ACCEPTED CTR064365 GL,AL,WC 02.27.24-02.11.25.pdf

PDF 2 MB Posted

Attached to
Master Agreement AZ|CTR064365
Contract number
CTR064365
Issued by
Arizona

About this file

This document is a comprehensive insurance policy and related endorsements for P.A.C.E. Electrical Construction, Inc., based in Tucson, Arizona. The insurance coverage is provided by multiple insurers, including Service American Indemnity Company, Admiral Insurance Company, Acuity, and Landmark American Insurance Company. The primary certificate of liability insurance is issued for the company's operations, with Arizona Department of Transportation (ADOT) listed as the certificate holder, specifically for Contract No. CTR064365.

The insurance package includes commercial general liability, automobile liability, umbrella liability, and workers' compensation coverage. The policy periods are effective from February 27, 2024, to February 27, 2025, with various coverage limits. For general liability, there's a $1,000,000 per occurrence limit and a $2,000,000 general aggregate limit. Automobile liability is set at $1,000,000, and the umbrella liability provides an additional $5,000,000 in coverage. The workers' compensation policy includes $1,000,000 limits for each accident, employee disease, and overall policy disease limit. The endorsements provide additional protections such as additional insured status for various entities, waiver of subrogation, and expanded coverage for hired and owned vehicles.

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Other files

File Type Posted
CTR064365 Post Award Documents.pdf PDF
CTR064365_Contract_Amendment_Summary_2.pdf PDF
CTR064365_Contract_Amendment_Summary_3.pdf PDF
CTR064365_Contract_Documents.pdf PDF
CTR064365_Pricing.xlsx XLSX spreadsheet
Usage Report-4TH QUARTER (1).xlsx XLSX spreadsheet
2024.02.11 COI.pdf PDF
CTR064365_Contract_Amendment_Summary_One__1_.pdf PDF
Usage Report-3RD QUARTER.xlsx XLSX spreadsheet
CTR064365_Contract_Amendment_Summary_4.pdf PDF
Usage Report-1ST QUARTER.xlsx XLSX spreadsheet
Usage Report-2ND QUARTER.xlsx XLSX spreadsheet
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Text version

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)

© 1988-2015 ACORD CORPORATION. All rights reserved.

CERTIFICATE HOLDER

The ACORD name and logo are registered marks of ACORD

HIRED

AUTOS ONLY

2/4/2025

Crest Insurance Group, LLC 5285 E. Williams Circle Suite 4500 Tucson AZ 85711

Chi McCoy 520-881-5760 ext. 1166 520-618-2454 cmccoy@crestins.com

Service American Indemnity Company 39152 PACEELE-03 Admiral Insurance Company 24856

P.A.C.E. Electrical Construction, Inc.

515 E. 24th Street Tucson AZ 85713

Acuity 14184 Landmark American Insurance Co. 33138

1770951

B X 1,000,000 X 300,000

X $5K Ded occ 5,000

1,000,000

2,000,000 X

X PPA CAP @$5M

Y Y CA000052068-01 2/27/2024 2/27/2025

2,000,000

C 1,000,000

X

X X

Y Y ZU4171 2/27/2024 2/27/2025

D X 5,000,000 X

LHA106874 2/27/2024 2/27/2025

5,000,000 X 0

A XY SAMTWC1031500 2/11/2024 2/11/2025

1,000,000

1,000,000

1,000,000

Certificate holder and others when required in a written contract or agreement are Additional Insured (General Liability & Automobile Liability) including Products Completed. Coverage is Primary & Non-Contributory (General Liability). Waiver of Subrogation (General Liability, Automobile Liability & Workers Compensation) applies. This form is subject to all policy forms, terms, endorsements, conditions definitions & exclusions.

Contract No.: CTR064365

ADOT

MD 100P, 1655 W. Jackson St Phoenix AZ 85007

Cindy Lewis Accepted

Policy Number: CA000052068-01 CG2010 07 04

Effective Date: 02/27/2024

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

ADDITIONAL INSURED - OWNERS, LESSEES OR

CONTRACTORS - SCHEDULED PERSON OR

ORGANIZATION

This endorsement modifies insurance provided under the following:

COMMERCIAL GENERAL LIABILITY COVERAGE PART

SCHEDULE

Name Of Additional Insured Person(s) Or Or2anization(s): Location(s) Of Covered Operations

Information required to complete this Schedule, if not shown above, will be shown in the Declarations.

A. Section II - Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by:

1. Your acts or omissions; or

2. The acts or omissions of those acting on your behalf;

in the performance of your ongoing operations for the additional insured(s) at the location(s) designated above.

B. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply:

This insurance does not apply to "bodily injury" or "property damage" occurring after:

1. All work, including materials, parts or equipment furnished in connection with such work, on the project ( other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or

2. That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project.

CG2010 0704 © ISO Properties, Inc., 2004 Page 1 ofl □ cmccoy Typewritten text

ADOT

Policy Number: CA000052068-01 AD 68 93 0123

Effective Date: 02/27/2024

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

CONTRACTORS ENHANCED COVERAGE

(Commercial General Liability Coverage Form)

This endorsement modifies insurance provided under the following:

COMMERCIAL GENERAL LIABILITY COVERAGE FORM

I. AMENDED EXCLUSIONS

NON-OWNED WATERCRAFT COVERAGE - Up to 55 feet

SECTION I - COVERAGES - COVERAGE A- BODILY INJURY AND PROPERTY DAMAGE LIABILITY, sub paragraph (2) of Exclusion g. Aircraft, Auto or Watercraft, is amended as follows:

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

(a) Less than 55 feet long; and

(b) Not being used to carry persons or property for a charge;

MEDICAL PAYMENTS -

PRODUCTS-COMPLETED OPERATIONS HAZARD

SECTION I - COVERAGES - COVERAGE C - MEDICAL PAYMENTS Exclusion f. Products-Completed Operations Hazard is deleted in its entirety.

CONSOLIDATED (WRAP-UP) INSURANCE PROGRAM EXCLUSION

(LIMITED EXCEPTION FOR OPERATIONS A WAY FROM PROJECT LOCATION)

The following exclusion is added to paragraph 2., Exclusions of COVERAGE A- BODILY INJURY AND PROPERTY DAMAGE LIABILITY (Section I - Coverages):

This insurance does not apply to "bodily injury" or "property damage" arising out of either your ongoing operations or operations included within the "products-completed operations hazard" at any location for which a consolidated (wrap-up) insurance program has been provided by the prime contractor/project manager or owner of the construction project in which you are involved.

This exclusion applies whether or not the consolidated (wrap-up) insurance program:

(1) Provides coverage identical to that provided by this Coverage Form;

(2) Has limits adequate to cover all claims; or

(3) Remains in effect.

However, if the consolidated (wrap-up) insurance program does not provide coverage for your operations that are performed away from the location of the construction project, this exclusion will not apply.

AD 68 93 0123 Includes copyrighted material of Insurance Services Office, Inc., with its permission.

Page 1 of8 □

II. AMENDED COVERAGES

KNOWLEDGE OF OCCURRENCE

The following paragraph is added to Section IV - Commercial General Liability Conditions Paragraph 2. Duties In The Event Of Occurrence, Offense, Claim or Suit:

Notice of an "occurrence" which may result in a claim under this insurance shall be given as soon as practicable after knowledge of the "occurrence" has been reported to you, one of your "executive officers", or any "employee" authorized by you to give or receive notice of an "occurrence".

UNINTENTIONAL ERRORS AND OMISSIONS

The following paragraph is added to Section IV - Commercial General Liability Conditions Paragraph 6. Representations:

However, the unintentional omission of, or unintentional error in, any information given or provided by you shall not prejudice your rights under this insurance. However, this provision does not affect our right to collect additional premium or to exercise our right of cancellation or non-renewal.

III. ADDED COVERAGES

PERSONAL PROPERTY OF OTHERS IN YOUR CARE, CUSTODY OR CONTROL -

LIMITED COVERAGE

SCHEDULE

Sub-Limits of Insurance:

$10,000 Each Occurrence (Included in the Each Occurrence Limit shown in the Declarations)

$10,000 Aggregate (Included in the General Aggregate Limit shown in the Declarations)

The Sub-Limits oflnsurance shown above are included within and not in addition to the Each Occurrence Limit and the General Aggregate Limit shown in the Declarations.

Supplementary Payments will reduce the Each Occurrence and Aggregate Sub-Limits of Insurance shown above.

It is agreed COMMERCIAL GENERAL LIABILITY COVERAGE FORM - SECTION I - COVERAGE A Exclusion j. (4) is deleted, but only with respect to personal property of others in the care, custody or control of the Named Insured, subject to the following exclusions, conditions and limitations.

1. Exclusions

This insurance does not apply to:

a. "Property damage" arising out of operations performed on behalf of the Named Insured by others;

b. "Property damage" arising out of an "occurrence" at premises owned, rented, leased, operated, occupied or used by you;

c. "Property damage" to property while in transit;

d. "Property damage" arising out of any error, omission or deficiency in the design, specifications, workmanship or materials of the personal property in the Named Insured's care, custody or control;

e. "Property damage" arising out of delay, loss of market, loss of use, loss of profits, or any similar indirect or consequential loss of any kind;

f. "Property damage" included within the "products-completed operations hazard"; or

g. Damages exceeding the actual cash value of the personal property in the care, custody or control of the Named Insured at the time of the "occurrence."

2. Conditions

Our right and duty to defend ends when we have used up the applicable sub-limit of insurance in the payment of judgments or settlements or Supplementary Payments under the insurance provided by this endorsement.

