2023-9-1_COI.pdf
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- Attached to
- Master Agreement AZ|CTR062831
- Contract number
- CTR062831
- Issued by
- Arizona
About this file
This document is a comprehensive insurance policy package for Chicanos Por La Causa, Inc., involving multiple insurance carriers including Philadelphia Indemnity Insurance Company, CopperPoint Western Insurance Company, and Lovitt & Touche (insurance agency). The policy covers various liability aspects and is specifically structured to provide insurance coverage for the organization's operations, with the State of Arizona and its departments, agencies, boards, commissions, and universities named as additional insureds. The policy period runs from September 1, 2022 to September 1, 2023.
The insurance package includes multiple coverage types with significant limits: Commercial General Liability ($1M per occurrence, $3M aggregate), Commercial Auto Liability ($1M per accident), Professional Liability ($1M per incident, $3M aggregate), Workers' Compensation, Umbrella Liability ($10M per occurrence), and specialized coverages like Abusive Conduct Liability and Employee Benefits Liability. The policy is specifically related to a contract (CTR062831) for Homeless Youth Street Outreach and Drop-In Center Services, with the State of Arizona Department of Economic Security as the primary contract holder. The total premium for this comprehensive coverage is $129,998.00, with various endorsements ensuring broad protection for the organization's activities, including waivers of subrogation and primary insurance status.
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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
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)
© 1988-2015 ACORD CORPORATION. All rights reserved.
CERTIFICATE HOLDER
The ACORD name and logo are registered marks of ACORD
HIRED
AUTOS ONLY
6/27/2023
Lovitt & Touche A Marsh & McLennan Agency LLC Co 4703 E Camp Lowell Drive, #101 Tucson AZ 85712
Kim Canez 520-722-7136
Kcanez@lovitt-touche.com
Philadelphia Indemnity Insurance Co. 18058 CHICA-2 CopperPoint Western Insurance Company 13209
Chicanos Por La Causa, Inc.
1112 E. Buckeye Rd.
Phoenix AZ 85034-4043
1881350682
A X 1,000,000 X 1,000,000
20,000
1,000,000
3,000,000 X
Y Y PHPK2458589 9/1/2022 9/1/2023
3,000,000
A 1,000,000
X
X $500 Comp X $1000 Coll
Y Y PHPK2458589 9/1/2022 9/1/2023
A X X 10,000,000PHUB830462 9/1/2022 9/1/2023
10,000,000 X 10,000
B XY 1019216 9/1/2022 9/1/2023
1,000,000
1,000,000
1,000,000 A Prof Liab - Occurrence
SAML - Occurrence PHPK2458589 9/1/2022 9/1/2023 Per Claim
Aggregate $1,000,000 $3,000,000
Additional Insureds applies with respects General Liability per form PI-GLD-HS 10/11, Automobile Liability per form PI-CA-001 09/15 and Excess Liability if required in a written contract. A Waiver of Subrogation applies to the General Liability per form PI-GLD-HS 10/11 and Automobile Liability per form PI-CA-001 09/15 if required in a written contract. Coverage is Primary and any other insurance maintained by Additional Insured is Non-Contributory with respects General Liability per form CG2001 04/13. When required by written contract or agreement.
RE: CTR062831 Homeless Youth Street Outreach and Drop-In Center Services If required by written contract and subject to all policy terms, conditions, definitions & exclusions: General and Professional Liability: The State of Arizona & the Department of Economic Security shall be named as additional insureds with respect to liability arising out of the activities performed by or on behalf of the Contractor. Policy shall contain waiver of subrogation against the State of Arizona, its departments, agencies, boards, commissions, universities and its officers, officials, agents, and employees for losses arising from work See Attached...
State of Arizona Department of Economic Security 1789 West Jefferson Ave, Mail Drop 1541 Phoenix AZ 85007
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:
CHICA-2
1 1
Lovitt & Touche Chicanos Por La Causa, Inc.
1112 E. Buckeye Rd.
Phoenix AZ 85034-4043
25 CERTIFICATE OF LIABILITY INSURANCE
performed by or on behalf of the Contractor. Automobile Liability: The State of Arizona & the Department of Economic Security shall be named as additional insureds with respect to liability arising out of the activities performed by or on behalf of the Contractor, involving automobiles owned, leased, hired or borrowed by the Contractor. Worker's Compensation: Policy contains a waiver of subrogation in favor of the State of Arizona, its departments, agencies, boards, commissions, universities and its officers, officials, agents, and employees for losses arising from work performed by or on behalf of the Contractor. Coverage is Primary with respect to all other available sources. Sexual Abuse and Molestation coverage is included. Umbrella Liability is Follow Form to Professional Liability.
COMMERCIAL GENERAL LIABILITY
CG 20 01 04 13
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
CG 20 01 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 1
PRIMARY AND NONCONTRIBUTORY –
OTHER INSURANCE CONDITION
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART
The following is added to the Other Insurance Condition and supersedes any provision to the contrary:
Primary And Noncontributory Insurance This insurance is primary to and will not seek contribution from any other insurance available to an additional insured under your policy provided that:
(1) The additional insured is a Named Insured under such other insurance; and
(2) You have agreed in writing in a contract or agreement that this insurance would be primary and would not seek contribution from any other insurance available to the additional insured.
