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HomeMy WebLinkAboutPortillo Concrete Inc; 2022-05-02; PWM22-1819TRANPWM22-1819TRAN FY 2020-21 ADA IMPROVEMENT PROGRAM CONT. NO. 6049 Page 1 of 6 City Attorney Approved 1/20/2020 CITY OF CARLSBAD MINOR PUBLIC WORKS CONTRACT FY 2020-21 ADA IMPROVEMENT PROGRAM; CONT. NO. 6049 This agreement is made on the ______________ day of _________________________, 2022, by the City of Carlsbad, California, a municipal corporation, (hereinafter called "City"), and Portillo Concrete Inc., a California corporation whose principal place of business is 3527 Citrus Street, Lemon Grove, California, 91945 (hereinafter called "Contractor"). City and Contractor agree as follows: DESCRIPTION OF WORK. Contractor shall perform all work specified in the Contract documents for the project described by these Contract Documents (hereinafter called "Project"). PROVISIONS OF LABOR AND MATERIALS. Contractor shall provide all labor, materials, tools, equipment, and personnel to perform the work specified by the Contract Documents unless excepted elsewhere in this Contract. CONTRACT DOCUMENTS. The Contract Documents consist of this Contract, exhibits to this Contract, Contractor's Proposal, the Plans and Specifications, the General Provisions, addendum(s) to said Plans and Specifications, and all proper amendments and changes made thereto in accordance with this Contract or the Plans and Specifications, all of which are incorporated herein by this reference. When in conflict, this Contract will supersede terms and conditions in the Contractor’s proposal. LABOR. Contractor will employ only skilled workers and abide by all State laws and City of Carlsbad Ordinances governing labor. GUARANTEE. Contractor guarantees all labor and materials furnished and agrees to complete the Project in accordance with directions and subject to inspection approval and acceptance by Scott Lyle (City Project Manager). PAYMENT. The City shall withhold retention as required by Public Contract Code Section 9203. WAGE RATES. The general prevailing rate of wages for each craft or type of worker needed to execute the Contract shall be those as determined by the Director of Industrial Relations pursuant to Sections 1770, 1773 and 1773.1 of the Labor Code. Pursuant to Section 1773.2 of the Labor Code, a current copy of the applicable wage rates is on file in the Office of the City Engineer. Contractor shall not pay less than the said specified prevailing rates of wages to all workers employed by him or her in execution of the Contract. Contractor shall be responsible for insuring compliance with provisions of section 1777.5 of the Labor Code and section 4100 et seq. of the Public Contracts Code, "Subletting and Subcontracting Fair Practices Act." The City Engineer is the City's "duly authorized officer" for the purposes of section 4107 and 4107.5. The provisions of Part 7, Chapter 1, of the Labor Code commencing with section 1720 shall apply to the Contract for work. A contractor or subcontractor shall not be qualified to bid on, be listed in a bid proposal, subject to the requirements of Section 4104 of the Public Contract Code or engage in the performance of any contract for public work, unless currently registered and qualified to perform public work pursuant to Section 1725.5. This project is subject to compliance monitoring and enforcement by the Department of Industrial Relations. Contractor and any subcontractors shall comply with Section 1776 of the California Labor Code, which generally requires keeping accurate payroll records, verifying and certifying payroll records, and making them available for inspection. Contractor shall require any subcontractors to comply with Section 1776. DocuSign Envelope ID: 9ABB2BDC-959B-4BE6-BCEE-8DACE479186F May 2nd PWM22-1819TRAN FY 2020-21 ADA IMPROVEMENT PROGRAM CONT. NO. 6049 Page 2 of 6 City Attorney Approved 1/20/2020 FALSE CLAIMS. Contractor hereby agrees that any contract claim submitted to the City must be asserted as part of the contract process as set forth in this agreement and not in anticipation of litigation or in conjunction with litigation. Contractor acknowledges that California Government Code sections 12650 et seq., the False Claims Act, provides for civil penalties where a person knowingly submits a false claim to a public entity. These provisions include false claims made with deliberate ignorance of the false information or in reckless disregard of the truth or falsity of the information. The provisions of Carlsbad Municipal Code sections 3.32.025, 3.32.026, 3.32.027 and 3.32.028 pertaining to false claims are incorporated herein by reference. Contractor hereby acknowledges that the filing of a false claim may subject the Contractor to an administrative debarment proceeding wherein the contractor may be prevented from further bidding on public contracts for a period of up to five (5) years and that debarment by another jurisdiction is grounds for the City of Carlsbad to disqualify the Contractor or subcontractor from participating in contract bidding. Signature: ___________________________________ Print Name: ____Mario Portillo, President and CEO____ REQUIRED INSURANCE. The successful contractor shall provide to the City of Carlsbad, a Certification of Commercial General Liability and Property Damage Insurance and a Certificate of Workers’ Compensation Insurance indicating coverage in a form approved by the California Insurance Commission. The certificates shall indicate coverage during the period of the contract and must be furnished to the City prior to the start of work. The minimum limits of liability insurance are to be placed with California admitted insurers that have a current Best's Key Rating of not less than "A-:VII"; OR with a surplus line insurer on the State of California’s List of Approved Surplus Line Insurers (LASLI) with a rating in the latest Best’s Key Rating Guide of at least “A:X”; OR an alien non-admitted insurer listed by the National Association of Insurance Commissioners (NAIC) latest quarterly listings report. Commercial General Liability Insurance of Injuries including accidental death, to any one person in an amount not less than……..$1,000,000 Subject to the same limit for each person on account of one accident in an amount not less than ….…$1,000,000 Property damage insurance in an amount of not less than……..$1,000,000 Automobile Liability Insurance in the amount of $1,000,000 combined single limit per accident for bodily injury and property damage. In addition, the auto policy must cover any vehicle used in the performance of the contract, used onsite or offsite, whether owned, non-owned or hired, and whether scheduled or non-scheduled. The automobile insurance certificate must state the coverage is for “any auto” and cannot be limited in any manner. The above policies shall have non-cancellation clauses providing that 30 days written notice shall be given to the City prior to such cancellation. The policies shall name the City of Carlsbad as an additional insured. The full limits available to the named insured shall also be available and applicable to the City as an additional insured. WORKERS’ COMPENSATION AND EMPLOYER’S LIABILITY. Workers’ Compensation limits as required by the California Labor Code. Workers’ Compensation will not be required if Contractor has no employees and provides, to City’s satisfaction, a declaration stating this. DocuSign Envelope ID: 9ABB2BDC-959B-4BE6-BCEE-8DACE479186F PWM22-1819TRAN FY 2020-21 ADA IMPROVEMENT PROGRAM CONT. NO. 6049 Page 3 of 6 City Attorney Approved 1/20/2020 BUSINESS LICENSE. The Contractor and all subcontractors are required to have and maintain a valid City of Carlsbad Business License for the duration of the contract. INDEMNITY. The Contractor shall assume the defense of, pay all expenses of defense, and indemnify and hold harmless the City, and its officers and employees, from all claims, loss, damage, injury and liability of every kind, nature and description, directly or indirectly arising from or in connection with the performance of the Contract or work; or from any failure or alleged failure of Contractor to comply with any applicable law, rules or regulations including those related to safety and health; and from any and all claims, loss, damages, injury and liability, howsoever the same may be caused, resulting directly or indirectly from the nature of the work covered by the Contract, except for loss or damage caused by the sole or active negligence or willful misconduct of the City. The expenses of defense include all costs and expenses including attorneys’ fees for litigation, arbitration, or other dispute resolution method. JURISDICTION. The Contractor agrees and hereby stipulates that the proper venue and jurisdiction for resolution of any disputes between the parties arising out of this agreement is San Diego County, California. Start Work: Contractor agrees to start within five (5) working days after receipt of Notice to Proceed. Completion: Contractor agrees to complete work within sixty (60) working days after receipt of Notice to Proceed. CONTRACTOR’S INFORMATION. Portillo Concrete, Inc. 3527 Citrus Street (name of Contractor) 680144 (street address) Lemon Grove, CA 91945 (Contractor’s license number) A, B, C-8 10/31/2022 (city/state/zip) 619-466-4639 (license class. and exp. date) 1000004389 (telephone no.) (DIR registration number) 6/30/2022 (fax no.) mportillo@portilloconcreteinc.com (DIR registration exp. date) (e-mail address) /// /// /// /// /// /// /// /// DocuSign Envelope ID: 9ABB2BDC-959B-4BE6-BCEE-8DACE479186F PWM22-1819TRAN FY 2020-21 ADA IMPROVEMENT PROGRAM CONT. NO. 6049 Page 4 of 6 City Attorney Approved 1/20/2020 AUTHORITY. The individuals executing this Agreement and the instruments referenced in it on behalf of Contractor each represent and warrant that they have