability which the employer named in item 1 of the Information Page may have arising out of NOT INSURED operations conducted jointly by the employer with any other person, firm or corporation, except as specifically set forth in item 1 of the Information Page or by endorsement attached to this policy. FAILURE TO SECURE THE PAYMENT OF FULL COMPENSATION BENEFITS FOR ALL EMPLOYEES AS REQUIRED BY LABOR CODE SECTION 3700 IS A VIOLATION OF LAW AND MAY SUBJECT THE EMPLOYER TO THE IMPOSITION OF A WORK STOP ORDER, LARGE FINES AND OTHER SUBSTANTIAL PENALTIES (Labor Code Section 3710.1, et seq.). This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective: 02/01/2019 Insured: Insurance Company: Cypress Insurance Company WC 04 03 36 (Ed. 1-07) Policy No.: GTWC013587 Countersigned by Endorsement No.: Premium $ WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 99 04 07A (Ed 01-07) PREMIUM DISCOUNT ENDORSEMENT The premium for this policy and the policies, if any, listed in Item 3 of the Schedule may be eligible for a discount. This endorsement shows your estimated discount in Items 1 or 2 of the Schedule. The final calculation of premium discount will be determined by our manuals and your premium basis as determined by audit. Premium subject to retrospective rating is not subject to premium discount. 1. STATE CA WC 99 04 07A (Ed 01-07) SCHEDULE ESTIMATED ELIGIBLE PREMIUM $ 57,530 Premium Discount Table (In Percent) Standard Premium Discount Standard Premium Discount $ 1 - $ 25,384 0% $ 85,185 - $ 91,999 2.5% $ 25,385 - $ 26,189 0.1% $ 92,000 - $ 99,999 2.6% $ 26,190 - $ 27,048 0.2% $ 100,000 - $ 107,999 2.7% $ 27,049 - $ 27,965 0.3% $ 108,000 - $ 117,390 2.8% $ 27,966 - $ 28,946 0.4% $ 117,391 - $ 128,570 2.9% $ 28,947 - $ 29,999 0.5% $ 128,571 - $ 142,104 3% $ 30,000 - $ 31,131 0.6% $ 142,105 - $ 158,823 3.1% $ 31,132 - $ 32,352 0.7% $ 158,824 - $ 179,999 3.2% $ 32,353 - $ 33,672 0.8% $ 180,000 - $ 205,262 3.3% $ 33,673 - $ 35,105 0.9% $ 205,263 - $ 229,411 3.4% $ 35,106 - $ 36,666 1% $ 229,412 - $ 259,999 3.5% $ 36,667 - $ 38,371 1.1% $ 260,000 - $ 299,999 3.6% $ 38,372 - $ 40,243 1.2% $ 300,000 - $ 339,999 3.7% $ 40,244 - $ 42,307 1.3% $ 340,000 - $ 392,307 3.8% $ 42,308 - $ 44,594 1.4% $ 392,308 - $ 463,635 3.9% $ 44,595 - $ 47,142 1.5% $ 463,636 - $ 539,999 4% $ 47,143 - $ 49,999 1.6% $ 540,000 - $ 623,076 4.1% $ 50,000 - $ 52,856 1.7% $ 623,077 - $ 736,363 4.2% $ 52,857 - $ 56,060 1.8% $ 736,364 - $ 899,999 4.3% $ 56,061 - $ 59,676 1.9% $ 900,000 - $ 1,999,999 4.4% $ 59,677 - $ 63,792 2% $ 1,100,000 - $ 1,344,443 4.5% $ 63,793 - $ 68,518 2.1% $ 1,344,444 - $ 1,728,570 4.6% $ 68,519 - $ 73,999 2.2% $ 1,728,571 - $ 2,419,999 4.7% $ 74,000 - $ 79,309 2.3% $ 2,420,000 - $ 4,033,332 4.8% $ 79,310 - $ 85,184 2.4% $ 4,033,333 - $ 12,099,999 4.9% Page 1 of 2 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 99 04 07A (Ed 01-07) 2. AVERAGE PERCENTAGE DISCOUNT: 3. OTHER POLICIES: 4. If there are no entries in Items 1, 2 and 3, of the Schedule see the Premium Discount Endorsement attached to your policy number This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective: 02/01/2019 Policy No.: GTWC013587 Endorsement No.: Insured: Insurance Company: Cypress Insurance Company WC 99 04 07A (Ed 01-07) Countersigned by Page 2 of 2 Premium $ P.O. Box 881236, San Francisco, CN 94133 1 Phone. (888) 495-3949 1 bllllc.com POLICYHOLDER NOTICE PAYROLL RECORD REQUIREMENTS FOR DUAL WAGE CONSTRUCTION OR ERECTION CLASSIFICATIONS Dual wage classifications are pairs of classifications that describe the same construction or erection operation yet are assigned based upon whether the employee's hourly wage is above or below a specified threshold. Each pair of dual wage classifications contains one "high wage" classification that is assignable to payrolls earned by employees whose regular hourly wage equals or exceeds a specified wage threshold and one "low wage" classification that is assignable to payrolls earned by employees whose regular hourly wage is less than the specified threshold. Your policy includes one or more dual wage construction or erection classifications. The assignment of a high wage classification to any non -salaried employee is contingent on verifying that employee's hourly wage by reconciling the total number of hours the employee actually worked during the policy period against the employee's time cards or time sheets that document the operations performed, the daily start and stop times and the total hours worked each day for that employee. The non -salaried employee's regular hourly wage shall be determined by dividing that employee's total remuneration by the hours worked, irrespective of whether the employee is paid on an hourly, piecework, production or commission basis. The payroll earned by any non -salaried employees for whom we are unable to verify the total number of hours worked will be assigned to the low wage classification that describes the operations performed. The regular hourly wage of salaried employees is determined by dividing the total annual remuneration by 2000 hours. If an employee is salaried for less than 12 months, the regular hourly wage for the salaried period is calculated on a prorated basis. SERKSI ilRE I LATILANN_AI- I IONIESTATE INSL"ILANCE CONIPANi BROOKNN OOL) INSL-I2ANCE t:0\TP.11NY CON" PINENTAL DIVIDE INSL-IRIVCE CONIPAN'Y CSPRE° 'INSI RANCECC)NIIANY i OAK RIti ERIN9! R:ANCECOMPANF : RHDXOOD FI REANDCASC,U;I) INq RANCE COMPANY WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 99 0412 (Ed 1-19) CALIFORNIA CONTRACTORS SCHEDULE ENDORSEMENT This endorsement applies only to the insurance provided by the policy because California is shown in item 3.A. of the Information Page. The classifications of operations included in this endorsement are made a part of Item 4 of the Information Page. THE APPEARANCE OF A CODE OR CLASSIFICATION IS NOT A GUARANTEE OF COVERAGE. ADDITIONAL CODES OR CLASSIFICATIONS ARE SUBJECT TO UNDERWRITING APPROVAL. Code No. Description of Operations 5020 Ceiling Installation - suspended acoustical grid type. 5027 Masonry - employees whose regular hourly wage does not equal or exceed $27.00 per hour - N.O.C. 5028 Masonry - employees whose regular hourly wage equals or exceeds $27.00 per hour N.O.C. Assignment of this classification is subject to verification at the time of final audit that the employee's regular hourly wage equals or exceeds $27.00 per hour. The payroll of an employee whose regular hourly wage is not shown to equal or exceed $27.00 per hour shall be classified as 5027, "Masonry". 5040 (3) Painting - steel structures or bridges 5057 Iron or Steel Erection - N.O.C. 5059 Iron or Steel Erection - structural - in the construction of buildings not over two stories in height. 5102(l) Iron, Steel, Brass, Bronze or Aluminum Erection - non-structural. 5107 Door, Door Frame or Pre -Glazed Window Installation - not overhead doors. 5108 Door Installation- overhead doors. 5140 Electrical Wiring - within buildings - including installation or repair of fixtures or appliances - including shop - employees whose regular hourly wage equals or exceeds $32.00 per hour. Assignment of this classification is subject to verification at the time of final audit that the employee's regular hourly wage equals or exceeds $32.00 per hour. The payroll of an employee whose regular hourly wage is not shown to equal or exceed $32.00 per hour shall be classified as 5190, "Electrical Wiring". 5146(1) Cabinet or Fixtures - portable; interior trim- installation - N.O.C. At a particular job or location, Classification 5146(1) shall not be used for division of payroll in connection with Classifications 5403/5432, Carpentry, or 5632/5633, Steel Framing. 5160 Elevator Erection or Repair 5183(1) Plumbing - including shop - gas, steam, hot water or other pipe fittings installation, including house connections installation - employees whose regular hourly wage does not equal or exceed $26.00 per hour - N.O.C. 5183(2) Refrigeration Equipment - not household units - installation, service and repair - Including shop - employees whose regular hourly wage does not equal or exceed $26.00 per hour N.O.C. WC 99 04 12 (Ed. 1-19) Page 2 of 7 Base Rate $ 7.95 $ 23.06 $ 9.43 $ 18.26 $ 11.46 $ 17.20 $ 13.27 $ 10.52 $ 17.53 $ 3.41 $ 9.30 $ 3.39 $ 10.47 $ 10.47 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY CALIFORNIA CONTRACTORS SCHEDULE ENDORSEMENT WC 99 04 12 (Ed 1-19) Code No. Description of Operations Base Rate 5185 Automatic Sprinkler Installation - within buildings - including storage and yard $ 11.62 employees - employees whose regular hourly wage does not equal or exceed $27.00 per hour. 5186 Automatic Sprinkler Installation - within buildings - including storage and yard $ 3.90 employees - employees whose regular hourly wage equals or exceeds $27.00 per hour. Assignment of this classification is subject to verification at the time of final audit that the employee's regular hourly wage equals or exceeds $27.00 per hour. The payroll of an employee whose regular hourly wage is not shown to equal or exceed $27.00 per hour shall be classified as 5185, "Automatic Sprinkler Installation". 5187(1) Plumbing - including shop - gas, steam, hot water or other pipe fittings installation, $ 5.22 including house connections installation - employees whose regular hourly wage equals or exceeds $26.00 per hour - N.O.C. Assignment of this classification is subject to verification at the time of final audit that the employee's regular hourly wage equals or exceeds $26.00 per hour. The payroll of an employee whose regular hourly wage is not shown to equal or exceed $26.00 per hour shall be classified as 5183(1), "Plumbing". 5187(2) Refrigeration Equipment - not household units - installation, service and repair - $ 5.22 including shop - employees whose regular hourly wage equals or exceeds $26.00 per hour - N.O.C. Assignment of this classification is subject to verification at the time of final audit that the employee's regular hourly wage equals or exceeds $26.00 per hour. The payroll of an employee whose regular hourly wage is not shown to equal or exceed $26.00 per hour shall be, classified as 5183(2), "Refrigeration Equipment". 5190 Electrical Wiring - within buildings - including installation or repair of fixtures or $ 7.70 appliances - including shop - employees whose regular hourly wage does not equal or exceed $32.00 per hour. 5195 Communications Cabling - within buildings - including shop. $ 7.41 5201(2) Concrete or Cement Work - pouring or finishing of concrete floor slabs, poured in $ 13.56 place and on the ground, and concrete slab -type foundations, for other than concrete buildings or structural steel buildings of multi -story construction - including the making or stripping of forms - employees whose regular hourly wage does not equal or exceed $25.00 per hour. 5205(2) Concrete or Cement Work - pouring or finishing of concrete floor slabs, poured in $ 9.32 place and on the ground, and concrete slab -type foundations, for other than concrete buildings or structural steel buildings of multi -story construction - including the making or stripping of forms - employees whose regular hourly wage equals or exceeds $25.00 per hour. Assignment of this classification is subject to verification at the time of final audit that the employee's regular hourly wage equals or exceeds $25.00 per hour. The payroll of an employee whose regular hourly wage is not shown to equal or exceed $25.00 per hour shall be classified as 5201(2), "Concrete or Cement Work". 5213 Concrete Construction - N.O.C. $ 8.89 5214 Concrete or Cement Work - pouring or finishing of precast concrete wall panels, $ 8,47 precast floor slabs or precast roof slabs at ground level and at job site - including the making or stripping of forms. WC 99 04 12 (Ed. 1-19) Page 3 of 7 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY CALIFORNIA CONTRACTORS SCHEDULE ENDORSEMENT Code No. Description of Operations 5225 Reinforcing Steel Installation - placing for concrete construction. 5348 Tile, Stone, Mosaic or Terrazzo Work - not fireproof tile construction. 5403 Carpentry - including the installation of interior trim, builders finish, doors and cabinet work in connection therewith - employees whose regular hourly wage does not equal or exceeds $32.00 per hour - N.O.C. 5432 Carpentry - including the installation of interior trim, builders finish, doors and cabinet work in connection therewith - employees whose regular hourly wage equals or exceeds $32.00 per hour - N.O.C. Assignment of this classification is subject to verification at the time of final audit that the employee's regular hourly wage equals or exceeds $32.00 per hour. The payroll of an employee whose regular hourly wage is not shown to equal or exceed $32.00 per hour shall be classified as 5403, "Carpentry". 5436 Hardwood Floor Laying - including finishing. 5443 Lathing. 5446 Wallboard Application - within buildings - including finishing and preparation prior to painting - employees whose regular hourly wage does not equal or exceed $ 34.00 per hour N.O.C. 5447 Wallboard Application - within buildings - including finishing and preparation prior to painting employees whose regular hourly wage equals or exceeds $34.00 per hour - N.O.C. Assignment of this classification is subject to verification at the time of final audit that the employee's regular hourly wage equals or exceeds $ 34.00 per hour. The payroll of an employee whose regular hourly wage is not shown to equal or exceed $ 34.00 per hour shall be classified as 5446, "Wallboard Application". 5467 Glaziers - away from shop - employees whose regular hourly wage does not equal or exceed $32.00 per hour. 5470 Glaziers - away from shop - employees whose regular hourly wage equals or exceeds $32.00 per hour. Assignment of this classification is subject to verification at the time of final audit that the employee's regular hourly wage equals or exceeds $32.00 per hour. The payroll of an employee whose regular hourly wage is not shown to equal or exceed $32.00 per hour shall be classified as 5467,"Glaziers." 5474(1) Painting or Wallpaper Installation - including shop operations - employees whose regular hourly wage does not equal or exceed $26.00 per hour - N.O.C. 5474(3) Painting - water, oil or gasoline storage tanks - including shop operations - employees whose regular hourly wage does not equal or exceed $26.00 per hour. 5479 Insulation Work - installation or application of acoustical or thermal insulating materials in buildings or within building walls - N.O.C. WC 99 04 12 (Ed. 1-19) Page 4 of 7 WC 99 04 12 (Ed 1-19) Base Rate $ 9.89 $ 8.71 $ 23.70 $ 9.47 $ 7.98 $ 10.76 $ 12.31 $ 6.14 $ 16.69 $ 5.76 $ 15.76 $ 15.76 $ 10.49 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY CALIFORNIA CONTRACTORS SCHEDULE ENDORSEMENT WC 99 04 12 (Ed 1-19) Code No. Description of Operations Base Rate 5482(1) Painting or Wallpaper Installation - including shop operations - employees whose $ 7.39 regular hourly wage equals or exceeds $26.00 per hour - N.O.C. Assignment of this classification is subject to verification at the time of final audit that the employee's regular hourly wage equals or exceeds $26.00 per hour. The payroll of an employee whose regular hourly wage is not shown to equal or exceed $26.00 per hour shall be classified as 5474(1), "Painting or Wallpaper Installation". 