2020.12.1 COI.pdf

ANY PROPRIETOR/PARTNER/EXECUTIVE

OFFICER/MEMBER EXCLUDED?

INSR ADDL SUBR

LTR INSD WVD

PRODUCER CONTACT

NAME:

FAXPHONE

(A/C, No):(A/C, No, Ext):

E-MAIL

ADDRESS:

INSURER A :

INSURED INSURER B :

INSURER C :

INSURER D :

INSURER E :

INSURER F :

POLICY NUMBER

POLICY EFF POLICY EXP

TYPE OF INSURANCE LIMITS(MM/DD/YYYY) (MM/DD/YYYY)

AUTOMOBILE LIABILITY

UMBRELLA LIAB

EXCESS LIAB

WORKERS COMPENSATION

AND EMPLOYERS' LIABILITY

DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)

AUTHORIZED REPRESENTATIVE

EACH OCCURRENCE $

DAMAGE TO RENTEDCLAIMS-MADE OCCUR $PREMISES (Ea occurrence)

MED EXP (Any one person) $

PERSONAL & ADV INJURY $

GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $

PRO-POLICY LOC PRODUCTS - COMP/OP AGGJECT

OTHER: $

COMBINED SINGLE LIMIT

$(Ea accident)

ANY AUTO BODILY INJURY (Per person) $

OWNED SCHEDULED

BODILY INJURY (Per accident) $AUTOS ONLY AUTOS

HIRED NON-OWNED PROPERTY DAMAGE

$AUTOS ONLY AUTOS ONLY (Per accident)

OCCUR EACH OCCURRENCE

CLAIMS-MADE AGGREGATE $

DED RETENTION $

PER OTH-

STATUTE ER

E.L. EACH ACCIDENT

E.L. DISEASE - EA EMPLOYEE $

If yes, describe under

E.L. DISEASE - POLICY LIMITDESCRIPTION OF OPERATIONS below

INSURER(S) AFFORDING COVERAGE NAIC #

COMMERCIAL GENERAL LIABILITY

Y / N

N / A (Mandatory in NH)

SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE

THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN

ACCORDANCE WITH THE POLICY PROVISIONS.

THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.

THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED

REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.

IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed.

If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).

COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:

CERTIFICATE HOLDER CANCELLATION

© 1988-2015 ACORD CORPORATION. All rights reserved.ACORD 25 (2016/03)

CERTIFICATE OF LIABILITY INSURANCE

DATE (MM/DD/YYYY)

The ACORD name and logo are registered marks of ACORD

NATIV-2 OP ID: C3

08/26/2020

Maurer-Noel-Evans LLC insurance@mne.biz 4545 E Shea Blvd Ste 258 Phoenix, AZ 85028-6009 Terry Evans/terry@mne.biz

602-277-2821 602-277-2846 certificates@mne.biz

CNA % Ultra Advisors PIE InsuranceNative Health

4041 N Central Ave Bldg C Phoenix, AZ 85012-3330

Cincinnati Insurance Co Philadelphia Insurance Company

C X 1,000,000

X Y Y ETD0560395 12/01/2019 12/01/2020 1,000,000

X 5,000

1,000,000

3,000,000

X 3,000,000

1,000,000C

Y ETD0560395 12/01/2019 12/01/2020

X

X X

XX 1,000,000C

ETD0560395 12/01/2019 12/01/2020 1,000,000

XB

WC22719 12/01/2019 12/01/2020 1,000,000

1,000,000

1,000,000

A HMA4015960669 01/03/2020 01/03/2021 Claim 1,000,000

D Directors Officers PHSD1420141 02/26/2020 02/26/2021 Claim 2,000,000

Contract #CTR050598-Health Start. AZ Dept of Health Services & State of Arizona its departments,agencies,boards,commissions,universities, and officers,officials,agents,and employees shall be named additional insured with respect to automobile ( including autos owned,leased,hired,or borrowed by the contractor) liability arising out of

ARIZO15

Arizona Dept of Health Service 150 N 18th Ave Ste 530 Phoenix, AZ 85007

602-277-2821

10677 23850

1000000/3000000Abuse

Professional LIab

Date

HOLDER CODE

INSURED'S NAME

PAGE

NOTEPAD:

work performed by or on behalf of the contractor. Auto renewal verification.

ARIZO15 2

Native Health 08/26/2020

NATIV-2

OP ID: C3

Includes copyrighted material of Insurance

GA 262 09 17 Services Office, Inc., with its permission. Page 1 of 23

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

SOCIAL SERVICES COMMERCIAL GENERAL LIABILITY

BROADENED ENDORSEMENT

This endorsement modifies insurance provided under the following:

COMMERCIAL GENERAL LIABILITY COVERAGE PART

A. Endorsement - Table of Contents:

Coverage: Begins on Page:

1. Employee Benefit Liability Coverage

2. Unintentional Failure To Disclose Hazards

3. Damage To Premises Rented To You

4. Supplementary Payments

5. Medical Payments

6. 180 Day Coverage For Newly Formed Or Acquired Organizations

7. Waiver Of Subrogation

8. Automatic Additional Insured - Specified Relationships

• Managers Or Lessors Of Premises;

• Lessor Of Leased Equipment;

• Vendors;

• State Or Governmental Agency Or Subdivision Or Political Subdivision - Permits

Or Authorizations;

• Mortgagee, Assignee Or Receiver;

• Grantor Of Franchise;

• Owners, Lessees Or Contractors;

