2023-08-23 Pace Analytical Services GAUWP End.pdf

SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE

THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN

ACCORDANCE WITH THE POLICY PROVISIONS.

INSURER(S) AFFORDING COVERAGE

INSURER F :

INSURER E :

INSURER D :

INSURER C :

INSURER B :

INSURER A :

NAIC #

NAME:

CONTACT

(A/C, No):

FAX

E-MAIL

ADDRESS:

PRODUCER

(A/C, No, Ext):

PHONE

INSURED

REVISION NUMBER:CERTIFICATE NUMBER:COVERAGES

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).

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.

OTHER:

(Per accident)

(Ea accident)

N / A

SUBR

WVD

ADDL

INSD

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.

$PROPERTY DAMAGE

BODILY INJURY (Per accident)

BODILY INJURY (Per person)

COMBINED SINGLE LIMIT

AUTOS ONLY

AUTOSAUTOS ONLY

NON-OWNED

SCHEDULEDOWNED

ANY AUTO

AUTOMOBILE LIABILITY

Y / N

WORKERS COMPENSATION

AND EMPLOYERS' LIABILITY

OFFICER/MEMBER EXCLUDED?

(Mandatory in NH)

DESCRIPTION OF OPERATIONS below If yes, describe under

ANY PROPRIETOR/PARTNER/EXECUTIVE

E.L. DISEASE - POLICY LIMIT

E.L. DISEASE - EA EMPLOYEE

E.L. EACH ACCIDENT

ER

OTH-

STATUTE

PER

LIMITS(MM/DD/YYYY)

POLICY EXP

(MM/DD/YYYY)

POLICY EFF

POLICY NUMBERTYPE OF INSURANCELTR

INSR

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

EXCESS LIAB

UMBRELLA LIAB $EACH OCCURRENCE

$AGGREGATE

OCCUR

CLAIMS-MADE

DED RETENTION $

$PRODUCTS - COMP/OP AGG

$GENERAL AGGREGATE

$PERSONAL & ADV INJURY

$MED EXP (Any one person)

$EACH OCCURRENCE

DAMAGE TO RENTED

$PREMISES (Ea occurrence)

COMMERCIAL GENERAL LIABILITY

CLAIMS-MADE OCCUR

GEN'L AGGREGATE LIMIT APPLIES PER:

POLICY

PRO-

JECT LOC

CERTIFICATE OF LIABILITY INSURANCE

DATE (MM/DD/YYYY)

CANCELLATION

AUTHORIZED REPRESENTATIVE

ACORD 25 (2016/03)

© 1988-2016 ACORD CORPORATION. All rights reserved.

CERTIFICATE HOLDER

The ACORD name and logo are registered marks of ACORD

HIRED

AUTOS ONLY

Willis Towers Watson Midwest, Inc.

c/o 26 Century Blvd P.O. Box 305191 Nashville, TN 372305191 USA

Pace Analytical Services, LLC 1800 Elm St. SE Minneapolis, MN 55414

This Voids and Replaces Previously Issued Certificate Dated 08/26/2022 WITH ID: W25735502.

Div/Loc: 80

Solicitation Number: BPM004422; Contract #CTR061676.

Arizona Department of Environmental Quality Attn: Ana Machiche 1110 W. Washington Street Phoenix, AZ 85007

08/29/2022

1-877-945-7378 1-888-467-2378 certificates@willis.com

The Charter Oak Fire Insurance Company 25615

Travelers Property Casualty Company of Ame

Lloyd's Syndicate 2623 (Beazley Furlong Li

25674

C2166

W25743803

A

1,000,000

500,000

10,000

1,000,000

2,000,000

2,000,000

Y Y H-660-3H339745-COF-22 08/01/2022 08/01/2023

B

1,000,000

08/01/202308/01/2022Y Y 810-2N839583-22-I2-G

B 5,000,000

10,000

Y Y CUP-5N703311-22-I2 08/01/2022 08/01/2023 5,000,000

UB-8K063715-22-I2-G

B Y

1,000,000 No 08/01/2022 08/01/2023

1,000,000

1,000,000

C Professional Liability

Claims Made

Each ClaimW33150220101 08/01/2022 08/01/2023

Aggregate

Y

SIR

264895822996177SR ID: BATCH:

$100,000

$5,000,000

$5,000,000

Willis Towers Watson Certificate Center

ACORD 101 (2008/01)

The ACORD name and logo are registered marks of ACORD

© 2008 ACORD CORPORATION. All rights reserved.

THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM,

FORM NUMBER: FORM TITLE:

ADDITIONAL REMARKS

ADDITIONAL REMARKS SCHEDULE Page of

AGENCY CUSTOMER ID:

LOC #:

AGENCY

CARRIER NAIC CODE

POLICY NUMBER

NAMED INSURED

EFFECTIVE DATE:

Pace Analytical Services, LLC 1800 Elm St. SE Minneapolis, MN 55414

The State of Arizona, and its departments, agencies, boards, commissions, universities, officers, officials, agents, and employees are included as Additional Insureds as respects to General Liability, Auto Liability and Umbrella/Excess Liability where required by written contract.

General Liability, Auto Liability and Umbrella/Excess Liability policies shall be Primary to any other insurance in force for or which may be purchased by Additional Insureds where required by written contract.

Waiver of Subrogation applies in favor of Additional Insureds with respects to General Liability, Auto Liability, Umbrella/Excess Liability and Workers Compensation as permitted by law.

Waiver of Subrogation where required by written agreement/contract prior to the date of loss or incident for Professional Liability.

2 2

Willis Towers Watson Midwest, Inc.

See Page 1

See Page 1 See Page 1 See Page 1

25 Certificate of Liability Insurance

W25743803CERT:2648958BATCH:22996177SR ID:

COMM RCI L G NERAL IAB LI YE A E L I T

T IS ENDORSEMENT CHANGES T E POLICY. PLEASE REA IT CA EF LLYH H D R U .

BLANKET ADDITIONAL INSURED – A TOMA IC STA USU T T

IF REQUIRED BY WRITTEN CONTRACT (CONTRACTORS)

Thi e dorseme t m d fie i surance prov ded und er he f l o ing:s n n o i s n i t o l w

COMM RCI L G NERAL IAB LI Y COVERAG PA TE A E L I T E R

The fol owing is ad ed tol d SE TI N II – WHO IS AN (a)C O The Addi ional Insured – Owne s, Le -t r s INSU EDR : see or Contra tors – Scheduled Persos c n or Organizat o endorsem n CG 20 10i n e tAny erson or o ganiza io tha :p r t n t 07 04 o CG 20 10 04 13, the Addi ionalr t

a. Yo agree in a writ en cont a t o ag ee ent tou t r c r r m In ured – Owne s, Le see or Con ra -s r s s t c i clu e as an a ditio al insured on thi Cov ragen d d n s e to s – Com le ed Ope ations endorser p t r - Pa t anr ; d m n CG 20 37 07 04 or CG 20 3 7 04 13,e t

b. Ha not been added a an additio al in ured fos s n s r or both o such endo seme ts wi h ei hef r n t t r the sam proje t by at a hm nt o an en orsee c t c e f d - o ho e ed tio date ; orf t s i n s m n under thi Cov rage Pa t which includee t s e r s (b) Ei her or bot o the fol o ing the Addit h f l w : -such perso or organi at on in the endorsem nt'sn z i e tio al In ured – Owne s, Le sees o Con-n s r s r schedule; tra to s – Scheduled Person Or Organ -c r i i a insured but:s n , za ion en orsem n CG 20 10, o the Ad-t d e t r

a. On y with re pe t to lia ili y fo "bodily injury di ional Insured – Owl s c b t r t ne s, Le see or s s r" or

