1-Modlogics_Attachment_5_C_Supplement_Insurance_COI.pdf

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BPM002979

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100 N 15Wh AYe., SXiWe 402 PhReQi[, AZ 85007

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10/16/2020

Powers-Leavitt Insurance Agency, Inc.

PO Box 125

Buckeye AZ 85326

April Tuzon (623)386-4452 (866)836-5280 april-tuzon@leavitt.com

MODLOGICS LLC

402 N 37TH DR STE 102

PHOENIX AZ 85009-4177

Selective Way Insurance Company 26301 Scottsdale Indemnity Company 15580

20-21 GL, AUTO, WK, UM

A

X

X

X

X Y S 2302839 2/23/2020 2/23/2021

1,000,000

500,000

15,000

1,000,000

3,000,000

3,000,000

A X

X Y S 2302839 2/23/2020 2/23/2021

Hired & Nonowned Physical

Damge Comp/Coll Del $1,000

1,000,000

Physical Damage Limit $75,000

A

X X

X Y S 2302839 09/15/2020 2/23/2021

1,000,000

1,000,000

C WWC3453640 2/23/2020 2/23/2021

X X

1,000,000

1,000,000

1,000,000

A Business Property-inc nonowned S 2302839 2/23/2020 2/23/2021 $750,000 $1,000 ded

Installation Floater & Transit S 2302839 2/23/2020 2/23/2021 $50,000 $1,000 ded

Solicitation No. BPM002979 moving and relocation services The State of Arizona, and its departments, agencies, boards, commissions, universities, officers, officials, agents, and employees are additional insureds with respect to liability arising out of the activities performed by or on behalf of the contractors also involving automobiles owned, leased, hired and/or non-owned by the contractor as per form CG7300 1/19 & CA7809 11/17 attached. Waiver of subrogation applies in favor of The State of Arizona, and its departments, agencies, boards, commissions, universities, officers, officials, agents, and employees for losses arising from work performed by or on

The State of Arizona State Procurement Office 100 N 15th Ave Ste 402 Phoenix, AZ 85007

C Powers/KRLUCI

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

LOCJECT

PRO-

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)

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)

behalf of the contractor as per forms CG7300 1/19 & CA7809 11/17 & WC000313 4/84 attached.

Umbrella follows from.

COMMENTS/REMARKS

COPYRIGHT 2000, AMS SERVICES INC.OFREMARK

ElitePac�

General Liabilit\ E[tension Endorsement

COMMERCIAL GENERAL LIABILITY

CG 73 00 01 19

SUMMARY OF COVERAGES (including inde[)

This is a summar\ of the various additional coverages and coverage modifications provided b\ this endorsement. No coverage is provided b\ this summar\. Refer to the actual endorsement (Pages 3-through-9) for changes affecting \our insurance protection.

DESCRIPTION PAGE FOUND

Additional Insureds - Primar\ and Non-Contributor\ Provision Page 8

Blanket Additional Insureds - As Required B\ Contract Page 5 Owners, Lessees or Contractors (includes Architects, Engineers or Surve\ors Lessors of Leased Equipment Managers or Lessors of Premises Mortgagees, Assignees and Receivers An\ Other person or organi]ation other than a joint venture Grantors of Permits

Broad Form Vendors Coverage Page 7

Damage To Premises Rented To You (Including Fire, Lightning or E[plosion) Page 3

Electronic Data Liabilit\ ($100,000) Page 4

Emplo\ee Definition Amended Page 9

Emplo\ees As Insureds Modified Page 5

Emplo\er¶s Liabilit\ E[clusion Amended (Not applicable in New York) Page 3

Incidental Malpractice E[clusion modified Page 7

Knowledge of Occurrence, Claim, Suit or Loss Page 7

Liberali]ation Clause Page 8

Mental Anguish Amendment (Not applicable to New York) Page 9

Newl\ Formed or Acquired Organi]ations Page 5

Non-Owned Aircraft Page 3

Non-Owned Watercraft (under 60 feet) Page 3

Not-for-profit Members - as additional insureds Page 5

Personal And Advertising Injur\ - Discrimination Amendment (Not applicable in New York) Page 8

Products Amendment (Medical Pa\ments) Page 4

Supplementar\ Pa\ments Amended - Bail Bonds ($5,000) and Loss of Earnings ($1,000) Page 4

Two or More Coverage Parts or Policies Issued B\ Us Page 8

Unintentional Failure to Disclose Ha]ards Page 8

Waiver of Transfer of Rights of Recover\ (subrogation) Page 8

When Two or More Coverage Parts of this Polic\ Appl\ to a Loss Page 3

Cop\right, 2018 Selective Insurance Compan\ of America. All rights reserved. CG 73 00 01 19 Includes cop\righted material of Insurance Services Office, Inc., with its permission. Page 1 of 9

THIS PAGE IS INTENTIONALLY LEFT BLANK.

Includes cop\righted material of Insurance Services Office, Inc., with its permission. Page 2 of 9

General Liabilit\ E[tension Endorsement

COMMERCIAL GENERAL LIABILITY

CG 73 00 01 19

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

This endorsement modifies the insurance provided under the following:

COMMERCIAL GENERAL LIABILITY COVERAGE PART

The SECTIONS of the Commercial General Liabilit\ Coverage Form identified in this endorsement will be amended as shown below. However, if (a) tZo or more Coverage Parts of this polic\, or (b) tZo or more forms or endorsements Zithin the same Coverage Part appl\ to a loss, coverage provision(s) with the broadest language will appl\, unless specificall\ stated otherwise within the particular amendment covering that loss.

With respect to coverage provided b\ this endorsement, the provisions of the Coverage Form appl\ unless modified b\ the endorsement.

