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10/11/2021 Farmer Woods Group 919 North 1st Street Phoenix AZ 85004 Alena Avnukov (602)264-0566 (602)277-4706 alena-avnukov@leavitt.com Dibble CM, LLC 7878 n 16th St Ste 300 Phoenix AZ 85020-4660 Acadia Insurance Company 031325 Continental Western Insurance Company 010804 Argonaut Insurance Company 19801 21/22 CPKG A X X X X Y CPA454132719 1/27/2021 1/27/2022 1,000,000 100,000 5,000 1,000,000 2,000,000 2,000,000 Employee Benefits 1,000,000 A X X Y CPA454132719 1/27/2021 1/27/2022 1,000,000 Underinsured motorist BI single limit 1,000,000 B X X X 10,000 X Y CUA454132819 1/27/2021 1/27/2022 5,000,000 C Error and Ommissions 121AE016780900 2/28/2021 2/28/2022 Each Claim/Aggregate 2,000,000 D Cyber Liability AXIS-P-06677161 06/12/2021 06/12/2022 Per Claim/Aggregate 3,000,000 RE: #WA1521.453 Fire Station 10 well site improvements Phase II City of Chandler, , its officers, officials, agents, representatives, subconsultants and consultant & employees are additional insured as required in a written contract per forms CLCG0443 09/16 (on going), CLCG2023 09/16(com ops), CLCL0114 09/16(Primary non contributory) & CLCA2014 10/13(AI Auto), Waiver of Subrogation as required in a written contract per forms CLCG0443 09/16(GL) & CLCA2014 10/13(Auto) attached. Excess follows form. Seperation of Insureds (Severability Clause) provided per the CG0001 04/13 attached. City of Chandler Public Works & Utilities Dept P.O. Box 4008 Mail Stop 407 Chandler, AZ 85244-4008 Paula.brown@chandleraz.gov Alena Avnukov/AIAVNU Y The ACORD name and logo are registered marks of ACORD CERTIFICATE HOLDER © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) AUTHORIZED REPRESENTATIVE CANCELLATION DATE (MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE LOC JECT PRO- POLICY GEN'L AGGREGATE LIMIT APPLIES PER: OCCUR CLAIMS-MADE COMMERCIAL GENERAL LIABILITY PREMISES (Ea occurrence) $ DAMAGE TO RENTED EACH OCCURRENCE $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ PRODUCTS - COMP/OP AGG $ $ RETENTION DED CLAIMS-MADE OCCUR $ AGGREGATE $ EACH OCCURRENCE $ UMBRELLA LIAB EXCESS LIAB DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) INSR LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFF (MM/DD/YYYY) POLICY EXP (MM/DD/YYYY) LIMITS PER STATUTE OTH- ER E.L. EACH ACCIDENT E.L. DISEASE - EA EMPLOYEE E.L. DISEASE - POLICY LIMIT $ $ $ ANY PROPRIETOR/PARTNER/EXECUTIVE If yes, describe under DESCRIPTION OF OPERATIONS below (Mandatory in NH) OFFICER/MEMBER EXCLUDED? WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED HIRED AUTOS NON-OWNED AUTOS AUTOS AUTOS COMBINED SINGLE LIMIT BODILY INJURY (Per person) BODILY INJURY (Per accident) PROPERTY DAMAGE $ $ $ $ THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSD ADDL WVD SUBR N / A $ $ (Ea accident) (Per accident) OTHER: THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: INSURED PHONE (A/C, No, Ext): PRODUCER ADDRESS: E-MAIL FAX (A/C, No): CONTACT NAME: NAIC # INSURER A : INSURER B : INSURER C : INSURER D : INSURER E : INSURER F : INSURER(S) AFFORDING COVERAGE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. INS025 (201401) COMMERCIAL GENERAL LIABILITY CL CG 20 23 09 16 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CL CG 20 23 09 16 Includes copyrighted material of Insurance Services Office, Inc. with its permission Page 1 of 2 ADDITIONAL INSURED – OWNERS, LESSEES OR CONTRACTORS – COMPLETED OPERATIONS: AUTOMATIC STATUS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Additional Insured(s) 1. Section II – Who Is An Insured is amended to include as an additional insured any person or organization for whom you have agreed to add as an additional insured on your policy in a written contract or written agreement, but only with respect to liability for “bodily injury” or “property damage” caused, in whole or in part, by “your work” performed for that additional insured and included in the “products-completed operations hazard”. 2. The insurance afforded to such additional insured(s) described in Paragraph 1. above is subject to each of the following additional provisions: a. The coverage provided to the additional insured by this endorsement does not apply to “bodily injury” or “property damage” beyond: (1) The period of time required by the written contract or written agreement described in Paragraph 1. above, or 10 years from the date of the completion of “your work” described in Paragraph 1. above, whichever is less; or (2) Two years from the date of the completion of “your work” described in Paragraph 1. above, if the written contract or written agreement does not specify the period of time. b. The insurance afforded to the additional insured(s) only applies to the extent permitted by law. c. The written contract or written agreement must have been executed prior to when the “bodily injury” or “property damage” occurs. d. The following is added to Section III – Limits Of Insurance: The most we will pay on behalf of the additional insured(s) is the amount of insurance: (1) Required by the written contract or written agreement described in Paragraph 1. above; or (2) Available under the applicable Limits of Insurance shown in the Declarations of this policy or coverage part; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations of this policy or coverage part. B. Professional Liability Exclusion With respect to coverage provided by this endorsement, the following exclusion is added to Paragraph 2. Exclusions of Section I – Coverage A – Bodily Injury And Property Damage Liability: This insurance does not apply to “bodily injury” or “property damage” arising out of: Page 2 of 2 Includes copyrighted material of Insurance Services Office, Inc. with its permission CL CG 20 23 09 16 Professional Liability Having rendered or having failed to render any professional architectural, engineering or surveying services, including: 1. The preparation, approval, or failure to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or 2. Supervisory, inspection, architectural or engineering activities. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in having supervised, hired, employed, trained or monitored others by that insured, if the “occurrence” which caused the “bodily injury” or “property damage” involved the rendering of or the failure to render any professional architectural, engineering or surveying services. C. Duties In Event Of Occurrence, Claim Or Suit With respect to the coverage provided by this endorsement, the following replaces Paragraphs 2.a. and 2.b. of Section IV – Commercial General Liability Conditions: a. You and any additional insured must see to it that we are notified as soon as practicable of an “occurrence” which may result in a claim. To the extent possible, notice should include: (1) How, when and where the “occurrence” 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”. b. If a claim is made or “suit” is brought against any insured, the insured must: (1) Immediately record the specifics of the claim or “suit” and the date received; and (2) Notify us as soon as practicable. The insured must see to it that we receive written notice of the claim or “suit” as soon as practicable. COMMERCIAL GENERAL LIABILITY CL CG 04 43 09 16 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CL CG 04 43 09 16 Includes copyrighted material of Insurance Services Office, Inc. with its permission Page 1 of 8 CONTRACTORS