Co tra tors – Com le ed Ope atio s en-n c p t r n"prope ty dam ge that o cur , or fo "perso alr a " c s r n do sem nt CG 20 37, wi hout a edit or e t n i ni ju y caused by an o f n e that is com it ed,n r " f e s m t da e o uch endo sem nt pe i ie ;t f s r e s c f dsubsequent to the signing of that contract or ag ee ent and while that pa t o the cont a t or m r f r c r the person o o gan zat on i an addit onal inr r i i s i -ag ee ent s in e fe t andr m i f c ; sure only i the in ury or dama e i ca sed,d f j g s u

b. On y a de cri ed in Paragraph be i whole o in part by al s s b - n r , cts o om ssions or i f(1), (2) or (3) y u or you subcont a tor in the pe fo man eo r r c r r clow, whichev r appl e :e i s o "y u work" to whi h the writ en cont act of o r c t r r(1) If the wri ten cont act or ag ee ent speci i a -t r r m f c l ag ee ent ap lie ; or m p s rly require you to prov de addi ional insureds i t

(3) If ne ther aragraphi P (1) nor (2) abov appl e :e i scov rage to tha person or organi ation bye t z the se o :u f (a) The perso or o ganizat o is a addin r i n n -tio al i sured only if a d to the ex entn n , n t(a) The Additional Insured – Owners, Les-that the injury o dama e i ca sed by, r g s usee o Cont actors – (Form B) en orses r r d -a t or omi sions o y u o y u subcon-c s s f o r o rm n G 20 10 11 85; ore t C tra to in the pe fo ma ce o "y ur workc r r r n f o "(b) Ei her or bot o the fol o ing the Addit h f l w : -to whi h the wri ten co tra t o agree-c t n c rtio al In ured – Owne s, Le sees o Con-n s r s r m nt applie ; ande stra to s – Scheduled Person Or Organ -c r i

(b) Su h pe son o organiza io does notc r r t nzation endorsement CG 20 10 10 01, or qual fy a an addi ional insured with rei s t -the Addit onal Insured – Owne s, Le seei r s s spe t to the independent acts or om s-c ior Co tra tors – Com leted Ope ationsn c p r sio s o uch erson or organizationn f s p .endo sem nt G 20 37 0 01;r e C 1

The insurance prov ded to such addi ional i sured isi t nthe person o o gan zat on i an addit onal inr r i i s i -subje t o he fo lowing p ov sion :c t t l r i ssure only if the inju y or dama e ari e outd r g s s o "y u work" to whi h the writ en cont act of o r c t r r a. If the Lim t o Insurance o thi Cov rage Parti s f f s e ag ee ent ap lie ;r m p s shown i the De larat on ex eed the m nim mn c i s c i u

(2) If the wri ten cont act or ag ee ent speci i a -t r r m f c l l m t req ired by the wri ten co t act o agree-i i s u t n r r ly require you to prov de addi ional insureds i t m n , the i surance prov ded to the addit o al i -e t n i i n n cov rage to tha person or organi ation bye t z sure wi l be lim ted to such m nim m requi edd l i i u r the se o :u f l m t . For the purpo es o de erm ni g whethei i s s f t i n r

CG 6 04 02 19D © 2017 T e Travelers Indemnity Company. All rights reh served. Pa e 1 o 2g f

COMM RCI L G NERAL IAB LI YE A E L I T

th s lim tation , the mi im m lim ts requi ed i a claimi i n u i r n . To the ex ent po sible sucht s , by the written co tra t or agreem nt wi l be con- no ice should inn c e l t cl de:u si e ed to incl de the m nim m lim t o any Umd r u i u i s f - (a) How, when and where the "o cur en ec r c " brel a or Ex ess lia il ty cov rage requi ed fo thel c b i e r r or o fe se took la e;f n p c addi ional insured by that written cont a t ot r c r

(b) The nam s and add e se o any inj rede r s s f u ag ee ent Thi prov sion wil not increa e ther m . s i l s pe sons an witne se ; andr d s s l m t o in urance escribed in Sect oni i s f s d i III – Lim ti s

(c) The nature and loca ion o any injury ot f rOf I surancen .

dama e a i i g out o the "o cur en e og r s n f c r c " r

b. The in uran e prov ded to such a dit onal insureds c i d i o fe se.f n doe not apply tos :

(2) If a claim is ma e o "sui " i brought agai std r t s n

(1) Any "bodi y inju y , "property dam ge ol r " a " r the ad it onal nsuredd i i :

"pe sonal injury arising out o the prov d ng,r " f i i

(a) Im e ia ely re ord the o them d t c for fai ure to prov de, any pro e sional archil i f s -cla m or "suit an the date re eiv d; andi " d c ete tu al, e gineer ng or surv yin se v ce ,c r n i e g r i s i clu ing:n d (b) No i y us a soon a pra ticable an seet f s s c d to i that we re eiv wri ten not ce o thet c e t i f(a) The prepari g, approv ng, or fa l ng ton i i i cla m or "suit a soon ai " s sprepa e o approv , ma s, shop draw-r r e p i g , opin on , repo ts, surv ys, fiel o -n s i s r e d r (3) Im ed ately send us copie o a l legal pam i s f l -de s or change o de s, o the prepari g, pe s re eiv d in r r r r n r c e co ne tion wi h the claim on c t r approv n , o fai ing to prepare or ap- "sui ", coope ate wi h us i g r l t r t in the inv stigat one i prov , drawings and spe i i a ion ; and o the claim o dee c f c t s f r fense agai stn the "suit , and othe wi e com ly with all pol cy" r s p i( )b Su erv so y, in pe t on, archi ect ral op i r s c i t u r condi ion .t sengineerin a t v t e .g c i i i s

(4) Te der the de en e and indem i y o anyn f s n t f(2) Any "bodily inj ry or "property dam geu " a " cla m or "sui " to any prov der o o her insur-i t i f tcaused by " work a d included in the" n an e whi h wou d cov r such addit onal i -c c l e i n"produ ts- om leted ope ation hazard" unc c p r s -le s the wri ten con ra t or ag ee ent spe if - sure fo a s t t c r m c i d r loss we cov r. Howev r, this co -e e n cal y require you to prov de such cov ragel s i e di ion does no a fe t whethe the insurancet t f c r fo that addit o al in ured during the pol cyr i n s i prov ded to such addi ional insured is prim ryi t a pe iodr . to o her i suran e av ila le to such ad it onalt n c a b d i i sured whi h cov rs that person o organizan c e r -c. The addit o al insured m st com ly with the i n u p tio a a nam d in ured a descri ed in Pa -n s e s s b rlowing utie :d s ag aphr 4., Ot er In urance o Se tionh s , f c IV –(1) G v us written no ice a soon a pra tica lei e t s s c b Co m rcial General Lia il ty ondit on .m e b i C i so a "o cur en e or an o fe se which mayf n c r c " f n