Policy #PHPK2458589
PI-GLD-HS (10/11)
Includes copyrighted material of Insurance Services Office, Inc., with its permission.
© 2011 Philadelphia Indemnity Insurance Company
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
GENERAL LIABILITY DELUXE ENDORSEMENT:
HUMAN SERVICES
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE
It is understood and agreed that the following extensions only apply in the event that no other specific coverage for the indicated loss exposure is provided under this policy. If such specific coverage applies, the terms, conditions and limits of that coverage are the sole and exclusive coverage applicable under this policy, unless otherwise noted on this endorsement. The following is a summary of the Limits of Insurance and additional coverages provided by this endorsement. For complete details on specific coverages, consult the policy contract wording.
Coverage Applicable Limit of Insurance Page #
Extended Property Damage Included 2
Limited Rental Lease Agreement Contractual Liability $50,000 limit 2
Non-Owned Watercraft Less than 58 feet 2
Damage to Property You Own, Rent, or Occupy $30,000 limit 2
Damage to Premises Rented to You $1,000,000 3
HIPAA Clarification 4
Medical Payments $20,000 5
Medical Payments Extended Reporting Period 3 years 5
Athletic Activities Amended 5
Supplementary Payments Bail Bonds $5,000 5
Supplementary Payment Loss of Earnings $1,000 per day 5
Employee Indemnification Defense Coverage $25,000 5
Key and Lock Replacement Janitorial Services Client Coverage $10,000 limit 6
Additional Insured Newly Acquired Time Period Amended 6
Additional Insured Medical Directors and Administrators Included 7
Additional Insured Managers and Supervisors (with Fellow Employee Coverage)
Included 7
Additional Insured Broadened Named Insured Included 7
Additional Insured Funding Source Included 7
Additional Insured Home Care Providers Included 7
Additional Insured Managers, Landlords, or Lessors of Premises Included 7
Additional Insured Lessor of Leased Equipment Included 7
Additional Insured Grantor of Permits Included 8
Additional Insured Vendor Included 8
Additional Insured Franchisor Included 9
Additional Insured When Required by Contract Included 9
Additional Insured Owners, Lessees, or Contractors Included 9
Additional Insured State or Political Subdivisions Included 10
Includes copyrighted material of Insurance Services Office, Inc., with its permission.
© 2011 Philadelphia Indemnity Insurance Company
Duties in the Event of Occurrence, Claim or Suit Included 10
Unintentional Failure to Disclose Hazards Included 10
Transfer of Rights of Recovery Against Others To Us Clarification 10
Liberalization Included 11
Bodily Injury includes Mental Anguish Included 11
Personal and Advertising Injury includes Abuse of Process, Discrimination
Included 11
A. Extended Property Damage
SECTION I COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE
LIABILITY, Subsection 2. Exclusions, Paragraph a. is deleted in its entirety and replaced by the following:
a. Expected or Intended Injury
This exclusion does not apply t reasonable force to protect persons or property.
B. Limited Rental Lease Agreement Contractual Liability
SECTION I COVERAGES, COVERAGE A. BODILY INJURY AND PROPERTY DAMAGE
LIABILITY, Subsection 2. Exclusions, Paragraph b. Contractual Liability is amended to include the following:
(3) named insured for their liability assumed in a contract or agreement regarding the rental or lease of a premises on behalf of their client, up to $50,000. This coverage extension only applies to rental lease agreements.
liability insurance of the client.
C. Non-Owned Watercraft
SECTION I COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE
LIABILITY, Subsection 2. Exclusions, Paragraph g. (2) is deleted in its entirety and replaced by the following:
(2) A watercraft you do not own that is:
(a) Less than 58 feet long; and
(b) Not being used to carry persons or property for a charge;
This provision applies to any person, who with your consent, either uses or is responsible for the use of a watercraft. This insurance is excess over any other valid and collectible insurance available to the insured whether primary, excess or contingent.
D. Damage to Property You Own, Rent or Occupy
SECTION I COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE
Includes copyrighted material of Insurance Services Office, Inc., with its permission.
© 2011 Philadelphia Indemnity Insurance Company
LIABILITY, Subsection 2. Exclusions, Paragraph j. Damage to Property, Item (1) is deleted in its entirety and replaced with the following:
(1) Property you own, rent, or occupy, including any costs or expenses incurred by you, or any other person, organization or entity, for repair, replacement, enhancement, restoration or maintenance of such property for any reason, including prevention of injury your client, up to a $30,000 limit. A client is defined as a person under your direct care and supervision.
E. Damage to Premises Rented to You
1. If damage by fire to premises rented to you is not otherwise excluded from this Coverage Part, the w
a. The last paragraph of SECTION I COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, Subsection 2. Exclusions; is deleted in its entirety and replaced by the following:
Exclusions c. through n. do not apply to damage by fire, lightning, explosion, smoke, or leakage from automatic fire protective systems to premises while rented to you or temporarily occupied by you with permission of the owner. A separate limit of insurance applies to this coverage as described in SECTION III LIMITS OF INSURANCE.
b. SECTION III LIMITS OF INSURANCE, Paragraph 6. is deleted in its entirety and replaced by the following:
Subject to Paragraph 5. above, the Damage To Premises Rented To You Limit is the most we will pay under Coverage A for damages because of "property damage" to any one premises, while rented to you, or in the case of damage by fire, lightning, explosion, smoke, or leakage from automatic fire protective systems while rented to you or temporarily occupied by you with permission of the owner.