GENERAL LIABILITY ULTRA ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SUMMARY OF COVERAGE EXTENSIONS Provision Name Of Coverage Extension Included or Limit of Insurance A. Miscellaneous Additional Insureds Included B. Aggregate Limits Of Insurance For Construction Projects: 1. Single Construction Project Aggregate Limit (Away From Premises) Equal To General Aggregate Limit 2. Cap For All Damages From All Ongoing Construction Projects $5,000,000 C. Expected Or Intended Injury Or Damage Included D. Joint Venture / Partnership / Limited Liability Company Coverage Included E. Knowledge Of Occurrence Included F. Legal Liability – Damage To Premises Rented To You (Fire, Lightning, Explosion, Smoke, Or Leakage From Automatic Fire Protective Systems) Included G. Medical Payments $10,000 H. Mobile Equipment Redefined Included I. Newly Formed Or Acquired Organizations – Extended Period Of Coverage Included J. Non-Owned Watercraft (Increased to maximum length of less than 51 feet) Included K. Supplementary Payments – Increased Limits: 1. Bail Bonds $3,000 2. Loss Of Earnings $1,000 L. Unintentional Omission Or Unintentional Error In Disclosure Included M. Waiver Of Subrogation Included The above is a summary only. Please consult the specific provisions that follow for complete information on the extensions provided. The provisions of the Commercial General Liability Coverage Part apply except as otherwise provided in this endorsement. This endorsement applies only if such Coverage Part is included in this policy. A. MISCELLANEOUS ADDITIONAL INSUREDS 1. Section II – Who Is An Insured is amended to include as an insured any person or organization (referred to as additional insured below) described in Paragraphs A.1.c.(1) through A.1.c.(4) below when you and such person or organization have agreed in writing in a contract or agreement that such person or organization be added as an additional insured on your policy, provided that: a. The written contract or written agreement is: (1) Currently in effect or becoming effective during the term of this policy; and (2) Fully executed by you and the additional insured prior to the “bodily injury”, “property damage” or “per- sonal and advertising injury”. b. The insurance afforded by this provision does not apply to any person or organi- zation included as an additional insured Page 2 of 8 Includes copyrighted material of Insurance Services Office, Inc. with its permission CL CG 04 43 09 16 by a separate endorsement issued by us and made a part of this policy or coverage part. c. Only the following persons or organi- zations are additional insureds under this provision, with coverage for such additional insureds limited as provided herein: (1) Managers Or Lessors Of Premises A manager or lessor of premises but only with respect to liability arising out of the ownership, maintenance or use of that part of the premises leased to you and subject to the following additional exclusions: This insurance does not apply to: (a) Any “occurrence” which takes place after you cease to be a tenant in that premises. (b) Structural alterations, new con- struction or demolition operations performed by or on behalf of such additional insured. (2) Lessor Of Leased Equipment Any person or organization from whom you lease equipment but 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 or organization. A person’s or organization’s status as an additional insured under this endorsement ends when their written contract or written agreement with you for such leased equipment ends. This insurance does not apply to any “occurrence” which takes place after the equipment lease expires. (3) Controlling Interest Any person(s) or organization(s) with a controlling interest in the Named Insured, but only with respect to their liability arising out of: (a) Their financial control of you; or (b) Premises they own, maintain or control while you lease or occupy these premises. This insurance does not apply to structural alterations, new con- struction or demolition operations performed by or for such additional insured. (4) Owners Or Contractors For Whom You Are Performing Ongoing Operations (a) Any person or organization for whom you are performing operations but only with respect to liability for “bodily injury”, “property damage” or “personal and advertising injury” caused, in whole or in part, by: (i) Your acts or omissions; or (ii) The acts or omissions of those acting on your behalf: in the performance of your ongoing operations for the additional insured. A person’s or organization’s status as an additional insured under this provision ends when your operations for that additional insured are completed. (b) With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: (i) “Bodily injury”, “property damage” or “personal and advertising injury” arising out of the rendering of, or the failure to render, any professional architectural, engineering or surveying services, including: (1.1) The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, CL CG 04 43 09 16 Includes copyrighted material of Insurance Services Office, Inc. with its permission Page 3 of 8 field orders, change orders or drawings and specifications; or (1.2) Supervisory, inspec- tion, architectural or engineering activities. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision, hiring, employ- ment, training or monitoring of others by that insured, if the “occurrence” which caused the “bodily injury” or “property damage”, or the offense which caused the “personal and advertising injury”, involved the rendering of or the failure to render any professional architectural, engineering or surveying services. (ii) “Bodily injury” or “property damage” occurring after: (1.1) All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, mainten- ance 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 (1.2) That portion of “your work” out of which the injury or damage arises has been put to its intended use by any person or organization other than another con- tractor or sub- contractor engaged in performing opera- tions for a principal as a part of the same project. 2. With respect to coverage provided by this Provision A. Miscellaneous Additional Insureds, the following additional provisions apply: a. Any insurance provided to an additional insured designated under Paragraphs A.1.c.(1) through A.1.c.(4) above does not apply: (1) To “bodily injury” or “property dam- age” included within the “products- completed operations hazard”; or (2) To “bodily injury”, “property damage” or “personal and advertising injury” arising out of the sole negligence of such additional insured. b. The insurance afforded to such additional insured only applies to the extent permitted by law. c. The insurance afforded to such additional insured will not be broader than that which you are required to provide by the written contract or written agreement. 3. With respect to the insurance afforded to the additional insureds within this Provision A. Miscellaneous 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: a. Required by the written contract or written agreement; or b. 