the legal power, right and actual authority to bind Contractor to the terms and conditions of this Agreement. CONTRACTOR PORTILLO CONCRETE INC., a California corporation CITY OF CARLSBAD, a municipal corporation of the State of California By: By: (sign here) Mario Portillo, President/CEO Paz Gomez. Deputy City Manager, Public Works, as authorized by the City Manager (print name/title) By: (sign here) Tina Portillo, Secretary/CFO (print name/title) If required by City, proper notarial acknowledgment of execution by Contractor must be attached. If a corporation, Agreement must be signed by one corporate officer from each of the following two groups: Group A Group B Chairman, President, or Vice-President Secretary, Assistant Secretary, CFO or Assistant Treasurer Otherwise, the corporation must attach a resolution certified by the secretary or assistant secretary under corporate seal empowering the officer(s) signing to bind the corporation. APPROVED AS TO FORM: CELIA A. BREWER, City Attorney BY: _____________________________ Assistant City Attorney DocuSign Envelope ID: 9ABB2BDC-959B-4BE6-BCEE-8DACE479186F PWM22-1819TRAN FY 2020-21 ADA IMPROVEMENT PROGRAM CONT. NO. 6049 Page 5 of 6 City Attorney Approved 1/20/2020 EXHIBIT A LISTING OF SUBCONTRACTORS BY GENERAL CONTRACTOR Set forth below is the full name and location of the place of business of each subcontractor whom the Contractor proposes to subcontract portions of the Project in excess of one-half of one percent of the total bid, and the portion of the Project which will be done by each subcontractor for each subcontract. NOTE: The Contractor understands that if it fails to specify a subcontractor for any portion of the Project to be performed under the contract in excess of one-half of one percent of the bid, the contractor shall be deemed to have agreed to perform such portion, and that the Contractor shall not be permitted to sublet or subcontract that portion of the work, except in cases of public emergency or necessity, and then only after a finding, reduced in writing as a public record of the Awarding Authority, setting forth the facts constituting the emergency or necessity in accordance with the provisions of the Subletting and Subcontracting Fair Practices Act (Section 4100 et seq. of the California Public Contract Code). If no subcontractors are to be employed on the project, enter the word "NONE." SUBCONTRACTORS Portion of Project to be Subcontracted Business Name and Address DIR Registration No. License No., Classification & Expiration Date % of Total Contract NONE Total % Subcontracted: 0% The Contractor must perform no less than 50% of the work with its own forces. DocuSign Envelope ID: 9ABB2BDC-959B-4BE6-BCEE-8DACE479186F PWM22-1819TRAN FY 2020-21 ADA IMPROVEMENT PROGRAM CONT. NO. 6049 Page 6 of 6 City Attorney Approved 1/20/2020 EXHIBIT B FY 2020-21 ADA IMPROVEMENT PROGRAM All work shall be performed in accordance with the City of Carlsbad’s Engineering Standards, the Standard Specifications for Public Works Construction 2021 edition and the supplements thereto as published by the “Greenbook” Committee of Public works Standards, Inc. Scope of work shall include survey monument installation and curb ramp modifications. Ramp modification locations are as follows (see also Exhibit C for limits of work): •Driveway entrance off Carlsbad Village Drive into the Mission Church parking lot •Northeast corner of Acacia Ave and Carlsbad Blvd •Northeast corner of Hemlock Ave and Carlsbad Blvd JOB QUOTATION ITEM NO. UNIT QTY DESCRIPTION PRICE 1 LS 1 Mobilization $3,006 2 LS 1 Tier 2 SWPPP Preparation, Implementation, and Maintenance $144 3 LS 1 Traffic Control, Implementation, and Maintenance $1,152 4 LS 1 Mission Church – remove curbs on each side and replace with transition into parking lot $4,045 5 LS 1 Hemlock – remove the curb and replace with a transition to the existing wall $2,628 6 LS 1 Acacia – remove the curb and replace with a transition to the existing wall $2,412 7 LS 1 Record drawing $500 8 EA 5 Survey Monument $3,750 TOTAL* $17,637 *Includes taxes, fees, expenses and all other costs. DocuSign Envelope ID: 9ABB2BDC-959B-4BE6-BCEE-8DACE479186F The City of Carlsbad provides this Permission for Right of Entry for scheduled entry and maintenance work within an easement on your property described as: NAME: Ezra Ministries Inc. STREET ADDRESS: 825 Carlsbad Village Drive, Carlsbad CA 92008 ASSESSOR’S PARCEL NUMBER: 203-352-18-00 For the purposes of facilitating sidewalk improvements on Carlsbad Village Drive, the City’s contractor will need to perform work on your property. For further details regarding the subject improvements please refer to the attached exhibit. Specific project improvements requiring this entry include concrete removal and construction adjacent to the Jefferson Street Alley on your property. Authorization of this Right-of-Entry Agreement grants the City and its contractor permission to enter and construct these improvements on the property addressed above. The City’s contractor shall perform all work in a professional manner per the approved engineering plans and specifications. These documents will be provided after approval and upon request. The City will only be responsible for all damages and liability arising from the sole or active negligence or willful misconduct of the City, or its contractors, entering the property for the above-stated reasons. When completed, the City will restore any affected real property to a condition similar to the existing condition before the construction. Permission described in this Agreement shall end when the project Notice of Completion is filed with the County Clerk’s office. Therefore, I hereby grant the City of Carlsbad, and its contractor, permission to enter my property to construct the above-described improvements. OWNER, Print Name OWNER, Signature DATE CITY OF CARLSBAD PERMISSION FOR RIGHT OF ENTRY EXHIBIT C 3-23-2022 DAVID MENARD DocuSign Envelope ID: 9ABB2BDC-959B-4BE6-BCEE-8DACE479186F MPW Exhibit for CVD and Jefferson St. Alley (SL 3/16/2022) Remove and replace ex. concrete. Match grades at south side of new ADA ramp and at transition limits within ex. parking lot (~25 SF). Apply broom finish to concrete in this area. Remove and replace ex. concrete. Match grades at south side of new ADA ramp and at transition limits within ex. parking lot (~25 SF). Apply broom finish to concrete in this area. Remove and replace 2-foot width of AC along edge of newly poured concrete for transition into parking lot. Depth of AC should be 6 inches. This work is only required if contractor unable to construct clean sawcut at proposed limits of concrete. DocuSign Envelope ID: 9ABB2BDC-959B-4BE6-BCEE-8DACE479186F DocuSign Envelope ID: 9ABB2BDC-959B-4BE6-BCEE-8DACE479186Fvi 1 , vF CARLSBAD PERMISSION FOR RIGHT OF ENTRY The City of Carlsbad provides this Permission for Right of Entry for scheduled entry and maintenance work within an easement on your property described as: NAME: Young Family Trust 01-14-20 STREET ADDRESS: 102 Acacia Avenue, Carlsbad CA 92008 ASSESSOR'S PARCEL NUMBER: 204-233-10-00 -------------------For the purposes of facilitating sidewalk improvements on Carlsbad Boulevard and Acacia Avenue, the City's contractor will need to perform work adjacent to your property. For further details regarding the subject improvements please refer to the Construction Plans for the FY 2020-21 ADA Improvements Program, Project No. CIP 6049, Drawing No.506-3A (available upon request). Specific project improvements requiring this entry include curb removal and sidewalk reconstruction adjacent to the southern perimeter of your property. Authorization of this Right-of-Entry Agreement grants the City and its contractor permission to enter and construct these improvements on the property addressed above. The City's contractor shall perform all work in a professional manner per the approved engineering plans and specifications. These documents will be provided after approval and upon request. The City will only be responsible for all damages and liability arising from the sole or active negligence or willful misconduct of the City, or its contractors, entering the property for the above-stated reasons. When completed, the City will restore any affected real property to a condition similar to the existing condition before the construction. Permission described in this Agreement shall end when the project Notice of Completion is filed with the County Clerk's office. Therefore, I hereby grant the City of Car d, · r, permission to enter my property to construct the above-describ pr '{o0 N ~ ILJ fk U-S.L r OWNER, t Name 2 Ex. pole foundation to remain. Remove and replace ex. concrete. Place concrete above ex. wall footing. Match grade at back of new ADA ramp and slope to toe of ex. wall. Remove and replace existing concrete (~30 SF). Place concrete above ex. wall footing. MPW Exhibit for Acacia Ave and Carlsbad Blvd (SL 3/16/2022) West Corner DocuSign Envelope ID: 9ABB2BDC-959B-4BE6-BCEE-8DACE479186F DocuSign Envelope ID: 9ABB2BDC-959B-4BE6-BCEE-8DACE479186F CITY OF CARLSBAD PERMISSION FOR RIGHT OF ENTRY The City of Carlsbad provides this Permission for Right of Entry for scheduled entry and maintenance work within an easement on your property described as: 'Pt:t c.; ~--e.