Pa e 2 o 2g f © 2017 T e Travelers Indemnity Company. All rights reh served. CG 6 04 02 19D fol-your or settlement practicable.

specifics applies result

COMMERCIAL�GENERAL�LIABILITY�

Includes�copyrighted�material�of�Insurance�Services�Office,�Inc.�with�its�permission.�

LIABILITY:�

THIS�ENDORSEMENT�CHANGES�THE�POLICY.�PLEASE�READ�IT�CAREFULLY.�

XTEND�ENDORSEMENT�FOR�MEDICAL�AND�

BIOTECHNOLOGY�

This�endorsement�modifies�insurance�provided�under�the�following:�

COMMERCIAL�GENERAL�LIABILITY�COVERAGE�PART�

GENERAL�DESCRIPTION�OF�COVERAGE�–�This�endorsement�broadens�coverage.�However,�coverage�for�any� injury,�damage�or�medical�expenses�described�in�any�of�the�provisions�of�this�endorsement�may�be�excluded�or� limited�by�another�endorsement�to�this�Coverage�Part,�and�these�coverage�broadening�provisions�do�not�apply�to� the� extent� that� coverage� is� excluded� or� limited� by� such� an� endorsement.� The� following� listing� is� a� general� coverage�description�only.�Read� all� the� provisions�of� this�endorsement� and� the�rest�of�your�policy�carefully� to� determine�rights,�duties,�and�what�is�and�is�not�covered.�

A.� Non-Owned�Watercraft–�75�Feet�Long�Or�Less�

B.� Clinical�Trial�Participants�–�Bodily�Injury�To� Employees�Or�Volunteer�Workers�

C.� Who�Is�An�Insured�–�Unnamed�Subsidiaries�

D.� Who�Is�An�Insured�–�Medical�Or� Biotechnology�

I.� Blanket� Additional� Insured� –� Persons� Or� Organizations�For�Your�Ongoing�Operations�As� Required�By�Written�Contract�Or�Agreement�

J.� Blanket�Additional�Insured�–�Broad�Form�Vendors�

K.� Blanket�Additional�Insured�–�Controlling�Interest�

Products�Advisors�And�Contract�Or�Clinical� L.� Blanket� Additional� Insured� –� Mortgagees,� Research�Organizations� Assignees,�SuccessorsOr�Receivers�

E.� Who�Is��An��Insured��–�Employees�–� Supervisory� M.� Blanket� Additional� Insured� –� Governmental� Positions� Entities�–�Permits�Or�Authorizations�Relating�To�

F.� Who� Is� An� Insured� –� Employees� –� Representations,�Warnings�Or�Instructions�With�

Premises�

N.��Blanket� Additional� Insured� –� Governmental� Respect�To�Products�Or�Work� Entities�–�Permits�Or�Authorizations�Relating�To�

G.�Who�Is�An�Insured�–�Newly�Acquired�Or�Formed� Limited�Liability�Companies�

Operations�

O.�Medical�Payments�–�Increased�Limit�

H.���Who�Is��An��Insured��–��Liability��For�Conduct� Of� P.�Blanket�Waiver�Of�Subrogation� Unnamed�Partnerships�Or�Joint�Ventures� Q.�Contractual�Liability�–�Railroads�

R.�Damage�To�Premises�Rented�To�You�

PROVISIONS� e.�Any�person�or�organization�that,�with�your�

A.� NON-OWNED�WATERCRAFT�–�75�FEET�LONG�

OR�LESS�

express�or�implied�consent,�either�uses�or� is�responsible�for�the�use�of�a�watercraft�

1.� The�following�replaces�Paragraph�(2)�of� that�you�do�not�own�that�is:�

Exclusion�g.,�Aircraft,�Auto�Or�Watercraft,� (1)� 75�feet�long�or�less;�and� in� Paragraph� 2.� of� SECTION� I� –� (2)� Not�being�used�to�carry�any�person�or�

COVERAGES�–�COVERAGE�A�–�BODILY� property�for�a�charge.�

INJURY� AND� PROPERTY� DAMAGE�

B.�CLINICAL�TRIAL�PARTICIPANTS�–� BODILY�

(2)� A�watercraft�you�do�not�own�that�is:�

INJURY�TO�EMPLOYEES�OR�VOLUNTEER�

WORKERS�

(a)� 75�feet�long�or�less;�and� 1.� The�following�is�added�to� Exclusion� e.,� (b)� Not�being��used�to�carry��any�person�or� Employer's��Liability,��in��Paragraph��2.���of� property�for�a�charge;� SECTION�I�–�COVERAGES�–�COVERAGE�A� 2.� The�following�replaces� Paragraph�

SECTION�II�–�WHO�IS�AN�INSURED:�

2.e.� of� –� BODILY� INJURY� AND� PROPERTY�

DAMAGE�LIABILITY:�

CG�D4�30�02�19� ©�2017�The�Travelers�Indemnity�Company.�All�rights�reserved.� Page�1�of�5�

POLICY NUMBER 660-3H339745

CG�D4�30�02�19�Page�2�of�5� ©�2017�The�Travelers�Indemnity�Company.�All�rights�reserved.� similar�other�insurance.�

COMMERCIAL�GENERAL�LIABILITY�

This�exclusion�also�does�not�apply�to�"bodily� a.� An�advisor�or�consultant,�including�a�scientific� injury"�to�an�"employee"�arising�out�of�his�or� advisory�board�and�its�members,�in�a�review� her���voluntary���participation���as� a�� human� of�the�design�or�development�of�"your�medical� subject�in�a�"clinical�trial".� products"�or�"your�biotechnology�products";�or�

2.��The�following�is�added�to�Paragraph�2.a.(1)�of� b.����A��contract��or��clinical��research�organization,� SECTION�II�–�WHO�IS�AN�INSURED:� including��its��employees,�for�a�"clinical�trial"�of�

Paragraphs�(1)(a),�(b)�and�(c)�above�do�not� apply�to�"bodily�injury"�to�a�co-"employee"�or�

"your� medical� products"� or� "your� biotechnology�products";� co-"volunteer�worker"�arising�out�of�his� or�her� is� an� insured,� but� only� for� "bodily� injury"� or� voluntary��participation��as�a�human�subject� in� "property�damage"�arising�out�of�those�products.� a�"clinical�trial".� However,�no�such�person�or�organization�is�an�

C.��WHO� IS� AN� INSURED� –� UNNAMED�

SUBSIDIARIES�

The�following�is�added�to�SECTION�II�–�WHO�IS� insured� for� "bodily� injury"�or� "property�damage"� arising� out� of� its� providing� or� failing� to� provide� professional�health�care�services.�

E.� WHO� IS�AN�INSURED�–�EMPLOYEES�–�

AN�INSURED:�

SUPERVISORY�POSITIONS�

Any�of�your�subsidiaries,�other�than�a�partnership� or�joint�venture,�that�is�not�shown�as�a�Named� Insured�in�the�Declarations�is�a�Named�Insured�if:�

The�following�is�added�to�Paragraph�2.a.(1)�of�

SECTION�II�–�WHO�IS�AN�INSURED:�

a.� You� are� the� sole� owner� of,� or� maintain� an� ownership�interest�of�more�than�50%�in,�such� subsidiary�on�the�first�day�of�the�policy�period;� and�

Paragraphs�(1)(a),�(b)�and�(c)�above�do�not�apply� to�"bodily� injury"� to�a�co-"employee"�while� in� the� course�of�the�co-"employee's"�employment�by�you� arising� out�of�work� by�any�of�your� "employees"� who�hold�a�supervisory�position.� b.� Such���subsidiary����is���not���an�� insured���under�

F.���WHO��IS���AN���INSURED���–��EMPLOYEES�–

REPRESENTATIONS,� WARNINGS� OR�

No�such��subsidiary�is�an�insured�for�"bodily�injury"� INSTRUCTIONS� WITH� RESPECT� TO� or�"property�damage"�that��occurred,�or�"personal� PRODUCTS�OR�WORK�and�advertising�injury"�caused�by�an�offense� committed:� a.� Before�you�maintained�an�ownership� interest�

The�following�is�added�to�Paragraph�2.a.(1)� of�

SECTION�II�–�WHO�IS�AN�INSURED:�

of�more�than�50%�in�such�subsidiary;�or� Paragraphs�(1)(a),�(b)�and�(c)�above�do�not�apply� to�"bodily�injury"�or�"personal�injury"�arising�out�of� b.� After�the�date,�if�any,�during�the�policy�period� any:� that�you�no�longer�maintain�an�ownership� interest�of�more�than�50%�in�such�subsidiary.� (i)� Representation��made���at��any��time,��or� that� should��have��been��made,��by��any��of� your�

For�purposes�of�Paragraph�1.�of�Section�II�–�Who� "employees"����with����respect���to���the��fitness,� Is��An���Insured,���each���such���subsidiary�will�� be� quality,�durability,�performance,�handling,� deemed�to�be�designated�in�the�Declarations�as:� maintenance,���operation,���safety,���or���use�of a.� A�limited�liability�company;� "your�products"�or�"your�work";�or� b.� An�organization�other�than�a�partnership,�joint� (ii)�Warnings�or�instructions�provided,�or�that� venture�or�limited�liability�company;�or� � should��have��been��provided,��by��any�of�your� c.� A�trust;� "employees"� with��respect��to��"your�products"� as�indicated�in�its�name�or�the�documents�that� govern�its�structure.�

D.���WHO��� IS����AN� INSURED�–�MEDICAL�OR�

BIOTECHNOLOGY� PRODUCTS� ADVISORS�

or�"your�work".�

G.� WHO�IS�AN�INSURED�–�NEWLY�ACQUIRED�

OR�FORMED�LIMITED�LIABILITY�COMPANIES�

The�following�replaces�Paragraph�3.�of�SECTION�

AND��CONTRACT��OR��CLINICAL� RESEARCH� II�–�WHO�IS�AN�INSURED:�ORGANIZATIONS�

3.�Any�organization�you�newly�acquire�or� form,�

The�following�is�added�to�SECTION�II�–�WHO�IS� other�than�a�partnership�or�joint�venture,�and� AN�INSURED:� of�which�you�are� the� sole�owner� or� in� which� Any�person��or�organization�that�is�serving� or�has� you� maintain� an� ownership� interest� of� more� served�as:� than�50%,�will�qualify�as�a�Named�Insured� if�

CG�D4�30�02�19� ©�2017�The�Travelers�Indemnity�Company.�All�rights�reserved.�

Page�3�of�5�

COMMERCIAL�GENERAL�LIABILITY�

there�is�no�other�similar�insurance�available�to� The�following�is�added�to�SECTION�II�–�WHO�IS� that�organization.�However:� AN�INSURED:� a.� Coverage�under�this�provision�is�afforded� only:�

(1)� Until� the�180th�day�after�you�acquire� or�form�the�organization�or�the�end�of� the�policy�period,�whichever�is�earlier,� if�you�do�not�report�such�organization� in�writing�to�us�within�180�days�after� you�acquire�or�form�it;�or�

(2)� Until� the� end� of� the� policy� period,� when�that�date�is�later�than�180�days� after� you� acquire� or� form� such� organization,� if� you� report� such� organization� in� writing� to� us� within� 180�days�after�you�acquire�or�formit;�

Any�person� or� organization� that� is�not�otherwise� an�insured�under�this�Coverage�Part�and�that�you� have�agreed�in�a�written�contract�or�agreement�to� include�as�an�additional�insured�on�this�Coverage� Part�is�an�insured,�but�only�with�respect�to�liability� for�"bodily�injury"�or�"property�damage"�that:� a.� Occurs� subsequent� to� the� signing� of� that� contract�or�agreement;�and� b.� Is�caused,�in�whole�or�in�part,�by�your�acts�or� omissions�in�the�performance�of�your�ongoing� operations� to� which� that� contract� or� agreement�applies�or�the�acts�or�omissions�of� any� person� or� organization� performing� such� operations�on�your�behalf.� b.� Coverage�A� does�not�apply�to�"bodily� The�limits�of�insurance�provided�to�such�insured� injury"�or�"property�damage"�that�occurred� before� you� acquired� or� formed� the� organization;�and� c.� Coverage�B�does�not�apply�to� "personal� and� advertising� injury"� arising� out� of� an� offense�committed�before�you�acquired�or� formed�the�organization.� will� be� the� minimum� limits� that� you� agreed� to� provide�in�the�written�contract�or�agreement,�or� the�limits�shown�in�the�Declarations,�whichever� are�less.�

J.� BLANKET�ADDITIONAL�INSURED�–�BROAD�

FORM�VENDORS�

The�following�is�added�to�SECTION�II�–�WHO�IS� For�the�purposes�of�Paragraph�1.�of�Section�II� AN�INSURED:�

–�Who�Is�An�Insured,�each�such�organization� Any�person�or�organization�that�is�a�vendor�and� will��be���deemed���to���be���designated�in�� the� that�you�have�agreed�in�a�written�contract�or� Declarations�as:� agreement�to�include�as�an�additional�insured�on� a.� A�limited�liability�company;� this�Coverage�Part�is�an�insured,�but�only� with� b.� An�organization,�other�than�a�partnership,� joint�venture�or�limited�liability�company;� respect�to�liability�for�"bodily�injury"�or�"property� damage"�that:� or� a.�Occurs�subsequent�to�the�signing�of� that� c.� A�trust;� as�indicated�in�its�name�or�the�documents� contract�or�agreement;�and� b.�Arises�out�of�"your�products"�that�are� that�govern�its�structure.� distributed�or�sold�in�the�regular�course�of�

H.� WHO�IS�AN�INSURED�–�LIABILITY�FOR� such�vendor's�business.�

CONDUCT�OF�UNNAMED�PARTNERSHIPS�OR� The�insurance�provided�to�such�vendor�is�subject� JOINT�VENTURES� to�the�following�provisions:�

The���following���replaces��the���last�paragraph�� of� a.���The��limits��of���insurance��provided���to� such� SECTION�II�–�WHO�IS�AN�INSURED:� vendor��will���be��the��minimum��limits��that�you�

No� person� or� organization� is� an� insured� with� respect� to� the� conduct� of� any� current� or� past� partnership�or�joint�venture�that�is�not�shown�as�a� agreed� to�provide� in� the� written� contract� or� agreement,� or� the� limits� shown� in� the�

Declarations,�whichever�are�less.� Named� Insured� in� the� Declarations.� This� b.�The�insurance�provided�to�such�vendor�does� paragraph�does�not�apply�to�any�such�partnership� not�apply�to:� or�joint�venture�that�otherwise�qualifies�as� an� insured�under�Section�II�–�Who�Is�An�Insured.�

I.� BLANKET�ADDITIONAL�INSURED�–�PERSONS�

OR�ORGANIZATIONS�FOR�YOUR�ONGOING�

(1)� Any�express�warranty�not�authorized�by� you�or�any�distribution�or�sale�for�a� purpose�not�authorized�by�you;�

OPERATIONS�AS�REQUIRED�BY�WRITTEN�

CONTRACT�OR�AGREEMENT�

(2)� Any�change�in�"your�products"�made�by� such�vendor;�

CG�D4�30�02�19�Page�4�of�5� ©�2017�The�Travelers�Indemnity�Company.�All�rights�reserved.�

COMMERCIAL�GENERAL�LIABILITY�

(3)� Repackaging,�unless��unpacked�solely�for� This� �paragraph� �does� � not� � apply� � to� �any� the�purpose�of� inspection,�demonstration,� premises�owner,�manager�or� lessor� that�has� testing,��or��the�substitution�of�parts�under� financial�control�of�you.� instructions��from���the��manufacturer,�� and� L.��BLANKET� ADDITIONAL� INSURED� –� then�repackaged�in�the�original�container;� MORTGAGEES,���ASSIGNEES,� SUCCESSORS�

(4)�� Any�failure�to�make�such�inspections,� adjustments,� tests� or� servicing� as�

OR�RECEIVERS�

The�following�is�added�to�SECTION�II�–�WHO�IS� vendors���agree��to���perform� or��normally� AN�INSURED:� undertake�to�perform�in�the� regular� course�of�business,�in�connection�with�the� distribution�or�sale�of�"your�products";�

(5)� Demonstration,�installation,�servicing�or�

Any�person��or��organization�that�is��a�mortgagee,� assignee,�successor�or�receiver�and�that�you� have�agreed�in�a�written�contract�or�agreement�to� include�as�an�additional�insured�on�this�Coverage� repair�operations,�except�such�operations� Part� is� an� insured,� but� only� with� respect� to� its� performed��at��such��vendor's�premises� in� liability� as� mortgagee,� assignee,� successor� or� connection����with����the����sale��of��� "your� receiver� for� "bodily� injury",� "property� damage"� or� products";�or� "personal�and�advertising�injury"�that:�

(6)� "Your��products"��that,�after�distribution� or� a.�Is�"bodily�injury"�or�"property�damage"�that� sale���by���you,���have���been�� labeled���or� occurs,�or�is�"personal�and�advertising�injury"� relabeled�or�used�as�a�� container,�part�or� caused� by� an� offense� that� is� committed,� ingredient�of�any�other�thing�or�substance� subsequent� to� the� signing�of� that� contract�or� by�or�on�behalf�of�such�vendor.� agreement;�and�

Coverage�under�this�provision�does�not�apply�to:� b.���Arises�out�of��the�ownership,��maintenance�or� a.� Any��person��or��organization�from�whom� you� use�of�the�premises�for�which�that�mortgagee,� have� acquired� "your� products",� or� any� ingredient,� part� or� container� entering� into,� accompanying� or� containing� such� products;� or� b.� Any� vendor� for� which� coverage� as� an� additional�insured�specifically�is�scheduled�by� endorsement.�

K.� BLANKET� ADDITIONAL� INSURED� –�

CONTROLLING�INTEREST�

assignee,�successor�or� receiver� is� required� under� that� contract� or� agreement� to� be� included� as� an� additional� insured� on� this� Coverage�Part.�

The� insurance� provided� to� such� mortgagee,� assignee,�successor�or�receiver�is�subject�to�the� following�provisions:� a.� The� limits� of� insurance� provided� to� such� mortgagee,�assignee,�successor�or�receiver� will�be�the�minimum�limits�that�you�agreed�to�

1.� The�following�is�added�to�SECTION�II�–�WHO� provide�in�the�written�contract�or�agreement,� IS�AN�INSURED:� or�the�limits�shown�in� the� Declarations,�

Any�person�or�organization�that�has�financial� whichever�are�less.� control�of��you�is��an��insured��with��respect� to� b.�The�insurance�provided�to�such�person�or� liability�for��"bodily��injury",�"property�damage"� � organization�does�not�apply�to:� or�"personal�and�advertising�injury"�that�arises� (1)�Any�"bodily�injury"�or�"property�damage"� out�of:� � that���occurs,� or� any���"personal� and� a.� Such�financialcontrol;�or� b.� Such� � person's� or� organization's� ownership,� maintenance� or� use� of� premises�leased�to�or�occupied�by�you.� advertising�injury"�caused�by�an�offense� that�is�committed,�after�such�contract�or� agreement�is�no�longer�in�effect;�or�

(2)�Any�"bodily�injury",�"property�damage"�or� "personal�and�advertising�injury"�arising�

The��insurance��provided��to��such�person� or� out�of�any�structural�alterations,�new� organization���does���not���apply�to��structural� construction� or� demolition� operations� alterations,���new���construction�or��demolition� performed� by� or� on� behalf� of� such� operations�performed�by�or�on�behalf� of�such� mortgagee,� assignee,� successor� or� person�or�organization.� receiver.�

2.� The�following�is�added�to�Paragraph�4.�of�

SECTION�II�–�WHO�IS�AN�INSURED:�

COMMERCIAL�GENERAL�LIABILITY�

CG�D4�30�02�19� ©�2017�The�Travelers�Indemnity�Company.�All�rights�reserved.� Includes�copyrighted�material�of�Insurance�Services�Office,�Inc.�with�its�permission.�

Page�5�of�5� entity�does�not�apply�to:�

M.� BLANKET� ADDITIONAL� INSURED� –� 7.�Subject�to�Paragraph�5.�above,�the� Medical�

GOVERNMENTAL�ENTITIES�–�PERMITS�OR� Expense�Limit�is�the�most�we�will�pay�under� AUTHORIZATIONS�RELATING�TO�PREMISES� Coverage�C� for� all� medical� expenses�

The�following�is�added�to�SECTION�II�–�WHO�IS�

AN�INSURED:�

Any�governmental�entity�that�has�issued�a�permit� because�of�"bodily�injury"�sustained�by�any� one�person,�and�will�be�the�higher�of:� a.�$10,000;�or� or��authorization�with��respect��to�premises�owned� b.�The�amount�shown�in�the�Declarations�of� or��occupied�by,��or�rented��or�loaned�to,�you�and� � this� Coverage� Part� for� Medical� Expense� that��you��are��required��by��any��ordinance,� law,� � Limit.�building�code�or�written�contract�or�agreement�to� include�as�an�additional�insured�on�this�Coverage� Part�is�an�insured,�but�only�with�respect�to�liability�

P.�BLANKET�WAIVER�OF�SUBROGATION�

The�following�is�added�to�Paragraph�8.,�Transfer� for��"bodily�injury",��"property�damage"�or� "personal� Of�Rights�Of�Recovery�Against�Others�To�Us,� and� advertising��� injury"� arising� out� of�the� of�SECTION�IV�–�COMMERCIAL�GENERAL� existence,��ownership,��use,�maintenance,� repair,� LIABILITY�CONDITIONS:� construction,�erection�or�removal�of�any�of� the� following� for� which� that� governmental� entity� has� issued� such� permit� or� authorization:� advertising� signs,� awnings,� canopies,� cellar� entrances,� coal� holes,� driveways,� manholes,� marquees,� hoist� away� openings,�sidewalk� vaults,�elevators,�street� banners�or�decorations.�

If�the�insured�has�agreed�in�a�contract�or� agreement� to� waive� that� insured's� right� of� recovery�against�any� person� or�organization,�we� waive�our�right�of�recovery�against�such�person�or� organization,� but� only� for� payments� we� make� because�of:�

N.� BLANKET� ADDITIONAL� INSURED� –� a.�"Bodily�injury"�or�"property�damage"� that� GOVERNMENTAL��ENTITIES��–�� PERMITS��OR� occurs;�or� AUTHORIZATIONS� RELATING� TO� b.�"Personal�and�advertising�injury"�caused�by�

OPERATIONS�

an�offense�that�is�committed;� The�following�is�added�to�SECTION�II�–�WHO�IS� subsequent�to�the�execution�of�the�contract�or�

AN�INSURED:�

agreement.

Any�governmental�entity�that�has�issued��a�permit� or���authorization���with����respect����to���operations� performed�by�you�or�on�your�behalf�and�that�you� 1.� The�following�replaces�Paragraph�c.� of�the� are�required�by�any�ordinance,�law,�building�code� or�written�contract�or�agreement�to�include�as� an� definition� of� "insured� contract"� in� the� DEFINITIONS�Section:� additional��insured��on��this��Coverage��Part�is� an� c.�Any�easement�or�licenseagreement;� insured,�but�only�with�respect�to�liability�for�"bodily� injury",���"property���damage"���or���"personal���and� Paragraph�f.(1)�of�the�definition�of�"insured� advertising�injury"�arising�out�of�such�operations.� contract"�in�the� deleted.�

DEFINITIONS� Section�is�

The���insurance���provided���to��such���governmental�

R.� DAMAGE�TO�PREMISES�RENTED�TO�YOU

a.� Any� "bodily� injury",� "property� damage"� or� "personal�and�advertising�injury"�arising�out�of� operations�performed�for�the� governmental�

The�following�replaces�the�definition�of�"premises� damage"�in�the�DEFINITIONS�Section:�

"Premises�damage"�means�"property�damage"�to:� entity;�or� a.���Any���premises����while���rented���to� you� or� b.� Any�"bodily�injury"�or�"property�damage"� temporarily�occupied�by�you�with�permission� included� in� the� "products-completed� of�the�owner;�or� operations�hazard".� b.���The��contents��of���any��premises��while�� such�

O.� MEDICAL�PAYMENTS�–�INCREASED�LIMIT� premises��is��rented��to��you,��if��you��rent�such�

The�following�replaces�Paragraph�7.�of�SECTION�

III�–�LIMITS�OF�INSURANCE:�

premises�for�a�period�of�seven�or�fewer� consecutive�days.�

Q.�CONTRACTUAL�LIABILITY�–�RAILROADS�

2.�

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

DESIGNATED PERSON OR ORGANIZATION – NOTICE OF

CANCELLATION PROVIDED BY US

This endorsement modifies insurance provided under the following:

ALL COVERAGE PARTS INCLUDED IN THIS POLICY

SCHEDULE

CANCELLATION: Number of Days Notice:

PERSON OR

ORGANIZATION:

ADDRESS:

PROVISIONS

If we cancel this policy for any legally permitted reason other than nonpayment of premium, and a number of days is shown for Cancellation in the Schedule above, we will mail notice of cancellation to the person or organization shown in such Schedule. We will mail such notice to the address shown in the Schedule above at least the number of days shown for Cancellation in such Schedule before the effective date of cancellation.

IL T4 05 05 19 © 2019 The Travelers Indemnity Company. All rights reserved. Page 1 of 1

POLICY NUMBER: ISSUE DATE: 8-1-2022

POLICY NUMBER: GENERAL PURPOSE ENDORSEMENT

PageIL T8 03

Includes copyrighted material of Insurance Services Office, Inc. with its permission.

COMMERCIAL AUTO

POLICY NUMBER 810-2N839583

BUSINESS AUTO EXTENSION ENDORSEMENT

This endorsement modifies insurance provided under the following:

BUSINESS AUTO COVERAGE FORM

GENERAL DESCRIPTION OF COVERAGE – This endorsement broadens coverage. However, coverage for any injury, damage or medical expenses described in any of the provisions of this endorsement may be excluded or limited by another endorsement to the Coverage Part, and these coverage broadening provisions do not apply to the extent that coverage is excluded or limited by such an endorsement. The following listing is a general cover-age description only. Limitations and exclusions may apply to these coverages. Read all the provisions of this en-dorsement and the rest of your policy carefully to determine rights, duties, and what is and is not covered.

A. BROAD FORM NAMED INSURED

B. BLANKET ADDITIONAL INSURED

C. EMPLOYEE HIRED AUTO

D. EMPLOYEES AS INSURED

E. SUPPLEMENTARY PAYMENTS – INCREASED

LIMITS

F. HIRED AUTO – LIMITED WORLDWIDE COV-

ERAGE – INDEMNITY BASIS

G. WAIVER OF DEDUCTIBLE – GLASS

PROVISIONS

A. BROAD FORM NAMED INSURED

The following is added to Paragraph A.1., Who Is An Insured, of SECTION II – COVERED AUTOS

LIABILITY COVERAGE:

Any organization you newly acquire or form dur-ing the policy period over which you maintain 50% or more ownership interest and that is not separately insured for Business Auto Coverage.

Coverage under this provision is afforded only un-til the 180th day after you acquire or form the or-ganization or the end of the policy period, which-ever is earlier.