AD 68 93 0123 Includes copyrighted material of Insurance Services Office, Inc., Page 2 of8 □

3. Limits of Insurance

a. The amount we will pay for damages is limited as described below with respect to damages covered under this endorsement:

(1) The Aggregate Limit shown in the Schedule is the most we will pay for the sum of all damages because of "property damage";

(2) The Each Occurrence Limit shown above is the most we will pay for the sum of all damages because of "property damage" arising out of any one "occurrence";

(3) Supplementary Payments will reduce the Each Occurrence and Aggregate Limits of Insurance shown in the Schedule; and

( 4) All sums we pay for damages or Supplementary Payments under this endorsement will reduce the Each Occurrence Limit and the General Aggregate Limit shown in the Declarations.

4. Other Insurance

This insurance is excess over any other valid and collectible Property or Inland Marine insurance available to you, either as a Named Insured or an Additional Insured, whether primary, excess, contingent or any other basis.

PRIMARY AND NONCONTRIBUTORY -

OTHER INSURANCE CONDITION

(Insurance Services Office Endorsement CG 20 01 04 13)

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.

WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US

(Insurance Services Office Endorsement CG 24 04 05 09)

SCHEDULE

Name Of Person Or Organization:

Any person or organization, but only if the following conditions are met:

(1) You have expressly agreed to the waiver in a written contract; and

(2) The injury or damage first occurs subsequent to the execution of the written contract.

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 ofrecovery 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.

AD 68 93 0123 Includes copyrighted material of Insurance Services Office, Inc., with its permission.

Page 3 of8 □

Highlight

Scheduled Railroad:

CONTRACTUAL LIABILITY - RAILROADS

(Insurance Services Office Endorsement CG 24 17 10 01)

SCHEDULE

Designated Job Site:

Any railroad, but only if the following conditions are met:

a. You have expressly agreed to indemnify the railroad in a written contract entered into by you; and

Any job site covered by this insurance where you are performing operations for or affecting a Scheduled Railroad.

b. The injury or damage occurs subsequent to the execution of the written contract.

(If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.)

With respect to operations performed for, or affecting, a Scheduled Railroad at a Designated Job Site, the defmition of "insured contract" in the Definitions section is replaced by the following:

9. "Insured Contract" means:

a. 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 to premises while rented to you or temporarily occupied by you with permission of the owner is not an "insured contract";

b. A sidetrack agreement;

c. Any easement or license agreement;

d. An obligation, as required by ordinance, to indemnify a municipality, except in connection with work for a municipality;

e. An elevator maintenance agreement;

f. That part of any other contract or agreement pertaining to your business (including an indemnification of a municipality in connection with work performed for a municipality) under which you assume the tort liability of another party to pay for "bodily injury" or "property damage" to a third person or organization. Tort liability means a liability that would be imposed by law in the absence of any contract or agreement.

Paragraph f. does not include that part of any contract or agreement:

(1) That indemnifies an architect, engineer or surveyor for injury or damage arising out of:

(a) Preparing, approving or failing to prepare or approve maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or

(b) Giving directions or instructions, or failing to give them, if that is the primary cause of the injury or damage;

(2) Under which the insured, if an architect, engineer or surveyor, assumes liability for an injury or damage arising out of the insured's rendering or failure to render professional services, including those listed in Paragraph (1) above and supervisory, inspection, architectural or engineering activities.

DESIGNATED CONSTRUCTION PROJECT(S) GENERAL AGGREGATE LIMIT

(WITH TOTAL AGGREGATE LIMIT FOR COVERAGES A, BAND C)

SCHEDULE

Designated Construction Projects:

All construction projects covered by this insurance.

(If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.)

AD 68 93 0123 Includes copyrighted material of Insurance Services Office, Inc., Page 4 of8 □

A. For all sums which the insured becomes legally obligated to pay as damages caused by "occurrences" under COVERAGE A (SECTION I), and for all medical expenses caused by accidents under COVERAGE C (SECTION I), which can be attributed only to ongoing operations at a single designated construction project shown in the Schedule above:

1. A separate Designated Construction Project General Aggregate Limit applies to each designated construction project, and that limit is equal to the amount of the General Aggregate Limit shown in the Declarations.

However, the most we will pay under the Designated Construction Project General Aggregate Limit for all Designated Construction Projects combined is $5,000,000 .

2. The Designated Construction Project General Aggregate Limit is the most we will pay for the sum of all damages under COVERAGE A, except damages because of"bodily injury" or "property damage" included in the "products completed operations hazard", and for medical expenses under COVERAGE C regardless of the number of:

a. Insureds;

b. Claims made or "suits" brought; or

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

3. Any payments made under COVERAGE A for damages or under COVERAGE C for medical expenses shall reduce the Designated Construction Project General Aggregate Limit for that designated construction project. Such payments shall not reduce the General Aggregate Limit shown in the Declarations nor shall they reduce any other Designated Construction Project General Aggregate Limit for any other designated construction project shown in the Schedule above.