-V\et,0, -~ r:;,. -. NAME: Moore Revocable Trust 09-24 1§- 37 lb-372-~ STREET ADDRESS: 3722-3728 Carlsbad Boulevard, Carlsbad CA 92008 ASSESSOR'S PARCEL NUMBER: 204-251-22-03 ------------------- For the purposes of facilitating sidewalk improvements on Carlsbad Boulevard and Hemlock Avenue, the City's contractor will need to perform work on your property. For further details regarding the subject improvements please refer to the attached exhibit. Specific project improvements requiring this entry include curb removal and sidewalk reconstruction adjacent to the southern perimeter of your property. Authorization of this Right-of-Entry Agreement grants the City and its contractor permission to enter and construct these improvements on the property addressed above. The City's contractor shall perform all work in a professional manner per the approved engineering plans and specifications. These documents will be provided after approval and upon request. The City will only be responsible for all damages and liability arising from the sole or active negligence or willful misconduct of the City, or its contractors, er:1tering the property for the above-stated reasons. When completed, the City will restore any affected real property to a condition similar to the existing condition before the construction. Permission described in this Agreement shall end when the project Notice of Completion is filed with the County Clerk's office. Therefore, I hereby grant the City of Carlsbad, and its contractor, permission to enter my property to construct the above-~escribed improve men~!? 7ha~ J S--i?,v~s ~-- ew-N-E-R, Print Name ©WNER, Signature Prc-~1i)t"1_,/-~Cr f1c--J1--u,-'.) lfuA-Pres,z!J-ev(,~ I Pace' (l__ 1/1--e.t--__:; AoA- DATE Remove and replace ex. concrete. Place concrete over ex. rock cutouts and above wall footing. Match grade at back of new ADA ramp and slope to toe of ex. wall. MPW Exhibit for Hemlock Ave and Carlsbad Blvd (SL 3/16/2022) Cap existing sprinkler heads. Remove and replace existing concrete (~110 SF). Place concrete over ex. rock cutouts and above wall footing. Perform pothole investigation in ex. rock cutout to determine depth to top of wall footing prior to removal of concrete. Ex. pole foundation to remain. Remove and replace existing sidewalk panel to nearest joint. DocuSign Envelope ID: 9ABB2BDC-959B-4BE6-BCEE-8DACE479186F I ----- 10/26/2021 Michael Ehrenfeld Company Insurance Agents An Acrisure Agency CA 0K07568 2655 Camino Del Rio North #200 San Diego CA 92108 Carol Russell (619)683-9990 (619)683-9999 crussell@ehrenfeldinsurance.com PORTILLO CONCRETE INC 3527 CITRUS ST LEMON GROVE CA 91945-1518 Financial Pacific Insurance Company 31453 Preferred Professional Insurance Company003699 21-22 GL, AU, XS, IM A X X X X Y 60531460 9/29/2021 7/29/2022 1,000,000 100,000 5,000 1,000,000 2,000,000 2,000,000 Employee Benefits 1,000,000 A X X X X Y 60531460 9/29/2021 7/29/2022 1,000,000 A X X X Y 60531460 9/29/2021 7/29/2022 2,000,000 2,000,000 B Y ON11963-01 10/21/2021 10/21/2022 X 1,000,000 1,000,000 1,000,000 A Commercial Inland Marine 60531460 9/29/2021 7/29/2022 Installation Floater $25,000 Deductible $1,000 Leased/Rented Equipment $250,000 RE: ALL OPERATIONS - CONCRETE REPAIR CITY OF CARLSBAD, ITS OFFICERS, OFFICIALS, EMPLOYEES AND VOLUNTEERS ARE INCLUDED AS ADDITIONAL INSURED PER FORMS ATTACHED. AUTO ADDITIONAL INSURED APPLIES PER ENDORSEMENT ATTACHED. WAIVER OF SUBROGATION APPLIES IN FAVOR OF CERTIFICATE HOLDER ON THE GENERAL LIABILITY, AUTO LIABILITY AND WORKERS COMPENSATION COVERAGES WHERE REQUIRED BY WRITTEN CONTRACT. CITY OF CARLSBAD/CMWD C/O EXIGIS INSURANCE COMPLIANCE SERVICES PO BOX 4668 - ECM #35050 NEW YORK, NY 10163-4668 graham.jordan@carlsbadca.gov Todd Tropio/KCASIA Y The ACORD name and logo are registered marks of ACORD CERTIFICATE HOLDER ©1988-2014 ACORD CORPORATION.All rights reserved. ACORD 25 (2014/01) AUTHORIZED REPRESENTATIVE CANCELLATION DATE (MM/DD/YYYY)CERTIFICATE OF LIABILITY INSURANCE LOCJECTPRO-POLICY GEN'L AGGREGATE LIMIT APPLIES PER: OCCURCLAIMS-MADE COMMERCIAL GENERAL LIABILITY PREMISES (Ea occurrence)$DAMAGE TO RENTED EACH OCCURRENCE $ MED EXP (Any one person)$ PERSONAL &ADV INJURY $ GENERAL AGGREGATE $ PRODUCTS - COMP/OP AGG $ $RETENTIONDED 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) INSRLTR TYPE OF INSURANCE POLICY NUMBER POLICY EFF(MM/DD/YYYY)POLICY EXP(MM/DD/YYYY)LIMITS PERSTATUTE OTH-ER E.L.EACH ACCIDENT E.L. DISEASE - EA EMPLOYEE E.L. DISEASE - POLICY LIMIT $ $ $ ANY PROPRIETOR/PARTNER/EXECUTIVE Ifyes,describe underDESCRIPTION OF OPERATIONS below (Mandatory in NH)OFFICER/MEMBER EXCLUDED? WORKERS COMPENSATIONAND EMPLOYERS' LIABILITY Y / N AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED HIRED AUTOS NON-OWNEDAUTOSAUTOS 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 PERIODINDICATED. 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. INSDADDL WVDSUBR 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 POLICIESBELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZEDREPRESENTATIVE 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 thecertificate 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): CONTACTNAME: 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 INACCORDANCE WITH THE POLICY PROVISIONS. INS025 (201401) ___., ACORD® I ~ I -□ □ -- R □ □ - -- -- -- -H I I I I I □ - I ✓J-J)__J~ POLICY NUMBER:COMMERCIAL GENERAL LIABILITYCG 20 37 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CG 20 37 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 1 ADDITIONAL INSURED OWNERS, LESSEES ORCONTRACTORSCOMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PARTPRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s)Or Organization(s)Location And Description Of Completed Operations Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury" or"property damage" caused, in whole or in part, by "your work" at the location designated and described in the Schedule of this endorsement performed for that additional insured andincluded in the "products -completed operations hazard". However: 1.The insurance afforded to such additional insured only applies to the extent permitted by law; and 2.If coverage provided to the additional insuredis required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement toprovide for such additional insured. B.With respect to the insurance afforded to these additional insureds, the following is added to Section III Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on be half of the additional insured is theamount of insurance: 1.Required by the contract or agreement; or 2.Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. Primary Clause: When the coverage afforded by this endorsement applies and when required by written contract, coverage provided to the additional insured is primary and our obligations are not affected unless any of the other available insurance is also primary. Insurance afforded to an additional insured on policies where it is the named insured will be non-contributory. For the Purposes of this endorsement "Residential Structure" is defined as follows: "Residential Structure" means any structure where 30% or more of the square foot area is used or is intended to be used for human residency including but not limited to single or multifamily housing, condominiums, townhouses, co- operatives or planned unit developments and also includes their common areas and/or appurtenant structures (including pools, hot tubs, detached garages, guest houses or any similar structures). When there is no individual ownership of units, residential structure does not include military housing, college/university housing or dormitories, long term care facilities, hotels, motels, or apartments. Residential structure also does not include hospitals or prisons. Any person(s) or organization(s) whom you are required toadd as an additional insured on this policy under a writtencontract or written agreement. Various Projects and Project Locations Exclusions: This endorsement does not apply to workperformed on Residential Structures. 60531460 Primary Clause: When the coverage afforded by this endorsement applies and when required by written contract,coverage provided to the additional insured is primary and our obligations are not affected unless any of the otheravailable insurance is also primary. Insurance afforded to an additional insured on policies where it is the namedinsured will be non-contributory. Any person(s) or organization(s) whom you are required toadd as an additional insured on this policy under a writtencontract or written agreement Various Projects and Project Locations 60531460POLICY NUMBER: COMMERCIAL GENERAL LIABILITY CG 20 10 0413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED -OWNERS, LESSEES OR CONTRACTORS -SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Location(s) Of Covered Operations Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II -Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured(s) at the location(s) designated above. However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to "bodily injury" or "property damage" occurring after: 1. All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or 2. That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. CG 20 10 0413 © Insurance Services Office, Inc., 2012 Page 1 of 2 C. With respect to the insurance afforded to these additional insureds, the following is added to Section Ill -Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. Page 2 of 2 © Insurance Services Office, Inc., 2012 CG 20 10 0413 CG 71 03 02 15 ULTRA LIABILITY PLUS ENDORSEMENT COMMERCIAL GENERAL LIABILITY EXTENSION ENDORSEMENT SUMMARY OF COVERAGES This is a summary of the various additional coverages and coverage modifications provided by this endorsement. No coverage is provided by this summary. * Extended Property Damage * Expanded Fire Legal Liability to include Explosion, Lightning and Sprinkler Leakage * Coverage for non-owned watercraft is extended to 51 feet in length * Property Damage - Borrowed Equipment * Property Damage Liability - Elevators * Coverage D - Voluntary Property Damage Coverage $5,000 Occurrence with a $10,000 Aggregate * Coverage E - Care, Custody and Control Property Damage Coverage $25,000 Occurrence with a $100,000 Aggregate - $500 Deductible * Coverage F - Electronic Data Liability Coverage - $50,000 * Coverage G - Product Recall Expense $25,000 Each Recall Limit with a $50,000 Aggregate - $1,000 Deductible * Coverage H - Water Damage Legal Liability - $25,000 * Increase in Supplementary Payments: Bail Bonds to $1,000 * Increase in Supplementary Payments: Loss of Earnings to $500 * For newly formed or acquired organizations - extend the reporting requirement to 180 days * Broadened Named Insured * Automatic Additional Insured - Owners, Lessees or Contractors - Automatic Status When Required in Construction Agreement With You * Automatic Additional Insured - Vendors * Automatic Additional Insured - Lessor of Leased Equipment Automatic Status When Required in Lease Agreement With You * Automatic Additional Insured - Managers or Lessor of Premises * Additional Insured - Engineers, Architects or Surveyors Not Engaged by the Named Insured * Additional Insured - Employee Injury to Another Employee * Automatically included - Aggregate Limits of Insurance (per location) * Automatically included - Aggregate Limits of Insurance (per project) * Knowledge of occurrence - Knowledge of an “occurrence”, “claim or suit” by your agent, servant or employee shall not in itself constitute knowledge of the named insured unless an officer of the named insured has received such notice from the agent, servant or employee * Blanket Waiver of Subrogation * Liberalization Condition * Unintentional failure to disclose all hazards. If you unintentionally fail to disclose any hazards existing at the inception date of your policy, we will not deny coverage under this Coverage Form because of such failure. However, this provision does not affect our right to collect additional premium or exercise our right of cancellation or non-renewal. * Mobile equipment to include snow removal, road maintenance and street cleaning equipment less than 1,000 lbs GVW * Bodily Injury Redefined REFER TO THE ACTUAL ENDORSEMENT FOLLOWING ON PAGES 2 THROUGH 12 FOR CHANGES AFFECTING YOUR INSURANCE PROTECTION CG 71 03 02 15 Includes copyrighted material of Insurance Services Office, Inc., with its permission.Page 1 of 12 CG 71 03 02 15 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ULTRA LIABILITY PLUS ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SECTION I - COVERAGES A.The following changes are made at COVERAGE A - BODILY INJURY AND PROPERTY DAMAGE LIABILITY 1. Extended Property Damage At 2. Exclusions exclusion a. Expected or Intended Injury is replaced with the following: “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. Expanded Fire Legal Liability At 2. Exclusions the last paragraph is deleted and replaced by the following: Exclusions c.through n.do not apply to damage by fire, explosion, lightning, smoke resulting from such fire, explosion, or lightning or sprinkler leakage to premises while rented to you or temporarily occupied by you with permission of this owner. A separate limit of insurance applies to this coverage as described in SECTION III - LIMITS OF INSURANCE . 3. Non-Owned Watercraft At 2. Exclusions exclusion g. Aircraft, Auto Or Watercraft (2) (a)is deleted and replaced by the following:(a) Less than 51 feet long; 4. Property Damage – Borrowed Equipment At 2. Exclusions the following is added to paragraph (4)of exclusion j. Damage To Property : This exclusion does not apply to “property damage” to borrowed equipment while at a jobsite and while not being used to perform operations. The most we will pay for “property damage” to any one piece of borrowed equipment under this coverage is $25,000 per occurrence. The insurance afforded under this provision is excess over any valid and collectible property insurance (including deductible) available to the insured, whether primary, excess, contingent or on any other basis. 5. Property Damage Liability – Elevators At 2. Exclusions the following is added to paragraphs (3), (4)and (6)of exclusion j. Damage To Property: This exclusion does not apply to “property damage” resulting from the use of elevators. However, any insurance provided for such “property damage” is excess over any valid and collectible property insurance (including deductible) available to the insured, whether primary, excess, contingent or on any other basis. B.The following coverages are added: 1. COVERAGE D - VOLUNTARY PROPERTY DAMAGE COVERAGE “Property damage” to property of others caused by the insured: a.While in your possession; or b.Arising out of “your work”. Coverage applies at the request of the insured, whether or not the insured is legally obligated to pay. For the purposes of this Voluntary Property Damage Coverage only: Exclusion j. Damage to Property is deleted and replaced by the following: CG 71 03 02 15 Includes copyrighted material of Insurance Services Office, Inc., with its permission.Page 2 of 12 2. CG 71 03 02 15 j.Damage to Property “Property damage” to: (1)Property held by the insured for servicing, repair, storage or sale at premises you own, rent, lease, operate or use; (2)Property transported by or damage caused by any “automobile”, “watercraft” or “aircraft” you own, hire or lease; (3)Property you own, rent, lease, borrow or use. The amount we will pay is limited as described below in SECTION III - LIMITS OF INSURANCE For the purposes of this Voluntary Property Damage Coverage, our right and duty to defend ends when we have paid the Limit of Liability or the Aggregate Limit for this coverage. 2. COVERAGE E - CARE, CUSTODY AND CONTROL PROPERTY DAMAGE COVERAGE For the purpose of this Care, Custody and Control Property Damage Coverage only: a.Item (4)of Exclusion j.does not apply. The amount we will pay is limited as described below in SECTION III - LIMITS OF INSURANCE For the purposes of this Care, Custody and Control Property Damage Coverage, our right and duty to defend ends when we have paid the Limit of Liability or the Aggregate Limit for this coverage. 3. COVERAGE F - ELECTRONIC DATA LIABILITY COVERAGE For the purposes of this Electronic Data Liability Coverage only: a.Exclusion p.of Coverage A – Bodily Injury And Property Damage Liability in Section I – Coverages is replaced by the following: 2.Exclusions This insurance does not apply to: 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” that does not result from physical injury to tangible property. However, this exclusion does not apply to liability for damages because of “bodily injury” b. “Property Damage”means: (1)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 (2)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; or (3)Loss of, loss of use of, damage to, corruption of, inability to access or inability to properly manipulate “electronic data”, resulting from physical injury to tangible property. All such loss of “electronic data” shall be deemed to occur at the time of the “occurrence” that caused it. For the purposes of this Electronic Data Liability Coverage, “electronic data” is not tangible property. The amount we will pay is limited as described below in SECTION III - LIMITS OF INSURANCE 4. COVERAGE G - PRODUCT RECALL EXPENSE a.Insuring Agreement (1)We will pay 90% of "product recall expense" you incur as a result of a "product recall" you initiate during the coverage period. (2)We will only pay for "product recall expense" arising out of "your products" which have been physically relinquished to others. The amount we will pay is limited as described below in SECTION III - LIMITS OF INSURANCE CG 71 03 02 15 Includes copyrighted material of Insurance Services Office, Inc., with its permission.Page 3 of 12 CG 71 03 02 15 b. Exclusions This insurance does not apply to "product recall expense" arising out of: (1)Any fact, circumstance or situation which existed at the inception date of the policy and which you were aware of, or could reasonably have foreseen that would have resulted in a "product recall". (2)Deterioration, decomposition or transformation of a chemical nature, except if caused by an error in the manufacture, design, processing, storage, or transportation of "your product". (3)The withdrawal of similar products or batches that are not defective, when a defect in another product or batch has been found. (4)Acts, errors or omissions of any of your employees, done with prior knowledge of any of your officers or directors. (5)Inherent vice, meaning a natural condition of property that causes it to deteriorate or become damaged. (6)“Bodily Injury” or “Property Damage”. (7)Failure of “your product” to accomplish its intended purpose, including any breach of warranty of fitness, quality, efficacy or efficiency, whether written or implied. (8)Loss of reputation, customer faith or approval, or any costs incurred to regain customer market, or any other consequential damages. (9)Legal fees or expenses. (10)Damages claimed for any loss, cost or expense incurred by you or others for the loss of use of “your product”. (11)“Product recall expense” arising from the “product recall” of any of “your products” for which coverage is excluded by endorsement. (12)Any “product recall” initiated due to the expiration of the designated shelf life of “your product”. 5. COVERAGE H - WATER DAMAGE LEGAL LIABILITY The Insurance provided under Coverage H (Section I) applies to “property damage” arising out of water damage to premises that are both rented to and occupied by you. The Limit under this coverage shall not be in addition to the Damage To Premises Rented To You Limit. The amount we will pay is limited as described below in SECTION III - LIMITS OF INSURANCE C. SUPPLEMENTARY PAYMENTS - COVERAGES A AND B is amended: 1.To read SUPPLEMENTARY PAYMENTS 2. Bail Bonds Item 1.b.is amended as follows: b.Up to $1,000 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. 