c. SECTION V DEFINITIONS, Paragraph 9.a., is deleted in its entirety and replaced by the following:
A contract for a lease of premises. However, that portion of the contract for a lease of premises that indemnifies any person or organization for damage by fire, lightning, explosion, smoke, or leakage from automatic fire protective systems to premises while rented to you or temporarily occupied by you with permission of the owner is not an "insured contract";
2. SECTION IV COMMERCIAL GENERAL LIABILITY CONDITIONS, Subsection 4. Other Insurance, Paragraph b. Excess Insurance, (1) (a) (ii) is deleted in its entirety and replaced by the following:
That is insurance for fire, lightning, explosion, smoke, or leakage from automatic fire protective systems for premises rented to you or temporarily occupied by you with permission of the owner;
3. The Damage To Premises Rented To You Limit section of the Declarations is amended to the greater of:
Includes copyrighted material of Insurance Services Office, Inc., with its permission.
© 2011 Philadelphia Indemnity Insurance Company
a. $1,000,000; or
b. The amount shown in the Declarations as the Damage to Premises Rented to You Limit.
This is the most we will pay for all damage proximately caused by the same event, whether such damage results from fire, lightning, explosion, smoke, or leaks from automatic fire protective systems or any combination thereof.
F. HIPAA
SECTION I COVERAGES, COVERAGE B PERSONAL AND ADVERTISING INJURY LIABILITY,
is amended as follows:
1. Paragraph 1. Insuring Agreement is amended to include the following:
We will pay those sums that the insured becomes legally obligated to pay as damages because ity and Accountability Act (HIPAA). We have
2. Paragraph 2. Exclusions is amended to include the following additional exclusions:
This insurance does not apply to:
a. Intentional, Willful, or Deliberate Violations
b. Criminal Acts riminal penalties under the HIPAA.
c. Other Remedies
Any remedy other than monetary damages for penalties assessed.
d. Compliance Reviews or Audits
Any compliance reviews by the Department of Health and Human Services.
3. SECTION V DEFINITIONS is amended to include the following additional definitions:
a.
b.
c. regulations included in the
HIPAA.
Includes copyrighted material of Insurance Services Office, Inc., with its permission.
© 2011 Philadelphia Indemnity Insurance Company
G. Medical Payments Limit Increased to $20,000, Extended Reporting Period
If COVERAGE C MEDICAL PAYMENTS is not otherwise excluded from this Coverage Part:
1. The Medical Expense Limit is changed subject to all of the terms of SECTION III - LIMITS OF INSURANCE to the greater of:
a. $20,000; or
b. The Medical Expense Limit shown in the Declarations of this Coverage Part.
2. SECTION I COVERAGE, COVERAGE C MEDICAL PAYMENTS, Subsection 1. Insuring Agreement, a. (3) (b) is deleted in its entirety and replaced by the following:
(b) The expenses are incurred and reported to us within three years of the date of the accident.
H. Athletic Activities
SECTION I COVERAGES, COVERAGE C MEDICAL PAYMENTS, Subsection 2. Exclusions, Paragraph e. Athletic Activities is deleted in its entirety and replaced with the following:
e. Athletic Activities
To a person injured while taking part in athletics.
I. Supplementary Payments
SECTION I COVERAGES, SUPPLEMENTARY PAYMENTS - COVERAGE A AND B are amended as follows:
1. b. is deleted in its entirety and replaced by the following:
1. b. Up to $5000 for cost of bail bonds required because of accidents or traffic law violations arising out of the use of any vehicle to which the Bodily Injury Liability Coverage applies. We do not have to furnish these.
1.d. is deleted in its entirety and replaced by the following:
1. d. All reasonable expenses incurred by the insured at our request to assist us in the investigation or defense of the claim or "suit", including actual loss of earnings up to $1,000 a day because of time off from work.
J. Employee Indemnification Defense Coverage
SECTION I COVERAGES, SUPPLEMENTARY PAYMENTS COVERAGES A AND B the following is added:
We will pay occurring in the course of employment.
proceeding is $25,000 regardl
Includes copyrighted material of Insurance Services Office, Inc., with its permission.
© 2011 Philadelphia Indemnity Insurance Company
K. Key and Lock Replacement Janitorial Services Client Coverage
SECTION I COVERAGES, SUPPLEMENTARY PAYMENTS COVERAGES A AND B is amended to include the following:
W , up to a $10,000 limit per occurrence and $10,000 policy aggregate.
We will not pay for loss or damage resulting from theft or any other dishonest or criminal act that authorized representatives or any one to purpose commit, whether acting alone or in collusion with other persons.
The following, when used on this coverage, are defined as follows:
a. "Client" means an individual, company or organization with whom you have a written contract or work order for your services for a described premises and have billed for your services.
b. "Employee" means:
(1) Any natural person:
(a) While in your service or for 30 days after termination of service;
(b) Who you compensate directly by salary, wages or commissions; and
(c) Who you have the right to direct and control while performing services for you; or
(2) Any natural person who is furnished temporarily to you:
(a) To substitute for a permanent "employee" as defined in Paragraph (1) above, who is on leave; or
(b) To meet seasonal or short-term workload conditions;
while that person is subject to your direction and control and performing services for you.