4. The limits shown in the Declarations for Each Occurrence, Fire Damage and Medical Expense continue to apply.

However, instead of being subject to the General Aggregate Limit shown in the Declarations, such limits will be subject to the applicable Designated Construction Project General Aggregate Limit.

B. For all sums which the insured becomes legally obligated to pay as damages caused by "occurrences" under COVERAGE A (SECTION I), and for all medical expenses caused by accidents under COVERAGE C (SECTION I), which cannot be attributed only to ongoing operations at a single designated construction project shown in the Schedule above:

1. Any payments made under COVERAGE A for damages or under COVERAGE C for medical expenses shall reduce the amount available under the General Aggregate Limit or the Products-Completed Operations Aggregate Limit, whichever is applicable; and

2. Such payments shall not reduce any Designated Construction Project General Aggregate Limit.

C. When coverage for liability arising out of the "products-completed operations hazard" is provided, any payments for damages because of "bodily injury' or "property damage" included in the "products-completed operations hazard" will reduce the Products-Completed Operations Aggregate Limit, and not reduce the General Aggregate Limit nor the Designated Construction Project General Aggregate Limit.

D. If the applicable designated construction project has been abandoned, delayed, or abandoned and then restarted, or if the authorized contracting parties deviate from plans, blueprints, designs, specifications or timetables, the project will still be deemed to be the same construction project.

E. The provisions of Limits Oflnsurance (SECTION III) not otherwise modified by this endorsement shall continue to apply as stipulated.

IV. ADDITIONAL INSUREDS

ADDITIONAL INSURED - LESSOR OF LEASED EQUIPMENT

AUTOMATIC STATUS WHEN REQUIRED IN LEASE AGREEMENT WITH YOU

(Insurance Services Office Endorsement CG 20 34 04 13)

A. Section II- Who Is An Insured is amended to include as an additional insured any person(s) or organization(s) from whom you lease equipment when you and such person(s) or organization(s) have agreed in writing in a contract or agreement that such person(s) or organization(s) be added as an additional insured on your policy. Such person(s) or organization(s) is an insured only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by your maintenance, operation or use of equipment leased to you by such person(s) or organization(s).

However, the insurance afforded to such additional insured:

AD 68 93 0123 Includes copyrighted material of Insurance Services Office, Inc., Page 5 of8 □

1. Only applies to the extent permitted by law; and

2. Will not be broader than that which you are required by the contract or agreement to provide for such additional insured.

A person's or organization's status as an additional insured under this endorsement ends when their contract or agreement with you for such leased equipment ends.

B. With respect to the insurance afforded to these additional insureds, this insurance does not apply to any "occurrence" which takes place after the equipment lease expires.

C. With respect to the insurance afforded to these additional insureds, the following is added to Section III - Limits Of Insurance:

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

1. Required by the contract or agreement you have entered into with the additional insured; or

2. Available under the applicable Limits oflnsurance shown in the Declarations;

whichever is less.

This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations.

ADDITIONAL INSURED - MANAGERS OR LESSORS OF PREMISES

(Insurance Services Office Endorsement CG 20 11 04 13)

SCHEDULE

Designation Of Premises (Part Leased To You):

All premises leased to you and covered by this insurance.

Name Of Person(s) Or Organization(s) (Additional Insured):

Any person or organization that is a manager or lessor ofreal property, but only if coverage as an additional insured is required by a written contract or written agreement that is an "insured contract", and provided the "bodily injury" or "property damage" first occurs, or the "personal and advertising injury" offense is first committed, subsequent to the execution of the contract or agreement.

Information required to complete this Schedule, if not shown above, will be shown in the Declarations.

A. Section II- Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability arising out of the ownership, maintenance or use of that part of the premises leased to you and shown in the Schedule and subject to the following additional exclusions:

This insurance does not apply to:

1. Any "occurrence" which takes place after you cease to be a tenant in that premises.

2. Structural alterations, new construction or demolition operations performed by or on behalf of the person(s) or organization(s) shown in the Schedule.

However:

1. The insurance afforded to such additional insured only applies to the extent permitted by law; and

2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured.

B. With respect to the insurance afforded to these additional insureds, the following is added to Section III - Limits Of Insurance:

If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance:

1. Required by the contract or agreement; or

2. Available under the applicable Limits of Insurance shown in the Declarations;

whichever is less.

This endorsement shall not increase the applicable Limits oflnsurance shown in the Declarations.

AD 68 93 0123 Includes copyrighted material of Insurance Services Office, Inc., Page 6 of8 □

ADDITIONAL INSURED - MORTGAGEE, ASSIGNEE OR RECEIVER

(Insurance Services Office Endorsement CG 20 18 04 13)

SCHEDULE

Name Of Person(s) Or Or2anization(s) Desi2nation Of Premises

Any person or organization that is a mortgagee, assignee or All premises covered by this insurance.

receiver for a premises shown in this Schedule, but only if coverage as an additional insured is required by a written contract or written agreement that is an "insured contract", and provided the "bodily injury" or "property damage" first occurs, or the "personal and advertising injury" offense is first committed, subsequent to the execution of the contract or agreement.