3. Loss of Earnings Item 1.d.is amended as follows: 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 $500 a day because of time off from work. 4.The following language is added to Item 1. However, we shall have none of the duties set forth above when this insurance applies only for Voluntary Property Damage Coverage and/or Care, Custody or Control Property Damage Coverage and we have paid the Limit of Liability or the Aggregate Limit for these coverages. CG 71 03 02 15 Includes copyrighted material of Insurance Services Office, Inc., with its permission.Page 4 of 12 CG 71 03 02 15 SECTION II- WHO IS AN INSURED A.The following change is made: Extended Reporting Requirements Item 3.a.is deleted and replaced by the following : a.Coverage under this provision is afforded only until the 180th day after you acquire or form the organization or the end of the policy period, whichever is earlier. B.The following provisions are added: BROAD FORM NAMED INSURED Item 1.f.is added as follows: f.Any legally incorporated entity of which you own more than 50 percent of the voting stock during the policy period only if there is no other similar insurance available to that entity. However: (1)Coverage A does not apply to “bodily injury” or “property damage” that occurred before you acquired more than 50 percent of the voting stock; and (2)Coverage B does not apply to “personal and advertising injury” arising out of an offense committed before you acquired more than 50 percent of the voting stock. 5. Additional Insured - Owners, Lessees or Contractors - Automatic Status When Required in Construction or Service Agreement With You a.Any person or organization for whom you are performing operations when you and such person or organization have agreed in writing in a contract or agreement that such person or organization be added as an additional insured on your policy is an insured. Such person or organization is an additional insured only with respect to your liability for "bodily injury", "property damage" or "personal and advertising injury" which may be imputed to that person or organization directly arising out of: 1.Your acts or omissions; or 2.The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured. However, the insurance afforded to such additional insured: 1.Only applies to the extent permitted by law; and 2.Will not be broader than that which you are required by the contract or agreement to provide for such additional insured. b.With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to: 1."Bodily injury", "property damage" or "personal and advertising injury" arising out of the rendering of, or the failure to render, any professional architectural, engineering or surveying services, including: a.The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or b.Supervisory, inspection, architectural or engineering activities. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by that insured, if the "occurrence" which caused the "bodily injury" or "property damage", or the offense which caused the "personal and advertising injury", involved the rendering of or the failure to render any professional architectural, engineering or surveying services. 2."Bodily injury" or "property damage" occurring after: a.All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or CG 71 03 02 15 Includes copyrighted material of Insurance Services Office, Inc., with its permission.Page 5 of 12 4. CG 71 03 02 15 b.That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. 6. Additional Insured - Vendors a.Any person(s) or organization(s) (referred to throughout this additional coverage as vendor), but only with respect to "bodily injury" or "property damage", which may be imputed to that person(s) or organization(s) arising out of “your products” shown with the Schedule which are distributed or sold in the regular course of the vendor's business is an insured. However: (1)The insurance afforded to such vendor only applies to the extent permitted by law; and (2)If coverage provided to the vendor is required by a contract or agreement, the insurance afforded to such vendor will not be broader than that which you are required by the contract or agreement to provide for such vendor. b.With respect to the insurance afforded to these vendors, the following additional exclusions apply: (1)This insurance afforded the vendor does not apply to: (a)“Bodily injury” or “property damage” for which the vendor 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 that the vendor would have in the absence of the contract or agreement; (b)Any express warranty unauthorized by you; (c)Any physical or chemical change in the product made intentionally by the vendor; (d)Repackaging, except when unpacked solely for the purpose of inspection, demonstration, testing, or the substitution of parts under instructions from the manufacturer, and then repackaged in the original container. (e)Any failure to make such inspections, adjustments, tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business, in connection with the distribution or sale of products. (f)Demonstration, installation, servicing or repair operations, except such operations performed at the vendor's premises in connection with the sale of the product. (g)Products which, after distribution or sale by you, have been labeled or relabeled or used as a container, part or ingredient of any other thing or substance by or for the vendor. (h)"Bodily injury" or "property damage" arising out of the sole negligence of the vendor for its own acts or omissions or those of its employees or anyone else acting on its behalf. However, this exclusion does not apply to: i.The exceptions contained in Sub-paragraphs d.or f.; or ii.Such inspections, adjustments, tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business, in connection with the distribution or sale of the products. (2)This insurance does not apply to any insured person or organization, from whom you have acquired such products, or any ingredient, part or container, entering into, accompanying or containing such products. 7. Additional Insured – Lessor of Leased Equipment – Automatic Status When Required in Lease Agreement With You a.Any person(s) or organization(s) from whom you lease equipment when you and such person(s) or organization(s) have agreed in writing in a contract or agreement that such person(s) or organization(s) be added as an additional insured on your policy. Such person(s) or organization(s) is an insured only with respect to your liability for "bodily injury", "property damage" or "personal and advertising injury" directly arising out of the maintenance, operation or use of equipment leased to you, which may be imputed to such person or organization as the lessor of equipment. CG 71 03 02 15 Includes copyrighted material of Insurance Services Office, Inc., with its permission.Page 6 of 12 CG 71 03 02 15 However, the insurance afforded to such additional insured: (1)Only applies to the extent permitted by law; and (2)Will not be broader than that which you are required by the contract or agreement to provide for such additional insured. A person's or organization's status as an additional insured under this endorsement ends when their contract or agreement with you for such leased equipment ends. b.With respect to the insurance afforded to these additional insureds, this insurance does not apply to any "occurrence" which takes place after the equipment lease expires. 8. Additional Insured – Managers or Lessors of Premises a.Any person(s) or organization(s), 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: (1)Any "occurrence" which takes place after you cease to be a tenant in that premises. (2)Structural alterations, new construction or demolition operations performed by or on behalf of the person(s) or organization(s) afforded coverage by this additional coverage. However: (1)The insurance afforded to such additional insured only applies to the extent permitted by law; and (2)If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. 9. Additional Insured - Engineers, Architects or Surveyors Not Engaged by the Named Insured a.Any architects, engineers or surveyors who are not engaged by you are insureds, but only with respect to liability for "bodily injury" or "property damage" or “personal and advertising injury" which may be imputed to that architect, engineer or surveyor arising out of: (1)Your acts or omissions; or (2)Your acts or omissions of those acting on your behalf; in the performance of your ongoing operations performed by you or on your behalf. But only if such architects, engineers or surveyors, while not engaged by you, are contractually required to be added as an additional insured to your policy. However, the insurance afforded to such additional insured: (1)Only applies to the extent permitted by law; and (2)Will not be broader than that which you are required by the contract or agreement to provide for such additional insured. b.With respect to the insurance afforded to these additional insureds, the following additional exclusion applies: This insurance does not apply to "bodily injury", "property damage" or "personal and advertising injury" arising out of the rendering of or failure to render any professional services, including: (1)The preparing, approving, or failing to prepare or approve, maps, drawings, opinions, reports, surveys, change orders, designs or specifications; or (2)Supervisory, inspection or engineering services. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by that insured, if the "occurrence" which caused the “bodily injury" or "property damage", or the offense which caused the "personal and advertising injury", involved the rendering of or the failure to render any professional services. CG 71 03 02 15 Includes copyrighted material of Insurance Services Office, Inc., with its permission.Page 7 of 12 CG 71 03 02 15 10. Additional Insured - Employee Injury to Another Employee With respect to your “employees” who occupy positions which are supervisory in nature: Paragraph 2.a.(1)of SECTION II – WHO IS A NAMED INSURED is amended to read: a.