COVERAGES - Amendments

SECTION I - COVERAGE A BODILY INJURY AND

PROPERTY DAMAGE LIABILITY

EXCLUSIONS

Emplo\er¶s Liabilit\ Amendment (This provision is not applicable in the State of New York).

The following is added to E[clusion e. Emplo\er¶s Liabilit\ under COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, 2. E[clusions:

This e[clusion also does not appl\ to an\ ³temporar\ worker´.

Non-OZned Aircraft, Auto or Watercraft A. Paragraph (2) of E[clusion g. Aircraft, Auto Or

Watercraft under COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, 2. E[clus-ions is deleted in its entiret\ and replaced with the following:

(2) A watercraft \ou do not own that is:

(a) Less than 26 feet long and not being used to carr\ persons or propert\ for a charge; or

(b) At least 26 feet, but less than 60 feet long, and not being used to carr\ persons or propert\ for a charge. An\ person is an insured who uses or is responsible for the use of such watercraft with \our e[pressed or implied consent. However, if the insured has an\ other valid and collectible insurance for ³bodil\ injur\´ or ³propert\ damage´ that would be covered under this provision, or on an\ other basis, this coverage is then e[cess, and subject to Condition 4. Other Insurance, b. E[cess Insurance under

SECTION IV - COMMERCIAL GENERAL

LIABILITY CONDITIONS.

B. The following is added to E[clusion g. Aircraft, Auto Or Watercraft under COVERAGE A BODILY

INJURY AND PROPERTY DAMAGE LIABILITY, 2.

E[clusions:

This e[clusion does not appl\ to:

(6) An\ aircraft, not owned or operated b\ an\ insured, which is hired, chartered or loaned with a paid crew. However, if the insured has an\ other valid and collectible insurance for ³bodil\ injur\´ or ³propert\ damage´ that would be covered under this provision, or on an\ other basis, this coverage is then e[cess, and subject to Condition 4. Other Insurance, b. E[cess Insurance under SECTION IV - COMMERCIAL

GENERAL LIABILITY CONDITIONS.

Damage To Premises Rented to You A. The last paragraph of Paragraph 2. E[clusions under COVERAGE A BODILY INJURY AND PROPERTY DAMAGE is deleted in its entiret\ and replaced with the following:

E[clusions c. through n. do not appl\ to damage b\ fire, lightning or e[plosion to premises rented to \ou or temporaril\ occupied b\ \ou with the permission of the owner. A separate limit of insurance applies to this coverage as described in SECTION III - LIMITS

OF INSURANCE.

Includes cop\righted material of Insurance Services Office, Inc., with its permission. Page 3 of 9

B. Paragraph 6. under SECTION III - LIMITS OF INSURANCE is deleted in its entiret\ and replaced with the following:

6. Subject to Paragraph 5. above, the most we will pa\ under COVERAGE A for damages because of ³propert\ damage´ to an\ one premises, while rented to \ou, or in the case of damage caused b\ fire, lightning or e[plosion, while rented to \ou or temporaril\ occupied b\ \ou with permission of the owner, for all such damage caused b\ fire, lightning or e[plosion pro[imatel\ caused b\ the same event, whether such damage results from fire, lightning or e[plosion or an\ combination of the three, is the amount shown in the Declara-tions for the Damage To Premises Rented To You Limit.

C. Paragraph a. of Definition 9. ³Insured contract´ under SECTION V - DEFINITIONS is deleted in its entiret\ and replaced with the following:

a. A contract for a lease of premises. However, that portion of the contract for a lease of premises that indemnifies an\ person or organi]ation for damage b\ fire, lightning or e[plosion to premises while rented to \ou or temporaril\ occupied b\ \ou with the permission of the owner is not an ³insured contract´;

Electronic Data Liabilit\ A. E[clusion p. Access or Disclosure Of Confidential

Or Personal Information And Data-related Liabilit\ under COVERAGE A BODILY INJURY

AND PROPERTY DAMAGE LIABILITY, 2.

E[clusions is deleted in its entiret\ and replaced b\ the following:

p. Access or Disclosure Of Confidential Or

Personal Information And Data-related Liabilit\ Damages arising out of:

(1) An\ access to or disclosure of an\ person¶s or organi]ation¶s confidential or personal information, including patents, trade secrets, processing methods, customer lists, financial information, credit card information or an\ other t\pe of nonpublic information;

or

(2) The loss of, loss of use of, damage to, corruption of, inabilit\ to access, or inabilit\ to manipulate ³electronic data´ that does not result from ph\sical injur\ to tangible propert\.

This e[clusion applies even if damages are claimed for notification costs, credit monitoring e[penses, forensic e[penses, public relations e[penses or an\ other loss, cost or e[pense incurred b\ \ou or others arising out of that which is described in Paragraph (1) or (2) above.

B. The following paragraph is added to SECTION III -

LIMITS OF INSURANCE:

Subject to 5. above, the most we will pa\ under COVERAGE A for ³propert\ damage´ because of all loss of ³electronic data´ arising out of an\ one ³occurrence´ is a sub-limit of $100,000.

SECTION I - COVERAGE C MEDICAL PAYMENTS

EXCLUSIONS

An\ Insured Amendment E[clusion a. An\ Insured under COVERAGE C MEDICAL PAYMENTS, 2. E[clusions is deleted in its entiret\ and replaced with the following:

a. An\ Insured

To an\ insured.

This e[clusion does not appl\ to:

(1) ³Not-for-profit members´;

(2) ³Golfing facilit\´ members who are not paid a fee, salar\, or other compensation; or

(3) ³Volunteer workers´.

This e[clusion e[ception does not appl\ if COVERAGE C MEDICAL PAYMENTS is e[cluded b\ another endorsement to this Coverage Part.