• Controlling Interest; and

• Benefactors Or Grantors

9. Property Damage To Borrowed Equipment

10. Employees As Insureds - Specified Health Care Services

11. Broadened Notice Of Occurrence

12. Nonowned Aircraft

13. Bodily Injury Redefined

14. Expected Or Intended Injury Redefined

15. Former Employees As Insureds

16. Broadened Who Is An Insured

17. Replacement Of Customers Keys Or Locks

18. Limited Employee Criminal Defense Expense Coverage

19. Limited Assault Expense Coverage

20. Limited Rental Lease Agreement Contractual Liability Coverage

21. Fellow Employee Coverage

22. Personal And Advertising Injury Redefined

23. Voluntary Property Damage Coverage

24. Worldwide Liability Coverage Extension

25. Client Defined

B. Limits Of Insurance:

The Commercial General Liability Limits of Insurance apply to the insurance provided by this endorse-ment, except as provided below:

1. Employee Benefit Liability Coverage

Each Employee Limit: $1,000,000 Aggregate Limit: $3,000,000 Deductible Amount: $ 1,000

3. Damage To Premises Rented To You

GA 262 09 17 Services Office, Inc., with its permission. Page 2 of 23

a. The lesser of:

(1) The Each Occurrence Limit shown in the Declarations; or

(2) $1,000,000

b. $30,000 aggregate sublimit for damage caused by your "client"

4. Supplementary Payments

a. Bail Bonds: $5,000

b. Loss Of Earnings: $1,000

9. Property Damage To Borrowed Equipment

Each Occurrence Limit: $10,000 Deductible Amount: $ 250

17. Replacement Of Customers Keys Or Locks

Each Occurrence Limit: $25,000 Deductible Amount: $ 250

18. Limited Employee Criminal Defense Expense Coverage

Each Criminal Proceedings Limit: $10,000 Aggregate Limit: $50,000

19. Limited Assault Expense Coverage

Each Person Limit: $10,000 Aggregate Limit: $25,000

20. Limited Rental Lease Agreement Contractual Liability Coverage

Each Occurrence Limit: $100,000

23. Voluntary Property Damage Coverage

Each Occurrence Limit: $1,000 Aggregate Limit: $5,000 Deductible Amount: $ 250

GA 262 09 17 Services Office, Inc., with its permission. Page 3 of 23

C. Coverages

1. Employee Benefit Liability Coverage

a. The following is added to The follow-ing is added to Section I - Coverag-es:

(1) Insuring Agreement

(a) We will pay those sums that the insured becomes legally obligated to pay as damag-es caused by any act, error or omission of the insured, or of any other person for whose acts the insured is legally liable, to which this insurance applies. We will have the right and duty to defend the insured against any "suit" seeking those damages. However, we will have no duty to defend against any "suit" seeking damages to which this in-surance does not apply. We may, at our discretion, in-vestigate any report of an act, error or omission and settle any claim or "suit" that may result. But:

1) The amount we will pay for damages is limited as described in Sec-tion III - Limits Of In-surance; and

2) Our right and duty to defend ends when we have used up the appli-cable limit of insurance in the payment of judgments or settle-ments.

No other obligation or liabil-ity to pay sums or perform acts or services is covered unless explicitly provided for under Supplementary Pay-ments.

(b) This insurance applies to damages only if the act, er-ror or omission, is negligent-ly committed in the "admin-istration" of your "employee benefit program"; and

1) Occurs during the poli-cy period; or

2) Occurred prior to the "first effective date" of this endorsement pro-vided:

a) You did not have knowledge of a claim or "suit" on or before the "first effective date" of this endorsement.

You will be deemed to have knowledge of a claim or "suit" when any "author-ized representa-tive";

i) Reports all, or any part, of the act, error or omission to us or any oth-er insurer;

ii) Receives a written or ver-bal demand or claim for damages be-cause of the act, error or omission; and

b) There is no other applicable insur-ance.

(2) Exclusions

This insurance does not apply to:

(a) Bodily Injury, Property Damage Or Personal And Advertising Injury

"Bodily injury", "property damage" or "personal and advertising injury".

(b) Dishonest, Fraudulent, Criminal Or Malicious Act

Damages arising out of any intentional, dishonest, fraudulent, criminal or mali-cious act, error or omission, committed by any insured, including the willful or reck-less violation of any statute.

(c) Failure To Perform A Con-tract

Damages arising out of fail-ure of performance of con-tract by any insurer.

GA 262 09 17 Services Office, Inc., with its permission. Page 4 of 23

(d) Insufficiency Of Funds

Damages arising out of an insufficiency of funds to meet any obligations under any plan included in the "employee benefit pro-gram".

(e) Inadequacy Of Perfor-mance Of Invest-ment/Advice Given With Respect To Participation

Any claim based upon:

1) Failure of any invest-ment to perform;

2) Errors in providing in-formation on past per-formance of investment vehicles; or

3) Advice given to any person with respect to that person's decision to participate or not to participate in any plan included in the "em-ployee benefit pro-gram".

(f) Workers' Compensation And Similar Laws

Any claim arising out of your failure to comply with the mandatory provisions of any workers' compensation, un-employment compensation insurance, social security or disability benefits law or any similar law.

(g) ERISA

Damages for which any in-sured is liable because of li-ability imposed on a fiduci-ary by the Employee Re-tirement Income Security Act of 1974, as now or hereafter amended, or by any similar federal, state or local laws.

(h) Available Benefits

Any claim for benefits to the extent that such benefits are available, with reasonable effort and cooperation of the insured, from the applicable funds accrued or other col-lectible insurance.

(i) Taxes, Fines Or Penalties

Taxes, fines or penalties, including those imposed under the Internal Revenue Code or any similar state or local law.