Information required to complete this Schedule, if not shown above, will be shown in the Declarations.

A. Section II- Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to their liability as mortgagee, assignee, or receiver and arising out of the ownership, maintenance, or use of the premises by you and shown in the Schedule.

However:

1. The insurance afforded to such additional insured only applies to the extent permitted by law; and

2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured.

B. This insurance does not apply to structural alterations, new construction and demolition operations performed by or for that person or organization.

C. With respect to the insurance afforded to these additional insureds, the following is added to Section III - Limits Of Insurance:

If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance:

1. Required by the contract or agreement; or

2. Available under the applicable Limits oflnsurance shown in the Declarations;

whichever is less.

This endorsement shall not increase the applicable Limits oflnsurance shown in the Declarations.

ADDITIONAL INSURED - TRADE SHOW SPONSOR-

AUTOMATIC STATUS WHEN REQUIRED IN WRITTEN AGREEMENT WITH YOU

A. Section II - Who Is An Insured is amended to include as an additional insured any person or organization who is a sponsor of a trade show where you are operating a booth or displaying your product, but only:

1. For injury or damage occurring at the trade show; and

2. When you and such person or organization have agreed in writing in a contract or agreement executed prior to the beginning of the trade show that such person or organization be added as an additional insured on your policy.

Such person or organization is an additional insured 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;

while attending the trade show sponsored by this additional insured.

AD 68 93 0123 Includes copyrighted material of Insurance Services Office, Inc., Page 7 of8 □

A person's or organization's status as an additional insured under this endorsement ends when your attendance at the trade show ends.

B. With respect to the insurance afforded to these additional insureds, the following additional exclusion applies:

This insurance does not apply to "bodily injury" or "property damage" arising out of ''your work" or "your product" and included in the "products-completed operations hazard".

C. With respect to the insurance afforded to these additional insureds, the following is added to Section III - Limits Of Insurance:

If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance:

1. Required by the contract or agreement; or

2. Available under the applicable Limits oflnsurance shown in the Declarations;

whichever is less.

This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations.

ADDITIONAL INSURED - STATE OR GOVERNMENTAL AGENCY OR SUBDIVISION

OR POLITICAL SUBDIVISION - PERMITS OR AUTHORIZATIONS

(INSURANCE SERVICES OFFICE ENDORSEMENT CG 20 12 04 13)

SCHEDULE

State Or Governmental Agency Or Subdivision Or Political Subdivision:

Any state or governmental agency or subdivision or political subdivision that has issued a permit or authorization for operations performed by you or on your behalf.

Information required to complete this Schedule, if not shown above, will be shown in the Declarations.

A. Section II - Who Is An Insured is amended to include as an additional insured any state or governmental agency or subdivision or political subdivision shown in the Schedule, 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 governmental agency or subdivision or political subdivision has issued a permit or authorization.

However:

a. The insurance afforded to such additional insured only applies to the extent permitted by law; and

b. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured.

2. This insurance does not apply to:

a. "Bodily injury", "property damage" or "personal and advertising injury" arising out of operations performed for the federal government, state or municipality; or

b. "Bodily injury" or "property damage" included within the "products-completed operations hazard".

B. With respect to the insurance afforded to these additional insureds, the following is added to Section III - Limits Of Insurance:

If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance:

1. Required by the contract or agreement; or

2. Available under the applicable Limits of Insurance shown in the Declarations;

whichever is less.

This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations.

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ADDITIONAL INSURED -AUTOMATIC STATUS WHEN REQUIRED IN

WRITTEN AGREEMENT WITH YOU - PRIMARY

CA-7214(10-98)

This endorsement modifies insurance provided under the following:

BUSINESS AUTO COVERAGE FORM

GARAGE COVERAGE FORM

MOTOR CARRIER COVERAGE FORM

1. Who Is an Insured under Section II - Liability Coverage is amended to include any person or organization with whom you have agreed in writing in a contract or agreement that such person or organization be added as an additional insured on your policy. Such persons or organizations are addi tional insureds only with respect to liability arising out of operations performed for the additional insured by you.

2. The coverage provided by this endorsement will be primary and noncontributory with respect to any other coverage available to the additional insured.

3. The Limits of Insurance applicable to the additional insured are those specified in the written con- tract or agreement or in the Declarations for this Coverage Form, whichever is less. These Limits of Insurance are inclusive and not in addition to the Limits of Insurance shown in the Declarations.

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ACUITY ENHANCEMENTS - BUSINESS AUTO

This endorsement modifies insurance provided under the following:

BUSINESS AUTO COVERAGE FORM

MOTOR CARRIER COVERAGE FORM

A. Temporary Substitute Vehicle Physical Dam age The following is added to item C Certain Trail ers, Mobile Equipment and Temporary Substi tute Autos under Section I - Covered Autos:

If Physical Damage Coverage is provided by this Coverage Form, any auto you do not own while used with permission of its owner as a temporary substitute for a covered auto you own that is out of service because of its breakdown, repair, servicing, loss or destruction is a covered auto for Physical Damage Coverage.