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. B. AGGREGATE LIMITS OF INSURANCE FOR CONSTRUCTION PROJECTS 1. For all sums which the insured becomes legally obligated to pay as damages caused Page 4 of 8 Includes copyrighted material of Insurance Services Office, Inc. with its permission CL CG 04 43 09 16 by “occurrences” under Section I – Coverage A, and for all medical expenses caused by accidents under Section I – Coverage C, which can be attributed only to ongoing operations at construction projects away from premises owned by or rented to the insured: a. The most we will pay will be capped at $5,000,000, regardless of the number of: (1) “Occurrences”; (2) Insureds: (3) Claims made or “suits” brought; (4) Persons or organizations making claims or bringing “suits”; or (5) Separate construction projects. b. Subject to Paragraph B.1.a. above: (1) A separate Single Construction Project General Aggregate Limit applies to each construction project away from premises owned by or rented to the insured, and that limit is equal to the amount of the General Aggregate Limit shown in the Declarations. (2) The Single Construction Project General Aggregate Limit is the most we will pay for the sum of all damages under Section I – Coverage A, except damages because of “bodily injury” or “property damage” included in the “products-completed operations hazard”, and for medical expenses under Section I – 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 Section I – Coverage A for damages or under Section I – Coverage C for medical expenses shall reduce the Single Construction Project General Aggre- gate Limit for that construction project away from premises owned by or rented to the insured. Such payments shall not reduce the General Aggregate Limit shown in the Declarations nor shall they reduce any other Single Construction Project General Aggregate Limit for any other separate construction project away from premises owned by or rented to the insured. (4) The limits shown in the Declarations for Each Occurrence, Damage To Premises Rented To You and Medical Expense continue to apply. However, instead of being subject to the General Aggregate Limit shown in the Declarations, such limits will be subject to the applicable Single Construction Project General Aggregate Limit. 2. For all sums which the insured becomes legally obligated to pay as damages caused by “occurrences” under Section I – Coverage A, and for all medical expenses caused by accidents under Section I – Coverage C, which cannot be attributed only to ongoing operations at a single construction project away from premises owned by or rented to the insured: a. 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 b. Subject to Paragraph B.1.a. above, such payments shall not reduce any Single Construction Project General Aggregate Limit. 3. 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 Single Construction Project General Aggregate Limit. 4. If a single construction project away from premises owned by or rented to the insured has been abandoned, delayed, or abandoned and then restarted, or if the CL CG 04 43 09 16 Includes copyrighted material of Insurance Services Office, Inc. with its permission Page 5 of 8 authorized contracting parties deviate from plans, blueprints, designs, specifications or timetables, the project will still be deemed to be the same construction project. 5. If endorsement CG 25 03, Designated Construction Project(s) General Aggregate Limit (or a similar construction project(s) aggregate endorsement) is also a part of this policy or coverage part, the most we will pay for the total of: a. All sums which the insured becomes legally obligated to pay as damages caused by “occurrences” under Section I – Coverage A; and b. All medical expenses caused by accidents under Section I – Coverage C, which can be attributed only to ongoing operations at: (1) Any construction project(s) designated in such CG 25 03 endorsement (or in a similar such construction project(s) aggregate endorsement); (2) Any construction project(s) to which the provisions of Provision B. Aggregate Limits Of Insurance For Construction Projects in this endorsement apply; and/or (3) Any construction project(s) to which: (i) The provisions of Provision B. Aggregate Limits Of Insurance For Construction Projects in this endorsement; and (ii) The provisions of such CG 25 03 endorsement (or a similar such construction project(s) aggregate endorsement) both apply, is subject to Paragraph B.1.a. above. 6. The provisions of Section III – Limits Of Insurance not otherwise modified by this endorsement shall continue to apply as stipulated. C. EXPECTED OR INTENDED INJURY OR DAMAGE Exclusion 2.a. Expected Or Intended Injury of Section I – Coverage A – Bodily Injury And Property Damage Liability is deleted and replaced by the following: a. Expected Or Intended Injury Or Damage “Bodily injury” or “property damage” expected or intended from the standpoint of the insured. This exclusion does not apply to “bodily injury” or “property damage” resulting from the use of reasonable force to protect persons or property. D. JOINT VENTURE / PARTNERSHIP / LIMITED LIABILITY COMPANY COVERAGE 1. The following is added to Section II – Who Is An Insured: 4. You are an insured when you had an interest in a joint venture, partnership or limited liability company which terminated or ended prior to or during this policy period, but only to the extent of your interest in such joint venture, partnership or limited liability company. However, this coverage does not apply: a. Prior to the termination or end date of any joint venture, partnership or limited liability company; b. If there is other valid and collectible insurance purchased specifically to insure the joint venture, partnership or limited liability company; or c. To a joint venture, partnership or limited liability company which is, or ever was, insured under a “consolidated (wrap-up) insurance program” (also known as an owner- controlled insurance program, OCIP). 2. With respect to the coverage provided by this Provision D. Joint Venture / Partnership / Limited Liability Company Coverage, the last Paragraph of Section II – Who Is An Insured is replaced by the following: Except as provided in 4. above, no person or organization is an insured with respect to the Page 6 of 8 Includes copyrighted material of Insurance Services Office, Inc. with its permission CL CG 04 43 09 16 conduct of any current, or past partnership, joint venture or limited liability company that is not shown as a Named Insured in the Declarations. 3. As used in this endorsement, “consolidated (wrap-up) insurance program” (also known as an owner-controlled insurance program, OCIP) means a construction, erection or demolition project for which the prime contractor/project manager or owner of the construction, erection or demolition project has secured general liability insurance covering some or all of the contractors or subcontractors involved in the project, sometimes referred to as a Contractor Controlled Insurance Program (CCIP). E. KNOWLEDGE OF OCCURRENCE Paragraph 2.a. Duties In The Event Of Occurrence, Offense, Claim Or Suit of Section IV – Commercial General Liability Conditions is deleted and replaced by the following: 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 only when the “occurrence” or offense is known to: (1) You, if you are an individual; (2) A partner, if you are a partnership; (3) A manager, if you are a limited liability company; or (4) An “executive officer” or the “employee” designated by you to give such notice, if you are an organization other than a partnership or limited liability company. To the extent possible, notice should include: (i) How, when and where the “occur-rence” or offense took place; (ii) The names and addresses of any injured persons and witnesses; and (iii) The nature and location of any injury or damage arising out of the “occur-rence” or offense. F. LEGAL LIABILITY – DAMAGE TO PREMISES RENTED TO YOU (Fire, Lightning, Explosion, Smoke Or Leakage From Automatic Fire Protective Systems) If damage to premises rented to you is not otherwise excluded from this policy or coverage part, then the following provisions apply: 1. Under Section I – Coverage A – Bodily Injury And Property Damage Liability the last paragraph (after the exclusions) is deleted and replaced by the following: Exclusion c. through n. do not apply to damage by fire, lightning, explosion, “smoke”, or leakage from automatic fire protective systems to premises while rented to you or temporarily occupied by you with the permission of the owner. A separate limit of insurance applies to this coverage as described in Section III – Limits Of Insurance. 