(j) Employment-Related Practices

Any liability arising out of any:

(1) Refusal to employ;

(2) Termination of em-ployment;

(3) Coercion, demotion, evaluation, reassign-ment, discipline, defa-mation, harassment, humiliation, discrimina-tion or other employ-ment - related practic-es, acts or omissions;

or

(4) Consequential liability as a result of (1), (2) or

(3) above.

This exclusion applies whether the insured may be held liable as an employer or in any other capacity and to any obligation to share damages with or repay someone else who must pay damages because of the injury.

(3) Supplementary Payments

Section I - Coverages, Sup-plementary Payments - Cov-erages A And B also apply to this Coverage.

b. Who Is An Insured

As respects Employee Benefit Lia-bility Coverage, Section II - Who Is An Insured is replaced by the follow-ing:

(1) If you are designated in the Dec-larations as:

(a) An individual, you and your spouse are insureds, but only with respect to the conduct of a business of which you are the sole owner.

(b) A partnership or joint ven-ture, you are an insured.

GA 262 09 17 Services Office, Inc., with its permission. Page 5 of 23

Your members, your part-ners, and their spouses are also insureds but only with respect to the conduct of your business.

(c) A limited liability company, you are an insured. Your members are also insureds, but only with respect to the conduct of your business.

Your managers are in-sureds, but only with re-spect to their duties as your managers.

(d) An organization other than a partnership, joint venture or limited liability company, you are an insured. Your "executive officers" and di-rectors are insureds, but on-ly with respect to their du-ties as your officers or direc-tors. Your stockholders are also insureds, but only with respect to their liability as stockholders.

(e) A trust, you are an insured.

Your trustees are also in-sureds, but only with re-spect to their duties as trus-tees.

(2) Each of the following is also an insured:

(a) Each of your "employees" who is or was authorized to administer your "employee benefit program";

(b) Any persons, organizations or "employees" having proper temporary authoriza-tion to administer your "em-ployee benefit program" if you die, but only until your legal representative is ap-pointed; or

(c) Your legal representative if you die, but only with re-spect to duties as such.

That representative will have all your rights and du-ties under this Coverage Part.

(3) Any organization you newly ac-quire or form, other than a part-nership, joint venture or limited liability company, and over which you maintain ownership or majority interest, will qualify as a Named Insured if no other simi-lar insurance applies to that or-ganization. However, coverage under this provision:

(a) Is afforded only until the 180th day after you acquire or form the organization or the end of the policy period, whichever is earlier; and

(b) Does not apply to any act, error or omission that was committed before you ac-quired or formed the organi-zation.

c. Limits Of Insurance

As respects Employee Benefit Lia-bility Coverage, Section III - Limits Of Insurance is replaced by the fol-lowing:

(1) The Limits of Insurance shown in Section B. Limits Of Insur-ance, 1. Employee Benefit Li-ability Coverage and the rules below fix the most we will pay regardless of the number of:

(a) Insureds;

(b) Claims made or "suits" brought;

(c) Persons or organizations making claims or bringing "suits";

(d) Acts, errors or omissions; or

(e) Benefits included in your "employee benefit pro-gram".

(2) The Aggregate Limit shown in Section B. Limits Of Insurance,

1. Employee Benefit Liability Coverage of this endorsement is the most we will pay for all damages because of acts, errors or omissions negligently commit-ted in the "administration" of your "employee benefit pro-gram".

(3) Subject to the limit described in

(2) above, the Each Employee Limit shown in Section B. Limits Of Insurance, 1. Employee Benefit Liability Coverage of this endorsement is the most we will pay for all damages sus-tained by any one "employee", including damages sustained by such "employee's" dependents and beneficiaries, as a result of:

(a) An act, error or omission; or

GA 262 09 17 Services Office, Inc., with its permission. Page 6 of 23

(b) A series of related acts, er-rors or omissions, regard-less of the amount of time that lapses between such acts, errors or omissions;

negligently committed in the "administration" of your "em-ployee benefit program".

However, the amount paid under this endorsement shall not ex-ceed, and will be subject to the limits and restrictions that apply to the payment of benefits in any plan included in the "employee benefit program".

(4) Deductible Amount

(a) Our obligation to pay dam-ages on behalf of the in-sured applies only to the amount of damages in ex-cess of the Deductible Amount stated in the Decla-rations as applicable to Each Employee. The limits of insurance shall not be re-duced by the amount of this deductible.

(b) The Deductible Amount stated in the Declarations applies to all damages sus-tained by any one "employ-ee", including such "em-ployee's" dependents and beneficiaries, because of all acts, errors or omissions to which this insurance ap-plies.

(c) The terms of this insurance, including those with respect to:

1) Our right and duty to defend the insured against any "suits" seeking those damag-es; and

2) Your duties, and the duties of any other in-volved insured, in the event of an act, error or omission, or claim;

apply irrespective of the ap-plication of the Deductible Amount.

(d) We may pay any part or all of the Deductible Amount to effect settlement of any claim or "suit" and, upon no-tification of the action taken, you shall promptly reim-burse us for such part of the Deductible Amount as we have paid.

d. Additional Conditions

As respects Employee Benefit Lia-bility Coverage, Section IV - Com-mercial General Liability Condi-tions is amended as follows:

(1) Item 2. Duties In The Event Of Occurrence, Offense, Claim Or Suit is deleted in its entirety and replaced by the following:

2. Duties In The Event Of An Act, Error Or Omission, Or Claim Or Suit

a. You must see to it that we are notified as soon as practicable of an act, error or omission which may result in a claim.