5482(3) Painting - water, oil or gasoline storage tanks - including shop operations - $ 7.39 employees whose regular hourly wage equals or exceeds $26.00 per hour. Assignment of this classification is subject to verification at the time of final audit that the employee's regular hourly wage equals or exceeds $26.00 per hour. The payroll of an employee whose regular hourly wage is not shown to equal or exceed $ 26.00 per hour shall be classified as 5474(3), "Painting". 5484 Plastering or Stucco Work - employees whose regular hourly wage does not equal $ 22.28 or exceed $29.00 per hour. 5485 Plastering or Stucco Work - employees whose regular hourly wage equals or $ 13.15 exceeds $29.00 per hour. Assignment of this classification is subject to verification at the time of final audit that the employee's regular hourly wage equals or exceeds $29.00 per hour. The payroll of an employee whose regular hourly wage is not shown to equal or exceed $29.00 per hour shall be classified as 5484, "Plastering or Stucco Work". 5538(1) Sheet Metal Work - erection, installation or repair - including shop - employees $ 10.35 whose regular hourly wage does not equal or exceed $27.00 per hour - N.O.C. 5542(1) Sheet Metal Work - erection, installation or repair - including shop - employees $ 6.00 whose regular hourly wage equals or exceeds $27.00 per hour - N.O.C. Assignment of this classification is subject to verification at the time of final audit that the employee's regular hourly wage equals or exceeds $27.00 per hour. The payroll of an employee whose regular hourly wage is not shown to equal or exceed $27.00 per hour shall be classified as 5538(1), "Sheet Metal Work". 5552 Roofing - all kinds - including yard employees - employees whose regular hourly $ 52.43 wage does not equal or exceed $25.00 per hour. 5553 Roofing - all kinds - including yard employees - employees whose regular hourly $ 20.16 wage equals or exceeds $25.00 per hour. Assignment of this classification is subject to verification at the time of final audit that the employee's regular hourly wage equals or exceeds $25.00 per hour. The payroll of an employee whose regular hourly wage is not shown to equal or exceed $25.00 per hour shall be classified as 5552, "Roofing". 5606 Contractors - construction or erection - executive level supervisors - no direct $ 1.36 supervision - division of a single employee's payroll with any other classification is not permitted. 5632 Steel Framing - light gauge - including the incidental installation of interior trim, $ 23.70 builders finish, doors and cabinet work in connection therewith employees whose regular hourly wage does not equal or exceed $32.00 per hour. WC 99 04 12 (Ed. 1-19) Page 5 of 7 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY CALIFORNIA CONTRACTORS SCHEDULE ENDORSEMENT WC 99 04 12 (Ed 1-19) Code No. Description of Operations Base Rate 5633 Steel Framing - light gauge - including the incidental installation of interior trim, $ 8.61 builders finish, doors and cabinet work - employees whose regular hourly wage equals or exceeds $32.00 per hour. Assignment of this classification is subject to verification at the time of final audit that the employee's regular hourly wage equals or exceeds $32.00 per hour. The payroll of an employee whose regular hourly wage is not shown to equal or exceed $32.00 per hour shall be classified as 5632, "Steel Framing". 6218(1) Excavation - N.O.C. - including borrowing, filling or backfilling - employees whose $ 10.12 regular hourly wage does not equal or exceed $31.00 per hour. 6218(2) Grading Land - N.O.C. - including borrowing, filling or backfilling - employees $ 10.12 whose regular hourly wage does not equal or exceed $31.00 per hour. 6220(1) Excavation - N.O.C. - including borrowing, filling or backfilling - employees whose $ 7.04 regular hourly wage equals or exceeds $31.00 per hour. Assignment of this classification is subject to verification at the time of final audit that the employee's regular hourly wage equals or exceeds $31.00 per hour. The payroll of an employee whose regular hourly wage is not shown to equal or exceed $31.00 per hour shall be classified as 6218(1), "Excavation N.O.C.". 6220(3) Land Leveling - grading farm lands - employees whose regular hourly wage equals $ 7.04 or exceeds $31.00 per hour. Assignment of this classification is subject to verification at the time of final audit that the employee's regular hourly wage equals or exceeds $31.00 per hour. The payroll of an employee whose regular wage is not shown to equal or exceed $31.00 per hour shall be classified as 6218(3), " Land Leveling". 6307 Sewer Construction - all operations - including construction of laterals and $ 14.47 tunneling at street crossings - employees whose regular hourly wage does not equal or exceed $31.00 per hour. 6308 Sewer Construction - all operations - including construction of laterals and $ 9.15 tunneling at street crossings - employees whose regular hourly wage equals or exceeds $31.00 per hour. Assignment of this classification is subject to verification at the time of final audit that the employee's regular hourly wage equals or exceeds $31.00 per hour. The payroll of an employee whose regular hourly wage is not shown to equal or exceed $31.00 per hour shall be classified as 6307, "Sewer Construction". 6315(2) Gas Mains or Connections Construction - including tunneling at street crossings - $ 9.93 employees whose regular hourly wage does not equal or exceed $31.00 per hour. 6316(1) Water Mains or Connections Construction - including tunneling at street crossings $ 10.02 - employees whose regular hourly wage equals or exceeds $31.00 per hour. Assignment of this classification is subject to verification at the time of final audit that the employee's regular hourly wage equals or exceeds $31.00 per hour. The payroll of an employee whose regular hourly wage is not shown to equal or exceed $31.00 per hour shall be classified as 6315(1), "Water Mains or Connections Construction." WC 99 04 12 (Ed. 1-19) Page 6 of 7 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY CALIFORNIA CONTRACTORS SCHEDULE ENDORSEMENT WC 99 04 12 (Ed 1-19) Code No. Description of Operations Base Rate 6316(2) Gas Mains or Connections Construction- including tunneling at street crossings - $ 10.02 employees whose regular hourly wage equals or exceeds $31.00 per hour. Assignment of this classification is subject to verification at the time of final audit that the employee's regular hourly wage equals or exceeds $31.00 per hour. The payroll of an employee whose regular hourly wage is not shown to equal or exceed $31.00 per hour shall be classified as 6315(2) "Gas Mains or Connections Construction." 6325 Conduit Construction or Underground Wiring - including tunneling at street $ 6.31 crossings. All tunneling other than at street crossings shall be separately classified. 6361 (1) Canal Construction - all operations Pile Driving, tunneling, dam or sewer $ 8.56 construction shall be separately classified. 6400 Fence Construction - metal or wood. $ 11.56 8227 Construction or Erection Permanent Yards or Shops - for maintenance of $ 9.08 equipment or storage of material. 9519(1) Household Appliances - installation, service or repair - shop or outside. $ 13.04 9521 (2) Floor Covering - installation. $ 10.21 9529(l) Scaffolds, Shoring, Concrete or Cement Distributing Towers, Hod Hoists or $ 9.39 Construction Elevators - installation or removal. This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective 02/01/2019 Policy No. GTWC013587 Endorsement No. Insured Premium $ Insurance Company Countersigned by Cypress Insurance Company WC 99 04 12 (Ed. 1-19) Page 7 of 7 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 99 06 07 D (Ed 10-17) CALIFORNIA CANCELLATION ENDORSEMENT This endorsement applies only to the insurance provided by the policy because California is shown in Item 3.A. of the Information Page. The cancellation condition in Part Six (Conditions) of the policy is replaced by these conditions: Cancellation: 1. You may cancel this policy. You must mail or deliver advance written notice to us stating when the cancellation is to take effect. 2. We may cancel this Policy for one or more of the following reasons: a. Non-payment of premium; b. Failure to report payroll; c. Non-payment of deductible billing; d. Failure to permit us to audit payroll as required by the terms of this policy or of a previous policy issued by us; e. Failure to pay any additional premium resulting from an audit of payroll required by the terms of this policy or any previous policy issued by us; f. Material misrepresentation made by you or your agent; g. Failure to cooperate with us in the investigation of a claim, h. Failure to comply with Federal or State safety orders; i. Failure to comply with written recommendations of our designated loss control representatives; j. The occurrence of a material change in the ownership of your business; k. The occurrence of any change in your business or operations that materially increases the hazard for frequency or severity of loss; I. The occurrence of any change in your business or operation that requires additional or different classification for premium calculation; m. The occurrence of any change in your business or operation which contemplates an activity excluded by our reinsurance treaties. 3. If we cancel your policy for any of the reasons listed in (a) through (g), we will give you 10 days advance written notice, stating when the cancellation is to take effect. Mailing that notice to you at your mailing address shown in Item 1 of the Information Page will be sufficient to provide notice. If we cancel your policy for any of the reasons listed in Items (h) through (m), we will give you 30 days advance written notice; however, we agree that in the event of cancellation and reissuance of a policy effective upon a material change in ownership or operations, notice will not be provided. 4. The policy period will end on the day and hour stated in the cancellation notice. 5. A short rate penalty applies if you cancel this policy or if we cancel due to non-payment of premium, failure to report payroll, or non-payment of deductible billing. First, the standard premium, defined as the base premium (computed in accordance with Part 1, Section 2, Subsection 3 of the WCIRB's California Basic Underwriting Manual) adjusted for the experience modification factor and all other pricing factors except for premium discount and expense constant, will be multiplied by the quotient of the number of days for which the policy was written divided by the number of days the policy remained in force to produce the full standard premium. Second, the extended number of days will be determined by dividing the number of days the policy was in force by the number of days for which the policy was written and multiplying the quotient by 365 days. When the policy is written for a one-year period, the extended number of days will equal the number of days the policy remained in force. Third, the short rate percentage corresponding to the extended number of days will be obtained from the short rate cancellation table. Fourth, the short rate premium will be equal to the product of the full standard premium times the short rate percentage. The short rate table below will be used in computing the short rate premium. In no event will the final earned premium be less than the policy minimum premium. WC 99 06 07D Page 1 of 2 (Ed 10-17) WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 99 06 07 D (Ed 10-17) Short Rate Table Extended Number of Days Percent of Full Policv Premiun Extended Number of Days Percent of Fill Policy Premien Extended Number of Days Percent of Full Policy Premien 1 ...... 5% 95-98 . .... 3790 19_72.1 69% 2 6°'0 99-102 ...... 38°0 274_278 7040 3-4 7% 103-105 39% 229-232 ...... 71% 5-6 8410 106-109 ...... 40%233-137 72.00� 7-8 9% 110-113 .... 4190 238-241 73% 9-10 ...... 1090 114-116 .... 42°% 242-246 (8 mos.) 7490 11-12 ..... 11% 117-120 .... 43% 247_250 ...... 75% 13-14 ...... 12% 121-124 (4 mos.) 44% 251-255 769'0 15-16 ...... 13% 125-127 .... 45% 356-260 77% 17-18 ...... 1440 128-131 ...... 46% 261-264 ...... 780,0 19-20 .... 15% 132-13547,0°' 365-269 7940 21-22 .... 169'0 136-138 . .... 48°0 270-273 (9 mos.) 80% 23-25 17% 139-142 .... 49°,0 274-278 ...... 81% 26-29 18% 143-146 .... 50°0 279-282 82% 30-32 (1 mo.) 19% 147-149 ...... 5190 283-387 8390 33-36 ...... 20% 150-153 (5 mos) 524u 288-291 84°u 37-40 .... 21% 154-156 ...... 53% 797.796 8590 41-43 229'0 157-160 ...... 54% 297-301 86°0 44-47 23% 161-164 ...... 55°0 302-305 (10 mos.) 879% 48-51 ...... 24% 165-167 ...... 56% 306-310 ...... 88% 52-54 ... 25% 168-171 ...... 57% 311-314 89:0o� 55-58 ... 26% 172-175 584° 315-319 900,0 59-62 (2 mos.) 27% 176-178 ...... 59% 321-323 9190 63-65 ... .. 280,0 179-182 (6 mos.) 60% 324-328 929'0 66-69 ...... 29% 183-187 61% 339-332 9390 70-73 ...... 300/0 188-191 62% 333-337 (Il mos.) 941'0 74-76 3190 192-196 ... 63°0 338-342 9590 77-80 32% 197-200 .... 64% 343-346 ... .. 961u 81-83 33% 201-205 ...... 65% 347-351 ...... 97% 84-87 ...... 34% 206-209 ...... 66% 352-355 ...... 989'0 88-91 (3 mos.) 3590 210-214 (7 mos.) 67% 356-360 ...... 99°0 92-94 ...... 36% 215-218 ...... 