(3) "Employee" does not mean:
(a) Any agent, broker, person leased to you by a labor leasing firm, factor, commission merchant, consignee, independent contractor or representative of the same general character; or
(b) Any "manager," director or trustee except while performing acts coming within the scope of the usual duties of an "employee."
c. "Manager" means a person serving in a directorial capacity for a limited liability company.
L. Additional Insureds
SECTION II WHO IS AN INSURED is amended as follows:
1. If coverage for newly acquired or formed organizations is not otherwise excluded from this
Includes copyrighted material of Insurance Services Office, Inc., with its permission.
© 2011 Philadelphia Indemnity Insurance Company
Coverage Part, Paragraph 3.a. is deleted in its entirely and replaced by the following:
a. Coverage under this provision is afforded until the end of the policy period.
2. Each of the following is also an insured:
a. Medical Directors and Administrators Your medical directors and administrators, but only while acting within the scope of and during the course of their duties as such. Such duties do not include the furnishing or failure to furnish professional services of any physician or psychiatrist in the treatment of a patient.
b. Managers and Supervisors Your managers and supervisors are also insureds, but only with respect to their duties as your managers and supervisors. Managers and employment by you or performing duties related to the conduct of your business.
This provision does not change Item 2.a.(1)(a) as it applies to managers of a limited liability company.
c. Broadened Named Insured Any organization and subsidiary thereof which you control and actively manage on the effective date of this Coverage Part. However, coverage does not apply to any organization or subsidiary not named in the Declarations as Named Insured, if they are also insured under another similar policy, but for its termination or the exhaustion of its limits of insurance.
d. Funding Source Any person or organization with respect to their liability arising out of:
(1) Their financial control of you; or
(2) Premises they own, maintain or control while you lease or occupy these premises.
This insurance does not apply to structural alterations, new construction and demolition operations performed by or for that person or organization.
e. Home Care Providers At the first Named Insured's option, any person or organization under your direct supervision and control while providing for you private home respite or foster home care for the developmentally disabled.
f. Managers, Landlords, or Lessors of Premises Any person or organization with respect to their liability arising out of the ownership, maintenance or use of that part of the premises leased or rented to you subject to the following additional exclusions:
This insurance does not apply to:
(1) e a tenant in that premises; or
(2) Structural alterations, new construction or demolition operations performed by or on behalf of that person or organization.
g. Lessor of Leased Equipment Automatic Status When Required in Lease Agreement With You Any person or organization from whom you lease equipment when you and such person or organization have agreed in writing in a contract or agreement that such person or organization is to be added as an additional insured on your policy. Such person or
Includes copyrighted material of Insurance Services Office, Inc., with its permission.
© 2011 Philadelphia Indemnity Insurance Company or aused, in whole or in part, by your maintenance, operation or use of equipment leased to you by such person or organization.
A when their contract or agreement with you for such leased equipment ends.
With respect to the insurance afforded to these additional insureds, this insurance does not
h. Grantors of Permits Any state or political subdivision granting you a permit in connection with your premises subject to the following additional provision:
(1) This insurance applies only with respect to the following hazards for which the state or political subdivision has issued a permit in connection with the premises you own, rent or control and to which this insurance applies:
(a) The existence, maintenance, repair, construction, erection, or removal of advertising signs, awnings, canopies, cellar entrances, coal holes, driveways, manholes, marquees, hoist away openings, sidewalk vaults, street banners or decorations and similar exposures;
(b) The construction, erection, or removal of elevators; or
(c) The ownership, maintenance, or use of any elevators covered by this insurance.
i. Vendors which are distributed or sold in the regular course of the vendor's business, subject to the following additional exclusions:
(1) The insurance afforded the vendor does not apply to:
(a) "Bodily injury" or "property damage" for which the vendor is obligated to pay damages by reason of the assumption of liability in a contract or agreement. This exclusion does not apply to liability for damages that the vendor would have in the absence of the contract or agreement;
(b) Any express warranty unauthorized by you;
(c) Any physical or chemical change in the product made intentionally by the vendor;
(d) Repackaging, except when unpacked solely for the purpose of inspection, demonstration, testing, or the substitution of parts under instructions from the manufacturer, and then repackaged in the original container;
(e) Any failure to make such inspections, adjustments, tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business, in connection with the distribution or sale of the products;
(f) Demonstration, installation, servicing or repair operations, except such operations performed at the vendor's premises in connection with the sale of the product;
Includes copyrighted material of Insurance Services Office, Inc., with its permission.
© 2011 Philadelphia Indemnity Insurance Company
(g) Products which, after distribution or sale by you, have been labeled or relabeled or used as a container, part or ingredient of any other thing or substance by or for the vendor; or
(h) "Bodily injury" or "property damage" arising out of the sole negligence of the vendor for its own acts or omissions or those of its employees or anyone else acting on its behalf. However, this exclusion does not apply to:
(i) The exceptions contained in Sub-paragraphs (d) or (f); or
(ii) Such inspections, adjustments, tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business, in connection with the distribution or sale of the products.