To the extent possible, notice should include:

(1) What the act, error or omission was and when it oc-curred; and

(2) The names and addresses of any-one who may suf-fer damages as a result of the act, error or omission.

b. If a claim is made or "suit" is brought against any insured, you must:

(1) Immediately rec-ord the specifics of the claim or "suit" and the date re-ceived; and

(2) Notify us as soon as practicable.

You must see to it that we receive written no-tice of the claim or "suit" as soon as prac-ticable.

c. You and any other in-volved insured must:

(1) Immediately send us copies of any demands, notices, summonses or le-gal papers re-ceived in connec-

GA 262 09 17 Services Office, Inc., with its permission. Page 7 of 23 tion with the claim or "suit";

(2) Authorize us to ob-tain records and other information;

(3) Cooperate with us in the investigation or settlement of the claim or de-fense against the "suit"; and

(4) Assist us, upon our request, in the enforcement of any right against any person or or-ganization which may be liable to the insured be-cause of an act, error or omission to which this in-surance may also apply.

d. No insured will, except at that insured's own cost, voluntarily make a payment, assume any obligation, or incur any expense without our consent.

(2) Item 5. Other Insurance is re-placed by the following:

5. Other Insurance

If other valid and collectible insurance is available to the insured for a loss we cover under this Coverage Part, our obligations are limited as follows:

a. Primary Insurance

This insurance is pri-mary except when c.

below applies. If this in-surance is primary, our obligations are not af-fected unless any of the other insurance is also primary. Then, we will share with all that other insurance by the meth-od described in b. be-low.

b. Method Of Sharing

If all of the other insur-ance permits contribu-tion by equal shares, we will follow this method also. Under this approach each insurer contributes equal amounts until it has paid its applicable limit of insurance or none of the loss remains, whichever comes first.

If any of the other in-surance does not per-mit contribution by equal shares, we will contribute by limits.

Under this method, each insurer's share is based on the ratio of its applicable limit of in-surance to the total ap-plicable limits of insur-ance of all insurers.

c. No Coverage

This insurance shall not cover any loss for which the insured is en-titled to recovery under any other insurance in force previous to the ef-fective date of this Coverage Part.

e. Additional Definitions

As respects Employee Benefit Lia-bility Coverage, Section V - Defini-tions is amended as follows:

(1) The following definitions are added:

1. "Administration" means:

a. Providing information to "employees", including their dependents and beneficiaries, with re-spect to eligibility for or scope of "employee benefit programs";

b. Interpreting the "em-ployee benefit pro-grams";

c. Handling records in connection with the "employee benefit pro-grams"; or

d. Effecting, continuing or terminating any "em-ployee's" participation in any benefit included in the "employee bene-fit program".

GA 262 09 17 Services Office, Inc., with its permission. Page 8 of 23

However, "administration" does not include:

a. Handling payroll deduc-tions; or

b. The failure to effect or maintain any insurance or adequate limits of coverage of insurance, including but not limited to unemployment in-surance, social security benefits, workers' com-pensation and disability benefits.

2. "Cafeteria plans" means plans authorized by appli-cable law to allow "employ-ees" to elect to pay for cer-tain benefits with pre-tax dollars.

3. "Employee benefit pro-grams" means a program providing some of all of the following benefits to "em-ployees", whether provided through a "cafeteria plan" or otherwise:

a. Group life insurance;

group accident or health insurance; den-tal, vision and hearing plans; and flexible spending accounts;

provided that no one other than an "employ-ee" may subscribe to such benefits and such benefits are made gen-erally available to those "employees" who satis-fy the plan's eligibility requirements;

b. Profit sharing plans, employee savings plans, employee stock ownership plans, pen-sion plans and stock subscription plans, pro-vided that no one other than an "employee" may subscribe to such benefits and such ben-efits are made general-ly available to all "em-ployees" who are eligi-ble under the plan for such benefits;

c. Unemployment insur-ance, social security benefits, workers' com-pensation and disability benefits; and

d. Vacation plans, includ-ing buy and sell pro-grams; leave of ab-sence programs, in-cluding military, mater-nity, family, and civil leave; tuition assis-tance plans; transporta-tion and health club subsidies.

4. "First effective date" means the date upon which cover-age was first effected in a series of uninterrupted re-newals of insurance cover-age.

(2) The following definitions are de-leted in their entirety and re-placed by the following:

8. "Employee" means a per-son actively employed, for-merly employed, on leave of absence or disabled, or re-tired. "Employee" includes a "leased worker". "Employ-ee" does not include a "temporary worker".

21. "Suit" means a civil pro-ceeding in which money damages because of an act, error or omission to which this insurance applies are alleged. "Suit" includes:

a. An arbitration proceed-ing in which such dam-ages are claimed and to which the insured must submit or does submit with our con-sent;

b. Any other alternative dispute resolution pro-ceeding in which such damages are claimed and to which the in-sured submits with our consent; or

c. An appeal of a civil proceeding.

2. Unintentional Failure To Disclose Haz-ards

Section IV - Commercial General Lia-bility Conditions, 7. Representations is amended by the addition of the following:

GA 262 09 17 Services Office, Inc., with its permission. Page 9 of 23

Based on our dependence upon your rep-resentations as to existing hazards, if un-intentionally you should fail to disclose all such hazards at the inception date of your policy, we will not reject coverage under this Coverage Part based solely on such failure.