6840 361-365 (12 mos.) 10040 This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective: 02/01/2019 Policy No.: GTWC013587 Endorsement No.: Insured: Insurance Company: Cypress Insurance Company WC 99 06 07D (Ed 10-17) Countersigned by Page 2 of 2 Premium $ WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 99 06 08 (Ed 1-07) PREMIUM It is agreed that the policy is amended to read: PART FIVE - PREMIUM D. Premium Payments You will pay all premium when due. You will pay the premium even if part or all of a workers compensation law is not valid. Minimum Premium means the minimum cost to be paid for this policy of insurance. The Minimum Premium must be paid prior to the inception date of the policy of insurance and the Minimum Premium is deemed fully earned at the inception of the policy period and non-refundable. E. Final Premium The premium shown on the Information Page, schedules, and endorsements is an estimate. The final premium will be determined after this policy ends by using the actual, not the estimated, premium basis and the proper classifications and rates that lawfully apply to the business and work covered by this policy. If the final premium is more than the premium you paid to us, you must pay us the balance. If it is less, we will refund the balance to you. The final premium will not be less than the highest minimum premium for the classifications covered by this policy. If this policy is canceled, final premium will be determined in the following way unless our manuals provide otherwise: 1. If we cancel (except due to non-payment of premium), final premium will be calculated pro rata based on the time this policy was in force. Final premium will not be less than the Minimum Premium 2. If you cancel (or we cancel due to non-payment of premium), the premium will be more than pro rata; it will be based on the time this policy was in force, and increased by our short rate cancellation table and procedure. Final premium will not be less than the Minimum Premium. If legal action is required to collect the Final Audit premium due and owing under this policy of insurance, you agree that the legal action shall be properly filed in the Superior Court of the State of California, County of San Francisco, California and consent to jurisdiction in that court. The prevailing party to such action to collect said premium shall be entitled to reasonable costs and attorney fees, as well as interest if applicable. This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective: 02/01/2019 Policy No.: GTWC013587 Endorsement No.: Insured: Insurance Company: Cypress Insurance Company Countersigned by WC 99 06 08 (Ed 1-07) Premium $ WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY PN 04 99 01 F (Ed. 10-16) POLICYHOLDER NOTICE YOUR RIGHT TO RATING AND DIVIDEND INFORMATION Information Available to You A. Information Available from Us -Cypress Insurance Company (1) General questions regarding your policy should be directed to: Cypress Insurance Company P.O. Box 881236, San Francisco, CA 94188 Phone: 888.495-8949 Fax: 866-228-4613 www.bhhc.com (2) Dividend Calculation. If this is a participating policy (a policy on which a dividend may be paid), upon payment or nonpayment of a dividend, we shall provide a written explanation to you that sets forth the basis of the dividend calculation. The explanation will be in clear, understandable language and will express the dividend as a dollar amount and as a percentage of the earned premium for the policy year on which the dividend is calculated. (3) Claims Information. Pursuant to Sections 3761 and 3762 of the California Labor Code, you are entitled to receive information in our claim files that affects your premium. Copies of documents will be supplied at your expense during reasonable business hours. For claims covered under this policy, we will estimate the ultimate cost of unsettled claims for statistical purposes eighteen months after the policy becomes effective and will report those estimates to the Workers' Compensation Insurance Rating Bureau of California (WCIRB) no later than twenty months after the policy becomes effective. The cost of any settled claims will also be reported at that time. At twelve-month intervals thereafter, we will update and report to the WCIRB the estimated cost of any unsettled claims and the actual final cost of any claims settled in the interim. The amounts we report will be used by the WCIRB to compute your experience modification if you are eligible for experience rating. B. Information Available from the Workers' Compensation Insurance Rating Bureau of California (1) The WCIRB is a licensed rating organization and the California Insurance Commissioner's designated statistical agent. As such, the WCIRB is responsible for administering the California Workers' Compensation Uniform Statistical Reporting Plan -1995 (USRP) and the California Workers' Compensation Experience Rating Plan -1995 (ERP). Contact information for the WCIRB is: WCIRB, 1221 Broadway, Suite 900, Oakland, CA 94612, Attention: Customer Service. You may also contact WCIRB Customer Service at 1-888-229-2472, by fax at 415-778-7272, or via the Internet at the WCIRB's website: http://www.wcirb.com. The regulations contained in the USRP and the ERP are available for public viewing through the WCIRB's website. (2) Policyholder Information. Pursuant to California Insurance Code (CIC) Section 11752.6, upon written request, you are entitled to information relating to loss experience, claims, classification assignments, and policy contracts as well as rating plans, rating systems, manual rules, or other information impacting your premium that is maintained in the records of the WCIRB. Complaints and Requests for Action requesting policyholder information should be forwarded to: WCIRB, 1221 Broadway, Suite 900, Oakland, CA 94612, Attention: Custodian of Records. The Custodian of Records can be reached by telephone at 415-777- 0777 and by fax at 415-778-7272. (3) Experience Rating Form. Each experience rated risk may receive a single copy of its current Experience Rating Form free of charge by completing a Policyholder Rate Sheet Request Form on the WCIRB's website at http://www.wcirb.com/ratesheet. The Experience Rating Form will include a Loss -Free Rating, which is the experience modification that would have been calculated if $0 (zero) actual losses were incurred during the experience period. This hypothetical rating calculation is provided for informational purposes only. Dispute Process You may dispute our actions or the actions of the WCIRB pursuant to CIC Sections 11737 and 11753.1. A. Our Dispute Resolution Process. If you are aggrieved by our decision adopting a change in a classification assignment that results in increased premium, or by the application of our rating system to your workers' compensation insurance, you may dispute these matters with us. If you are dissatisfied with the outcome of the initial dispute with us, you may send us a written Complaint and Request for Action as outlined below. Page 1 of 2 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY PN 04 99 01 F (Ed. 10-16) to: Cypress Insurance Company, P.O. Box 881236, San Francisco, CA 94188 Phone: (888) 495-8949 Fax: (866) 228-4613 After you send your Complaint and Request for Action, we have 30 days to send you a written notice indicating whether or not your written request will be reviewed. If we agree to review your request, we must conduct the review and issue a decision granting or rejecting your request within 60 days after sending you the written notice granting review. If we decline to review your request, if you are dissatisfied with the decision upon review, or if we fail to grant or reject your request or issue a decision upon review, you may appeal to the insurance commissioner as described in paragraph II.C., below. B. Disputing the Actions of the WCIRB. If you have been aggrieved by any decision, action, or omission to act of the WCIRB, you may request, in writing, that the WCIRB reconsider its decision, action, or omission to act. You may also request, in writing, that the WCIRB review the manner in which its rating system has been applied in connection with the insurance afforded or offered you. For requests related to classification disputes, the reporting of experience, or coverage issues, your initial request for review must be received by the WCIRB within 12 months after the expiration date of the policy to which the request for review pertains, except if the request involves the application of the Revision of Losses rule. For requests related to your experience modification, your initial request for review must be received by the WCIRB within 6 months after the issuance, or 12 months after the expiration date, of the experience modification to which the request for review pertains, whichever is later, except if the request for review involves the application of the Revision of Losses rule. If the request involves the Revision of Losses rule, the time to state your appeal may be longer. (See Section VI, Rule 14 of the ERP). You may commence the review process by sending the WCIRB a written Inquiry. Written Inquiries should be sent to: WCIRB, 1221 Broadway, Suite 900, Oakland, CA 94612, Attention: Customer Service. Customer Service can be reached by telephone at 1-888-229-2472, and by fax at 415-778-7272. If you are dissatisfied with the WCIRB's decision upon an Inquiry, or if the WCIRB fails to respond within 90 days after receipt of the Inquiry, you may pursue the subject of the Inquiry by sending the WCIRB a written Complaint and Request for Action. After you send your Complaint and Request for Action, the WCIRB has 30 days to send you written notice indicating whether or not your written request will be reviewed. If the WCIRB agrees to review your request, it must conduct the review and issue a decision granting or rejecting your request within 60 days after sending you the written notice granting review. If the WCIRB declines to review your request, if you are dissatisfied with the decision upon review, or if the WCIRB fails to grant or reject your request or issue a decision upon review, you may appeal to the insurance commissioner as described in paragraph II.C., below. Written Complaints and Requests for Action should be forwarded to: WCIRB, 1221 Broadway, Suite 900, Oakland, CA 94612, Attention: Complaints and Reconsiderations. The WCIRB's telephone number is 1-888-229-2472, and the fax number is 415-371-5204. C. California Department of Insurance - Appeals to the Insurance Commissioner. If, after you follow the appropriate dispute resolution process described above, we or the WCIRB decline to review your request, if you are dissatisfied with the decision upon review, or if we or the WCIRB fail to grant or reject your request or issue a decision upon review, you may appeal to the insurance commissioner pursuant to CIC Sections 11737, 11752.6, 11753.1 and Title 10, California Code of Regulations, Section 2509.40 et seq. You must file your appeal within 30 days after we or the WCIRB send you the notice rejecting review of your Complaint and Request for Action or the decision upon your Complaint and Request for Action. If no written decision regarding your Complaint and Request for Action is sent, your appeal must be filed within120 days after you sent your Complaint and Request for Action to us or to the WCIRB. The filing address for all appeals to the insurance commissioner is: Administrative Hearing Bureau California Department of Insurance 45 Fremont Street, 22nd Floor San Francisco, California 94105 You have the right to a hearing before the insurance commissioner, and our action, or the action of the WCIRB, may be affirmed, modified, or reversed. III. Resources Available to You in Obtaining Information and Pursuing Disputes A. Policyholder Ombudsman. Pursuant to California Insurance Code Section 11752.6, a policyholder ombudsman is available at the WCIRB to assist you in obtaining and evaluating the rating, policy, and claims information referenced in I.A. and I. B., above. The ombudsman may advise you on any dispute with us, the WCIRB, or on an appeal to the insurance commissioner pursuant to Section 11737 of the Insurance Code. The address of the policyholder ombudsman is WCIRB, 1221 Broadway, Suite 900, Oakland, CA 94612, Attention: Policyholder Ombudsman. The policyholder ombudsman can be reached by telephone at 415-778-7159 and by fax at 415-371-5288. B. California Department of Insurance - Information and Assistance. Information and assistance on policy questions can be obtained from the Department of Insurance Consumer HOTLINE, 1 -800 -927 -HELP (4357) or http://www.insurance.ca.gov. For questions and correspondence regarding appeals to the Administrative Hearing Bureau, see the contact information in paragraph II.C. This notice does not change the policy to which it is attached Page 2 of 2 SEPARATOR PAGE Gemini Insurance Company a Berktey Company 475 Steamboat Road Greenwich, CT 06830 ARCHITECTS, ENGINEERS, CONSTRUCTION MANAGERS ft DESIGN BUILD PROFESSIONAL LIABILITY INSURANCE DECLARATIONS (Claims -Made Form) Policy No: HPM-DP-00309-03 1. Named Insured: G2 Construction, Inc. Principal Address: 1352 E BORCHARD AVE SANTA ANA CA 92705-4413 of: HPM-DP-00309-02 2, Policy Period: 2127/2019 to 2/27/2020 both days at 12:01 A.M. Standard Time at the address of the Named Insured as stated herein 3. Insurance is effective with GEMINI INSURANCE COMPANY 5.59 4. Limits of Liability (Including Claims Expenses), unless the Policy is otherwise endorsed: (A) Each Claim: $2,000,000 (B) Policy Period Aggregate: $2,000,000 2/27/2015 except 2/27/2019 for limits of (C) Retroactive Date: liability $1,000,000/$1,000,000 excess $1,000,0001$1,000,000 (D) Self Insured Retention Each Claim: $ 10,000 (E) Policy Period Aggregate Self Insured Retention: $ 30,000 (F) Rate: Flat (G) Premium: $7,500 Policy Fee: $295 (H) Minimum Earned Premium: 25% of the premium shown in G above 5. Forms attached hereto and special conditions: See attached Schedule of Forms and Endorsements Dated: February 26, 2019 Authorized Re esgntative FORMS AND ENDORSEMENTS SCHEDULE It is hereby understood and agreed the following forms and endorsements are attached to and are a part of this Policy: # Form/Endorsemen t Number Form/Endorsement Name 1 HPM 5424192 07 13 Design Professional Advantage Professional / Pollution Liability Insurance Policy 2 HPM 1010 0018 07 13 Nuclear Energy Liability Exclusion Endorsement 3 HPM 1010 0039 07 13 Technology Based Services, Technology Product, Computer Network Security, Multimedia and Advertising Endorsement 4 HPM 1010 0040 07 13 Pre -claim Assistance Endorsement 5 HPM 1010 0035 07 13 Transportation Pollution Liability Coverage Extension 6 HPM 1010 0046 07 13 Crisis Management Expense Coverage Extension 7 HPM 1010 0026 07 13 Design Build Endorsement 8 HPM 1010 0034 07 13 Commercial General Liability Warranty 9 HPM 1010 0033 07 13 Written Contracts Warranty 10 HPM 1010 0058 03 18 Cyber Liability Coverage Endorsement 11 BCIM 0001 09 12 Claim Notice 12 BCIM 0003 05 13 Service of Suit 13 BCIM 0008 05 13 Signature Page Endorsement 14 15 16 17 HPM 1010 0048 04 13 DESIGN PROFESSIONAL ADVANTAGE PROFESSIONAL LIABILITY INSURANCE POLICY This is a Claims Made and Reported Policy. Please Read It Carefully. In consideration of the of payment of premium and subject to the Declarations, limitations, conditions, provisions and other terms of this Policy, the Company and the Insured agree as follows: INSURING AGREEMENTS A. The Company shall pay Damages and Claim Expenses on behalf of the Insured resulting from any Claim first made against the Insured and reported to the Company in writing during the Policy Period or any applicable Extended Reporting Period for any Wrongful Act or Personal and Advertising Injury committed on or after the Retroactive Date stated in the Declarations and before the Policy terminates. B. The Company shall pay Damages and Claim Expenses on behalf of the Insured resulting from any Claim first made against the Insured and reported to the Company in writing during the Policy Period or any applicable Extended Reporting Period for Pollution Conditions committed by the Insured solely in the performance of or failure to perform Professional Services on or after the Retroactive Date stated on the Declarations and before the Policy terminates. C. Defense. As part of and subject to the Limits of Liability, the Company shall have the right and duty to defend, any Claim against the Insured, to which this Policy applies, even if any of the allegations of the Claim are groundless, false, or fraudulent. However, the Company shall have no duty to defend any Claim, and may withdraw from the defense of any Claim, after the applicable Limits of Liability have been exhausted by Damages and/or Claim Expenses. D. Consent to Settle. The Company shall have the right to make any investigation it deems necessary and, with the written consent of the Insured, make any settlement of a Claim covered by this Policy. If the Company recommends settlement or compromise of a Claim, and the Insured refuses to give written consent to settlement as recommended by the Company, then the Insured thereafter shall be responsible for fifty percent (50%) of all Damages and Claim Expense in excess of the amount for which settlement could have been made as recommended by the Company; provided that the Company's liability under this Policy