2. The paragraph immediately after Subpara- graph j.(6) of Paragraph 2. Exclusions of Section I – Coverage A – Bodily Injury And Property Damage Liability is deleted and replaced by the following: Paragraphs (1), (3) and (4) of this exclusion do not apply to “property damage” (other than damage by fire, lightning, explosion, “smoke” and leakage from automatic fire protective systems) 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. 3. Paragraph 6. of Section III – Limits Of Insurance is deleted and replaced by the following: 6. Subject to Paragraph 5. above, the greater of: a. $300,000; or b. The Damage To Premises Rented To You Limit shown in the Declarations; is the most we will pay under Coverage A for damages because of “property damage” to premises while rented to you, CL CG 04 43 09 16 Includes copyrighted material of Insurance Services Office, Inc. with its permission Page 7 of 8 or in the case of damage by fire, lightning, explosion, “smoke” or leakage from automatic fire protective systems, while rented to you or temporarily occupied by you with permission of the owner. This limit will apply to all damage proximately caused by the same event, whether such damage results from fire, lightning, explosion, “smoke”, leakage from automatic fire protective systems, or other covered causes of loss or any combination thereof. 4. Subparagraph b.(1)(a)(ii) of Paragraph 4. Other Insurance of Section IV – Commercial General Liability Conditions is deleted and replaced by the following: (ii) That is fire, lightning, explosion, “smoke”, or leakage from automatic fire protective systems insurance for premises rented to you or temporarily occupied by you with permission of the owner; 5. Subparagraph a. of Definition 9. “Insured contract” of Section V – Definitions is deleted and replaced by the following: 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, lightning, explosion, “smoke”, or leakage from automatic fire protective systems to premises while rented to you or temporarily occupied by you with permission of the owner is not an “insured contract”. 6. As used in this Provision F. Legal Liability – Damage To Premises Rented To You: “Smoke” does not include smoke from agricultural smudging, industrial operations or “hostile fire”. G. MEDICAL PAYMENTS If Coverage C – Medical Payments is not otherwise excluded from this policy or coverage part, the Medical Expense Limit is changed, subject to the terms of Section III – Limits Of Insurance, to the greater of: a. $10,000; or b. The Medical Expense Limit shown in the Declarations. H. MOBILE EQUIPMENT REDEFINED Subparagraph f.(1) of Definition 12. “Mobile equipment” of Section V – Definitions is deleted and replaced by the following: (1) Equipment with a gross vehicle weight of 1,000 pounds or more and designed primarily for: (a) Snow removal; (b) Road maintenance, but not construction or resurfacing; or (c) Street cleaning; I. NEWLY FORMED OR ACQUIRED ORGANIZATIONS – EXTENDED PERIOD OF COVERAGE Paragraph 3. of Section II – Who Is An Insured is deleted and replaced by the following: 3. Any organization you newly acquire or form, other than: (i) A partnership, joint venture, or limited liability company; or (ii) An organization excluded either by the provisions of this policy or coverage part, or by endorsement, and over which you maintain ownership or majority interest of more than 50% will qualify as a Named Insured if there is no other similar insurance available to that organization. However: a. Coverage under this provision is afforded only until the next anniversary date of this policy’s effective date after you acquire or form the organization or the end of the policy period, whichever is earlier; b. Section I – Coverage A – Bodily Injury And Property Damage Liability does not apply to “bodily injury” or “property damage” that occurred before you acquired or formed the organization; and Page 8 of 8 Includes copyrighted material of Insurance Services Office, Inc. with its permission CL CG 04 43 09 16 c. Section I – Coverage B – Personal And Advertising Injury Liability does not apply to “personal and advertising injury” arising out of an offense committed before you acquired or formed the organization. J. NON-OWNED WATERCRAFT Subparagraph (2) of Exclusion 2.g. Aircraft, Auto Or Watercraft of Section I – Coverage A – Bodily Injury And Property Damage Liability is deleted and replaced by the following: (2) A watercraft you do not own that is: (a) Less than 51 feet long; and (b) Not being used to carry persons or property for a charge; K. SUPPLEMENTARY PAYMENTS – INCREASED LIMITS Section I – Supplementary Payments – Coverages A And B is changed as follows: 1. The limit shown in Paragraph 1.b. for the cost of bail bonds is changed from $250 to $3,000; and 2. The limit shown in Paragraph 1.d. for loss of earnings because of time off from work is changed from $250 a day to $1,000 a day. L. UNINTENTIONAL OMISSION OR UNINTENTIONAL ERROR IN DISCLOSURE The following provision is added to Paragraph 6. Representations of Section IV – Commercial General Liability Conditions: However, the unintentional omission of, or the unintentional error in, any information given or provided by you shall not prejudice your rights under this insurance. This provision does not affect our right to collect additional premium or to exercise our right of cancellation or non-renewal. M. WAIVER OF SUBROGATION Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV – Commercial General Liability Conditions is amended by the addition of the following: Notwithstanding anything to the contrary in the previous paragraph, we waive any right of recovery we may have against a person or organization because of payments we make for injury or damage arising out of your ongoing operations or “your work” included in the “products-completed operations hazard”, if: a. Such operations or work were done under a written contract or written agreement between you and such person or organization that contained a provision requiring such waiver; and b. Such written contract or written agreement was: (1) Made prior to the covered injury or damage; and (2) In effect at the time of the covered injury or damage. This waiver applies only with respect to such person or organization. COMMERCIAL GENERAL LIABILITY CL CG 01 14 09 16 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CL CG 01 14 09 16 Includes copyrighted material of Insurance Services