3. Damage To Premises Rented To You

a. The last Paragraph of 2. Exclusions under Section I - Coverage A - Bod-ily Injury And Property Damage Li-ability is replaced by the following:

Exclusions c. through q. do not ap-ply to "property damage" by fire, ex-plosion, lightning, smoke or soot to premises while rented to you or temporarily occupied by you with permission of the owner, for which the amount we will pay is limited to the Damage To Premises Rented To You Limit as described in Sec-tion III - Limits Of Insurance.

b. The insurance provided under Sec-tion I - Coverage A - Bodily Injury And Property Damage Liability ap-plies to "property damage" arising out of water damage to premises that are both rented to and occupied by you.

(1) As respects Water Damage Le-gal Liability, as provided in Par-agraph 3.b. above:

The exclusions under Section I - Coverage A - Bodily Injury And Property Damage Liabil-ity, 2. Exclusions, other than i.

War and the Nuclear Energy Liability Exclusion (Broad Form), are deleted and the fol-lowing are added:

This insurance does not apply to:

(a) "Property damage":

(i) Assumed in any con-tract or agreement; or

(ii) Caused by or resulting from any of the follow-ing:

1) Wear and tear;

2) Rust or other cor-rosion, decay, de-terioration, hidden or latent defect or any quality in property that causes it to dam-age or destroy it-self;

3) Smog;

4) Mechanical break-down including rupture or bursting caused by centrif-ugal force;

5) Settling, cracking, shrinking or ex-pansion;

6) Nesting or infesta-tion, or discharge or release of waste products or secretions, by in-sects, birds, ro-dents or other an-imals; or

7) Presence, growth, proliferation, spread or any ac-tivity of fungus, in-cluding mold or mildew, and any mycotoxins, spores, scents or byproducts pro-duced or released by fungi.

(b) "Property Damage" caused directly or indirectly by any of the following:

(i) Earthquake, volcanic eruption, landslide or any other earth move-ment;

(ii) Water that backs up or overflows or is other-wise discharged from a sewer, drain, sump, sump pump or related equipment;

(iii) Water under the ground surface pressing on, or flowing or seeping through:

1) Foundations, walls, floors or paved surfaces;

2) Basements, whether paved or not; or

3) Doors, windows or other openings.

GA 262 09 17 Services Office, Inc., with its permission. Page 10 of 23

(c) "Property damage" caused by or resulting from water that leaks or flows from plumbing, heating, air condi-tioning, fire protection sys-tems, or other equipment, caused by or resulting from freezing, unless:

(i) You did your best to maintain heat in the building or structure; or

(ii) You drained the equipment and shut off the water supply if the heat was not main-tained.

(d) "Property damage" to:

(i) Plumbing, heating, air conditioning, fire pro-tection systems, or oth-er equipment or appli-ances; or

(ii) The interior of any building or structure, or to personal property in the building or structure caused by or resulting from rain, snow, sleet or ice, whether driven by wind or not.

c. Limit Of Insurance

With respect to the insurance afford-ed in Paragraphs 3.a. and 3.b.

above, the Damage To Premises Rented To You Limit as shown in the Declarations is amended as fol-lows:

(1) Paragraph 6. of Section III - Limits Of Insurance is replaced by the following:

6. Subject to Paragraph 5.

above, the Damage To Premises Rented To You Limit is the most we will pay under Coverage A - Bodily Injury And Property Dam-age Liability for damages because of "property dam-age" to any one premises:

a. While rented to you, or temporarily occupied by you with permission of the owner;

b. In the case of damage by fire, explosion, light-ning, smoke or soot, while rented to you; or

c. In the case of damage by water, while rented to and occupied by you.

(2) The most we will pay is limited as described in Section B. Lim-its Of Insurance, 3. Damage To Premises Rented To You of this endorsement.

4. Supplementary Payments

Under Section I - Supplementary Pay-ments - Coverages A And B:

a. Paragraph 2. is replaced by the fol-lowing:

Up to the limit shown in Section B.

Limits Of Insurance, 4.a. Bail Bonds of this endorsement 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 ap-plies. We do not have to furnish these bonds.

b. Paragraph 4. is replaced by the fol-lowing:

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 the limit shown in Section B. Limits Of Insurance, 4.b. Loss Of Earnings of this en-dorsement per day because of time off from work.

5. Medical Payments

Section I - Coverage C - Medical Pay-ments, 2. Exclusions, a. Any Insured is replaced by the following:

a. Any Insured

To any insured, except:

(1) A "volunteer worker"; or

(2) A student in training, medical di-rector or administrator who is providing services on your be-half.

6. 180 Day Coverage For Newly Formed Or Acquired Organizations

Section II - Who Is An Insured is amended as follows:

Subparagraph a. of Paragraph 3. is re-placed by the following:

a. Insurance under this provision is af-forded only until the 180th day after you acquire or form the organization

GA 262 09 17 Services Office, Inc., with its permission. Page 11 of 23 or the end of the policy period, whichever is earlier;

7. Waiver Of Subrogation

Section IV - Commercial General Lia-bility Conditions, 9. Transfer Of Rights Of Recovery Against Others To Us is amended by the addition of the following:

We waive any right of recovery we may have against any person or organization against whom you have agreed to waive such right of recovery in a written contract or agreement because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a written contract or agree-ment with that person or organization and included in the "products-completed op-erations hazard". However, our rights may only be waived prior to the "occurrence" giving rise to the injury or damage for which we make payment under this Cov-erage Part. The insured must do nothing after a loss to impair our rights. At our re-quest, the insured will bring "suit" or transfer those rights to us and help us en-force those rights.