(2) This insurance does not apply to any insured person or organization, from whom you have acquired such products, or any ingredient, part or container, entering into, accompanying or containing.
j. Franchisor Any person or organization with respect to their liability as the grantor of a franchise to you.
k. As Required by Contract Any person or organization where required by a written contract executed prior to the occurrence of a loss. Such person or organization is an additional insured for "bodily injury," "property damage" or "personal and advertising injury" but only for liability arising out of the negligence of the named insured. The limits of insurance applicable to these additional insureds are the lesser of the policy limits or those limits specified in a contract or agreement. These limits are included within and not in addition to the limits of insurance shown in the Declarations
l. Owners, Lessees or Contractors Any person or organization, but only with respect to liability for "bodily injury," "property damage" or "personal and advertising injury" caused, in whole or in part, by:
(1) Your acts or omissions; or
(2) The acts or omissions of those acting on your behalf;
in the performance of your ongoing operations for the additional insured when required by a contract.
With respect to the insurance afforded to these additional insureds, the following additional exclusions apply:
This insurance does not apply to "bodily injury" or "property damage" occurring after:
(a) All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or
(b) That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project.
Includes copyrighted material of Insurance Services Office, Inc., with its permission.
© 2011 Philadelphia Indemnity Insurance Company
m. State or Political Subdivisions Any state or political subdivision as required, subject to the following provisions:
(1) This insurance applies only with respect to operations performed by you or on your behalf for which the state or political subdivision has issued a permit, and is required by contract.
(2) This insurance does not apply to:
(a) "Bodily injury," "property damage" or "personal and advertising injury" arising out of operations performed for the state or municipality; or
(b) "Bodily injury" or "property damage" included within the "products-completed operations hazard."
M. Duties in the Event of Occurrence, Claim or Suit
SECTION IV COMMERCIAL GENERAL LIABILITY CONDITIONS, Paragraph 2. is amended as follows:
a. is amended to include:
This condition
(1) You, if you are an individual;
(2) A partner, if you are a partnership; or
(3) An executive officer or insurance manager, if you are a corporation.
b. is amended to include:
This condition is known to:
(1) You, if you are an individual;
(2) A partner, if you are a partnership; or
(3) An executive officer or insurance manager, if you are a corporation.
N. Unintentional Failure To Disclose Hazards
SECTION IV COMMERCIAL GENERAL LIABILITY CONDITIONS, 6. Representations is amended to include the following:
It is agreed that, based on our reliance on your representations as to existing hazards, if you should unintentionally fail to disclose all such hazards prior to the beginning of the policy period of this Coverage Part, we shall not deny coverage under this Coverage Part because of such failure.
O. Transfer of Rights of Recovery Against Others To Us
SECTION IV COMMERCIAL GENERAL LIABILITY CONDITIONS, 8. Transfer of Rights of
Includes copyrighted material of Insurance Services Office, Inc., with its permission.
© 2011 Philadelphia Indemnity Insurance Company
Recovery Against Others To Us is deleted in its entirety and replaced by the following:
If the insured has rights to recover all or part of any payment we have made under this Coverage Part, those rights are transferred to us. The insured must do nothing after loss to impair them. At our request, the insured will bring "suit" or transfer those rights to us and help us enforce them.
Therefore, the i ecovery prior to the occurrence of a loss, provided the waiver is made in a written contract.
P. Liberalization
SECTION IV COMMERCIAL GENERAL LIABILITY CONDITIONS, is amended to include the following:
If we revise this endorsement to provide more coverage without additional premium charge, we will automatically provide the additional coverage to all endorsement holders as of the day the revision is effective in your state.
Q. Bodily Injury Mental Anguish
SECTION V DEFINITIONS, Paragraph 3. Is deleted in its entirety and replaced by the following:
njury means:
a. Bodily injury, sickness or disease sustained by a person, and includes mental anguish resulting from any of these; and
b. Except for mental anguish, includes death resulting from the foregoing (Item a. above) at any time.
R. Personal and Advertising Injury Abuse of Process, Discrimination
If COVERAGE B PERSONAL AND ADVERTISING INJURY LIABILITY COVERAGE is not otherwise excluded from this Coverage Part, the definition of amended as follows:
1. SECTION V DEFINITIONS, Paragraph 14.b. is deleted in its entirety and replaced by the following:
b. Malicious prosecution or abuse of process;
2. SECTION V DEFINITIONS, Paragraph 14. is amended by adding the following:
Discrimination based on race, color, religion, sex, age or national origin, except when:
a. Done intentionally by or at the direction of, or with the knowledge or consent of:
(1) Any insured; or
(2) Any executive officer, director, stockholder, partner or member of the insured;
b. Directly or indirectly related to the employment, former or prospective employment, termination of employment, or application for employment of any person or persons by an insured;
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© 2011 Philadelphia Indemnity Insurance Company
c. Directly or indirectly related to the sale, rental, lease or sublease or prospective sales, rental, lease or sub-lease of any room, dwelling or premises by or at the direction of any insured; or
d. Insurance for such discrimination is prohibited by or held in violation of law, public policy, legislation, court decision or administrative ruling.
The above does not apply to fines or penalties imposed because of discrimination.
PI-CA-001 (09/15)
© 2015 Philadelphia Indemnity Insurance Company
Includes copyrighted material of Insurance Services Office, Inc., with its permission.
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
COMMERCIAL AUTOMOBILE ELITE ENDORSEMENT
This endorsement modifies insurance provided under the following:
BUSINESS AUTO COVERAGE PART
Following is a summary of the Limits of Insurance and additional coverages provided by this endorsement. For complete details on specific coverages, consult the policy contract wording.