Office, Inc. with its permission Page 1 of 1 PRIMARY AND NONCONTRIBUTORY – OTHER INSURANCE CONDITION (ADDITIONAL INSURED) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART Paragraph (v) is added to Paragraph (1)(a) of Paragraph b. Excess Insurance under Paragraph 4. Other Insurance of Section IV – Commercial General Liability Conditions, as follows: (1) This insurance is excess over: (a) Any of the other insurance, whether primary, excess, contingent or on any other basis: (v) That is available to any person or organization who has been added as an additional insured to this policy by endorsement. However, with respect to an additional insured added by endorsement for liability caused, in whole or in part: 1. By your acts or omissions, or the acts or omissions of those acting on your behalf: (a) In the performance of your ongoing operations; or (b) In connection with your premises; 2. By your maintenance, operation or use of equipment leased to you by such person or organization; or 3. By “your work” performed for that additional insured and included in the “products-completed operations hazard”; this insurance shall be primary to and will not seek contribution from the additional insured’s own insurance if you and such additional insured have agreed prior to loss in a written contract or written agreement, in effect during this policy period, that this insurance be primary and noncontributory as respects liability described in Subparagraph (1)(a)(v)1., (1)(a)(v)2. or (1)(a)(v)3. above. However, this insurance, in all cases, is excess over any other liability insurance available to the additional insured to which such person or organization has been added as an additional insured. COMMERCIAL AUTO CL CA 20 14 10 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CL CA 20 14 10 13 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 7 BUSINESS AUTO ULTRA PLUS ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modi- fied by the endorsement. SUMMARY OF COVERAGE EXTENSIONS Paragraph No. Name Of Extension Limit or Included A. Included B. Airbags Coverage Extension Included C. Employees As Insureds Included D. Hired Auto Physical Damage Coverage (Limited) $65,000 E. Employee Hired Autos (Limited) $65,000 F. Knowledge Of Accident, Claim, Suit, Or Loss Included G. Limited Fellow Employee Coverage Included H. Limited Loan/Lease Gap Coverage $1,500 I. Limited Rental Reimbursement Coverage 45 Days Sublimits: 1. $75 Maximum Rental Expenses Per Day 2. $3,375 Maximum Rental Expenses Because Of Loss To Any One Covered "Auto" 3. $15,000 Maximum Rental Expenses Because Of All "Loss" To All Covered "Autos" In Any One Policy Period. J. Newly Formed Or Acquired Organizations Included K. Supplementary Payments Increased Limits: 1. Bail Bonds $3,000 2. Loss Of Earnings (Per Day) $1,000 L. Towing And Labor Coverage Extension $75 M. Waiver Of Subrogation By Contract Or Agreement Included The above is a summary only. Please consult the specific provisions that follow for complete information on the extensions provided. If there is a conflict between this summary and the endorsement provisions that follow, the endorsement provisions shall prevail. CPA4541327 Page 2 of 7 Includes copyrighted material of Insurance Services Office, Inc., with its permission. CL CA 20 14 10 13 A. ADDITIONAL INSURED BY CONTRACT OR AGREEMENT 1. The Who Is an Insured provision for Cov- ered Autos Liability Coverage is changed to add as an additional insured any person or organization when you and such person or organization have agreed in writing in a contract or agreement that such person or organization be added as an additional in- sured on your policy, subject to the following additional provisions a. Such person or organization is an addi- tional insured only with respect to their vicarious legal responsibility for by an "accident" and resulting from your ownership, maintenance or use of a x- tent of that liability. b. Such person or organization is not an additional insured for any owned by, hired from, or borrowed from such person or organization or a mem- ber of such person's household. c. Such written contract or agreement must be executed prior to, and be in ef- d. Paragraph H. n- tained in Section V Definitions is changed to add sub-paragraph d. to the end of that definition, as follows: that part of any contract or agreement: d. That pertains to the ownership, which indemnifies a person or or- ganization for other than the vicari- ous liability of such person or organ- by an "accident" and resulting from your ownership, maintenance or use of a covered 2. None of the following shall be an additional insured under this endorsement: a. b. m- for 3. Paragraph A.1. Who Is An Insured con- tained in Section II Covered Autos Lia- bility Coverage, is changed to delete sub- paragraph c. 4. The additional insured Is not required to pay for any premiums stated in the policy or earned from the policy. Any return premium shall be payable to you. 5. You are authorized to act for the additional insured in all matters pertaining to this in- surance. 6. The additional insured will retain any right of recovery as a claimant under this policy. B. AIRBAGS COVERAGE EXTENSION Exclusion B.3.a. contained in Section III Physical Damage Coverage does not apply to the unintended discharge of an airbag. However, coverage is excess over any other collectible insurance or warranty specifically designed to provide coverage. C. EMPLOYEES AS INSUREDS The following is added to the Section II Cov- ered Autos Liability Coverage, Paragraph A.1. Who Is An Insured provision: Any "employee" of yours is an "insured" while using a covered "auto" you don't own, hire or borrow in your business or your personal affairs. However, the insurance provided by this pro- vision, C. Employees As Insureds, does not apply if separate Employees As Insured cov- erage (or any similar or equivalent coverage) has been provided by a separate endorsement issued by us and made a part of this policy or coverage part. D. HIRED AUTO PHYSICAL DAMAGE COV- ERAGE (LIMITED) Covered Autos Liability Coverage in this policy or coverage part, then such Physical Damage Coverage that is provided in this policy or or borrow, subject to the following additional provisions: 1. This extension for Hired Auto Physical Damage Coverage (Limited) does not apply to: a. borrow that is a land vehicle that would qualify under the definition of "mobile equipment" under this policy or coverage part 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; CL CA 20 14 10 13 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 3 of 7 b. Any "auto" you lease, hire, rent or bor- row from any of your "employees", part- ners (if you are a partnership), members (if you are a limited liability company) or members of their households; or c. borrow: (1) For a period of more than 30 days; or (2) With a driver. 2. Physical Damage Coverage The Physical Damage Coverage provided will be: (a) With respect to Other Than Collision coverage: (1) Comprehensive Coverage if any this coverage under this policy or coverage part; or, (2) Specified Causes Of Loss Coverage if, under this coverage part or policy, has this coverage and no other Comprehensive Coverage; and (b) owned by you has this coverage under this policy or coverage part. 3. Limit Of Insurance be the lesser of: a. The actual cash value of the damaged "loss"; b. The cost to repair or replace the property of like kind and quality; or c. $65,000, except that such amount will be reduced by a deductible as determined by paragraph D.4. below. 