for such Claim shall not exceed the remaining portion of the applicable Limits of Liability. HPM 5424192 07 13 Page 1 of 17 II. DEFINITIONS Whenever used in this Policy: A. "Advertisement' means a notice that is broadcast or published to the general public or specific market segments about the goods, products or services of the Named Insured for the purpose of attracting customers or supporters. B. "Application" means all signed applications, including attachments and other materials submitted therewith or incorporated therein, submitted by the Insured to the Company for this Policy or for any policy of which this Policy is a direct or indirect renewal or replacement. Application shall also include all documents provided by the Insured to the Company in connection with the underwriting or issuance of this Policy and any information contained on the website(s) of the Insured, whether provided to the Company directly or indirectly through the use of public databases or similar sources. C. "Bodily Injury" means physical injury, sickness, disease or death of any person, and includes emotional distress, mental injury, mental tension, mental anguish, pain or suffering or shock whether or not accompanied by physical injury, sickness or disease. D. "Circumstance" means any fact, event or situation that could reasonably be the basis for a Claim. E. "Claim" means a demand received by the Insured for money or services and alleging a Wrongful Act, including the service of suit or institution of arbitration, mediation or other formal alternative dispute resolution proceeding. Claim shall not include a demand for equitable, non -pecuniary or injunctive relief or for legal fees or expenses in connection therewith. F. "Claim Expenses" means: 1. fees charged by any lawyer selected by mutual agreement between the Company and the Insured. However, if after a good faith attempt by the Company, the Company and the Insured cannot agree on the selection of the lawyer, the Company shall select the lawyer; 2. all other reasonable fees, costs and expenses resulting from the investigation and defense of a Claim, if incurred by the Company or by the Insured with the written consent of the Company. "Claim Expenses" shall not include salary charges of any employee or officer of the Company or any supervisory counsel or claims representative retained by the Company. The determination by the Company as to the reasonableness of Claim Expenses shall be conclusive on the Insured. G. "Company" means the insurer named in Item 3 of the Declarations. HPM 5424192 07 13 Page 2 of 17 H. "Damages" means monetary judgments or settlements and includes punitive or exemplary damages or the multiple portion of any multiplied damage award in any Claim if such punitive or exemplary damages or any multiplied damage award are insurable under the law pursuant to which this Policy shall be construed. The enforceability of the foregoing shall be governed by such applicable law which most favors coverage for punitive or exemplary damages or the multiple portion of any multiplied damage award. "Damages" shall not include: 1. taxes, fines or statutory penalties, sanctions, whether imposed by law or otherwise (except as provided above with respect to punitive or exemplary damages); 2. amounts for which the Insured is not financially liable or for which there is no legal recourse against the insured; 3. relief which may be deemed uninsurable under the applicable law. I. "Disciplinary Proceeding" means any proceeding by an administrative, regulatory or disciplinary official, board, or agency to investigate charges of professional misconduct in the performance of or failure to perform Professional Services. However, Disciplinary Proceeding shall not include a criminal proceeding or an Organizational Peer Review. J. "Insured" means the Named Insured, any Insured Person and any of the following persons: 1. any natural person who is an independent contractor but only for Professional Services performed on behalf and at the direction of the Named Insured, and the Named Insured has agreed to provide insurance for the independent contractor's Professional Services; 2. any natural person who is a leased employee but only for Professional Services performed while acting under the direct supervision and exclusively on behalf of the Named Insured. 3. any natural person who is a temporary employee but only for Professional Services performed while acting under the direct supervision and exclusively on behalf of the Named Insured. K. "Insured Contract" means that part of any contract or agreement under which the Named Insured assumes tort liability of the Insured's client to pay for compensatory damages to persons other than an Insured, because of Bodily Injury or Property Damage resulting from Pollution Conditions. However, Insured Contract shall not include any tortious conduct that otherwise would not be covered under this Policy, nor if the tortious conduct was solely that of the client. For the purposes of this definition, Insured shall exclude any employee of the Named Insured, solely while acting in their professional capacity on the behalf of the Named Insured. HPM 5424192 07 13 Page 3 of 17 L. "Insured Person" means any natural person who was, is or becomes a principal, partner, managing member, officer, director, employee or Volunteer of the Named Insured, but only while in the performance of Professional Services on behalf of the Named Insured. Coverage under this Policy shall also extend to: the lawful spouse or lawful domestic partner of an Insured Person, if named as a co-defendant with such Insured Person solely by reason of such spouse's status as a spouse or such domestic partner's status as a domestic partner, or such spouse's or domestic partner's ownership interest in property that is sought by a claimant as recovery for an alleged Wrongful Act of such Insured Person; and 2. the estate, heirs, executors, administrators, assigns and legal representatives of any Insured Person in the event of the death, incapacity, insolvency or bankruptcy of such Insured Person; but any such coverage shall apply only with respect to a Wrongful Act of such Insured Person. All terms and conditions of this Policy including, without limitation, the self-insured retention applicable to Claim Expenses and Damages incurred by the Insured Person, shall also apply to Claim Expenses and Damages incurred by the lawful spouse, lawful domestic partner, estate, heirs, executors, administrators, assigns and legal representatives of such Insured Person. 3. any Named Insured with regard to its participation in a joint venture, but soley for the Named Insured's liability for their performance of Professional Services under the respective joint venture. 4. solely as respects this coverage for Pollution Conditions, the term "Insured" shall also mean the client for whom the Named Insured performs or performed covered Professional Services, provided that a written contract or agreement with that client is in effect between the Named Insured and the client, requiring the client to be insured under the Professional Liability Insurance Policy of the Named Insured. However, such clients are included under this Policy solely with respect to Claims arising from covered Professional Services performed by the Named Insured, and the Policy does not apply to Claims arising from the client's own liability. This Policy applies to clients of the Named Insured only for the Limits of Liability up to and not exceeding the amount required by the written contract with the Named Insured and subject to the Limits of Liability of this Policy. M. "Named Insured" means the entity stated in Item 1 of the Declarations. N. "Personal and Advertising Injury" means injury, including consequential Bodily Injury, arising out of one or more of the following offenses: 1. False arrest, detention or imprisonment; HPM 5424192 07 13 Page 4 of 17 2. Malicious prosecution; 3. The wrongful eviction from, wrongful entry into, or invasion of the right of private occupancy of a room, dwelling or premises that a person occupies, committed by or on behalf of its owner, landlord or lessor; 4. Oral or written publication of material that slanders or libels a person or organization or disparages a person's or organization's goods, products or services; 5. Oral or written publication of material that violates a person's right of privacy; 6. The use of another's advertising idea in the Advertisement of the Named Insured; or 7. Infringing upon another's copyright, trade dress or slogan in the Advertisement of the Named Insured; 8. Unintentional disclosure of material that violates a person's right of privacy. O. "Policy Period" means the period from the inception date of this Policy to the Policy expiration date stated in Item 2 of the Declarations or its earlier cancellation date, if any. P. "Pollution Conditions" means the discharge, dispersal, release or escape of smoke, vapors, soot, fumes, acids, alkalis, toxic chemicals, liquids or gases, waste materials or other irritants, contaminants or pollutants into or upon the land, the atmosphere or any watercourse or body of water, which results in Bodily Injury or Property Damage. Q. "Professional Services" means only those services the Insured is legally qualified to perform for others in the Insured's capacity as an architect, engineer, land surveyor, landscape architect, construction manager, interior designer, land planner, space planner, expert witness, scientist or technical consultant with respect to the foregoing listed services. R. "Property Damage" means: (1) physical injury to or destruction of tangible property including the resulting loss of use thereof; or (2) cleanup costs; or (3) loss of use of tangible property that has not been physically injured or destroyed. S. "Related Party" means any entity: 1. in which any Insured own(s) or controls) more than 51% of the issued and outstanding shares, units or other portions of the capital thereof; 2. which owns or controls any Insured; or 3. under common ownership or control with any Insured; T. "Retroactive Date" means the date stated in Item 4 (C) of the Declarations. HPM 5424192 07 13 Page 5 of 17 U. "Volunteer" means a person who is not an employee, and who donates his or her work and acts at the direction of and within the scope of duties determined by the Insured, and is not paid a fee, salary or other compensation. V. "Wrongful Act" means any actual or alleged negligent act, error or omission committed or attempted solely in the performance of or failure to perform Professional Services by an Insured or by any other person for whose acts the Named Insured is legally liable. Ill. EXCLUSIONS This Policy shall not apply: A. to any Claim based upon, arising from, or in consequence of any fraudulent act or omission or any willful violation of any statute, rule or law by any Insured, if a final and non -appealable judgment or adjudication adverse to such Insured establishes such a fraudulent act or omission or willful violation; B. to any Claim: 1. based upon or arising out of the ownership, maintenance, use, operation, loading or unloading of any automobile, aircraft, watercraft or rolling stock of any kind. However, this Exclusion shall not apply to Pollution Conditions arising out of the ownership, maintenance, use, operation, loading or unloading of any automobile, aircraft, watercraft or rolling stock within the boundaries of the job site; 2. caused by, arising out of, relating to, resulting from, contributed to, or aggravated by faulty construction workmanship in any construction, erection, fabrication, installation, assembly, manufacture or remediation performed by, on behalf of or at the direction of any Insured, any Related Party, or any entity acting in the capacity of an agent, contractor or subcontractor of any Insured or any Related Party. However, this exclusion shall not apply to any Wrongful Act committed by any Insured in connection with the hiring or supervision of any entity acting in the capacity of an agent, contractor or subcontractor of any Insured. C. to any Claim brought against, by, on behalf of, for the benefit of or in the right of: 1. any Related Party; or 2. any entity who has a direct or indirect beneficial ownership interest in real property in which any Insured has a direct or indirect beneficial ownership interest; D. to any Claim by, on behalf of, or in the right of: 1. any Insured, including any Claim by the Trustee in Bankruptcy, Receiver, Liquidator or other successor to any Insured, against another Insured; or 2. any agent, independent contractor or subcontractor of any Insured, including without limitation, any employee of any agent, independent contractor or subcontractor of any Insured; HPM 5424192 07 13 Page 6 of 17 E. to any Claim based upon or arising out of any circumstance, if written notice of such circumstance has been given under any policy of which this Policy is a direct or indirect renewal or replacement and if such prior policy affords coverage (or would afford such coverage except for the exhaustion of its limits of liability) for such Claim, in whole or in part, as a result of such notice; F. to any Claim based upon or arising out of any actual or alleged violation of the Employee Retirement Income Security Act of 1974, and amendments thereto, or similar provisions of any federal, state or local statute or common law; G. to any Claim based upon or arising out of the Insured gaining in fact any personal profit or advantage to which such Insured was not legally entitled, if a final and non - appealable judgment or adjudication adverse to such Insured establishes such conduct; H. to any Claim based upon or arising as a result of liability of others assumed by the Insured under any contract or agreement. However, this Exclusion shall not apply to: 1. liability assumed in a contract or agreement that is an Insured Contract, provide the Wrongful Act or Pollution Conditions occur subsequent to the execution of the contract or agreement; or 2. liability that the Insured would have in the absence of the contract or agreement; 3. any Claim against an Insured by a client or customer, if and to the extent that the Claim alleges a breach of contractual obligations in the rendering of or failure to render Professional Services; I. to any Claim: 1. based upon or arising out of any violation or alleged violation of the Securities Act of 1933, as amended, or the Securities Exchange Act of 1934, as amended, or any state Blue Sky or securities law or similar state or federal statute and any regulation or order issued pursuant to any of the foregoing statutes, unless endorsed hereon; or 2. brought by, on behalf of, or in the name or right of, or for the benefit of any security holder of the Named Insured. For the purposes of this exclusion, "security' means a security of any nature whatsoever, including but not limited to stocks, shares, bonds, debentures, options, derivatives, partnership interests, limited liability Company interests, any other forms of debt or equity instrument, and any other forms of ownership interest; J. to any Claim based upon or arising out of discrimination which includes but shall not be limited to Claims based on an individual's race, creed, color, age, gender, national origin, religion, disability, marital status or sexual