8. Automatic Additional Insured - Speci-fied Relationships

a. The following is added to Section II - Who Is An Insured:

(1) Any person(s) or organization(s) described in Paragraph 8.a.(2) of this endorsement (hereinafter referred to as additional insured) whom you are required to add as an additional insured under this Coverage Part by reason of a written contract, written agreement, written permit or written authorization or, only with respect to Paragraph 8.a.(2)(i) of this endorsement, an oral agreement or contract.

(2) Only the following persons or organizations are additional in-sureds under this endorsement, and insurance coverage provid-ed to such additional insureds is limited as provided herein:

(a) Managers Or Lessors Of Premises

The manager or lessor of a premises leased to you with whom you have agreed per Paragraph 8.a.(1) of this endorsement to provide in-surance, but only with re-spect to liability arising out of the ownership, mainte-nance or use of that part of the premises leased to you, subject to the following ad-ditional exclusions:

This insurance does not ap-ply to:

(i) Any "occurrence" which takes place after you cease to be a tenant in that premises;

(ii) Structural alterations, new construction or demolition operations performed by or on be-half of such additional insured.

(b) Lessor Of Leased Equip-ment

Any person or organization from whom you lease equipment when you and such person(s) or organiza-tion(s) have agreed per Paragraph 8.a.(1) of this endorsement to provide in-surance. Such person(s) or organization(s) are insureds only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by your maintenance, operation or use of equipment leased to you by such person(s) or organization(s). 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.

However, this insurance does not apply to any "oc-currence" which takes place after the equipment lease expires.

(c) Vendors

Any person or organization (referred to below as ven-dor) with whom you have agreed per Paragraph 8.a.(1) of this endorsement to provide insurance, but only with respect to "bodily injury" or "property damage" arising out of "your prod-ucts" which are distributed or sold in the regular course

GA 262 09 17 Services Office, Inc., with its permission. Page 12 of 23 of the vendor's business, subject to the following ad-ditional exclusions:

(i) The insurance afforded the vendor does not apply to:

1) "Bodily injury" or "property damage" for which the ven-dor is obligated to pay damages by reason of the as-sumption of liabil-ity 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;

2) Any express war-ranty unauthorized by you;

3) Any physical or chemical change in the product made intentionally by the vendor;

4) Repackaging, ex-cept when un-packed solely for the purpose of in-spection, demon-stration, testing, or the substitution of parts under in-structions from the manufacturer, and then repackaged in the original con-tainer;

5) Any failure to make such inspec-tions, adjustments, tests or servicing as the vendor has agreed to make or normally under-takes to make in the usual course of business, in connection with the distribution or sale of the prod-ucts;

6) Demonstration, in-stallation, servic-ing or repair oper-ations, except such operations performed at the vendor's premises in connection with the sale of the product;

7) Products which, after distribution or sale by you, have been labeled or re-labeled or used as a container, part or ingredient of any other thing or sub-stance by or for the vendor; or.

8) "Bodily injury" or "property damage" arising out of the sole negligence of the vendor for its own acts or omis-sions or those of its employees or anyone else acting on its behalf.

However, this ex-clusion does not apply to:

a) The excep-tions con-tained in Par-agraphs (c)(i)4) or 6) of this endorse-ment; or

b) Such inspec-tions, adjust-ments, tests or servicing as the vendor has agreed to make or nor-mally under-takes to make in the usual course of business, in connection with the distri-bution or sale of the prod-ucts.

(ii) This insurance does not apply to any in-sured person or organi-zation:

1) From whom you have acquired

GA 262 09 17 Services Office, Inc., with its permission. Page 13 of 23 such products, or any ingredient, part or container, entering into, ac-companying or containing such products; or

2) When liability in-cluded within the "products-completed opera-tions hazard" has been excluded under this Cover-age Part with re-spect to such products.

(d) State Or Governmental Agency Or Subdivision Or Political Subdivision - Permits Or Authorizations

Any state or governmental agency or subdivision or po-litical subdivision with which you have agreed per Para-graph 8.a.(1) of this en-dorsement to provide insur-ance, subject to the follow-ing additional provision:

This insurance applies only:

(i) With respect to the fol-lowing hazards for which the state or gov-ernmental agency or subdivision or political subdivision has issued a permit or authoriza-tion in connection with premises you own, rent or control and to which this insurance applies:

1) The existence, maintenance, re-pair, construction, erection or remov-al of advertising signs, awnings, canopies, cellar entrances, coal holes, driveways, manholes, mar-quees, hoist away openings, side-walk vaults, street banners or deco-rations and similar exposures; or

2) The construction, erection or remov-al of elevators; or

3) The ownership, maintenance or use of any eleva-tors covered by this insurance.

(ii) With respect to opera-tions performed by you or on your behalf for which the state or gov-ernmental agency or subdivision or political subdivision issued, in writing, a contract, agreement, permit or authorization.

However, with regard to (d)(ii) above, this in-surance does not apply to:

1) "Bodily injury", "property damage" or "personal and advertising injury" arising out of op-erations performed for the federal government, state or municipality; or

2) "Bodily injury" or "property damage" included within the "products-completed opera-tions hazard".

(e) Mortgagee, Assignee Or Receiver

Any person or organization with whom you have agreed per Paragraph 8.a.(1) of this endorsement to provide in-surance, but only with re-spect to their liability as mortgagee, assignee, or re-ceiver and arising out of the ownership, maintenance, or use of the premises by you.

However, this insurance does not apply to structural alterations, new construc-tion and demolition opera-tions performed by or for that person or organization.

(f) Grantor Of Franchise

Any person or organization with whom you have agreed per Paragraph 8.a.(1) of this endorsement to provide in-surance, but only with re-spect to their liability as the

GA 262 09 17 Services Office, Inc., with its permission. Page 14 of 23 grantor of a franchise to you.