B. Who Is an Insured

The following are added to Who Is an Insured under Section II - Liability Coverage:

1. Newly Acquired Organizations

Any organization you newly acquire or form, other than a partnership, joint venture or limited liability company, and over which you maintain ownership or majority interest, will qualify as a Named Insured if there is no other similar insurance available to that organization. However:

a. Coverage under this provision is af forded only until the 180th day after you acquire or form the organization or the end of the policy period, whichever is earlier;

b. This coverage does not apply to bodily injury or property damage that occurred before you acquired or formed the or ganization;

c. No person or organization is an insured with respect to the conduct of any cur rent or past partnership, joint venture or limited liability company that is not shown as a Named Insured in the Dec larations.

2. Employees as Insureds

Any employee of yours is an insured while using a covered auto you do not own, hire or borrow in your business or your personal affairs.

C. Increased Supplementary Payments

1. The limit shown in paragraph A2a(2) of Section II - Liability Coverage is increased to $3,000.

2. The limit shown in paragraph A2a(4) of Section II - Liability Coverage is increased to $300.

CA-7255(10-16)

D. Fellow Employee Coverage

The Fellow Employee Exclusion contained in Section 11 - Liability Coverage does not apply.

E. Towing for Covered Autos after Covered Losses The following is added to paragraph A4 Cov erage Extensions of Section Ill - Physical Dam age Coverage in the Business Auto Coverage Form and to paragraph A4 Coverage Extension under Section IV - Physical Damage Coverage in the Motor Carrier Coverage Form and the Towing Coverage endorsement, if it applies to your policy:

If a covered loss to a covered auto renders the vehicle undriveable, we will pay for reasonable and necessary costs to tow the vehicle to the nearest service or salvage facility. This cover age only applies to a covered auto insured for Comprehensive or Collision coverage. Such pa yments will not reduce the limits of insurance described in C Limit of Insurance.

F. Transportation Expenses

The Transportation Expenses Coverage Exten sion is replaced by the following:

We will also pay up to $75 per day to a maxim um of $1,500 for temporary transportation ex pense incurred by you because of the total theft of a covered auto of the private passenger or light truck type. We will pay only for those cov ered autos for which you carry either Compre hensive or Specified Causes of Loss Coverage.

We will pay for temporary transportation exp enses incurred during the period beginning 48 hours after the theft and ending, regardless of the policy's expiration, when the covered auto is returned to use or we pay for its loss.

G. Increased Sub-limit for Audio, Visual and Data Electronic Equipment Coverage The sub-limit shown in paragraph C2 of the Limit of Insurance Provision of Section Ill - Physical Damage Coverage in the Business Auto Cov erage Form is increased to $3,000.

H. The following are added to Coverage Extensions under Section Ill - Physical Damage Coverage in the Business Auto Coverage Form and to Se ction IV - Physical Damage Coverage in the Motor Carrier Coverage Form:

1. Accidental Airbag Discharge

We will pay to replace an airbag that de ploys without the car being involved in an accident. This coverage applies only to a co vered auto which you own.

2. Loan/Lease Gap Coverage

In the event of a total loss to a covered auto of the private passenger or light truck

CA-7255(10-16) Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 5 type, we will pay any unpaid amount due on the lease or loan, less:

a. The amount paid under the Physical Damage Coverage Section of the poli cy; and

b. Any:

(1) Overdue lease/loan payments at the time of the Joss;

(2) Financial penalties imposed under a lease for excessive use, abnormal wear and tear or high mileage;

(3) Security deposits not returned by the lessor;

(4) Costs for extended warranties, Credit Life Insurance, Health, Acci dent or Disability Insurance purcha sed with the loan or lease; and

(5) Carry-over balances from previous loans or leases.

3. Hired Auto Physical Damage Coverage If hired autos are covered autos for Liability Coverage, then the Physical Damage Cov erages provided under this Coverage Form for any auto you own are extended to autos of the private passenger or light truck type which you lease, hire, rent or borrow for a period of 30 days or less, subject to the foll owing limit.

The most we will pay under this extension is the lesser of the actual cash value, the cost of repair or $50,000, minus a deductible. The deductible will be equal to the largest de ductible applicable to any owned auto of the private passenger or light truck type for that coverage. Subject to the above limit, deduct ible and excess provisions, we will provide coverage equal to the broadest coverage ap plicable to any covered auto you own of the private passenger or light truck type.

4. Rental Reimbursement Coverage for Pri vate Passenger Vehicles or Light Trucks

a. This coverage applies only to a covered auto of the private passenger or light truck type.

b. We will pay for rental reimbursement expenses incurred by you for the rental of an auto because of a covered loss to an auto to which this extension applies.