Coverage extensions under this endorsement only apply in the event that no other specific coverage for these extensions is provided under this policy. If such specific coverage applies, the terms, conditions and limits of that coverage are the sole and exclusive coverage applicable under this policy, unless otherwise noted in this endorsement.
Any deductible listed in the Auto Declarations Page will apply unless specific deductible provisions are set forth under a coverage enhancement below.
Coverage Applicable Limit of Insurance Page
Who is An Insured Board Members Newly Acquired Entities Designated Insured Lessor of Leased Autos
Included Included Included Included
Cost of Bail Bonds $5,000 2 Reasonable Expenses – Loss of Earnings $500 per day 2 Fellow Employee Coverage Amended 3 Towing $100 per disablement 3 Glass Breakage (Windshields and Windows) No deductible applies 3 Transportation Expenses $100 per day / $3,000 maximum 3 Hired Auto Physical Damage – Loss of Use $100 per day / $1,000 maximum 3 Hired Auto Physical Damage ACV or repair or replacement of the vehicle whichever is less
Personal Effects $500 4 Rental Reimbursement $100 per day / 30 days 4 Accidental Discharge – Air Bag Amended 4 Electronic Equipment $1000 5 Original Equipment Manufacturer Parts Replacement
Included 5
Auto Loan / Lease Gap Coverage Amended 5 One Comprehensive Coverage Deductible Per Occurrence
Amended 6
Notice of and Knowledge of Occurrence Amended 7 Blanket Waiver of Subrogation Amended (as required by written contract) 7 Unintentional Errors or Omissions Amended 7 Mental Anguish – Bodily Injury Redefined Amended 7
© 2015 Philadelphia Indemnity Insurance Company
Includes copyrighted material of Insurance Services Office, Inc., with its permission.
I. LIABILITY COVERAGE EXTENSIONS
A. Who Is An Insured
SECTION II – LIABILITY COVERAGE, A. Coverage, 1. Who Is An Insured is amended by adding the following:
The following are also "insureds":
1. Board Members – Board members (or their spouses) while renting a vehicle while on business for the named insured.
2. Newly Acquired Entities – Any business entity newly acquired or formed by you during the policy period, provided you own 50% or more of the business entity and the business entity is not separately insured for Business Auto Coverage. Coverage is extended up to a maximum of 180 days following the acquisition or the formation of the business entity.
3. Designated Insured – Any person or organization designated by the “insured” is an "insured" for Liability Coverage, but only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured Provision contained in SECTION II of the Coverage Form.
4. Lessor of Leased Autos – The lessor of a “leased auto” is an “insured" only for "bodily injury" or "property damage" resulting from the acts or omissions by:
a. You;
b. Any of your "employees" or agents; or
c. Any person, except the lessor or any "employee" or agent of the lessor, operating a “leased auto” with the permission of any of the above.
Any “leased auto” in the policy schedule will be considered a covered "auto" you own and not a covered "auto" you hire or borrow.
The coverages provided under this endorsement apply to any “leased auto” in the policy schedule until the expiration date of the lease, or when the lessor or his or her agent takes possession of the “leased auto,” whichever occurs first.
“Leased auto” means an “auto” leased or rented to you, including any substitute, replacement or extra “auto” needed to meet seasonal or other needs, under a leasing or rental agreement that requires you to provide direct primary insurance for the lessor.
B. Cost of Bail Bonds
SECTION II – LIABILITY COVERAGE, A. Coverage, 2. Coverage Extensions, a.
Supplementary Payments, Item (2) is deleted in its entirety and replaced with the following:
(2) Up to $5,000 for cost of bail bonds (including bonds for related traffic law violations) required because of an "accident" we cover. We do not have to furnish these bonds.
C. Reasonable Expenses
SECTION II – LIABILITY COVERAGE, A. Coverage, 2. Coverage Extensions, a.
Supplementary Payments, Item (4) is deleted in its entirety and replaced with the following:
© 2015 Philadelphia Indemnity Insurance Company
Includes copyrighted material of Insurance Services Office, Inc., with its permission.
(4) All reasonable expenses incurred by the "insured" at our request, including actual loss of earnings up to $500 a day because of time off from work.
D. Fellow Employee Coverage
SECTION II – LIABILITY COVERAGE, B. Exclusions, 5. Fellow Employee is deleted in its entirety and replaced by the following:
"Bodily injury" to any fellow "employee" of the "insured" arising out of and in the course of the fellow "employee's" employment or while performing duties related to the conduct of your business.
However, this exclusion does not apply to any manager or officer of your company.
II. PHYSICAL DAMAGE COVERAGE EXTENSIONS
A. Towing
SECTION III – PHYSICAL DAMAGE COVERAGE, A. Coverage, 2. Towing is deleted in its entirety and replaced with the following:
2. Towing
We will pay up to $100 for towing and labor costs incurred each time a covered "auto" is disabled. However, the labor must be performed at the place of disablement. No deductible applies to this enhancement.
B. Glass Breakage
SECTION III – PHYSICAL DAMAGE COVERAGE, A. Coverage, 3. Glass Breakage – Hitting A Bird Or Animal – Falling Objects Or Missiles is amended by adding the following:
No deductible applies to "loss" to glass used in the windshield or windows.