“Bodily injury” or “personal and advertising injury” (1)To you, to your partners or members (if you are a partnership or joint venture), or to your members (if you are a limited liability company); (2)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)above; or (3)Arising out of his or her providing or failing to provide professional healthcare services. Paragraph 3.a.is deleted. For the purpose of this Item 10 only, a position is deemed to be supervisory in nature if that person performs principle work which is substantially different from that of his or her subordinates and has authority to hire, direct, discipline or discharge. SECTION III - LIMITS OF INSURANCE A. The following Items are deleted and replaced by the following: 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;and d.Damages under Coverage H. 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" and Coverage G. 6.Subject to 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, explosion, lightning, smoke resulting from such fire, explosion, or lightning or sprinkler leakage while rented to you or temporarily occupied by you with permission of the owner. B.The following are added: 8.Subject to Paragraph 5.of SECTION III – LIMITS OF INSURANCE $25,000 is the most we will pay under Coverage H for Water Damage Legal Liability. 9. Coverage G - Product Recall Expense Aggregate Limit $50,000 Each Product Recall Limit $25,000 a.The Aggregate Limit shown above is the most we will pay for the sum of all "product recall expense" you incur as a result of all "product recalls" you initiate during the endorsement period. b.The Each Product Recall Limit shown above is the most we will pay, subject to the Aggregate and $1,000 deductible, for "product recall expense" you incur for any one "product recall” you initiate during the endorsement period. We will only pay for the amount of Product Recall Expenses which are in excess of the deductible amount. The deductible applies separately to each Product Recall. The limits of insurance will not be reduced by the amount of this deductible. We may, or will if required by law, pay all or any part of any deductible amount. Upon notice of our payment of a deductible amount, you shall promptly reimburse us for the part of the deductible amount we paid. CG 71 03 02 15 Includes copyrighted material of Insurance Services Office, Inc., with its permission.Page 8 of 12 CG 71 03 02 15 Aggregate Limits of Insurance (Per Location) The General Aggregate Limit applies separately to each of your "locations" owned by or rented to you or temporarily occupied by you with the permission of the owner. "Location" means premises involving the same or connecting lots, or premises whose connection is interrupted only by a street, roadway, waterway or right-of-way of a railroad. Aggregate Limits of Insurance (Per Project) The General Aggregate Limit applies separately to each of your projects away from premises owned by or rented to you. 12.With respects to the insurance afforded to additional insureds afforded coverage by items 5 through 10 of SECTION II – WHO IS AN INSURED above, the following is added: The most we will pay on behalf of the additional insured is the amount of insurance: a.Required by the contract or agreement; 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. 13.Subject to 5.of SECTION III – LIMITS OF INSURANCE , a $5,000 "occurrence" limit and a $10,000 "aggregate" limit is the most we will pay under Coverage A for damages because of "property damage" covered under Coverage D - Voluntary Property Damage Coverage . For the purposes of this Voluntary Property Damage Coverage, our right and duty to defend ends when we have paid the Limit of Liability or the Aggregate Limit for this coverage. 14.Subject to 5.of SECTION III – LIMITS OF INSURANCE , a $25,000 "occurrence" limit and a $100,000 "aggregate" limit is the most we will pay under Coverage E - Care, Custody and Control Coverage regardless of the number of: a.Insureds; b.Claims made or "suits" brought; or c.Persons or organizations making claims or bringing "suits". Deductible - Our obligation to pay damages on your behalf applies only to the amount of damages in excess of $500. This deductible applies to all damages because of "property damage" as the result of any one "occurrence" regardless of the number of persons or organizations who sustain damages because of that "occurrence". We may pay any part or all of the deductible amount to effect settlement of any claim or "suit" and upon notification of the action taken, you shall promptly reimburse us for such part of the deductible amount as has been paid by us. As respects this coverage "Aggregate" is the maximum amount we will pay for all covered "occurrences" during one policy period. For the purposes of this Care, Custody and Control Property Damage Coverage, our right and duty to defend ends when we have paid the Limit of Liability or the Aggregate Limit for this coverage. 15.Subject to 5.of SECTION III – LIMITS OF INSURANCE , the most we will pay for “property damage” under Coverage F - Electronic Data Liability Coverage for loss of “electronic data” is $50,000 without regard to the number of “occurrences”. CG 71 03 02 15 Includes copyrighted material of Insurance Services Office, Inc., with its permission.Page 9 of 12 11. 10. CG 71 03 02 15 SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS A.The following conditions are amended: 1. Knowledge of Occurrence a.Condition 2.,Items a.and b. are deleted and replaced by the following: (1)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. Knowledge of an "occurrence" by your agent, servant or employee shall not in itself constitute knowledge of the named insured unless an officer of the named insured has received such notice from the agent, servant or employee. To the extent possible, notice should include: i.How, when and where the "occurrence" 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 "occurrence" or offense. (b)If a claim is made or "suit" is brought against any insured, you must: i.Immediately record the specifics of the claim or "suit" and the date received; and ii.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. Knowledge of a claim or "suit" by your agent, servant or employee shall not in itself constitute knowledge of the named insured unless an officer of the named insured has received such notice from the agent, servant or employee. 2.Where Broad Form Named Insured is added in SECTION II – WHO IS AN INSURED of this endorsement, Condition 4. Other Insurance b. Excess Insurance (1).(a)is replaced by the following: Any of the other insurance, whether primary, excess, contingent or on any other basis, that is available to an insured solely by reason of ownership by you of more than 50 percent of the voting stock, and not withstanding any other language in any other policy. This provision does not apply to a policy written to apply specifically in excess of this policy. B.The following are added: 1.Condition (5) of 2.c. (5)Upon our request, replace or repair the property covered under Voluntary Property Damage Coverage at your actual cost, excluding profit or overhead. 10. Blanket Waiver Of Subrogation We waive any right of recovery we may have against any person or organization because of payments we make for injury or damage arising out of: premises owned or occupied by or rented or loaned to you, ongoing operations performed by you or on your behalf, done under a contract with that person or organization, “your work”, or “your products”. We waive this right where you have agreed to do so as part of a written contract, executed by you before the “bodily injury” or “property damage” occurs or the “personal injury” or “advertising injury” offense is committed. 11. Liberalization If a revision to this Coverage Part, which would provide more coverage with no additional premium becomes effective during the policy period in the state designated for the first Named Insured shown in the Declarations, your policy will automatically provide this additional coverage on the effective date of the revision. 12. Unintentional Failure to Disclose All Hazards Based on our reliance on your representations as to existing hazards, if you unintentionally should fail to disclose all such hazards at the inception date of your policy, we will not deny coverage under this Coverage Part because of such failure. However, this provision does not affect our right to collect additional premium or exercise our right of cancellation or non-renewal. CG 71 03 02 15 Includes copyrighted material of Insurance Services Office, Inc., with its permission.Page 10 of 12 (a) CG 71 03 02 15 13.The following conditions are added in regard to Coverage G - Product Recall Expense: In event of a "product recall", you must: a.See to it that we are notified as soon as practicable of a "product recall". To the extent possible, notice should include how, when and where the "product recall" took place and estimated "product recall expense". b.Take all reasonable steps to minimize "product recall expense". This will not increase the limits of insurance. c.If requested, permit us to question you under oath at such times as may be reasonably required about any matter relating to this insurance or your claim, including your books and records. Your answers must be signed. d.Permit us to inspect and obtain other information proving the loss. You must send us a signed, sworn statement of loss containing the information we request to investigate the claim. You must do this within 60 days after our request. e.Cooperate with us in the investigation or settlement of any claim. f.Assist us upon our request, in the enforcement of any rights against any person or organization which may be liable to you because of loss to which this insurance applies. SECTION V – DEFINITIONS A.At item 12. Mobile Equipment the wording at f.