4. Deductible Our obligation to pay for, repair, return or replace such damaged or stolen covered will be reduced by a deductible for each coverage afforded under D.2.(a) and D.2.(b) above equal to the amount of the largest deductible applicable for that you. However, no deductible will apply to 5. Loss Of Use under this extension D. Hired Auto Physical Damage Coverage (Limited), and subject to the coverages provided under paragraph D.2. Coverage above, we will also pay expenses for loss of use of such dditional provisions: a. written rental contract or agreement; b. Such loss of use is a direct this extension D. Hired Auto Physical Damage Coverage (Limited): (1) responsible; and (2) As a result of which the leasing or rental entity sustains a monetary loss; c. The most we will pay for any expenses for loss of use is $300 per day, subject to a maximum of $2,100l; and d. Paragraph b. Loss Of Use Expenses of Paragraph 4. Coverage Extensions of Paragraph A. Coverage contained in Section III Physical Damage Coverage does not apply. 6. Other Insurance Coverage under this extension D. Hired Auto Physical Damage Coverage (Limited) will be excess over any other valid and collectible insurance available to the afforded if any physical damage coverage is Item Four Schedule Of Hired Or Borrowed Covered Auto Coverage And Premiums in the Business Auto Declarations in this policy or coverage part (or which would have been provided except for the application of an exclusion). E. EMPLOYEE HIRED AUTOS (LIMITED) 1. Cov- ered Autos Liability Coverage in this poli- cy or coverage part, then the following pro- vision applies: Page 4 of 7 Includes copyrighted material of Insurance Services Office, Inc., with its permission. CL CA 20 14 10 13 Changes In Covered Autos Liability Cov- erage The following is added to the Who Is An In- sured Provision: An "employee" of yours is an "insured" while operating an "auto" hired or rented under a written contract in an "employee's" name, with your permission, while performing du- ties related to the conduct of your business. However, this extension does not apply to: a. Any "auto" that is hired or rented with a driver; b. period of more than 30 days; c. "Mobile equipment", or d. a land vehicle that would qualify under the def- inition of "mobile equipment" under this policy or coverage part if it were not subject to a compulsory or financial re- sponsibility law or other motor vehicle insurance law where it is licensed or principally garaged. 2. If hired "autos" are covered "autos" for Physical Damage Coverage in this policy or coverage part, then the following provi- sions apply: a. Changes in General Conditions Paragraph 5.b. of the Other Insurance Condition of Section IV Business Au- to Conditions is replaced by the follow- ing: For Hired Auto Physical Damage Cov- erage, the following are deemed to be covered "autos" you own: (1) Any covered "auto" you lease, hire, rent or borrow; and (2) Any covered "auto" hired or rented by your "employee" under a written contract in an "employee's" name, with your permission, while perform- ing duties related to the conduct of your business. However, none of the following are cov- ered "autos: (i) Any "auto" that is leased, hired rented or borrowed with a driver; (ii) for a period of more than 30 days; (iii) "Mobile equipment", or (iv) Any other land vehicle that would qualify under the defini- tion of "mobile equipment" un- der this policy or coverage part if it were not subject to a com- pulsory or financial responsibility law or other motor vehicle in- surance law where it is licensed or principally garaged. b. Limit Of Insurance will be the lesser of: (1) The actual cash value of the time of the "loss"; (2) The cost to repair or replace the property of like kind and quality; or (3) $65,000, 3. Any insurance afforded by this provision E. Employee Hired Autos (Limited) does not apply if separate Employees Hired Autos coverage (or any similar or equivalent cov- erage) has been provided by a separate en- dorsement issued by us and made a part of this policy or coverage part. F. KNOWLEDGE OF ACCIDENT, CLAIM, SUIT, OR LOSS Sub-paragraph a. contained in Paragraph A.2. Duties In The Event Of Accident, Claim, Suit or Loss, of Section IV Business Auto Conditions is replaced by the following: a. In the event of "accident", claim, "suit" or "loss", you must give us or our authorized representative prompt notice of the "acci- dent" or "los 1. You, if you are an individual; 2. A partner, if you are a partnership; 3. A manager, if you are a limited liability company; or 4. designated by you to give such notice, if you are an organization other than a partnership or a limited liability compa- ny. Include: (1) How, when and where the "accident" or "loss" occurred; (2) The "insured's" name and address; and CL CA 20 14 10 13 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 5 of 7 (3) To the extent possible, the names and addresses of any injured persons and witnesses. G. LIMITED FELLOW EMPLOYEE COVERAGE Paragraph 5. Fellow Employee of Paragraph B. Exclusions contained in Section II Covered Autos Liability Coverage is replaced by the following: 5. Fellow Employee a. "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; or b. The spouse, child, parent, brother or sis- ter of that fellow "employee" as a con- sequence of Paragraph a. above. However, this exclusion does not apply to Such coverage is excess over any other collectible insurance, and Paragraph 5. Other Insurance of Paragraph B. General Conditions under Section IV Business Auto Conditions is changed accordingly. Any insurance provided by this provision G. Limited Fellow Employee Coverage does not apply if separate Fellow Employee Coverage (or any similar or equivalent coverage) has been provided by a separate endorsement is- sued by us and made a part of this policy or coverage part. As used in this provision, "executive officer" means a person holding any of the officer positions created by your charter, constitution, by-laws or any other similar governing document. H. LIMITED LOAN/LEASE GAP COVERAGE Paragraph 4. Coverage Extensions of Para- graph A. Coverage contained in Section III Physical Damage Coverage is amended to add the following: I v- long-term leased by you for a period of 12 con- secutive months or longer, we will pay any un- paid amount due on your loan or lease for such o the following addition- al provisions: 1. We will only pay the lesser of: a. The sum of such unpaid amount, less (1) The amount paid under the Physi- cal Damage Coverage Section of the policy or coverage part; and (2) Any: (a) Overdue loan/lease payments at (b) Financial penalties imposed un- der a lease for excessive use, abnormal wear and tear or high mileage; (c) Security deposits not returned by the Lessor; (d) Costs for extended warranties, Credit Life Insurance, Health, Accident or Disability Insurance purchased with the loan or lease; and (e) Carry-over balances from previ- ous loans or leases; or b. $1,500. 