preference. However, this exclusion shall not apply to Claim Expenses for any Claim arising out of such discrimination unless it is established or proven by: (1) an admission by any Insured; HPM 5424192 07 13 Page 7 of 17 or (2) a finding, determination, or ruling, order, or judgment in a judicial, administrative or arbitration proceeding; K. to any Claim based upon or arising out of infringement of copyright, trademark or patent; L. to any Claim based upon or arising out of any obligation of the Insured under any workers' compensation, disability benefits or unemployment compensation law or any similar law, including but not limited to any Bodily Injury to an employee of the Insured arising out of and in the course of employment by the Insured, or any Claim by the spouse, child, parent or sibling of that employee as a consequence of the Bodily Injury to that employee. This exclusion applies whether the Insured may be liable as an employer or in any other capacity and to any obligation to share Damages with, indemnify or repay a party that pays or is liable to pay Damages because of the Bodily Injury; M. to any Claim based upon or arising out of the bankruptcy, liquidation or insolvency of the Insured; N. to any Claim based upon or arising out of the alleged breach of any express or implied warranty or guarantee. However, this exclusion shall not apply to the Insured's warranty or guarantee that the Professional Services of the Insured conform with generally accepted architectural or engineering standards; O. to any Claim based upon or arising out of any actual or alleged: 1. refusal to employ any person or organization; 2. termination of employment of any person or organization; or 3. employment-related practices, acts or omissions, including, without limitation, coercion, demotion, evaluation, reassignment, discipline, defamation, harassment, or humiliation; 4. physical, sexual and/or mental abuse, molestation or harassment, even if an alleged cause of the damage(s) was: a. the failure of any Insured or agent to prevent, bar or halt any such conduct, b. the failure of any Insured or agent to hire, employ, train, supervise, retain or control any person to prevent, bar or halt any such conduct, or c. any other negligent act, error or omission of any Insured or agent; P. to any Claim based upon or arising out of the manufacture of goods or products sold, supplied or distributed by the Insured or any Related Party, or others under license from the Insured or any Related Party. However, this exclusion shall not apply to computer software sold or supplied by the Insured in the provision of Professional Services; HPM 5424192 07 13 Page 8 of 17 Q. to any Claim based upon or arising out of the Insured's ownership, rental, leasing, operation, maintenance, use or repair of any real or personal property, including property damage to property owned, occupied, rented or leased by or to the Insured; R. To any Claim arising out of or resulting from any act, error or omission or Pollution Condition committed or arising prior to the inception date of this Insurance: a. if any director, officer, principal, partner, insurance manager or any member of the risk management or legal department of the Named Insured on or before the inception date knew or could have reasonably foreseen that such act, error or omission or Pollution Condition might be expected to be the basis of a Claim; or b. in respect of which any Insured has given notice of a Circumstance to the insurer of any other policy or certificate in force prior to the inception date of this Policy. S. To any Claim arising out of related or continuing acts, errors or omissions or Pollution Conditions where the first such act, error or omission or Pollution Condition was committed or arose prior to the Retroactive Date set forth in the Declarations. Severability of Exclusions: With respect to the Exclusions in Section III. of this Policy, it is understood and agreed that the Wrongful Act of any Insured Person shall not be imputed to any other Insured Person to determine if coverage is available; and only the Wrongful Act of any former, present or future risk manager, chief financial officer, in-house general counsel, chief executive officer, president, chairperson, managing member, or managing partner of the Named Insured or Subsidiary shall be imputed to such Named Insured or Subsidiary to determine if coverage is available. IV. TERRITORY This Policy applies to any Wrongful Act committed by the Insured anywhere in the world. However, if a Claim is made and suit or arbitration proceedings are brought against the Insured outside the United States of America, its territories and possessions, Puerto Rico or Canada, the Company shall have the right but not the duty to investigate, settle or defend, the Claim, suit or arbitration proceedings. If the Company elects not to investigate, settle or defend the Claim, the Insured, under the supervision of the Company, shall make or cause to be made such investigation and defense as reasonably necessary and, subject to prior written authorization by the Company, may effect settlement. The Company will reimburse the Insured for Claim Expenses and Damages in excess of the applicable self-insured retention (if any) and subject to the applicable Limits of Liability set forth in Item 4 of the Declarations. All monetary terms of this Policy are in United States of America dollars. If judgment is rendered, settlement is denominated or another element of Damages or Claim Expenses is stated in a currency other than United States of America dollars, payment under this Policy shall be made in United States of America dollars at the rate of exchange published in The Wall Street Journal on the date the final judgment is HPM 5424192 07 13 Page 9 of 17 reached, the amount of the settlement is agreed upon or the element of Damages or Claim Expenses is due, respectively. No coverage will be available under this Policy for any Claim brought against the Insured in any country with which the United States of America does not have active diplomatic relations at the time such Claim is made. V. LIMITS OF LIABILITY A. The liability of the Company for all Claim Expenses and Damages for each Claim FIRST MADE AGAINST THE INSURED AND REPORTED TO THE COMPANY DURING THE POLICY PERIOD, THE AUTOMATIC EXTENDED REPORTING PERIOD OR THE OPTIONAL EXTENDED REPORTING PERIOD, IF PURCHASED, shall not exceed the amount stated in Item 4(A) of the Declarations for each Claim. B. The total liability of the Company for all Claim Expenses and Damages for all Claims FIRST MADE AGAINST THE INSURED AND REPORTED TO THE COMPANY DURING THE POLICY PERIOD, THE AUTOMATIC EXTENDED REPORTING PERIOD OR THE OPTIONAL EXTENDED REPORTING PERIOD, IF PURCHASED, shall not exceed the amount stated in Item 4(B) of the Declarations as Policy Period Aggregate. C. The Limits of Liability for Claims FIRST MADE AND REPORTED DURING THE AUTOMATIC EXTENDED REPORTING PERIOD OR THE OPTIONAL EXTENDED REPORTING PERIOD shall be part of, and not in addition to the Limits of Liability as stated in Item 4 of the Declarations and as stated above. If any Insured has purchased or does purchase other insurance covering Claims FIRST MADE AND REPORTED DURING THE AUTOMATIC EXTENDED REPORTING PERIOD OR THE OPTIONAL EXTENDED REPORTING PERIOD, the coverage provided under this Policy for such Claims shall apply in excess of such insurance. D. Self -Insured Retention. The self-insured retention amount stated in Item 4 (D) of the Declarations shall be paid by the Insured to the Company and shall be applicable to all Claim Expenses and Damages for each and every Claim. A single self-insured retention shall apply to Claims arising from the same or related Wrongful Act(s). The self-insured retention amount stated in Item 4(E) of the Declarations shall be the maximum aggregate self-insured retention obligation of the Insured to pay Claim Expenses and Damages for all Claims. The self-insured retention amount shall be paid by the Insured as a condition precedent to payment of any Claim Expenses or Damages by the Company hereunder. Such amount shall be paid by the Insured within thirty (30) days of written demand by the Company. If, prior to the commencement of litigation against the Insured, the Company and the Insured agree to use mediation to resolve a Claim, and the Company and the Insured subsequently resolve the Claim by mediation prior to the commencement of litigation, then the self-insured retention obligation of the Insured shall be reduced by fifty percent (50%) to a maximum reduction of $25,000. E. Multiple Insureds, Claims and Claimants. The inclusion herein of more than one Insured shall not operate to increase the Company's Limits of Liability. Claims HPM 5424192 07 13 Page 10 of 17 alleging, based upon, arising out of or attributable to the same or related Wrongful Act(s) shall be treated as a single Claim regardless of whether made against one or more than one Insured. All such Claims, whenever made, shall be considered first made at the date of the earliest of such Claims, and if that date falls within the Policy Period, the Automatic Extended Reporting Period, or Optional Extended Reporting Period, if purchased, in which the earliest Claim arising out of such Wrongful Act(s) was first made, all such Claims shall be subject to the Limits of Liability and retention set forth in such Policy. F. Supplementary Payments. The Company will reimburse the: Insured up to $1,000 for loss of earnings to each Insured for each day or part of a day such Insured is in attendance, at the request of the Company, at a trial, hearing or arbitration proceeding involving a Claim against such Insured. The maximum amount payable by the Company hereunder shall not exceed $10,000 despite the number of Insureds, the number of days the Insured is in attendance, or the number of trials, hearings or arbitration proceedings the Insured is required to attend; 2. Insured up to $10,000 each Disciplinary Proceeding for reasonable attorney fees, costs and expenses resulting from the investigation or defense of each Disciplinary Proceeding incurred as a result of a notice of a proceeding both first received by the Insured and reported in writing to the Company during the Policy Period, arising out of a Wrongful Act. The maximum amount payable by the Company hereunder shall not exceed $20,000 as Policy Period Aggregate despite the number of Insureds or the number of Disciplinary Proceedings. The Company shall not be obligated to defend any Disciplinary Proceeding, or pay any fine, penalty or award resulting from any Disciplinary Proceeding. 3. Insured, notwithstanding Section II Definitions and Section III Exclusions and subject to all other terms and conditions of this Policy, for fines, sanctions and/or penalties levied against any Insured pursuant to the American with Disabilities Act of 1990 (ADA), the Federal Fair Housing Act (FFHA) or the Occupational Safety and Health Act (OSHA). This extension of coverage is further subject to the laws of the applicable jurisdiction regarding the insurability of such fines, sanctions and/or penalties. The maximum amount payable by the Company hereunder shall not exceed $25,000 ADA, FFHA, and OSHA Penalty Extension as Policy Period Aggregate despite the number of Insureds or the number of fines, sanctions and/or penalties. Supplementary payments are not subject to the self-insured retention and shall not reduce the Limits of Liability. i,71�N W_11u6I A. Notice of Claims. As a condition precedent to coverage under this Policy, the Insured shall provide the Company written notice of any Claim made against any Insured as soon as practicable, but in no event later than: (1) the expiration date of this Policy; (2) the expiration date of the Automatic Extended Reporting Period; or (3) the expiration date of the Optional Extended Reporting Period, if purchased. HPM 5424192 07 13 Page 11 of 17 In the event a Claim is brought against any Insured, the Insured shall forward to the Company every demand, notice, summons, complaint or other process or any threat of an intention to hold the Insured responsible for any Wrongful Act received directly by the Insured or by the Insured's representatives. Written notice of any Claim against any Insured, as well as of each demand on or suit against the Insured, shall be delivered to the Company at the address stated in Item 7 of the Declarations. B. Discovery Clause. If during the Policy Period any Insured first becomes aware or has reasonable grounds to suspect that an Insured has committed or may have committed a Wrongful Act for which coverage is otherwise provided hereunder, and provided the Insured during the Policy Period gives notice to the Company of: 1. a description of the anticipated Wrongful Act that may be alleged; 2. the nature of the potential injury, monetary or non -monetary damages which could result from such anticipated Wrongful Act; and 3. the circumstances by which the Insured first became aware of or suspected such anticipated Wrongful Act; then any Claim that may subsequently be made against any Insured arising out of such anticipated Wrongful Act shall be deemed for the purposes of this insurance to have been made during the Policy Period. C. Assistance and Cooperation of the Insured. The Insured shall cooperate with the Company and upon the Company's request shall (1) provide to the Company copies of documents and such other things held by or available to the Insured which relate to any Claim or to the Wrongful Act, transactions or other events which shall have given rise to such Claim, (2) submit to examination and interview by a representative of the Company, under oath if required, (3) attend hearings, depositions and trials, (4) assist in effecting settlement, securing and giving evidence, obtaining the attendance of witnesses and in the conduct of suits and other proceedings, as well as in the giving of a written statement or statements to the Company's representatives and meeting with such representatives for the purpose of investigation and/or defense and, (5) render written status reports regarding each Claim no less frequently than every three months and otherwise as may be necessary in order to keep the Company currently informed as to fees, costs and expenses being incurred in connection with such Claim and as to all material developments or anticipated developments in connection with such Claim, including but not limited to such subjects as settlement, potentially dispositive motions as to the Claim in its entirety or any aspect thereof and the deposition of any Insured, all without charge to the Company. The Insured shall further cooperate with the Company and do whatever is necessary to secure and affect any rights of indemnity, contribution or apportionment which any Insured may have. The Insured shall exercise the right to either reject or demand the arbitration of any Claim made against the Insured in accordance with the written instructions of the Company. The Insured shall not, except at the Insured's own cost, make any payment, admit any liability, settle any Claims, or assume any obligation, provided, however, the Insured shall have the right to make HPM 5424192 07 13 Page 12 of 17 any settlement of any Claim covered by the terms of this Policy subject to the condition that the aggregate amount of