C. Transportation Expenses
SECTION III – PHYSICAL DAMAGE COVERAGE, A. Coverage, 4. Coverage Extensions, a.
Transportation Expenses is deleted in its entirety and replaced with the following:
a. Transportation Expenses
We will pay up to $100 per day to a maximum of $3,000 for temporary transportation expenses incurred by you because of a “loss” to a covered “auto.” We will pay for temporary transportation expenses incurred during the period beginning 48 hours after the “loss” and ending, regardless of the policy’s expiration, when the covered “auto” is returned to use or we pay for its “loss.”
D. Hired Auto Physical Damage – Loss of Use
The last sentence of SECTION III – PHYSICAL DAMAGE COVERAGE, A. Coverage, 4.
Coverage Extensions, b. Loss of Use Expenses is deleted in its entirety and replaced with the following:
However, the most we will pay for any expenses for loss of use is $100 per day, to a maximum of $1,000.
© 2015 Philadelphia Indemnity Insurance Company
Includes copyrighted material of Insurance Services Office, Inc., with its permission.
E. Hired Auto Physical Damage
SECTION III – PHYSICAL DAMAGE COVERAGE, A. Coverage, 4. Coverage Extensions is amended by adding the following extension:
Hired Auto Physical Damage
Any "auto" you lease, hire, rent or borrow from someone other than your “employees” or partners, or members of their household is a covered "auto" for each of your physical damage coverages.
The most we will pay for any “loss” in any one “accident” is the ACV or the cost for repair or replacement of the vehicle, whichever is less.
For each covered “auto” our obligation to pay will be reduced by a deductible of $500 for Comprehensive Coverage and $1000 for Collision Coverage.
F. Personal Effects Coverage
SECTION III – PHYSICAL DAMAGE COVERAGE, A. Coverage, 4. Coverage Extensions is amended by adding the following extension:
Personal Effects Coverage
We will pay up to $500 for “loss” to personal effects, which are:
1. Owned by an “insured”; and
2. In or on your covered “auto.”
This coverage applies only in the event of the total theft of your covered “auto.” No deductible applies to this coverage.
G. Rental Reimbursement
SECTION III – PHYSICAL DAMAGE COVERAGE, A. Coverage, 4. Coverage Extensions is amended by adding the following extension:
Rental Reimbursement Coverage
We will pay up to $100 per day, for up to 30 days, for rental reimbursement expenses incurred by you for the rental of an “auto” because of “loss” to a covered “auto.”
We will also pay up to $300 for reasonable and necessary expenses incurred by you to remove and replace your materials and equipment from the covered “auto.”
If “loss” results from the total theft of a covered “auto,” we will pay under this coverage only that amount of your rental reimbursement expenses which is not already provided under Item III. C.
Transportation Expenses of this endorsement.
H. Accidental Discharge – Airbag Coverage
SECTION III – PHYSICAL DAMAGE COVERAGE, B. Exclusions, Paragraph 3. is amended by adding the following exception:
© 2015 Philadelphia Indemnity Insurance Company
Includes copyrighted material of Insurance Services Office, Inc., with its permission.
This exclusion does not apply to the accidental discharge of an airbag. This coverage is excess of any other collectible insurance or warranty. No deductible applies to this coverage.
I. Electronic Equipment Coverage
The following supersedes anything to the contrary in SECTION III – PHYSICAL DAMAGE COVERAGE, B. Exclusions, Paragraph 4.
Exclusions 4.c. and 4.d. do not apply to:
Any risk management or monitoring equipment and electronic equipment that receives or transmits audio, visual or data signals and that is not designed solely for the reproduction of sound. This coverage applies only if the equipment is permanently installed in the covered "auto" at the time of the "loss" or the equipment is removable from a housing unit which is permanently installed in the covered "auto" at the time of the "loss," and such equipment is designed to be solely operated by use of the power from the "auto's" electrical system, in or upon the covered "auto."
The most we will pay for all “loss” to risk management or monitoring equipment, audio, visual or data electronic equipment that is not designed solely for the reproduction of sound and any accessories used with this equipment as a result of any one “accident” is the least of:
a. The actual cash value of the damaged or stolen property at the time of the “loss”;
b. The cost of repairing or replacing the damaged or stolen property with other property of like kind and quality; or
c. $1,000.
This coverage will not apply if there is other insurance provided by this policy for the above-described electronic equipment. We will, however, pay any deductible, up to $500, that is applicable under the provisions of the other insurance.
J. Original Equipment Manufacturer (OEM) Parts Replacement
SECTION III – PHYSICAL DAMAGE COVERAGE, C. Limit of Insurance, Paragraph 1. is amended to include:
However, if the covered “auto” has less than 20,000 miles on its odometer, then the following condition will apply:
We will pay the cost to replace the damaged parts (excluding glass and mechanical parts) with new Original Equipment Manufacturer replacement parts if the damaged parts cannot be repaired.
K. Auto Loan / Lease Gap Protection
SECTION III – PHYSICAL DAMAGE COVERAGE, C. Limit of Insurance is amended to include the following:
4. In the event of “loss” to a covered “auto” that is loaned or leased to an “insured”:
a. The most we will pay for “loss” in any one “accident” is the lesser of:
© 2015 Philadelphia Indemnity Insurance Company
Includes copyrighted material of Insurance Services Office, Inc., with its permission.