Product Amendment E[clusion f. Products-Completed Operations Ha]ard under COVERAGE C MEDICAL PAYMENTS, 2.

E[clusions is deleted in its entiret\ and replaced with the following:

f. Products-Completed Operations Ha]ard

Included within the ³products-completed operations ha]ard´.

This e[clusion does not appl\ to ³\our products´ sold for use or consumption on \our premises, while such products are still on \our premises.

This e[clusion e[ception, does not appl\ if COVERAGE C MEDICAL PAYMENTS is e[cluded b\ another endorsement to this Coverage Part.

SECTION I - SUPPLEMENTARY PAYMENTS -

COVERAGES A AND B

E[penses For Bail Bonds And Loss Of Earnings A. Subparagraph 1.b. under SUPPLEMENTARY

PAYMENTS - COVERAGES A AND B is deleted in its entiret\ and replaced with the following:

b. Up to $5,000 for cost of bail bonds required because of accidents or traffic law violations arising out of the use of an\ vehicle to which Bodil\ Injur\ Liabilit\ Coverage applies. We do not have to furnish these bonds.

Includes cop\righted material of Insurance Services Office, Inc., with its permission. Page 4 of 9

B. Subparagraph 1.d. under SUPPLEMENTARY PAYMENTS - COVERAGES A AND B is deleted in its entiret\ and replaced with the following:

d. All reasonable e[penses incurred b\ the insured at our request to assist us in the investigation or defense of the claim or ³suit´, including actual loss of earnings up to $1,000 a da\ because of time off from work.

SECTION II - WHO IS AN INSURED - Amendments Not-for-Profit Organi]ation Members The following paragraph is added to SECTION II - WHO

IS AN INSURED:

If \ou are an organi]ation other than a partnership, joint venture, or a limited liabilit\ compan\, and \ou are a not-for-profit organi]ation, the following are included as additional insureds:

1. Your officials;

2. Your trustees;

3. Your members;

4. Your board members;

5. Your commission members;

6. Your agenc\ members;

7. Your insurance managers;

8. Your elective or appointed officers; and

9. Your ³not-for-profit members´.

However onl\ with respect to their liabilit\ for \our activities or activities the\ perform on \our behalf.

Emplo\ees As Insureds Modified A. Subparagraph 2.a.(1)(a) under SECTION II - WHO

IS AN INSURED does not appl\ to ³bodil\ injur\´ to a ³temporar\ worker´ caused b\ a co-³emplo\ee´ who is not a ³temporar\ worker´.

B. Subparagraph 2.a.(2) under SECTION II - WHO IS AN INSURED does not appl\ to ³propert\ damage´ to the propert\ of a ³temporar\ worker´ or ³volunteer worker´ caused b\ a co-³emplo\ee´ who is not a ³temporar\ worker´ or ³volunteer worker´.

C. Subparagraph 2.a.(1)(d) under SECTION II - WHO IS AN INSURED does not appl\ to ³bodil\ injur\´ caused b\ cardio-pulmonar\ resuscitation or first aid services administered b\ a co-³emplo\ee´.

With respect to this provision onl\, Subparagraph (1) of E[clusion 2. e. Emplo\er¶s Liabilit\ under SECTION I -

COVERAGES, COVERAGE A BODILY INJURY AND

PROPERTY DAMAGE LIABILITY does not appl\.

NeZl\ Formed Or Acquired Organi]ations A. Subparagraph 3.a. under SECTION II - WHO IS AN

INSURED is deleted in its entiret\ and replaced with the following:

a. Coverage under this provision is afforded onl\ until the 180th da\ after \ou acquire or form the organi]ation or the end of the polic\ period, whichever is earlier. However, COVERAGE A does not appl\ to ³bodil\ injur\´ or ³propert\ damage´ that occurred before \ou acquired or formed the organi]ation.

B. The following paragraph is added to SECTION II

- WHO IS AN INSURED, Paragraph 3:

If \ou are engaged in the business of con-struction of dwellings three stories or less in height, or other buildings three stories or less in height and less than 25,000 square feet in area, \ou will also be an insured with respect to ³\our work´ onl\, for the period of time described above, for \our liabilit\ arising out of the conduct of an\ partnership or joint venture of which \ou are or were a member, even if that partnership or joint venture is not shown as a Named Insured. However, this provision onl\ applies if \ou maintain or maintained an interest of at least fift\ percent in that partnership or joint venture for the period of that partnership or joint venture.

This provision does not appl\ to an\ partnership or joint venture that has been dissolved or otherwise ceased to function for more than thirt\-si[ months.

With respect to the insurance provided b\ this provision, NeZl\ Formed or Acquired Organi]ations, the following is added to SECTION IV - COMMERCIAL GENERAL LIABILITY, Paragraph 4. Other Insurance, Subparagraph b. E[cess Insurance:

The insurance provided b\ this provision, NeZl\ Formed or Acquired Organi]ations, is e[cess over an\ other insurance available to the insured, whether primar\, e[cess, contingent or on an\ other basis.

(All other provisions of this section remain unchanged) Blanket Additional Insureds - As Required B\ Contract Subject to the Primar\ and Non-Contributor\ provision set forth in this endorsement, SECTION II - WHO IS AN INSURED is amended to include as an additional insured:

A. OZners, Lessees or Contractors/Architects, Engineers and Surve\ors

1. An\ person or organi]ation for whom \ou are performing operations when \ou and such person or organi]ation have agreed in a written contract, written agreement or written permit that such person or organi]ation be added as an additional insured on \our commercial general liabilit\ polic\; and

Includes cop\righted material of Insurance Services Office, Inc., with its permission. Page 5 of 9

2. An\ other person or organi]ation, including an\ architects, engineers or surve\ors not engaged b\ \ou, whom \ou are required to add as an additional insured under \our polic\ in the contract or agreement in Paragraph 1. above:

Such person or organi]ation is an additional insured onl\ with respect to liabilit\ for ³bodil\ injur\´, ³propert\ damage´ or ³personal and advertising injur\´ caused, in whole or in part, b\:

a. Your acts or omissions; or

b. The acts of omissions of those acting on

\our behalf;

in the performance of \our ongoing operations performed for the additional insured in Paragraph 1., above.