(1)is deleted and replaced by the following: f.(1)Equipment designed primarily for: (a)Snow removal; (b)Road maintenance, but not construction or resurfacing; or (c)Street cleaning; except for such vehicles that have a gross vehicle weight less than 1,000 lbs which are not designed for highway use. B.Item 3. “bodily injury”is deleted and replaced with the following: 3.“bodily injury” means physical injury, sickness or disease sustained by a person. This includes mental anguish, mental injury, shock, fright or death that results from such physical injury, sickness or disease. C.The following definitions are added for this endorsement only: 23. “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, tape drives, cells, data processing devices or any other media which are used with electronically controlled equipment. 24. "Product recall"means a withdrawal or removal from the market of "your product" based on the determination by you or any regulatory or governmental agency that: a.The use or consumption of "your product" has caused or will cause actual or alleged "bodily injury" or "property damage"; and b.Such determination requires you to recover possession or control of "your product" from any distributor, purchaser or user, to repair or replace "your product", but only if "your product" is unfit for use or consumption, or is hazardous as a result of: (1)An error or omission by an insured in the design, manufacturing, processing, labeling, storage, or transportation of "your product"; or (2)Actual or alleged intentional, malicious or wrongful alteration or contamination of "your product" by someone other than you. CG 71 03 02 15 Includes copyrighted material of Insurance Services Office, Inc., with its permission.Page 11 of 12 CG 71 03 02 15 25. "Product recall expense"means reasonable and necessary expenses for: a.Telephone, radio and television communication and printed advertisements, including stationery, envelopes and postage. b.Transporting recalled products from any purchaser, distributor or user, to locations designated by you. c.Remuneration paid to your employees for overtime, as well as remuneration paid to additional employees or independent contractors you hire. d.Transportation and accommodation expense incurred by your employees. e.Rental expense incurred for temporary locations used to store recalled products. f.Expense incurred to properly dispose of recalled products, including packaging that cannot be reused. g.Transportation expenses incurred to replace recalled products. h.Repairing, redistributing or replacing covered recalled products with like products or substitutes, not to exceed your original cost of manufacturing, processing, acquisition and/or distribution. These expenses must be incurred as a result of a "product recall". CG 71 03 02 15 Includes copyrighted material of Insurance Services Office, Inc., with its permission.Page 12 of 12 COMMERCIAL AUTO CA 71 09 01 17 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CA 71 09 01 17 Includes copyrighted material of Insurance Services Office, Inc., with its permission.Page 1 of 7 BUSINESS AUTO ULTRA ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM COMMON POLICY CONDITIONS COVERAGE INDEX DESCRIPTION PAGE Temporary Substitute Auto Physical Damage 2 Broad Form Insured 2 Employee as Insureds 2 Additional Insured Status by Contract, Agreement or Permit 2 Bail Bond Coverage 3 Loss of Earnings Coverage 3 Amended Fellow Employee Coverage 3 Towing and Labor 3 Physical Damage Additional Transportation Expense Coverage 3 Extra Expense - Theft 3 Rental Reimbursement and Additional Transportation Expense 4 Personal Effects Coverage 4 Personal Property of Others 4 Locksmith Coverage 4 Vehicle Wrap Coverage 5 Airbag Accidental Discharge 5 Audio, Visual and Data Electronic Equipment Coverage 5 Auto Loan/Lease Total Loss Protection 5 Glass Repair – Deductible Amendment 5 Amended Duties in the Event of Accident, Claim, Suit or Loss 6 Waiver of Subrogation Required by Contract 6 Unintentional Failure to Disclose 6 Hired, Leased, Rented or Borrowed Auto Physical Damage 6 Mental Anguish 7 Extended Cancellation Condition 7 The COVERAGE INDEX set forth above is informational only and grants no coverage. Terms set forth in are likewise for information only and by themselves shall be deemed to grant no coverage. Page 2 of 7 Includes copyrighted material of Insurance Services Office, Inc., with its permission.CA 71 09 01 17 A. TEMPORARY SUBSTITUTE AUTO PHYSICAL DAMAGE SECTION I – COVERED AUTOS, paragraph C. Certain Trailers, Mobile Equipment and Temporary Substitute Autos is amended by adding the following at the end of the existing language: If Physical Damage Coverage is provided under this Coverage form for an "auto" you own, the Physical Damage coverages provided for that owned "auto" are extended to any "auto" you do not own while used with the permission of its owner as a temporary substitute for the covered "auto" you own that is out of service because of its breakdown, repair, servicing, "loss", or destruction B. BROADENED LIABILITY COVERAGES SECTION II – LIABILITY COVERAGE in Paragraph A. Coverage at 1. Who Is An Insured is amended to include the following: d.Any legally incorporated subsidiary in which you own more than 50% of the voting stock on the effective date of the Coverage Form. However, the Named Insured does not include any subsidiary that is an "insured" under any other automobile policy or would be an "insured" under such a policy but for its termination or the exhaustion of its Limit of Insurance. e.Any organization that is acquired or formed by you, during the term of this policy and over which you maintain majority ownership. However, the Named Insured does not include any newly formed or acquired organization: (1)That is a joint venture or partnership, (2)That is an "insured" under any other policy, (3)That has exhausted its Limits of Insurance under any other policy, or (4)180 days or more after its acquisition or formation by you, unless you have given us notice of the acquisition or formation Coverage does not apply to "bodily injury" or "property damage" that results from an accident that occurred before you formed or acquired the organization. f.Any employee of yours while acting in the course of your business or your personal affairs while using a covered "auto" you do not own, hire or borrow. g.Any person or organization whom you are required to add as an additional insured on this policy under a written contract or agreement; but the written contract or agreement must be: (1)Currently in effect or becoming effective during the term of this policy; and (2)Executed prior to the "bodily injury" or "property damage." The additional insured status will apply only with respect to your liability for "bodily injury" or "property damage" which may be imputed to that person(s) or organization(s) directly arising out of the ownership, maintenance or use of the covered "autos" at the location(s) designated, if any. Coverage provided by this endorsement will not exceed the limits of liability required by the written contract or written agreement even if the limits of liability stated in the policy exceed those limits. This endorsement shall not increase the limits stated in Section II. C. Limits of Insurance. For any covered "auto" you own this Coverage Form provides primary coverage. CA 71 09 01 17 Includes copyrighted material of Insurance Services Office, Inc., with its permission.Page 3 of 7 C. BROADENED SUPPLEMENTARY PAYMENTS SECTION II. LIABILITY A. Coverage 2. Coverage Extensions a. Supplementary Payments (2)and (4)are replaced by the following: (2)Up to $5,000 for cost of bail bonds (including bonds for related traffic violations) required because of an "accident" we cover. We do not have to furnish these bonds. (4)All reasonable expenses incurred by the "insured" at our request, including actual loss of earning up to $500 a day because of time off from work. D. AMENDED FELLOW EMPLOYEE EXCLUSION Only with respect to your "employees" who occupy positions which are supervisory in nature,SECTION II. LIABILITY B. Exclusion 5. Fellow Employee is replaced by: 5. Fellow Employee "Bodily Injury": a.To you, or your partners or members (if you are a partnership or joint venture), or to your members (if you are a limited liability company); b.To your "executive officers" and directors (if you are an organization other than a partnership, joint venture, or limited liability company) but only with respect to performance of their duties as your officers or directors; c.For which there is an obligation to share damages with or repay someone else who must pay damages because of the injury described in paragraph a and b above; or d.Arising out of his or her providing or failing to provide professional health care services. For purposes of this endorsement, a position is deemed to be supervisory in nature if that person performs principle work which is substantially different from that of his or her subordinates and has authority to hire, transfer, direct, discipline or discharge. E. BROADENED PHYSICAL DAMAGE COVERAGES SECTION III – PHYSICAL DAMAGE COVERAGE A. Coverage is amended as follows: 2. Towing is deleted and replaced with the following: 2. Towing and Labor We will pay towing and labor costs incurred, up to the limits shown below, each time a covered "auto" is disabled: a.For private passenger type vehicles we will pay up to $100 per disablement. b.For all other covered "auto's" we will pay up to $500 per disablement However, the labor must be performed at the place of disablement. 