(1) The actual cash value of the damaged or stolen property as of the time of the “loss”;
or
(2) The cost of repairing or replacing the damaged or stolen property with other property of like, kind and quality.
b. Our Limit of Insurance for “total loss” will be the greater of:
(1) The balance due under the terms of the lease or loan, to which your "auto" is subject but not including:
(a) Past due payments;
(b) Financial penalties imposed under the lease;
(c) Security deposits not refunded;
(d) Costs for extended warranties or insurance; or
(e) Final payment due under a “balloon loan”; or
(2) Actual cash value of the stolen or damaged property.
An adjustment for depreciation and physical condition will be made in determining actual cash value at the time of “loss.”
c. Additional Definitions
(1) “Total loss” for the purpose of this coverage, means a loss in which the estimated cost of repairs, plus the salvage value, exceeds the actual cash value.
(2) “Balloon loan” is one with periodic payments that are insufficient to repay the balance over the term of the loan, thereby requiring a large final payment.
d. Additional Conditions
This coverage will apply only to the original lease or loan written on your covered “auto.”
In order for this coverage to apply, leased “autos” must be leased or rented to you under a leasing or rental agreement, for a period of not less than six months, which requires you to provide direct primary insurance for the benefit of the lessor.
L. One Comprehensive Coverage Deductible
SECTION III – PHYSICAL DAMAGE COVERAGE, D. Deductible is amended by adding the following:
Only one Comprehensive Coverage Deductible per occurrence will apply to any “loss” resulting from a covered peril.
For the purpose of this extension, occurrence means a single incident, including continuous or repeated exposure to substantially the same general harmful conditions within a 24-hour period.
© 2015 Philadelphia Indemnity Insurance Company
Includes copyrighted material of Insurance Services Office, Inc., with its permission.
III. BUSINESS AUTO CONDITIONS
A. Notice and Knowledge of Occurrence
SECTION IV – BUSINESS AUTO CONDITIONS, A. Loss Conditions, 2. Duties In The Event Of Accident, Claim, Suit Or Loss, Paragraph a. is deleted in its entirety and replaced with the following:
a. In the event of “accident,” claim, “suit” or “loss,” you must give us, or our authorized representative, prompt notice of the “accident” or “loss.” Include:
(1) How, when and where the “accident” or “loss” occurred;
(2) The “insured’s” name and address; and
(3) To the extent possible, the names and addresses of any injured persons and witnesses.
Your duty to give us or our authorized representative prompt notice of the “accident” or “loss” applies only when the “accident” or “loss” is known to:
(1) You, if you are an individual;
(2) A partner, if you are a partnership; or
(3) An executive officer or insurance manager, if you are a corporation.
B. Blanket Waiver Of Subrogation
SECTION IV – BUSINESS AUTO CONDITIONS, A. Loss Conditions, 5. Transfer Of Rights Of Recovery Against Others To Us, is amended by adding the following exception:
However, we waive any right of recovery we may have against any person or organization because of payments we make for “bodily injury” or “property damage” arising out of the operation of a covered “auto” when you have assumed liability for such “bodily injury” or “property damage” under an “insured contract.”
C. Unintentional Errors or Omissions
SECTION IV – BUSINESS AUTO CONDITIONS, B. General Conditions, 2. Concealment, Misrepresentation, Or Fraud is amended by adding the following:
The unintentional omission of, or unintentional error in, any information given by you shall not prejudice your rights under this insurance. However, this provision does not affect our right to collect additional premium or exercise our right of cancellation or non-renewal.
IV. DEFINITIONS
A. Mental Anguish
SECTION V – DEFINITIONS, C. "Bodily injury" is amended by adding the following:
“Bodily injury” also includes mental anguish but only when the mental anguish arises from other bodily injury, sickness, or disease.
POLICY NUMBER: COMMERCIAL GENERAL LIABILITY
CG 24 04 05 09
CG 24 04 05 09 © Insurance Services Office, Inc., 2008 Page 1 of 1
WAIVER OF TRANSFER OF RIGHTS OF RECOVERY
AGAINST OTHERS TO US
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART
SCHEDULE
Name Of Person Or Organization:
Information required to complete this Schedule, if not shown above, will be shown in the Declarations.
The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV – Conditions:
We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the "products-completed operations hazard". This waiver applies only to the person or organization shown in the Schedule above.
PHPK2458589
The State of Arizona (complete name per manuscript) 2700 N. Central Ave., Ste 1100 Phoenix, AZ 85004 - 1149
POLICY NUMBER: COMMERCIAL AUTO
CA 04 44 10 13
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
CA 04 44 10 13 © Insurance Services Office, Inc., 2011 Page of
WAIVER OF TRANSFER OF RIGHTS OF RECOVERY
AGAINST OTHERS TO US (WAIVER OF SUBROGATION)
This endorsement modifies insurance provided under the following:
AUTO DEALERS COVERAGE FORM
BUSINESS AUTO COVERAGE FORM
MOTOR CARRIER COVERAGE FORM
With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement.
This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below.
Named Insured:
Endorsement Effective Date:
SCHEDULE
Name(s) Of Person(s) Or Organization(s):
Information required to complete this Schedule, if not shown above, will be shown in the Declarations.
The Transfer Of Rights Of Recovery Against Others To Us…
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