However, this insurance does not appl\ to:

³Bodil\ injur\´, ³propert\ damage´ or ³personal and advertising injur\´ arising out of the rendering of, or the failure to render, an\ professional architectural, engineering or surve\ing services b\ or for \ou, including:

a. The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surve\s, field orders, change orders or drawings and specifi-cations; and

b. Supervisor\, inspection, architectural or engineering activities.

Professional services do not include services within construction means, methods, techniques, sequences and procedures emplo\ed b\ \ou in connection with \our operations in \our capacit\ as a construction contractor.

A person or organi]ation¶s status as an additional insured under this endorsement ends when \our operations for the person or organi]ation described in Paragraph 1. above are completed.

B. Other Additional Insureds An\ of the following persons or organi]ations with whom \ou have agreed in a written contract, written agreement or written permit that such persons or organi]ations be added as an additional insured on \our commercial general liabilit\ polic\:

1. Lessors of Leased Equipment

An\ person or organi]ation from whom \ou lease equipment, but onl\ with respect to liabilit\ for ³bodil\ injur\´, ³propert\ damage´ or ³per-sonal and advertising injur\´ caused, in whole or in part, b\ \our maintenance, operation or use of equipment leased to \ou b\ such person or organi]ation.

With respect to the insurance afforded to these additional insureds, this insurance does not appl\ to an\ ³occurrence´ which takes place after the equipment lease e[pires.

2. Managers or Lessors of Premises An\ person or organi]ation from whom \ou lease premises, but onl\ with respect to liabilit\ arising out of the ownership, maintenance or use of that part of the premises leased to \ou.

This insurance does not appl\ to an\ ³occur-rence´ which takes place after \ou cease to be a tenant of that premises.

3. Mortgagees, Assignees or Receivers An\ person or organi]ation with respect to their liabilit\ as mortgagee, assignee or receiver and arising out of the ownership, maintenance or use of \our premises.

This insurance does not appl\ to an\ ³occurrence´ which takes place after the mortgage is satisfied, or the assignment or receivership ends.

4. An\ Person or Organi]ation Other Than A Joint Venture An\ person or organi]ation (other than a joint venture of which \ou are a member), but onl\ with respect to liabilit\ for ³bodil\ injur\´, ³propert\ damage´ or ³personal and advertising injur\´ caused, in whole or in part, b\ \our acts or omissions or the acts of omissions of those acting on \our behalf in the performance of \our ongoing operations or in connection with propert\ owned b\ \ou.

5. State or Governmental Agenc\ or Political Subdivision - Permits or Authori]ations An\ state or governmental agenc\ or subdivision or political subdivision, but onl\ with respect to:

a. Operations performed b\ \ou or on \our behalf for which the state or governmental agenc\ or subdivision or political subdivision has issued a permit or authori]ation; or

b. The following ha]ards for which the state or governmental agenc\ or subdivision or political subdivision has issued a permit or authori]ation in connection with premises \ou own, rent or control and to which this insurance applies:

Includes cop\righted material of Insurance Services Office, Inc., with its permission. Page 6 of 9

(1) The e[istence, maintenance, repair, construction, erection or removal of advertising signs, awnings, canopies, cellar entrances, coal holes, drivewa\s, manholes, marquees, hoist awa\ openings, sidewalk vaults, street banners or decorations and similar e[posures;

(2) The construction, erection or removal of elevators; or

(3) The ownership, maintenance or use of an\ elevators covered b\ this insurance.

This insurance does not appl\ to:

(a) ³Bodil\ injur\´ or ³propert\ damage´ arising out of operations performed for the federal government, state or municipalit\; or

(b) ³Bodil\ injur\´ or ³propert\ damage´ included within the ³products-completed operations ha]ard´.

With respect to Paragraphs 2. through 4., this insurance does not appl\ to structural alterations, new construction or demolition operations performed b\ or on behalf of such person or organi]ation.

The provisions of this coverage e[tension do not appl\ unless the written contract or written agreement has been signed b\ the Named Insured or written permit issued prior to the ³bodil\ injur\´ or ³propert\ damage´ or ³personal and advertising injur\´.

Broad Form Vendors Coverage Subject to the Primar\ and Non-Contributor\ provision set forth in this endorsement, SECTION II - WHO IS AN INSURED is amended to include as an additional insured an\ person or organi]ation (referred to below as vendor) for whom \ou have agreed in a written contract or written agreement to provide coverage as an additional insured under \our polic\. Such person or organi]ation is an additional insured onl\ with respect to ³bodil\ injur\´ or ³propert\ damage´ arising out of ³\our products´ which are distributed or sold in the regular course of the vendor¶s business. However, the insurance afforded the vendor does not appl\ to:

a. ³Bodil\ injur\´ or ³propert\ damage´ for which the vendor is obligated to pa\ damages b\ reason of the assumption of liabilit\ in a contract or agreement; however this e[clusion does not appl\ to liabilit\ for damages that the vendor would have in the absence of the contract or agreement;

b. An\ e[press warrant\ unauthori]ed b\ \ou;

c. An\ ph\sical or chemical change in the product made intentionall\ b\ the vendor;

d. Repackaging, unless unpacked solel\ 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. An\ failure to make such inspections, adjustments, tests or servicing as the vendor has agreed to make or normall\ undertakes to make in the usual course of business in connection with the sale of the product; or

f. Products which, after distribution or sale b\ \ou, have been labeled or re-labeled or used as a container, part of ingredient of an\ other thing or substance b\ or for the vendor; however this insurance does not appl\ to an\ insured person or organi]ation, from who \ou have acquired such products, or an\ ingredient, part or container, entering into, accompan\ing or con-taining such products.