2. This that is a land vehicle that would qualify under the definition of "mobile equipment" under this policy or coverage part 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; 3. The insurance afforded for Limited Loan/Lease Gap Coverage in this exten- sion endorsement does not apply if separate Loan/Lease Gap Coverage is endorsement issued by us and made a part of this policy or coverage part. I. LIMITED RENTAL REIMBURSEMENT COV- ERAGE We will pay for rental reimbursement expenses following additional provisions: 1. As used in this Rental Reimbursement Coverage provisio motor vehicle, "trailer" or semitrailer designed for travel on public roads. a. Page 6 of 7 Includes copyrighted material of Insurance Services Office, Inc., with its permission. CL CA 20 14 10 13 b. Any other land vehicle that would qualify under the definition of "mobile equip- ment" under this policy or coverage part 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. 2. Payment applies in addition to the otherwise applicable amount of each coverage you 3. No deductible applies to this coverage. 4. We will pay only for those expenses incurred during the policy period beginning 24 hours expiration date of the policy, with the lesser of the following number of days: a. The number of days reasonably required to repair or replace the covered b. 45 days 5. Our payment is limited to the lesser of the following amounts: a. Necessary and actual expenses incurred. b. The maximum rental expenses shown below: (1) $75 any one day; (2) $3,375 because of "loss" to any one covered "auto"; (3) $15,000 because of all "loss" to all covered autos in any one policy period. 6. This coverage does not apply while there are for your operations. 7. Paragraph a. Transportation Expenses of Paragraph 4. Coverage Extension of Paragraph A. Coverage contained in Section III Physical Damage Coverage, does not apply and is entirely deleted. 8. The insurance afforded for Limited Rental Reimbursement Coverage in this extension endorsement does not apply if separate Rental Reimbursement Coverage is issued by us as an endorsement and made a part of this policy or coverage part. J. NEWLY FORMED OR ACQUIRED ORGANI- ZATIONS The Named Insured shown in the Business Auto Declarations is amended to include any organization you newly form or acquire, other than: (i) a partnership, joint venture, or limited liability company; or (ii) an organization excluded either by the provisions of this Coverage Part, or by endorsement, and over which you maintain ownership or majority interest of more than 50%, subject to the following additional provisions: 1. This insurance does not apply to any newly formed or acquired organization that is an but for its termination or the exhaustion of its Limit of Insurance. 2. Coverage under this provision does not apply to injury, damage, that occurred before you formed or acquired the organization. 3. Coverage under this provision is afforded only until the next anniversary date of this form the organization, or the end of the poli- cy period, whichever is earlier. K. SUPPLEMENTARY PAYMENTS IN- CREASED LIMITS The following changes are made to the Para- graph a. Supplementary Payments of Para- graph 2. Coverage Extensions of Paragraph A. Coverage contained in Section II Covered Autos Liability Coverage: 1. The limit shown in Subparagraph (2) for the cost of bail bonds is changed from $2,000 to $3,000. 2. The limit shown in Subparagraph (4) for all reasonable expenses incurred at our re- quest, including actual loss of earnings be- cause of time off work, is changed from $250 to $1,000 per day. L. TOWING AND LABOR COVERAGE EX- TENSION Paragraph 2. Towing of Paragraph A. Coverage under Section III Physical Damage Coverage is entirely replaced by the following: both Comprehensive Coverage and Collision Coverage in this policy or coverage part, we will pay up to $75 for towing and labor costs senger following additional provisions: 1. The labor must be performed at the place of disablement; CL CA 20 14 10 13 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 7 of 7 2. This coverage does not apply to stolen 3. p Physical Damage Towing And Labor coverage shown under Item Two of the Business Auto Declarations in this policy or coverage part, the most we will pay for each covered disablement is the greater of: a. The limit shown under Item Two in the Declarations, or b. $75 4. As used in this coverage: a. - wheel auto of the private passenger or station wagon type; and b. -up or panel truck, sport utility vehicle or similar (GVW) of 11,000 pounds or less. Gross Vehicle Weight (GVW) is the maximum loaded weight for which a by the manufacturer. M. WAIVER OF SUBROGATION BY CONTRACT OR AGREEMENT The following is added to Paragraph A.5. Transfer Of Rights Of Recovery Against Others To Us contained in Section IV Business Auto Conditions: Notwithstanding anything to the contrary in the previous paragraph, we waive any right of recovery we may have against a person or organization because of payments we make for arising out of the operation, maintenance, use, you and such person or organization have agreed in writing in a contract or agreement to waive such right of recovery, provided: 1. Such written contract or agreement was: a. Made prior to the covered injury or damage; and b. In effect at the time of the covered injury or damage; and 2. The injury or damage arises out of the oper- ations contemplated by such written contract or agreement. This waiver applies only to such person or organization designated in such written contract or agreement. COMMERCIAL GENERAL LIABILITY CG 00 01 04 13 CG 00 01 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 16 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 "our" 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". <!-Bookmark:COMMERCIAL GENERAL LIABILITY COVERAGE FORM_CG 00 01_04/13:EndBoomark-!> Page 2 of 16 © Insurance Services Office, Inc., 2012 CG 00 01 04 13 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 (1) 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 3 of 16 f. Pollution (1) "Bodily injury" or "property damage" arising out of the actual, alleged or threatened discharge, dispersal, seepage, migration, release or escape of "pollutants": (a) At or from any premises, site or location which is or was at any time owned or occupied by, or rented or loaned to, any insured. However, this subparagraph does not apply to: (i) "Bodily injury" if sustained within a building and caused by smoke, fumes, vapor or soot produced by or originating from equipment that is used to heat, cool or dehumidify the building, or equipment that is used to heat water for personal use, by the building's occupants or their guests; (ii) "Bodily injury" or "property damage" for which you may be held liable, if you are a contractor and the owner or lessee of such premises, site or location has been added to your policy as an additional insured with respect to your ongoing operations performed for that additional insured at that premises, site or location and such premises, site or location is not and never was owned or occupied by, or rented or loaned to, any insured, other than that additional insured; or (iii) "Bodily injury" or "property damage" arising out of heat, smoke or fumes from a "hostile fire"; (b) At or from any premises, site or location which is or was at any time used by or for any insured or others for the handling, storage, disposal, processing or treatment of waste; (c) Which are or were at any time transported, handled, stored, treated, disposed of, or processed as waste by or for: (i) Any insured; or (ii) Any person or organization for whom you may be legally responsible; or (d) At or from any premises, site or location on which any insured or any contractors or subcontractors working directly or indirectly on any insured's behalf are performing operations if the "pollutants" are brought on or to the premises, site or location in connection with such operations by such insured, contractor or subcontractor. However, this subparagraph does not apply to: (i) "Bodily injury" or "property damage" arising out of the escape of fuels, lubricants or other operating fluids which are needed to perform the normal electrical, hydraulic or mechanical functions necessary for the operation of "mobile equipment" or its parts, if such fuels, lubricants or other operating fluids escape from a vehicle part designed to hold, store or receive them. This exception does not apply if the "bodily injury" or "property damage" arises out of the intentional discharge, dispersal or release of the fuels, lubricants or other operating fluids, or if such fuels, lubricants or other operating fluids are brought on or to the premises, site or location with the intent that they be discharged, dispersed or released as part of the operations being performed by such insured, contractor or subcontractor; (ii) "Bodily injury" or "property damage" sustained within a building and caused by the release of gases, fumes or vapors from materials brought into that building in connection with operations being performed by you or on your behalf by a contractor or subcontractor; or (iii) "Bodily injury" or "property damage" arising out of heat, smoke or fumes from a "hostile fire". (e) At or from any premises, site or location on which any insured or any contractors or subcontractors working directly or indirectly 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". Page 4 of 16 © Insurance Services Office, Inc., 2012 CG 00 01 04 13 (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 01 04 13 © Insurance Services Office, Inc., 2012 Page 5 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. l. 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 Page 6 of 16 © Insurance Services Office, Inc., 2012 CG 00 01 04 13 (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 01 04 13 © Insurance Services Office, Inc., 2012 Page 7 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. l. 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. Page 8 of 16 © Insurance Services Office, Inc., 2012 CG 00 01 04 13 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. CG 00 01 04 13 © Insurance Services Office, Inc., 2012 Page 9 of 16 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"; 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. Page 10 of 16 © Insurance Services Office, Inc., 2012 CG 00 01 04 13 2. Each of the following is also an insured: a. 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 (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. 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: 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. 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. CG 00 01 04 13 © Insurance Services Office, Inc., 2012 Page 11 of 16 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: 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". 6. 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. 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. Page 12 of 16 © Insurance Services Office, Inc., 2012 CG 00 01 04 13 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. (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. c. The first Named Insured must keep records of the information we need for premium computation, and send us copies at such times as we may request. 6. Representations By accepting this policy, you agree: a. The statements in the Declarations are accurate and complete; CG 00 01 04 13 © Insurance Services Office, Inc., 2012 Page 13 of 16 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: a. A land motor vehicle, trailer or semitrailer designed for travel on public roads, including any attached machinery or equipment; or 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. Page 14 of 16 © Insurance Services Office, Inc., 2012 CG 00 01 04 13 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; f. 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. 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. CG 00 01 04 13 © Insurance Services Office, Inc., 2012 Page 15 of 16 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. 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. (c) 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 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: (1) 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. Page 16 of 16 © Insurance Services Office, Inc., 2012 CG 00 01 04 13 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: 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. 19. "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. 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. INSR ADDL SUBR LTR INSR WVD DATE (MM/DD/YYYY) PRODUCER CONTACT NAME: FAX PHONE (A/C, No): (A/C, No, Ext): E-MAIL ADDRESS: INSURER A : INSURED INSURER B : INSURER C : INSURER D : INSURER E : INSURER F : POLICY NUMBER POLICY EFF POLICY EXP TYPE OF INSURANCE LIMITS (MM/DD/YYYY) (MM/DD/YYYY) COMMERCIAL GENERAL LIABILITY AUTOMOBILE LIABILITY UMBRELLA LIAB EXCESS LIAB WORKERS COMPENSATION AND EMPLOYERS' LIABILITY DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) AUTHORIZED REPRESENTATIVE INSURER(S) AFFORDING COVERAGE NAIC # Y / N N / A (Mandatory in NH) ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? EACH OCCURRENCE $ DAMAGE TO RENTED $ PREMISES (Ea occurrence) CLAIMS-MADE OCCUR MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ $ PRO- OTHER: LOC JECT COMBINED SINGLE LIMIT $ (Ea accident) BODILY INJURY (Per person) $ ANY AUTO OWNED SCHEDULED BODILY INJURY (Per accident) $ AUTOS ONLY AUTOS AUTOS ONLY HIRED PROPERTY DAMAGE $ AUTOS ONLY (Per accident) $ OCCUR EACH OCCURRENCE $ CLAIMS-MADE AGGREGATE $ DED RETENTION $ $ PER OTH- STATUTE ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ If yes, describe under E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS below POLICY NON-OWNED SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer any rights to the certificate holder in lieu of such endorsement(s). COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: CERTIFICATE HOLDER CANCELLATION © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ACORD 25 (2016/03) ACORDTM CERTIFICATE OF LIABILITY INSURANCE Property & Casualty Ins Co of Hartford 10/13/2021 Greyling Ins. Brokerage/EPIC 3780 Mansell Rd. Suite 370 Alpharetta, GA 30022 Trudy Henry 770-552-4225 866-550-4082 aceccertificates@greyling.com Dibble & Associates Consulting 7878 N. 16th St., Ste. 300 Phoenix, AZ 85020 34690 21-22 A N 20WEGAC0MAS 11/01/2021 11/01/2022 X 1,000,000 1,000,000 1,000,000 Re: Dibble CM, Chandler Project No. WA1521.453, Fire Station Well Site Improvements Waiver of Subrogation is applicable where required by written contract & allowed by law. Should any of the above described policies be cancelled by the issuing insurer before the expiration date thereof, 30 days' written notice (except 10 days for nonpayment of premium) will be provided to the Certificate Holder. City of Chandler Public Works & Utilities Department P.O. Box 4008, Mail Stop 407 Chandler, AZ 85244-4008 1 of 1 #S2934856/M2891865 DIBBASSOC Client#: 53946 KTRU1