Payment applies in addition to the other wise applicable amount of each cov erage you have on a covered auto. No deductibles apply to this coverage.

c. We will pay only for those expenses incurred during the policy period begin ning 24 hours after the loss and ending, regardless of the policy's expiration, with the lesser of the following number of days:

(1) The number of days reasonably re quired to repair or replace the cov ered auto. If Joss is caused by theft, this number of days is added to the number of days it takes to locate the covered auto and return it to you.

(2) 30 days.

d. Our payment is limited to the lesser of the following amounts:

(1) Necessary and actual expenses in curred.

(2) $75 per day to a maximum of $1,500.

e. This coverage does not apply while there are spare or reserve autos avail able to you for your operations.

f. If Joss results from the total theft of a covered auto to which this extension applies, we will pay under this coverage only that amount of your rental reim bursement expenses which is not al ready provided for under the Physical Damage Coverage Extensions.

g. The Rental Reimbursement Coverage described above does not apply to a co vered auto that is described or designa ted as a covered auto on Rental Reim bursement Coverage Form CA-9923F.

5. Fire Extinguisher Recharge We will pay the actual cost of recharging or replacing, whichever is less, fire extinguish ers kept in your covered auto that are inten tionally discharged in an attempt to extin guish a fire.

6. Rental Reimbursement, Business Income and Extra Expense Coverage Limits The most we will pay for all Joss for each covered auto involved in any one accident for Rental Reimbursement, Business Income and Extra Expense combined is $10,000.

Coverage

a. Rental Reimbursement Coverage

(1) We will pay for expenses incurred by you during the period of restora tion for the rental of an auto made necessary because of a covered Joss to a covered auto used in your business. The loss must be caused by a cause of loss covered under item A 1 of Physical Damage Cov erage in this Coverage Part.

(2) This Rental Reimbursement Cov erage does not apply to a covered auto of the private passenger or

CA-7255(10-16) Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page2 of 5 light truck type because coverage for these vehicles is provided in item 4 of this endorsement.

b. Business Income and Extra Expense Coverage

(1) Business Income Coverage

(a) Actual Loss Sustained Cover age - We wi II pay the actual loss of business income sus tained by you as the result of the necessary suspension of your business during the pe riod of restoration due to a loss to a covered auto used in your business. The loss must be caused by a cause of loss co vered under item A 1 of Phys ical Damage Coverage in this Coverage Part.

(b) Specified Amount per Day Coverage - At your option, we will pay up to $250 per day for a maximum of seven days du ring the period of restoration for income loss. The loss must be caused by a cause of loss covered under item A 1 of Physical Damage Coverage in this Coverage Part.

(2) Extra Expense Coverage

We will pay the necessary and rea sonable extra expenses that you in cur during the period of restoration that you would not have incurred had there been no loss to a cov ered auto used in your business.

The loss must be caused by a cause of loss covered under item A 1 of Physical Damage Coverage in this Coverage Part.

Conditions

a. Any payment for Business Income made under Specified Amount per Day Cov erage reduces the payment we make under any other coverages listed in ext ension 6.

b. No other deductible applies to these coverages.

c. We will not pay under these coverages if you do not repair or replace the cov ered auto.

d. You must resume all or part of your business as quickly as possible.

e. If you have other autos you can use to reduce the amount of loss payable un der these coverages, you are required to use them.

f. We will not pay for loss or expenses caused by suspension, lapse or can cellation of any license, lease or con tract. But if the suspension, lapse or cancellation is directly caused by the suspension of your business, we will cover such loss that affects your busi ness income.

g. We will pay for expenses you incur to reduce the amount that would other wise have been payable under this cov erage. We will not pay more than the amount by which you actually reduce the business income loss or extra ex pense incurred.

7. Fuel in Vehicle Coverage We will also pay, with respect to a covered loss, the actual loss sustained for the loss to the fuel used to operate your vehicle but only with respect to a covered auto. You must provide documentation supporting your claim for damages.

Deductible A deductible applies to this coverage. Refer to paragraph N Deductible Applicable to Fuel in Vehicle, Miscellaneous Equipment Used With Covered Vehicle Coverages, and Electronic Logging Devices or Electronic On-Board Recorders Coverages.

8. Miscellaneous Equipment Used With Co vered Vehicle Coverage We will also pay, with respect to a covered loss, the actual cash value, repair cost or replacement cost, whichever is less, for loss to your miscellaneous equipment but only with respect to a covered auto.

Exclusions We will not pay for loss caused by:

a. Theft, unless there are visible signs or marks of forcible entry into the covered auto and the theft is reported to law enforcement authorities; or

b. Mysterious disappearance.

Deductible A deductible applies to this coverage. Refer to paragraph N Deductible Applicable to Fuel in Vehicle, Miscellaneous Equipment Used With Covered Vehicle Coverages, and Electronic Logging Devices or Electronic On Board Recorders Coverages.