The provisions of this coverage e[tension do not appl\ unless the written contract or written agreement has been signed b\ the Named Insured prior to the ³bodil\ injur\´ or ³propert\ damage´.

Incidental Malpractice Subparagraph 2.a.(1)(d) under SECTION II - WHO IS AN INSURED is deleted in its entiret\ and replaced with the following:

(d) Arising out of his or her providing or failing to provide professional health care services.

This does not appl\ to nurses, emergenc\ medical technicians or paramedics if \ou are not in the business or occupation of providing an\ such professional services.

This also does not appl\ to ³bodil\ injur\´ caused b\ cardio-pulmonar\ resuscitation or first aid services administered b\ a co-³emplo\ee´.

This provision does not appl\ if \ou are a Social Service or Senior Living risk.

SECTION IV - COMMERCIAL GENERAL LIABILITY

CONDITIONS - Amendments KnoZledge Of Occurrence, Claim, Suit Or Loss The following is added to Paragraph 2. Duties in the Event of Occurrence, Offense, Claim or Suit under

SECTION IV - COMMERCIAL GENERAL LIABILITY

CONDITIONS:

The requirements under this paragraph do not appl\ until after the ³occurrence´ or offense is known to:

1. You, if \ou are an individual;

2. A partner, if \ou are a partnership;

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3. An ³e[ecutive officer´ or insurance manager, if \ou are a corporation;

4. Your members, managers or insurance manager, if \ou are a limited liabilit\ compan\; or

5. Your elected or appointed officials, officers, members, trustees, board members, commission members, agenc\ members, or \our administrator or \our insurance manager if \ou are an organi]ation other than a partnership, joint venture, or limited liabilit\ compan\.

Primar\ and Non-Contributor\ Provision The following is added to Paragraph 4. Other Insur-ance, b. E[cess Insurance under SECTION IV -

COMMERCIAL GENERAL LIABILITY CONDITIONS:

This insurance is primar\ to and we will not seek contribution from an\ other insurance available to an additional insured under this polic\ provided that:

(1) The additional insured is a Named Insured under such other insurance; and

(2) You have agreed in a written contract, written agreement or written permit that this insurance would be primar\ and would not seek contribution from an\ other insurance available to the additional insured.

Unintentional Failure To Disclose Ha]ards The following is added to Paragraph 6. Representations under SECTION IV - COMMERCIAL GENERAL

LIABILITY CONDITIONS:

However, if \ou should unintentionall\ fail to disclose an\ e[isting ha]ards in \our representations to us at the inception date of the polic\, or during the polic\ period in connection with an\ additional ha]ards, we shall not den\ coverage under this Coverage Part based upon such failure to disclose ha]ards.

Waiver Of Transfer Of Rights Of Recover\ The following is added to Paragraph 8. Transfer of Rights Of Recover\ Against Others To Us under

SECTION IV - COMMERCIAL GENERAL LIABILITY

CONDITIONS:

We will waive an\ right of recover\ we ma\ have against a person or organi]ation because of pa\ments we make for ³bodil\ injur\´ or ³propert\ damage´ arising out of \our ongoing operations or ³\our work´ done under a written contract or written agreement and included in the ³products-completed operations ha]ard´, if:

1. You have agreed to waive an\ right of recover\ against that person or organi]ation in a written contract or written agreement;

2. Such person or organi]ation is an additional insured on \our polic\; or

3. You have assumed the liabilit\ of that person or organi]ation in that same contract, and it is an ³insured contract´.

The section above onl\ applies to that person or organi]ation identified above, and onl\ if the ³bodil\ injur\´ or ³propert\ damage´ occurs subsequent to the e[ecution of the written contract or written agreement.

Liberali]ation The following condition is added to SECTION IV -

COMMERCIAL GENERAL LIABILITY CONDITIONS:

If we revise this Coverage Part to provide more coverage without additional premium charge, subject to our filed compan\ rules, \our polic\ will automaticall\ provide the additional coverage as of the da\ the revision is effective in \our state.

TZo or More Coverage Parts or Policies Issued B\ Us (This provision is not Applicable in the state of New York or Wisconsin).

The following condition is added to SECTION IV -

COMMERCIAL GENERAL LIABILITY CONDITIONS:

It is our intention that the various coverage parts or policies issued to \ou b\ us, or an\ compan\ affiliated with us, do not provide an\ duplication or overlap of coverage. We have e[ercised diligence to draft our coverage parts and policies to reflect this intention.

However, if the facts and circumstances that will respond to an\ claim or ³suit´ give rise to actual or claimed duplication or overlap of coverage between the various coverage parts or policies issued to \ou b\ us or an\ compan\ affiliated with us, the limit of insurance under all such coverage parts or policies combined shall not e[ceed the highest applicable limit under this coverage, or an\ one of the other coverage forms or policies.

This condition does not appl\ to an\ E[cess or Umbrella polic\ issued b\ us specificall\ to appl\ as e[cess insurance over this coverage part or polic\ to which this coverage part is attached.

SECTION V - DEFINITIONS

Discrimination (This provision does not appl\ in New York).

A. The following is added to Definition 14. ³Personal and advertising injur\´:

³Personal and advertising injur\´ also means ³discrimination´ that results in injur\ to the feelings or reputation of a natural person, however onl\ if such ³discrimination´ or humiliation is:

1. Not done b\ or at the direction of:

a. The insured; or

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b. An\one considered an insured under

SECTION II - WHO IS AN INSURED;

2. Not done intentionall\ to cause harm to another person.

3. Not directl\ or indirectl\ related to the em-plo\ment, prospective emplo\ment or termi-nation of emplo\ment of an\ person or persons b\ an\ insured.