4. Coverage Extensions a. Transportation Expenses is amended to provide the following limits: We will pay up to $60 per day to a maximum of $1,800. All other terms and provisions of this section remain applicable. The following language is added to 4. Coverage Extensions: c. Theft Recovery Expense If you have purchased Comprehensive Coverage on an "auto" that is stolen, we will pay the expense of returning that stolen auto to you. The limit for this coverage extension is $5,000. Page 4 of 7 Includes copyrighted material of Insurance Services Office, Inc., with its permission.CA 71 09 01 17 d. Rental Reimbursement We will provide Rental Reimbursement and Additional Expense coverage only for those Physical Damage coverages for which a premium is shown in the Declarations or schedule pages. Coverage applies only to a covered "auto". (1)We will pay for auto rental expense and the expense incurred by you because of "loss" to remove and transfer your materials and equipment from a covered "auto" to a covered "auto." Payment applies in addition to the otherwise applicable coverage you have on a covered "auto." No deductible applies to this coverage. (2)We will pay only for expenses incurred during the policy period and beginning 24 hours after the "loss" and ending, regardless of the policy's expiration, with the lesser of the following number of days: (a)The number of days reasonably required to repair or replace the covered "auto." If "loss" is caused by theft, this number of days is added to the number of days it takes to locate the covered "auto" and return it to you, or (b)30 days. (3)Our payment is limited to the lesser of the following amounts: (a)Necessary and actual expenses incurred; or (b)$75 per day. (c)This coverage does not apply while there are spare or reserve "autos" available to you for your operations. (d)If "loss" results from the total theft of a covered "auto" of the private passenger or light truck type, we will pay under this coverage only that amount of your rental reimbursement expense which is not already provided for under the SECTION III – PHYSICAL DAMAGE COVERAGE, A. Coverage, 4. Coverage Extensions, a. Transportation Expenses. e. Personal Effects If you have purchased Comprehensive Coverage on this policy for an "auto" you own and that "auto" is stolen, we will pay, without application of a deductible, up to $500 for Personal Effects stolen with the "auto". The insurance provided under this provision is excess over any other collectible insurance. For this coverage extension, Personal Effects means tangible property that is worn or carried by an "insured". f. Personal Property of Others We will pay up to $500 for loss to personal property of others in or on your covered "auto." This coverage applies only in the event of "loss" to your covered "auto" caused by fire, lightning, explosion, theft, mischief or vandalism, the covered "auto's" collision with another object, or the covered "auto's" overturn. No deductibles apply to this coverage. g. Locksmith Coverage We will pay up to $250 per occurrence for necessary locksmith services for keys locked inside a covered private passenger "auto". The deductible is waived for these services. CA 71 09 01 17 Includes copyrighted material of Insurance Services Office, Inc., with its permission.Page 5 of 7 h. Vehicle Wrap Coverage If you have Comprehensive or Collision coverage on an "auto" that is a total loss, in addition to the actual cash value of the "auto", we will pay up to $1,000 for vinyl vehicle wraps which are displayed on the covered "auto" at the time of total loss. Regardless of the number of autos deemed a total loss, the most we will pay under this Vehicle Wrap Coverage for any one "loss" is $5,000. For purposes of this coverage provision, signs or other graphics painted or magnetically affixed to the vehicle are not considered vehicle wraps. F. SECTION III – PHYSICAL DAMAGE COVERAGE, B. Exclusions is amended at 3.to include the following language: If you have purchased Comprehensive or Collision Coverage under this policy, this exclusion does not apply to mechanical breakdown relating to the accidental discharge of an air bag. This coverage applies only to a covered auto you own and is excess of any other collectible insurance or warranty. No deductible applies to this coverage. G. BROADENED LIMITS OF INSURANCE SECTION III – PHYSICAL DAMAGE COVERAGE – C. Limit of Insurance at 1.b.is amended to provide the following limits: b.Limits of $1,000 per "loss" is increased to $5,000 per "loss". All other terms and provisions of this section remain applicable. SECTION III – PHYSICAL DAMAGE COVERAGE – C. Limit of Insurance is amended by adding the following language: 4.In the event of a total "loss" to a covered "auto" shown in the Schedule pages, subject at the time of the "loss" to a loan or lease, we will pay any unpaid amount due including up to a maximum of $500 for early termination fees or penalties on the lease or loan for a covered"auto" less: a.The amount paid under the Physical Damage Coverage Section of the policy; and b.Any: (1)Overdue lease / loan payments at the time of the "loss''; (2)Financial penalties imposed under a lease for excessive use, abnormal wear and tear or high mileage; (3)Security deposits not returned by the lessor; (4)Costs for extended warranties, Credit Life Insurance, Health, Accident or Disability Insurance purchased with the loan or lease; and (5)Carry-over balances from previous loans or leases. H. GLASS REPAIR – DEDUCTIBLE SECTION III – PHYSICAL DAMAGE COVERAGE – D. Deductible is amended by adding the following: Any deductible shown in the Declarations as applicable to the covered "auto" will not apply to glass breakage if the damaged glass is repaired, rather than replaced. Page 6 of 7 Includes copyrighted material of Insurance Services Office, Inc., with its permission.CA 71 09 01 17 I. AMENDED DUTIES IN THE EVENT OF ACCIDENT, CLAIM, SUIT OR LOSS Under SECTION IV – BUSINESS AUTO CONDITIONS, A. Loss Conditions , the following is added to paragraph 2. Duties In The Event of Accident, Suit or Loss: d.Knowledge of any "accident", "claim", "suit" or "loss" will be deemed knowledge by you when notice of such "accident", "claim", "suit" or "loss" has been received by: (1)You, if you are an individual; (2)Any partner or insurance manager if you are a partnership; (3)An executive officer or insurance manager, if you are a corporation; (4)Your members, managers or insurance manager, if you are a limited liability company; or (5)Your officials, trustees, board members or insurance manager, if you are a not-for-profit organization. J. WAIVER OF SUBROGATION REQUIRED BY CONTRACT Under SECTION IV,BUSINESS AUTO CONDITIONS, A. Loss Conditions 5. Transfer of Rights of Recovery Against Others to Us the following language is added: However, we waive any rights of recovery we may have against the person or organization with whom you have agreed in writing in a contract, agreement or permit, to provide insurance such as is afforded under the policy to which this endorsement is attached. This provision does not apply unless the written contract or written agreement has been executed, or permit has been issued, prior to the "bodily injury" or "property damage." K. UNINTENTIONAL FAILURE TO DISCLOSE Under SECTION IV – BUSINESS AUTO CONDITIONS, B. General Conditions , the following is added to 2. Concealment, Misrepresentation Or Fraud: Your unintentional error in disclosing, or failing to disclose, any material fact existing at the effective date of this Coverage Form, or during the policy period in connection with any additional hazards, will not prejudice your rights under this Coverage Form. L. HIRED, LEASED, RENTED OR BORROWED AUTO PHYSICAL DAMAGE Under SECTION IV – BUSINESS AUTO CONDITIONS B. General Conditions 5. Other Insurance Paragraph 5.b.is replaced by the following: b. (1)For "Comprehensive" and "Collision" Auto Physical Damage coverage provided by this endorsement, the following are deemed to be covered "autos" you own: (a)Any Covered "auto" you lease, hire, rent or borrow; and (b)Any Covered "auto" hired or rented by your "employee" under a contract in that individual "employee's" name, with your permission, while performing duties related to the conduct of your business. However, any "auto" that is leased, hired, rented or borrowed with a driver is not a covered "auto" (2) Limit of Insurance For This Section The most we will pay for any one "loss" is the lesser of the following: (a)$75,000 per accident, or (b)actual cash value at the time of loss, or (c)cost of repair. CA 71 09 01 17 Includes copyrighted material of Insurance Services Office, Inc., with its permission.Page 7 of 7 Minus a $500 deductible. An adjustment for depreciation and physical condition will be made in determining actual cash value in the event of a total loss. No deductible applies to "loss" caused by fire or lightning. (3)This Hired Auto Physical Damage coverage is excess over any other collectible insurance. (4) Definitions For This Section (a)Comprehensive Coverage: from any cause except the covered "auto's" collision with another object or the covered "auto's" overturn. We will pay glass breakage, "loss" caused by hitting a bird or animal and, "loss" caused by falling objects or missiles. (b)Collision Coverage: caused by the covered "auto's" collision with another object or by the covered "auto's" overturn. M. MENTAL ANGUISH Under SECTION V – DEFINITIONS, C.is replaced by the following: C."Bodily injury" means bodily injury, sickness or disease sustained by a person including mental anguish or death resulting from bodily injury, sickness, or disease. N. EXTENDED CANCELLATION CONDITION Under CANCELLATION,of the COMMON POLICY CONDITIONS form, item 2.b.is replaced by the following: b.60 days before the effective date of cancellation if we cancel for any other reason.              WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT-CALIFORNIA We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. Schedule Person or Organization Job Description This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Insured Insurance Company Countersigned By