9. Electronic Logging Devices or Electronic On-Board Recorders We will also pay, with respect to a covered loss, up to $3,000 for the actual loss sus tained to an electronic on-board recorder or electronic logging device permanently in-

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Deductible A deductible applies to this coverage. Refer to paragraph N Deductible Applicable to Fuel in Vehicle, Miscellaneous Equipment Used With Covered Vehicle Coverages, and Elec tronic Logging Devices or Electronic On Board Recorders Coverages for further information.

I. Deductible Provision Paragraph D, Deductible of Section Ill - Phys ical Damage Coverage in the Business Auto Coverage Form and paragraph D, Deductible of Section IV - Physical Damage Coverage in the Motor Carrier Coverage Form are replaced by the following:

1. For each covered auto, our obligation to pay for, repair, return or replace damaged or stolen property will be reduced by the app licable deductible shown in the Declarations.

Any Comprehensive Coverage deductible shown in the Declarations does not apply to loss caused by fire or lightning.

2. For combinations of tractor, truck, semitrailer or trailers when attached together by coupling devices at the time of loss, one de ductible will apply.

a. If more than one auto of the combina tion is damaged or stolen, the largest applicable deductible shown in the Dec larations will apply.

b. If only one auto of the combination is damaged or stolen, the deductible shown in the Declarations for that auto will apply.

3. The deductibles will not apply to loss caused by a collision of a covered auto with any other auto insured by us.

4. If the insured chooses to have a damaged windshield or other glass repaired instead of replaced, no deductible will apply to the loss.

J. Knowledge of Claim or Suit The following is added to the Duties in the Event of Accident, Claim, Suit or Loss Condition:

Knowledge of an accident, claim, suit or loss by an agent or employee of any insured shall not in itself constitute knowledge of the insured unless your partners, executive officers, directors, man agers, members or a person who has been des ignated by them to receive reports of accidents, claims, suits or loss shall have received such notice from the agent or employee.

K. Waiver of Subrogation for Written Contracts The following is added to the Transfer of Rights of Recovery Against Others to Us Condition:

We waive any right of recovery we may have against a person or organization because of payments we make for bodily injury or property damage arising out of your use of a covered auto which occurs while under a contract with that person or organization. The waiver applies only to a person or organization with whom you have a written contract or agreement requiring you to waive the right of recovery under this policy. The written contract or agreement must have been executed prior to the accident caus ing bodily injury or property damage.

L. Worldwide Coverage Territory for Hired Autos The following is added to paragraph B7 of Sec tion IV - Business Auto Conditions in the Busi ness Auto Coverage Form and to paragraph B7 of Section V - Motor Carrier Conditions in the Motor Carrier Coverage Form:

With respect to autos hired for 30 days or less, the coverage territory is extended to include all parts of the world if the insured's responsibility to pay damages is determined in a suit in the United States of America (including its territor ies and possessions), Puerto Rico or Canada or in a settlement we agree to.

M. Mental Anguish Coverage The Definition of bodily injury is amended to include mental anguish.

N. Deductible Applicable to Fuel in Vehicle, Miscellaneous Equipment Used With Cov ered Vehicle Coverages and Electronic Log ging Devices or Electronic On-Board Re corders

1. If loss to property covered by these exten sions is the result of a loss to the covered auto under this Coverage Form's Compre hensive or Collision Coverage, then for each covered auto our obligation to pay for, repair, return or replace damaged or stolen property will be reduced by the applicable deductible shown in the Declarations. Any Comprehen sive Coverage deductible shown in the Declarations does not apply to loss to pro perty covered by an extension caused by fire or lightning.

2. If loss to property covered by these exten sions is the result of a loss to the covered auto under this Coverage Form's Specified Causes of Loss Coverage, then for each covered auto our obligation to pay for, repair, return or replace damaged or stolen property will be reduced by a $100 deductible.

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3. In the event that there is more than one app licable deductible, only the highest deduct ible will apply. In no event will more than one deductible apply.

0. Coverage Extensions Definitions

1. "Business income" means the:

a. Net income (Net profit or loss before income taxes) that would have been earned or incurred if no loss would have occurred; and

b. Continuing normal operating expenses incurred, including payroll.

2. "Extra expense" means those expenses you incur to avoid or minimize the suspension of business and to continue your business op erations.

3. "Light trucK' means a truck with a gross ve hicle weight of 10,000 pounds or less.

4. "Miscellaneous equipment' means hand trucks, dollies, pallets, pads, covers, binders, tarps, tie-downs, chains and other similar eq uipment used in the handling of property being transported.

5. "Period of restoration" means the period of time that:

a. Begins:

(1) Twenty-four hours after the time of Joss for Rental Reimbursement Cov erage or Business Income Cov erage; or

(2) Immediately after the time of Joss for Extra Expense Coverage; and

b. Ends at the earliest of:

(1) The time required to resume your normal business operations; or

(2) The time that is reasonably neces sary to repair or replace the cov ered auto.

Period of restoration does not include…

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