such settlement and of the Claim Expenses incurred in connection with such Claim shall not exceed the self-insured retention amount stated in Item 4 of the Declarations. D. False or Fraudulent Claims. If any Insured shall knowingly submit a false Claim or commit fraud in proffering any Claim under this Policy, as regards amount or otherwise as to any material fact, the insurance provided under this Policy shall become void as to such Insured from the date such false or fraudulent Claim is proffered, without regard to whether the Company has actually relied upon or been damaged by such Claim. VII. EXTENDED REPORTING PERIODS A. Automatic Extended Reporting Period. If the Company or the Named Insured shall cancel or refuse to renew this Policy, then the Company shall provide the Named Insured an automatic and noncancellable extension of this Policy, subject otherwise to its terms, Limits of Liability, exclusions and conditions, to apply to Claims first made against the Insured during the thirty (30) days immediately following the effective date of such nonrenewal or cancellation, for any Wrongful Act committed before the effective date of such nonrenewal or cancellation and after the Retroactive Date, and otherwise covered by this insurance. This Automatic Extended Reporting Period shall terminate after thirty (30) days from the effective date of such nonrenewal or cancellation. B. Optional Extended Reporting Period. If the Company or the Named Insured shall cancel or refuse to renew this Policy, then the Named Insured, upon payment of an additional premium as set forth herein, shall have the option to extend this Policy, subject otherwise to its terms, Limits of Liability, exclusions and conditions, to apply to Claims first made against the Insured during the 12, 24, 36, 48, or 60 months as purchased immediately following the effective date of such nonrenewal or cancellation, for any Wrongful Act committed before the effective date of such nonrenewal or cancellation and after the Retroactive Date, and otherwise covered by this insurance. The extension, if purchased, shall be endorsed hereto and shall be referred to as the "Optional Extended Reporting Period." The premium for the Optional Extended Reporting Period, if purchased, shall be 12 months at 75%, 24 months at 150%, 36 months at 200%, 48 months at 225%, or 60 months at 250%, of the full annual premium for this Policy, plus any additional premium owed for this Policy. C. The Named Insured's option to elect the Optional Extended Reporting Period must be exercised by notice in writing to the Company not later than thirty (30) days after the effective date of the nonrenewal or cancellation of this Policy. If the premium for the Optional Extended Reporting Period is not paid within thirty (30) days of the effective date of the nonrenewal or cancellation of this Policy, the option to elect the Optional Extended Reported Period shall be void. D. At the commencement of the Optional Extended Reporting Period, the entire premium shall be deemed fully earned, and in the event the Named Insured terminates the Optional Extended Reporting Period for any reason, the Company HPM 5424192 07 13 Page 13 of 17 shall not be liable to return to the Named Insured any portion of the premium for the Optional Extended Reporting Period. E. As a condition precedent to the Named Insured's option to elect the Optional Extended Reporting Period, any and all premiums and self-insured retentions that are due must have been paid and the Named Insured must have complied with all other terms and conditions of this Policy. If such conditions precedent are not satisfied or if the notice required under this Section VII. C. is not timely given to the Company, the Named Insured shall not at a later date be able to exercise such option. F. If this Policy is cancelled or nonrenewed due to the nonpayment of premium, the Automatic Extended Reporting Period or Optional Extended Reporting Period shall not be available to any Insured. The Automatic Extended Reporting Period or Optional Extended Reporting Period shall not be available to any Insured: (1) whose fraud causes this Policy to be cancelled or nonrenewed, or (2) whose license, right to practice, or right to conduct business has been revoked, suspended by, or surrendered at the request of, any regulating authority. G. The fact that the period during which Claims must first be made against the Insured and reported to the Company under this Policy is extended by virtue of any Automatic Extended Reporting Period or Optional Extended Reporting Period shall not in any way increase the Limits of Liability of this Policy. H. The first thirty (30) days of the Optional Extended Reporting Period, if purchased, shall run concurrently with the Automatic Extended Reporting Period. Vlll. CONDITIONS A. Subrogation and Waiver of Subrogation. In the event of any payment under this Policy, the Company shall be subrogated to all the Insured's rights of recovery therefore against any person or organization. The Insured shall execute and deliver instruments and papers and do whatever else is necessary to secure such rights and the Insured shall do nothing to prejudice such rights. Any amount recovered upon the exercise of such rights of subrogation shall be applied as follows: first, to the repayment of expenses incurred toward subrogation; second, to Damages and/or Claim Expenses paid by the Insured in excess of the Limits of Liability hereunder; third, to Damages and/or Claim Expenses paid by the Company; fourth, to Damages and Claim Expenses paid by the Insured in excess of the self-insured retention; and last, to repayment of the self-insured retention. The Company hereby waives subrogation rights against the Insured's client to the extent that the Insured had, prior to the Claim or prior to providing notice of an anticipated Wrongful Act in accordance with Section VI Claims, B. Discovery Clause, entered into a written agreement requiring the Insured to waive such rights. B. Action Against the Company. No action shall lie against the Company unless, as a condition precedent thereto, the Insured shall have fully complied with all the terms of this Policy, nor until the amount of the obligation of the Insured to pay shall have been fully and finally determined either by judgment against the Insured after HPM 5424192 07 13 Page 14 of 17 actual trial or by written agreement of the Insured, the claimant and the Company. In the event any person or organization or the legal representative thereof has secured a judgment against an Insured and such judgment remains unsatisfied after the expiration of thirty (30) days from the service of notice of entry of the judgment upon the attorney for the Insured, or upon the insured, and upon the Company, then an action may, except during a stay or limited stay of execution against the Insured on such judgment, be maintained against the Company under this Policy for the amount of such judgment to the extent of the insurance afforded by this Policy. Nothing contained in this Policy shall give any person or organization the right to join the Company as a party in any action against any insured to determine the Insured's liability. Bankruptcy or insolvency of any Insured or of the Insured's estate shall not relieve the Company of any of its obligations hereunder. C. Representations and Severability. In issuing this Policy, the Company has relied upon the statements, representations and information contained in the Application. Every Insured acknowledges and agrees that all such statements, representations and information (i) are true and accurate, (ii) were made or provided in order to induce the Company to issue this Policy, and (iii) are material to the Company's acceptance of the risk to which this Policy applies. If any of the statements, representations or information in the Application (hereafter referred to as "Facts") are not true and accurate, there shall be no coverage for any Claim made pursuant to this Policy with respect to any Insured Person who knew, as of the effective date of the Policy Period, of any f=acts that were not truthfully and accurately disclosed in the Application. The knowledge of any Insured Person shall not be imputed to any other Insured Person for the purposes of determining coverage. D. Other insurance. This insurance shall be in excess of the amount of the applicable self-insured retention of this Policy and any other valid insurance available to the Insured whether such insurance is collectible or uncollectible only because the Limits of Liability thereof shall have been exhausted, whether such other insurance is stated to be primary, pro rata, contributory, excess, contingent or otherwise, unless such other insurance is written only as a specific excess insurance over the Limits of Liability provided in this Policy. E. Changes. Notice to any agent or knowledge possessed by any agent or other person acting on behalf of the Company shall not affect a waiver or a change in any part of this Policy or estop the Company from asserting any right under the terms of this Policy, nor shall the terms of this Policy be waived or changed, except by written endorsement issued to form a part of this Policy. F. Assignment. Assignment of interest under this Policy shall not bind the Company unless its consent is endorsed in writing hereon. G. Cancellation. This Policy may be canceled by the Named Insured by mailing or delivering prior written notice to the Company or by surrender of this Policy to the Company. If this Policy is canceled by the Named Insured, the Company shall retain the greater of the customary short rate proportion of the premium hereon or the Earned Minimum Premium set forth in Item 4 (H) of the Declarations. This Policy may also be canceled by or on behalf of the Company by delivering to the Named Insured by registered, certified or other first class mail, or by electronic means, written notice stating when not less than ninety (90) days after the date of such HPM 5424192 07 13 Page 15 of 17 notice the cancellation shall be effective. The proof of delivery of such notice shall be sufficient proof of notice. If this Policy is canceled by or on behalf of the Company, the Company shall retain the pro rata proportion of the premium hereon. The Company may cancel this Policy on ten (10) days notice for nonpayment of premium due. H. Conformity to Statute. Any terms of this Policy which are in conflict with the terms of any applicable laws construing this Policy are hereby amended to conform to such laws. I. Singular Form of a Word. Whenever the singular form of a defined word is used herein, the same shall include the plural when required by context. J. Named Insured Authorization. By acceptance of this Policy, the Named Insured agrees to act on behalf of every Insured with respect to the payment or return of premium, the receipt and acceptance of any endorsements, the cancellation of the Policy, the negotiation of renewal, and the giving and receiving of any notice provided for by the terms and conditions of this Policy. K. Reporting Requirements. The Named Insured agrees to notify the Company in writing within forty-five (45) days thereafter of any change in the name or address of the Named insured as stated in Item 1 of the Declarations and of any mergers or acquisitions involving the Named Insured. There shall be coverage under the Policy for such merged or acquired entity or organization for the forty-five (45) day period immediately following the effective date of such merger or acquisition, but only with respect to Wrongful Acts committed by any Insured after the effective date of such merger or acquisition. There shall be no coverage under the Policy for such merged or acquired entity after the forty-five (45) day period immediately following the effective date of such merger or acquisition, unless, after receipt of such notice: (1) the Company agrees in writing to extend coverage therefore, and (2) the Named Insured pays any additional premium the Company may charge for such extension of coverage. However, in no event shall coverage apply to any Wrongful Acts committed by, on behalf of, or at the direction of any Insured or such entity which has merged with or been acquired by the Named Insured prior to the effective date of such merger or acquisition. L. Material Events. If, during the Policy Period, any of the following events occur: 1. the Named Insured is dissolved, sold, acquired by, merged into or consolidated with another entity such that the Named Insured is not the surviving entity, or such that any person, entity or affiliated group of persons or entities obtains: a. the right to elect or appoint more than fifty percent (50%) of the Named Insured's directors, trustees or member managers, as applicable; b. more than fifty percent (50%) of the Named Insured's equity or assets; 2. the Named Insured ceases to do business for any reason; or HPM 5424192 07 13 Page 16 of 17 3. a receiver, liquidator, conservator, trustee, rehabilitator or similar administrator is appointed for the Named Insured; coverage under this Policy will continue until the end of the Policy Period in full force and effect with respect to Claims for Wrongful Acts committed before such event, but coverage will cease with respect to Claims for Wrongful Acts committed after such event. After any such event, the Insured may not cancel this Policy, regardless of Condition VIII.G., and the entire premium for the Policy will be deemed fully earned. IX. ARBITRATION A. Conditions. Any dispute or controversy arising out of or relating to this Policy shall be settled by binding arbitration. The Insured and the Company, before entering into arbitration, shall each appoint an arbitrator. Each arbitrator shall be a present or former insurance industry executive. Within thirty (30) days after one party notifies the other of its demand for arbitration detailing the issue(s) to be arbitrated and names its arbitrator, the other party shall name its arbitrator. Within thirty (30) days of the naming of the second arbitrator, the two arbitrators will select a third arbitrator to be chairman of the panel. None of the arbitrators shall be current or former officers, principals, directors, stockholders, partners, or employees of the Insured or Company. The three arbitrators shall comprise the arbitration panel for the purpose of this Policy. B. Judgment. Each party to this Policy shall submit its case with supporting documents to the arbitration panel within thirty (30) days after appointment of the third arbitrator. However, the panel may extend this period for a reasonable time. Unless extended by the consent of the parties to this arbitration, the majority of the three arbitrators shall issue a written decision resolving the controversy before them within thirty (30) days of the time both parties are required to submit their case and related documentation. The arbitrators' written award shall state the facts reviewed, conclusion reached, and the reasons for their conclusions. Said award shall be final and binding upon both parties and judgment on the award may be entered by any court of competent jurisdiction. C. Fees and Expenses. Each party shall pay the fees and expenses of its arbitrator, unless otherwise agreed by the parties. The remaining costs of the arbitration shall be