4. Not arising out of an\ ³advertisement´ b\ the insured.

B. The following definition is added to SECTION V -

DEFINITIONS:

³Discrimination´ means:

a. An\ act or conduct that would be considered discrimination under an\ applicable federal, state, or local statute, ordinance or law;

b. An\ act or conduct that results in disparate treatment of, or has disparate impact on, a person, because of that person¶s race, religion, gender, se[ual orientation, age, disabilit\ or ph\sical impairment; or

c. An\ act or conduct characteri]ed or interpreted as discrimination b\ a person based on that person¶s race, religion, gender, se[ual orienta-tion, age, disabilit\ or ph\sical impairment.

It does not include acts or conduct characteri]ed or interpreted as se[ual intimidation or se[ual harass-ment, or intimidation or harassment based on a person¶s gender.

Electronic Data The following definition is added to SECTION V -

DEFINITIONS:

³Electronic data´ means information, facts or programs stored as or on, created or used on, or transmitted to or from computer software, including s\stems and applications software, hard or flopp\ disks, CD-ROMS, tapes, drives, cell, data processing devices or an\ other media which are used with electronicall\ controlled equipment. For the purpose of the Electronic Data Liabilit\ coverage provided b\ this endorsement, Definition 17. ³Propert\ damage´ is deleted in its entiret\ and replaced b\ the following:

17. ³Propert\ damage´ means:

a. Ph\sical injur\ to tangible propert\, including all resulting loss of use of that propert\. All such loss of use shall be deemed to occur at the time of the ph\sical injur\ that caused it; or

b. Loss of, loss of use of, damage to, corruption of, inabilit\ to access, or inabilit\ to properl\ manipulate ³electronic data´, resulting from ph\sical injur\ to tangible propert\. All such loss of ³electronic data´ shall be deemed to occur at the time of the ³occurrence´ that caused it.

For the purpose of the Electronic Data Liabilit\ coverage provided b\ this endorsement, ³electronic data´ is not tangible propert\.

Emplo\ee Amendment Definition 5. ³Emplo\ee´ under SECTION V - DEFINI- TIONS is deleted in its entiret\ and replaced b\ the following:

5. ³Emplo\ee´ includes a ³leased worker´, or a

³temporar\ worker´. If \ou are a School, ³Emplo\ee´ also includes a student teacher.

Golfing Facilit\ The following definition is added to SECTION V -

DEFINITIONS:

³Golfing facilit\´ means a golf course, golf club, driving range, or miniature golf course.

Mental Anguish Amendment (This provision does not appl\ in New York).

Definition 3. ³Bodil\ injur\´ under SECTION V - DEFINITIONS is deleted in its entiret\ and replaced with the following:

3. ³Bodil\ injur\´ means bodil\ injur\, sickness or disease sustained b\ a person, including death resulting from an\ of these at an\ time. This includes mental anguish resulting from an\ bodil\ injur\, sickness or disease sustained b\ a person. (In New York, mental anguish has been determined to be ³bodil\ injur\´).

Not-for-profit Member The following definition is added to SECTION V -

DEFINITIONS:

³Not-for-profit member´ means a person who is a member of a not-for-profit organi]ation, including clubs and churches, who receives no financial or other compensation.

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Commercial AXtomobile E[tension

COMMERCIAL AUTO

CA 78 09 11 17

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

This endorsement modifies insurance provided under the following:

BUSINESS AUTO COVERAGE FORM

With respect to coverage provided b\ this endorsement, the provisions of the Business Auto Coverage Form appl\ unless modified b\ the endorsement.

AMENDMENTS TO SECTION II - LIABILITY COVER-

AGE

A. If this polic\ provides Auto Liabilit\ coverage for

Owned Autos, the following extensions are applica-ble accordingl\:

NEWLY ACQUIRED OR FORMED ORGANIZA-

TIONS

The following is added to SECTION II, A.1. - Who Is An InsXred:

An\ organi]ation \ou newl\ acquire or form, other than a partnership, joint venture or limited liabilit\ compan\ over which \ou maintain ownership or majorit\ interest, will qualif\ as a Named Insured if there is no similar insurance available to that organi- ]ation. However:

1. Coverage under this provision is afforded onl\ until the 180th da\ after \ou acquire or form the organi]ation or the end of the polic\ period, whichever is earlier;

2. Coverage does not appl\ to ³bodil\ injur\´ or ³propert\ damage´ resulting from an ³accident´ that occurred before \ou acquired or formed the organi]ation.

No person or organi]ation is an ³insured´ with re-spect to the conduct of an\ current or past partner-ship, joint venture or limited liabilit\ compan\ that is not shown as a Named Insured in the Declarations.

EXPENSES FOR BAIL BONDS AND LOSS OF

EARNINGS

Paragraphs (2) and (4) of SECTION II, A.2.a. - SXpplementar\ Pa\ments are deleted in their entiret\ and replaced with the following:

(2) Up to the Limit of Insurance shown on the

ElitePac Schedule for the cost of bail bonds (in-cluding bonds for related traffic law violations) required because of an ³accident´ covered under this polic\. We do not have to furnish these bonds.

(4) All reasonable expenses incurred b\ the ³insured´ at our request. This includes actual loss of earnings because of time off from work, which we will pa\ up to the Limit of Insurance shown on the ElitePac Schedule.

EMPLOYEE INDEMNIFICATION AND EMPLOY-

ER¶S LIABILITY AMENDMENT

The following is added to SECTION II, B.4. - E[clXsions:

This exclusion does not appl\ to a ³volunteer work-er´ who is not entitled to workers compensation, disabilit\ or unemplo\ment compensation benefits.