(g) Owners, Lessees Or Con-tractors

Any person or organization with whom you have agreed per Paragraph 8.a.(1) of this endorsement to provide in-surance, but only with re-spect to liability for "bodily injury," "property damage" or " personal and advertis-ing injury" caused, in whole or in part, by:

i) Your acts or omissions;

or

ii) The acts or omissions of those acting on your behalf;

in the performance of your ongoing operations for the additional insured when re-quired by a written contract.

With respect to the insur-ance afforded to these addi-tional insureds, the following exclusions apply:

This insurance does not ap-ply to "bodily injury" or "property damage" occur-ring after:

1) All work, including ma-terials, parts or equip-ment furnished in con-nection with such work, on the project (other than service, mainte-nance or repairs) to be performed by or on be-half of the additional in-sured(s) at the location of the covered opera-tions has been com-pleted; or

2) That portion of "your work" out of which the injury or damage arises has been put to its in-tended use by any per-son or organization other than another con-tractor or subcontractor engaged in performing operations for a princi-pal as a part of the same project.

(h) Controlling Interest

Any person or organization with whom you have agreed per Paragraph 8.a.(1) of this endorsement to provide in-surance, but only with re-spect to their liability arising out of:

(i) Their financial control of you; or

(ii) Premises they own maintain or control while you lease or oc-cupy these premises.

This insurance does not ap-ply to structural alterations, new construction and demo-lition operations performed by or for that person or or-ganization.

(i) Benefactors Or Grantors

Any person or organization with whom you have agreed per Paragraph 8.a.(1) above to provide insurance, but only with respect to "bodily injury", "property damage", or "personal and advertising injury" arising out of:

(i) Their providing financ-ing or funding to you; or

(ii) Premises they own, maintain or control while you lease or oc-cupy these premises.

This insurance does not ap-ply to structural alterations, new construction and demo-lition operations performed by or for that person or or-ganization.

(3) The insurance afforded to addi-tional insureds described in Par-agraph 8.a.(1) of this endorse-ment:

(a) Only applies to the extent permitted by law; and

(b) Will not be broader than that which you are required by the written contract, written agreement, written permit or written authorization to pro-vide for such additional in-sured; and

(c) Does not apply to any per-son, organization, vendor, state, governmental agency

GA 262 09 17 Services Office, Inc., with its permission. Page 15 of 23 or subdivision or political subdivision, specifically named as an additional in-sured under any other pro-vision of, or endorsement added to, this Coverage Part, provided such other provision or endorsement covers the injury or damage for which this insurance ap-plies.

b. With respect to the insurance afford-ed to the additional insureds de-scribed in Paragraph 8.a.(1) of this endorsement, the following is added to Section III - Limits Of Insurance:

The most we will pay on behalf of the additional insured is the amount of insurance:

(1) Required by the written contract, written agreement, written permit or written authorization de-scribed in Paragraph 8.a.(1) of this endorsement; 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.

c. Section IV - Commercial General Liability Conditions is amended to include the following:

Automatic Additional Insured Pro-vision

This insurance applies only if the "bodily injury" or "property damage" occurs, or the "personal and advertis-ing injury" offense is committed:

(1) During the policy period; and

(2) Subsequent to your execution of the written contract or written agreement, or the issuance of a written permit or written authori-zation, described in Paragraph 8.a.(1).

d. Section IV - Commercial General Liability Conditions is amended as follows:

Condition 5. Other Insurance is amended to include:

Primary And Noncontributory In-surance

This insurance is primary to and will not seek contribution from any other insurance available to an additional insured per Paragraph 8.a.(1) of this endorsement provided that:

(1) The additional insured is a Named Insured under such oth-er insurance; and

(2) You have agreed in writing in a contract, agreement, permit or authorization described in 8.a.(2) of this endorsement that this in-surance would be primary and would not seek contribution from any other insurance available to the additional insured.

9. Property Damage To Borrowed Equipment

a. The following is added to Exclusion 2.j. Damage To Property under Section I - Coverage A - Bodily In-jury And Property Damage Liabil-ity:

Paragraphs (3) and (4) of this exclu-sion do not apply to tools or equip-ment loaned to you, provided they are not being used to perform opera-tions at the time of loss.

b. With respect to the insurance provid-ed by this section of the endorse-ment, the following additional provi-sions apply:

(1) The Limits of Insurance shown in the Declarations are replaced by the limits designated in Sec-tion B. Limits Of Insurance, 9.

Property Damage To Bor-rowed Equipment of this en-dorsement with respect to cov-erage provided by this endorse-ment. These limits are inclusive of and not in addition to the lim-its being replaced. The Limits of Insurance shown in Section B.

Limits Of Insurance, 9. Proper-ty Damage To Borrowed Equipment of this endorsement fix the most we will pay in any one "occurrence" regardless of the number of:

(a) Insureds;

(b) Claims made or "suits" brought; or

(c) Persons or organizations making claims or bringing "suits".

(2) Deductible Clause

GA 262 09 17 Services Office, Inc., with its permission. Page 16 of 23

(a) Our obligation to pay dam-ages on your behalf applies only to the amount of dam-ages for each "occurrence" which are in excess of the Deductible Amount stated in Section B. Limits Of Insur-ance, 9. Property Damage To Borrowed Equipment of this endorsement. The limits of insurance will not be reduced by the applica-tion of such Deductible Amount.

(b) Section IV - Commercial General Liability Condi-tions, 2. Duties In The Event Of Occurrence, Of-fense, Claim Or Suit, ap-plies to each claim or "suit" irrespective of the amount.