B. BLANKET ADDITIONAL INSURED

The following is added to Paragraph c. in A.1., Who Is An Insured, of SECTION II – COVERED

AUTOS LIABILITY COVERAGE:

Any person or organization who is required under a written contract or agreement between you and that person or organization, that is signed and executed by you before the "bodily injury" or "property damage" occurs and that is in effect during the policy period, to be named as an addi-tional insured is an "insured" for Covered Autos Liability Coverage, but only for damages to which

H. HIRED AUTO PHYSICAL DAMAGE – LOSS OF

USE – INCREASED LIMIT

I. PHYSICAL DAMAGE – TRANSPORTATION

EXPENSES – INCREASED LIMIT

J. PERSONAL PROPERTY

K. AIRBAGS

L. NOTICE AND KNOWLEDGE OF ACCIDENT OR

LOSS

M. BLANKET WAIVER OF SUBROGATION

N. UNINTENTIONAL ERRORS OR OMISSIONS

this insurance applies and only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured provision contained in Section II.

C. EMPLOYEE HIRED AUTO

1. The following is added to Paragraph A.1., Who Is An Insured, of SECTION II – COV-

ERED AUTOS LIABILITY COVERAGE:

An "employee" of yours is an "insured" while operating an "auto" hired or rented under a contract or agreement in an "employee's" name, with your permission, while performing duties related to the conduct of your busi-ness.

2. The following replaces Paragraph b. in B.5., Other Insurance, of SECTION IV – BUSI-

NESS AUTO CONDITIONS:

b. For Hired Auto Physical Damage Cover-age, the following are deemed to be cov-ered "autos" you own:

(1) Any covered "auto" you lease, hire, rent or borrow; and

(2) Any covered "auto" hired or rented by your "employee" under a contract in an "employee's" name, with your

CA T3 53 02 15

© 2015 The Travelers Indemnity Company. All rights reserved. Page 1 of 4 permission, while performing duties related to the conduct of your busi-ness.

However, any "auto" that is leased, hired, rented or borrowed with a driver is not a covered "auto".

D. EMPLOYEES AS INSURED

The following is added to Paragraph A.1., Who Is An Insured, of SECTION II – COVERED AUTOS

LIABILITY COVERAGE:

Any "employee" of yours is an "insured" while us-ing a covered "auto" you don't own, hire or borrow in your business or your personal affairs.

E. SUPPLEMENTARY PAYMENTS – INCREASED

LIMITS

1. The following replaces Paragraph A.2.a.(2), of SECTION II – COVERED AUTOS LIABIL-

ITY COVERAGE:

(2) Up to $3,000 for cost of bail bonds (in-cluding bonds for related traffic law viola-tions) required because of an "accident" we cover. We do not have to furnish these bonds.

2. The following replaces Paragraph A.2.a.(4), of SECTION II – COVERED AUTOS LIABIL-

ITY COVERAGE:

(4) All reasonable expenses incurred by the "insured" at our request, including actual loss of earnings up to $500 a day be-cause of time off from work.

F. HIRED AUTO – LIMITED WORLDWIDE COV-

ERAGE – INDEMNITY BASIS

The following replaces Subparagraph (5) in Para-graph B.7., Policy Period, Coverage Territory, of SECTION IV – BUSINESS AUTO CONDI-

TIONS:

(5) Anywhere in the world, except any country or jurisdiction while any trade sanction, em-bargo, or similar regulation imposed by the United States of America applies to and pro-hibits the transaction of business with or within such country or jurisdiction, for Cov-ered Autos Liability Coverage for any covered "auto" that you lease, hire, rent or borrow without a driver for a period of 30 days or less and that is not an "auto" you lease, hire, rent or borrow from any of your "employees", partners (if you are a partnership), members (if you are a limited liability company) or members of their households.

(a) With respect to any claim made or "suit" brought outside the United States of America, the territories and possessions of the United States of America, Puerto Rico and Canada:

(i) You must arrange to defend the "in-sured" against, and investigate or set-tle any such claim or "suit" and keep us advised of all proceedings and ac-tions.

(ii) Neither you nor any other involved "insured" will make any settlement without our consent.

(iii) We may, at our discretion, participate in defending the "insured" against, or in the settlement of, any claim or "suit".

(iv) We will reimburse the "insured" for sums that the "insured" legally must pay as damages because of "bodily injury" or "property damage" to which this insurance applies, that the "in-sured" pays with our consent, but only up to the limit described in Para-graph C., Limits Of Insurance, of

SECTION II – COVERED AUTOS

LIABILITY COVERAGE.

(v) We will reimburse the "insured" for the reasonable expenses incurred with our consent for your investiga-tion of such claims and your defense of the "insured" against any such "suit", but only up to and included within the limit described in Para-graph C., Limits Of Insurance, of

SECTION II – COVERED AUTOS

LIABILITY COVERAGE, and not in addition to such limit. Our duty to make such payments ends when we have used up the applicable limit of insurance in payments for damages, settlements or defense expenses.

(b) This insurance is excess over any valid and collectible other insurance available to the "insured" whether primary, excess, contingent or on any other basis.

(c) This insurance is not a substitute for re-quired or compulsory insurance in any country outside the United States, its ter-ritories and possessions, Puerto Rico and Canada.

Page 2 of 4 © 2015 The Travelers Indemnity Company. All rights reserved. CA T3 53 02 15

You agree to maintain all required or compulsory insurance in any such coun-try up to the minimum limits required by local law. Your failure to comply with compulsory insurance requirements will not invalidate the coverage afforded by this policy, but we will only be liable to the same extent we would have been liable had you complied with the compulsory in-surance requirements.

(d) It is understood that we are not an admit-ted or authorized insurer outside the United States of America, its territories and possessions, Puerto Rico and Can-ada. We assume no responsibility for the furnishing of certificates of insurance, or for compliance in any way with the laws of other countries relating to insurance.

G. WAIVER OF DEDUCTIBLE – GLASS

The following is added to Paragraph D., Deducti-ble, of SECTION III – PHYSICAL DAMAGE

COVERAGE:

No deductible for a covered "auto" will apply to glass damage if the glass is repaired rather than replaced.

H. HIRED AUTO PHYSICAL DAMAGE – LOSS OF

USE – INCREASED LIMIT

The following replaces the last sentence of Para-graph A.4.b., Loss Of Use Expenses, of SEC-

TION III – PHYSICAL DAMAGE COVERAGE:

However, the most we will pay for any expenses for loss of use is $65 per day, to a maximum of $750 for any one "accident".

I. PHYSICAL DAMAGE – TRANSPORTATION

EXPENSES – INCREASED LIMIT

The following replaces the first sentence in Para-graph A.4.a., Transportation Expenses, of

SECTION III – PHYSICAL DAMAGE COVER-

AGE:

We will pay up to $50 per day to a maximum of $1,500 for temporary transportation expense in-curred by you because of the total theft of a cov-ered "auto" of the private passenger type.

J. PERSONAL PROPERTY

The following is added to Paragraph A.4., Cover-age Extensions, of SECTION III – PHYSICAL

DAMAGE COVERAGE:

Personal Property

We will pay up to $400 for "loss" to wearing ap-parel and other personal property which is:

(1) Owned by an "insured"; and

(2) In or on your covered "auto".

This coverage applies only in the event of a total theft of your covered "auto".

No deductibles apply to this Personal Property coverage.