shared equally by both parties. Arbitration shall take place in Los Angeles, California, unless otherwise agreed to by both parties. HPM 5424192 07 13 Page 17 of 17 THIS ENDORSEMENT AMENDS THE POLICY. PLEASE READ IT CAREFULLY NUCLEAR ENERGY LIABILITY EXCLUSION ENDORSEMENT In consideration of the premium charged it is hereby understood and agreed that: I. This Policy does not apply: A. Under any Liability Coverage, to Bodily Injury or property damage . with respect to which an Insured under this Policy is also an insured under a nuclear liability policy issued by Nuclear Energy Liability Insurance Association, Mutual Atomic Energy Liability Underwriters or Nuclear Insurance Association of Canada, or would be an Insured under any such policy but for its termination upon exhaustion of its limit of liability; or 2. resulting from the hazardous properties of nuclear material and with respect to which (a) any person or organization is required to maintain financial protection pursuant to the Atomic Energy Act of 1954, or any law amendatory thereof, or (b) the Insured is, or had this Policy not been issued would be, entitled to indemnity from the United States of America, or any agency thereof, under any agreement entered into by the United States of America, or any agency thereof, with any person or organization. B. Under any Medical Payments Coverage, or any Supplementary Payments Provision relating to first aid, to expenses incurred with respect to Bodily injury resulting from the hazardous properties of nuclear material and arising out of the operation of a nuclear facility by any person or organization. C. Under any Liability Coverage, to Bodily Injury or property damage resulting from the hazardous properties of nuclear material, if the nuclear material (a) is at any nuclear facility owned by, or operated by or on behalf of, an Insured or (b) has been discharged or dispersed therefrom; 2. the nuclear material is contained in spent fuel or waste at any time possessed, handled, use, processed, stored, transported or disposed of by or on behalf of an Insured; or 3. the Bodily Injury or property damage arises out of the furnishing by an Insured of services, materials, parts or equipment in connection with the planning, construction, maintenance, operation or use of any nuclear facility, but if such facility is located within the United States of America, its territories or possessions or Canada, this Exclusion (3) applies only to property damage to such nuclear facility and any property threat. II. As used in this endorsement: HPM 1010 0018 07 13 Page 1 of 2 "hazardous properties" include radioactive, toxic or explosive properties; "nuclear material" means source material, special nuclear material or by-product material; "source material," "special nuclear material," and "by-product material" have the meanings given them in the Atomic Energy Act of 1954 or in any law amendatory thereof, "spent fuel" means any fuel element or fuel component, solid or liquid, which has been used or exposed to radiation in a nuclear reactor; "waste" means any waste material (1) containing by-product material and (2) resulting from the operation by any person or organization of any nuclear facility included within the definition of nuclear facility under Paragraph (a) or (b) thereof, "nuclear facility" means: 1. any nuclear reactor, 2. any equipment or device designed or used for (a) separating the isotopes of uranium or plutonium, (b) processing or utilizing spent fuel, or (c) handling, processing or packaging waste, 3. any equipment or device used for the processing, fabricating or alloying of special nuclear material if at any time the total amount of such material in the custody of the Insured at the premises where such equipment or device is located consists of or contains more than 25 grams of plutonium or uranium 233 or any combination thereof, or more than 250 grams of uranium 235, 4. any structure, basin, excavation, premises or place prepared or used for the storage or disposal of waste, and includes the site on which any of the foregoing is located, all operations conducted on such site and all premises used for such operations; "nuclear reactor" means any apparatus designed or used to sustain nuclear fission in a self- supporting chain reaction or to contain a critical mass of fissionable material; "property damage" includes all forms of radioactive contamination of property. All other terms remain unchanged. HPM 1010 0018 07 13 Page 2 of 2 THIS ENDORSEMENT AMENDS THE POLICY. PLEASE READ IT CAREFULLY. TECHNOLOGY BASED SERVICES, TECHNOLOGY PRODUCTS, COMPUTER NETWORK SECURITY, AND MULTIMEDIA AND ADVERTISING ENDORSEMENT It is hereby understood and agreed that section I INSURING AGREEMENTS are amended to include the following: E. The Company shall pay Damages and Claim Expenses on behalf of the Insured resulting from any Claim first made against the Insured and reported to the Company in writing during the Policy Period or any applicable Extended Reporting Period for any negligent act, error or omission, or any unintentional breach of contract, in rendering or failure to render Technology Based Services committed on or after the Retroactive Date stated in the Declarations and before the Policy terminates. F. The Company shall pay Damages and Claim Expenses on behalf of the Insured resulting from any Claim first made against the Insured and reported to the Company in writing during the Policy Period or any applicable Extended Reporting Period for any negligent act, error or omission, or any unintentional breach of contract that results in the failure of Technology Products to perform the function or serve the purpose intended on or after the Retroactive Date stated in the Declarations and before the Policy terminates. G. The Company shall pay Damages and Claim Expenses on behalf of the Insured resulting from any Claim first made against the Insured and reported to the Company in writing during the Policy Period or any applicable Extended Reporting Period for any negligent act, error or omission in the course of providing or managing Computer Systems committed on or after the Retroactive Date stated in the Declarations and before the Policy terminates that results in: 1. The inability of a third party, who is authorized to do so, to gain access to Computer Systems or your Technology Based Services; 2. The failure to prevent Unauthorized Access to Computer Systems that results in: a. The destruction, deletion or corruption of electronic data on Computer Systems b. Theft of Data from Computer Systems; or c. Denial of service attacks against Internet sites or computers; or 3. The failure to prevent transmission of Malicious Code from Computer Systems to third party computers and systems. HPM 1010 0039 07 13 H. The Company shall pay Damages and Claim Expenses on behalf of the Insured resulting from any Claim first made against the Insured and reported to the Company in writing during the Policy Period or any applicable Extended Reporting Period arising out of one or more of the following acts committed on our after the Retroactive Date stated in the Declarations and before the Policy terminates in the course of the Insured's performance of Professional Services, Media Activities or Technology Based Services: 1. Defamation, libel, slander, product disparagement, trade libel, prima facie tort, infliction of emotional distress, outrage, outrageous conduct, or other tort related to disparagement or harm to the reputation or character of any person or organization; 2. Invasion of or interference with the right to privacy or of publicity; 3. Misappropriation of any name of likeness for commercial advantage; 4. False arrest, detention or imprisonment or malicious prosecution; 5. Invasion of or interference with any right of private occupancy, including trespass, wrongful entry, eviction or eavesdropping; 6. Plagiarism, piracy or misappropriation of ideas under implied contract; 7. Infringement of copyright; 8. Infringement of trade dress, domain name, title or slogan, or the dilution or infringement of trademark or service mark; 9. Negligence regarding the content of any Media Communication, including harm caused through any reliance or failure to rely upon such content; or 10. Misappropriation of trade secret It is also understood and agreed that section II. DEFINITIONS are amended to include the following: V. "Computer Systems" means computers and associated input and output devices, data storage devices, networking equipment, and back up facilities: 1. Operated by and either owned by or leased to the Insured; or 2. Operated by a third party service provider and used for the purpose of providing hosted computer application services to the Insured or for processing, maintaining, hosting or storing the Insured's electronic data, pursuant to written contract with the Insured for such services. W. "Malicious Code" means any virus, Trojan Horse, worm or other similar software program, code or script intentionally designed to insert itself into computer memory or onto a computer disk and spread itself from one computer to another. X. "Media Communication" means the display, broadcast, dissemination, distribution or release of Medial Material to the public by the Insured. HPM 1010 0039 07 13 Y. "Media Material" means information in the form of words, sounds, numbers, images, or graphics in electronic, print or broadcast form, including Advertisement, but does not mean computer software: Z. "Media Activities" means Media Communications and/or the gathering, collection or recording of Media Material for inclusion in any Media Communications in the ordinary course of the Insured's business. AA. "Technology Based Services" means computer and electronic technology services, including data processing, Internet services, data and application hosting, computer systems analysis, technology consulting and training, custom software programming for a specific client of the Insured, computer and software systems installation and integration, computer and software support, and network management services performed by the Insured, or by others acting under the Insured's trade name, for others for a fee, but shall not mean Technology Products. BB. "Technology Products" means a computer or telecommunications hardware or software product, or related electronic product that is created, manufactured or developed by the Insured for others, or distributed, licensed, leased or sold by the Insured to others, for compensation, including software updates, service packs and other maintenance releases provided for such product. CC. "Theft of Data" means the unauthorized taking, misuse or disclosure of information on Computer Systems, including but not limited to charge, debit, and credit card information, banking, financial, and investment services account information, proprietary information, and personal, private, and confidential information. DD. "Unauthorized Access" means: 1. The use of or access to Computer Systems by a person not authorized to do so by the Insured; or 2. The authorized use of or access to Computer Systems in a manner not authorized by the Insured. It is also understood and agreed that section III. EXCLUSIONS are amended to include the following exclusions applicable to INSURING AGREEMENTS E, F, G & H: R. to any Claim based upon, arising from, or in consequence of inaccurate, inadequate or incomplete description of the price of goods, products or services cost guarantees, cost representations, or contract price estimates of probable costs or cost estimates actually or allegedly being exceeded; S. to any Claim based upon, arising from, or in consequence of the failure of goods, products, or services to conform with any represented quality or performance contained in Advertising; T. to any Claim based upon, arising from, or in consequence of any actual or alleged gambling, contest, lottery, promotional game or other game of chance. HPM 1010 0039 07 13 U. to any Claim based upon, arising from, or in consequence of any actual or alleged obligation to make licensing fee or royalty payments, including but not limited to the amount or timeliness of such payments V. to any Claim based upon, arising from, or in consequence of the reprinting, recall, removal or disposal of any media material, including any media or products containing such media material. W. to any Claim based upon, arising from, or in consequence of the withdrawal, recall, inspection, repair, replacement, reproduction, removal or disposal of: 1. Technology Products, including any products or other property of others that incorporate Technology Products; 2. Work product resulting from or incorporating the results of Technology Based Services; or 3. Any products or other property on which Technology Based Services are performed; Provided, that this exclusion shall not apply to Claims for the resulting loss of use of such media material or technology Products, or loss of use of the work product resulting from such Technology Based Services. X. to any Claim based upon, arising from, or in consequence of the failure to install available software product updates and releases, or to apply security related software patches, to computers and other components of Computer Systems. Y. to any Claim based upon, arising from, or in consequence of any failure or malfunction of electrical or telecommunications infrastructure or services, unless under the Insured's operational control or fire, flood, earthquake, volcanic eruption, explosion, lightning, wind, hail, tidal wave, landslide, act of God or other physical of force majeure event. Z. to any Claim based upon, arising from, or in consequence of antitrust violation, restraint of trade, unfair competition, violation of the Sherman Antitrust Act, the Clayton Act, the Robinson-Patman Act, as amended, or any similar law of legislation of any state, province or other jurisdiction, false, deceptive or misleading advertising. AA. to any Claim based upon, arising from, or in consequence of a Claim brought by or on behalf of the Federal Trade Commission and Federal Communications Commission, or any similar governmental entity, in such entitiy's regulatory or official capacity. BB. to any Claim based upon, arising from, or in consequence of actual or alleged infringement of copyright or misappropriation of trade secret arising out of or related to Technology Products CC. to any Claim based upon, arising from, or in consequence of the existence, emission or discharge of any electromagnetic field, electromagnetic radiation or electromagnetism that actually or allegedly affects the health, safety HPM 1010 0039 07 13 or condition of any person or the environment, or that affects the value, marketability, condition or use of any property. DD. to any Claim based upon, arising from, or in consequence of the delay in delivery or performance, or failure to deliver or perform at or within an agreed upon period of time. All other terms and conditions remain unchanged. HPM 1010 0039 07 13 THIS ENDORSEMENT AMENDS THE POLICY. PLEASE READ IT CAREFULLY PRE -CLAIM ASSISTANCE ENDORSEMENT In consideration of the premium paid, it is hereby understood and agreed that if during the Policy Period the Insured reports a specific Wrongful Act in accordance with Section VI. CLAIMS, B. Discovery Clause of the Policy, the Company, at its sole