FELLOW EMPLOYEE COVERAGE

The FelloZ Emplo\ee Exclusion, SECTION II, B.5. - is deleted in its entiret\.

CARE, CUSTODY OR CONTROL AMENDMENT

The following is added to SECTION II, B.6. - E[clXsions:

This exclusion does not appl\ to propert\ owned b\ an\one other than an ³insured´, subject to the follow-ing:

1. The most we will pa\ under this exception for an\ one ³accident´ is the Limit of Insurance stat-ed in the ElitePac Schedule; and

2. A per ³accident´ deductible as stated in the ElitePac Schedule applies to this exception.

B. If this polic\ provides Auto Liabilit\ coverage for Owned Autos or Non-Owned Autos, the following extension is applicable accordingl\:

LIMITED LIABILITY COMPANIES

The following is added to SECTION II, A.1. - Who Is An InsXred:

If \ou are a limited liabilit\ compan\, \our members and managers are ³insureds´ while using a covered ³auto´ \ou don¶t own, hire or borrow during the course of their duties for \ou.

BLANKET ADDITIONAL INSUREDS - As ReqXired B\ Contract The following is added to SECTION II, A.1. - Who Is An InsXred:

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An\ person or organi]ation whom \ou have agreed in a written contract, written agreement or written permit that such person or organi]ation be added as an additional ³insured´ on \our polic\. Such person or organi]ation is an additional ³insured´ onl\ with respect to liabilit\ for ³bodil\ injur\´ or ³propert\ damage´ caused, in whole or in part, b\ \our owner-ship, maintenance or use of a covered ³auto´. This coverage shall be primar\ and non-contributor\ with respect to the additional ³insured´. This provision onl\ applies if:

1. It is required in the written contract, written agreement or written permit identified in this sec-tion;

2. It is permitted b\ law; and

3. The written contract or written agreement has been executed (executed means signed b\ a named insured) or written permit issued prior to the ³bodil\ injur\´ or ³propert\ damage´.

C. If this polic\ provides Auto Liabilit\ coverage for Non- Owned Autos, the following extension is applicable accordingl\:

EMPLOYEES AS INSUREDS

If this polic\ provides Auto Liabilit\ coverage for Non-Owned Autos, the following is added to SECTION II, A.1. - Who Is An InsXred:

An\ ³emplo\ee´ of \ours is an ³insured´ while using a covered ³auto´ \ou don¶t own, hire or borrow in \our business or \our personal affairs.

An ³emplo\ee´ of \ours is an ³insured´ while operat-ing an ³auto´ hired or rented under a contract or agreement in that ³emplo\ee¶s´ name with \our per-mission, while performing duties related to the con-duct of \our business.

AMENDMENTS TO SECTION III - PHYSICAL

DAMAGE COVERAGE

If this polic\ provides Comprehensive, Specified Causes of Loss or Collision coverage, the following extensions are applicable for those ³autos´ for which Comprehen-sive, Specified Causes of Loss or Collision coverage is purchased:

TOWING AND LABOR

SECTION III, A.2. - ToZing is deleted in its entiret\ and replaced with the following:

We will pa\ all reasonable towing and labor costs up to the maximum Limit of Insurance shown on the ElitePac Schedule per tow each time a covered ³Private Passen-ger Auto´, ³Social Service Van or Bus´ or ³Light Truck´ is disabled and up to the maximum Limit of Insurance per tow each time a covered ³Medium Truck´, ³Heav\ Truck´ or ³Extra Heav\ Truck´ is disabled.

For labor charges to be eligible for reimbursement the labor must be performed at the place of disablement.

This coverage extension does not appl\ to Emergenc\ Services Organi]ations and Governmental Entities.

GLASS BREAKAGE DEDUCTIBLE

The following is added to SECTION III, A.3. - Glass Breakage - Hitting A Bird Or Animal - Falling Objects or Missiles:

If damaged glass is repaired rather than replaced, no deductible will appl\ for such repair. This extension does not appl\ to Emergenc\ Services Organi]ations and Governmental Entities.

ADDITIONAL TRANSPORTATION EXPENSES SEC-

TION III, A.4.a. - Transportation E[penses is deleted in its entiret\ and replaced with the following:

We will pa\ up to the maximum Limit of Insurance shown on the ElitePac Schedule for temporar\ transportation expenses that \ou incur because of an\ ³loss´ to a cov-ered ³auto´, but onl\ if the covered ³auto´ carries the coverages and meets the requirements described in 1.

or 2. below:

1. We will pa\ temporar\ transportation expenses for total theft of a covered ³auto´. We will onl\ pa\ for such expenses incurred during the period beginning 24 hours after the theft and ending, regardless of the polic\¶s expiration, when the covered ³auto´ is re-turned to use or we pa\ for its ³loss´.

2. For ³loss´ other than total theft of a covered ³auto´ under Comprehensive or Specified Causes of Loss Coverage, or for an\ ³loss´ under Collision Coverage to a covered ³auto´, we will onl\ pa\ for those tem-porar\ transportation expenses incurred during the polic\ period beginning 24 hours after the ³loss´ and ending, regardless of the polic\¶s expiration, with the lesser of the number of da\s reasonabl\ required to repair or replace the covered ³auto´ or 30 da\s.

Paragraph 2. of this extension does not appl\ while there are spare or reserve ³autos´ available to \ou for \our operations.

This coverage extension does not appl\ to Emergenc\ Services Organi]ations and Governmental Entities.