K. AIRBAGS

The following is added to Paragraph B.3., Exclu-sions, of SECTION III – PHYSICAL DAMAGE

COVERAGE:

Exclusion 3.a. does not apply to "loss" to one or more airbags in a covered "auto" you own that in-flate due to a cause other than a cause of "loss" set forth in Paragraphs A.1.b. and A.1.c., but only:

a. If that "auto" is a covered "auto" for Compre-hensive Coverage under this policy;

b. The airbags are not covered under any war-ranty; and

c. The airbags were not intentionally inflated.

We will pay up to a maximum of $1,000 for any one "loss".

L. NOTICE AND KNOWLEDGE OF ACCIDENT OR

LOSS

The following is added to Paragraph A.2.a., of

SECTION IV – BUSINESS AUTO CONDITIONS:

Your duty to give us or our authorized representa-tive prompt notice of the "accident" or "loss" ap-plies only when the "accident" or "loss" is known to:

(a) You (if you are an individual);

(b) A partner (if you are a partnership);

(c) A member (if you are a limited liability com-pany);

(d) An executive officer, director or insurance manager (if you are a corporation or other or-ganization); or

(e) Any "employee" authorized by you to give no-tice of the "accident" or "loss".

M. BLANKET WAIVER OF SUBROGATION

The following replaces Paragraph A.5., Transfer Of Rights Of Recovery Against Others To Us, of SECTION IV – BUSINESS AUTO CONDI-

TIONS :

5. Transfer Of Rights Of Recovery Against Others To Us

We waive any right of recovery we may have against any person or organization to the ex-tent required of you by a written contract signed and executed prior to any "accident" or "loss", provided that the "accident" or "loss" arises out of operations contemplated by

CA T3 53 02 15

© 2015 The Travelers Indemnity Company. All rights reserved. Page 3 of 4 such contract. The waiver applies only to the person or organization designated in such contract.

N. UNINTENTIONAL ERRORS OR OMISSIONS

The following is added to Paragraph B.2., Con-cealment, Misrepresentation, Or Fraud, of

SECTION IV – BUSINESS AUTO CONDITIONS:

The unintentional omission of, or unintentional error in, any information given by you shall not prejudice your rights under this insurance. How-ever this provision does not affect our right to col-lect additional premium or exercise our right of cancellation or non-renewal.

Page 4 of 4 © 2015 The Travelers Indemnity Compa ny. All rights reserved . CA T3 53 02 15

PERSON OR

ORGANIZATION:

ADDRESS:

PROVISIONS

IL T4 05 05 19 © 2019 The Travelers Indemnity Company. All rights reserved. Page 1 of 1

ANY PERSON OR ORGANIZATION TO WHOM YOU

HAVE AGREED IN A WRITTEN CONTRACT THAT

NOTICE OF CANCELLATION OF THIS POLICY

WILL BE GIVEN, BUT ONLY IF:

1. YOU SEND US A WRITTEN REQUEST TO

PROVIDE SUCH NOTICE, INCLUDING THE

NAME AND ADDRESS OF SUCH PERSON OR

ORGANIZATION, AFTER THE FIRST NAMED

INSURED RECEIVES NOTICE FROM US OF

THE CANCELLATION OF THIS POLICY; AND

2. WE RECEIVE SUCH WRITTEN REQUEST AT

LEAST 14 DAYS BEFORE THE BEGINNING OF

THE APPLICABLE NUMBER OF DAYS SHOWN

IN THIS SCHEDULE.

THE ADDRESS FOR THAT PERSON OR ORGANIZ-

ATION INCLUDED IN SUCH WRITTEN REQUEST

FROM YOU TO US.

If we cancel this policy for any legally permitted reason other than nonpayment of premium, and a number of days is shown for Cancellation in the Schedule above, we will mail notice of cancellation to the person or organization shown in such Schedule. We will mail such notice to the address shown in the Schedule above at least the number of days shown for Cancellation in such Schedule before the effective date of cancellation.

CANCELLATION: Number of Days Notice: 30

SCHEDULE

ALL COVERAGE PARTS INCLUDED IN THIS POLICY

This endorsement modifies insurance provided under the following:

CANCELLATION PROVIDED BY US

DESIGNATED PERSON OR ORGANIZATION – NOTICE OF

POLICY NUMBER: 810-2N839583 ISSUE DATE: 08-01-22

UMBRELLA

EU 00 01 07 16 © 2016 The Travelers Indemnity Company. All rights reserved. Page 1 of 22

EXCESS FOLLOW-FORM AND UMBRELLA

LIABILITY INSURANCE

THIS POLICY, IN PART, PROVIDES FOLLOW-FORM LIABILITY COVERAGE.

COVERAGE WILL APPLY ON A CLAIMS-MADE BASIS WHEN FOLLOWING

CLAIMS-MADE UNDERLYING INSURANCE.

COVERAGE WILL APPLY ON A DEFENSE-WITHIN-LIMITS BASIS WHEN

FOLLOWING UNDERLYING INSURANCE UNDER WHICH DEFENSE

EXPENSES ARE PAYABLE WITHIN, AND NOT IN ADDITION TO, THE LIMITS

OF INSURANCE. WHEN FOLLOWING SUCH UNDERLYING INSURANCE,

PAYMENT OF DEFENSE EXPENSES UNDER THIS POLICY WILL REDUCE,

AND MAY EXHAUST, THE LIMITS OF INSURANCE OF THIS POLICY.

PLEASE READ THE ENTIRE POLICY CAREFULLY.

Various provisions in this policy restrict coverage. Read the entire policy carefully to determine rights, duties and what is and is not covered.

Throughout this policy, the words "you" and "your" refer to the Named Insured shown in the Declarations and any other person or organization qualifying as a Named Insured under this policy. The words "we", "us" and "our" refer to the company providing this insurance.

The word "insured" means any person or organization qualifying as such under SECTION II – WHO IS AN

INSURED.

Other words and phrases that appear in quotation marks have special meaning. Refer to SECTION VI –

DEFINITIONS.

SECTION I – COVERAGES

A. COVERAGE A – EXCESS FOLLOW-FORM

LIABILITY

1. We will pay on behalf of the insured those sums, in excess of the "applicable underlying limit", that the insured becomes legally obligated to pay as damages to which Coverage A of this insurance applies, provided that the "underlying insurance" would apply to such damages but for the exhaustion of its applicable limits of insurance. If a sublimit is specified in any "underlying insurance", Coverage A of this insurance applies to damages that are in excess of that sublimit only if such sublimit is shown for that "underlying insurance" in the Schedule Of Underlying Insurance.

2. Coverage A of this insurance is subject to the same terms, conditions, agreements, exclusions and definitions as the "underlying insurance", except with respect to any provisions to the contrary contained in this insurance.

3. The amount we will pay for damages is limited as described in SECTION III – LIMITS OF

INSURANCE.

4. For the purposes of Paragraph 1. above:

a. The applicable limit of insurance stated for the policies of "underlying insurance" in the Schedule Of Underlying Insurance will be considered to be reduced or exhausted only by the following payments:

(1) Payments of judgments or settlements for damages that are covered by that "underlying insurance". However, if such "underlying insurance" has a policy period which differs from the policy period of this Excess Follow-Form And Umbrella Liability Insurance, any such payments for damages that would not be covered by this Excess Follow-Form And Umbrella Liability

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