discretion, may investigate such specific Wrongful Act as it deems appropriate. Any costs or expenses the Company incurs that would normally be considered as Claims Expenses as a result of that report of claim will be paid by the Company with the following conditions: a. All such costs or expenses must be incurred prior to the date that any Claim based upon or arising out of the specific Wrongful Act is made; b. In the event that a Claim is subsequently made against the Insured based out of the reported Wrongful Act, the Insured will reimburse the Company for all such costs and expenses incurred by the Company up to the limit of the Self -Insured Retention. All requests by the Insured under this Endorsement shall be reported to the Company through: Claims Department Gemini Insurance Company CIO Berkley Custom Insurance Managers, LLC 3 Stamford Plaza 301 Tresser Blvd., 6th Floor Stamford, CT 06901 Claims(O.Berkleycustom.com Toll Free: 855-597-7616 All other terms and conditions remain unchanged HPM 1010 0040 07 13 THIS ENDORSEMENT AMENDS THE POLICY. PLEASE READ IT CAREFULLY TRANSPORTATION POLLUTION LIABILITY COVERAGE EXTENSION In consideration of the premium charged, it is hereby understood and agreed that the policy is amended as follows: Section III EXCLUSIONS B. 1 of this Policy shall be deleted and replaced with the following: Section 111. EXCLUSIONS This policy shall not apply: B. to any Claim: 1. a. based upon or arising out of the ownership, maintenance, use, operation, loading or unloading of any automobile, aircraft, watercraft or rolling stock of any kind. However, this Exclusion shall not apply to Pollution Conditions arising out of the ownership, maintenance, use, operation, loading or unloading of any automobile, aircraft or rolling stock within the boundaries of the job site; the ownership, maintenance, use, operation, loading or unloading of owned autos or autos you lease, hire or rent. The exclusionary language set forth in B. 1.a. shall not apply to Claims otherwise covered under Insuring Agreement B. if the Pollution Condition is proximately caused by the disposal, treatment or storage of any materials. All other terms and conditions remain unchanged. HPM 1010 0035 07 13 THIS ENDORSEMENT AMENDS THE POLICY. PLEASE READ IT CAREFULLY CRISIS MANAGEMENT EXPENSE COVERAGE EXTENSION In consideration of the premium charged, it is hereby understood and agreed that the policy is amended as follows: Section V. LIMITS OF LIABILITY F. Supplementary Payments of this Policy is amended to include the following. The Company will reimburse the: 4. Insured, up to $10,000 for Crisis Event Expense for each Crisis Event first made against the Insured and reported to the Company in writing during the Policy Period or any applicable Extended Reporting Period. The maximum amount payable by the Company hereunder shall not exceed $30,000 as Policy Period Aggregate despite the number of Insureds or the number of Crisis Events. Payments under this provision must be agreed to in writing by the Company before they are incurred. For the purpose of this endorsement the following definitions are added. II. DEFINITIONS V. "Crisis Event" means; 1. a Wrongful Act 2. the sudden death of an active principal of the Insured 3. an incident of workplace violence 4. any other event that the Named Insured and the Company agree will have a material adverse impact upon the Named Insured's reputation. W. "Crisis Event Expense" means reasonable fees, costs and expenses incurred by the Named Insured for consulting services provided by a Crisis Management or Public Relations firm to the Named Insured in response to a Crisis Event. "Crisis Event Expense" shall not include any salaries, overhead or other internal costs of the Insured. All other terms and conditions remain unchanged. HPM 1010 0046 07 13 THIS ENDORSEMENT AMENDS THE POLICY. PLEASE READ IT CAREFULLY. DESIGN/BUILD ENDORSEMENT On projects for which the Insured, a subsidiary of the Insured, a subcontractor to the Insured, an entity under common ownership, or an entity that owns the Insured, performs Professional Services and construction, erection, fabrication, installation, assembly, manufacture, or the supply of equipment or materials incorporated therein, the following Exclusions are added: It is herby understood and agreed that this Policy shall not apply to Claims or Claims Expense based upon or arising out of: 1. The acquisition of any real estate or the securing of financing for the acquisition of any real estate; 2. The advising or requiring of, or failure to advise or require or failure to maintain or procure any financing or monies for the payment of any portion of any project, or of services or labor connected with any project; 3. Cost overruns or the exceeding of any budget or other cost limitation; 4. Failure to complete any construction in a timely manner or within a prescribed period of time; 5. The insolvency or bankruptcy of the Insured or any contractor, subcontractor or supplier of the Insured; 6. The preparation or failure to prepare cost estimates; 7. Any faulty workmanship, construction or work not in accordance with the design of the project or the construction documents (including but not limited to the drawings and specifications) if such work is performed by: a. The Insured, or b. A subcontractor to the Insured, or c. Any enterprise and/or any subsidiary of any enterprise that any Insured controls, manages, operates, or holds ownership in or any enterprise that controls, manages, operates, or holds ownership in the Named Insured. All other terms and conditions remain unchanged. HPM 1010 0026 07 13 THIS ENDORSEMENT AMENDS THE POLICY. PLEASE READ IT CAREFULLY COMMERCIAL GENERAL LIABILITY COVERAGE WARRANTY It is warranted that the Named Insured will maintain Commercial General Liability coverage in force at all times during the term of this policy. All other terms and conditions remain unchanged HPM 1010 0034 07 13 THIS ENDORSEMENT AMENDS THE POLICY. PLEASE READ IT CAREFULLY WRITTEN CONTRACTS WARRANTY It is warranted that the Named Insured will use written contracts with clients and sub- contractors at all times. All other terms and conditions remain unchanged HPM 1010 0033 07 13 Cyber Liability Coverage Endorsement This endorsement attaches to and forms a part of Policy. It modifies insurance provided under the Design Professional Advantage Professional/Pollution Liability Policy. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. It is agreed that the following changes are made to the Policy: Section II. DEFINITIONS, E. Claim is amended by adding the following: The term "Claim" includes a "Cyber Claim." Section li. DEFINITIONS is amended with the addition of the following definitions "Computer Systems" means computer software, hardware and firmware and associated input and output devices (including wireless and mobile devices), data storage and data processing devices, networking equipment and backup facilities, including cloud computing devices and facilities, remote servers at a co -location or data hosting services or any other Electronic Data storage not in the Named Insured's direct control. "Content" means data, digital code, images, drawings, scents, sounds, tastes, texts or textures. "Cyber Claim" means a demand received by the Insured for money or services and alleging a Cyber Security Breach, including the service of suit or institution of arbitration, mediation or other formal alternative dispute resolution proceeding. Cyber Claim shall not include a demand for equitable, non -pecuniary or injunctive relief or for legal fees or expenses in connection therewith. "Cyber Security Breach" means the failure to: 1. prevent the introduction or transmission of a computer virus or any other Malicious Code into a Computer System; 2. prevent unauthorized access to, or use of, Computer Systems; 3. prevent a denial of service attack upon or directed at a Computer System; 4. prevent the malicious or fraudulent destruction, deletion or corruption of Electronic Data; 5. provide the Named Insured's clients with access to a Computer System, when the Named Insured's clients have authorized use of the Computer Systems, due to 1-4 above; 6. prevent: i. theft of, dissemination of, access to, publication of or disclosure of any Electronic Data consisting of a person's or organization's confidential or personal information; or Page 1 of 2 HPM 1010 0058 03 18 Cyber Liability Coverage Endorsement theft of, loss of, loss of use of, corruption of, damage to disruption of, or inability to access or alter Electronic Data, "Electronic Data" means information, knowledge or programs recorded on, stored on, created or used on, or transmitted to or from a Computer System. "Malicious Code" means any virus, Trojan Horse, worm or other similar software program code or script intentionally designed to insert itself into computer memory or onto a computer disk and spread itself from one computer to another. III. Notwithstanding Section V. LIMITS OF LIABILITY: a. the liability of the Company for all Claim Expenses and Damages for each Cyber Claim FIRST MADE AGAINST THE INSURED AND REPORTED TO THE COMPANY DURING THE POLICY PERIOD, THE AUTOMATIC EXTENDED REPORTING PERIOD OR THE OPTIONAL EXTENDED REPORTING PERIOD, IF PURCHASED, SHALL NOT EXCEED the amount shown in the below schedule as the Per Cyber Claim Limit. b. The total liability of the Company for all Claim Expenses and Damages for all Cyber Claims FIRST MADE AGAINST THE INSURED AND REPORTED TO THE COMPANY DURING THE POLICY PERIOD, THE AUTOMATIC EXTENDED REPORTING PERIOD OR THE OPTIONAL EXTENDED REPORTING PERIOD, IF PURCHASED, shall not exceed the amount shown in the below schedule as the Policy Period Cyber Aggregate Limit. G. The Cyber Self -Insured Retention amount stated in the schedule below shall be paid by the Insured to the Company and shall be applicable to all Claim Expenses and Damages for each and every Cyber Claim Schedule $25,000 Per Cyber Claim Limit $25,000 Policy Period Cyber Aggregate Limit $1,000 Cyber Self -Insured Retention All other terms and conditions of the Policy apply. Page 2 of 2 HPM 1010 0058 03 18 CLAIM NOTICE THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. In the event of claim to which this policy may apply, please give immediate notice to: Claims Department Gemini Insurance Company C/O Berkley Custom Insurance Managers, LLC 3 Stamford Plaza 301 Tresser Blvd., 6th Floor Stamford, CT 06901 Claims(a Berkleycustom. com Toll Free: 855-597-7616 This endorsement docs not change any other provision of the policy. ClaimNotice BCIM00010912 THIS ENDORSEMENT AMENDS THE POLICY. PLEASE READ IT CAREFULLY SERVICE OF SUIT ENDORSEMENT In the event of failure of the Company to pay any amount claimed to be due under the terms of this policy, the Company, at the request of the Insured, will submit to the jurisdiction of a court of competent jurisdiction within the United States. Nothing in this condition constitutes or should be understood to constitute a waiver of the Company's rights to commence an action in any court of competent jurisdiction in the United States to remove an action to a United States District Court or to seek a transfer of a case to another court as permitted by the laws of the United States or of any state in the United States. In any suit instituted against the Company upon this policy, the Company will abide by the final decision of such court or of any appellate court in the event of appeal. It is further agreed that service of process in such suit may be made upon the Claims Department Gemini Insurance Company 3 Stamford Plaza 301 Tresser Blvd., 6th Floor Stamford, CT 06901. Further, pursuant to any statute of any state, territory, or district of the United States which makes provision therefore, the Company hereby designates the Superintendent, Commissioner or Director of Insurance, or other officer specified for that purpose in the statute, as its true and lawful attorney upon whom service may be made of any lawful process in any action, suit, or proceeding instituted by or on behalf of the Insured or any beneficiary hereunder arising out of this policy of insurance and hereby designated a Claims officer as the person to whom the said officer is authorized to mail such process or a true copy thereof. All other terms and conditions remain unchanged. BCIM0003 0513 Gemini Insurance Company 475 Steamboat Rd Greenwich, CT 06830 IN WITNESS WHEREOF, we have caused this policy to be executed and attested, but the policy will not be valid unless countersigned by one of our duly authorized representatives, where required by law. Scccetc�cy BCIM0008 0513 r„r'"✓ buide+nt U. S. TREASURY DEPARTMENT'S OFFICE OF FOREIGN ASSETS CONTROL ("OFAC") NOTICE TO POLICYHOLDERS No coverage is provided by this Policyholder Notice nor can it be construed to replace any provisions of your policy. You should read your policy and review your Declarations page for complete information on the coverage you are provided. This Notice provides information concerning possible impact on your insurance coverage due to directives issued by OFAC. Please read this Notice carefully. The Office of Foreign Assets Control (OFAC) administers and enforces sanctions policy, based on Presidential declarations of "national emergency". OFAC has identified and listed numerous: • Foreign agents; • Front organizations; • Terrorists; • Terrorist organizations; and • Narcotics traffickers; as "Specially Designated Nationals and Blocked Persons". This list can be located on the United States Treasury's website — http//www.treas.gov/ofac. In accordance with OFAC regulations, if it is determined that you or any other insured, or any person or entity claiming the benefits of this insurance has violated U.S. sanctions law or is a Specially Designated National and Blocked Person, as identified by OFAC, this insurance will be considered a blocked or frozen contract and all provisions of this insurance are immediately subject to OFAC. When an insurance policy is considered to be such a blocked or frozen contract, neither payments nor premium refunds may be made without authorization from OFAC. Other limitations on the premiums and payments also apply. Contract Review Services While your coverage is in force, you are eligible to receive complimentary contract review services provided by the experienced attorneys of Daniels, Rodriguez, Berkeley, Daniels, & Cruz, P.A. The attorneys will be ready to help you navigate the complicated issues created by the legal documents you enter into and to benefit from the advice of attorneys experienced in the issues faced by Architects, Engineers, Surveyors and other Design Professionals. Daniels, Rodriguez, Berkeley, Daniels & Cruz, P.A. is AV 11 rated by Martindale -Hubbell. An AV ® rating is a significant accomplishment - a testament to the fact that a lawyer's peers rank them at the highest level of professional excellence. The firm is also listed in Martindale -Hubbell's Bar Register of Preeminent Lawyers and Best's Directory of Recommended Insurance Attorneys and Adjusters. The attorneys of Daniels, Rodriguez, Berkeley, Daniels & Cruz, P.A. have defended Architects, Engineers and Surveyors in professional malpractice cases for more than 30 years. To have a contract reviewed email the contract to ContractReview@dkdr.com with your comments and concerns. Thank you.