HIRED AUTO PHYSICAL DAMAGE COVERAGE

The following is added to SECTION III, A.4. - CoYerage E[tensions:

Ph\sical Damage coverage is hereb\ extended to appl\ to Ph\sical Damage ³loss´ to ³autos´ leased, hired, rent-ed or borrowed without a driver. We will provide cover-age equal to the broadest coverage available to an\ covered ³auto´ shown in the Declarations. But, the most we will pa\ for ³loss´ to each ³auto´ under this coverage extension is the lesser of:

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1. The Limit of Insurance stated in the ElitePac Sched-ule; or

2. The actual cash value of the damaged or stolen propert\ as of the time of the ³loss´; or

3. The actual cost of repairing or replacing the dam-aged or stolen propert\ with other propert\ of like kind and qualit\. A part is of like kind and qualit\ when it is of equal or better condition than the pre-accident part. We will use the original equipment from the manufacturer when:

(a) The operational safet\ of the vehicle might otherwise be impaired;

(b) Reasonable and diligent efforts to locate the appropriate rebuilt, aftermarket or used part have been unsuccessful; or

(c) A new original equipment part of like kind and qualit\ is available and will result in the lowest overall repair cost.

For each leased, hired, rented or borrowed ³auto´ our obligation to pa\ ³losses´ will be reduced b\ a deductible equal to the highest deductible applicable to an\ owned ³auto´ for that coverage. No deductible will be applied to ³losses´ caused b\ fire or lightning.

SECTION IV, B.5. Other InsXrance Condition, Para-graph 5.b. is deleted in its entiret\ and replaced b\ the following:

For Hired Auto Ph\sical Damage Coverage, the follow-ing are deemed to be covered ³autos¶´ \ou own:

1. An\ covered ³auto´ \ou lease, hire, rent, or borrow;

and

2. An\ covered ³auto´ hired or rented b\ \our ³em-plo\ee´ under a contract or agreement in that ³emplo\ee¶s´ name, with \our permission, while performing duties related to the conduct of \our business.

However, an\ ³auto´ that is leased, hired, rented or borrowed with a driver is not a covered ³auto´.

This coverage extension does not appl\ to Emergenc\ Services Organi]ations and Governmental Entities.

HIRED AUTO LOSS OF USE COVERAGE

The following is added to SECTION III, A.4. - CoYerage E[tensions:

We will pa\ expenses for which \ou are legall\ responsi-ble to pa\ up to the Limit of Insurance shown on the ElitePac Schedule per ³accident´ for loss of use of a leased, hired, rented or borrowed ³auto´ if it results from an ³accident´.

This coverage extension does not appl\ to Emergenc\ Services Organi]ations, Governmental Entities, and Schools.

AUTO LOAN/LEASE GAP COVERAGE (Not Applica-ble in NeZ York) The following is added to SECTION III, A.4. - CoYerage E[tensions:

In the event of a total ³loss´ to a covered ³auto´ we will pa\ an\ unpaid amount due on the lease or loan for a covered ³auto´, less:

1. The amount paid under the Ph\sical Damage Cover-age Section of the polic\; and

2. An\:

a. Overdue lease/loan pa\ments at the time of ³loss´;

b. Financial penalties imposed under a lease for excessive use, abnormal wear and tear, high mileage or similar charges;

c. Securit\ deposits not refunded b\ the lessor or financial institution;

d. Costs for extended warranties, credit life, health, accident, or disabilit\ insurance purchased with the loan or lease; and

e. Carr\-over balances from previous leases or loans.

You are responsible for the deductible applicable to the ³loss´ for the covered ³auto´.

PERSONAL EFFECTS

The following is added to SECTION III, A.4. - CoYerage E[tensions:

If this polic\ provides Comprehensive Coverage for a covered ³auto´ \ou own and that covered ³auto´ is stolen, we will pa\ up to the Limit of Insurance shown on the ElitePac Schedule, without application of a deducti-ble, for lost personal effects that were in the covered ³auto´ at the time of theft. Personal effects do not include jewelr\, tools, mone\, or securities. This coverage is excess over an\ other collectible insurance.

AIRBAG COVERAGE

The following is added to SECTION III, B.3.a. - E[clX-sions:

Mechanical breakdown does not include the accidental discharge of an airbag.

This coverage extension does not appl\ to Emergenc\ Services Organi]ations and Governmental Entities.

EXPANDED AUDIO, VISUAL, AND DATA ELEC-

TRONIC EQUIPMENT COVERAGE

SECTION III, B.4. - E[clXsions This exclusion does not appl\ to the following:

1. Global positioning s\stems;

2. ³Telematic devices´; or

3. Electronic equipment that reproduces, receives or transmits visual or data signals and accessories used with such equipment, provided such equipment is:

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a. Permanentl\ installed in or upon the covered ³auto´ at the time of the ³loss´;

b. Removable from a housing unit that is perma-nentl\ installed in the covered ³auto´ at the time of the ³loss´;

c. Designed to be solel\ operated b\ use of power from the ³auto¶s´ electrical s\stem; or

d. Designed to be used solel\ in or upon the covered ³auto´.

For each covered ³loss´ to such equipment, a deductible of $50 shall appl\, unless the deductible otherwise appli-cable to such equipment is less than $50, at which point the lower deductible, if an\, will appl\.

COMPREHENSIVE DEDUCTIBLE - LOCATION

TRACKING DEVICE

The following is added to SECTION III, D. - DedXctible:

An\ Comprehensive Coverage Deductible shown in the Declarations will be reduced b\ 50% for an\ ³loss´ caused b\ theft if the covered ³auto´ is equipped with a location tracking device and that device was the sole method used to recover the ³auto´.

PHYSICAL DAMAGE LIMIT OF INSURANCE

SECTION III, C. - Limit Of InsXrance is deleted in its entiret\ and replaced with the following:

The most we will pa\ for a ³loss´ in an\ one ³accident´ is the lesser of:

1. The actual cash value of the damaged or stolen…