(c) We may pay any part or all of the deductible amount to effect settlement of any claim or "suit" and, upon no-tification of the action taken, you shall promptly reim-burse us for such part of the deductible amount as has been paid by us.

10. Employees As Insureds - Specified Health Care Services

Paragraph 2.a.(1)(d) under Section II - Who Is An Insured does not apply to:

Your "employees" who provide profes-sional health care services on your behalf as a duly licensed nurse, emergency medical technician or paramedic in the ju-risdiction where an "occurrence" or of-fense to which this insurance applies takes place.

11. Broadened Notice Of Occurrence

Paragraph a. of Condition 2. Duties In The Event Of Occurrence, Offense, Claim Or Suit under Section IV - Com-mercial General Liability Conditions is replaced by the following:

a. You must see to it that we are noti-fied as soon as practicable of an "oc-currence" or an offense which may result in a claim. To the extent possi-ble, notice should include:

(1) How, when and where the "oc-currence" or offense took place;

(2) The names and addresses of any injured persons and wit-nesses; and

(3) The nature and location of any injury or damage arising out of the "occurrence" or offense.

This requirement applies only when the "occurrence" or offense is known to an "authorized representative".

12. Nonowned Aircraft

The following is added to Exclusion 2.g.

Aircraft, Auto Or Watercraft under Sec-tion I - Coverage A - Bodily Injury And Property Damage Liability:

This exclusion does not apply to an air-craft you do not own, provided:

a. The pilot in command holds a current effective certificate, issued by a duly constituted authority of the United States of America or Canada, desig-nating that person as a commercial or airline transport pilot;

b. The aircraft is rented with a trained, paid crew; and

c. The aircraft does not transport per-sons or cargo for a charge.

13. Bodily Injury Redefined

Section V - Definitions, 4. "Bodily injury" is replaced by the following:

4. "Bodily injury" means bodily harm or injury, sickness, disease, disability, humiliation, shock, fright, mental an-guish or mental injury, including care, loss of services or death resulting from any of these at any time.

14. Expected Or Intended Injury Redefined

The last sentence of Exclusion 2.a. Ex-pected Or Intended Injury under Sec-tion I - Coverage A - Bodily Injury And Property Damage Liability is replaced by the following:

This exclusion does not apply to "bodily injury" or "property damage" resulting from the use of reasonable force to pro-tect persons or property.

15. Former Employees As Insureds

The following is added to Paragraph 2.

under Section II - Who Is An Insured:

2. Each of the following is also an in-sured:

Any of your former "employees", di-rectors, managers, members, part-ners or "executive officers", including but not limited to retired, disabled or those on leave of absence, but only for acts within the scope of their em-

GA 262 09 17 Services Office, Inc., with its permission. Page 17 of 23 ployment by you or for duties related to the conduct of your business.

16. Broadened Who Is An Insured

a. Section II - Who Is An Insured, Paragraph 2. is amended to include:

2. Each of the following is also an insured:

a. Your officials, trustees, board members, insurance managers, medical directors and administrators while acting within the scope of their duties as such.

b. Your students in training and "not for profit mem-bers", but only with respects to their liability for duties or activities they perform on your behalf.

c. Your "independent contrac-tor" but only with respects to their liability for services provided to your "client".

b. Section IV - Commercial General Liability Conditions, 5. Other In-surance is replaced by the following:

5. Other Insurance

This insurance is excess over any other valid and collectible insurance, including deductible, or agreement of indemnity avail-able to the "independent con-tractor", whether primary, ex-cess, contingent or on any other basis. Other valid and collectible insurance includes, but is not limited to, policies or insurance programs purchased or estab-lished by or on behalf of the "in-dependent contractor" to insure against liability arising from ac-tivities of the "independent con-tractor", whether primary, ex-cess, contingent, or on any other basis.

c. Section V - Definitions is amended to include:

1. "Independent contractor" means a social service pro-fessional who you do not classify as an "employee", and to whom you refer "cli-ents" or who provide ser-vices to your "clients" on your behalf. An "independ-ent contractor" does not in-clude those performing con-struction, weatherization, maintenance and related services.

2. "Not for profit members" means a person who is a member of a not-for-profit organization, including clubs and churches, who receives no financial or other com-pensation.

17. Replacement Of Customers Keys Or Locks

Section I - Coverage A - Bodily Injury And Property Damage Liability, 2. Ex-clusions, j. Damage To Property, (4) is replaced by the following:

(4) Personal property in the care, custo-dy, or control of an insured.

However, this exclusion does not ap-ply to the replacement of keys, ad-justment of locks to accept new keys, or if required, replacement and instal-lation of locks, or the hiring of tempo-rary security services as a result of you or your "employees" losing keys on your customer's premises.

(a) The most we will pay is limited as described in Section B. Lim-its Of Insurance, 17. Replace-ment Of Customers Keys Or Locks of this endorsement.

(b) Our obligation to pay damages on your behalf applies only to the amount of damages for each "occurrence" which are in ex-cess of the Deductible Amount stated in Section B. Limits Of Insurance, 17. Replacement Of Customers Keys Or Locks of this endorsement. The limits of insurance will not be reduced by the application of such deducti-ble amount.

18. Limited Employee Criminal Defense Expense Coverage

a. Coverage

(1) We will pay defense costs in-curred by your medical director or administrator for criminal pro-ceedings arising solely from acts in his or her capacity as medical director or administrator for you.

However, you must have a prior written agreement with the med-ical director or administrator whereby you agree to pay the medical director or administrator for such defense costs, and the

GA 262 09 17 Services Office, Inc., with its permission.